Enye indlela abesifazane abangakwazi ukuzwa ubuhlungu besifuba nge-"normal" corridary arteries
Ngenkathi isifo se-coronary artery (i-CAD) sibalulekile kubesifazane njengabantu, izici eziningana zingenza i-CAD ibe nzima nakakhulu ukuxilongwa kwabesifazane. Enye yalezi zici "i-pattern-female" ye-CAD. E-female-pattern CAD, i- coronary angiography - "i-standard standard" yokuthola i-CAD - ivame ukuchazwa ngokuthi iyinto evamile.
- I-female-pattern CAD ingenye yezimo eziningana ezingaveza i-CAD nge-"normal" corterary arteries. Funda lapha mayelana nabanye.
Phakathi nenqubo yesifo eyaziwa ngokuthi i- atherosclerosis , i-artery coronary's smoothness, elastical yinkimbinkimbi iba lukhuni, inqwabelene futhi ivuvuke nazo zonke izinhlobo "zeglue" - kubandakanya i-calcium deposits, ama-fatty deposits, namaseli angavamile okuvuvukala. I-antherosclerosis ngokuvamile iyinkqubo ejwayelekile kakhulu eyenza ukuthi ikhiqize amapulethi ahlukene. Lezi zingqimba, ezingacatshangwa ngokuthi "izimpumputhe" ezinkulu ezifake esiteshini somcibisholo, ngokuvamile zibangelwa ukuvinjwa kwamakhemikhali ngaphakathi komthambo. (Imvelo yabo yendawo eyenza ukuba bakwazi ukuhlinzeka ngemithi nge- angioplasty , stents noma ukuhlinzwa okudlulayo .) Iziguli ezine-CAD zingase zibe ne-plaque eyodwa noma ezimbili kuphela, noma zingase zibe nezinqwaba ezihanjiswa kuzo zonke izifo zomzimba.
Kwabesifazane abane-CAD yesifazane , i-atherosclerosis ayifaki ama-plaque ahlukene, ngakho-ke ama-blockages asendaweni ayengekho. Esikhundleni salokho, ama-plaque kulawa besifazane ahlukana kakhulu, afaka phakathi kwesinye isizinda sonke se-artery, ukuze uhlaka lwe-artery luthinteke kulo lonke.
Ngenkathi kungekho ndawo eqondayo yokuvimba, umjikelezo wangaphakathi we-artery uba mkhulu kakhulu. Nge-catheterization ye-cardiac i-coronary arteries ibonakala ibushelelekile futhi ijwayelekile ngokwejwayelekile (nakuba ingase ivele ivele ibe "encane" ububanzi).
Ukuchazwa kwabesifazane abanesimo se-female CAD kucatshangwa ukuthi kungcono kune-CAD ejwayelekile, kodwa lokhu akuyona isimo esibucayi.
Ukuhlasela kwenhliziyo nokufa kwenzeka.
Ngokuqondile, i-female-pattern CAD ingabangela i-coronary syndrome (AcS) . I-ACS iyenzeka ngoba ama-plaque ahlakazekayo angahle aphule futhi aqhekeke (njengama-plaque adidayo enza ku-CAD ejwayelekile kakhulu), okwenza igazi liguqulwe ngaphakathi komthambo futhi likhiphe ukuvinjelwa okungazelelwe kwe-arterial. Uma i-clot isilahlekelwa izidakamizwa, i-catheterization elandelayo yezinhliziyo ibonisa ukuthi imishanguzo "evamile" ye-coronary ishicilelo efana ne-female-CAD iphethini, ngaleyo ndlela iphazamise isazi sezinhliziyo.
Indlela-iphethini yama-CAD ihlolwe kanjani?
Ukuxilongwa kwe-pattern-female CAD kungenziwa ngokucacile ngenqubo entsha ebizwa nge-intravascular ultrasound (IVUS). I-IVUS (engavamile ukuyenza ngesikhathi sokugaya, futhi engatholakali ngisho nasezibhedlela eziningi) idinga ukufaka i-catheter ekhethekile emgodini we-coronary esebenzisa i-ultrasound (isib. I- echocardiography ) ukubona ngeso lengqondo udonga lwe-artery ngaphakathi. Amacwecwe ahlukanisa i-pattern-female CAD angabonakala ngale ndlela. Esicwaningweni samuva, ngaphezu kwengxenye yabesifazane abanezimpawu ze-angina ezinemithambo ye-coronary "evamile" kwakunezigcawu ezinjalo ezaziwa ngokusetshenziswa kwe-IVUS.
Ukuba khona kwe-female-pattern i-CAD kungenziwa ngokulinganisa ikhono le-artery coronary ukuze linciphise ngokuphendula umuthi okuthiwa i-acetylcholine. Imishanguzo eqinile ebonwe ku-pattern-female CAD ihluleka ukudlula ngokujwayelekile.
I-female-pattern CAD kufanele icatshangelwe kunoma yiliphi owesifazane oye waba ne-angina noma i-ACS, kodwa ubani onomzimba "ovamile" we-coronary arthritis on the catheterization cardiac.
I-pattern-Female CAD iphathwe kanjani?
Ngenxa yokuthi ukunciphisa imithanguzo ye-coronary e-female-pattern CAD ihlukanisa, izindlela zokwelapha ezihloswe ekunciphiseni izivimbelo zendawo - njenge-angioplasty, i-stents, nokuhlinzwa ngokudlulela - ngokuvamile ayisebenzi.
Esikhundleni salokho, ukwelashwa kufanele kube yidokotela. Ukwelashwa okuphelele kwalesi simo akukaze kuchazwe, kepha indlela eningi yokwenyuka ibonakala iyona engcono kakhulu ngalesi sikhathi, futhi kufanele ihlanganise ukuguqulwa kokuguqulwa kwesisindo , ukwelapha ukunciphisa ingozi yokugcoba (aspirin), kanye nezidakamizwa ukuvikela isisu senhliziyo ngokwayo (beta blockers futhi mhlawumbe i-ACE inhibitors). Abacwaningi manje sebegxile ekuqapheliseni i-CAD yesifazane-iphethini, futhi ukuqonda okungcono kwalesi simo futhi ukwelashwa kwayo kungenzeka kakhulu esikhathini esizayo.
Okwamanje, uma ungowesifazane oye waba nobuhlungu besifuba se-angina kodwa isifundo sakho se-catheterization yamagciwane siye sabonisa imishanguzo ye-coronary "evamile", wena nodokotela wakho kufanele uqaphele ukuthi umsebenzi wakho awukakapheli. Kulesi silungiselelo, isifundo "sokujwayelekile" sokufunda nge-angiography asikhiphi inkinga yenhliziyo. Esikhundleni salokho, kusho ukuthi uphenyo olwengeziwe luyadingeka ukuze uthole imbangela yezibonakaliso zakho.
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I-CJ ene-Pepine, Ischemic isifo senhliziyo kubantu besifazane: amaqiniso nokucabanga okufisa. J Am Coll Cardiol Pepine 43 (10): 1727.