Zachidule Zomwe Zimayambitsa Mtima
Kuwonongeka kwa mtima (kapena matenda a myocardial infarction) ndi vuto lalikulu lomwe gawo la mtima wa minofu limamwalira, kawirikawiri chifukwa magazi ake amasokonezeka. Kawirikawiri, matenda a mtima amapezeka pamene phokoso la atherosclerotic limatuluka mwadzidzidzi (mitsempha yomwe imapereka magazi ku minofu ya mtima), zomwe zimapangitsa kuti mitsempha ikhale yovuta kwambiri.
Kuvutika kwa mtima kungakhale ndi zotsatira zoopsa zambiri.
Nthawi zambiri (koma osati nthawi zonse) imakhala ndi zizindikiro zazikulu, makamaka kupweteka kwa chifuwa, dyspnea (kupuma kwa mpweya), kapena kuwonongeka kwa chiwonongeko. Ngati minofu ya mtima yowonongeka ili ndi mphamvu yokwanira yolephereka mtima, ikhoza kukhala ndi vuto la mtima, kapena kenako. Nthenda yamtima imayambitsa kusakhazikika kwa magetsi mu mtima, zomwe zingayambitse imfa mwadzidzidzi kuchokera ku ventricular fibrillation .
Pazifukwa zabwino-zomwe zimakhala zovuta kwambiri ngati mutachita mofulumira mukakhala ndi zizindikiro za matenda a mtima, madokotala anu nthawi yomweyo amazindikira vutoli ndipo mofulumira amapereka chithandizo choyenera-matenda a mtima ndikumveka kwakukulu . Zimasonyeza kuti muli ndi matenda aakulu ( matenda a mitsempha yamtundu, kapena CAD ) omwe atha kale kuwonongeka kwa mtima wanu ndipo akhoza kuwononga kwambiri pokhapokha mutachita zoyenera. Mu zochitika zochepa kwambiri, vuto la mtima lingabweretse chilema chachikulu komanso kufa msanga. Mwanjira iliyonse, matenda a myocardial infarction ndi chochitika chachikulu mu moyo wa wina aliyense.
Ngati mwakhala ndi matenda a mtima, kapena ngati mwayi wanu wokhala ndi wina uli pamwamba , pali zambiri zomwe muyenera kuzidziwa. Pozindikira zifukwa, zizindikiro, njira zothandizira, komanso matenda a mtima, komanso pogwira ntchito limodzi ndi dokotala, mutha kukhala ndi moyo wathanzi.
Kodi N'chiyani Chimayambitsa Mitundu ya Mtima?
> Kuyang'anitsitsa pamapangidwe a mapepala m'mitsempha yomwe ingayambitse matenda a mtima.
Kawirikawiri, matenda a mtima amayamba chifukwa cha kuphulika kwakukulu kwa chikhomo mu mitsempha yamakono. Kuphulika kwa chipika kumayambitsa njira yotsekemera mkati mwa mitsempha ndi mawonekedwe a magazi. Magazi amagazi amachititsa kuti mitsempha ikhale yotalika. Ngati kutsekemera kwakukulu kumakhala kokwanira, minofu ya mtima yomwe imaperekedwa ndi mitsempha imayamba kufa-ndipo matenda a mtima amapezeka.
Funso la chifukwa chake mabala aphulika, ndipo malo omwe amatha kutha, ndi malo a kafukufuku wamankhwala. Ngakhale kuti nthawi zina chimbudzi chidzasokonekera pamtundu wina wa "chikoka" (monga kupsinjika kwa thupi kapena kukhumudwa), nthawi zambiri kupasuka kwapachika kumachitika popanda chifukwa chodziwika, mobwerezabwereza, komanso popanda chodziwika.
Komanso, sizikuwonekera bwino kuti madokotala akuluakulu amadandaula za (mtundu womwe umazindikiritsidwa pambuyo pa kutaya mtima monga "ziphuphu zazikulu") ndizochepa kusiyana ndi zing'onozing'ono, zopanda malire. Chowonadi ndi chakuti, aliyense yemwe ali ndi CAD ayenera kuonedwa kuti ali pachiopsezo cha matenda a mtima-kaya zilembo zawo zimatchedwa "zazikulu" -ndipo ziyenera kuchitidwa moyenera.
'Mitundu' ya Kugonjetsa Mtima
Chidutswa cha mitsempha yamakono chimatha kupanga zinthu zosachepera zitatu zosiyana siyana, zomwe zimapangidwira pamodzi pansi pa dzina lachilendo, kapena ACS . Zizindikiro ndi mitundu itatu ya ACS zimakhala zofanana, ndipo zitatu zonse zimaonedwa kuti ndi zachipatala. Komabe, awiri okhawo amaonedwa kuti ndi amtima.
