So wo mogya ntini no twetwe mpofirim? Wɔfrɛ eyi (Vasospasm)!

So woate nka mpofirim, ɛyɛ den, anaa ɛyɛ yaw wɔ wo nipadua no fã biako pɛn? Ebetumi aba sɛ esiane sɛ wo mogya ntini biako mu yɛ den mpofirim nti. Wɔ aduruyɛ mu no, wɔfrɛ eyi vasospasm , anaasɛ mogya ntini a ɛtwetwe . Sɛ yɛbɛka no tiawa a, ɛte sɛ nsu paipu a esiw mpofirim, na atwa nsu a ɛsen no mu. Ɛho hia sɛ wote eyi ase efisɛ ebetumi aka wo nipadua no afã horow pii.

Dɛn ankasa ne eyi (Vasospasm)?

Sɛ yɛbɛka no tiawa a, vasospasm yɛ ntini anaa mogya ntini a ɛwɔ wo nipadua mu no a ɛtwetwe mpofirim na ɛkyɛ . Wo de susuw nea ɛbɛba sɛ wobɔ wo nsateaa mu na wubue wo nsateaa mu kakra a, hwɛ? Efi ase yɛ yaw bere tiaa bi akyi, ɛnte saa? Saa na ɛba sɛ wo ntini ahorow no mu yɛ den bere nyinaa a.

Wɔde ntini na ɛyɛ yɛn ntini afasu . Saa ntini ahorow yi twetwe ne ho bere nyinaa na ama wɔatumi adi mogya mmoroso so. Eyi yɛ ade a ɛfata. Nanso, wɔ vasospasm mu no, saa ntini ahorow yi twetwe wɔ ɔkwan a ɛnteɛ so na ɛkyɛ dodo . Eyi ma mogya a ɛsen fa saa ntini no mu no so tew. Eyi ma mframa pa dodow a ɛkɔ ntini a atwa ho ahyia no mu no so tew. Sɛ eyi kɔ so a, ntini no afasu betumi asɛe.

Titiriw no, baabi a nneɛma a ɛnteɛ wɔ mogya ntini no mu no, yɛfrɛ no (endothelial dysfunction) , hokwan kɛse wɔ hɔ sɛ (vasospasm) bɛba.

Dɛn na ɛba bere a vasospasm ba no?

Sɛ vasospasm ba a, ntini a ɛyɛ mmerɛw a ɛwɔ ntini no afasu mu no yɛ wɔn ade boro so wɔ nsɛnkyerɛnne a ɛkyerɛ sɛ ɛbɛtwetwe no ho. Mpɛn pii no, saa ntini ahorow yi twetwe bere tiaa bi. Nanso wɔ vasospasm mu no, wɔtwetwe bere tenten sen sɛnea ɛho hia.

Ɔkwan bɛn so na (Vasospasm) ka me nipadua?

Vasospasm tumi ba yɛn nipadua mu ntini ahorow pii mu, nanso ɛtaa ba mmeae bi. Nhwɛsoɔ:

• Coronary Arteries: Sɛ vasospasm ba ntini a ɛde mogya kɔ koma no mu no mu a, wɔfrɛ no Prinzmetal angina . Eyi betumi asiw mogya a ɛkɔ koma no mu ano na ama obi anya komayare . Fa no sɛ, mpofirim ara, ɛyaw a ano yɛ den wɔ koko mu, na ɛtɔ mmere bi a ɛma ɛyɛ den sɛ wobɛhome.
• Cerebral Arteries: Sɛ ntini a ɛde mogya kɔ amemene no mu (vasospasm) ba a, mogya a ɛkɔ amemene no mu no betumi atew, na ɛde amemene no mu ntini asɛe (cerebral infarct) , tebea a ɛte sɛ ``komayare'' a ɛkɔ amemene no mu. Eyi betumi ama kasa mu ayɛ den na akwaa akwaa anyɛ adwuma.
• Ntini a ɛwɔ nsateaa ne nansoaa mu: Sɛ ntini a ɛyɛ mmerɛw ba nsateaa no mu a, nsateaa no betumi ayɛ nwini, ayɛ mmerɛw, na ne kɔla asesa. Eyi yɛ tebea a ɛnyɛ dɛ koraa.
• Nipple Vasospasm: Sɛ tebea yi ba ɛnanom a wɔma nufu mu a, nufu a wɔma wɔn nufu betumi ayɛ yaw kɛse.

