Matenda a Mtima: Amuna ndi Akazi

Kusiyana Kosangalatsa Chifukwa cha Gender

Mtima wa mkazi ukuwoneka ngati wa mwamuna, koma pali kusiyana kwakukulu. Mwachitsanzo, mtima wa mkazi nthawi zambiri ndi waung'ono monga momwe zilili m'zipinda za mkati. Makoma omwe amagawaniza ena mwa zipindazi ndi owonda. Mtima wa mkazi umapuma mofulumira kuposa wa munthu, koma umakana pafupifupi 10 peresenti yochepera magazi ndi aliyense. Mkazi akakhala atakakamizika, amayamba kuthamanga ndipo mtima wake umakana magazi ambiri.

Munthu akamangokhalira kupsyinjika, mitsempha ya mtima wake imakhala yowonjezera, kukweza kuthamanga kwa magazi.

Nchifukwa chiyani kusiyana kumeneku kuli nkhani? Zimakhudzidwa chifukwa chiwerewere chimathandiza pa zizindikiro, mankhwala, ndi zotsatira za matenda ena amtima.

Matenda a Coronary Artery (CAD)

CAD, chomwe chimayambitsa matenda a mtima, ndi chimodzimodzi mwa amuna ndi akazi. Mafuta ena ozungulira m'magazi amaikidwa m'makoma a mitsempha ya mtima, kupanga mapepala otchedwa plaques. Pamene zipikazi zimakula pang'onopang'ono, zimakhala zovuta ndipo pang'onopang'ono zimachepetsanso mitsempha, zomwe zimalepheretsa magazi kuyenda. Nthawi zambiri zipikazo zimakhala zofewa ndikukhala zosasunthika ndikutha. Izi zimayambitsa chiwonongeko cha zochitika zomwe zimapanga magazi omwe amasiya magazi. Mwanjira iliyonse, zotsatira zake ndi matenda a mtima.

Ngakhale zili choncho, amayi ali ndi zifukwa zoopsa za CAD zomwe amuna alibe. Amakhalanso ndi zizindikiro zosiyana za matenda a mtima. Pamene zizindikiro zikuwonekera, CAD ingavutike kwambiri kuti muzindikire kugwiritsa ntchito njira zatsopano zoyesera.

Pambuyo pa matenda a mtima, amai samachita nthawi zonse komanso amuna. Nthawi zina zimakhala chifukwa amayi samalandira chithandizo chabwino kwambiri cha matenda awo. Nthawi zina, ndi chifukwa chakuti sakudziwa kuti anali pangozi mpaka itachedwa. Nazi njira zisanu ndi chimodzi zomwe CAD imasiyana pakati pa abambo ndi amai:

1. Azimayi ali ndi zifukwa zoopsa zomwe amuna alibe. Matenda ena omwe amapezeka mwa amayi okha amachulukitsa chiopsezo cha CAD. Izi zikuphatikizapo endometriosis, polycystic ovary matenda (PCOS), shuga, ndi kuthamanga kwa magazi komwe kumachitika panthawi yoyembekezera. Endometriosis yapezeka kuti idzaika chiopsezo cha amayi khumi ndi makumi anayi pazaka zapakati pa 40 aliwonse. Azimayi amalankhulana ndi chikhalidwe cha amuna, monga kuthamanga kwa magazi, shuga yapamwamba ya magazi, ma cholesterol ambiri, kusuta, ndi kunenepa kwambiri. Mofanana ndi amuna, amayi akhoza kuthandizidwa ndi mbiri ya banja la matenda a mtima , makamaka pamene bambo kapena mchimwene amapezeka kuti ali ndi CAD asanakwanitse zaka 55 kapena mayi kapena mlongo anapezeka asanafike zaka 65.

