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1、冠心病：无症状心绞痛心肌梗死心律失常猝死心律失常：冠心病高血压心衰糖尿病洋地黄等中毒心律失常的食疗FoodTherapyofCardiacArrythmias3Atermforanyofalargeandheterogeneousgroupofconditionsinwhichthereisabnormalelectricalactivityintheheart.Theheartbeatmaybetoofastortooslow,andmayberegularorirregular.心律失常（综合征）1.房性2.房室结性3.房室性4.室性5
2、.传导阻滞6.猝死心律失常的西医治疗:发作控制，预防发作1.起搏器2.除颤器(ICD)3.射频消融4.手术5.药物:早搏，急性严重发作控制，贫困患者心律失常的发生机制点冲动产生或/和传导异常1.折返，Reentry2.自律性提高，RaisedAutomaticity3.后除极，Afterdepolarization4.异常基因表达，Abnormalgeneexpression心肌病变药物毒性儿茶酚胺酸碱中毒缺血乏氧Re-entryoccurwhenanelectricalimpulserecurrentlytravelsinatightci
3、rclewithintheheart,ratherthanmovingfromoneendofthehearttotheotherandthenstopping.Everycardiaccellisabletotransmitimpulsesineverydirection,butwillonlydosooncewithinashortperiodoftime.Normally,theactionpotentialimpulsewillspreadthroughtheheartquicklyenoughthateachcellwillonl
4、yrespondonce.However,ifconductionisabnormallyslowinsomeareas,partoftheimpulsewillarrivelateandpotentiallybetreatedasanewimpules:atrialflutter,mostparoxysmalsupraventriculartachycardia,anddangerousventriculartachycardia.自律性：Automaticity后除极：AfterdepolarizationPhase2--NaPhase
5、3--CaPhase4--3Nainward/Caoutward基因缺陷多离子靶点假说基因治疗靶向治疗西医治疗心律失常药物的分类：1.自律性增高2.后除极3.折返4.异常基因表达降低自律性阻断后除极消除折返基因治疗多靶点治疗ClassificationofAnti-ArrythmiaAgents?1.第一类:钠通道阻滞剂Ia---Trecovery=1-10s奎尼丁,普鲁卡因胺Ib---Trecovery<1s利多卡因,苯妥英Ic---Trecovery>10s普罗帕酮2.Class2:Beta阻滞剂倍他乐克3.Class3:钠钙钾阻滞Am
6、iodarone(胺碘酮）Sotalol(索他洛尔，IKr)4.Class4:CB,Verapamil(维拉帕米）目前心律失常防治药物：美托洛尔阿替洛尔艾司洛尔3.心得安4.胺碘酮（可达龙）5.维拉帕米（异搏定）6.慢心律，利多卡因4.乙马噻嗪（莫雷西秦）5.普罗帕酮（心律平）6.苯妥英钠7.腺苷伤心药一线药物基础药物特殊用途AdsofAmiodaroneThedrugaffectsthetriiodothyronine(T3)andthyroxine(T4)metabolism.Iflong-termuse,thethyroidfunct
7、ionmaybedisturbed,andothersideeffectsoccur,suchascornealmicro-deposits,photosensitivity,pulmonaryfibrosis,bradycardia,A-Vblock,andventriculartachycardia.Class4:Verapamil维拉帕米SiteofAction:SinusandA-VnodesL-CBDecreaseofAutomaticity,conductivity,andexcitability一名女患者，82岁，有儿子陪同来
8、到心血管内科。医生嘱咐其进行心电、CT等检查。当天，没有取出结果。第二天。老人家让儿子来那结果。儿子给医生看结果。医生问，患者呢？儿子说：“老母亲，啥病也没有，就说吃饭不香，过去
