双语 | 心肌梗塞的症状、诊断和治疗 (Symptoms, Diagnosis, and Treatments)。
昨天朋友圈摄影大赛进入第六天，突然来了一则关于心肌梗塞的消息，让朋友圈摄影大赛从灿烂变成灰色，因为一位移动医疗创业者和先行者因为心肌梗塞而不幸离世。春雨医生的创始人 CEO：张锐。
春雨医生是一款知名产品，截止到2015年5月，春雨有用户6000万，医生100000人，日均8万个问题。春雨已经占到整个移动医疗市场用户量的60%，而且每日新增用户也是市场第一。目前处于Pre-IPO的阶段，不幸这位梦想的缔造者却因为心肌梗塞而遗憾辞世。他开创了移动医疗轻问诊新时代，虽不幸离世，但他的那种解决长期以来“看病难”问题的理想和追求，想必会激励更多医疗创业的后来者。
梦想固然重要，身体却更重要，所以有必要了解下心肌梗塞疾病。今天我们编译了一篇关于心肌梗塞（Heart Attack）的文章，让大家初步了解心肌梗塞的一些干货知识。
原文：Heart Attack: Symptoms, Diagnosis, and Treatments
Written by Christian Nordqvist；Reviewed by Debra Sullivan, PhD, MSN, CNE, COI
编译：译匠公众号（根据原文，有所精简）
https://v.qq.com/txp/iframe/player.html?vid=e0328krzx7y&width=500&height=375&auto=0
Heart attack is the death of a segment of heart muscle caused by the loss of blood supply.
心肌梗塞，是由于心肌缺血而导致的心脏肌肉坏死。
The blood supply is usually lost because a coronary artery, one that supplies blood to the heart muscle, is blocked by a blood clot (coronary thrombosis).
心肌失血常由于冠状动脉，向心肌输血被血块阻塞所致（冠状动脉血栓症）；
If some of the heart muscle dies, the patient experiences chest pain and electrical instability of the heart muscle tissue.
如果部分心脏肌肉坏死，会导致患者心率不齐并感到胸部疼痛。
This article will cover information about how and why heart attacks occur, how they are treated, and how to prevent them.
本文涵盖心肌梗塞如何/为何发生、如何治疗以及如何预防等方面的知识。
What is a heart attack? 什么是心肌梗塞？
Symptoms 症状
Causes 成因
Diagnosis 诊断
Treatments 治疗
Recovery 恢复
Complications 并发症
Prevention 预防
What is a heart attack?
什么是心机梗塞？
Other terms used for a heart attack include myocardial infarction, cardiac infarction, and coronary thrombosis (Infarction refers to the process whereby an area of dead tissue is caused by a loss of blood supply).
心肌梗塞的其他术语还包括： myocardial infarction，cardiac infarction, 和 coronary thrombosis 。梗塞指由于失血导致的组织区域坏死过程。
According to the American Heart Association:
据美国心脏协会（American Heart Association）定义：
During a heart attack, the heart muscle that loses its blood supply starts to suffer injury.
How much damage occurs depends on the size of the area that is supplied by the blocked artery, as well as the length of time between injury and treatment.
The damaged heart muscle heals by forming scar tissue. The healing process may take several weeks.
Despite severe injury to a part of the heart, the rest of the organ carries on working.
However, as part of the heart has been damaged, it will probably be weaker and will not pump as much blood as it used to.
With the right treatment and lifestyle changes, further damage can be prevented or limited.
心肌梗塞的过程中，由于缺少血液供应，心肌开始受损；
损伤程度取决于阻塞冠状动脉的范围大小以及受损和治疗之间的时长（所以及时治疗非常重要）；
受损的心脏肌肉由于疤痕组织的形成而得以恢复，但恢复过程可能持续数周。
尽管部分心脏严重受损，其余器官依然能够继续工作。
但受损的部分心脏会更虚弱，心脏的供血能力会下降。
及时就医并改变生活方式，可以有效预防或控制进一步受损。
Symptoms of a heart attack
心肌梗塞的症状
Chest discomfort, mild pain
Coughing
Nausea
Vomiting
Crushing chest pain
Pressure tightness, pain, squeezing or aching in the chest or arms that spreads to the neck, jaw, or back
Dizziness
Dyspnea (shortness of breath)
Face seems gray
A feeling of terror that your life is coming to its end
Feeling really awful (general feeling)
Restlessness
Feeling clammy and sweaty
胸部不适或轻微疼痛
咳嗽
恶心反胃
呕吐
胸部剧痛
胸闷，胸痛，胸部或胳膊酸痛，痛感蔓延到颈部，下颚和后背
Dizziness 头晕
气短
脸色灰白
濒死感
感觉很糟糕
躁动不安
湿冷和出汗
Causes of a heart attack
心肌梗塞的成因
Age: Risk increases when a man is over 45, and a woman is over 55.
