Heart damage
Visceral injury, acupuncture and heart damage is the most serious consequence of a kind. “Q • After attending to the end of” yes “center who ring die,” said the ring die, refers to one day die. Modern domestic accident injuring about acupuncture heart first appeared in 1954 in the report [1], have so far been reported in six cases, including five deaths. Abroad, regardless of Europe, America and Japan, both of these accidents. Especially in Japan, is not rare. Acupuncture injure the heart, although its incidence is not high, but the prognosis is extremely poor, so acupuncture practitioners must not be taken lightly.
[Injury]
Due to cardiac surface is smooth, hard and tough, but also in the pulsating state, generally difficult to hurt. Acupuncture therapy, stab the heart because there are basically the following:
An acupoint reasons: the heart of the second to the eighth rib between the ribs, was a little flat after the cone, left left anterior midline, the right to the right midclavicular line. In this surface projection area the city, except in front of the sternum and costal protection, behind the spine, esophagus, less susceptible to direct damage acupuncture, the remaining parts of the points, such as the thorn improper, are likely to hurt the heart.
(A), easily lead to heart damage parts: Bilateral God letters, step Gallery, lingxu left the Ying window, milk roots. Dovetail points, is also prone to accidents points. Generally, the points common to the chest, it is because the heart bulging front, from the skin surface close, so adults only about 4cm.
(Two), may result in damage points: Bilateral of Xinyu, Governor Yu, Geshu and left the stage door, the words meaning words hi, diaphragm clearance. Far away from the heart of the back surface, the middle and across the lungs, only acupuncture can occur only when the deeper and often simultaneously damage the lungs and heart.
Second, the pathological reasons: When the heart itself is sick, the possibility of injury acupuncture will be greatly increased. Cardiomegaly or pericardial effusion, can stab Road shorter, while the surface projection area increases, which could cause damage caused increase in the number of points. Myocarditis, due to myocardial inflammation, degeneration and necrosis, organizational structures often become very loose, so that the tip will tend to impair myocardial tissue. Pericarditis, especially constrictive pericarditis, cardiac visceral and parietal adhesions, thickening and calcification, pericardial cavity occlusion become a fibrous scar tissue shell, the surface became very rough, resulting in easy needle stabbed.
Third, the operation reasons: (a), improper practices: 1. Acupuncture too deep in the wrong direction. Chest chest wall is thin, almost from the heart, deep puncture is easy to mistakenly. Or acupuncture, charge hand too heavy, barbed Road shorter, even thorns are not deep enough, can also cause damage. There are only 1.5cm in length of the needle, leading to right ventricular rupture death. Acupuncture in the wrong direction, can make non-cardiac projection points within the region, such as dovetail cavity Shi needle, it will also hurt the heart. 2 needle too long, needle-stick injuries when the heart, the heart continued for autonomy as contraction and relaxation, over time, will lead to the heart wall cracks tend to continue to increase, the occurrence of mechanical heart rupture.
(Two), Cave buried needles: This refers mm needle into the points, inadvertently broken on the inside; or for intentionally cut pin tail, buried in the Cave, which is more common in Japan. Needle buried in the body and damage the heart walk. This situation can occur shortly after the needle buried, can also be separated more than a decade later. Pin parts are often buried near the heart or activity related to the size.
Fourth, the indirect causes: relatively rare. Have occurred in patients with newly diagnosed severe cardiovascular disorders, because do not understand acupuncture, excessive stress, fear, causing heart damage. Such as Japan, one case of elderly patients in their stomach disorders acupuncture treatment process, sudden death. Necropsy confirmed to be in the state of the aortic arch atherosclerosis rupture, causing hemopericardium the rules.
Clinical manifestations
Acupuncture damage the heart, one of the major blood vessels stab the heart, a heart wall directly punctured. Pathological changes can cause two types: one is bleeding, hemorrhagic shock caused not only easy, but also because of acupuncture-induced cardiac gap is small, pericardial hemorrhage difficult to discharge, oppress the heart, resulting in cardiac tamponade phenomenon. Such as acupuncture hurt coronary artery, it can lead to myocardial ischemia and heart failure. Another type of cardiac function, multi-functional structure due stabbed heart, causing arrhythmia, reduced cardiac output, pulmonary edema, heart failure.
