I-angina engazinzile iyisibonelo se- angina esenzeka ngokungahleliwe noma esingenakuqaphelwa futhi asihambisani nanoma yisiphi isiqalo esicacile njengokwenza ngokomzimba noma ukucindezeleka ngokomzwelo. I-angina engazinzile ifomu le -coronary syndrome elimangalisayo (ACS) , futhi njenge-ACS, i-angina engaqiniseki kufanele ibhekwe njengesimo esiphuthumayo sezokwelapha.
Sibutsetelo
U-Angina uthathwa ngokuthi "engazinzile" uma engasalandeli amaphethini okubikezelayo afanekisela " angina ozinzile ." I-angina engazinzile ihlukaniswe ngokuthi "engaqiniseki" ezimweni ezimbili.
Okokuqala, ngokungafani nama-angina azinzile, izimpawu zenzeka ngendlela ehleliwe futhi engaqondakali. Ngenkathi e-angina esinezinzile, izimpawu ngokuvamile zilethwa ngokuzikhandla, ukukhathala, intukuthelo, noma olunye uhlobo lokucindezeleka, ezimpawu ezinama-angina ezingaguquki zingenza (futhi ngokuvamile ziyenze) ngaphandle kokuqala okubonakalayo. Empeleni, i-angina engazinzile ngokuvamile ivela ekuphumuleni, futhi ingabavusa ngisho nabantu abalele ngokuphumula. Ngaphezu kwalokho, engangeni engazinzile, izimpawu zivame ukuqhubeka isikhathi esingaphezu kwemizuzu embalwa nje, futhi i- nitroglycerin ngokuvamile ihluleka ukukhulula ubuhlungu. Ngakho: i-angina engazinzile "ayizinzile" ngoba izimpawu zingase zenzeke kaningi ngaphezu kokuvamile, ngaphandle kwanoma iyiphi i-trigger ebonakalayo, futhi ingaqhubeka isikhathi eside.
Okwesibili, futhi okubaluleke nakakhulu, i-angina engazinzile "ayizinzile" ngoba, njengezinhlobo zonke ze-ACS, kuvame ukubangelwa ukuqhuma kwangempela kwe- plaque emgodini we- coronary . E-angina engazinzile, i-plaque ephukile, ne-clot yegazi eseduze njalo ehlotshaniswa nokuphuka, okhiqiza ukuvinjelwa okuyingxenye yomthamo.
Ukuvinjelwa okuyingxenye kungathatha iphethini "lokugubha" (njengoba i-clot yegazi ikhula futhi iyancipha), ikhiqiza i-angina ezayo futhi ihamba ngendlela engafaneleki. Uma i-clot ingabangela ukuvinjelwa okuphelele kwe-artery (okwenzeka ngokuvamile), imisipha yenhliziyo ehlinzekwa yilo mshini ochaphazelekayo isengozini enkulu yokugcina umonakalo ongenakugwema.
Ngamanye amazwi, ingozi eseduze ye- infarction ye-myocardial ephelele kakhulu e-angina engaqiniseki. Ngokusobala, isimo esinjalo "asizinzile," futhi ngenxa yalesi sizathu siphuthumayo sezokwelapha.
Izimpawu
Noma ubani onomlando we-coronary artery disease kufanele akhohlwe i-angina engaqiniseki uma i-angina yabo iqala ukuvela emazingeni aphansi okusebenza ngokomzimba kunokuba evamile uma kwenzeka ngesikhathi sokuphumula uma kuqhubeka isikhathi eside kunokujwayelekile uma kunzima kakhulu ukukhulula ne-nitroglycerin, noma ikakhulu uma livusa ebusuku.
Abantu abangenawo umlando we-coronary artery disease bangase bahlakulele i-angina engazinzile. Ngeshwa, laba bantu kubonakala sengathi besengozini enkulu yokuhlaselwa yinhliziyo ngoba, ngeshwa, ngokuvamile abaqapheli izimpawu njenge-angina. Izimpawu zakudala ze-angina zihlanganisa ukucindezela kwesifuba noma ubuhlungu, ngezinye izikhathi ukucindezela noma "obuthakathaka" obunjalo, ngokuvamile kuvame ukufika emlonyeni noma ngakwesokunxele. Ngeshwa, iziguli eziningi ezine-angina azikho izimpawu zakudala. Ukukhathazeka kwabo kungaba mnene kakhulu futhi kungenziwa endaweni yangasemuva, isisu, amahlombe, noma noma yiziphi izingalo zombili. Ukukhathazeka, ukuphefumula, noma umane nje umuzwa wokuphuza isifo kungase kube uphawu olulodwa kuphela. Lokho okushoyo, ngokuyinhloko, ukuthi noma ubani oneminyaka ephakathi noma ngaphezulu, ikakhulukazi noma ubani onezici eziningi eziyingozi zokugula komzimba, kufanele aqaphele izimpawu ezingase zimelele i-angina.
