Angina wosasunthika ndi chitsanzo cha angina chomwe chimapezeka mwadzidzidzi kapena mosadziŵika bwino ndipo sichinthu chogwirizana ndi chowoneka chilichonse chowoneka ngati kuumirira thupi kapena kupsinjika maganizo. Angina wosakhazikika ndi mtundu wa matenda oopsa a ACS , ndipo ngati ACS yonse, angina yosakhazikika ayenera kuonedwa kuti ndi yowopsa mwachipatala.
Mwachidule
Angina amaoneka ngati "wosasunthika" pamene sichikutsatiranso zochitika zodziwika bwino za " angina yolimba ." Angina wosasunthika amaikidwa ngati "osakhazikika" mu zochitika ziwiri.
Poyamba, mosiyana ndi angina okhazikika, zizindikiro zimachitika mwachisawawa komanso mosadziŵika bwino. Ali mkati mwa angina, zizindikiro zimabweretsedwamo, kutopa, mkwiyo, kapena vuto linalake, muzisonyezo zosasunthika za angina zingathe (ndipo nthawi zambiri zimachitika) popanda chowonekera. Ndipotu, angina wosasunthika kaŵirikaŵiri amapezeka pamtunda, ndipo amatha kuukitsa anthu ku tulo tokha. Komanso, mu angina osasunthika, zizindikirozo zimangokhalapo kwa mphindi zingapo, ndipo nitroglycerin nthawi zambiri silingathetsere ululu. Kotero: angina wosakhazikika ndi "wosasunthika" chifukwa zizindikiro zingayambe kawirikawiri kuposa nthawi zonse, popanda chowoneka bwino, ndipo zingapitirire kwa nthawi yaitali.
Chachiwiri, komanso chofunika kwambiri, angina wosakhazikika ndi "wosasunthika" chifukwa, monga mitundu yonse ya ACS, nthawi zambiri imayambitsidwa ndi chigoba chokhazikika pamtunda. Mu angina wosasunthika, chipika chopunthidwa, ndi magazi omwe nthawi zambiri amagwirizanitsidwa ndi kupasuka, kutseketsa pang'onopang'ono kwa mitsempha.
Kutsekera pang'ono kumalo kungatenge mtundu wa "kugwedeza" (monga magazi amatha kukula ndi kufooka), kupanga angina yomwe imabwera ndikupita mwatsatanetsatane. Ngati chovalacho chingachititse kuti mitsempha ikhale yotsekemera (zomwe zimachitika kawirikawiri), minofu yamtima yomwe imaperekedwa ndi mitsempha yotereyi ili pachiwopsezo chachikulu chokhazikitsa chiwonongeko chosasinthika.
Mwa kuyankhula kwina, chiopsezo chachikulu cha myocardial infarction ndi chachikulu kwambiri mu angina osakhazikika. Mwachiwonekere, chikhalidwe choterocho "chosasunthika," ndipo chifukwa chaichi ndizodzidzidzi zamankhwala.
Zizindikiro
Aliyense amene ali ndi mbiri ya matenda a mitsempha ayenera kuganiza kuti angina wosasunthika ngati angina awo ayamba kuchitika pamatenda ochepa kuposa momwe amachitira akamapuma ngati apitirira nthawi yambiri ngati zimakhala zovuta kuthetsa nitroglycerin, makamaka ngati imadzutsa iwo usiku.
Anthu omwe alibe mbiri yakale ya matenda a mitsempha akhoza kukhalanso angina osakhazikika. Tsoka ilo, anthu awa akuwoneka kuti ali pachiopsezo chachikulu cha matenda a mtima chifukwa, mwatsoka, nthawi zambiri samadziwa zizindikiro monga angina. Zizindikiro zamakono za angina zimaphatikizapo kupsinjika kwa chifuwa kapena kupweteka, nthawi zina kufinya kapena "kulemera" mu khalidwe, nthawi zambiri kumathamanga mpaka kumsana kapena kumanzere. Tsoka ilo, odwala ambiri omwe ali ndi angina alibe zizindikiro zapachiyambi. Kusokonezeka kwawo kungakhale kofatsa kwambiri ndipo kungakhale kumalo kumbuyo, mimba, mapewa, kapena mwina kapena mikono yonse. Kupwetekedwa mtima, kupuma, kapena kungokhala ndi mtima wokhumudwa kungakhale chizindikiro chokha. Izi zikutanthawuza kuti aliyense yemwe ali ndi zaka zapakati kapena zapakati, makamaka amene ali ndi vuto limodzi kapena zoopsa zambiri za matenda a mitsempha, ayenera kukhala tcheru ku zizindikiro zomwe zingayimire angina.