The main symptoms in acupuncture immediately or soon after injury, precordial pain, height shortness of breath, cyanosis, transient syncope, fainting episodes can occur when the limbs, convulsions, apnea, etc., as well as shock, and even cardiac arrest. Such as cardiac tamponade, showing pale, shortness of breath, such as smothering, restlessness, weak pulse, heart sounds distant and insignificant. X-ray examination showed: increased heart shadow, pericardial full, weak heartbeat.
Such as heart damage, then see severe arrhythmia, palpitations, chest tightness, and even heart failure. For intramuscular needle caused by sudden cardiac patients pain syndromes, and quickly went into shock. Because often without aura, and the one o’clock finding out reasons, misdiagnosis, causing doctors who require special attention.
[Prevention]
First, grasp the heart of the city projection area point distribution: not only be familiar with the normal circumstances, but should be aware of heart disease when the points involved. In the choice of the projection area points when it is prudent precise and appropriate.
Second, strict control of needling depth and direction: Although the heart has a certain distance away from the chest, but the chest and back projection area of acupuncture points should be according to the conventional depth, or prone to accidents. Also note that acupuncture direction, chest cavity, the rib edge spines or piercing; points back to the side of the spine obliquely (specific needling depth and may refer to “pneumothorax” section). Dovetail points, may be due to a different direction and depth of damage to the heart and liver, respectively, stab the hole, it is desirable piercing tip slightly downward, depth of not more than one inch, in order to prevail without piercing the peritoneum, into the needle, send needle should be slow, gentle way, to prevent accidents, we must put an end to every garment needle.
If one case of 19-year-old woman, the Department of schizophrenia. Dovetail in acupuncture points, take the 2-inch needle xiphoid half inch vertical needle, to raise the level of the sternum midline stab an inch, with the G6802-type therapeutic apparatus is energized, connecting music pool and dove tail needle handle, see Dovetail needle beating obvious. A few minutes later the patient suddenly screamed, head thrown back, eyes on the turn, and vomiting. Soon needle injection, see the patient has lips cyanosis, breathing and heartbeat have stopped. The chest cardiac massage, heart breathing has recovered, but continued coma. The end result of severe pulmonary infection and death [2].
Third, pay close attention to the needle cases: chest and back points, needle retention time should not be too long, generally not to exceed 15min, operation, non-violent re-inserted mention to twirling based, with a slight lift and thrust. Needle retention period, the patient is asked to maintain their position, can not be changed, respiratory rhythm should be smooth symmetry, if any, coughing, sneezing, etc., should be returned to the subcutaneous needle. Once you see the pin tail swing rhythm occurs, or if the needle body has pulse or breathing exercises with the corresponding round of the scratch, then the show has been and heart touching needle, the needle should be rapid retreat.
In order to avoid damage the heart or other accident, do not use needle or needle buried cavity, the domestic current push pin needle buried, but also with caution. Should prevent needle acupuncture fold.
[Processing Method]
Where there are clinical signs of heart damage, immediately go to the pin, and rushed medical rescue. Including absolute bed rest, sedation, oxygen, apply cardiac diuretic drugs, such as limiting water intake to prevent heart failure. In case of shock, should anti-shock treatment. Such as severe injury, cardiac rupture, bleeding, you should immediately transfer surgery, thoracic surgery when necessary, to mend damaged heart wall clear pericardial hemorrhage.
Heart damage, must race against time, without delay. There is a 28-year-old male patient with chest acupuncture (note: the original name does not indicate specific points) after 2h feel chest tightness, palpitation, general malaise, then without any treatment. Until the needle after 10h, patients with cold sweat, thirst, cold limbs. Blood pressure is 9.3/5.4kpa (70/40mmHg), the pulse reached 136 beats / min, was sent to hospital for treatment. Result, emergency admission heartbeat has stopped. After thoracotomy, see pericardial extreme swelling, blood clots within about 700ml, left ventricular anterior wall three spurting hole, He died to death. Loss of treatment time [1].
In short, heart damage, the potential acute and critically ill, requiring doctor without delay, resolute decision, rushed disposal.