So woate koma mu ntini mu yare ho asɛm pɛn? Yɛn mu pii ate ho asɛm. Wɔ aduruyɛ mu no, wɔfrɛ eyi Coronary Artery Disease ( CAD ). Sɛ yɛbɛka no tiawa a, ɛyɛ tebea a srade ne srade boaboa ano wɔ ntini a ɛde mogya kɔ koma no mu no mu, na ɛma mogya no so tew. Nanso saa ntini ahorow yi betumi asiw wɔ akwan horow so. Ɛnnɛ, yɛrebɛka tebea bi a ɛyɛ den kakra a ehia sɛ wɔde adwene si so titiriw ho asɛm. Ɛne sɛ, bere a srade boaboa ano na esiw ntini a ɛwɔ koma no mu ntini kɛse bi mu kyekyɛ yɛ nkorabata ketewaa no. Fa no sɛ kar akwan a akyeakyea wɔ ɔkwan bi a ɛte sɛ Y so, baabi a akwan abien no mu paapae no ara. Nnuruyɛfo frɛ eyi sɛ ‘Bifurcation Blockage’.
Dɛn ankasa ne nea wɔfrɛ no Bifurcation Blockage yi?
Okay, momma yɛmfa eyi nhyɛ ɔkwan a ɛyɛ mmerɛw so. Wo koma yɛ ntini a ɛyɛ adwuma a ennyae. Enya ahoɔden ne mframa pa a ehia fi mogya ntini a wɔfrɛ no coronary arteries mu . Ntini atitiriw yi nkorabata yɛ nkorabata nketewa de mogya kɔ koma no afã horow nyinaa.
Afei, saa Bifurcation Blockage yi ba bere a srade bi (yɛfrɛ no plaque ) ba wɔ baabi a ntini kɛse bi mu paapae yɛ nkorabata ketewaa bi, kyerɛ sɛ, wɔ Y-junction bi. Saa akisikuru yi siw mogya no kwan. Nnuruyɛfo frɛ saa nkorabata ketewa yi “afã nkorabata anwenne.” Wɔsan frɛ saa abotan yi sɛ “abifurcation lesion.”
Saa beae yi yɛ nea ɛyɛ den kakra sɛ ɛbɛsiw sen mmeae afoforo. Esiane sɛ ɛsono mogya a ɛkɔ ne nhyɛso mu wɔ ha nti, hokwan kɛse wɔ hɔ sɛ plaque bɛhyehyɛ mmeae yi. Na ebetumi ayɛ den kakra sɛ wɔbɛsa.
So akwan titiriw ahorow bi wɔ hɔ a ɛma wosiw kwan yi?
Yiw, nnuruyɛfo kyekyɛ saa asiw yi mu sɛnea emu yɛ den, kyerɛ sɛ, ntini no fã kɛse a asiw. Wɔfrɛ eyi sɛ stenosis . Nneɛma atitiriw abien na ɛwɔ hɔ.
| Ɔkwan a wɔfa so siw kwan | Nkyerɛkyerɛmu a ɛnyɛ den |
|---|---|
| Asɛm a ɛyɛ mmerɛw a wɔde siw kwan | Eyi ne bere a mogya ntini no siw nnu 70%. Eyi kyerɛ sɛ baabi da so ara wɔ hɔ a mogya betumi asen. Ɛnyɛ den koraa sɛ wɔbɛsa eyi. |
| Nneɛma a wɔde siw kwan a ɛyɛ den | Ɛha yi, mogya ntini no asiw bɛboro 70%, a ɛkyerɛ sɛ asiw kɛse. Ɛtɔ mmere bi a, nneɛma bɛboro biako na ebetumi asiw kwan. Anaasɛ mogya a ɛtwetwe anaasɛ calcification na ɛde saa akwanside yi aba. Ade foforo ne sɛ, ɛtɔ mmere bi a, sɛ saa nkorabata ketewa no mu paapae wɔ anim a ɛyɛ nnam yiye (bɛboro digrii 70) a, ɛyɛ den yiye sɛ wɔde nnwinnade bɛhyɛ mu na wɔasa saa beae no yare. |
Tebea yi abu so dɛn wɔ yɛn man yi mu?