Mtundu woyamba wa ACS umatchedwa angest wosakhazikika. Mu angina wosasunthika, magazi omwe amachokera ku chiphuphu sichikukwanira (kapena sakhala nthawi yaitali) kuti awononge mitsempha ya mtima wosatha-angina wosakhazikika osati matenda a mtima.
Komabe, popanda ang'anga osasinthasintha angina nthawi zambiri amatsatiridwa posachedwa ndi matenda a mtima. Werengani za angina osakhazikika .
Mtundu wotsatira wa ACS umatchedwa ST-elevation myocardial infarction (STEMI). Dzina limeneli limachokera kukuti gawo la "ST segment" la electrocardiogram (ECG) likuwonekera kwambiri mu izi, mtundu waukulu wa ACS. Ndi STEMI, magazi amagazi ndi aakulu kwambiri, choncho mbali yaikulu ya minofu ya mtima yomwe imaperekedwa ndi mitsempha yowonongeka idzafa popanda kuchiza msanga. Werengani za STEMI .
Mitundu yachitatu ya ACS ndi yopanda matenda a ST segment infectious infarction (NSTEMI), yomwe ingaganizidwe ngati chikhalidwe pakati pa angina osakhazikika ndi STEMI. Apa, kutseka kwa mitsempha yamakono kumangokhala mopanda phindu, komabe kumakhala kochepa kokwanira kubweretsa mavuto ena ku minofu ya mtima. Werengani za NSTEMI.
Onse STEMI ndi NSTEMI, popanda chithandizo chokwanira, zidzasokoneza mwakachetechete minofu ya mtima, choncho mitundu yonse ya ACS imaonedwa ngati ndi mtima.
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Chifukwa Chake Muyenera Kutenga Aspirin Ngati Mukukhala ndi Maganizo a Mtima
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Ubwino wa Mapulogalamu a Rehab Cardiac
Ndikofunika kuti madokotala azitha kusiyanitsa pakati pa mitundu iwiri ya matendawa chifukwa chakuti mankhwalawa amatha kusiyana pakati pawo.
Zizindikiro za Kuthamanga kwa Mtima
Chizindikiro chachikondi cha matenda a mtima ndi kupweteka pamtima, chomwe chingayambane ndi nsagwada kapena mkono, ndipo izi zikhoza kutengeka ndi kutukuta, ndi kumverera koopsa kwambiri kapena chiwonongeko chomwe chikubwera.
Komabe, anthu ambiri omwe ali ndi matenda a mtima alibe zizindikiro izi. Iwo sangakhale ndi ululu pachifuwa konse-kapena ululu uliwonse. Angathe kufotokozera kuti zizindikiro zawo ndizovuta, kapena kusokonezeka kwa nondescript- "kumangokhala kumverera kokondweretsa." Ndipo zizindikiro sizikhoza kufika pachifuwa, koma mmbuyo mwake, kumapewa, pamutu, mikono, kapena m'mimba mwa m'mimba.
Anthu omwe ali ndi ziphuphu zoopsa kwambiri amatha kukhala ndi mseru kapena kusanza, kapena kupuma pang'ono. Kapena, iwo akhoza kungokhala ndi zomwe iwo akunena kuti ndi "kupweteketsa mtima" ndi china chirichonse.
Kawirikawiri, zizindikiro za matenda a mtima zili ndi khalidwe lotere kotero kuti n'zosavuta kuzitsuka. N'zosavuta kungodikirira kuti aone ngati akuchoka okha. Ndipo nthawi zambiri, iwo amachita. Anthu awa ndi omwe adzawoneke mtsogolomu, pamene potsiriza adzawona dokotala, ngati atakhala ndi chotchedwa " mtima wa mtima wamtendere ."
Vuto ndilokuti kupweteka kwa mtima konse-ngakhale osayankhula-kumapangitsa kuwonongeka kwamuyaya kwa minofu ya mtima, nthawi zambiri kuwonongeka komwe kumayambitsa kulemala, kapena kuchepetsera nthawi ya moyo ndi kuchuluka kwa ndalama. Pofuna kuchepetsa kuwonongeka, n'kofunika kuzindikira kuti vuto la mtima likhoza kuchitika, ndi kupeza chithandizo mwamsanga, pamene minofu ya mtima ikadali salvageable.