Vasospasm abu so dɛn?

Sɛnea nhwehwɛmu ahorow bi kyerɛ no, ɛnanom a wɔma nufu no mu bɛyɛ 20% betumi anya ntini a ɛyɛ mmerɛw wɔ wɔn nufusu ntini mu. Afei nso, wɔn a wonya tebea bi te sɛ mogya ntini a apaapae wɔ amemene no mu (aneurysm) no mu 50% kosi 90% wɔ asiane mu sɛ wobenya ntini a ɛyɛ mmerɛw.

Dɛn ne vasospasm ho sɛnkyerɛnne ahorow?

Ɛsono sɛnkyerɛnne ahorow no gyina baabi a ntini a ɛyɛ mmerɛw no ba so. Ma yɛnhwɛ sɛnea ɛyɛ adwuma.

Nsɛnkyerɛnne a Ɛkyerɛ sɛ Coronary Vasospasms

Eyinom taa ba bere a wɔagye wɔn ahome, anadwo, anɔpatutuutu, ne awɔw a ano yɛ den akyi . Nhwehwɛmu bi ada no adi sɛ ɛne adwene mu tebea horow te sɛ dadwen ne adwenemhaw nso wɔ abusuabɔ .

Nsɛnkyerɛnne titiriw a ɛkyerɛ ne sɛ:

• Koma a ɛyɛ yaw anaasɛ nyinsɛn a woyi gu mpofirim a ɛyɛ koma no wu.
• Nnipa a wɔtotɔ piti.
• Angina a ɛyɛ den: Eyi kyerɛ sɛ ɛyɛ wo koko mu yaw, titiriw bere a wɔreyɛ adwumaden no.
• Acute coronary syndrome: Eyi betumi ayɛ komayare anaasɛ angina a entumi nnyina.

Nsɛnkyerɛnne a Ɛkyerɛ sɛ Cerebral Vasospasms

Vasospasm a ɛwɔ amemene no mu no betumi de sɛnkyerɛnne ahorow te sɛ:

• Tiyɛ a emu yɛ den mpofirim a emu yɛ den wɔ sikɔne kakraa bi mu.
• Dae a ɛma obi da dodo.
• Nkate a ɛyera anaasɛ ontumi ntutu ne nsa, nan, anaa nipadua no fã biako.

Nsɛnkyerɛnne a ɛkyerɛ sɛ Vasospasms wɔ Nsa anaa Anan mu

Sɛ wowɔ vasospasm wɔ wo nsa, wo nan, anaa wo nsateaa mu a, wubetumi ahu sɛnkyerɛnne ahorow a edidi so yi:

• Nsateaa a ɛyɛ nwini anaasɛ ɛyɛ mmerɛw.
• Wora kɔla sesa (ɛdan fitaa, bruu, kɔkɔɔ).
• Nsateaa a ɛbɔ anaasɛ ɛyɛ mmerɛw wɔ nsateaa no mu.

Nipple Vasospasms Ho Nsɛnkyerɛnne wɔ Ɛnanom a Wɔma Nufu Mu

Sɛ ɛna bi a ɔma nufu nya saa tebea yi a, obetumi anya yare no ho sɛnkyerɛnne te sɛ:

• Ɛyaw a emu yɛ den wɔ nufu no mu .
• Nsakrae a ɛba nufusu kwan no kɔla mu (ebetumi adan fitaa, afei kɔkɔɔ, bruu, anaa kɔkɔɔ).

Dɛn ne nneɛma a ɛde vasospasm ba?

