Kufunika kwa Mayikaliyumu Yotetezeka
Q. Mwamuna wanga ali ndi vuto la mtima chifukwa cha matenda ake a umphawi. Dokotala woyamba yemwe tinamuwona anamuuza kuti kupyolera mu opaleshoni sikungapindule chifukwa chotsekemera chotsekedwa chimapereka minofu ya mtima yomwe yafa kale. Koma dokotala wachiwiri akuti ndizotheka kuti minofu ya mtima iwonongedwe kotheratu, koma kungokhala "kubisala." Iye akunena kuti kupitirira opaleshoni kungalole kuti minofu ikhale "yodzuka," ndipo mtima wake ukulephera. Kodi mungandiuze chiyani za kubwezeretsa minofu ya mtima, ndipo mukuganiza kuti katswiri wamagetsi angakhale wolondola?
Yankho:
Mfundo yofunika kwambiri yokhudza "kujambula njinga yamagetsi" (myocardium amatanthauza minofu ya mtima) akadakali ngati lingaliro lachilendo kwa madotolo ena, koma akatswiri a cardiologist akudziwa bwino izo. Kwa anthu ena omwe ali ndi matenda a mitsempha (CAD) , zigawo zina za minofu ya mtima zomwe zimaoneka kuti zowonongeka kwambiri ndi zosagwira ntchito ziridi zothandiza, ndipo zingathe "kutsitsimutsidwa" ngati magazi akubwezeretsedwa.
Zikuoneka kuti pakati pa 20 ndi 50% a anthu omwe ali ndi vuto la mtima lopangidwa ndi CAD ali ndi kuchuluka kwa malo ogwiritsira ntchito njoka zamoto, choncho, angathe kukhala ndi mphamvu yowonjezereka ngati magazi atha kubwezeretsedwa ku minofu yawo ya mtima.
Njira "Yakale" Yoganizira za Mutu Waumphawi
Lingaliro lachipatala lachibadwidwe silinatulukirepo kanthu monga chinthu chowombera njuchi.
Minofu yamtima imagwira ntchito nthawi zonse malinga ngati pali magazi okwanira. Ngati kuthamanga kwa magazi sikukwanira kukwaniritsa zofunikira za minofu ya mtima (mwachitsanzo, pamene munthu ali ndi CAD ayamba kuwonetsa), minofu imakhala yochepa kwambiri (imakhala ndi njala), ndipo angina ikhoza kuchitika.
Matenda achischemic samagwira ntchito mwachizolowezi. Ndipotu, kuchita echocardiogram nthawi yochita masewero olimbitsa thupi ndi njira imodzi yodziwira ischemia, popeza mayeso a echo angaganizire zigawo za mtima wa minofu yomwe imalephera kugwira ntchito mosavuta pamene akusowa oxygen yokwanira.
Momwe madokotala ankakonda kuganizira za CAD, mwina ischemia idzachoka posachedwa (chifukwa, mwachitsanzo, munthu yemwe ali ndi CAD amasiya kuwonetsera pamene angina akuwonekera), kapena ischemia ikanatha mpaka matenda a mtima (myocardial infarction, kapena imfa ya mtima) minofu) zinachitika.
Choncho, kalasi yamagalimoto yomwe imaperekedwa ndi mitsempha yodwala matenda ikhoza kukhalapo mwa chimodzi mwa zitatuzi: zachibadwa, ischemic, kapena akufa.
Koma zikutanthauza kuti minofu ya mtima ingapitirizebe kudera lachinayi, boma lotchedwa hibernation.
Kodi Kachilomboka Kachilomboka N'chiyani?
Mankhwala ofooketsa mabomba ndi omwe amangomva ngati. Monga chimbalangondo chowombera kupyola m'nyengo yozizira, ngakhale kuti maonekedwe onse amawoneka ngati akufa, sikuti afa, koma amangoti ndi "dormant". Sichikugwiranso ntchito - sizimagwirizanitsa ndi mtima uliwonse, ndipo sizikuthandizira ku ntchito ya mtima.
Koma sizinakhalenso zakufa. Ndikumangokhala otetezeka. Icho chatseka ntchito iliyonse ya ntchito yomwe siimangokhala yovuta kwambiri kuti akhalebe wamoyo.