Angina: An illness where not enough oxygen reaches the heart, causing chest pain resembling a heart attack, but it resolves after taking medication. Angina raises the risk of a heart attack.
High blood cholesterol levels: Increases the risk of developing blood clots in the arteries.
Diabetes: People with diabetes have a higher risk of developing several diseases and conditions, many of them contribute to a higher risk of heart attack.
Diet: Someone who consumes large quantities of, for example, saturated fats, will eventually have a higher risk of having a heart attack.
Genes: You can inherit a higher risk of heart attack.
Heart surgery: Patients who have had heart surgery have a higher risk.
Hypertension (high blood pressure)
Obesity, overweight.
Physical inactivity: More active people have a lower risk.
Previous heart attack: Anybody who has already had a heart attack is more likely to have another one, compared with people who have not.
Smoking.
HIV: People who are HIV positive have a 50 percent higher risk of heart attack.
Work stress: Individuals with stressful jobs, or shift workers have an increased risk of heart attack.
年龄：大于45岁的男性和55岁的女性有更高的患病几率。
心绞痛：心脏氧气供应不足而导致的胸部疼痛，但是会随着服药而缓解。
血液胆固醇水平过高：增加了在冠状动脉中形成血栓的风险。
糖尿病患者很容易数病并发，很有可能导致心肌梗塞。
饮食：摄入过量的饱和脂肪将会增加心肌梗塞的风险。
遗传基因：心肌梗塞高风险，也可遗传。
心脏手术：做过心脏手术的人患病风险更高。
高血压
肥胖、超重
缺乏运动：经常运动的人患病风险更低。
有心肌梗塞病史：已经发生过一次心肌梗塞，则再次患病几率更高。
吸烟
HIV：HIV 阳性患者的患病风险比常人高50% 。
工作压力：压力过大或者轮班工作人群有心肌梗塞风险更高。
Diagnosis of heart attacks
心肌梗塞的诊断
ECG (Electrocardiograph): Monitors the electrical activity of the heart muscles
Cardiac enzyme tests: Blood tests detect enzymes produced during a heart attack
Chest X-ray: To look for swelling of the heart
心电图：监测心肌电活动
血液酶测试：在心肌梗塞过程中检测血液中产生的酶
胸部X光：检查心脏肿瘤
Treatments for a heart attack
心肌梗塞的治疗
The faster the heart attack patient can be treated, the more successful his/her treatment will be. 心肌梗塞患者治疗越快，治疗越容易成功。
Treatments during a heart attack
心肌梗塞时的治疗
Manual chest compressions - continuous chest compressions to the heart at about 100 beats per minute.
Defibrillator - the defibrillator sends electric shocks across the patient's chest - the aim is to use electricity to shock the heart back into proper activity.
Aspirin - often given to patients during a heart attack. Aspirin will help stop the clot in the artery from growing.
Thrombolytics - these dissolve blood clots.
Painkillers - morphine is sometimes injected into the patient to control the pain and reduce anxiety.
心肌复苏：如果患者停止呼吸，应立即开始心肌复苏
心脏按压
心脏除颤：目的是通过电击使心脏恢复活动
阿司匹林：阿司匹林能够阻止血栓在冠状动脉中继续形成
溶栓药物：溶解血栓
止痛药：控制疼痛并缓解焦虑
Treatments following a heart attack
心肌梗塞后的治疗手段：
Aspirin and other antiplatelets: Antiplatelets lower the chances of blood clotting
Beta-blockers: Make the heart beat slower and with less force
ACE (Angiotensin-converting enzyme) inhibitors: Ease the workload on the heart by opening up blood vessels and lowering blood pressure
Statins: Lower blood cholesterol levels
阿司匹林和其他抗血小板药物：降低血栓形成的几率
Beta-blockers：降低心跳的速度和力度
ACE （血管收缩素转换酵素） 抑制剂：通过打开血管和降低血压降低心脏负荷
Statins：降低血液中的胆固醇含量
Procedures after a heart attack:
心肌梗塞后的手术治疗：
Angioplasty: This procedure opens up the coronary artery. A small wire enters the artery and is pushed until it reaches the clot in the coronary artery. A small balloon at the end of the wire is placed at the narrowest part of the artery and inflated, squashing the clot. A flexible metal mesh, called a stent, is then placed there to keep the artery open.
CABG (Coronary artery bypass graft): The damaged blood vessel is bypassed with grafts taken from blood vessels elsewhere in the body. The bypass effectively goes around the blocked area of the artery, allowing blood to pass through into the heart muscle.
