30% of cerebral infarctions are caused by atrial fibrillation. Reminder: to prevent cardiac cerebral infarction, taking aspirin has no effect
For cerebral infarction, the etiology is not single. Statistics show that about 14-30% of ischemic strokes (cerebral infarction) are caused by cardiac stroke, and about 25% are hidden. It is speculated that the mechanism is mainly related to cardiogenic cerebral embolism. Among the causes of cardiogenic cerebral embolism, atrial fibrillation is the most important cause. About 79% of cardiogenic cerebral infarctions are caused by atrial fibrillation. Atrial fibrillation occurs in the heart, cerebral infarction occurs in the brain? How the two are related, today I will briefly interpret the truth for everyone.
We all know that our heart is an important organ that supplies blood to the body. In order to supply blood to the body, the heart works hard every day and beats regularly. When the heart contracts, blood is pumped out of the heart, and when the heart is diastolic, blood returns to the heart, which is normal. The regular fluctuations allow the heart to provide a strong guarantee for the body's blood supply.
Atrial fibrillation, on the other hand, is a disease problem in which the rhythm of the heartbeat has changed, which is what we often call arrhythmia. As the name suggests, atrial fibrillation refers to atrial fibrillation, which is the most common persistent arrhythmia. When atrial fibrillation occurs, the excitation frequency of the atrium can be as high as 300 beats/min, and the heart rate can be as high as 100~160 beats/min. In addition to the rapid heartbeat, atrial fibrillation can also lead to atrial dysfunction, and the right atrium loses effective contractile function. . Simply put, the regular beating of the heart is completely disrupted.
The heartbeat is disrupted, the heart rate becomes faster, and the right atrium loses its systolic function, which causes some blood to stay in the heart. The longer the blood stays in the heart, the greater the risk of forming a clot, which we usually put Known as thrombus or emboli, such thrombi usually attach to the left atrial appendage of the heart, and if these thrombi fall off and enter the cerebral blood vessels with blood circulation, blocking the cerebral blood vessels will form a cardiogenic cerebral infarction. If it enters the lower limbs Blood circulation will block the blood vessels of the lower extremities, causing ischemic necrosis of the lower extremities.
The study found that if atrial fibrillation continues for more than 48 hours, a mural thrombus will form in the left atrium. Once the mural thrombus is formed, the risk of causing cardiac cerebral infarction will become very high. The treatment of tremor is the top priority for the prevention of cardiogenic cerebral infarction.
How should atrial fibrillation be treated to reduce the risk of cardiac cerebral infarction? In terms of drug treatment, it mainly includes two aspects, one is to improve arrhythmia, restore normal sinus rhythm or control the excessively fast ventricular rate, and the other is to prevent the risk of cardiac cerebral infarction caused by thrombus falling off .
In terms of heart rate control, there are many drugs, such as common beta-blockers that can slow down the heart rate and strengthen heart rate control, such as metoprolol, bisoprolol, etc., and are used for conversion in atrial fibrillation. Heart rhythm drugs such as flecainide, dofetilide, propafenone, ibutilide and amiodarone.
For the prevention of cardiogenic cerebral infarction, anticoagulation therapy is often required. For the anticoagulation therapy of atrial fibrillation, it is generally recommended that patients over 65 years of age have atrial fibrillation problems, if they have suffered a stroke or transient On the premise of cerebral ischemia, anticoagulation therapy is required. First of all, it should be clear that the anticoagulation therapy for cardiogenic cerebral infarction is not the same as the antiplatelet therapy taking aspirin. The main anticoagulant drugs for the prevention of cardiogenic cerebral infarction are warfarin and other anticoagulant drugs, and newer drugs include rivaroxaban, dabigatran, etc. It should be pointed out that anticoagulation treatment must be treated by a doctor Strict evaluation of the drug, medication under the guidance of a doctor, excessive anticoagulation will lead to an increase in the risk of bleeding, which deserves special attention.