Chest tightness pain during exercise, suspected coronary hematoma...If left unattended, it's life threatening

Feb 03, 2025

Photo source=Getty Images Bank (Hallim University Medical Center)

Kim, a man in his 80s, recently felt severe pain that seemed to tighten his chest several times during a walk. Feeling abnormal, he visited the cardiovascular center at Hallym University's Dongtan Sacred Heart Hospital, and was diagnosed with a large hematoma in the coronary artery (cardiovascular system). Jukjong was large and hard, and it was a situation where surgical treatment was prioritized due to invasion of many blood vessels, but the patient was old and underlying diseases such as high blood pressure and diabetes made it difficult to operate. Accordingly, Professor Chun Dae-young of the Department of Circulatory Medicine removed the atherosclerosis blocking the coronary artery and secured normal blood flow with a percutaneous procedure. Since then, Kim has no longer felt chest pain and is living his daily life.

In winter, the number of patients with cardiovascular diseases such as acute myocardial infarction increases due to low temperatures, constricting blood vessels and poor blood circulation.

Recently, due to aging, the number of patients with atherosclerosis whose coronary arteries supplying blood to the heart are blocked by atherosclerosis has been steadily increasing every year. According to statistics from the Health Insurance Review and Assessment Service, the number of patients with atherosclerosis in coronary arteries in Korea has increased 57% over the past five years from 108,599 in 2019 to 170,434 in 2023.

Considering that the number of patients in 2014 was 76,583 patients, it is an increase of 123% over the past 10 years. As of 2023, the number of male patients was 115,132, more than twice that of 55,302 female patients.

Bamboo is a hard mass formed by cholesterol deposition inside blood vessels. It narrows the inside of blood vessels, causing blood circulation disorders, and if it ruptures incompletely, it may form blood clots. As a result, neglecting coronary atherosclerosis can cause myocardial infarction, angina, and stroke, which can lead to death in severe cases. In particular, bamboo species in elderly patients with a lot of calcification are harder and larger than bamboo species in young patients, and are not easy to remove because they appear frequently in several coronary arteries.

◇ Various coronary atherosclerosis treatments…Old Man Is Effective in Rotational Bamboo Ablation

Typical methods for treating coronary atherosclerosis include coronary artery bypass surgery, percutaneous coronary artery surgery (balloon dilatation), rotational bamboo resection, and medication. Coronary artery bypass surgery is an operation that removes some blood vessels from a patient's body and creates a detour to the narrowed coronary artery. Although it is the most reliable treatment, it is limited to patients with old age or underlying diseases because it is a surgical treatment.

In the case of coronary angioplasty, the narrowed blood vessel is widened with a balloon catheter and a stent is installed to relieve stenosis. Although it can be treated through percutaneous procedures without incision, if the calcification of bamboo is severe, the stent cannot be fully unfolded and bamboo is likely to recur.

Drug treatment is a method of preventing blood clots caused by atherosclerosis by using anti-clotting agents. However, since it cannot remove bamboo species, it can only be performed on patients with mild symptoms, and if the symptoms worsen, you must eventually choose a procedure or surgery.

Rotary bamboo resection (rotablator procedure) is a method of removing bamboo by inserting a diamond chip-coated perforator into the coronary artery through a percutaneous procedure and rotating it at high speed. The perforator operates according to the differential cutting principle, so that the elastic normal blood vessels are not damaged, and only inelastic hematomas can be selectively resected. Bamboo species are broken into microscopic pieces smaller than red blood cells and disappeared in the blood through capillaries. Due to these advantages, rotational atherosclerosis has recently been effectively used to treat atherosclerosis accompanied by severe calcification in old age. Because the weakened blood vessels can be damaged by strong pressure, the procedure is difficult and requires very careful manipulation.

Professor Chun Dae-young said, "The number of coronary atherosclerosis patients with calcification is steadily increasing due to aging, and these patients have large surgical restrictions and hard bamboo species, making it difficult to treat." Rotary bamboo resection is a good treatment alternative for elderly patients who have difficulty in surgical treatment because it directly removes bamboo species through percutaneous procedures.", he explained.

◇ High blood pressure, diabetes, hyperlipidemia, gout, and smokers should pay attention to chest pain

To prevent atherosclerosis caused by coronary atherosclerosis in winter, daily lifestyle management is important.

If the temperature difference is large while resting, or if chest pain becomes particularly severe during activities such as exercise, you should suspect atherosclerosis. In addition, because it is a disease caused by blood flow problems, coronary atherosclerosis is likely to occur in people suffering from chronic inflammatory diseases such as high blood pressure, diabetes, hyperlipidemia, and gout.

Professor Chun Dae-young said, `If you have any suspicious symptoms, you should visit a hospital immediately for treatment because coronary atherosclerosis with severe calcification is difficult to treat and if left unattended, it can be life-threatening"In order to prevent coronary atherosclerosis, steady exercise and health care are important to prevent risk factors such as high blood pressure, diabetes, hyperlipidemia, and gout from occurring" he advised.