Uma uye waba ne- infarction ye-myocardial (i-MI, noma ukuhlasela kwenhliziyo), ubeke inani elithile lomonakalo kumisipha yenhliziyo yakho. Uma umonakalo okwanele usuwenziwe, ungase ube engozini yokuhlaselwa kwenhliziyo . Ngakho-ke, ukuthatha izinyathelo zokuvimbela ukwehluleka kwenhliziyo kuyisici esibalulekile sokwelashwa ngemuva kwe-MI.
Kubantu abaye babe ne-MI enkulu kakhulu, ingozi yokuhluleka kwenhliziyo ingaba phezulu kakhulu.
Kulezi ziguli ukuhluleka kwenhliziyo kungase kube nzima, ngokuvamile phakathi kwamahora ambalwa okuqala noma izinsuku.
Kodwa ngisho nalapho i-MI ibangela kuphela umonakalo wemisipha olinganiselayo, ukuhluleka kwenhliziyo ekugcineni kungenzeka. Ukwelashwa kwezidakamizwa ezifanele kanye nezinguquko zendlela yokuphila kungabalulekile ekubambezelekeni noma ekuvimbeleni ukuhluleka kwenhliziyo.
Kuyini Ukukhumbuza?
Kungakhathaliseki ukwehluleka kwenhliziyo kwenzeke ngemuva kokuthi i-MI ixhomeke ekutheni umthambo wezinhliziyo ezingaphazamiseki uphendula kanjani. Ngemuva kwe-MI, imisipha yenhliziyo enempilo "ilula" emzamweni wokuthatha umthwalo wokusebenza kwemisipha ewonakele. Lokhu kuthutha kuholela ekwandiseni kwenhliziyo, inqubo ebizwa ngokuthi inhliziyo "yokulungisa".
Ukwehlisa kusiza inkontileka ye-muscle engaphazamiseki ngokukhululekile, futhi ikuvumela ukuba wenze umsebenzi omningi. Inhlitiyo yenhliziyo iziphatha into efana nebhodi le-rubber; lapho usulele ngokwengeziwe, nakakhulu "khipha" kunayo. Kodwa-ke, uma uphawula ibhande le-raber, noma uqhubeke ulula ngokuphindaphindiwe isikhathi eside, ekugcineni ulahlekelwa "ukuchofoza," bese kuba yi-flaccid.
Ngeshwa, imisipha yenhliziyo yenza into efanayo. Ukwelula okungapheli kwemizwa yenhliziyo kubangela ukuba buthakathaka, futhi ukwehluleka kwenhliziyo kungaholela. Ngakho-ke, ngenkathi ukulungiswa kungasiza inhliziyo ukuba isebenze kangcono esikhathini esifushane, ukulungisa kabusha isikhathi eside kuyinto embi. Uma ukulungiswa kungavinjelwa noma kungalinganiselwe, ingozi yokuthuthukisa ukwehluleka kwenhliziyo iyancipha.
Ukuqhathaniswa Kanjani Ukulungiswa?
Ingxenye ebalulekile yokuhlola impilo yakho ngemuva kokuba i-MI iqikelele ukuthi ukulungiswa kwenhliziyo kuyenzeka kangakanani. Lolu lwazi lungatholakala ngokwenza iskena se- MUGA noma i- echocardiogram , izindlela ezimbili ezingabonakali ngokubonakalayo kwe- ventricle kwesokunxele .
Indlela enhle yokulinganisa inani lemonakalo yemisipha yenhliziyo elibangelwa i-MI, futhi inani lokulungiswa okwenzekayo, ukukala ingxenyenamba ye-ventricular ejection (LVEF). I-LVEF yiphesenti yegazi elikhishwe yi-ventricle yesokunxele ngenhliziyo ngayinye. Ngokunwetshwa kwenhliziyo (okungukuthi, ngokulungiswa), i-fraction ejection iyawa. Uma i-LVEF ingaphansi kuka-40% (evamile ibe ngu-55% noma ngaphezulu), khona-ke ukulimala kwemisipha ephawulekayo kwenzekile. Okuphansi kwe-LVEF, umonakalo omkhulu, ukulungiswa okungaphezulu - futhi ingozi enkulu yokuhlaselwa kwenhliziyo.
