Izindlela Zokungena Ngama-cardiovascular Without Symptoms Appeal
Ukuhlaselwa kwenhliziyo okuthukile kuyisifo senhliziyo esenzeka ngaphandle kokubangela izimpawu ezibonakalayo - noma okungenani, ngaphandle kokubangela izimpawu ezinzima kangangokuthi isisulu asikwazi ukuzinaki. Ukuxilongwa kwenziwa ngokuphindaphindiwe, uma ubufakazi be-infarction ye-myocardial (ukuhlaselwa kwenhliziyo) kutholakala ku- electrocardiogram kumuntu ongenawo umlando womtholampilo wokuba nesifo senhliziyo.
Ngokujwayelekile, laba bantu bathola ukuthi babona udokotela ngesizathu esingavumelani ngokuphelele.
Uma kugcinwa ukuthi ukuhlaselwa kwesifo senhliziyo kuqala, ngokuvamile isiguli kanye nodokotela bayamangala.
Sibutsetelo
Iningi lethu livame ukucabanga nge- infarction ye-myocardial (ukushaya kwenhliziyo) njengesenzakalo esihle kakhulu - futhi isikhathi esiningi, kuwukuthi. Isifo senhliziyo sivame ukuvela lapho i-plaque atherosclerotic kwenye ye- artery coronary iphela. Ukuphuka kubangela i-clot yegazi ukuthi ifake emthini, okuholela ekuvinjeni okunamandla. Imisipha yenhliziyo ehlinzekwa yi-artery evinjiwe ngokushesha iba yi- ischemic (ilambile oksijini), okuyinto evame ukuholela ebuhlungu besifuba noma ezinye izimpawu ezisabekayo. Ngaphandle kokuba ukuvinjelwa kukhululeke phakathi namahora ambalwa, isistimic heart muscle ifa. Kuyinto yokufa kwengxenye yesisu senhliziyo eyenza ukuhlasela kwenhliziyo.
Ngokuvamile, izimpawu ezibangelwa umthambo we-coronary ovinjiwe zinzima ngokwanele kangangokuthi abantu abaningi abanenkinga ngokushesha bafuna usizo lwezokwelapha.
Kodwa-ke, akuvamile ukuthi abantu bahlupheke izifo ezingekho emzimbeni ngaphandle kokubona izimpawu ezibaphoqa ukuba babone udokotela.
Izilinganiso zamanje zithi cishe u-20% wezinhlungu zenhliziyo azitholakali kuze kube yisikhathi ngemuva kokuba umcimbi usuphelile. Inkinga, yilokho ukuthi ukwelashwa okunamandla akunakunikelwa uma wonke umuntu engazi ukuthi kuhlasela isifo senhliziyo, futhi ukwelashwa okusheshayo kubalulekile uma inani lomonakalo wenhliziyo elibangelwa ukuhlaselwa kwenhliziyo kufanele linciphise.
Izimpawu Nezibonakaliso Ze-"Typical" Attack Heart
Abantu abaningi abanesifo senhliziyo bazi ngokushesha ukuthi kukhona okungahambi kahle. Ngokuvamile, bazwa ubuhlungu obukhulu besifuba noma olunye uhlobo lokungahambi kahle kakhulu kwesifuba esifubeni. Futhi ngenkathi ubuhlungu noma ukungakhululeki kungase kube "okwesibindi" (isibonelo, kungathinta intamo, amahlombe, noma emuva esikhundleni sesifuba uqobo), ngokuvamile kunzima ukuzinaki. Izimpawu ezingeziwe zivame ukukhona, okungase kuhlanganise nokuphuka emkhunjini obandayo , ukuphefumula, noma umuzwa wokulahlwa okuzayo. Ngamafuphi, ukuhlaselwa kwenhliziyo kuvame ukuba ngaphezu "kokubonakalayo" - ngokuvamile kuyinto ehlakaniphile njengokushaywa ebusweni yi-two-by-four.
Kungani Inhliziyo Enye Ihlasela Ngamazwi?
Njengoba kunikezwe lezi zimpawu ezivamile, kungase kusimangaze ukuzwa lokho, ngenxa yabantu abambalwa abantu abahlaselwa yinhliziyo, isifo senhliziyo "sithulile." Okusho ukuthi, ukuhlasela kwenhliziyo kwenzeka - umthambo we-coronary uvinjelwe i-clot yegazi kanti ezinye zezinhlanzi zenhliziyo ziyafa - ngaphandle kokuthi isisulu siqaphela ukuthi kukhona okwenzekayo ikakhulukazi.
Kunezizathu eziningana zokuthi kungani abanye abantu bengase bahlaselwe yinhliziyo ngaphandle kwempawu ebonakalayo. Lokhu kufaka:
- Abanye abantu banomthwalo ophansi kakhulu , noma ukubekezelelana okuphakeme kakhulu ngobuhlungu, futhi nje "abaqapheli" izimpawu ezingase kube nzima kithi sonke ukungasinaki.
