Zisonyezero za kuperewera kwa mtima (kupuma pang'ono, kutupa) kungatsanzire ndi zina za matenda. Ndikofunika kubweretsa madandaulo kwa dokotala wanu, koma amagwiritsa ntchito zoposa izi kuti atsimikizire kuti mtima uli vuto. Njira yeniyeni ya matenda ya mtima imayesedwa pamayesero a mtima, omwe ali makamaka electrocardiogram (EKG) ndi echocardiogram (echo).
Ubongo wa natriuretic peptide (BNP) unayang'anitsitsa chifukwa ukhoza kuchitidwa pogwiritsa ntchito magazi, zomwe ndi zosavuta kuchita. BNP ndi yothandiza, koma osati yodalirika monga echo ndi EKG mu matenda a mtima kulephera.
Odzifufuza okha
Kuzindikira zizindikilo za mtima wosalimba kungakuthandizeni kuti muyesedwe ndi kulandira chithandizo chomwe mukufunikira kuchikulire matenda asanakwane. Izi zikhoza kukhala zonyenga poyamba ndipo zingapite patsogolo pang'onopang'ono, kotero n'zosavuta kunyalanyaza kapena kungozisakaniza mpaka kukalamba. Podziwa izi, onetsetsani kuti mukudandaula kwa dokotala aliyense pazinthu izi:
- Kupuma pang'ono: Izi zikhoza kuchitika mwachangu, pakuyenda, kugona, kugwada, kapena kugona. Mukhoza kupuma mobwerezabwereza, ngakhale pamene simukuchita.
- Kutopa: Mukhoza kutopa mosavuta, ngakhale pamene simunachite chilichonse chomwe chiyenera kukhala chotopetsa.
- Edema : Inu mukhoza kumva kutupa kapena mawonekedwe odzitukumula a mapazi kapena manja anu; kawirikawiri, sikumva kupweteka kapena kosasangalatsa. Ngati mumagwiritsa ntchito zovuta kuderalo ndipo zimakhala zokhazikika, zokhalapo kwa masekondi angapo kapena mphindi (kutchedwa pitting), zikhoza kukhala zotsatira za mtima wosagonjetsa, m'malo molemera kapena kupuma kwa madzi osagwirizana.
Mapulogalamu ndi Mayesero
Ngati muli ndi zizindikiro za mtima wosalimba, ndipo dokotala wanu amakayikira vutoli, akhoza kuyesa mayesero kuti atsimikizidwe kuti ali ndi vutoli.
Kuthamanga kwa mtima ndi m'mapapo: Dokotala wanu amamvetsera mtima wanu ndi mapapu pogwiritsa ntchito stethoscope paulendo uliwonse wamachiritso. Kawirikawiri, muyenera kukhala ndi maonekedwe a mitima iwiri ndi mtima uliwonse. Kulephera kwa mtima nthawi zambiri kumayambitsa mtima wachitatu. Mapapu anu angamveke atagonjetsedwa pamapapo anu ngati muli ndi vuto la mtima.
EKG: Mayeso ambiri omwe amagwiritsidwa ntchito pofufuza ntchito ya mtima, EKG ndi mayeso osasokoneza omwe amawaika pamagetsi pamtunda kuti azindikire ntchito zamagetsi za mtima. Ngati muli ndi zizindikiro za matenda a mtima, dokotala wanu akhoza kuitanitsa EKG kwa inu. Zojambula zojambulazo zimapangidwa pamapepala kapena pa kompyuta. Zovuta zachikhalidwe pa EKG, kuphatikizapo kupezeka kwa mafunde a Q, kuchoka pamatumba, ST depression, kuseri kwa ventricular hypertrophy, ndi arrhythmias zimawoneka mu mtima wosalimba. Komabe, ngakhale kulephera kwa mtima kumagwirizanitsidwa ndi chimodzi kapena zingapo mwa njirazi, izi sizikutanthauza kuti mtima uli wolephera komanso umakhalapo m'mitima yina.
Mayeso a B-mtundu wa natriuretic peptide (BNP): Awa ndi omwe amawunikira kwambiri magazi. BNP, mavitamini a puloteni, amamasulidwa m'magazi ndi maselo a mtima m'mimba nthawi zonse pamene thupi limakhala lolemera kwambiri. BNP imachititsa impso kusokoneza mchere ndi madzi ndi kuchepetsa kuthamanga kwa magazi kuti abwezeretsenso zinthu.
Anthu omwe ali ndi thanzi labwino, mabungwe a BNP amakhala pansi pa 100 pg / ml, ndipo maulendo opitirira 400 pg / ml amagwirizanitsidwa ndi mtima wosalimba. Maseŵera a BNP pakati pa 100 pg / ml ndi 400 pg / ml ndi ovuta kutanthauzira, ndi chifukwa chake mayeserowa saganiziridwa kuti ndi osowa mtima, amachirikiza.
Chifukwa sizodalirika kwambiri, dokotala wanu sangaganize kuti n'kopindulitsa poyesa matenda anu.
Kujambula
Mayesero ojambula angakhale othandiza pakuwona kusintha kwa thupi ndi kusintha kwa mtima, komanso kusintha kwa mapapo, zomwe zingathe kusiyanitsa mtima wa mtima ndi matenda ena a mtima ndi mapulaneti. Zosankha zambiri zingaganizidwe.