Zotsatira za kuyambitsa mtima
Zotsatira Zangwiro. Kuwonjezera pa kupanga mitundu ya zizindikiro zomwe tinangoyankhula, vuto lalikulu la mtima lingayambitse mavuto aakulu. Ngati kuchuluka kwa minofu ya mtima kumakhudzidwa ndi mitsempha yotsekedwa yotsekedwa ndi yambiri, munthu amene ali ndi vuto la mtima akhoza kukhala ndi vuto lalikulu la mtima. Kulephera kwa mtima uku kungapangitse kupuma pang'ono, kuthamanga kwa magazi, kutsika kwa mutu kapena syncope , ndi kulephera kwa magulu ambiri. Pokhapokha ngati magazi akutuluka akhoza kubwezeretsedwa ku mitsempha ya mtima yokhudzidwa mofulumira, mtundu uwu wa vuto lalikulu la mtima nthawi zambiri umabweretsa imfa.
Kuonjezera apo, panthawi ya ululu wa mtima wamtima, mitsempha yamtima ikhoza kukhala yosasunthika kwambiri, ndipo imakhala yothamanga kwambiri. Choncho chiopsezo cha imfa mwadzidzidzi mkati mwa maola angapo oyambirira a matenda a mtima ndi okwera. Komabe, mafinysi a ventricular amatha kuchiritsidwa bwino kwambiri (mwa kuwonongeka) ngati zimachitika ngati munthu akuchipatala. Ichi ndi chifukwa china chomwe chiri chofunikira kwambiri kuti musayese "kutuluka" zizindikiro zirizonse zomwe zingayimire matenda a mtima.
Zotsatira Zotsatira. Ngakhale atatha msinkhu wa matenda a mtima, pakadalibe nkhawa zambiri zomwe ziyenera kuthandizidwa.
Choyamba, kuwonongeka kwa minofu ya mtima kumasiya mtima kufookera, ndipo pamapeto pake mtima umatha kukula. Chachiwiri, malingana ndi kuchuluka kwa kuwonongeka kosatha kwa minofu ya mtima, chiopsezo cha imfa mwadzidzidzi chikhoza kukwezedwa. Chachitatu, chifukwa chakuti matenda a mtima achitika amachititsa munthu kukhala pachiopsezo chachikulu cha zotsatira za mtima.
Zonsezi zikutanthawuza kuti chithandizo cha matenda a mtima sichimatha pamene chochitika chovuta chikutha. Chithandizo chochuluka chomwe chikuwongolera kapena kuchepetsa zonse zitatuzi "zotsatira zake zotsatila" zotsatira ndizofunikira.
Kodi Kugonjetsa Mtima Kumapezeka Bwanji?
Kuzindikira matenda a mtima sikovuta kwambiri-malingana ngati zizindikiro za munthu zimayang'anitsitsa antchito azachipatala kuti akhoza. Kawirikawiri, munthu amene ali ndi zizindikiro zomwe amaganiza kuti zimakhudzana ndi mtima wawo, chifukwa cholakalaka kuganiza, amatsutsa zizindikiro akamadza ku chipinda chodzidzimutsa. Ili ndi njira yolakwika. Nthawi yomweyo antchito azachipatala amachenjezedwa kuti akhoza kukhala ndi matenda a myocardial infarction, mofulumira iwo adzachita kapena kutulutsa kuti matendawa.
Kumbukirani kuti, pankhani ya matenda a mtima, miniti iliyonse imafunika. Kotero ngati mulibe nkhawa kwambiri kuti zizindikiro zanu zingakhale zochokera mumtima mwanu, muyenera kunena kuti, "Ndikuganiza kuti ndikudwala matenda a mtima." Izi zidzathamangitsa mpira nthawi yomweyo.
Nthaŵi zambiri, kujambula ECG (zomwe zingasonyeze kusintha kosinthika kwa matenda a mtima) ndi kutumiza magazi kuti ayese mapuloteni a mtima (omwe angayang'ane ngati maselo a mtima akuchitika) adzatsimikizira kapena kusatsutsa matenda a mtima mwamsanga . Posakhalitsa matendawa apangidwa, njira zoyenera zowonongeka zingatengedwe kuti zisawonongeke.
Kuchiza: Maola Oyamba Oyambirira
Kuvutika kwa mtima kwapadera ndizochitika mwamsanga mwachipatala. Minofu ya mtima ikufa, ndipo chithandizo cham'tsogolo n'chofunika kwambiri. Mphindi zingapangitse kusiyana pakati pa kulephera kwathunthu ndi kulemala kosatha kapena imfa. Ichi ndichifukwa chake palibe aliyense amene ayenera kunyalanyaza zizindikiro zosautsa zomwe zimachitika kulikonse m'chiuno.