Nneɛma ahorow na ɛde ntini a ɛyɛ mmerɛw ba nipadua no afã horow.

Nneɛma a ɛde Vasospasm ba wɔ Koma no mu

Ɛwom sɛ wonnim nea ɛde eyi ba ankasa de, nanso nneɛma bi wɔ hɔ a ɛne tebea yi wɔ abusuabɔ:

• Nnuru a wɔfrɛ no Serotonin .
• Ayaresa a wɔde ko tia kokoram (Chemotherapy).
• Nnubɔne te sɛ cocaine, amphetamines, anaa wii a wɔde di dwuma .
• Awosu mu nkwaadɔm mu nsakrae.
• Ahonhono.
• Atiridiinini a ɛyɛ hu.

Nneɛma a ɛde Vasospasm ba wɔ Amemene no mu

Vasospasm a ɛwɔ amemene no mu no betumi afi:

• Amemene mu ntini a apaapae.
• Nneɛma afoforo a ɛma mogya tu wɔ amemene no ho.
• Nneɛma anaa nnuru a ɛma ntini no yɛ adwuma a wɔde wɔn ho bɛhyɛ mu.
• Mogya a ɛtwetwe atwa amemene no ho ahyia (Subarachnoid blood clot).

Nneɛma a ɛde Vasospasm ba wɔ Nsa anaa Anan mu

Nneɛma atitiriw a enti ɛte saa ne:

• Raynaud adeyɛ: Eyi ne bere a mogya a ɛkɔ nsateaa no mu no sɛe bere a ɔwɔ awɔw anaa adwennwen mu no.
• Scleroderma: Eyi yɛ yare a ɛma honam ani yɛ den na ɛyɛ den.
• Atherosclerosis: Ntini a ɛyɛ teateaa esiane srade a ɛwɔ ntini no afasu mu nti.
• Mogya a ɛtwetwe.

Nneɛma a ɛde vasospasm ba wɔ nufusu ntini mu wɔ ɛnanom a wɔma nufu mu

Nneɛma pii nti na ebetumi aka eyi:

• Raynaud adeyɛ a ɛyɛ nwonwa no.
• Nnuru bi.
• Esiane sɛ wɔayɛ no nufu oprehyɛn nti.
• Nyarewa a nipadua no tumi ko tia nyarewa.
• Awɔw a wɔde wɔn ho hyɛ mu.
• Akokoaa no a wobebue no ntɛm ara bere a akokoaa no anom awie no.
• Nnuru a wɔde ko tia fungal a wɔde gu nipadua no so ne nnuru bi te sɛ APNO cream.
• Nufusu ntini a ɛsɛe esiane akokoaa no a ɔnom nsa yiye anaasɛ nufu mu pɔmpɛ a ɔde di dwuma nti.
• Tawa a wɔde di dwuma.
• Nneɛma a wonnim sɛ ɛde ba.

Ɔkwan bɛn so na wobehu (Vasospasm)?

Nipadua mu nhwehwɛmu a oduruyɛfo bɛyɛ no ho hia yiye na ama wɔahu yare no. Nanso, wobetumi ayɛ sɔhwɛ ahorow a edidi so yi nso:

• ECG (Electrocardiogram - EKG): Hwɛ anyinam ahoɔden dwumadi a ɛwɔ koma no mu.
• Angiogram: Sɔhwɛ a ɛfa aduru bi a wɔde hyɛ koma no ntini mu ma ɛma ntini no mu yɛ den.
• Positron Emission Tomography (PET) a wɔde yɛ nhwehwɛmu.
• CT scan (Kɔmputa so Tomography - CT) a wɔde yɛ nhwehwɛmu.
• MRI scan (Magnetic Resonance Imaging - MRI) a wɔde hwehwɛ nneɛma mu.
• Echocardiogram: Wɔde ultrasound a wɔde hwehwɛ koma no mu.

Dɛn ne ayaresa ahorow a wɔde sa (Vasospasm)?

