Iyiphi indlela efanele yokuthola izifo zesifo somzimba we-coronary?
Ukubona izifo ze-coronary artery (CAD) kungaba inselele kuzo zonke iziguli nodokotela bazo ngoba kunabantu abaningi abasengozini yeCAD nokuhlolwa okuningi okungasetshenziswa. Ubani okufanele ahlolwe, futhi yiziphi izivivinyo okufanele abe nazo?
Kuyini i-CAD?
I-CAD isifo esingelapheki se- coronary arteries . E-CAD, ukutholakala kwesifo sokuqina kwamathambo kubangela ukuba umshini obushelelekile, obunwetshiwe we-arteries ukuze ubenze lukhuni, ugxilile futhi ugubhuke " ngamacwecwe ," okuyi-deposit calcium, amafutha, namangqamuzana angavamile okuvuvukala.
Lezi zinhlayizi zingakwazi ukungena esiteshini se-artery, okwenza ukuvinjelwa kwegazi okuyingxenye, isimo esivame ukubangelwa i- angina . Amapulangwe angaphinda aphume, ngokubangela ukuthi i-blood clot ibe yinkimbinkimbi ngaphakathi kwe-artery coronary eyenza ukuvinjelwa kwegazi kungazelelwe. Izifo eziningi ze- myocardial ( ukuhlaselwa kwenhliziyo ) ngenxa yokuphuka okuphawulekayo kwesikhala.
I-CAD isifo esingapheli, esiqhubekayo esivame ukuvela iminyaka eminingi ngaphambi kokuba umuntu azi ukuthi kukhona okungalungile. Ngokuvamile, isibonakaliso sokuqala sokuthi kunenkinga yilapho kwenzeka khona umcimbi ongenakuguqulwa, njengokungenwa kwe-myocardial noma ukuboshwa komzimba . Lokhu kusho ukuthi uma usengozini enkulu ye-CAD, akumele ulinde izimpawu zokuthuthukisa ngaphambi kokuthola ukuthi unenkinga.
Ukuthola i-CAD
Ukukhomba "Ukubaluleka Okubalulekile"
Ngokwesiko, ukuxilongwa kwe-CAD kuye kuxhomeke ekuvivinyweni okubheka ubufakazi bokuthi "okuphawulekayo" ku-artery coronary .
(Ngokuvamile, izazi ze-cardiologists zibheke ukuvinjelwa "okuphawulekayo" okuvimbela u-70% noma ngaphezulu kwesiteshi somsakazo.)
Ukuhlolwa kokuzivocavoca (noma ukuhlolwa kokucindezeleka ) kuvame ukusiza ekuhloleni imishanguzo ye-coronary. Ukuhlolwa kokucindezeleka okulawulwayo kungavamise ukuveza izimpawu ze-angina nezinguquko zesimo kwi-electrocardiogram (ECG) - okutholakele okuphakamisa kakhulu ukuthi amabhulogi akhona.
Funda Ngokuzama Ukucindezeleka
Ukwenza ukuhlolwa kokucindezeleka ngokubambisana nesifundo se- thallium / i-Cardiolite noma i- echocardiogram ithuthukisa ikhono lokuthola imishanguzo ye-coronary. I-Thallium ne-Cardiolite yizinto ezisakazwa yi-radioactive ezifakwe emgodini ngesikhathi sokuvivinya umzimba. Lezi zinto zithwalwa kumfutho wezinhliziyo nge- coronary arteries , ngaleyo ndlela ivumela inhliziyo ukuba ifakwe ngekhamera ekhethekile. Uma omunye noma ngaphezulu kwemithambo ye-coronary ivinjiwe kancane, izindawo zomsizi wenhliziyo ezinikezwa yizo mithwashongo ziboniswa esithombeni njengamabala amnyama. I-echocardiogram yenza isithombe senhliziyo yokushaya usebenzisa amagagasi omsindo. Noma yikuphi ukunyakaza okungajwayelekile emisipha yenhliziyo ebonwe kwi- echocardiogram ngesikhathi sokuvivinya umzimba kuphakamisa i-CAD.
