So ntini bi a ɛwɔ wo koma mu betumi apaapae mpofirim? Momma yensua biribiara fa SCAD (Spontaneous Coronary Artery Dissection) ho!

So woasusuw sɛnea obi a ɔwɔ apɔwmuden na ɔteɛteɛ n’apɔw mu yiye betumi anya komayare mpofirim ho pɛn? Anaasɛ ɛbɛyɛ dɛn na ababaa a ɔwɔ apɔwmuden a wabɛyɛ ɛna nkyɛe no betumi anya koko mu yaw mpofirim? Ɛnnɛ yɛbɛka komayareɛ bi a ɛyɛ nwonwa kakra, nanso ɛho hia paa ho asɛm. Eyi ne nea yɛfrɛ no SCAD, anaasɛ Spontaneous Coronary Artery Dissection .

Dɛn ne SCAD (Spontaneous Coronary Artery Dissection) a wɔde wɔn ho hyɛ mu? Momma yɛnte ase tiawa koraa.

Sɛ yɛbɛka no tiawa a, SCAD yɛ tetew anaa mpaapaemu a ɛba mpofirim wɔ ntini abien a ɛwɔ ahrawa mu ntini a ɛde mogya kɔ yɛn koma mu no fasu mu. Susuw ho saa kwan yi so: mogya ntini te sɛ afiri a ɛyɛ tratraa. Saa afiri yi fasu yɛ ntoatoaso pii. Wɔ SCAD mu no, saa layers yi biako tetew na mogya tu wɔ wɔn ntam. Dɛn na ɛba saa bere no? Saa mogya no boaboa ano na ɛtwe kɔ ntini no mu. Ɛyɛ mframa te sɛ balloon. Ne saa nti, mogya a ɛkɔ koma no mu no siw, anaasɛ efi ase tu brɛoo paa.

Eyi te sɛ akisikuru ketewaa bi a enyin wɔ nsu paipu mu na esiw ano. Afei koma no nnya mframa pa ne aduannuru a ehia no.

SCAD ma asiane a ɛwɔ hɔ sɛ wubenya tebea bi a wɔfrɛ no Acute Coronary Syndrome (ACS) no yɛ kɛse . Eyi nso yɛ ahrawa mu ntini mu yare bi. Eyi betumi ama obi ayɛ no yaw, anaasɛ angina . Ebetumi nso ama obi anya komayare, na ebetumi de ne nkwa ato asiane mu.

Dɛn na nsɛm yi kyerɛ?

Sɛ yɛhwɛ nea nsɛmfua abiɛsa yi SCAD kyerɛ wɔ ɔkwan soronko so a, wobɛte saa yare yi ase yiye.

• Nea ɛba ara kwa: Eyi kyerɛ sɛ ɛba mpofirim, a wɔmfa kɔkɔbɔ biara mma .
• Coronary Arteries: Eyinom ne mogya ntini atitiriw a ɛma yɛn koma nya mogya a oxygen pii wom na ɛho tew. Yɛwɔ ahrawa mu ntini atitiriw abien, benkum ne nifa. Wɔkyekyɛ mu yɛ no nkorabata nketewa.
• Ntwitwiridii: Wɔ nnuruyɛ mu no, asɛmfua yi kyerɛ ntini a wɔpaapae mu ma ɛyɛ ntoatoaso te sɛ nea ɛtetew.

So wote ase? Ɛno kyerɛ sɛ, yɛfrɛ eyi SCAD bere a mogya ntini bi a ɛwɔ koma no mu pae mpofirim fi mu a ntease biara nnim no.

Dɛn ne Acute Coronary Syndrome?

Eyi nyɛ yare biako. Ɛyɛ asɛmfua a wɔde di dwuma wɔ ɔkwan a ɛkɔ akyiri so ma tebea horow pii a mogya a ɛkɔ koma no mu no so tew mpofirim. Eyi taa ba bere a plaque a ɛyɛ srade a ɛboaboa ano wɔ ntini no mu (a wɔsan frɛ no atherosclerosis anaa "ntini a ɛyɛ den") no mu paapae mpofirim no. Eyi betumi ama obi anya tebea horow a ɛde ne nkwa to asiane mu te sɛ komayare , komayare, anaa ɔyare a ɛma obi hwe ase .