Ɛsono sɛnea wɔde sa yare no gyina baabi a ntini a ɛyɛ mmerɛw no ba so.

Ayaresa a Wɔde Ma Vasospasm a Ɛwɔ Koma Ntini Mu

• Nnuru a wɔnom wɔ calcium channel blockers kuw no mu.
• Nnuru a wɔnom wɔ nitrate kuw no mu.
• Mu duru a wɔtew so.
• Nnubɔne ne tawanom a wobegyae.
• Sɛ koma no nnyigyei a ɛnkɔ so pɛpɛɛpɛ te sɛ ventricular tachycardia wɔ hɔ a, fa afiri bi a wɔfrɛ no Implantable Cardioverter Defibrillator (ICD) hyehyɛ mu .

Ayaresa a Wɔde Ma Vasospasm a Ɛwɔ Amemene no Mu

• Nsu pii a wɔnom.
• Mogya mmoroso a ɛkɔ soro (wɔ nnuruyɛfo afotu so).
• Nea ɛde vasospasm ba a wobeyi afi hɔ.
• Nnuru te sɛ verapamil anaa nimodipine a wɔde fa ntini mu (intravenous - IV) ma. Eyinom yɛ nnuru a ɛtrɛw ntini mu.
• Ɛntaa mma koraa, sɛ ɛho hia a, wobetumi de nnuru a ɛtrɛw ntini mu ama.

Nsa anaa Anan mu Vasospasm Ayaresa

• Sɔks, mittens, ne ntade afoforo a ɛyɛ hyew a wɔhyɛ.
• Kwati a wɔbɛkwati tawanom.
• Nnuru a wɔnom fi calcium channel blockers kuw no mu, sɛ nhwɛso no, felodipine anaa amlodipine (Norvasc® anaa Katerzia®).
• Oprehyɛn a wɔbɛyɛ anaasɛ wɔde botulinum awuduru a wɔde bɛhyɛ obi mu.

Ayaresa a wɔde sa vasospasm wɔ nufu mu ntini mu

• Nufusu a ɛyɛ nwini a wɔbɛma ayɛ hyew na wɔakata so.
• Nneɛma a ebetumi ama mogya ntini mu ayɛ den, sɛ nhwɛso no, sigaretnom.
• Sɛ akwan a ɛwɔ atifi hɔ no ntumi nni so a, ɛtɔ mmere bi a ebia ɛho behia sɛ wɔde calcium channel blocker a wɔfrɛ no nifedipine (Nifedical®XL anaa Procardia®XL) anaa Selective Serotonin Reuptake Inhibitor (SSRI) di dwuma.

So ayaresa no mu nsunsuanso bɔne bi wɔ hɔ?

Nnuru bi a wɔde yɛ vasospasm betumi de ɔhaw ahorow te sɛ:

• Tipaeɛ.
• Yafunu mu a ɛyɛ yaw.
• Adwene a ɛyɛ basaa.
• Ti a ɛyɛ hare .
• Seizures - Eyi ho yɛ na yiye.

Ɔkwan bɛn so na wobetumi atew asiane a ɛwɔ hɔ sɛ ntini mu yare no so?

Akwan bi a wobɛfa so atew asiane a ɛwɔ hɔ sɛ ntini mu yare no so no ye ankasa ma wo koma ne wo mogya ntini (koma ne ntini) akwahosan nyinaa.

• Mfa tawa ho nneɛma nni dwuma.
• Ma wo srade dodow nkɔ so ntra nea ɛfata mu.
• To nsa a wonom ano hye.
• Sɛ wowɔ asikreyare a ɛto so abien a, di so yiye.
• Sɛ wowɔ mogya mmoroso a, di so.
• Kwati sɛ wode nnubɔne te sɛ cocaine bedi dwuma.

Ɔkwan bɛn so na wobetumi asiw (Vasospasm) ano?