- Izimo ezithile zezokwelapha - ikakhulukazi isifo sikashukela kanye nesifo esingenasifo sezinso - singathinta izinzwa ezithwala ukucindezeleka, ngakho-ke izimpawu ze- angina noma ukuhlaselwa kwenhliziyo ziyafiphala.
- Kwamanye abantu, i-ischemia yenhliziyo ingase ivele imane ibonise izimpawu ezingenasifo. Esikhundleni sokuthola ama-angina, ngokwesibonelo, bangase babone i- dyspnea (ukuphefumula okuncane) , ubuthakathaka besikhashana, noma ezinye izimpawu ezingekho ngqo ukuthi abantu abaningi abangeke baqonde ngokushesha inhliziyo yabo. Izimpawu ze-aytypical nge-ischemia yenhliziyo ikakhulukazi kubesifazane.
- Abanye abantu - ikakhulukazi uma izimpawu zingabonakali-zihle kakhulu ukungazinaki izibonakaliso nezimpawu zesifo senhliziyo , futhi ziyakwazi ukuzisusa ngenxa yokubanda, ukushaya inhliziyo , noma "into engiyidlile."
- Ubudala nobulili kuhlotshaniswa nokuhlaselwa kwenhliziyo. Ukuhlaselwa kwenhliziyo kungase kube nokuthula kubantu asebekhulile, ikakhulukazi labo abangaphezu kuka-75. Babonakala futhi ngokujwayelekile emadodeni kunabesifazane.
Uma ungeza zonke lezi zizathu up, kubonakala sengathi ukuhlaselwa kwenhliziyo eyodwa kwezingu-5 kuthula.
Ukubikezela kanye nokufa
Ungafa kunoma yikuphi ukuhlasela kwenhliziyo. Ngenkathi ukuphikisana okungaqondakali kungenziwa ukuthi uma kwenzeka ukufa kwenzeka ukuthi isifo senhliziyo asikwazi ukubhekwa "singathuli," kubantu abaningi abane-CAD isibonakaliso sokuqala noma izimpawu ababhekana nazo kusukela esimweni sabo kungukufa okungazelelwe . Ngempela, abantu abaningi abafa ngokuzumayo, ngaphandle komlando wangaphambili wezinkinga zenhliziyo, empeleni bane-CAD ephawulekayo - futhi kungenzeka ukuthi babhekana neziqephu eziningi ze-ischemia "engathuli," mhlawumbe ngisho nokuhlaselwa kwenhliziyo, ngaphambi kokuboshwa kwenhliziyo yabo ebulalayo.
Abantu ababonakala kahle kodwa bethola ukuthi ukuhlaselwa kwenhliziyo okuthule kubonakala sengathi banezibalo ezimbi kakhulu eziqhubekayo isikhathi eside kunabantu abahlaselwa yinhliziyo abayitholakaliswa futhi baphathwa ngokushesha. Ingozi eyandayo cishe ihlobene nokusabalala okukhulu kwesifo sikashukela noma isifo sezinso kulaba bantu, ubudala babo obudala, nokuthi iziqephu ezilandelayo ze-ischemia yenhliziyo nazo zingase zibe "zithule," ngakho-ke akunakwenzeka ukuphathwa ngokushesha .
Ukuxilongwa
Ngenxa yokuthi ukuhlaselwa kwenhliziyo okungenayo akuvezi izimpawu ezibangela ukuba isisulu sithole usizo lwezokwelapha, ukuxilongwa kwenziwa kuphela emva kweqiniso - ngemuva kokulimala okwenziwayo. Ngesinye isikhathi esikhathini esizayo, udokotela ngokuvamile uzobona ukuthi ukulimala kwenhliziyo kwenzeke ngokuhlola i-electrocardiogram. Ukuxilongwa kungaqinisekiswa ngokwenza i- echocardiogram , lapho isisindo senhliziyo esisenamandla manje esingabonwa khona.
Ukwelashwa Emva Kokuhlasela Kwenhliziyo Ethulile
Uma usutholakala ukuthi ube nesifo senhliziyo esicacile, amaqiniso amabili abalulekile manje ayaziwa ngawe. Okokuqala , une- artery coronary isifo esibalulekile (i-CAD) .
Futhi okwesibili , izimpawu zakho ngeke zithembeke njengesilinganiso sokuthi i-CAD yakho ilukhuni kangakanani, noma ukuthi iphathwa kanjani ngokwanele. Lokhu kungukuthi, ukungabikho kwezimpawu (njenge-angina) akuyona inkomba enokwethenjelwa yokuthi ukwelashwa kusebenza, noma ukuthi i-CAD yakho igxile.