Ngati mukuganiza kuti mungathe kukhala angina wosakhazikika, muyenera kupita kwa dokotala wanu, kapena ku chipinda chodzidzimutsa, mwamsanga.
Kudziwa
Zizindikiro ndizofunikira kwambiri pozindikira kuti angina wosakhazikika, kapena kuti, mtundu uliwonse wa ACS. Makamaka, ngati muli ndi zizindikiro zitatu zotsatirazi, dokotala wanu ayenera kutenga izo ngati chitsimikizo champhamvu kuti mtundu umodzi kapena wina wa ACS ikuchitika:
- Angina akupumula, makamaka ngati amatha mphindi 20 panthawi
- Zatsopano zatsopano zomwe zimakulepheretsani kuti muchite nawo masewera olimbitsa thupi
- Kuwonjezeka kwa angina yowonongeka, ndi zigawo zomwe zimapezeka nthawi zambiri, zakhalapo nthawi yaitali, kapena zimakhala zochepa kuposa kale
Dokotala wanu atakayikira ACS, ayenera kupeza nthawi yomweyo kuyesa kwa ECG ndi kuyezetsa magazi kuti ayesedwe.
Ngati gawo la ECG lodziwika kuti "zigawo za ST" likutambasulidwa (lomwe limasonyeza kuti mitsempha imatsekedwa kwathunthu), ndipo mavitamini a mtima amachulukanso (omwe amasonyeza kuwonongeka kwa maselo a mtima), "matenda aakulu" a myocardial infarction (MI) amapezeka (wotchedwanso "ST-gawo kukwera MI," kapena STEMI ).
Ngati zigawo za ST sizinakwereke (zomwe zimasonyeza kuti mitsempha sizimaletsedweratu), koma mapuloteni a mtima amawonjezeka (akuwonetsa kuti selo likuwonongeka), MI "yaying'ono" imapezeka (yomwe imatchedwanso "gawo la ST osati la ST , "kapena NSTEMI ).
Ngati zigawo za ST sizikwera ndipo mavitaminiwo ndi achilendo (kutanthauza kuti mitsempha sizimalephereka ndipo palibe kuwonongeka kwa selo), angina wosakhazikika amapezeka.
Zovuta, angina wosakhazikika ndi NSTEMI ndizofanana. Pa chikhalidwe chilichonse, kupasuka kwapopayi kwachitika mu mitsempha yamakono, koma mitsempha siitetezedwa kwathunthu kotero kuti magazi ena amakhalabe. Zonsezi, zizindikiro za angina zosakhazikika zilipo. Kusiyana kokha ndikoti mu NSTEMI zokwanira zowononga maselo a mtima zakhala zikuchitika kuti zipangitse kuwonjezeka kwa michere ya mtima. Chifukwa chakuti zinthu ziwirizi ndizofanana, mankhwala awo ali ofanana.
Chithandizo
Ngati muli ndi angina wosakhazikika kapena NSTEMI, muzitha kuchitidwa chimodzi mwa njira ziwiri: a) kuchitira nkhanza mankhwala osokoneza bongo kuti mukhazikitse mkhalidwewo, kenaka muyese mosaganizira, kapena b) muzitsutsa mankhwala osokoneza bongo kuti mukhazikitse vutoli, ndipo Konzani ndondomeko yoyamba yowonongeka (nthawi zambiri, angioplasty ndi stenting).
Zotsatira:
Hamm, CW, Braunwald, E. Chiwerengero cha angina chosasinthidwanso. Circulation 2000; 102: 118.
Meier, MA, Al-Badr, WH, Cooper, JV, et al. Kutanthauzira kwatsopano kwa matenda a myocardial infarction: Kusanthula ndi kutanthawuzira kumatanthauza kwa odwala omwe ali ndi syndromes odwala kwambiri. Arch Intern Med 2002; 162: 1585.