Munthu akakhala ndi chithandizo chamankhwala ndipo matenda opatsirana a myocardial akupezeka, mankhwala amayamba nthawi yomweyo. Kawirikawiri mankhwalawa amakhala ndi njira ziwiri zomwe zimagwirizana panthawi imodzimodzi: kukhazikika ndi revascularization.
"Kulimbitsa" kumaphatikizapo kuchotseratu zizindikiro zovuta, kuchepetsa kupanikizika pamutu wa mtima, kuthandizira kuthamanga kwa magazi (ngati kuli kotheka), kutenga njira zothetsera batala, ndi kuletsa mapangidwe a magazi mu mitsempha yowonongeka. Izi zimachitidwa mwa kupereka nitroglycerin , oxygen, morphine, beta blockers , statin , aspirin , ndi mankhwala ena otsutsa monga plavix .
Komabe, chinsinsi chenicheni cha zotsatira zabwino ndikutsegula mtima wamtima wakufa-ndiko kuti, kubwezeretsa magazi kudutsa mitsempha yotsekedwa-ndikuzichita mwamsanga. Kuwonongeka kwa mtima kosatha kumatha kupezeka ngati mitsempha imatha kutseguka mkati mwa maola anayi. Ndipo zina zowonongeka zingathe kupezedwa ngati mitsempha imatsegulidwa mkati mwa maola asanu ndi atatu kapena 12. Mwachionekere, nthawi ndi yofunika kwambiri.
Ndi matenda a STEMI (mtundu wa matenda a mtima omwe amachititsa kuti mitsempha yosatsekedwa ikhale yotsekedwa), revascularization imakwaniritsidwa, makamaka, pogwiritsira ntchito mankhwala osokoneza bongo- angioplasty ndi stenting . Nthawi zina njira imeneyi ndi yopanda phindu kapena yowopsya, pomwepo mankhwala othandizira (thriving-a-clot-busting) akugwiritsidwa ntchito kuthetsa vutolo ndikubwezeretsa magazi.
Ndi NSTEMI (mtundu wa nthenda ya mtima imene mitsempha yamakono imatsekedwa pang'onopang'ono), chithandizo cha thrombolytic chawonetsedwa kuti chimavulaza kwambiri kuposa chabwino, ndipo chiyenera kupeŵedwa. Nthawi zina anthu omwe ali ndi NSTEMI amatha kuchiritsidwa okha (zomwe zimakhala zovuta kuti angina azisamalidwa). Komabe, akatswiri a zamoyo amakhulupirira kuti kutupa kumathandiza kwambiri kuteteza minofu ya mtima ndi NSTEMI, ndipo kawirikawiri ndi njira yokondweretsera STEMI ndi NSTEMI.
Cholinga chachikulu pa maola angapo oyambirira ndikuonetsetsa kuti kuthamanga kwa magazi kubwezeretsedwa ku minofu ya mtima yomwe ili pangozi, kutenga njira zothandizira kuti apangidwe kachiwiri kwa magazi, komanso kuchepetsa ntchito ya mtima wochuluka. Nthawi zambiri makamaka ngati mankhwala akuyamba mofulumira, anthu omwe ali ndi vuto lalikulu la mtima amakhala olimba mkati mwa maola 24.
Pambuyo pa Tsiku Loyamba: Mudapulumuka Chiwonongeko cha Mtima-Tsopano Chiani?
Mukakhala mukuyenda bwino pamatenda oyamba-maola 24 oyambirira kapena kotero-ndi nthawi yoti inu ndi madotolo anu muyambe kulandira chithandizo choletsera zotsatira zitatu zotsatira za matenda a mtima: mtima wosalimba, kufa mwadzidzidzi, ndi kupweteka kwamtima.
Kuvutika kwa mtima kumapha minofu ya mtima. Mitsempha ya mtima yakufa imasandulika minofu yowopsya, yomwe imagwirizanitsa mtima palimodzi koma siyikuthandizira ku ntchito ya mtima. Munthu kapena amene amachititsa kuti mtima usapitirire pambuyo pa kuwonongeka kwa mtima kumadalira kuchuluka kwa kuwonongeka kwake ndi momwe minofu yotsala ya mtima imasinthira "kusintha" mmoyo watsopano. Mitundu yotsalira ya mtima, yomwe imakhalapo nthawi zambiri imayankha potembenuza mawonekedwe ake, ndondomeko yotchedwa "kukonzanso." Ngakhale kuti kukonzanso kwina kungakhale kopindulitsa poyamba, nthawi zambiri, kukonzanso kungayambitse mtima kulephera. Werengani za kusintha kwa mtima.
