4 signs of early detection of diabetic heart disease

The symptoms of "diabetic heart disease" are often atypical. Even patients with myocardial infarction can not feel pain. It is easy to be ignored or missed. Patients are often unknowingly "killed by a blow", which is exactly what it is. Terrible.

4 signs of early detection of diabetic heart disease

Cardiovascular disease is one of the most common chronic complications in people with diabetes. About three-quarters of patients with type 2 diabetes have cardiovascular disease, and more than 80% of people with diabetes eventually die from cardiovascular complications.

Like all diseases, if diabetic heart disease (referred to as "glycemic heart disease") can be diagnosed early and treated early, the prognosis of patients will be greatly improved. However, because the symptoms of diabetic heart disease are hidden and atypical, they are often overlooked or missed. For this reason, we need to understand the atypical symptoms of diabetic heart disease. So, what are the "spirits" of diabetic heart disease?


1. From lying to standing, the "pressure difference" suddenly changes

Many people with diabetes often feel dizziness, vertigo, flustered, sweating, black eyes, and even fainting. When measuring blood pressure, it was found that the systolic blood pressure decreased from 20 mmHg or diastolic blood pressure from greater than 10 mmHg from supine position to standing. This condition is called "post position hypotension".

When a normal person changes in position, the body can maintain normal blood pressure by increasing vascular tone and cardiac output. However, due to long-term hyperglycemia, diabetics cause autonomic nerves (especially sympathetic nerves) that innervate blood vessels, causing blood vessels to fail in time. Contraction, resulting in a transient drop in blood pressure. " orthostatic hypotension" is one of the characteristics of diabetic heart disease.

2. Rest still, heartbeat

Normal people have a faster heart rate during exercise and a slower heart rate during rest. However, some people with diabetes have a heart rate at rest, and their heart rate is more than 90 times per minute. They are accompanied by symptoms such as palpitations, palpitation, chest tightness, and dizziness. This is due to long-term glucotoxicity leading to vagus nerve function damage.

In addition, some people with diabetes have a "fixed heart rate", that is, heart rate does not increase or slow down with activity or rest. This is because the patient's vagus nerve and sympathetic nerve are both paralyzed and the heart completely loses its autonomic innervation.

3. A myocardial infarction occurs without chest pain

In patients with common coronary heart disease, when myocardial ischemia and hypoxia, the tissue will produce a large amount of lactic acid, which stimulates the sensory nerves of the heart and produces pain (ie, angina). However, even if the heart has severe ischemia and hypoxia, the patient often has no symptoms of angina pectoris, and even when there is a critical condition such as acute myocardial infarction, the painless myocardial infarction is easily missed or misdiagnosed. An important cause of sudden death in people with diabetes.

This is because the sensory nerves of diabetic patients are generally slow and even lose function, making the pain symptoms mild and atypical. Therefore, diabetic patients need to have regular cardiovascular related examinations (such as electrocardiogram) even if they do not have the corresponding symptoms of cardiovascular disease, so as to early detection and early intervention.

4. I am young and suffer from heart disease.

The incidence of cardiovascular disease in diabetics is not only 2 to 4 times higher than that of non-diabetics, but also the age of onset is 5 to 10 years earlier than non-diabetics. Many obese patients with type 2 diabetes have high blood pressure at a young age. Coronary heart disease, even acute myocardial infarction. This is because people with diabetes often have multiple cardiovascular risk factors, so the risk of cardiovascular disease increases, the age is advanced, and the condition is more serious.

As the saying goes, the gun is easy to hide, and the dark arrow is hard to prevent. "Glycemic heart disease" has the characteristics of concealed symptoms and atypical symptoms. Diabetic patients must understand this aspect. Do not let go of these clues.

Even if patients do not have any self-conscious symptoms, they should go to the hospital for physical examination (such as blood sugar, blood lipids, blood pressure, electrocardiogram, heart ultrasound, etc.) to achieve early detection, early intervention, early treatment, and prevent problems before they occur.

Compared with patients with common coronary heart disease, the condition of diabetic heart disease is more complicated and more difficult to treat. In terms of treatment, lifestyle intervention should be combined with drug treatment. In addition to reasonable control of sugar, it is necessary to comprehensively control various cardiovascular risk factors, including blood pressure reduction, lipid regulation, weight loss, smoking cessation and so on.

It is important to emphasize that for diabetic patients with coronary heart disease, the glycemic control standard is slightly looser than that of ordinary diabetic patients, fasting blood glucose does not exceed 7.0mmol/L, postprandial blood glucose is 8-10mmol/L, and glycated hemoglobin (HbA1c) is 7.5% to 8.0% can be used to avoid hypoglycemia, which is even more harmful to cardiovascular disease than hyperglycemia.

In addition, in the selection of hypoglycemic drugs, patients with "glycemic heart disease" should try to choose hypoglycemic agents that can reduce body weight and have a clear protective effect on the cardiovascular system, such as metformin, SGLT-2 inhibitor, α-glucosidase inhibitor. and many more.