Is 80% stenosis of the anterior descending branch of the heart severe

80% of stenosis in the anterior descending branch of the heart is a serious condition that requires immediate medical intervention. The degree of coronary artery stenosis directly affects myocardial blood supply, and the main risks include acute myocardial infarction, malignant arrhythmia, and sudden cardiac death, usually requiring stent implantation or bypass surgery.

1. Risk of myocardial ischemia:

The anterior descending branch is responsible for supplying blood to 2/3 of the left ventricular anterior wall, and 80% stenosis can lead to significant myocardial ischemia during exercise. Typical manifestations include exertional chest pain, chest tightness, shortness of breath, ST segment depression or T wave inversion on electrocardiogram, and abnormal wall motion on cardiac ultrasound.

2. Plaque stability: Plaques with a stenosis degree exceeding 70% are prone to rupture, leading to platelet aggregation and thrombus formation. This type of lesion is often accompanied by unstable features such as large lipid core and thin fibrous cap, and requires intensified antiplatelet therapy such as aspirin combined with ticagrelor.

3. Effects on cardiac function:

Long term ischemia can lead to myocardial hibernation or stunning, resulting in a progressive decrease in left ventricular ejection fraction. Cardiac nuclear scanning can detect fixed perfusion defects, and late stage heart failure symptoms such as paroxysmal nocturnal dyspnea and lower limb edema may occur.

4. Indications for revascularization:

According to the guidelines for the diagnosis and treatment of coronary heart disease, evidence of primary vascular stenosis ≥ 70% accompanied by ischemia is the absolute indication for revascularization. Drug coated stents are preferred for interventional treatment, and complex lesions may require coronary artery bypass grafting. The 10-year patency rate of the mammary artery graft is over 90%.

5. Secondary preventive measures:

After surgery, it is necessary to strictly control low-density lipoprotein levels below 1.4 mmol/L, in combination with statins and ezetimibe. Beta blockers can reduce myocardial oxygen consumption, ACEI drugs can improve ventricular remodeling, and regular follow-up coronary CTA can evaluate stent patency.

Patients need to establish a healthy lifestyle, with a daily salt intake of no more than 5 grams, and adopt a Mediterranean diet to increase their intake of deep-sea fish. Perform 150 minutes of moderate intensity aerobic exercise per week to avoid sudden intense activity. Quit smoking and control body mass index below 24, monitor blood pressure to maintain below 130/80mmHg. Within 1 year after surgery, check blood lipids, blood glucose and other indicators every 3 months. If chest pain persists and does not improve, seek medical attention immediately. psychological intervention is equally important, as anxiety and depression may increase the burden on the heart. It is recommended to regulate emotions through mindfulness training.