Coronary heart disease (CHD) is a common cardiovascular disease in clinical practice, which tends to occur in the elderly. Coronary artery stenosis or occlusion is often caused by coronary atherosclerosis, which affects the blood supply of the myocardium, and then induces disease. If patients with CHD cannot receive relevant treatment measures in time, it can lead to long-term ischemia of the myocardium, causing arrhythmia. Clinical practice has proven that if patients with coronary heart disease experience arrhythmia, it can lead to changes in hemodynamics, further decline in myocardial blood supply function, and reduce the quality of life of patients. Therefore, arrhythmia is one of the main factors leading to death in patients with coronary heart disease. If the relevant risk factors that cause arrhythmia in patients with coronary heart disease are identified early and intervention measures are taken, the risk of arrhythmia in patients with coronary heart disease can be reduced, which is beneficial for promoting their recovery.
1、 Age ≥ 70 years old
With the increase of patient age, the elasticity of the patient's vascular wall shows a degenerative decrease. In addition, the pathological basis of coronary heart disease can easily lead to cardiac hypoxia and ischemia, thereby reducing myocardial tissue compliance, increasing intracardiac volume, increasing intracardiac pressure, and inducing arrhythmia.
2、 The patients with diabetes
diabetes have abnormal metabolism mechanism. The metabolism of carbohydrate, lipid and other substances in the body is in a state of disorder for a long time. There is a risk of heart disease and a variety of blood vessels, which has seriously hindered the myocardial metabolic function of patients. Moreover, coronary heart disease itself will also cause some damage to the cardiac function, further leading to the deterioration of the patient's cardiac function, thus increasing the risk of arrhythmia.
3、 Combining chronic obstructive pulmonary disease (COPD) with coronary heart disease can increase the risk of arrhythmia in patients. The reason is that COPD can lead to water, electrolyte, and acid-base imbalances in the patient's body, infections, hypoxemia, etc., which can easily cause organic damage to the heart, leading to myocardial metabolic disorders and inducing arrhythmia.
4、 Myocardial infarction
Patients with acute myocardial infarction are more prone to arrhythmia due to the abnormal increase in transmural repolarization dispersion after the occurrence of acute myocardial infarction, which can easily lead to ectopic or micro reentrant excitation foci, thereby reducing the patient's ventricular fibrillation threshold and inducing various arrhythmias.
5、 Decreased blood potassium levels
Decreased blood potassium levels are an important risk factor for inducing arrhythmia, as potassium ions are the main cations in cells and play an important role in maintaining action and resting potentials. After coronary heart disease occurs, it can cause stress reactions, activate the activity of the sympathetic adrenal medulla system, increase catecholamine synthesis and release, thereby increasing Na+pump activity, promoting K+influx, and reducing extracellular blood potassium levels; At the same time, due to the increased activity of the sympathetic nervous system, it can enhance the sodium and potassium retention function of the renal tubules, leading to a large excretion of K+, resulting in the formation of a local high potassium environment in the infarcted lesion, which forms an electrical conduction gradient with the low blood potassium environment at the edge of the lesion, increasing the incidence of reentry and easily inducing arrhythmia.
6、 The dynamic state of action potential in the myocardial middle layer cells of coronary heart disease patients with cardiac enlargement is significantly weaker than that of endocardial and epicardial cells, creating necessary conditions for the occurrence of ventricular intramural reentry excitation. In addition, the patient's sympathetic nervous system excitability is relatively high, while the stability of myocardial potential and ventricular fibrillation threshold are low, which makes coronary heart disease patients with cardiac enlargement prone to arrhythmia.
7、 Smoking
Smoking is an important factor in inducing cardiovascular disease. Smoking can increase the level of free radicals in the body, damage the endothelial function, promote the development of atherosclerosis, enhance platelet activity and increase the level of fibrin, thus increasing the risk of thrombosis; Moreover, nicotine in tobacco can act on cardiac ion channels, shorten the duration of action potentials, depolarize myocardial cells, and induce arrhythmia.
8、 Coronary artery bypass grafting (CABG) treatment
Patients who undergo coronary artery bypass grafting surgery are prone to arrhythmia, which may be related to factors such as transient myocardial ischemia and hypoxia during surgery, decreased circulating blood volume after surgery, ischemia-reperfusion injury, and surgical damage.