Wɔfrɛ tebea yi SCAD sɛn?

Aduruyɛ ho abenfo ka sɛ SCAD yɛ tebea a wontumi nhu. Wobu akontaa sɛ nnipa ɔha biara a wonya acute coronary syndrome (ACS) no mu bɛyɛ baanan (4%) wɔ SCAD. Bio nso, SCAD na ɛde ACS a ɛba mmea a wonnii mfe 50 mu bɛyɛ baanan biara mu biako (25%) ba! Eyi kyerɛ sɛ ebia abu so wɔ mmea nkumaa mu sen sɛnea wususuw.

Dɛn nti na SCAD ba? Dɛn na ɛde ba?

Abenfo da so ara nnim nea ɛde SCAD ba ankasa. Nea ɛyɛ nwonwa no, nnipa pii a wonya saa tebea yi yɛ mmofra, wɔn ho yɛ den, na wɔwɔ apɔwmuden. Wɔn nso nni komayare biara a wɔadi kan anya.

Wɔwo SCAD ayarefo binom nnansa yi ara . Wɔahu nso sɛ SCAD taa ba bere a obi rekɔ brayɛ anaa bere a wagyae brayɛ akyi . Enti, adwenem naayɛ bi wɔ hɔ sɛ ebia nsakrae a ɛba mmea nkwaadɔm mu no di dwuma wɔ eyi mu.

SCAD ho yɛ na koraa wɔ mmarima mu, na ɛba wɔ nea ennu ɔha biara mu du (10%) mu. Wɔ mmarima mu no, saa tetew yi taa ba bere a wɔateɛteɛ wɔn apɔw mu denneennen (ahoɔden ntetee) anaa ade a emu yɛ duru a wɔama so akyi . Saa nipadua mu mmɔdenbɔ yi betumi atetew ntini no fasu mu.

Ɛntaa mma koraa sɛ ɔfe a emu yɛ den anaa ahoɔden a ɛwɔ ɔfe mu betumi ama saa ntini no fasu yi apaapae. Ɛtɔ mmere bi a, ahrawa mu ntini betumi apaapae bere a akwanhyia a ɛyɛ hu bi asi anaasɛ bere a wɔreyɛ aduruyɛ te sɛ koma mu ntini a wɔde hyɛ nipadua mu no . Nanso, biribi wɔ hɔ a enti ɛte saa.

Hena na ɔwɔ asiane kɛse mu sɛ obenya SCAD?

Nnipa a wɔwɔ aduruyɛ mu tebea horow bi wɔ asiane kɛse mu sɛ wobenya ahrawa mu ntini a ɛpaapae. Momma yɛnhwɛ nea wɔyɛ:

• Ntini a ɛka bom yɛ nyarewa - sɛ nhwɛso no , Marfan syndrome .
• Mogya mmoroso (Mogya mmoroso a asiane wom).
• Fibromuscular Dysplasia (FMD) - Eyi yɛ yare a ɛka ntini ahorow.
• Thyroid dwumadi a ɛso tew ( Hypothyroidism ).
• Nyarewa a ɛma obi ho hyehye no - nhwɛso ahorow bi ne lupus , multiple sclerosis (MS) , ne sarcoidosis .
• Nnubɔne a wɔde di dwuma ho haw ahorow .

Dɛn ne SCAD ho sɛnkyerɛnne ahorow? Ɔkwan bɛn so na wohu sɛ wɔwɔ yare no?

Sɛ mogya a ɛkɔ koma no mu so tew esiane SCAD nti a, ebetumi ama obi anya komayare anaasɛ koko mu yaw bi a wɔfrɛ no angina a entumi nnyina . Saa angina yi yɛ asiane kɛse efisɛ ɛma asiane a ɛwɔ hɔ sɛ obi benya komayare no yɛ kɛse.

