Makamaka Aang'ono, Kuthamangitsidwa Kwa Mtima Kungakhale Chifukwa cha Zochitika
Kwa zaka zingapo, akatswiri a cardiologist adziwa kuti matenda oopsa a ameri (CAD) mwa amayi akhoza kukhala osiyana kwambiri ndi amuna. Zizindikiro za amayi zikhoza kukhala zosiyana , mayesero opatsirana omwe amagwiritsidwa ntchito ku CAD angapereke yankho "lolakwika" kwa akazi , ndipo matenda omwe akudwalawo angakhale osiyana kwambiri .
zakhala zikuonekeratu kuti pali kusiyana kwina momwe CAD "imachitira" akazi ena.
Kwa atsikana achichepere omwe ali ndi matenda a mtima , kaconary thrombosis (mwala wamagazi mumatumbo) omwe amachititsa kuwonongeka kwa mtima kungayambitsedwe chifukwa cha kuwonongeka kwa chipika cha atherosclerotic , osati ndi kupasuka kwapadera kwa chipika . Pamene matenda a mtima amayamba chifukwa cha kutentha kwa nthaka, zizindikiro zingakhale zonyenga komanso zochepa kusiyana ndi "matenda" a mtima. ndipo mwina akhoza kusowa (kapena kusunthidwa) ndi dokotala. Zotsatira zake, mankhwala akhoza kuchedwa ndipo zotsatira zingakhale zoipitsitsa kwambiri.
Mmene Mtima Umapwetekera Kawirikawiri Amapezeka
Kawirikawiri, matenda aakulu a coronary syndrome (ACS) amayamba chifukwa cha kuphulika kwa chipika. Kuphulika kwapadera nthawi zambiri ndizochitika zovuta komanso zosiyana kwambiri zomwe zimayambitsa zotsatira zofulumira. Kuphulika kumatulutsa "gunk" mkati mwa chipika (cholesterol, calcium, maselo opuwala, ndi zina) ku magazi - ndipo izi zimayambitsa kupangidwira kwachangu.
Kawirikawiri, chovalacho chimayambitsa kutsekemera kwathunthu (kapena pafupifupi kukwanira) kwa mitsempha yamakono, ndi kuthamanga kwa magazi ku gawo la minofu ya mtima yotumizidwa ndi mitsemphayo imatsekedwa. Izi zowonongeka nthawi zambiri zimabweretsa chidziwitso chodzidzimutsa chokhudza ACS - zizindikiro za matenda a mtima kapena angina osakhazikika , kapena ngakhale imfa yapachidzidzidzi yakufa .
Kodi N'chiyani Chimapangitsa Kuti Madzi Akufa Azikhala Osiyana?
Zikuwoneka kuti, makamaka kwa amayi omwe ali ndi vuto la mtima asanakwanitse zaka 50 (makamaka, m'mayi am'mbuyo asanamwali), kupasuka kwapadera nthawi zambiri si chifukwa cha magazi. M'malo mwake, chovalacho chikhoza kuyambitsa kukanganuka kwa khoma la mitsempha ya magazi.
Kodi pali kusiyana kotani pakati pa kupasuka ndi kutentha? Chabwino, chiphuphu cha chikhomo chiri ngati pimple yomwe imatsegulidwa. (Zoonadi, zinthu mkati mwazitsulo zosiyana siyana siziri zosiyana kwambiri ndi zinthu mkati mwa chikhomo cha atherosclerotic.) Koma kutentha kwa nthaka kumakhala ngati chilonda chosaya. Chidebe chokhudzana ndi kutentha kwa nthaka kungakhale kochepetsetsa, kapena sipangakhale choyika pansi pa kutuluka kwa nthaka.
Kukula kwa nthaka, monga kupasuka kwa chipika, kungayambitse kupanga magazi. Komabe, chifukwa kutentha kwa nthaka (kusiyana ndi kuphulika), sikumveka kovuta, chovalacho chimapanga pang'ono pang'onopang'ono. Zizindikiro, zowonjezereka, zingakhalenso zochepa pang'onopang'ono, zowonongeka, ndipo nthawi zambiri zimakhala zovuta.
Chifukwa Chiyani Ichi N'chofunika Kwambiri?
