急性冠脉综合征

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概述

急性冠脉综合征这一术语用于描述与流向心脏的血流量突然减少有关的一系列疾病。这些疾病包括心脏病发作和不稳定型心绞痛。

当细胞死亡导致心脏组织受到损害或破坏时，就会发生心脏病发作。心脏病发作也称为心肌梗死。

流向心脏的血流量减少，会引起不稳定型心绞痛。其严重程度不足以导致细胞死亡或心脏病发作。但是血流量减少可能增加出现心脏病发作的风险。

急性冠脉综合征往往会导致严重的胸部疼痛或不适。这是一种需要立即诊断和护理的紧急医疗事件。治疗目标包括改善血流、治疗并发症和预防未来问题。

症状

急性冠脉综合征的症状通常会突然出现。其中包括：

  • 胸部疼痛或不适。通常描述为疼痛感、压迫感、紧绷感或灼热感。胸部疼痛也称为心绞痛。
  • 疼痛起源于胸部并扩散至身体的其他部位。这些部位包括肩部、手臂、上腹部、背部、颈部或颚部。
  • 恶心或呕吐。
  • 消化不良。
  • 气短，也称为呼吸困难。
  • 突然大量出汗。
  • 心跳加速。
  • 感觉头重脚轻或头晕。
  • 昏厥。
  • 异常疲劳。

胸部疼痛或不适是最常见的症状。但症状可能因年龄、性别和其他医疗状况不同而有很大差异。如果您是女性、老年人或患有糖尿病，则您很可能不会出现胸部疼痛或不适的症状。

何时就诊

急性冠脉综合征属于紧急医疗事件。胸部疼痛或不适可能是许多危及生命的疾病的症状。寻求紧急援助以获得快速诊断和正确护理。切勿自己开车前往医院。

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病因

急性冠脉综合征通常因向心肌输送血液、氧气和营养物质的血管壁上积聚脂肪沉积物造成。脂肪沉积物也称为斑块。供应心脏的血管也称为冠状动脉。

当脂肪沉积物破裂或分裂时，就会形成血凝块。血凝块会阻止血液流向心肌。

当细胞的氧气供应量过低时，心肌细胞就会死亡。细胞死亡可导致肌肉组织损伤。这称为心脏病发作。

即使没有细胞死亡，氧气减少也会导致心肌无法正常工作。这种变化可能是短期的，也可能是永久性的。如果急性冠脉综合征未导致细胞死亡，则称之为不稳定型心绞痛。

风险因素

急性冠脉综合征的风险因素与其他类型心脏病的风险因素相同。风险因素包括：

  • 衰老。
  • 高血压。
  • 高血胆固醇。
  • 抽烟。
  • 缺乏身体活动。
  • 饮食不健康。
  • 肥胖症或超重。
  • 糖尿病。
  • 胸部疼痛、心脏病发作或卒中的个人史或家族史。
  • 高血压、子痫前期或妊娠期糖尿病以及提前绝经病史。
  • COVID-19 感染。

来自妙佑医疗国际员工
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诊断与治疗
July 29, 2023
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