SCAD yɛ aduruyɛ mu tebea a egye ntɛmpɛ a ɛsɛ sɛ wɔsa no ntɛm ara. Sɛ wowɔ komayare ho sɛnkyerɛnne a edidi so yi mu biara a, frɛ 911 ntɛm ara (wɔ Sri Lanka no, frɛ 1990 Suwaseriya Ambulance Service):

• Adwene a ɛyɛ basaa anaasɛ obi a ɔtotɔ piti ( syncope ).
• Fifiri a ɛboro so ( Hyperhidrosis ) anaasɛ awɔw a wɔte nka.
• Koma a ɛbɔ anaasɛ koma a ɛbɔ denneennen .
• Ntini ne nnompe mu yaw wɔ abasa, mmati, anaa anom.
• Akisikuru ne ɔfe, anaasɛ yafunu a ɛyɛ yaw ( indigestion ).
• Ahome a ɛyɛ tiaa .
• Koko a ɛyɛ den, nhyɛso, anaa ɛyaw.

Saa sɛnkyerɛnne ahorow yi ne komayare de no yɛ pɛ pɛpɛɛpɛ. Enti, sɛ wuhyia biribi a ɛte sɛɛ , ntwentwɛn wo nan ase.

Ɔkwan bɛn so na wohu SCAD? (Nyare a Wɔahu) .

SCAD a wobehu no betumi ayɛ den. Sɛ wowɔ koko mu yaw anaa komayare ho sɛnkyerɛnne afoforo a, wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ nhwehwɛmu te sɛ eyinom mfa nhwɛ sɛ SCAD anaa:

• Enzyme marker test: Ɛhwɛ sɛ koma mu enzyme ahorow bi a ɛboaboa ano wɔ mogya no mu bere a obi anya komayare no dodow a ɛkɔ soro anaa.
• Angiogram: Eyi ma wutumi hu mogya a ɛsen wɔ wo koma mu wɔ mfonini ahorow a ɛkeka ne ho a ɛwɔ afã abiɛsa (3D) mu. Ebia eyi bɛka Coronary Computed Tomography Angiogram (CCTA) anaa Magnetic Resonance Angiogram (MRA) ho .
• Intravascular Optical Coherence Tomography (IVOCT): Eyi ma wotumi hwehwɛ ntini no mu fi mu kɔ akyi.
• Intravascular Ultrasound (IVUS): Eyi betumi ama wɔanya mfonini ahorow a emu da hɔ yiye na ɛkɔ akyiri wɔ ntini ahorow no mu.

Saa nhwehwɛmu ahorow yi na ɛma nnuruyɛfo tumi hu ankasa sɛ ebia wowɔ koma mu ntini a atetew anaa komayare foforo bi.

Ɔkwan bɛn so na wɔsa SCAD?

Nnipa dodow no ara a wɔwɔ SCAD, bɛyɛ nkyem anan mu abiɛsa (75%), de nnuru ma wɔn ho tɔ wɔn. Eyinom ne nnuru ahorow a wɔde ma:

• Mogya mmoroso nnuru (e.g., beta blockers ).
• Nnuru a ɛhwɛ srade a ɛkɔ soro so.
• Nnuru a ɛmma mogya ntumi nkɔ ( antiplatelet nnuru ).

Nanso, nnipa a wɔwɔ SCAD no mu bɛyɛ 14% betumi anya tebea a emu yɛ den kɛse. Ebia ɛho behia sɛ wɔde nnipa a wɔte saa kɔ ayaresabea na wɔma wɔn ayaresa ntɛm ara. Ayaresa a ɛtete saa no bi ne:

• Koma mu catheterization , coronary angioplasty ne stent a wɔde si hɔNea ɛka eyi ho ne sɛ wɔde biribi te sɛ balloon bɛhyɛ mogya ntini a asiw no mu na wɔde ahama ketewaa bi (stent) ahyɛ mu na amma ansiw bio.
• Coronary Artery Bypass Grafting (CABG): Nea ɛka eyi ho ne sɛ wɔbɛbɔ ɔkwan foforo a wɔbɛfa so ama mogya ntini a asiw.
• Mfiri a wɔde boa mogya a ɛkɔ nipadua no mu, te sɛ Left Ventricular Assist Device (LVAD) , anaa Implantable Cardioverter Defibrillator (ICD) a wɔde besisi hɔ.
• Koma a wɔde si ananmu - Wei ho yɛ na yiye.