Mitsempha ya mtima ikhoza kulowa mu nthawi ya hibernation pamene CAD imakhala yovuta kwambiri kuti ikhale ischemia yomwe ndi yachilendo komanso yosasinthasintha, m'malo mofanana ndi ischemia yomwe imabwera komanso imapita nthawi zambiri (yomwe ili ndi anthu ambiri omwe ali ndi angina). Kotero, kwenikweni, minofu ya mtima sikumangotenga magazi okwanira kuti azigwira bwino, koma ndi - chabe chabe - kupeza magazi okwanira kuti akhalebe ndi moyo.
Nchifukwa Chiyani Myocardium Yamtundu Yofunika Kwambiri?
Mitsempha yamtima yodalirika ndi mfundo yofunikira chifukwa minofu ikadali yotheka, ndipo hibernation ikhoza kusinthidwa.
Ngati magazi a minofu amatha kubwezeretsedwa - kupyolera mwa opaleshoni kapena kupopera - pali mwayi wodalirika wa myocardium yowonongeka ingathe "kudzuka," ndikuyambanso kupereka gawo la ntchito ya mtima. Kwa munthu amene ali ndi vuto la mtima , izi zimapangitsa kuti thupi likhale ndi mphamvu yowonjezera.
Mkwatibwi wa mwamuna wanu Zikumveka ngati dokotala wachiwiri adawona umboni wakuti mwamuna wanu akhoza kukhala ndi njinga zamoto, ndipo zomwe zimatsegula mitsempha yake yambiri yokhala ndi opaleshoni yowonjezereka ingalole kuti gawo lake la minofu liyambe kugwira ntchito.
Pali mayesero apadera omwe akatswiri a cardiologists angachite kuti athandize kusiyanitsa njuchi zam'mimba kuchokera ku minofu ya mtima yomwe siili yoyenerera (ndiyo, yakufa), kuphatikizapo maphunziro a MRI , ndi mayeso apadera oyesedwa.
Mfundo Yofunika Kwambiri
Popeza kuti kuyesedwa kwa mtundu umenewu sikungopweteka ndipo sikuti kulibe pangozi, kufunafuna mwayi wopeza njoka zamagetsi kumawoneka ngati kumveka bwino pa nkhani ya mwamuna wanu.
Ngati izi zikuwonetsa kuti akhoza kukhala ndi njinga yamakono yowonongeka, ndiye kuti "kudzuka" mbali imodzi ya minofu ya mtima ingathe kukweza mtima wake kwambiri. Kotero zikanakhala zomveka kwambiri kuganizira mozama kuti opaleshoni yoyamba ya opaleshoniyo ikupangitsa ngati kuyesedwa kumathandizira kukhalapo kwa njuchi yamoto.
> Zotsatira:
> Allman KC, Shaw LJ, Hachamovitch R, Udelson JE. Kuyesedwa kwa Myocardial Viability Testing and Impact of Revascularization pa Matenda a Mthupi mwa Odwala ndi Coronary Artery Disease ndi Kulephera kwa Left Ventricular: Meta-analysis. J Am Coll Cardiol 2002; 39: 1151.
> Kim SJ, Peppas A, Hong SK, ndi al. Kulimbika Kwambiri Kumapangitsa Mavuto a Myocardial Kuteteza ndi Chitetezo: Kuthamanga / ntchito ndi Njira zamagetsi. Circ Res 2003; 92: 1233.
> Parasher PS, Daher IN. Kuthamanga kwa Myocardial pambuyo pa Hypoxia: Kubwezeretsa Kwodabwitsa. Zojambulajambula za 2008; 25: 1011.
> Rahimtoola SH, La Canna G, Ferrari R. Njinga Yojambula Pamaso: Mbali Yina Yophunzirira Imakhala Yofunika. J Am Coll Cardiol 2006; 47: 978.
> Yambani CW, Jessup M, Bozkurt B, et al. 2013 ACCF / AHA Malangizo Othandizira Kulimbana ndi Mtima Wosatha: Lipoti la American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. J ndi Coll Cardiol 2013; 62: e147.