There are always symptoms of chest pain at night. What could be the reason?

A message about how to deal with chest pain circulates repeatedly in the circle of friends, just like taking a catwalk, appearing in front of you again and again. As a cardiologist, I received inquiries from my classmates, relatives and friends again and again. Is it true?/You don't say. /You don't say.

Chest pain at night, how to do?

This is really a rumor. I'm gonna throw up. Finally, it is simply reduced to one sentence: "Why don't you lie down? Also stressed that never lie down? What are we going to do? Are you ready to sit and ascend to heaven? Do you have to take an ambulance and a hospital? "

After spitting, we still have to take this rumor seriously.

There has never been a fixed model for the treatment of diseases. Everyone is an independent and concrete individual, and rashly setting up each case with the overall "experience" will only harm others and yourself.

Chest pain at night, especially when sleeping, is really mostly caused by coronary heart disease. Generally speaking, the reasons are as follows: 1. Drugs used daily to treat coronary heart disease may cause symptoms if they are taken during the day and their metabolism is completed at night. 2. At night, the vagal nerve tension increases and the blood vessels contract, which leads to the decrease of blood supply to the originally narrow blood vessels. However, patients with different basic diseases have chest pain symptoms at night, so they must not take medicine casually, so as not to delay the follow-up treatment and even aggravate the condition.

Let's analyze what patients with chest pain should do.

1. First, there are patients with high probability of coronary heart disease.

Actually, the intention is the same. The core of coronary heart disease is because of coronary artery stenosis, blood supply can not meet the oxygen demand of the heart itself, and myocardial cells lack oxygen to produce inflammatory transmitters, which stimulate nerves to produce pain. The degree of pain is usually related to the severity of the lesion. Transient blood supply deficiency is called angina pectoris, and total occlusion of blood vessels is called myocardial infarction.

Therefore, "severe pain can wake you up", which means that a myocardial infarction may have occurred. What should I do at this time? The correct answer is to master the patient's vital signs first. Almost all patients with heart disease have their own sphygmomanometer. At this time, it is necessary to measure the blood pressure and pulse frequency of both upper limbs (especially both sides) and make records. If the blood pressure is higher than 90/60mmHg, you can take 1-2 nitroglycerin tablets and isosorbide dinitrate tablets sublingually. Nitroglycerin needs to be stored in a sealed environment away from light. After three months, no matter how much is left, new drugs need to be replaced. In order to save money, the curative effect cannot be delayed. ) and quickly call 120 for help.

While waiting for the arrival of emergency personnel, appease the patient, try to lie on your back or sit down and reduce activities. Meanwhile, the patient's previous medical history (hypertension, diabetes, cerebral infarction, etc. ) has been collected. ) drugs that are usually taken on weekdays (packaging and instructions are ok). If you have been hospitalized before (any disease can be), it will be helpful to have a complete copy of your medical record. And record the onset time. If possible, measure the patient's blood pressure every 5 minutes (the side with higher measured value). Until the paramedics arrive.

According to the probability calculation, he is usually a hypertensive patient. The biggest harm of hypertension to the body is systemic arteriosclerosis. From the thickest aorta directly connected to the heart to the capillaries, the vascular endothelium will become "hard and brittle" due to excessive pressure. However, if the pressure is too high, the fragile part is easy to break and tear. In some cases, there will be a "sandwich" between the blood entering the intima and the middle layer of the blood vessel, and in some cases, the whole blood vessel wall will rupture and bleed.

Patients with hypertension usually have chest pain at night. The first thing to do is to measure the blood pressure of both upper limbs. If the blood pressure difference between the two sides is large (> 40mmHg is a clear indication), aortic dissection is highly suspected. After dialing 120, the patient still needs to maintain a comfortable position (preferably lying flat) to reduce activities, and can take short-acting antihypertensive drugs (such as captopril and nitrendipine). At the same time, sort out the patient's medical history, drugs and past medical information, and wait for the arrival of emergency personnel.

3. Two relatively rare patients, including pulmonary embolism, spontaneous pneumothorax and even more rare digestive symptoms. Mainly talk about the first two.

Pulmonary embolism, also known as pulmonary embolism, has a clear meaning. Some emboli (mostly venous thrombosis of lower limbs) block the pulmonary artery, making it impossible for blood to exchange gas smoothly. The main manifestation of this disease is chest tightness and shortness of breath, and some patients may show chest pain. If the patient usually has a history of varicose veins, edema of lower limbs, or even malignant tumors, and suddenly has chest pain at night, what family members can do at this time is to call 120, measure vital signs, master the medical history and take medicine. The diagnosis must be checked.