Nea ɛbɛyɛ na oduruyɛfo asiw vasospasm ano, titiriw wɔ amemene no mu no, obetumi ayɛ nneɛma te sɛ:

• Hwɛ nnuru a worenom no mu na hwɛ hu sɛ nnuru biara nni hɔ a ɛma mogya ntini no yɛ den.
• Nhyɛso a ɛkɔ soro a ɛwɔ atiridiinini mu a wosiw ano.
• Nnuru a esiw calcium kwan te sɛ nimodipine anaa verapamil a wɔde bɛma wo.

Nea ɛho hia: Saa nsɛm yi yɛ nsɛm a ɛfa nnipa nyinaa ho nkutoo. Sɛ wowɔ sɛnkyerɛnne bi anaa wopɛ sɛ wusua eyi ho ade pii a, yɛsrɛ wo hwehwɛ aduruyɛfo afotu.

So Vasospasms yɛ tebea a emu yɛ den?

Ntini a ɛtwetwe nsateaa, nansoaa, anaa nufu mu no betumi ayɛ yaw na ahaw. Nanso, ɛnyɛ nea ɛde nkwa to asiane mu .

Nanso, sɛ vasospasm ba wo koma anaa w’amemene mu , mogya a ɛkɔ saa akwaa no mu a ɛso atew no betumi asɛe ntini ahorow. Eyi betumi anya koma ne amemene no dwumadi so nkɛntɛnso kɛse.

Akoma mu ntini a ɛyɛ mmerɛw no mu nea ennu 5% na ɛma koma no yɛ adwuma yiye. Nanso, ayaresa a wɔde sa komayare no betumi ama asetra atu mpɔn.

Ebia ɛsɛ sɛ nnipa a wɔn amemene mu ntini a ɛyɛ den no tra ayaresabea adapɛn pii.

Mɛyɛ dɛn ahwɛ me ho?

• Fa aduru no di dwuma sɛnea wo duruyɛfo akyerɛ wo no pɛpɛɛpɛ.
• Sɛ wo sɛnkyerɛnne no ankɔ yiye a, ka kyerɛ wo duruyɛfo.
• Nneɛma a ɛkanyan vasospasm a wobɛkwati no betumi aboa ma wɔasiw tebea yi ano.
• Sɛ wowɔ komayare ho sɛnkyerɛnne (sɛ nhwɛso no, wo koko mu yaw kɛse, ɛyɛ den sɛ wobɛhome, ɔfe) a, kɔ baabi a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ ntɛm ara.

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Sɛ wohu sɛ wowɔ (vasospasm) anaasɛ wususuw sɛ wowɔ bi a, wubetumi abisa wo duruyɛfo nsɛm te sɛ eyinom:

• Sɛ nnuru a wɔde di dwuma mprempren no mmoa a, so nnuru afoforo bi wɔ hɔ a metumi anom?
• So wubetumi de me akɔ oduruyɛfo titiriw bi nkyɛn a obetumi aboa wɔ nufusu ho nsɛm ho (sɛ mewɔ vasospasm a ɛwɔ nufusu ntini no mu a)?
• Mpɛn ahe na ɛsɛ sɛ mihu wo (follow-up appointments)?
• Dɛn ne nkɔmhyɛ a ɛfa me tebea no ho?

Nea etwa to no, nneɛma a ɛsɛ sɛ yɛkae

Vasospasm betumi aka yɛn nipadua wɔ akwan horow so. Vasospasm ahorow bi wɔ hɔ a yebetumi adi so na yɛasiw ano. Enti, sɛ wowɔ nsɛmmisa anaasɛ w’adwene mu yɛ wo naa wɔ eyi ho a, nfɛre na wo ne wo duruyɛfo nkasa . Ɔbɛtu wo fo wɔ ayaresa nhyehyɛe ne akwan a wɔfa so siw ano a ɛfata sen biara ma wo ho. Kɔ so nya apɔwmuden!

` Vasospasm, mogya ntini a ɛtwetwe, ntini a ɛtwetwe, komayare, amemene mu yare, mogya a ɛkɔ nipadua no mu ho haw, nsateaa a ɛyɛ mmerɛw