

Zhou Yan

About me
Member of the 7th Rehabilitation Professional Committee of the Chinese Society of Rehabilitation Medicine, and Chairman of the 1st Youth Committee of the Geriatric Health Medical Professional Committee of the Hunan Provincial Women Physicians Association.
Proficient in diseases
Specializes in geriatric internal medicine diseases, particularly in the rescue of cardiovascular critical illnesses such as acute coronary syndrome, hypertensive crisis, malignant arrhythmia, acute heart failure, etc.

Voices

What causes urinary incontinence in the elderly?
Urinary incontinence in the elderly varies due to different mechanisms and types, with the two most common categories being genuine urinary incontinence, which is due to neurogenic bladder dysfunction or overactive detrusor muscles, damage to the urethral sphincter, or loss of bladder storage function. These are commonly seen in conditions like chronic stroke, dementia, Parkinson's disease, and psychiatric diseases. The other major category is caused by relaxation of the urethral sphincter or pelvic floor muscles surrounding the urethra, leading to reduced urethral pressure. Incontinence in this category may occur when negative pressure increases, such as during coughing, sneezing, straining during bowel movements, or changing body position. This type of urinary incontinence is more common in elderly women and in elderly men who have had prostate removal, leading to damage to the external urethral sphincter.

Is myocarditis serious?
Myocarditis is an inflammatory disease of the myocardium, most commonly caused by viral infections. The onset of the disease can be either sudden or slow, and it is mostly self-limiting, but in rare cases can lead to acute pump failure or sudden death. The severity of the condition largely depends on the extent and location of the lesions. Mild cases may have no symptoms at all, while severe cases can lead to cardiogenic shock or even sudden death. In clinical diagnosis, the majority of myocarditis cases present primarily with arrhythmias, and in a minority of cases, the initial symptoms may include syncope or Adams-Stokes syndrome. Thus, the severity of myocarditis is related to the variation in the condition itself.

How long does the course of Parkinson's disease usually last?
The course of Parkinson's disease generally lasts for how long? Parkinson's disease, also known as shaking palsy, is a common neurodegenerative disease, and the age at onset varies. For early-onset Parkinson's disease, it generally starts around age 40 to 50, while late-onset Parkinson's disease generally starts after age 50. As age gradually increases, the course of Parkinson's disease is generally about 20 to 40 years. Once diagnosed with Parkinson's disease, it is a lifelong condition. This disease is incurable, and can only be managed through medications, surgical treatments, physical rehabilitation, and psychological therapies to improve or control symptoms, but it cannot be cured. Therefore, once diagnosed with Parkinson's disease, the disease is lifelong.

Myocarditis is what?
Myocarditis is an inflammatory disease of the myocardium, primarily caused by viral infections. Typically, signs of infection such as fever, generalized fatigue, muscle soreness, or gastrointestinal symptoms like nausea and vomiting appear one to three weeks before the onset of myocarditis. Patients may experience palpitations, chest tightness, difficulty breathing, edema, and even fainting or sudden death. Clinically, viral myocarditis is mostly diagnosed due to arrhythmias as the main complaint or primary symptom, and in rare cases, it can lead to fainting or Aschoff's syndrome. For patients with myocarditis, timely examinations like myocardial enzymes, troponins, electrocardiograms, echocardiography, and cardiac MRI are crucial to confirm the diagnosis. Appropriate treatment should be administered to prevent the myocarditis from progressing to cardiac arrest or heart failure.

Can people with myocarditis drink alcohol?
Myocarditis is an inflammatory disease of the myocardium. Its pathogenesis is due to direct damage to the myocardium caused by viruses, and the interaction of the virus with the body's immune response to both myocardial injury and microvascular damage, which impairs the structure and function of the myocardial tissue. Drinking alcohol affects the myocardium and can also cause damage to it. Therefore, alcohol should not be consumed with myocarditis, as drinking can further aggravate the myocardium, leading to heart failure.

Can elderly people with prostate enlargement experience urinary incontinence?
In the advanced stages of lower urinary tract obstructive diseases caused by prostate enlargement, overflow urinary incontinence can occur. After chronic urinary retention caused by prostate enlargement, if the bladder is extremely full, the pressure inside the bladder can exceed the resistance of the normal urethral sphincter, allowing urine to overflow through the urethra. Additionally, pressure incontinence can also be caused by damage to the external urethral sphincter or to the perineal and urethral areas following prostate surgery due to prostate enlargement.

Is coronary arteriosclerosis serious?
The severity of arterial atherosclerosis is related to the location of the lesion and the narrowing it causes in the coronary arteries. This is because if the blood flow through the coronary arteries is insufficient to meet the metabolic demands of the heart muscle, it can lead to ischemia and hypoxia of the heart muscle, causing angina. Severe and prolonged ischemia can lead to myocardial necrosis, or myocardial infarction. When there is significant narrowing in the coronary artery lumen, for instance more than 50%-75%, the situation can be compensated during rest. However, during exercise or rapid heart rate or emotional excitation, the oxygen demand of the heart muscle increases. This may result in mild or transient myocardial oxygen supply, or an imbalance between supply and demand. Another scenario involves unstable atherosclerotic plaques that rupture, erode, or bleed, leading to platelet aggregation or thrombus formation, causing a rapid worsening of luminal narrowing. This results in a decreased supply of oxygen to heart muscle, leading to acute coronary syndrome, which is very severe. In fact, the degree of coronary artery atherosclerosis is positively correlated with plaque stability, plaque location, and the elasticity of the coronary artery.

Compensatory mechanisms of acute heart failure
There are several compensatory methods for acute heart failure. The first is mechanical ventilation, including non-invasive mechanical ventilation and tracheal intubation. Mechanical ventilation is commonly referred to as assisted breathing with a ventilator. The second is continuous renal replacement therapy, commonly known as total ultrafiltration, which can be used to remove excess fluid and metabolic waste from the body. The third is intra-aortic balloon counterpulsation, which can effectively improve myocardial perfusion, reduce myocardial oxygen consumption, and increase cardiac output. The fourth is extracorporeal membrane oxygenation, commonly known as ECMO, which provides external cardiopulmonary support when the heart cannot maintain systemic perfusion or when the kidneys cannot adequately exchange gases. The fifth is the implantable left ventricular assist device, which can maintain peripheral perfusion during acute heart failure and reduce myocardial oxygen consumption, thus reducing cardiac injury. These five methods can provide compensatory treatment when drug therapy is ineffective for patients with acute heart failure.

What should elderly people do if they have slight urinary incontinence?
Urinary incontinence is relatively common in the elderly. After excluding organic causes of urinary incontinence through examination, we should consider functional causes. This is mainly due to the relaxation of the urethral sphincter, pelvic floor, and the muscles around the urethra, which decreases the urethral pressure. When the abdominal pressure increases, it can cause urinary incontinence. We can improve the muscles of the pelvic floor gradually by undergoing pelvic floor rehabilitation therapy, which increases their strength and improves urinary incontinence. The key to pelvic floor rehabilitation is to provide patients with guidance and exercises for lifting the anus. By persisting in these exercises, the symptoms of urinary incontinence can be alleviated or eliminated.

Is angina pectoris coronary heart disease?
Coronary heart disease refers to the occurrence of atherosclerosis in the coronary arteries, leading to narrowing or blockage of the lumen, causing myocardial ischemia, hypoxia, and necrosis resulting in heart disease. Through different pathological anatomy and pathophysiology, there are five major types, including asymptomatic coronary heart disease, angina pectoris, myocardial infarction, ischemic cardiomyopathy, and sudden death. Angina pectoris is one type of coronary heart disease.