Uma uye waba nesifo senhliziyo esicacile, kufanele uthole zonke izindlela zokwelapha ezifana nanoma yimuphi omunye umuntu osinde ekuhlaselweni kwenhliziyo. Ukwelapha kufanele kuhloswe ku:
- Ukuvimbela ischemia eyengeziwe ngemithi, futhi mhlawumbe revascularization (nge stents noma ukuhlinzwa bypass ).
- Ukuvimbela ukuqala kwehluleka kwenhliziyo .
- Ukuvimbela ukufa kusuka ku- arrhythmias yenhliziyo .
Funda kabanzi mayelana nokuthi lezi zinyathelo ezintathu zinganciphisa kanjani ingozi yokuhlaselwa kwenhliziyo elandelayo .
Ngaphandle kwalolu hlelo olujwayelekile lwe-post-heart attack, abantu abaye bahlaselwa inhliziyo ngenhliziyo bangadinga ukwelashwa okungeziwe ngokusekelwe imiphumela yokuhlolwa kokucindezeleka .
Ukuhlolwa kokucindezeleka kungakhonza izinhloso ezimbili ezibalulekile kubantu abaye bahlaselwa inhliziyo ngenhliziyo. Okokuqala, kungavumela udokotela wakho ukuba alinganise "umbundu" wokuzivocavoca oveza ischemia kuwe. Okusho ukuthi, udokotela wakho angakwazi ukunikeza imiyalelo ethize mayelana nokuthi yimiphi imisebenzi ephephile ukuba uyenze. Njengoba ungeke usebenzise ukuqala kwe-angina njengesixwayiso sokuthi wenza okuningi, lolu hlobo lweseluleko lungabaluleka kakhulu.
Okwesibili, uma ischemia kwenzeka ngesikhathi sokuhlolwa kokucindezeleka, ngisho nabantu abaye bahlaselwa inhliziyo ngenhliziyo futhi / noma ischemia engathuliyo ngokuvamile bayozizwa "okuthile," ngisho noma kungavamile ukungena. Ngakho-ke, ukuhlolwa kokucindezeleka kungenza impendulo ebalulekile kubantu abane-ischemia esithulile - ingabafundisa ukuthi "yilokho okushiwo yi-ischemia efana nawe." Esikhathini esizayo, noma nini lapho uzwa "lokhu" ukuzwa-kungakhathaliseki ukuthi kunesihlungu emhlanjeni, ukuphefumula, ukukhathala okungazelelwe, noma ngabe kungaba yini - kusho ukuthi mhlawumbe une "angina elinganayo," futhi kufanele ngokushesha ayeke lokho okwenzayo futhi ulandele imiyalelo kadokotela wakho yokuphatha i-angina (njengokuthatha ithebhulethi ye-nitroglycerin ).
Izwi elivela
I-CAD - ngisho ne-CAD ephawuleka kakhulu - ayifuni njalo ukuveza izimpawu ezijwayelekile ezichazwe ezincwadini zezokwelapha. I-ischemia ye-cardiac ngisho nokuhlaselwa kwenhliziyo kuvame kakhulu kubantu abangakaze babe nezibonakaliso ezibonisa i-CAD. Abantu abaye bahlaselwa inhliziyo ngenhliziyo ikakhulukazi kudingeka baqaphele izinhliziyo zabo ukuvimbela ukulimala okunye komzimba.
Uma unezici eziningana zokubeka ingozi ku-CAD , njengokubhema, ukuhlala impilo yokuhlala phansi, ukugqithisa ngokweqile, noma uketshezi oluphakeme kakhulu noma umfutho wegazi ophezulu , ukungabi khona kwezimpawu akufanele kuthathwe njengobufakazi bokuthi konke kulungile ngemithambo yakho ye-coronary. Kufanele ukhulume nodokotela wakho ngalokho ongakwenza ukuze unciphise ingozi yakho enkulu , ngaphambi kokuba uhlupheke kakhulu, mhlawumbe ungenakuguquka, umonakalo enhliziyweni yakho - noma ngaphezulu.
> Imithombo:
> Aldweib N, Negishi K, Hachamovitch R, et al. Impact of Repeat Myocardial Revascularization Ngomphumela Ezigulini Eziyisicathulo Sokuthula emva kwe-Revascularization yangaphambili. J Am Coll Cardiol 2013; 61: 1616.
> Gehi AK, Ali S, Na B, et al. I-Ischemia engenakulinganiswa Nengozi Yezikhathi Zengqondo Ezivame Ukwenzeka Ezigulini Eziphuthumayo Nezifo Eziqinile Ze-Coronary Heart: Study of Heart and Soul Study. I-Arch Intern Med 2008; 168: 1423.
> Gibbons LW, Mitchell TL, Wei M, et al. Isivivinyo sokuzivocavoca esiphezulu njengesibikezelo soMngcipheko Wokufa kusuka ezifo zezinhliziyo zeCoronary in Men Asymptomatic. Am J Cardiol 2000; 86:53