1. Akazi ambiri amakhala okalamba pamene ali ndi vuto loyamba la mtima. Amuna ali pachiopsezo cha matenda a mtima kale kwambiri mu moyo kuposa akazi. Estrogen imapereka akazi ena chitetezo ku matenda a mtima mpaka atatha kusamba, pamene maitiro a estrogen akugwa. Ichi ndichifukwa chake zaka zakubadwa za matenda a mtima mwa amayi ndi 70, koma amuna 66.
2. Zizindikiro za matenda a mtima zingakhale zosiyana kwa akazi. Kupweteka kwa chifuwa (chomwe chimatchedwanso kuti kulemera kwa chifuwa pachifuwa) ndi chizindikiro chofala kwambiri cha matenda a mtima mwa amuna. Azimayi ena amakumana ndi ululu, koma amakhala ndi zizindikiro zosiyana. Mosiyana ndi zopweteka, zopweteka pachifuwa zomwe zimawonetsedwa m'mafilimu, amai nthawi zambiri amakhala ndi zizindikiro zochepa kwa masabata atatu kapena anayi asanatuluke m'mtima. Mbendera zofiira zikuphatikizapo:
   • Kutopa kwatsopano kapena kodabwitsa. Simukuchita khama, koma mumamva ululu, koma simungagone, kapena muli ndi "chifuwa". Mwachitsanzo, ntchito yosavuta ngati kupanga bedi kumakupangitsa kuti umve wotopa mopanda malire kapena kuti mwadzidzidzi mwatayika mukatha kuchita masewero olimbitsa thupi.
   • Kupuma pang'ono kapena thukuta. Tiziyang'anitsitsa ngati chizindikiro chimachitika popanda kuyesayesa, chimakhala ndi chizindikiro cha kupweteka pachifuwa kapena kutopa, kupweteka kwambiri patapita nthawi pambuyo poyesera, kapena kuyambitsa chisangalalo, chimfine chimene chimapezeka popanda chifukwa. Ndiponso, ngati kupuma pang'ono kumapweteka pamene wagona pansi ndi kumasulidwa mukakhala pansi.
   • Ululu mu khosi, mmbuyo, kapena mchira. Samalirani pamene palibe minofu kapena mgwirizano wodabwitsa womwe umapweteka kapena pamene vutolo likufalikira pamene mukudziyesera nokha ndipo muima pamene mukuima. Ululu ukhoza kukhala mu mkono, koma kawirikawiri ndi dzanja lamanzere la amuna. Komanso, samverani ululu umene umayamba mu chifuwa ndikufalikira kumbuyo, ululu umene umapezeka mwadzidzidzi ndipo ukhoza kukudzutsani usiku, kapena kupweteka kumunsi kwamanzere.

1. CAD mwa amai nthawi zina zimakhala zovuta kudziwa. Mafilimu a X-ray (angiogram) atengedwa m'katikati mwa mtima wamakono ndiyeso lagolidi lagolidi lopeza zochepetsedwa kapena zotsekedwa m'mitsempha yayikuru ya mtima. Koma amayi a CAD amakhudza kwambiri mitsempha yaing'ono yomwe sitingathe kuiwona bwinobwino. Ndicho chifukwa chake mkazi aliyense amene wapatsidwa chizindikiro "chonse chowonekera" atatha kuwona zizindikiro komanso ayenera kukhala ndi zizindikiro ayenera kuwona katswiri wamaganizo amene amadziwika kwambiri ndi amayi omwe ali ndi matenda a mtima.
2. Kuvutika kwa mtima kuli kovuta kwa mkazi kuposa mwamuna. Akazi samakonda kuchita chimodzimodzi ndi amuna atatha kupweteka kwa mtima. Nthawi zambiri amafunika kukhala ndi chipatala chotalikirapo ndipo amatha kufa asanachoke kuchipatala. Izi zikhoza kukhala chifukwa chakuti amayi omwe ali ndi matenda a mtima ali ndi zifukwa zina zosatetezedwa, monga shuga kapena kuthamanga kwa magazi. Nthawi zina, ndi chifukwa chakuti amaika mabanja awo poyamba ndipo samadziyang'anira okha.

