Seven common misconceptions about myocardial infarction explained: Scientific understanding helps avoid treatment delays.

7 Common Misconceptions about Myocardial Infarction

In recent years, although the Chinese public has gained a greater understanding of the dangers of myocardial infarction, many misconceptions still exist, leading to some patients not receiving timely and optimal treatment. Dr. Zhou has summarized seven common misconceptions about myocardial infarction to help everyone gain a more scientific understanding of the disease and its treatment.

Misconception 1: Myocardial infarction is a disease exclusive to the elderly: While coronary heart disease and myocardial infarction do have a higher incidence rate among the elderly, this does not mean that young people cannot suffer from them. In recent years, the age of onset of myocardial infarction has shown a significant trend towards younger ages, with countless patients in their thirties and forties suffering from it. Therefore, young people must not be complacent.

Misconception 2: No chest pain means no myocardial infarction

The most common symptom of myocardial infarction is sudden chest pain, often located in the precordial region or behind the sternum. However, myocardial infarction patients often experience atypical symptoms, such as back pain, chest tightness, shortness of breath, toothache, and left upper limb pain. Some patients have no obvious symptoms and are only diagnosed with myocardial infarction during a physical examination. This is more common in diabetic patients and the elderly.

Misconception 3: When experiencing angina, should one take nitroglycerin or a quick-acting nitroglycerin pill?

Nitroglycerin primarily dilates blood vessels by increasing the production of nitric oxide in the vascular endothelium. Studies have found that nitroglycerin takes effect within 1 minute after being placed under the tongue, reaching its maximum effect in 3-5 minutes.

The main ingredients of quick-acting nitroglycerin pills are borneol and chuanxiong. Borneol has a clearing and refreshing effect, while chuanxiong has a blood-activating and stasis-removing effect. Studies have found that 4 pills of quick-acting nitroglycerin take effect within 5 minutes after being placed under the tongue, reaching its maximum effect in 10-15 minutes.

From the above comparison, it is clear that nitroglycerin takes effect faster and can quickly and effectively improve symptoms of myocardial ischemia, especially myocardial infarction. However, it is contraindicated in cases of severe hypotension and tachycardia.

Myth 4: Never get a stent implanted, otherwise you'll have to take medication long-term.

Coronary artery disease requires long-term medication, even without a stent. Stent implantation does not increase the amount or type of medication required. When a patient's coronary arteries are severely narrowed or completely blocked, resulting in a myocardial infarction, a stent needs to be implanted immediately to open the blocked vessel. This prevents further myocardial cell death and sudden death.

For acute myocardial infarction, stent implantation should be performed based on the patient's specific condition. Long-term medication is still necessary afterward to control risk factors that lead to vascular stenosis.

Myth 5: A stent must be implanted after a myocardial infarction diagnosis.

The primary treatment for a myocardial infarction is to promptly open the blocked coronary arteries. The purpose of stent implantation is to address vascular stenosis; therefore, only patients with severely narrowed vessels require stent implantation. Patients whose vessels show no significant stenosis after thrombectomy or other procedures may not require stent implantation.

Myth 6: I'm young, stent implantation will affect my lifespan.

In clinical practice, Dr. Zhou has encountered some young patients with myocardial infarction who, upon hearing that they need stent implantation, immediately respond, "I'm young, I don't want a stent."

When asked why, they consider the following factors: 1. Stent implantation will shorten lifespan; 2. Stent implantation requires lifelong medication; 3. Stent implantation will cause blood vessels to narrow faster.

Correct Answer: 1. Stent implantation does not shorten lifespan; 2. Whether or not a stent is implanted, lifelong medication is required for coronary heart disease or myocardial infarction; 3. Stents are only used to open blocked blood vessels, just like stabilizing a collapsed coal mine. Think about it: if you need stent implantation, doesn't that mean your blood vessels were already narrowed before the stent was implanted? In fact, whether blood vessels narrow or narrow again is related to factors such as diet and genetics, and has nothing to do with whether or not a stent is implanted.

Myth 7: A diagnosis of myocardial infarction requires bed rest.

Many patients and their families believe that after stent implantation, they should rest completely and are unaware of how to exercise. Prolonged bed rest not only easily leads to deep vein thrombosis in the lower extremities, causing pulmonary embolism, but also causes a severe decline in physical strength, a reduced quality of life, and ultimately, more and more complications and repeated hospitalizations.

In fact, the harm of bed rest and lack of movement is very significant. Statistics show that one day of bed rest reduces oxygen uptake by 0.2 METs (metabolical rate units), equivalent to a two-year age decline in physical fitness for one day; one week of bed rest reduces muscle contractility by 10%–15%; long-term bed rest can produce or worsen adverse psychological reactions such as anxiety and depression.

Proper exercise can reduce lipid metabolism disorders, prevent restenosis of the implanted stent-covered blood vessels, promote collateral circulation in areas of myocardial necrosis, and reduce the incidence of complications and mortality in patients with coronary heart disease.

Therefore, after suffering a myocardial infarction or having a stent implanted, one should engage in moderate aerobic exercise under the guidance of a doctor to reduce the occurrence of complications.