Mitsempha yamakono ndi mitsempha ya magazi yomwe imapereka magazi ku myocardium (minofu ya mtima). Chifukwa zimayenera kugwira ntchito mosalekeza (mosiyana ndi minofu ina ya thupi, yomwe nthawi zambiri imakhala yopuma), minofu ya mtima imakhala ndi chofunika kwambiri cha mpweya ndi zakudya zomwe zimadalira magazi. Mitsempha yamakono imapangidwira kuti apereke magazi oyenera kuti mtima uchite bwino.
Ngati magazi amatha kupyolera mu mitsempha yotsekemera imatsekedwa pang'ono, minofu ya mtima ikhoza kukhala ischemic (oxygen-njala), vuto limene nthawi zambiri limabala angina ndi kutaya mu minofu ntchito (kuwonetsedwa ndifooka ndi dyspnea ). Ngati kuthamanga kwa magazi kutsekedwa kwathunthu, minofu ya mtima yomwe imaperekedwa ndi mitsempha yotsekedwa ikhoza kudwala matenda osokoneza bongo kapena selo imfa. Izi zimatchedwa matenda a myocardial, kapena matenda a mtima .
Anatomy of the Coronary Arteries
Mitsempha ikuluikulu yamakono, mitsempha yoyenera ya coronary (RC) ndi mzere wamakono (LM) wamakono, womwe umachokera ku aorta (mitsempha yaikulu ya thupi) kupyola pamphuno ya aortic ya mtima.
Mankhwala a LM mwamsanga amagwiritsa ntchito mitsempha ikuluikulu ikuluikulu - kumtunda kumanzere kutsika mitsempha (LAD) ndi mitsempha ya circumflex (Cx). Mitsempha ya mtima yokha, ndiye, imaperekedwa ndi imodzi mwa mitsempha yayikuluyi yoyamba: a LAD, a Cx, ndi a RC. Chithunzi (pamwamba) chikuwonetsa RC ndi mitsempha ya LAD.
(Chithunzi cha Cx chikuyimiridwa ndi mthunzi wonga wakufa pambuyo pa mtima.)
Mzere wa RC umawonetsedwa kumanzere kwa chiwerengerocho, ndikuyenda pamphepete mwa mtima. Mbali yayitali ya RC yomwe, pa chithunzithunzi, imapita kumapeto kwa mtima (pamwamba) imatchedwa "downerior descending artery" (PDA).
Anthu ambiri (pafupifupi 75%) PDA imachokera ku RC, monga chithunzichi. Izi zimatchedwa "zoyenera kwambiri". Komabe, mu 25% PDA imachokera ku mzere wa Cx, umene umatchedwa "kutsala kwambiri". Kusiyanitsa uku ndikofunika, popeza (mwachitsanzo) matenda a mtima omwe amachokera ku kutseka kwa RC. Mtima wodalirika udzawononga kwambiri kuposa momwe mungakhalire ndi mtima wakumanzere.
Mitsempha ya RC ndi nthambi zake zimapereka magazi ku malo ambiri oyenerera, chithunzithunzi chabwino, node ya sinus , ndi (mwa anthu ambiri) kachilombo ka AV .
Kubwerera kuchithunzichi, nthambi za LAD ndi nthambi zake zikuwonetsedwa ndikukwera pamwamba pamtima. The LAD amapereka atrium kumanzere ndi zigawo zazikulu za kumanzere ventricle - chipinda chachikulu mtima kupopera chipinda. Choncho matenda a mtima omwe amachokera ku LAD nthawi zonse amawononga kwambiri. Mipata yamakono ya Coronary ku LAD imatchulidwa ndi akatswiri a cardi monga "opanga akazi."
Kufunika kwa kuwonongeka kwa minofu ya mtima panthawi ya matenda a mtima kumadalira osati kokha kuti mitsempha imakhudzidwa bwanji komanso kuti malo otsekemera amatha bwanji. Kuzimitsa kwa pafupi ndi kuchotsedwa kwa mitsempha kungakhale kovulaza kwambiri kuposa kupingasa kwapakati pazitsulo, kapena mu nthambi imodzi yaing'ono.
Ngati matenda a mtima amapezeka, kuwonongeka kwamuyaya kumatetezedwa kawirikawiri kupeza njira zamakono zothetsera kutsegula mitsempha yowonongeka.
Zotsatira:
Farooq V, van Klaveren D, Steyerberg EW, et al. Makhalidwe abwino komanso okhudzana ndi matenda omwe amatsogolera kupanga chisankho pakati pa mitsempha yamakono kupyolera mu opaleshoni komanso kuthandizira kwa odwala payekha pokhapokha: chitukuko ndi kutsimikiziridwa kwa chiwerengero cha SYNTAX II. Lancet 2013; 381: 639.
Olemba / Ogwira ntchito a Task Force, Womangirira S, Kolh P, et al. 2014 ESC / EACTS Malangizo pa myocardial revascularization: Task Force on Myocardial Revascularization ya European Society of Cardiology (ESC) ndi European Association for Cardio-Thoracic Surgery (EACTS) Yapangidwa ndi thandizo lapadera la European Association of Percutaneous Cardiovascular Interventions ( EAPCI). Mtima; 35: 2541.