Mpɛn pii no, nnuruyɛfo bɔ mmɔden sɛ wɔde nnuru bedi tebea no ho dwuma, na ɛma ntini a atetew no ankasa sa. Sɛ ɛho hia koraa a, wobu oprehyɛn sɛ ɛho hia.

So wobetumi asiw SCAD ano?

Sɛ wo ntini mu atetew pɛnkoro a, ebia ebehia sɛ woto apɔw-mu-teɛteɛ a emu yɛ den ne ahoɔden ntetee bi ano hye na amma ansi bio. Ebia wo duruyɛfo nso de wo bɛkɔ nhyehyɛe bi a wɔde siesie koma no mu . Eyi betumi aboa ma wo koma akwahosan atu mpɔn na akyerɛ wo sɛnea wobɛteɛteɛ w’apɔw mu dwoodwoo.

Ɛwom sɛ wonhuu abusuabɔ biara tẽẽ biara wɔ SCAD ne awo ano aduru a wɔde hormone di dwuma ntam de, nanso nnuruyɛfo pii kamfo kyerɛ sɛ wonni kan nsusuw awo ano aduru a wɔmfa hormone nni dwuma ho. Sɛ nhwɛso no, vasectomy ma mmarima anaasɛ tubal ligation ma mmea. Bisa wo duruyɛfo no ɔkwan a eye ma wo.

Wubetumi nso ayɛ saa nneɛma yi de atew asiane a ɛwɔ hɔ sɛ wubenya komayare no so:

• Di aduan a ɛma koma nya ahoɔden na ama srade a ɛwɔ wo mu no so atew.
• Tew nkyene a wodi so na di mogya mmoroso so.
• To nsa a wonom no ano hye. Sɛ wowɔ ɔhaw bi wɔ nsanom ho a, hwehwɛ mmoa.
• Hu srade ahorow a wudi na tew srade a ɛnyɛ papa a wudi so.
• Sɛ wowɔ asikreyare , di so yiye.
• Sɛ wonom sigaret a, nya mmoa na ama woagyae.
• Kɔ so yɛ apɔw-mu-teɛteɛ na kura mu duru a ɛfata mu.

Dɛn ne obi a ɔwɔ SCAD no anidaso?

SCAD yɛ tebea a ɛde nkwa to asiane mu. Nnipa a wonya bi no mu bɛyɛ 5% wuwu. Sɛ obi tetew ntini mu a, ebetumi de asiane ahorow a edidi so yi aba:

• Angina a enni sabea: Nnipa kakraa bi betumi ate wɔn koko mu yaw anaa nhyɛso a ɛkɔ so daa. Ebia eyi rentumi nyɛ nnuru a wɔde di dwuma wɔ amanne kwan so te sɛ nitroglycerin ho dwuma yiye .
• Yare a ɛsan ba bio:Bɛyɛ nnipa du biara mu biako (10%) benya SCAD bio wɔ mfe abiɛsa akyi wɔ ayaresa a edi kan no akyi. Wo duruyɛfo no bɛyɛ nhwehwɛmu daa de abɔ mmɔden sɛ obehu nusu yi ntɛm.
• Koma a ɛyɛ hyew: SCAD betumi ama kotoku a atwa koma no ho ahyia no ayɛ hyew, a wɔfrɛ no pericarditis . Ebia wo duruyɛfo bɛhyɛ sɛ wɔnyɛ nhwehwɛmu te sɛ koma MRI anaa angiograms mfa nhwɛ sɛ ɔhaw yi wɔ hɔ anaa.