Spontaneous pneumothorax is more common in patients who are slim, emaciated or obese and have a history of respiratory diseases such as bullae, emphysema and chronic obstructive pulmonary disease. Pneumothorax with shallow chest pain is obviously related to respiratory activities, often accompanied by shortness of breath and cyanosis. What the family can do at this time is just like pulmonary embolism. Diagnosis also requires physical examination and auxiliary examination.

Finally, pay attention to rumors and try to eliminate rumors.

Let me talk about two principles first. Blood pressure is low, not only below 90/60mmHg, but also can't take nitroglycerin even if it is much lower than usual; Aortic dissection, taking aspirin may cause massive bleeding.

1. You said that patients with coronary heart disease accounted for the vast majority. After the ambulance arrived, listen to blood pressure, do ECG and chew aspirin. Wouldn't it be better if I gave it first? Here's the reality. Even hospitals with the qualification of "chest pain center" still have the possibility of misdiagnosis in the differential diagnosis of chest pain. Moreover, the function of chewing aspirin is to destroy the intestinal membrane of tablets and release them as soon as possible. It will take about 2 hours at the earliest. At present, the first aid ability can be almost midnight 15 minutes. It is much more practical to give medicine after a certain examination basis.

2. Even if I have a sandwich unfortunately, can't you have an emergency operation? Yes, but it takes time to transfer, review, diagnose, talk about surgery and prepare for surgery. Many people refuse to accept aspirin sandwiches. Who can guarantee that God will take care of you like this, and who can guarantee that you will last until after taking that aspirin operation?

3. How about Danshen Dripping Pills? How many pills can I take? No problem, but it won't help much. How about quick-acting jiuxin pills? Why not mention the name nb? Indeed, a good name does not necessarily mean a good curative effect. The feeling of "coolness" when taking these two drugs really makes patients feel more comfortable, but this is the role of "borneol" in the ingredients. Moreover, there is one in the instruction manual of nb Quick-acting Jiuxin Pills, which is extracted as follows: 4. During the treatment of angina pectoris, nitrates should be added.

So why not eat nitrate directly, and the effect is better?

Call 120 for a small matter. Don't we want to spare the doctor and family? Take the medicine and the pain will go away. Can't you see it the next day? Sudden chest pain at night is generally critical. Even if the symptoms have been relieved by the hospital, they should not be taken lightly. The emergency department will do some tests to evaluate your situation. If you need to stay on probation or be hospitalized, I will definitely communicate with you repeatedly. Resisting the disease or insisting on refusing further examination may mean that you are on the road of no return.

I believe that many people with angina pectoris should know this, that is, the frequency of angina pectoris attacks at night is often higher than during the day, which makes many patients wonder why angina pectoris attacks more easily at night. How to prevent angina pectoris at night? Come and read this article for patients with angina pectoris. These methods are very effective. Hurry up and learn!

Why do heart disease and angina pectoris easily occur at night? It is related to these three factors.

Why angina pectoris is easy to attack at night?

First, angina pectoris is easy to attack at night, because families in China usually have a big meal, and there are many things in their stomachs after the meal, which makes people feel difficult to breathe. To digest so much food, people must have more blood to supply the digestive system for related operations. This not only increases the burden on the heart, but also reduces the blood supply to the coronary artery, which is easy to cause angina pectoris or myocardial infarction.

Secondly, people often watch TV at night to entertain themselves. Many scenes in the process of watching TV will make people's emotions extremely excited, make their bodies excited, blood pressure will continue to rise, and coronary artery spasm will also occur, which naturally leads to a higher incidence of angina pectoris.

Third, after people fall asleep at night, their blood pressure will be about 20% lower than during the day. Some patients will take antihypertensive drugs before going to bed, so the blood pressure will be further reduced, the blood flow rate will be particularly slow, and the heart is prone to insufficient blood supply, so it is normal for angina pectoris to appear at a particularly high frequency.

How to prevent angina pectoris at night?

First, people sleep at night, try not to be stimulated and let their mood fluctuate too much.

Second, don't eat too much when eating, especially don't go to bed immediately after eating. Because if you sleep after a meal, the blood will be concentrated in the digestive tract, which will relatively reduce the blood in other parts and easily cause angina pectoris.

Thirdly, people should drink a cup of hot milk before going to bed, which can not only supplement the nutrients needed by the body, but also help people fall asleep quickly. In addition, the most important thing is to reduce the blood viscosity, so that angina pectoris will not occur.

For angina pectoris and other diseases, people must pay attention to maintenance in daily life, especially at night, because the attack at night is really a great threat to life.