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Tremendous progress has been made in treating heart disease, but it is still the biggest killer of Americans, accounting for one in seven deaths. Here are answers to some common questions about the symptoms and treatment of heart attacks and narrowed aortic valves.
在治疗心脏疾病方面，人们已经取得了长足的进展，不过它仍然是美国最大的死亡原因，大约每七个死亡病例中，就有一人是死于心脏病。以下是关于心肌梗塞和主动脉瓣狭窄的症状及疗法的一些常见问题和解答。
How do you know if you are having a heart attack?
如何判断自己会不会患心肌梗塞？
Most people feel pain, pressure or squeezing in their chest. What doctors call the Hollywood heart attack — a person suddenly clutches his or her chest and falls to the ground — is unusual. In addition to or instead of chest pain, about a third of people have symptoms that include abdominal pain, heavy sweating, back pain, neck pain, nausea and vomiting. Many people mistakenly dismiss such symptoms, said Dr. Mary Norine Walsh, the vice president of the American College of Cardiology.
很多人感到疼痛、压力、胸闷，不过医生们称作“好莱坞心梗”的症状——也就是一个人突然抓住胸口，颓然倒地——并不常见。大约有三分之一的人除了胸口疼之外，还会有腹痛、严重出汗、背痛、颈痛、恶心、呕吐等症状，或者只有上述症状而并无胸口疼。许多人会错误地忽视这些症状，美国心脏病学会(American College of Cardiolog)副会长玛丽·诺林·沃尔什(Mary Norine Walsh)说。
How can you decide if symptoms other than chest pain are actually from a heart attack?
该如何断定胸口疼之外的这些症状，实际上来源于心梗呢？
If your symptoms come on suddenly, or if they worsen over a period of hours or days, you should assume they are caused by a heart attack and go to an emergency room.
如果症状突如其来，或者在几小时或几天的时间里加剧，就应该认为它们是由心梗诱发的，应当去急诊室求医。
Do women have different symptoms than men?
女性的症状会与男性不同吗？
Probably not, but women are more likely to delay seeking help and doctors are more likely to dismiss their symptoms. That is especially true if the woman is younger, Dr. Walsh said. Women tend to on average have heart attacks about 10 years later than men, so doctors may dismiss worrisome symptoms in middle-aged women.
可能不会，不过女性推迟求助，以及医生对她们的症状不予理会的可能性都更高。沃尔什表示，如果女性更年轻一些尤其如此。女性患心梗的时间往往比男性平均晚大约10年，因此医生可能会对中年女性的一些令人担忧的症状不予考虑。
What should you do if you are having heart attack symptoms?
如果有心梗症状应该怎么办？
Call 911 for an ambulance to take you to the emergency room immediately. Do not try to drive yourself or have a friend or family member drive you. Paramedics can take an electrocardiogram on the way to the hospital that shows if you are having a heart attack and transmit it to the hospital. So as soon as you arrive, the medical staff is prepared and waiting. The paramedics can also administer oxygen and medications to ease your pain before you reach the hospital. And an ambulance is less likely to get stuck in traffic.
打急救电话，请对方立即派救护车接你去急诊室。不要试图自己开车，或是让朋友或家人开车送你去。急救护理人员可以在去医院的路上给你拍心电图，并将其传给医院。心电图能显示你是不是心梗发作了。因此，你一到医院，医务人员就已经准备就绪，在等候了。急救护理人员还能在你到达医院之前，给你输氧并提供缓解疼痛的药物。同时，救护车堵车的可能性也更小。
How can you find out if your local hospital is able to treat heart attacks quickly?
怎么能知道当地的医院是否有能力快速治疗心肌梗塞？
Time is of the essence when you are having a heart attack, and while most hospitals today are much quicker than they were a decade ago, some are faster than others. Often, paramedics know which hospital is best and will take you there. You don’t want to waste time fighting with paramedics when you are having a heart attack. “I have had patients drive three hours to come to my hospital when they were in the middle of a heart attack because they thought they needed to come to a big medical center,” Dr. Walsh sayid. “If paramedics say, ‘We’ll get you to this hospital,’ go,” she added.