心脏支架：此手术要打开动脉。将一个细线伸进冠状动脉直到抵达阻塞的部位，在细线的末端放置了一个气球，在抵达最狭窄处时，气球膨胀挤压消解血栓。之后，套在气球外围的金属网管会被撑开，从而将阻塞部位打开。如果冠状动脉狭窄部位过多，医生会建议进行心脏搭桥手术。
CABG (冠状动脉旁路移植术): 用身体其他部位移植的血管，绕过之前被阻塞的冠状动脉，搭建一个新的血管旁路，使其能够有效的覆盖被阻塞的区域，保证血液重新输送到心脏细胞。
Recovery after a heart attack
心肌梗塞的恢复
Physical activity: It is vital that a recovering heart attack patient tries to stay active. However, it is important that any exercise program is devised by a specialist.
Going back to work: When a heart attack patient can go back to work depends on various factors including the severity of the heart attack and the type of job. It is vital that people do not rush back to work.
Depression: About 20 percent of heart attack patients go on to have a major episode of depression not long afterward. Heart attack patients who feel depressed or anxious should tell their doctors immediately.
Driving: Experts advise that a person refrains from driving for at least 4 weeks after a heart attack.
Erectile dysfunction: Approximately one third of all men who have a heart attack have problems getting, or sustaining, an erection.
康复训练：保持运动对于心肌梗塞患者是至关重要的，当然需要在专业人员的建议下进行康复训练。
恢复工作：重新恢复工作的时间取决于多个因素，比如：心脏受损程度，工作种类。请勿急于恢复工作。
抑郁：大约有20%的心肌梗塞患者会患上抑郁症，如果感觉沮丧或焦虑，请及时就医。
驾驶：专家建议至少4周以后，心肌梗塞患者才可以驾驶。
性功能障碍：大约三分之一的男性患者在病后会性功能障碍。
Complications after a heart attack
心肌梗塞并发症
There are two types of complications, those that occur pretty much straight away, and those that happen later.
主要有两种并发症：发病时的引起的并发症和发病后引起的并发症：
Immediate complications
发病时引起的并发症：
Arrhythmias - the heart beats irregularly, either too fast or too slowly. Most patients, with time, will return to regular rhythms.
Cardiogenic shock - the patient's blood pressure suddenly drops dangerously. The heart cannot supply enough blood for the body to work adequately.
Hypoxemia - levels of blood oxygen become too low.
Pulmonary edema - fluid accumulation in and around the lungs.
DVT (deep vein thrombosis) - the deep veins of the legs and pelvis develop blood clots which either block or interrupt the flow of blood in the vein.
Myocardial rupture - the heart attack damages the wall of the heart. This increases the risk of a heart wall rupture.
Ventricular aneurysm - one of the chambers (ventricles) of the heart forms a bulge.
心律失常：心跳不规律，时快时慢，多数病人随着时间的推移能够恢复正常。
休克：病人的血液突然降至危险水平，心脏不能提供身体正常工作所需的血液。
血液含氧量过低
静脉血栓：大腿或骨盆的静脉产生血块，进而阻止或中断血液在静脉中的传输。
心肌破裂：由于心肌梗塞导致的损伤，心壁会有破裂的风险。
室壁瘤
Complications that can occur later
发病后引起的并发症：
Aneurysm - scar tissue builds up on the damaged heart wall. This leads to blood clots, low blood pressure, and abnormal heart rhythms.
Angina - Not enough oxygen is reaching the heart. Symptoms may be similar to those of a heart attack.
Congestive heart failure - the heart can only beat very weakly. The patient feels exhausted and breathless.
Edema - fluid accumulates in the ankles and legs (they swell).
Loss of erectile function - erectile dysfunction is generally caused by a vascular problem. However, it can also be the result of depression.
Loss of libido - this is especially the case with men.
Pericarditis - the lining of the heart becomes inflamed, causing serious chest pain.
动脉瘤：疤痕组织在受损的心脏壁积聚，导致血块，低血压，和心率失常。
心绞痛：当心脏缺氧时，会有这种感觉。
心脏衰竭：心跳较弱，患者感到气短、筋疲力尽。
浮肿：通常足踝和腿部会有浮肿。
性功能障碍：勃起功能障碍通常是由血管问题引起的。但是，也有时也是由抑郁导致的。
性欲减退：尤其对于男性而言。
心囊炎
Minimizing your chances of having a heart attack
心肌梗塞预防
Don't smoke
Eat a balanced, healthy diet
Get plenty of exercise
Get plenty of good quality sleep
Keep diabetes under control
Keep alcohol intake down
Keep blood cholesterol at optimum levels
Keep blood pressure at safe levels
Maintain a healthy body weight
Avoid stress where possible
Learn how to manage stress
不抽烟
平衡健康膳食
充足云端
充足的高质量睡眠
及时控制糖尿病的发生
降低酒精摄入
将血液中的胆固醇保持在最佳水平
将血压保持在安全水平
保持健康体重
尽可能避免压力
学会管理压力
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