Eyi yɛ tebea a abu so yiye. Akontaabu kyerɛ sɛ nnipa a wɔwɔ ahrawa mu ntini mu yare (CAD) a ɛhwehwɛ sɛ wɔde sa yare nyinaa mu 15% kosi 20% hyɛ saa kuw yi mu, a wonim no sɛ bifurcation blockages. Sɛ yɛbɛka no tiawa a, wɔ ayarefo 100 biara a wɔba ayaresabea a wɔn koma mu ntini asiw mu no, bɛyɛ 15-20 na asiw wɔ saa nhyiam yi so. Enti, eyi nyɛ biribi a ɛsɛ sɛ wobu no adewa.
Dɛn nti na eyi rekɔ so? Dɛn ne nea enti ankasa a ɛte saa?
Ade titiriw nti a ɛte saa ne srade a ɛwɔ hɔ a wɔfrɛ no plaque a yɛadi kan aka ho asɛm no. Eyi te sɛ nkannare ne efĩ a ɛboaboa ano wɔ nsu paipu mu bere a bere kɔ so no, na ɛma ntokuru ba paipu no mu. Saa mprɛte yi nam srade, srade, ne calcium a ɛboaboa ano wɔ yɛn mogya ntini afasu mu no so na ɛba. Bere kɔ so no, saa abonnua yi nyin yɛ kɛse na ɛma mogya fa ntini no mu yɛ ketewaa. Awiei koraa no, koma no nnya mogya dodow a wɔhwehwɛ no. Yɛfrɛ tebea yi atherosclerosis . Bifurcation blockage nso fi saa atherosclerosis tebea yi.
Hena na ɔwɔ asiane mu kɛse?
Ɛwom sɛ saa tebea yi betumi aba obiara so de, nanso nnipa binom wɔ asiane kɛse mu. Sɛ wowɔ asiane ahorow yi mu biako anaa nea ɛboro saa a, ɛbɛyɛ papa sɛ wobɛma w’ani ada hɔ kakra.
| Asiane a ɛde ba | Nkyerɛkyerɛmu a ɛnyɛ den |
|---|---|
| Mfe a obi adi ne ɔbarima anaa ɔbea | Asiane no yɛ kɛse ma mmea a wɔagyae brayɛ akyi ne mmarima a wɔadi boro mfe 45. |
| Asikyireyareɛ | Asikreyare betumi asɛe mogya ntini, na ama ayɛ mmerɛw sɛ plaque bɛboaboa ano. |
| Mu duru a ɛboro so anaa kɛseyɛ mmoroso | Bere a nipadua mu duru kɔ soro no, asiane afoforo te sɛ srade ne mogya mmoroso nso kɔ soro. |
| Abusua abakɔsɛm | Sɛ obi a ɔwɔ w’abusua mu (ɛna, agya, anuanom) wɔ komayare a, wo nso wowɔ asiane kɛse mu. |
| Mogya mmoroso (Hypertension) . | Sɛ nhyɛso kɔ soro a, mogya ntini no afasu sɛe na ɛnyɛ den sɛ plaque betumi ayɛ. |
| Cholesterol a ɛdɔɔso | Eyi ne ade titiriw a ɛma plaque yɛ. Asiane no yɛ kɛse sɛ srade bɔne (LDL) pii wɔ mogya no mu a. |
| Apɔw-mu-teɛteɛ a wonnya ne aduan pa a wonni | Nnipa a wɔnyɛ apɔw-mu-teɛteɛ na wodi aduan a ngo, asikre, ne nkyene pii wom no wɔ asiane kɛse mu. |
| Sigaretnom | Sigaretnom sɛe mogya ntini tẽẽ na ɛma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no yɛ kɛse. |
Nsɛnkyerɛnne bɛn na ebia wubenya?
Bifurcation blockage yɛ coronary artery disease (CAD) bi, enti sɛnkyerɛnne ahorow no te sɛ nea ɛwɔ hɔ. Sɛ wowɔ saa sɛnkyerɛnne yi biako anaa nea ɛboro saa a, kɔ oduruyɛfo nkyɛn ntɛm ara.