Zakhala zikudziwika kwa zaka zambiri kuti, pamene kuvutika mtima kwa atsikana kumakhala kosazolowereka, zikachitika akaziwa amakhala ndi zotsatira zoipitsitsa kusiyana ndi amuna a msinkhu womwewo. Zotsatira zoipitsitsazi, tsopano zikuwonekera, zikhoza kukhala mbali imodzi chifukwa chakuti ambiri mwa matendawa amayamba chifukwa cha kutentha kwa mitsempha.
Sizizindikiro zokhazokha zowonongeka ngati kupsa mtima, nkhaŵa kapena chinthu china chosakhala cha mtima, komabe zitsekozo zimatha kukhala zoopsa kwambiri kusiyana ndi zotchinga zomwe zimapangika chifukwa cha kutha. Monga tawonera, zotchinga zomwe zimapangidwanso ndi kutentha kwa nthaka zimayamba kukula mwadzidzidzi. Pachifukwa ichi (ndipo chifukwa zizindikiro zomwe zimayambitsa sizimakhala zoopsa kwambiri) ma cloti awa ali ndi nthawi yokhwima. Choncho, panthawi yomwe matenda a mtima amayamba kuonekera, zotchinga zimakula kwambiri, zowonjezereka, komanso zovuta kwambiri.
Kuzindikira Coronary Artery Erosions
Mwamwayi, mitsempha yamakono imakhala yovuta kwambiri kuiganizira musanayambe kupangitsa thrombosis.
Nthawi zambiri sitingathe kuzizindikira nthawi ya matenda odwala mtima kapena kuyesedwa . Choncho kutukuka kwa mitsempha yamakono ndi mtundu wina wa matenda a mitsempha yamakono okhudzana ndi mitsempha ya "yachibadwa" yamakono .
Ndani Amalandira Coronary Artery Erosions?
Ngakhale aliyense atha kukhala ndi mitsempha yamakono, izi zikuwoneka kuti ndizovuta kwambiri kuziwoneka kwa amayi omwe ali ndi chizolowezi chowotcha, makamaka omwe amasuta fodya. Choncho, pamene kusuta ndi chinthu choopsa kwa wina aliyense, ndizoopsa kwambiri pazitsulo zamakono. Ndi chifukwa chabwino kwambiri kuti atsikana omwe akusuta ayenera kusiya.
Palinso umboni wina wosonyeza kuti mchitidwe wamakono umatha kuwonedwa kawirikawiri mwa amayi amene akhala akuphatikizidwa mobwerezabwereza m'mitsempha ya coronary, monga Prinzmetal's angina .
Chidule
Akazi ang'onoang'ono nthawi zambiri amakhala ndi matenda osiyana kwambiri ndi "CAD yamakono" omwe amawoneka mwa amuna ndi akazi achikulire. Kuzindikira kwa izi kumayambitsa kuyesetsa kumvetsetsa bwino kusiyana kumeneku ndi kukhazikitsa njira zothandiza zothandizira.
> Zotsatira:
> Genuardi L. Burzotta F, Veralio R, et al. Kuchokera kwa Mphukira Kumayambitsa ST-gawo Kupanga Myocardial Infarction: Lipoti la Optical Coherence Tomography-Nkhani yolembedwa ndi Kukambitsirana Kwachidule. Matenda a Coronary Artery 2017; Kodi: 10.1097 / MCA.0000000000000463
> Kramer MCA, Rittersma SZH, de Winter RJ, et al. Kulumikizana kwa machiritso a Thrombus kwa Makhalidwe Okhazikika a Plaque Morphology mu Imfa ya Coronary Death. J Am Coll Cardiol 2009; DOI: 10.1016 / j.jacc.2009.09.007.
> Zoccai G, Peruzzi M, Romagnoli E. Kodi matendawa ndi omwe amachititsa kuti awonongeke? Kuyambiranso Kutentha kwa Mabala Akutentha vs. Kupita. Posachedwapa mu Maphunziro a Zamoyo. Kalasi ya American of Cardiology 2016; http://www.acc.org/latest-in-cardiology/articles/2016/02/26/09/34/is-the-pathophysiology-of-plaque-injury-in-acute-mi-changing (yofikira February 26, 2017)