How to judge whether the blood vessel is blocked or not?

As a cardiovascular doctor, judging whether the cardiovascular system is blocked is the basic skill.

Of course, we dare not boast that we can judge 1% accurately, but almost all cardiovascular blockages can be detected, except those with atypical symptoms, which are not sensitive to examination and unwilling to be further examined.

First, the doctor will briefly share with you how I judge cardiovascular blockage:

1. The patient has persistent angina symptoms, such as chest pain, precordial pain, back pain, pharyngeal tightness, abdominal pain, etc., which are persistent, or accompanied by sweating and frequent death.

2. ECG indicates that the back of ST-segment arch is elevated. At this time, we can basically diagnose that the blood vessel is blocked, and we need to make a decision whether to thrombolysis or stent reperfusion treatment.

3. If thrombolytic therapy is used, whether the blood vessels are opened or not can be judged according to the changes of electrocardiogram, myocardial enzymes and symptoms; If the angiography is relatively intuitive.

4. If the electrocardiogram is atypical, only ischemia or atypical symptoms, we still need the support of myocardial enzymes, and the increase of myocardial enzymes in multiples will help us to judge whether blood vessels are blocked.

5. There are some chronic occlusive blood vessels in clinic, which can only be found by angiography.

Therefore, the judgment of whether the cardiovascular system is blocked is based on symptoms, electrocardiogram, myocardial enzymes, angiography and so on.

Secondly, we need to talk about cerebral vascular occlusion, that is, cerebral infarction

1. Symptoms, dizziness, headache, hemiplegia, aphasia, walking deviation, limb weakness and so on.

2. Brain CT is needed to judge, but for some cerebral infarction within 24 hours, CT is not easy to find. We need to combine symptoms and CT to rule out bleeding, and then actively treat it with thrombolysis, anticoagulation and surgery.

3. After bleeding is excluded, further diagnosis needs to be made by head magnetic resonance imaging.

4. Some patients with mild cerebral infarction may have no symptoms, and most of them are found by CT or MRI.

Thirdly, let's talk about pulmonary vascular obstruction, that is, pulmonary embolism

1. Symptoms, sudden chest tightness or chest pain, dyspnea, low blood pressure, fast heart rate and low blood oxygen.

2. We need to feel the right heart load weight gain performance of ECG, and there is also the typical ECG S1Q3T3 performance. D2-mer in blood.

3. Enhanced CT is helpful to diagnose pulmonary vascular obstruction.

4. Anticoagulation or thrombolysis is the main treatment.

In a word, all blood vessels will be blocked theoretically, so we need to take different diagnostic measures according to different symptoms and clues, and strive for time for treatment, because the blood supply area may be necrotic after blood vessel blockage, so we must diagnose and treat it early.