Funda mayelana nokuhlolwa kwe-thallium / i-Cardiolite nama- echocardiograms
Uma ukuhlolwa kokucindezeleka kugcizelela kakhulu ukuthi kukhona okunye okukhona noma okuningi okukhona, iziguli ngokuvamile zibhekiselwa ukuphazamisa inhliziyo . Inhloso ye-catheterization ukuchaza ngokugcwele indawo kanye nobukhulu bazo zonke izivimbela zomzimba we-coronary , ngokuvamile ngenhloso ye- angioplasty , ukuphazamisa noma ukuhlinzwa ngokudlula .
Funda Nge-Catheterization Ka-Cardiac
Izivivinyo ezingapheliyo zithuthukiswa okungenzeka ngelinye ilanga zifake isidingo sokuguliswa kwe-cardiac catheterization.
Lokhu kufaka phakathi i-multislice CT scan ne- MRI yenhliziyo . Ngeshwa, akekho kulezi zindlela namuhla ongafaka ngokugcwele isidingo sokwelashwa kwenhliziyo .
Ukukhomba ama-Plaques Angabangeli Amabhulogi Okuphawulekayo
Eminyakeni yamuva nje, izazi ze-cardiologists ziye zaqaphela ukuthi kokubili ukuhlukunyezwa kwe-myocardial kanye ne- angina engaqiniseki kubangelwa ukuhlukana kwama- plaque emithanjeni ye-coronary . Kuvela ukuthi kuningi uma kungenjalo amacala amaningi, ama-plaques aphelisa ukubhujiswa ayeyobhekwa "angabalulekile" (okungukuthi, angabangeli ukuvinjelwa okuphawulekayo) ngaphambi kokuba aphule. Yingakho sivame ukuzwa ngabantu abahlushwa isifo senhliziyo masinyane ngemuva kokutshelwa ukuthi abanakho i-CAD ephawulekayo.
( Yilokho okwenzeka kumlobi weTV uTim Russert ngo-2008.)
Kusukela noma yikuphi ukusabalala okungahle kuphume, kuyasiza ukwazi ukuthi ama-plaque akhona - ngisho nezincane. Abantu abananoma yiliphi inani le-CAD kufanele bathathe izinyathelo zokuzinzisa izikhala futhi banciphise ubungozi bokuphulwa kwamapayipi . (Izinyathelo ezinjalo ngokuvamile zihlanganisa ukuphathwa kwezinto eziyingozi, izinguquko zokuphila, izitembu , ne-aspirin.)
Izikali ze-calcium zivela njengendlela ewusizo yokuthola ukutholakala kwemali encane ye-CAD. Ukuhlolwa kwe-calcium kuyindlela ye-scanning ye-CT engakwazi ukulinganisa amanani amaningi e- calcium emithanjeni ye-coronary . Njengoba i-calcium ibeka ngokujwayelekile emaceleni, ukulinganisa inani le-calcium emithanjeni ibonisa ukuthi ngabe i-CAD (futhi ngenxa yalokho i-plaques) ikhona nokuthi i-CAD ingaba yiningi kangakanani. Ngokukuxwayisa ukuthi okungenani u-CAD okwanele ukhiqiza amapuleti "athule", ukukhishwa kwe-calcium kungakunika ithuba lokushintsha indlela yakho yokuphila, futhi mhlawumbe uthathe imithi efanele, ngenkathi kusekhona isikhathi sokwenza kanjalo.
Funda kabanzi Ngama-Calcium Scans no-Who Can Benefit From Them
Imithombo:
Gibbons, RJ, Balady, GJ, uThimothy Bricker, J, et al. I-ACC / AHA 2002 Isibuyekezo somhlahlandlela wokuhlolwa kokuvivinya umzimba: Isihloko esifingqiwe. Umbiko we-American College of Cardiology / American Heart Association Task Force on Iziqondiso Zokuzikhandla (Ikomidi Lokuvuselela Izikhombandlela Zokuhlola Ukuzivivinya Ngo-1997). J Am Coll Cardiol 2002; 40: 1531.
Califf, RM, Armstrong, PW, Carver, JR, et al. Umsebenzi we-Task Force 5. Ukwakhiwa kwezigulane zibe yizingxenye ezincane eziphakathi, eziphakathi nendawo ezisezingeni eliphansi ngenhloso yokulawulwa kwezinto eziyingozi. J Am Coll Cardiol 1996; 27: 1007.