X-ray: Chifuwa cha X-ray ndiyeso yowonongeka mwamsanga yomwe nthawi zambiri imathandiza kwambiri kupeza matenda a mtima. Chifuwa chanu X-ray chingasonyeze kuti mtima wanu ukuwoneka wochulukitsidwa kapena ukhoza kusonyeza zizindikiro za kuyanjana m'mapapu anu ngati muli ndi vuto la mtima. Ngati dokotala wanu akuda nkhawa ndi matenda a m'mapapo ndi m'mtima, mutha kukhala ndi chifuwa cha X-ray.
Echocardiogram: Katswiri wina wotchedwa echocardiogram, womwe nthawi zambiri amatchulidwa ngati chiwongosoledwe, ndi mayeso osadziwika a ultrasound omwe amawonekera mtima pamene akugwira ntchito. Pulojekiti yaying'ono imaikidwa pachifuwa chanu, yomwe katswiri amapanga kuti agwire ntchito yamagetsi ndi zipinda monga mtima wanu mwachibadwa. Kulemba kwanu kungapereke zambiri zokhudzana ndi ntchito yanu. Pomwe pali vuto la mtima, makamaka minofu ya mtima wanu, kukhuta ndi kutaya chipinda chilichonse, ndipo mtima wamtima ukuyembekezeredwa kukhala wosadziwika. Dokotala wanu akhoza kuitanitsa echocardiogram kwa inu ngati muli ndi mtima wamphwando wosayenerera kapena mwakachetechete wamtundu wosadziwika.
Kulingalira kwa nyukiliya: Kuyesera kwapangidwe kameneka, kuphatikizapo positron test (PET) ndi pulotoni imodzi yopangidwa ndi computerized tomography (SPECT), zimaphatikizapo jekeseni wa ma soya opanga mavitamini omwe amasintha mtundu chifukwa cha kusintha kwa kagayidwe kake, kayendetsedwe ka thupi, ndi kupsinjika kwa mtima wanu. Kusintha kwa mitundu iyi kungathandize dokotala kudziwa ngati minofu inayake ya mtima wanu imatha kupopera monga momwe iyenera kukhalira. PET ndi SPECT zonsezi zimagwiritsidwa ntchito kuthandizira kupeza matenda a mtima, kuphatikizapo CAD ndi mtima wosalimba.
Kuyesa kupanikizika: Kuyesedwa kosautsa kumagwiritsa ntchito masewero olimbitsa thupi kuti aulule mavuto a mtima omwe angatuluke mwa kuyesetsa. Ndizothandiza kwambiri pofufuza angina (kupweteka pachifuwa) chifukwa cha matenda a mitsempha yamakono. Dokotala wanu angaganizire mayesero opsinjika maganizo ngati muli ndi zizindikiro zomwe zikukulirakulira. Kawirikawiri, anthu omwe ali ndi mtima wathanzi sangathe kulekerera mayesero, koma angathenso kuzindikira vuto la mtima.
Kusiyanitsa kusiyana
Ngati muli ndi zizindikiro za mtima wosagwirizana, gulu lanu lachipatala lingaganizire zinthu zina zomwe zimapangitsa mpweya wochepa kapena kupuma kwa mapeto. Nthaŵi zambiri, pali mayesero omwe amatha kusiyanitsa pakati pa zikhalidwe ndi mtima wosalimba. Komabe, matendawa angakhale ovuta ngati muli ndi vuto la mtima komanso matenda ena.
Matenda owopsa olepheretsa matendawa (COPD) : Matendawa amachititsa kuti mpweya ukhale wochepa, ndipo umakhala wovuta kwambiri. COPD imayambitsanso magudumu ndi chifuwa chomwe chimagwiritsidwa ntchito ndi ntchentche. Ngakhale kuti zizindikiro zina zimakhala zofanana ndi zofooketsa mtima, COPD ikhoza kusiyanitsa ndi kulephera kwa mtima chifukwa chosawonongeka pamapiritsi oyesera. Kawirikawiri COPD imayambitsidwa ndi kusuta ndipo imakhala ndi chithandizo cha okosijeni pamapeto pake.
Kuphatikizana (PE) : A PE, magazi mu mitsempha ya m'mapapo ya mitsempha, imayambitsa mavuto opuma ndi kupweteka pachifuwa. Makhalidwe a ululu wa dyspnea ndi pachifuwa anthu amasiyana nthawi zambiri amatha kusiyana pakati pa PE ndi mtima kulephera ndipo amatha kupereka ndondomeko chifukwa cha zizindikiro. Komabe, kuyesedwa koyezetsa magazi nthawi zambiri kumafunika kuti mudziwe bwinobwino.
Kulephera kwa impso: Kulephera kwa impso, monga kufooka kwa mtima, kungatenge nthawi kuti ikule, kukupangitsa zizindikiro kuwonjezereka. Pamene impso sizigwira ntchito monga momwe ziyenera kukhalira, kutopa ndi kupweteka kwa miyendo ndi manja zingapangitse, monga momwe mtima ulili. Kawirikawiri, kuperewera kwa impso kumayambitsa kusintha kwa magulu a electrolyte m'magazi, omwe sali owona mu mtima wolephera.
Pansi pa mitsempha ya thrombosis (DVT): DVT ndi magazi omwe nthawi zambiri amachititsa edema ndipo pamapeto pake amatha kuyambitsa PE. Kusiyanitsa kwakukulu pakati pa edema ya DVT ndi ya mtima kulephera ndiko kuti mu DVT, edema nthawi zambiri imakhala ndi mwendo umodzi wokha ndipo siwowonongeka. DVT ingayambitse matenda ochepa m'mimba yomwe imakhudzidwa, imatha kupezeka ndi ululu wa mwendo ndipo ayenera kuchiritsidwa ndi ochepa magazi.
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