Qaphela izifo ze-cardiologists ezicabanga "ngendlela yendabuko"
Indlela esicabanga ngayo ngeCoronary Artery Disease (CAD) kanye nokwelashwa kwayo kuphakathi kokushintsha okukhulu, futhi namhlanje, ezinye izazi ze-cardiologists zithuthele ngokuphelele "endleleni entsha" yokucabanga, kanti ezinye zisezintweni "zendabuko . " Ukungafani phakathi kwalezi zikole ezimbili zokucabanga kucacisa kakhulu ukuphikisana okwenziwe phakathi kwezintatheli zenhliziyo mayelana nokuthi ubani ozohlola i-CAD, indlela yokuzihlola, okudingeka aphathwe nge-CAD, nendlela yokuphatha ngayo.
Ngeshwa, odokotela basesebenze ngendlela yokucabanga engabikho emkhunjini - futhi ngenxa yalokho, bafaka iziguli zabo eziningi kokubili ukuzinikela nokwephulwa ngokweqile.
Indlela Yendabuko Yokucabanga Nge-CAD
Ngokwesiko, i-CAD isho ukuthi kunezingcingo ezilodwa noma ngaphezulu emithanjeni ye- coronary . Lezi zingqimba zingavimbela ukugeleza kwegazi, okungaveza ukwanda kwe-angina (ukuhlukumeza kwesifuba), futhi, uma kunzima, ama-blockages angakwazi ukuphelela ngokuzenzakalelayo, okwenza ukuba imisipha yenhliziyo ihlinzekwe yilo mshini wokufa, okubizwa ngokuthi "i-infarction ye-myocardial" noma ukuhlasela kwenhliziyo . Njengoba inkinga enkulu ukuvimbela, ukwelashwa okuyinhloko ukukhulula ukuvinjelwa, okungahle kwenziwe ngokuhlinzeka nge- bypass noma ukuphoqa . Umbono wendabuko we-CAD, ke ugxile ekuvinjeni, okusho ukuthi indawo enembile ye-anatomic kanye ne-degree of blockages ibalulekile ekuhloleni i-CAD. Izivivinyo zokuxilonga ezinganikezi lolu lwazi kanye nokwelashwa okungakusizi ukuvimbela amabhulogi akwanele ngokwanele.
I-cardiologists ecabanga ukuthi ngokwejwayelekile bavame ukugxila ekhatheni yezinhliziyo njengesivivinyo esisodwa esanele sokwelapha kanye nokugcoba njengendlela yokwelashwa okwanele kuphela, nakuba bayovuma ukuthi ngezinye izikhathi udokotela ohlinzayo we-cardiac kudingeka abe yingxenye yokuvimbela ngokukhethekile noma okunzima.
Indlela entsha yokucabanga nge-CAD
Manje siyazi ukuthi i-CAD ingaphezulu kakhulu kunezingcingo kuphela. I-CAD isifo esingapheli, esiqhubekayo esivame ukusabalala kakhulu emithanjeni ye-coronary kunokuba kuboniswe ukutholakala noma ukungabikho kwamabhulogi wangempela. Ama-plaque ngokuvamile akhona emithambo yegazi ebonakala "evamile" ekusebenzeni kwe- cardiac catheterization . Eqinisweni, ezinye iziguli, ikakhulukazi besifazane , zingaba ne-CAD evamile eveza ukusabalalisa okujwayelekile kwemithambo ye-coronary ngaphandle kokuvimbela kwangempela. Ngaphezu kwalokho, ukuhlaselwa kwenhliziyo kukhishwa uma i-plaque iphuka futhi ibangela i-clot ukuba yenze ngokungazelelwe ivimbele umthambo - futhi ngokuvamile lokhu kwenzeka emigqeni engabangela ukuvinjwa ngaphambi kokuphuka kwayo futhi bekuyobizwa ngokuthi "ayibalulekile" ekusebenziseni i-cardiac catheterization. Isihluthulelo ku-CAD akusiyo ukuthi ngabe kukhona ukuvimba okuqondile, kodwa ngabe ama-plaque womugqa we-coronary (okuvame ukungabangeli ukuvimbela okuphawulekayo) akhona.