- Koko mu yaw anaa nhyɛso (Angina): Eyi ne sɛnkyerɛnne titiriw. Ebetumi ayɛ te sɛ nea obi repiapia anaa ɔrepiapia wo koko no mfinimfini.
- Ahome tiaa: Sɛ wote nka sɛ wo home yɛ wo yaw bere a woabrɛ kakra, anaa bere a woreforo antweri no.
- Ɔbrɛ a ɛyɛ soronko a wobɛte nka: Sɛ wote nka sɛ woabrɛ paa anaasɛ woayɛ mmerɛw a ntease biara nnim.
- Mmati anaa abasa mu yaw: Ɛyaw a ɛkɔ fam wɔ abasa benkum so, titiriw.
- Adwene a ɛyɛ wo yaw (vertigo) anaasɛ wobɛtotɔ piti: Sɛ wote nka sɛ wo ti retwa na wuntumi nnyina hɔ.
- Akisikuru: Sɛ wote nka sɛ wobɛfe.
- Awɔw ne fifiri a wɔte nka.
- Koma a ɛbɔ a ɛnteɛ (Heart Palpitations) a wɔte nka.
Nea ɛho hia ne sɛ ɛnyɛ obiara na obehu saa sɛnkyerɛnne ahorow yi nyinaa. Ebia nnipa binom benya tebea no a enni sɛnkyerɛnne biara koraa. Enti, nyansa wom sɛ wobɛkɔ akɔhwɛ wo wɔ aduruyɛ mu daa sɛ wowɔ nneɛma a ɛde asiane ba a.
Ɔkwan bɛn so na oduruyɛfo hu eyi?
Sɛ woka sɛnkyerɛnne ahorow a woaka ho asɛm wɔ atifi hɔ no kyerɛ wo duruyɛfo a, ɔbɛhwɛ wo na ɔde wo akɔyɛ nhwehwɛmu mpɛn pii de akyerɛ sɛ wowɔ tebea yi.
- ECG (Electrocardiogram): Eyi hwehwɛ sɛnea koma no mu anyinam ahoɔden yɛ adwuma hwɛ sɛ ebia biribi asɛe koma no anaa.
- Adwennwen Sɔhwɛ: Wɔyɛ ECG bere a wonam afiri a wɔde tu mmirika so, na wɔhwɛ sɛnea wo koma yɛ adwuma bere a woayɛ basaa no.
- Echocardiogram: Wɔde ultrasound scan a wɔde hwehwɛ koma no mu.
- Cardiac Catheterization (Coronary Angiogram): Eyi ne sɔhwɛ titiriw a wɔde hwɛ sɛ ebia wo ntini ahorow no asiw anaa. Wɔde afiri ketewaa bi fa wo nan anaa wo nsa mu, de nhama gu ntini a ɛwɔ wo koma mu no mu, na wɔde nsu titiriw bi gu mu, na wɔtwe X-ray mfonini. Eyi ma wuhu baabi a akwanside ahorow no wɔ pefee.
- CCTA (Coronary Computed Tomography Angiogram): Eyi te sɛ angiogram, nanso ɛyɛ sɔhwɛ a wɔde CT scan afiri yɛ a wɔmfa afiri nhyɛ nipadua no mu.
Saa nhwehwɛmu ahorow yi bɛma wo duruyɛfo ahu sɛ ebia wowɔ bifurcation blockage ne sɛnea emu yɛ den no ankasa.
Dɛn ne ayaresa ahorow a wɔde sa eyi?
Bifurcation blockage a wɔbɛsa no yɛ den kakra efisɛ side-branch vessel no sua koraa, na ɛma ɛyɛ den sɛ wɔde nnwinnade bɛsa sen ntini titiriw.
Ayaresa titiriw ne angioplasty ne stent a wɔde bɛhyɛ mu . Eyi nyɛ oprehyɛn. Wɔfrɛ eyi sɛ Percutaneous Coronary Intervention (PCI) a wɔde wɔn ho hyɛ mu.
Nea ɛrekɔ so wɔ ha ni:
1. Oduruyɛfo no bɛma wo nsa anaa wo nan ho were no ayɛ mmerɛw, watwa ketewaa bi, na ɔde catheter bi afa mu.Wɔde afiri a ɛyɛ tratraa paa na ɛyɛ mmerɛw a wɔfrɛ no catheter hyɛ mogya ntini bi mu.