1. Akazi samakhala ndi mankhwala oyenera pambuyo pa matenda a mtima. Pambuyo pa matenda a mtima, amayi ali pachiopsezo chachikulu chotenga magazi omwe angayambitse matenda ena. Pa zifukwa zosadziwika, iwo sangathe kupatsidwa mankhwala kuti asateteze magazi oterewa. Izi zikhoza kufotokoza chifukwa chake amai ali ochepa kusiyana ndi amuna kuti azikhala ndi matenda a mtima mkati mwa miyezi 12.

Kulephera kwa Mtima

Kulephera kwa mtima kwa amuna kumachitika chifukwa cha kuwonongeka kwa matenda a mtima omwe amachititsa kuti minofu isagwire ntchito moyenera monga momwe iyenera kukhalira. Komabe, amayi amatha kukhala ndi vuto la mtima pamene kuthamanga kwa magazi, matenda a impso, kapena matenda ena amalepheretsa mtima wawo kukhala wosangalala bwino pakati pa zizungu. Akazi omwe ali ndi vutoli la mtima amakhala ambiri kuposa amuna omwe ali ndi vuto la mtima. Koma, amafunika kupita kuchipatala mobwerezabwereza kuti apume mpweya wochepa, ali ndi luso lochepa, ndipo amafunikira thandizo lakumayi.

Fungo la Atrial

Matenda a atrial (afib) ndi chikhalidwe chomwe chimapangitsa mtima kugunda mwachizoloŵezi, mofulumira, mwangwiro. Kafukufuku waposachedwapa apeza kuti amayi okhala ndi afib ali ndi zizindikiro zambiri, khalidwe loipitsitsa, moyo wochulukirapo, komanso zotsatira zoipa kuposa amuna. Amakhalanso ndi mwayi wochiritsidwa ndi afathe ndi catheter ablation, koma amatha kubwereranso kuchipatala chifukwa cha afib pambuyo pa ndondomeko kuposa amuna. Ngakhale mavutowa, amayi omwe amalandira chithandizo cha afib amakhala otha msinkhu kupulumuka ndipo sangathe kufa chifukwa cha vuto la mtima kusiyana ndi amuna omwe ali ndi afib.

Tetezani Nokha

Kaya ndiwe mwamuna kapena mkazi, sikuchedwa kuchepetsa mwayi wodwala matenda a mtima. Nazi zomwe muyenera kuchita:

• Siyani kusuta kapena musayambe
• Yesetsani kuchita masewera olimbitsa thupi (osachepera, kuyenda 30 minutes pa tsiku)
• Idyani zakudya zamtundu, ndiwo zamasamba, mbewu zonse, nsomba ndi zochepa zochokera ku zinyama, zakudya zophweka, ndi zakudya zokonzedwa
• Pitirizani kukhala wolemera thupi, kuthamanga kwa magazi, magazi, komanso shuga.

Dr Cho ndi katswiri wamaganizo ndi mutu wa mutu ku Tomsich Family Dipatimenti ya Ma ARV. Iye ndi amenenso ali Mtsogoleri wa Center Women's Cardiovascular Center.

> Zosowa

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> McSweeney JC, Rosenfeld AG, Abel WM, et al. Kupewa ndikumva matenda a mtima ischemicic monga mkazi: State of the Science. Circ, 2016; 133 (13): 1302-1331.

> Mehta LS, Beckie TM, DeVon HA, ndi al. Kugonana kwapadera kwa amayi: Mfundo ya sayansi ya American Heart Association. Circ, 2016; 133 (9): 916-947.

> Piccini JP, Simon DN, Steinberg BA, ndi al. Kusiyanasiyana kwa zotsatira za kachipatala ndi zogwira ntchito za mafilimu a abambo m'mabambo ndi amayi: Zotsatira za zaka ziwiri kuchokera ku registry ya ORBIT-AF. JAMA Cardiol, 2016; 1 (3): 282-291.

> Kaiser DW, Fan J, Schmitt S, et al. Kusiyanasiyana kwa kusiyana pakati pa amuna ndi akazi pakati pa kachipatala pakatha katheter kuperewera kwa mankhwala opatsirana. JACC Clinic Electrophysiol, 2016; DOI: 10.1016 / j.jacep.2016.04.014.