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Xie Zhi Hong
Cardiology
About me
The Secretary-General and Standing Committee Member of the Cardiovascular Disease Professional Committee of the Rehabilitation Medical Association in Ganzhou City, and a member of the Ganzhou City Working Committee of the Heart Emergency Branch of the China Medical Health International Exchange Promotion Association. He has chaired 4 provincial and municipal-level research projects, participated in more than 20 research projects, and published over 20 papers.
Proficient in diseases
Specializes in the diagnosis and treatment of coronary heart disease, hypertension, and structural heart disease. Research interests include hypertension, coronary heart disease, arrhythmia, and cardiac rehabilitation.
Voices
How to treat heart failure caused by rheumatic heart disease?
Patients with rheumatic heart disease who experience heart failure must identify the causes of the heart failure, such as whether the patient has been overworked, excited, or has an infection. If such causes exist, they should be first eliminated, followed by treatments including diuresis, cardiac stimulation, and heart rate control. The most important thing is to address the complications caused by rheumatic heart disease, such as surgical treatment for mitral stenosis or mitral insufficiency, or relieving constrictive pericarditis caused by rheumatic pericarditis, all of which are methods to treat heart failure.
Manifestations of the ST segment in myocardial infarction
Acute myocardial infarction is divided into three stages: the hyperacute phase, the acute phase, and the recovery phase. The hyperacute phase generally occurs within half an hour of the cardiac vessel blockage. During this time, the myocardium has not completely necrosed, but there can be high, pointed T-waves on the electrocardiogram (ECG), and the ST segment remains unchanged. This stage is prone to misdiagnosis. In the acute phase, which lasts for more than 30 minutes, the ST segment elevation begins to appear on the ECGs of most people. Most of these elevations are horizontal or saddleback, although slanting elevations are less common. During the recovery phase, the ST segment on the ECG gradually returns to normal, and later, T-wave changes occur. Some individuals may develop ventricular aneurysms, which might prevent the ST segment from returning completely to baseline.
Is rheumatic heart disease with atrial fibrillation severe?
Rheumatic heart disease often results from repeated instances of rheumatic fever leading to issues such as heart valve malformations, rheumatic inflammation of the heart, or pericarditis. Common symptoms include accelerated heartbeat, tightness in the chest, and difficulty breathing. In cases of severe mitral stenosis combined with significant enlargement of the left atrium, atrial fibrillation can occur, which is likely to lead to the formation of atrial thrombi in patients with mitral valve issues. Hence, this type of disease can cause considerable complications, primarily leading to further deterioration of heart function. Secondly, the formation of cardiac thrombi due to atrial fibrillation might lead to the thrombus dislodging, potentially resulting in sudden symptoms like paralysis, aphasia, or even sudden death. Therefore, patients with rheumatic heart disease concurrent with atrial fibrillation should seek treatment promptly. Alleviating the narrowing would be ideal. If that is not possible, consistent anticoagulation therapy should be maintained to prevent the formation of thrombi.
Is dilated cardiomyopathy the same as heart disease?
Heart disease is divided into several major categories: the first category is cardiovascular disease, the second category is arrhythmia disorders, which are those caused by abnormalities indicated on an electrocardiogram, and the third category is caused by cardiac structural issues, such as dilated cardiomyopathy, which is a heart disease caused by structural problems in the heart. Therefore, we should understand that dilated cardiomyopathy is actually a type of heart disease; it is not the same. Thus, this question is relatively easy to answer, as dilated cardiomyopathy is just one type of heart disease.
Is it necessary to perform amniocentesis for a ventricular septal defect?
Ventricular septal defect generally is not hereditary, and its genetic DNA should not be problematic. Therefore, the amniocentesis for patients with ventricular septal defect could potentially be problem-free. Although amniocentesis is not very diagnostic, it is still recommended for older patients or those with high risks of malformations or genetic variations. If there is only concern about a ventricular septal defect, a four-dimensional color Doppler ultrasound can be performed. Particularly after the 22nd week of pregnancy, a four-dimensional cardiac ultrasound can help in identification. However, some very small defects might not be detectable. But typically, a minor, isolated ventricular septal defect might impact heart function but generally does not significantly affect the growth and development of the child.
Is a ventricular septal defect with pulmonary hypertension mild or severe?
The most common complication of atrial septal defect is pulmonary hypertension, which can be classified as mild, moderate, or severe. Generally, mild pulmonary hypertension is not a major issue and is not considered very serious. However, moderate to severe pulmonary hypertension often accompanies repeated coughing, shortness of breath after exercise, or difficulty breathing. This situation is relatively serious and it is advisable to undergo surgery as soon as possible. If the condition reaches a severe stage, pulmonary hypertension could continuously increase. Furthermore, in patients with severe pulmonary hypertension, closing the atrial septum can lead to severe breathing difficulties and increased shortness of breath. Therefore, it is crucial to closely monitor patients with pulmonary hypertension.
What should I do if rheumatic heart disease catches a cold?
Patients with rheumatic heart disease, if they find they have caught a cold, should go to the hospital for an examination as soon as possible, including blood tests and an electrocardiogram. If a viral infection is suspected, antiviral treatment should be administered promptly. If a bacterial infection is suspected, antibiotics should be given promptly to control the infection. This can prevent the cold from turning into a lower respiratory tract infection or pneumonia. Because if a cold is not treated in time, it often can trigger an episode of heart failure in patients with rheumatic heart disease and can also lead to a further aggravation of rheumatic disease. Therefore, patients with rheumatic heart disease should prevent infections, and the use of long-acting penicillin once a month is very necessary.
Does a ventricular septal defect make it easier to catch a cold?
Mild atrial septal defects generally permit a normal life and do not easily cause colds. However, when pulmonary hypertension and heart failure occur with an atrial septal defect, it can lead to pulmonary congestion. At this point, bacterial colonization occurs, making respiratory infections more likely to develop. However, the colds we often refer to are upper respiratory tract infections, and atrial septal defects generally do not cause a decrease in immune system function. However, if the upper respiratory tract infection is not treated promptly, it can lead to bronchitis, lung infections, etc., often exacerbating heart failure associated with the atrial septal defect. Therefore, while an atrial septal defect does not cause colds, patients with an atrial septal defect should address colds early to prevent the onset of heart failure triggered by the cold.
Why can't vasodilators be used for mitral stenosis?
Mitral stenosis primarily restricts the return blood volume to the left ventricle. If the stenosis is particularly severe, it can lead to a significant decrease in return blood volume, resulting in poorer pumping function. There are several main factors that affect return blood volume. The first is sufficient circulating blood volume, and the second is the degree of mitral stenosis. Therefore, after using vasodilators, a large amount of blood flows into the capacitance vessels. As a result, the return blood volume decreases, which can further reduce the return blood volume through the already narrowed mitral valve, leading to worsening breathing difficulties in patients, severe cases can cause fainting, or even sudden death.
Does a ventricular septal defect require open chest surgery?
Ventricular septal defects (VSD) can generally be treated through interventional procedures. Normally, defects with a diameter smaller than 3mm do not require surgical treatment. If the diameter is greater than 3mm but less than 10mm, interventional treatment is often feasible. Another scenario involves the subarterial type of defect, which generally cannot be repaired via a catheter-based approach and requires open-chest surgery instead. Additionally, for very large defects, repair must be conducted through open-chest surgery. Thus, for VSD, there are two main treatment options. Specific decisions require echocardiography to analyze the size and location of the septal defect to determine whether open chest surgery is necessary. Generally, most cases can be resolved through minimally invasive interventional methods.