Uma ucabanga ukuthi kungenzeka ukuthi ungase ube nama-angina angaguquki, udinga ukuya kudokotela wakho, noma ekamelweni eliphuthumayo, ngokushesha.
Ukuxilongwa
Izimpawu zibaluleke kakhulu ekwenzeni ukuxilongwa kwe-angina engaqiniseki, noma impela, noma yiluphi uhlobo lwe-ACS. Ngokuyinhloko, uma unesinye noma izimpawu ezintathu ezilandelayo, udokotela wakho kufanele athathe lokho njengenkomba eqinile ukuthi uhlobo olulodwa noma olunye lwe-ACS lwenzeka:
- U-Angina ekuphumuleni, ikakhulukazi uma kuqhubeka imizuzu engaphezu kwengu-20 ngesikhathi
- Ukuqala okusha okukhanyayo okubeka ngokukhawuleka ikhono lakho lokuhlanganyela emisebenzini yomzimba
- Ukwenyuka kwe-angina esitebeleni, ngeziqephu ezivame kakhulu, ezinde isikhathi eside, noma zenzeke ngokunciphisa kancane kunaphambili
Uma udokotela wakho esola i-ACS, kufanele ngokushesha athole i- ECG kanye nokuhlolwa kwegazi ngokuhlolwa kwe- enzyme yenhliziyo .
Uma ingxenye ye-ECG eyaziwa ngokuthi "izingxenye ze-ST" iphakanyisiwe (ebonisa ukuthi umthambo uvinjelwe ngokuphelele), futhi izinyimba ze-cardiac zenyuka (okubonisa ukulimala kwamangqamuzana e-cardiac), "i-" enkulu "ye-myocardial infarction (MI) itholakala (ebizwa nangokuthi "ukuphakama kwesigaba se-ST," noma i- STEMI ).
Uma izingxenye ze-ST zingaphakanyiswa (kubonisa ukuthi umthambo awuvinjelwe ngokuphelele), kodwa izinyimba ze-cardiac ziyanda (okubonisa ukuthi umonakalo wamangqamuzana ukhona), i-MI "encane" ikhonjiswe (ebizwa nangokuthi "ingxenye engezansi ye-ST MI , "noma i- NSTEMI ).
Uma izingxenye ze-ST zingakhulumi futhi ama-enzyme ajwayelekile (okusho ukuthi umthambo awuvinjelwe ngokuphelele futhi akukho monakalo weseli okhona), i-angina engaqiniseki iyatholakala.
Ngokuphawulekayo, i-angina engazinzile ne-NSTEMI yizimo ezifanayo. Esimweni ngasinye, ukuqubuka kwamapayipi kwenzeka emgodini we-coronary, kodwa umthambo awuvinjelwe ngokuphelele okungenani ukugeleza kwegazi okunye kuhlala. Kuzo zombili lezi zimo, izibonakaliso ze-angina engazinzile zikhona. Umehluko kuphela ukuthi ku-NSTEMI umonakalo wesikhumba senhliziyo okwanele okwenzekile ukwenzela ukwanda kwezinyimba ze-cardiac. Ngenxa yokuthi lezi zimo ezimbili zifana kakhulu, ukwelashwa kwazo kufana.
Ukwelapha
Uma une-angina engazinzile noma i-NSTEMI, uzophathwa ngezindlela ezimbili ezijwayelekile: a) ukuphatha kabi izidakamizwa ukuze uqinise isimo, bese uhlola okungenasidingo, noma b) ukuphatha kabi izidakamizwa ukuze uzinze isimo, futhi hlela ukungenelela kokuqala okungenasisindo (ngokuvamile, i- angioplasty kanye ne-stenting).
Imithombo:
Hamm, CW, Braunwald, E. Ukuhlelwa kwe-angina engaqinisekisiwe kubuyekezwe. Ukujikeleza kuka-2000; 102: 118.
Meier, MA, Al-Badr, WH, Cooper, JV, et al. Ukuchazwa okusha kwe-infarction ye-myocardial: Ukuthola ukuhlonza kanye nokubikezelwa kweziguli ezinama-syndromes aconary acute. I-Arch Intern Med 2002; 162: 1585.