心梗发作时，时间至关重要。尽管现在大部分医院的行动都比十年前更迅速了，但其中一些还是比其他的更胜一筹。通常，急救护理人员知道哪家医院最好，并会把你送到那里去。心梗发作时，你是不希望把时间浪费在和急救护理人员斗争上的。“我有病人心梗发作了还自己驱车三小时来我所在的医院，因为他们认为自己需要来大型医疗中心，”沃尔仕说。“如果急救护理人员说，‘我们会送你去这家医院，’那就去吧，”她接着说。
There is no national registry you can consult to find out how long it takes the hospitals in your area to open a blocked coronary artery with a balloon after your arrival at the emergency room. These statistics — known as door to balloon time — are generally measured by the hospital’s median time, which is the point at which half are opened faster, and half slower. If you want to know your hospital’s median door to balloon time, you will have to call each one and ask for it. If they do not provide it, you can ask if they take certain steps that speed treatment. Do paramedics transmit a patient’s electrocardiogram from the ambulance en route to the emergency room? Does the emergency room doctor read the EKG and send out a single call to summon the cardiology team? Are the team members on call required to be within 30 minutes of the hospital?
目前没有全国性的登记资料供你查询，以了解在到达急诊室后，你所在地区的医院要用多久才能替你打通被阻塞的冠状动脉。这些统计数据，即从入院到血管打通的时间，一般是用医院的中位数时间来衡量的。以这个时间为标准，一半比它快，一半比它慢。如果想知道你要去的医院的中位数时间，你得挨个打电话问。如果医院拒绝提供，你可以问问它们会不会采取某些加速治疗的措施。在去急诊室的路上，急救护理人员会从救护车上传输患者的心电图吗？急诊室的医生会读取心电图并用一个电话就叫来心脏病医疗团队吗？待命的团队成员会被要求在30分钟之内赶到医院吗？
What are the symptoms of a severely narrowed aortic valve?
主动脉瓣严重狭窄有什么症状？
Cardiologists say there are three classic symptoms of this disease of aging: shortness of breath, a feeling of heaviness and pain in the chest, and fainting. Such symptoms are often mistakenly attributed the normal process of slowing down that comes with old age. Six months ago, an 85-year-old woman might have been driving a car and doing her own grocery shopping, said Dr. Michael Mack of Baylor Health Care System. Now she is doing none of those things. Her children notice but say: “Well, she’s 85. What do you expect?” If a doctor is consulted, he or she may chalk it up to anemia or a thyroid problem. Many older adults with severe aortic valve disease are never diagnosed, said Dr. Howard Herrmann of the University of Pennsylvania.
心脏病医生表示，这种老年病有三种典型症状：呼吸急促、感到胸闷胸口疼、昏厥。这种症状往往会被错误地归咎于伴随衰老而来的正常的行动迟缓。六个月前，一个85岁的老太太可能还自己开车去采购食品杂货，拜勒医疗保健系统(Baylor Health Care System)的迈克尔·麦克(Michael Mack)说。现在，这些事情她一样都做不了。她的孩子注意到了，但会说：“毕竟她都85了，还能指望什么？”如果咨询医生，可能会把这归结于贫血或甲状腺问题。宾夕法尼亚大学(University of Pennsylvania)的霍华德·赫尔曼(Howard Herrmann)说，很多患有严重的主动脉瓣疾病的老年人从未被诊断出来。
How can a doctor know if symptoms are caused by a narrowed aortic valve?
医生怎么知道症状是不是主动脉瓣狭窄造成的？
The doctor can hear a heart murmur in the patient’s chest. An echocardiogram can reveal the narrowed artery and the extent of the damage.
医生能听到患者的心脏杂音。超声心动图能显示动脉变窄，以及受损的程度。
Should everyone with a severely narrowed artery have it replaced?
所有主动脉瓣严重狭窄的人都应该更换主动脉瓣吗？
Now that there is a procedure, transcatheter aortic valve replacement, or TAVR, that allows doctors to replace valves without doing open-heart surgery, high risk patients who would have been considered at too great a risk of dying from open-heart surgery have a chance to have a valve replacement. But, Dr. Herrmann cautioned, some patients are still too frail to benefit or have another disease like cancer or dementia that limits life expectancy.
有一种手术叫经导管主动脉瓣置换术（transcatheter aortic valve replacement，简称TAVR），能让医生不做开胸手术就置换掉瓣膜。这样，被认为可能死于开胸手术的高危患者，就有换瓣膜的机会了。但赫尔曼告诫，一些患者还是会因为太过虚弱，而无法从这种手术中获益，也可能同时患有癌症或失智等其他缩短预期寿命的疾病。
