笔者从医数十年,耳闻目睹了不少猝死病人,其中有的是在生前诊断为冠心病,而有的则是依据发病情况、死亡经过或尸检结果确诊为冠心病的。这里挑选的几个案例,对预防冠心病猝死将有所裨益。 例1,江某,男,38岁,干部。一天气温骤降,江某起床后觉得“心口不适”、头晕。“心口痛”是江某的老毛病,一直认为是“胃痛”没有介意,照旧上班。上午9点多钟,江某感到“心口更加憋闷”。手足发凉,才请假回家休息。他骑车回到家里,将自行车搬上两个台阶后,突然昏倒不省人事。邻居忙去请医生。当医生赶到现场,江某的呼吸、心跳均已停止。 分析:寒冷及气温骤降是江某诱发冠心病急性心肌梗塞的主要原因。寒冷能刺激交感神经兴奋,引起细小动脉收缩,血压增高,外周血管阻力增加;还会使血液中纤维蛋白原浓度升高,引起血液粘度增加,形成血 I learned from the doctor for decades, I heard a lot of sudden death heard of patients, some of them diagnosed during their lifetime as coronary heart disease, while others are based on the incidence of death or autopsy results confirmed as coronary heart disease. Several cases selected here, to prevent sudden death in coronary heart disease will be helpful. Example 1, Jiangmou, male, 38 years old, cadre. Suddenly one day the temperature dropped, Jiangmou get up feeling “heart discomfort”, dizziness. “Mouth pain” is Jiang’s old problems, always thought it was “stomachache” did not mind, or work. More than 9 o’clock in the morning, Jiang felt “heart more oppressed.” Hand, foot and hair cool, just leave home to rest. He rode back home and took the bicycle to two steps before suddenly collapsing unconscious. Neighbors hurry to ask a doctor. When the doctor rushed to the scene, Jiang’s breathing, heartbeat have stopped. Analysis: The sudden cold and temperature drop is the main reason for Jiangmou induced acute myocardial infarction. Cold can stimulate the sympathetic excitement, causing small artery contraction, increased blood pressure, peripheral vascular resistance increased; also make the blood fibrinogen concentration increased, causing increased blood viscosity, the formation of blood