Ukuvimbela Ukulungiswa Kwezinhliziyo
Ucwaningo oluthile lwemitholampilo lubonise ukuthi amakilasi amabili ezidakamizwa anganciphisa kakhulu ukulungiswa emva kwe-MI, futhi athuthukise ukusinda kweziguli ezinezibonakaliso zokuhluleka kwenhliziyo ezayo. Lezi zidakamizwa ziyi- blocka blockers kanye ne- ACE inhibitors .
Abavimbela i-Beta basebenza ngokuvimbela umphumela we-adrenaline enhliziyweni, futhi banemiphumela ezuzisa kakhulu ezinhlobonhlobo zesifo senhliziyo.
Abavimbela i-Beta bancishisa ingozi ye- angina ezigulini ezinezifo ze- coronary artery (CAD) ; kuthuthukise ukusinda kweziguli ezinesifo senhliziyo; ukunciphisa ingozi yokufa okungazelelwe ezigulini emva kokuhlaselwa kwenhliziyo; futhi ukulibaziseka, ukuvimbela futhi ngisho nokuguqula ukulungiswa kwenhliziyo ngemuva kwe-MI.
Ngakho-ke, ngaphandle uma kunezizathu eziqinile zokungazisebenzisi (ezinye iziguli ezine-asthma ezinzima noma ezinye izifo zamaphaphu nje azikwazi ukuthatha lezi zidakamizwa), cishe wonke umuntu osinda enhliziyweni kufanele abekwe kwi-bloa ye-beta. I-beta blockers evame kakhulu echazwe ngemuva kokuba i-MI yi-Tenormin (i-atenolol) ne-Lopressor (metoprolol).
Ama-inhibitors e-ACE athuthukisa kakhulu ukuhlala isikhathi eside ngemuva kokuba i-MI enzima, futhi ngaphezu kwalokho, ukunciphisa ingozi yokuthuthukisa ukuhluleka kwenhliziyo (okubonakala ngokuvimbela noma ukubambezela ukulungiswa). Banciphisa ingozi yama-MIs aphindaphindiwe, isifo sohlangothi, nokufa okungazelelwe.
Ama-inhibitors e-ACE, njenge-blocka blockers, abhekwa njengokufanele uma unesifo senhliziyo. I-Vasotec (i-enalapril) ne-Capoten (i-captopril) yizidakamizwa ezivame ukusetshenziswa ngemuva kwe-MI.
Ukulondoloza Impilo Yenhliziyo
Ngaphandle kokwelapha okuhloswe ngokuqondile ekuvimbeleni ukuhluleka kwenhliziyo ngemuva kokuhlaselwa yinhliziyo, uzodinga ezinye izindlela zokwelapha ezibalulekile ukuze ugcine impilo yakho enhle ye-cardiac. Nansi uhlu lokuhlola lwe-post-heart okufanele ulubuyekeze nodokotela wakho.
Futhi nakuba ungakwazi ukwenza lutho mayelana nokuthi usuvele unayo i-CAD, kunezinto eziningana ongazenza ukuze unciphise noma umise ukuwohloka kwe-CAD yakho, ngakho-ke ukuvimbela umonakalo oqhubekayo wenhliziyo. Lezi zihlanganisa izinyathelo zokuthuthukisa ukudla kwakho, amazinga e-cholesterol, amandla okusebenzisa umzimba, nokwandisa isisindo sakho kanye nomfutho wegazi.
> Imithombo:
Nuttall, SL, Toescu, V, Kendall, MJ. I-beta Blockade ngemuva kokuhlukunyezwa kwe-myocardial. Abavimbela i-Beta banendima ebalulekile ekunciphiseni ukugula nokufa emva kokuhlukunyezwa. BMJ 2000; 320: 581.
Smith, SC Jr, Allen, J, Blair, SN, et al. Imikhombandlela ye-AHA / ACC yokuvikela kwesibili iziguli ezine-coronary nezinye izifo zesifo se-atherosclerotic: Isibuyekezo sika-2006 esiqinisekisiwe yi-National Heart, Lung, ne-Blood Institute. J Am Coll Cardiol 2006; 47: 2130.
Gara PT, Kushner FG, Ascheim DD, et al. I-ACCF / I-AHA isiqondiso sokuphathwa kwe-ST-elevation infarction: i-summary executive: umbiko we-American College of Cardiology Foundation / i-American Heart Association Task Force on Guidelines Practice. Ukujikeleza 2013; 127: 529.