What if a stent cannot be implanted? The establishment and maintenance of collateral circulation in the heart.

What to do if a stent cannot be implanted? Coronary artery disease can be life-threatening in severe cases. For patients with severe narrowing of the coronary arteries, especially those with acute myocardial infarction, timely stent implantation is an effective treatment. However, clinically, some patients are unable to receive stents due to personal reasons such as narrower blood vessels. So, what should patients do when angina symptoms occur frequently and medication is ineffective? An important relief method is to establish collateral circulation in the heart.

What is collateral circulation? Collateral circulation in the heart refers to the dilation of blood vessels that were originally anastomosing to the main blood vessels of the heart when blood flow is obstructed due to severe narrowing, forming bypasses and restoring blood supply to the distal end of the blood vessel.

If we compare the main blood vessels in the human body to the main channel of a river, when the main channel is blocked, the river water cannot flow far. This is because the blockage in the main channel has occurred.

Many branches appear along the river, allowing the water to flow far. In fact, the establishment of collateral circulation is a normal compensatory response of the body, albeit a slow one. If there were a way to accelerate the establishment of collateral circulation, it could undoubtedly quickly improve the patient's myocardial ischemia symptoms and relieve angina.

How to effectively establish collateral circulation:

The answer is consistent and appropriate exercise. Studies have shown that if patients with coronary heart disease consistently engage in aerobic exercise, it can accelerate the establishment of collateral circulation in narrowed blood vessels and relieve angina symptoms. This method is known as "exercise bypass."

How to exercise appropriately:

1. Exercise type: Primarily aerobic exercise, such as jogging, swimming, brisk walking, etc.;

2. Exercise frequency: 3-5 times per week is advisable;

3. Exercise intensity: Patients with coronary heart disease are advised to undergo an aerobic exercise assessment at a reputable hospital to determine their safe exercise level.

How to Protect Heart Health in Daily Life:

Quit Smoking and Limit Alcohol: Cigarettes contain large amounts of harmful substances such as nicotine and tar. These substances not only directly enter the bloodstream and act on vascular endothelial cells, damaging blood vessels, but also indirectly harm vascular endothelial function by interfering with lipid metabolism. Therefore, Dr. Zhou recommends that everyone not smoke and drink alcohol in moderation (no more than 20g of alcohol per day) or not drink alcohol at all.

Strictly Control Weight: When body mass index (BMI) increases, the incidence of coronary heart disease and stroke also increases. Overweight and obesity are risk factors for coronary heart disease and stroke. For every 2-point increase in BMI, the relative risk of coronary heart disease, stroke, and ischemic stroke increases by 15.4%, 6.1%, and 18.8%, respectively.

Balanced Diet and Moderate Exercise:

Principles of a Balanced Diet:

1. Eat a variety of foods, combining refined and whole grains;

2. Ensure sufficient protein intake, including fish, lean meat, and skim milk daily;

3. Control cholesterol intake, reducing consumption of fatty meats, animal fats, butter, and organ meats, and minimizing the use of coconut oil and palm oil;

4. Limit fried foods, margarine pastries, and coffee creamer and milk tea;

5. Ensure adequate dietary fiber intake, obtaining 25-30g daily from fruits and leafy green vegetables;

6. Ensure adequate vitamin and mineral intake, obtaining them primarily from dark green vegetables.

Appropriate Exercise: Exercise has benefits such as preventing atherosclerosis, improving myocardial ischemia, and improving vascular endothelial function. Exercise should primarily be aerobic, such as jogging, brisk walking, Tai Chi, and Baduanjin (Eight Pieces of Brocade), lasting 30-40 minutes each time, 3-5 times per week.