2. Afei, bere a wɔrehwɛ X-ray screen no, wɔkyerɛ afiri no kwan kɔ baabi pɔtee a ntini a asiw wɔ koma no mu no wɔ.
3. Balloon ketewaa bi wɔ catheter no awiei. Sɛ edu baabi a asiw no a, balloon no ma mframa bɔ. Afei plaque no mia ntini no fasu no so, na ebue ɔkwan a asiw no bio.
4. Afei, sɛnea ɛbɛyɛ a ɔkwan a wɔabue no anto mu bio no, wɔde afiri ketewaa bi a wɔde ahama ayɛ a wɔfrɛ no stent gu saa beae no.
Sɛ wowie saa ayaresa yi a, wo duruyɛfo bɛkyerɛw wo nnuru titiriw (dual antiplatelet therapy) na amma mogya a ɛbɛtɔ wɔ stent no mu. Ɛho hia sɛ wonom nnuru yi bere tenten a wɔakyerɛw ama wo no.
Dɛn ne akwan a wɔfa so sa yare no?
Akwan titiriw abien na ɛwɔ hɔ a wɔfa so de stent gu bifurcation blockages mu.
- Bere Tiaa mu Stent: Wɔ saa kwan yi so no, oduruyɛfo no de stent si ntini kɛse no mu nkutoo. Wɔmfa baa dwumadibea ketewa no nsi hɔ. Wobetumi de stent ahyɛ baa dwumadibea ketewa no mu akyiri yi, sɛ wunya yare no ho sɛnkyerɛnne bio nkutoo a.
- Nneɛma a Wɔde Sent Mmienu: Sɛ nea asiw no yɛ den yiye a, oduruyɛfo no betumi asi gyinae sɛ ɔde stent bɛhyɛ ntini kɛse no ne nkorabata ketewa a ɛpue no nyinaa mu.
So nsɛnnennen bi wɔ hɔ a ebetumi aba wɔ ayaresa akyi?
Ɛwom sɛ angioplasty ne stenting yɛ ayaresa a edi mu de, nanso nsɛnnennen betumi aba nnipa kakraa bi pɛ so.
| Nsɛnnennen a ɛba | Nkyerɛkyerɛmu a ɛnyɛ den |
|---|---|
| In-stent Restenosis a Ɛyɛ Fɛ | Eyi kyerɛ sɛ akuru ntini ba stent no ase, na ɛma ntini no san yɛ teateaa bio. Eyi taa ba wɔ asram 6 akyi wɔ ayaresa no akyi. Sɛ eyi ba a, ebia ebehia sɛ woyɛ angioplasty foforo anaa ayaresa foforo. |
| Stent Thrombosis a Wɔde Yɛ Adwuma | Eyi yɛ tebea a emu yɛ den, nanso ɛntaa nsi koraa, a mogya a ɛtɔ gu stent no mu na esiw ntini no mpofirim. Nea ɛbɛyɛ na woasiw eyi ano no, ɛsɛ sɛ wonom aduru a ɛmma mogya ntumi nkɔ yiye no. |
So wontumi nsiw tebea a ɛte sɛɛ ano?
Akyinnye biara nni ho sɛ ebetumi aba. Koma mu yare ne yɛn asetra kwan wɔ abusuabɔ kɛse. Enti, asetra kwan a ɛma koma pa a wogye tom no betumi atew asiane a ɛwɔ hɔ sɛ obi benya saa tebea yi so kɛse.
- Di aduan a ɛma koma nya ahoɔden. Tew nnuan a ngo, nkyene, ne asikre pii wom so sɛnea wubetumi. Fa nnuaba, nhabannuru, atoko, mpataa nketewa, ne aburow a wɔayam ka w’aduan ho.
- Sɛ wonom sigaret a, gyae nnɛ. Sigaretnom yɛ koma no atamfo akɛse no mu biako.
- Yɛ apɔw-mu-teɛteɛ daa. Yɛ biribi te sɛ nantew anaa sakre so anyɛ yiye koraa no simma 30 da biara.
- Di wo nipadua mu duru so. Mu duru pɔtee bi wɔ hɔ a ɛfata wo tenten. Bɔ mmɔden sɛ wobɛkɔ so akura mu.
