In the past 20 years, due to improved monitoring and treatment, the inpatient mortality rate of acute myocardial infarction has decreased significantly, from about 30% to less than 10%. However, the number of patients with re-infarction or multiple infarction has increased and become one of the main causes of death after myocardial infarction. Therefore, in addition to active treatment during the acute phase, rehabilitation and secondary prevention after myocardial infarction should be strengthened to prolong the life span of patients, improve their quality of life and restore their working ability. Secondary prevention after myocardial infarction includes.
1,Health promotion and education for patients and their families, so that patients and their families can be aware of the disease and understand the significance of various prevention and treatment measures, so that they can reduce their concerns about the disease and actively cooperate in prevention and treatment.
2,Arrange a reasonable diet to reduce the intake of total fat, saturated fatty acids and cholesterol, and restrict total calories in overweight people. If the lipid level is still abnormal after 3 months of dietary adjustment, lipid regulators can be used for the characteristics of the abnormal lipids.
3,Smokers should be advised to quit. Smoking is not only a risk factor for atherosclerosis, but also for angina pectoris, myocardial infarction and reinfarction. In patients recovering from myocardial infarction, the incidence of reinfarction in those who continue to smoke is approximately two times higher than in those who do not smoke or have quit smoking. In the Norwegian multicenter study, at 17 months after myocardial infarction, re-infarction was 45% less in those who quit smoking than in those who continued smoking, and at 3 years, cardiac cause of death and re-infarction were significantly lower in those who quit smoking than in those who smoked. Passive smoking has the same risk as smokers, so patients’ relatives should be advised to quit smoking, and patients should preferably work in a smoke-free environment when they return to work. Smoking may induce coronary artery spasm and platelet aggregation, reducing the reserve capacity of coronary arteries and collateral circulation. In patients with hypercholesterolemia, the degree of smoking is highly correlated with coronary atherosclerotic lesions, and smoking may aggravate coronary lesions, all of which may predispose to reinfarction.
4,Appropriate physical activity and exercise. Walking, gymnastics, taijiquan, qigong and other exercise methods can be taken to enhance physical fitness.
5,Combined with hypertension or diabetes, should be properly controlled.
6,Anti-platelet therapy. Platelets play an important role not only in the process of atherosclerosis formation, but also in myocardial ischemia, myocardial infarction or sudden death caused by coronary artery spasm, thrombosis or aggregation in the myocardial microcirculation. Aspirin is an inexpensive and easily available antiplatelet agent with low side effects, which facilitates long-term application.
7,Application of β-blockers. A large number of clinical trials have proved that β-blockers can reduce the incidence of reinfarction after myocardial infarction, the incidence of sudden death, cardiac mortality and overall mortality. Commonly used β-blockers include insulin, aminocardium, and medoxin.
8,After recovering from acute myocardial infarction, you should adhere to the medication under the guidance of the doctor and follow up with the clinic to observe the condition and adjust the medication. If angina pectoris recurs again, go to hospital in time to prevent reinfarction.
Supplement vitamin C and trace elements. To strengthen the elasticity and toughness of blood vessels and prevent bleeding, the trace element iodine can reduce the deposition of cholesterol lipids and calcium salts in the walls of blood vessels and hinder the formation of atherosclerotic lesions (seafood is rich in iodine); magnesium can improve myocardial excitability and help inhibit heart rhythm disorders (magnesium is more abundant in green leafy vegetables).
It is advisable to eat coarse grains and coarse fiber food to prevent constipation from having adverse effects on the heart.
Avoid: should control the intake of caloric food, do not make the body overweight. Avoid eating too much animal fat and animal offal containing high cholesterol. Control salt intake, salted vegetables, bean paste, sausages, cured meat, etc. It is best not to eat or eat less. Avoid smoking, alcohol and stimulating foods.
Healthy diet principles for patients with myocardial infarction
Myocardial infarction is the main complication of coronary heart disease, and a reasonable diet is important for the treatment of myocardial infarction. Patients with acute myocardial infarction should be strictly bedridden, nutrition should not be excessive, and the following issues should be noted when eating.
(1) Limit caloric intake to reduce the burden on the heart. Especially in the early stage of the disease, one should eat less and more meals, mainly liquid, and avoid meals that are too cold or too hot. As the condition improves, semi-liquid meals can be increased appropriately and calories can be gradually increased. Allow moderate amounts of lean meat, fish, fruits, etc. Keep the gastrointestinal tract open frequently to prevent aggravation of the disease by excessive straining during stooling.
(2) The diet should be balanced, light and nutritious to improve the nutritional supply of the body, including the cardiomyocytes, to protect and maintain the heart function and promote the patient’s early recovery. Excessive and stimulating foods should be avoided, and strong tea and coffee should not be consumed. Avoid eating large amounts of fat because there is a risk of thrombosis due to increased blood lipids and increased blood viscosity after meals, resulting in slow blood flow and platelet aggregation.
(3) Pay attention to the balance of sodium and potassium, and increase the intake of magnesium appropriately to prevent or reduce the occurrence and development of complications, especially arrhythmias and heart failure. Generally recommended low salt diet, but in the acute period if the loss of sodium in the urine is excessive, it is not necessary to overly restrict sodium. The dietary intake of sodium, potassium and magnesium should be adjusted at any time according to the condition.
(4) In acute myocardial infarction with cardiac insufficiency, there are often gastrointestinal disorders, so diet should be paid more attention. In the first 1 to 2 days of the disease, only give hot water juice, rice soup, honey water, lotus root powder and other liquid diet, ~7 times a day, ~150 ml each time. If the patient’s heart function improves and the pain is reduced, the diet of lean meat, steamed egg white and thin rice porridge can be gradually increased. With the recovery of the disease, the diet for coronary heart disease can be adopted 6 weeks after the disease, but the diet still needs to be soft and easy to digest.