前不久，演员张晋在旅行中突发心脏不适的经历引发公众关注。其妻子蔡少芬在采访中透露，张晋 此前已有两次类似症状，但心电图检查显示"一切正常"，直至病情恶化才确诊冠状动脉堵塞近80%，紧 急接受支架手术。这一事件让不少人感到疑惑：明明心脏在"带病工作"，为何心电图还会显示正常？今 天，应急总医院心血管内科主任、副主任医师范煜东就此热点展开健康解读。 心电图虽好 也有局限性 很多人对心电图存在过度信任，认为"正常"就是"健康"。这种认知偏差源于两方面原因。 心电图普及性高 但有"局限性" 心电图作为记录心脏电活动的重要工具，通过将电极贴在皮肤表 面，精准监测心脏收缩、舒张时的电信号变化。它的优势十分显著，快速、无创、成本低，能够在短时 间内初步判断心律失常、心肌缺血等急性问题，为临床诊断提供重要线索。 冠状动脉微血管病变 冠状动脉的微血管如同细密的网络，为心肌细胞供血供氧。当微血管发生病 变时，会影响心肌的血液灌注。这种病变常见于糖尿病患者、女性。糖尿病患者由于长期高血糖的影 响，微血管容易受到损伤；而女性在激素水平变化等因素的影响下，也更容易出现微血管病变。患者常 表现为胸痛，但由于病变部位特殊，心电图往往正常， ...

Core Insights - Different age groups require tailored health check-up items to effectively monitor health risks and conditions [1] Group 1: Health Check-up Recommendations by Age - For individuals aged 30-40, the focus should be on monitoring blood pressure, blood sugar, and blood lipids due to lifestyle factors leading to obesity [3][4] - Women in this age group should prioritize gynecological and breast examinations, while men should start prostate checks after age 35 [6][7] - For those aged 40-50, cardiovascular diseases and cancer risks increase, necessitating heart-related tests and cancer screenings [6][7] - Individuals over 50 should begin screening for bone density and metabolic levels, as well as gastrointestinal diseases and cardiovascular conditions [9][11] Group 2: Common Misconceptions about Health Check-ups - It is a misconception that more expensive tests yield better results; the focus should be on tests that are appropriate for individual health needs [13][15] - Waiting until experiencing discomfort before getting a check-up is incorrect; regular check-ups are essential for early disease detection [15][17] - Post-check-up, it is crucial to thoroughly review the report and seek further medical advice for any significant findings [17][19]

Group 1 - The core focus of health check-ups varies by age group, with specific tests recommended for different age ranges [1][5][9] - For individuals aged 30-40, monitoring blood pressure, blood sugar, and blood lipids is crucial, with recommendations for semi-annual checks [2][3] - Women in this age group should prioritize gynecological and breast examinations, while men should begin prostate checks after 35 [4][6] Group 2 - For the 40-50 age group, cardiovascular health and cancer screenings become critical, as this period is identified as a "high-risk" health phase [5][6] - Recommended tests include cardiac ultrasounds, ECGs, and lung CT scans to screen for lung cancer, alongside breast and cervical cancer screenings for women [6][7] - Individuals with a family history of tumors should undergo early screenings [8] Group 3 - For those aged 50 and above, bone density and vascular health are emphasized, with a focus on osteoporosis and gastrointestinal diseases [9][10] - Regular screenings for bone density and gastrointestinal issues, including gastroscopy, are advised, along with cardiovascular health checks [10] - Eye examinations are also recommended for this age group [10] Group 4 - Common misconceptions about health check-ups include the belief that more expensive tests yield better results, which is not necessarily true [11][12][13] - It is incorrect to wait until feeling unwell to seek check-ups, as early detection is key to effective intervention [13] - Post-examination, individuals should carefully review their reports and seek further medical advice for any significant findings [13]

Core Viewpoint - The increasing prevalence of arrhythmia among young and middle-aged individuals is raising public awareness about heart health, with lifestyle factors being a significant contributor to this trend [2][3]. Group 1: Prevalence and Causes - Approximately 17 million people die from cardiovascular diseases globally each year, with about 25% of these deaths attributed to arrhythmia [2]. - The common types of arrhythmia in young and middle-aged individuals include sinus tachycardia, supraventricular tachycardia, and premature beats, which are often triggered by lifestyle factors such as stress, poor sleep, and excessive consumption of stimulants [2][3]. - Factors contributing to the rise in arrhythmia among younger populations include high stress levels, anxiety, irregular sleep patterns, sedentary lifestyles, obesity, and excessive use of electronic devices [2][3]. Group 2: Differentiating Arrhythmias - Physiological arrhythmias are typically transient and reversible, often occurring during specific conditions like exercise or stress, while pathological arrhythmias are more serious and persistent without clear triggers [4][6]. - Symptoms indicating the need for immediate medical attention include severe palpitations, chest pain, and fainting, especially in individuals with a history of heart disease [4][7]. Group 3: Lifestyle Improvements - Improving lifestyle choices is crucial for managing arrhythmia symptoms, with recommendations including maintaining a regular sleep schedule, managing stress, and reducing intake of stimulants like caffeine and alcohol [5]. - A balanced diet rich in electrolytes and regular moderate-intensity aerobic exercise are also advised to mitigate symptoms [5]. - Self-monitoring of heart health, including awareness of family history and regular check-ups, is essential for early detection and management of potential heart issues [5].

在这项最新的研究中，人工智能模型接受了23万名患者超过120万对的心电图-超声心动图的对照训练，以检测多种形式的结构性心脏病。此后，团队对近 85000名此前未做过超声心动图检查且正在接受心电图检查的患者使用了EchoNext筛查工具，EchoNext识别出超过7500名存在未确诊的结构性心脏病的高风 险。在这些被EchoNext认定为高风险的人群中，有超过一半人接受了超声心动图检查。结果显示，AI工具对结构性心脏病诊断的准确率高达77.3%。 研究团队将EchoNext模型与人类心脏病专家进行了比较，共有13位心脏病专家对3200份心电图的评估（其中1600份使用AI辅助，1600份未使用AI辅助，每 位心脏病专家平均评估了246份心电图）来诊断结构性心脏病。结果显示，在未使用AI辅助的情况下，心脏病专家的准确率为64%；在使用AI辅助的情况 下，心脏病专家的准确率提升至69.2%，但仍低于EchoNext模型检测的77.3%的准确率。 由于缺乏常规且经济有效的筛查测试，许多有结构性心脏问题的人直到心脏功能严重受损时才被发现。 早期发现结构性心脏病对于改善预后至关重要，但广泛筛查仍然受限于超声心动图等影像工 ...