- Sɛ wowɔ asikreyare, mogya mmoroso, anaa srade a ɛwɔ wo mu a, di so denam nnuru a wo duruyɛfo akyerɛw ama wo no a wobɛnom so.
- Tew adwennwen so. Eye paa sɛ wode wo ho bɛhyɛ nneɛma te sɛ yoga ne nsusuwii mu.
- To nsa a wonom ano hye.
Bere bɛn na ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn ntɛm ara?
Kae eyi: Sɛ wuhu komayare ho sɛnkyerɛnne te sɛ wo koko mu yaw a emu yɛ den mpofirim, ahome a ɛyɛ tiaa, anaa fifiri a wofifi a, ntwentwɛn wo nan ase sekan biako mpo. Frɛ 911 ntɛm ara anaa fa ɔyarefo no kɔ Emergency Department (ETU) a ɛwɔ ayaresabea a ɛbɛn wo no.
Bio nso, sɛ wotaa hu sɛnkyerɛnne ahorow a edidi so yi a, hwɛ hu sɛ wobɛkɔ oduruyɛfo nkyɛn akɔhwehwɛ afotu.
- Koko mu yaw (angina), abasa anaa mmati mu yaw
- Awɔw ne fifiri a wɔte nka
- Ɔhome a ɛyɛ den
- Ɔbrɛ anaa mmerɛwyɛ a wontumi nkyerɛkyerɛ mu
Nsɛmmisa a ɛsɛ sɛ wubisa wo duruyɛfo
Sɛ wuhu sɛ wowɔ saa tebea yi a, ɛyɛ ade a ɛfata sɛ wubenya nsɛmmisa pii wɔ w’adwenem. Mma nkura biribiara mu, bisa wo duruyɛfoɔ na hu.
- Dɛn na ɛrema mete nka sɛ makɔ so ayɛ me saa?
- So asiane wɔ hɔ sɛ me mogya ntini afoforo no besiw saa ara?
- So angioplasty ne stenting betumi asa saa akisikuru yi koraa?
- Stent bɛn na wokamfo kyerɛ me?
- Stent dodow ahe na ebehia sɛ mede ahyɛ mu?
- Dɛn na ɛsɛ sɛ meyɛ de bɔ me koma ho ban?
- Nsɛnnennen bɛn na ɛsɛ sɛ ɛhaw me wɔ ayaresa akyi?
Mewɔ anidaso sɛ saa nsɛm yi bɛboa wo ma woanya tebea yi ho ntease pa. Kae sɛ eyi nyɛ biribi a ɛsɛ sɛ wusuro, na mmom ɛyɛ biribi a ɛsɛ sɛ wodi ho dwuma yiye.
Nkrasɛm a Wɔde Kɔ Fie
- Bifurcation blockage yɛ blockage pɔtee bi a ɛba baabi a mogya ntini bi a ɛwɔ koma no mu kyekyɛ yɛ nkorabata. Eyi yɛ nea ɛyɛ den kakra sen sɛnea wɔtaa siw kwan.
- Nsɛnkyerɛnne no te sɛ nea ɛwɔ komayare a ɛtaa ba mu no. Koko mu yaw ne ahome a ɛyɛ tiaa ne nea ɛde ba titiriw. Mmu w’ani ngu eyinom so da.
- Stent a wɔde si hɔ no yɛ ayaresa a edi mu, nanso ɛhwehwɛ sɛ oduruyɛfo a ne ho akokwaw de ne ho gye mu.
- Nea ɛho hia sen ayaresa mpo ne sɛ wobɛsakra w’asetra kwan. Adidi pa, apɔw-mu-teɛteɛ, ne subammɔne a yɛbɛkwati ho hia.
- Koko mu yaw a emu yɛ den yɛ ade a egye ntɛmpɛ. Kɔ ayaresabea bi Dwumadibea a Ɛhwɛ Nneɛma a Ɛho Hia Ntɛmntɛm (ETU) ntɛm ara.
Koma Yare, Bifurcation Blockage, Coronary Artery Yare, Stenting, Angioplasty, Koma mu Ɛyaw, Koma mu Yare
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