Lokhu kusho ukuthini lokhu
Nakuba ukuvimbela kwangempela kungabangela ukuhlaselwa kwe-angina nenhliziyo kanti ngenkathi ukwelapha ukuvimbela okukhethekile kubalulekile, ukwelashwa okuhloswe ekuphatheni ukuvimbela imvamisa ngokuvamile akudingekile futhi akumele ukondle ngokwanele i-CAD. Ubufakazi bakha ukuthi ngelashwa olunzulu lwezokwelapha - ngokuyinhloko ngokusekelwe ezithombeni kodwa kufaka phakathi ukuguqulwa kwesimo sezinto ezinobungozi - i-CAD ingagqanyulwa noma ibuye iguqulwe, futhi ama-plaque angakwazi "ukuqiniswa" ukunciphisa izinkinga abazoziqeda.
Kulabo bantu ngabanye, ukuzivocavoca , ukuyeka ukubhema , ukulahlekelwa isisindo, ukulawula ukucindezeleka kwegazi kanye (ochwepheshe abaningi bakholelwa) ukulawula kwe-cholesterol kubaluleke kakhulu.
Isihluthulelo, ke, ukunquma ukuthi ngabe umuntu kungenzeka abe ne-CAD esebenzayo, okungukuthi, ngabe ama-plaque kungenzeka abekhona, bese eqondisa ukwelashwa ngokufanele. Ngokwezinga elikhulu, ukukhetha ukuthi amakhemikhali angase abe khona kungenziwa kungenasidingo. Qala ngokuhlola okulula kwengozi ukukhetha ukuthi ingozi yakho iphansi, ephakathi noma ephezulu. ( Nansi indlela yokuhlola ingozi yakho ngokulula futhi kalula .) Abantu abasemagabeni aphansi kakhulu kungenzeka bangadingi ukungenelela okunye.
Abantu abasengozini enkulu kakhulu kufanele baphathwe kabi (nge-statins kanye nokuguqulwa kwezinto ezinobungozi), njengoba kungenzeka ukuthi babe namacwecwe. Abantu abasigaba sengozi eseceleni kufanele bacabangele ukuhlolwa okungenakuvunywa nge- EBT ukuskena (ama-calcium scans) : uma i-calcium deposits ikhona emithanjeni ye-coronary, khona-ke ibe nemigqomo futhi kufanele iphathwe kabi.
Nini Ukufuna I-Blockages
Ama-blockages emithanjeni ye-coronary ayabalulekile. Iningi labachwepheshe bacabanga ukuthi abantu abasengozini ephezulu kufanele babe nokuhlolwa kwe-thallium yokucindezeleka . Uma lokhu kuhlolwa kuphakamisa ukuvinjelwa okukhulu, ukuphahlazeka komzimba kufanele kucatshangelwe. Isivivinyo sokucindezeleka noma i-catheterization ye-cardiac kufanele futhi ihlolwe ngokujulile kunoma ubani (kungakhathaliseki ukuthi yiyiphi inhlekelele ebonakalayo) enezibonakaliso ze-angina. Ukunciphisa ukuvinjelwa ngokuhlinzwa noma ukugcoba kungaphumelela kakhulu ekwelapheni i- angina futhi, kwezinye izimo, kungathuthukisa ukusinda.
Isifingqo
Ukucabanga kwethu nge-CAD kushintshile kakhulu eminyakeni eyishumi edlule noma ngaphezulu. Akuyona nje isifo se-blockages okufanele siphathwe nge-stents. Ukwelapha okuhloswe ukuvimba noma ukuguqula i-CAD engapheli futhi ekuqinisekiseni amapulangwe ukunciphisa izinkinga abazoziqeda, kubaluleke kakhulu, kungakhathaliseki ukuthi iminyango "ebalulekile" ikhona noma cha.
Imithombo:
Ibutho Lemisebenzi Ye-USPreventative. Ukuhlolwa kwe-coronary heart heart: isitatimende sokuncoma. Ann Intern Med 2004; 140 (7): 569.
Naghavi M, Falk E, Hecht HS, et al. Ukusuka ku-plaque esengozini kuya esigulini esengozini: Ingxenye III. Ukwethulwa kwipharadigm entsha yokuvimbela ukuhlasela kwenhliziyo; ukuhlonza kanye nokwelashwa kwesiguli esinesifo esibucayi. Ukuhlolwa kwe-Heart Attack Prevention and Education (SHAPE) umbiko weqembu lomsebenzi. Isifinyezo esiphezulu. Am J Cardiol 2006; I-DOI: 10.1016.