Pali zinthu zingapo zomwe madokotala ayenera kuchita kuti athandize mitima ya odwala kuti asamacheze mtima ndi kuthandiza kutaya mtima. Mmodzi mwa awa ndi ntchito ya beta blockers ndi ACE inhibitors , koma njira zina zimafunikanso. Muyenera kudziŵa njira zonse zomwe zingapeweretse vuto la mtima, ndipo onetsetsani kuti dokotala akuvomereza zomwe zikukukhudzani.
Kukambirana kwapambuyo pamtima kamene kawirikawiri "kudumpha" ndi akatswiri a cardiologists ndi kukambirana za imfa yadzidzidzi. Iyi ndi nkhani yomwe madokotala ambiri amavutika kwambiri kuti akambirane. Komabe, imfa yodzidzimutsa ndiyo ngozi yaikulu kwa anthu ambiri atatha kupweteka kwa mtima, makamaka anthu omwe awonongeke kwambiri m'mitima yawo. Kuwonjezera apo, chiopsezo cha imfa mwadzidzidzi chikhoza kuchepetsedwa, mwa anthu omwe chiopsezo chawo ndi chachikulu kwambiri, pogwiritsira ntchito kowonongeka . Chotsani ndondomeko zokhudzana ndi zomwe anthu ayenera kuganiziridwa kuti zitha kuwonongedwa ndi matenda a mtima, ndipo dokotala wanu akukufunsani ngati mungakhale mmodzi mwa anthu amenewo.
Munthu amene wapulumuka matenda a mtima amadziwa za iwo omwe mwina sakudziwa kale: Ali ndi CAD, ndipo ali pangozi yowonjezereka ya vuto lina la mtima. Mavutowa akhoza kusintha kwambiri ndi mankhwala komanso kukhala ndi moyo wathanzi. Kuwonjezera pa beta blockers ndi ACE inhibitors (zothandiza popeweratu kusintha kwa mtima), anthu ambiri omwe ali ndi vuto la mtima amafunika kukhala ndi maimuna ndi aspirin, ndipo mwina pa mankhwala kuti athetse kapena kuteteza angina (monga nitrates kapena calcium channel blockers ).
Zochita za moyo zomwe zimapangitsa kuti moyo wa m'tsogolo ukhale woopsya ndikuphatikizapo kuthetsa ntchito zonse za fodya, kudya chakudya chamoyo chopatsa thanzi , kuchepetsa kulemera, kupeza bwino kwambiri matenda a shuga ndi kuthamanga kwa magazi (ngati muli ndi izi), ndikuchita masewero olimbitsa thupi (makamaka kuyamba ndi kukonzanso mtima mtima pulogalamu ).
Mndandanda wa Zotsatira za Mtima
Ndizo zambiri zomwe muyenera kuzidziwa ndi kuziganizira. Ingoganizani? Ndizochita zambiri kuti dokotala azidziwe ndi kuganizira. Ndipo masiku ano madokotala amavutitsidwa, ndizotheka kuti ngakhale dokotala wodzipereka kwambiri adzalephera kuchita zinthu zofunikira kwambiri kuti atsimikizire zotsatira zabwino pambuyo pa matenda a mtima.
Tsono pano pali mndandanda wa zizindikiro zokhudzana ndi mtima umene ungawathandize. Lembani mndandanda uliwonse wa mndandandawu ndi dokotala wanu, kuti musatsimikize kuti mwa inu mosakayika mumanyalanyaza sitepe yanu kuti mukhale ndi thanzi labwino la mtima wanu. Mwayendetsa bwino palimodzi-musalole kuti aliyense wa inu alole mpirawo kuti ugwetsedwe tsopano.
Mawu Ochokera
Kugunda kwa mtima ndi bizinesi yaikulu. Mwamwayi, ndi zomwe taphunzira zokhudza matenda a mtima m'zaka makumi angapo zapitazi, komanso ndi mankhwala atsopano omwe adakonzedwa kuti awachitire, mwayi wakufa kapena kukhala ndi zolema zamuyaya pambuyo poti matenda a mtima ayamba kuchepa kwambiri.
Komabe, kuti mulandire madalitso onse opititsa patsogolo chithandizo chamankhwala, muyenera kudziwa zonse zomwe mungathe zokhudzana ndi matenda a mtima-makamaka, momwe mungadziwire kuti mungakhale nawo, ndi zomwe muyenera kuyembekezera njira ya chithandizo. Tikukhulupirira kuti nkhaniyi ikuyamba ndi zomwe muyenera kuzidziwa.
> Zotsatira:
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