Enti, ɛho hia yiye sɛ wubedi aduruyɛ ho akwankyerɛ akyi pɛpɛɛpɛ na wɔayɛ nhwehwɛmu wɔ bere ano bere a woanya SCAD akyi.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wususuw sɛ worenya komayare a, frɛ 911 (1990 wɔ Sri Lanka) ntɛm ara.

Bio nso, sɛ wowɔ sɛnkyerɛnne ahorow yi bi a, kɔ oduruyɛfo nkyɛn:

• Koko mu yaw anaa nhyɛso ( Angina ).
• Fifiri a ɛyɛ nwini.
• Ɛyaw a ɛba nsa, anom, anaa mmati mu.
• Ɔhome a ɛyɛ den.
• Ɔbrɛ a ɛtra so, adwenemhaw, anaa mmerɛwyɛ a ntease biara nnim.

Dɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Sɛ wohu sɛ wowɔ SCAD a, ebia wobɛpɛ sɛ wubisa wo duruyɛfo nsɛm yi:

• Dɛn na ɛmaa minyaa saa SCAD yi?
• So metumi anya SCAD bio?
• Dɛn na ɛsɛ sɛ meyɛ de bɔ me koma akwahosan ho ban?
• So ɛsɛ sɛ mehaw me ho wɔ nsɛnnennen ho sɛnkyerɛnne ahorow ho?

SCAD yɛ tebea a ɛde sɛnkyerɛnne ahorow a ɛte sɛ komayare ba nnipa a asiane nnim sɛ wobenya komayare, titiriw mmea. Sɛ wowɔ komayare ho sɛnkyerɛnne a, frɛ nnuruyɛfo a wɔhwɛ ntɛmpɛ so ntɛm ara. Sɛ nhwehwɛmu ahorow kyerɛ sɛ wowɔ SCAD a, wo duruyɛfo no ne wo bɛkasa afa ayaresa a wubetumi apaw ho. Sɛ wɔsa yare mpo a, asiane wɔ hɔ sɛ ntini no bɛpae bio. Wo duruyɛfo bɛhwɛ wo koma akwahosan yiye na ama saa asiane no so atew.

Nkrasɛm a Wɔde Kɔ Fie

Okay, enti yɛaka SCAD ho asɛm pii, ɛnte saa? Nneɛma a ɛho hia paa a ɛsɛ sɛ wokae ni:

• SCAD yɛ komayare a ɛba mpofirim a wɔnhwɛ kwan a ebetumi aka mmea nkumaa a wɔwɔ apɔwmuden titiriw.
• Nsɛnkyerɛnne no te sɛ komayare pɛpɛɛpɛ. Sɛ wo koko yɛ wo yaw, ɛyɛ den sɛ wobɛhome, anaa wo ho fifiri a, mmu w’ani ngu so. Hwehwɛ nnuruyɛfo afotu ntɛm ara.
• SCAD a wobehu no betumi ayɛ den kakra, nanso wobetumi de sɔhwɛ ahorow a ɛfata asi so dua.
• Mpɛn pii no, wobetumi de nnuru asa, nanso ebia nnipa binom behia oprehyɛn anaa ayaresa foforo.
• Ɛho hia yiye sɛ woyɛ asetra mu nsakrae na wodi aduruyɛ mu afotu akyi wɔ SCAD akyi. Eyi betumi atew asiane a ɛwɔ hɔ sɛ ɛbɛsan aba bio no so.

Sɛ wo anaa obi a wunim no wɔ saa sɛnkyerɛnne ahorow yi a, mma wo ho nnpopo na kɔ oduruyɛfo nkyɛn ntɛm. Dodow a wohu ntɛm no, dodow no ara na ɛda adi sɛ ayaresa no bɛyɛ yiye. Kɔ so nya apɔwmuden!

` Spontaneous Coronary Artery Dissection, SCAD, komayare, koko mu yaw, ahurututu mu ntini, mmea akwahosan, ntɛmpɛ