He hoaaloha o ko kākou puʻuwai: E aʻo pono kākou e pili ana i ka Circumflex Artery!

Ua noʻonoʻo paha ʻoe i ke ʻano kupaianaha o ka hana ʻana o ko kākou puʻuwai ? Aia i loko o kēlā puʻuwai liʻiliʻi kahi pūnaewele koʻikoʻi o nā kīʻaha koko. ʻO kekahi o nā hoaaloha kūikawā o kēlā pūnaewele ua kapa ʻia ʻo 'Circumflex Artery'. Hiki i kāu kauka ke kapa iā ia ʻo ke aʻa 'LCx', a i ʻole 'circ'. No laila, i kēia lā, e kamaʻilio kākou e pili ana i kēia 'Circumflex Artery' me nā kikoʻī hou aku?

He aha ka 'Circumflex Artery'? E hoʻomaopopo maʻalahi kākou!

ʻAe, e noʻonoʻo e pili ana i kēia ʻano. ʻElua mau kīʻaha koko nui e hoʻolako i ke koko i ko kākou puʻuwai. ʻO lākou nā aʻa coronary hema a me ka ʻākau. A laila māhele ʻia ke aʻa coronary nui hema (ka Left Main Coronary Artery) i ʻelua mau lālā liʻiliʻi. ʻO kekahi o kēlā mau lālā ʻo ia ke aʻa circumflex a mākou e kamaʻilio nei. ʻO kekahi lālā ʻo ia ka aʻa descending anterior hema (LAD Artery). Kāhea nā kauka i kēia bifurcation o ke kīʻaha koko.

No laila, ʻo ka hana nui o kēia `(Circumflex Artery)` ʻo ia ka lawe ʻana i ke koko maʻemaʻe a me ka oxygen i ke kua a me nā ʻaoʻao o nā keʻena pamu ma ka ʻaoʻao hema o ka puʻuwai. Ua like ia me kahi paipu e lawe ana i ka wai i kahi pamu wai.

He aha ka mea e hana nei me kēia `Circumflex Artery`?

Loaʻa iā kākou kahi ʻōnaehana e lawe ana i ke koko ma o ko kākou kino holoʻokoʻa, a mākou e kapa nei ʻo ka ʻōnaehana Circulatory. ʻO kēia "Circumflex Artery" he kīʻaha koko koʻikoʻi e pili ana i ka puʻuwai ma ia ʻōnaehana.

ʻOkoʻa iki paha ka mea e hana ʻia ma ʻaneʻi ma muli o ke ʻano o ke kino o kēlā me kēia kanaka. Eia nō naʻe, i loko o kēlā me kēia kanaka, ua hoʻolako ʻia nā ʻāpana ma lalo nei o ka ʻaoʻao hema o ka puʻuwai me ke koko momona i ka oxygen e ka "Circumflex Artery":

• ʻAtrium hema - ʻO kēia ke keʻena hema o luna o ka puʻuwai.
• ʻO ka Ventricle Hema - ʻO kēia ke keʻena nui ma ka ʻaoʻao hema haʻahaʻa o ka puʻuwai.
• Nā ʻiʻo papillary i loko o ka ventricle hema.

I kekahi poʻe, akā ʻaʻole i nā mea a pau, ʻo kēia `(Circumflex Artery)` ka mea e hoʻolako i ke koko i kekahi ʻāpana koʻikoʻi o ka puʻuwai. ʻO ia ka `Sinoatrial Node` (`SA Node`). I ka hapa nui o nā kānaka, hana ʻia kēia hana e ke aʻa coronary nui ʻākau. ʻO kēia `(SA Node)` kekahi ʻāpana o ka ʻōnaehana hoʻokele uila o ka puʻuwai e kaohi ana i ko kākou puʻuwai. Ua kapa pū nā kauka iā ia ʻo ka ``pacemaker kūlohelohe`` o ka puʻuwai.

No laila, ma hea kēia 'Circumflex Artery'?

Ua ʻōlelo mua mākou ua māhele ʻia ke aʻa coronary nui hema o ko kākou puʻuwai i ʻelua lālā. Maanei e hoʻomaka ai kēia `(Circumflex Artery)`. Aia ia i loko o ka papa pale waho o ka puʻuwai i kapa ʻia ʻo `(Epicardium).` I ka pololei, hele ia ma kahi kahawai liʻiliʻi ma waena o nā keʻena ʻelua ma ka ʻaoʻao hema o ka puʻuwai.

He mau lālā ʻē aʻe ko ka `Circumflex Artery`?

ʻAe, hāʻawi pū kēia `(Circumflex Artery)` i nā lālā liʻiliʻi. Ua kapa ʻia kēia mau mea ʻo `Marginal Artery Branches`. ʻAʻole like ka helu o kēia mau lālā no kēlā me kēia kanaka. Loaʻa paha i kekahi poʻe ʻekolu wale nō lālā e hele ana i ka ʻaoʻao i kapa ʻia ʻo `Obtuse Marginal Branches`. ʻO ka maʻamau, hele kēia mau lālā liʻiliʻi ma waho o `Left Ventricle`, i kona `Apex`.

I loko o kahi heluna liʻiliʻi loa o ka poʻe, aia kekahi lālā ʻē aʻe o kēia `(Circumflex Artery)` i kapa ʻia ʻo `Left Posterior Ventricular – LPV Artery`. Eia nō naʻe, i ka hapa nui o ka poʻe, aia kekahi lālā ʻē aʻe o kēia `(LPV Artery)` (i kapa ʻia hoʻi ʻo `Posterolateral Artery`) i kapa ʻia ʻo `(Circumflex Artery)` mai ke aʻa coronary nui ʻākau.

He aha ka Coronary Arterial Dominance?

He kumuhana hohonu iki kēia, akā e hoʻāʻo kākou e hoʻomaopopo maʻalahi. ʻO ke aʻa nui e hoʻolako koko i ka papa ʻiʻo waena (`Myocardium`) o ko kākou puʻuwai ʻo ia ka `Posterior Descending Artery` (`PDA`). No laila, ʻo ke kūlana koʻikoʻi o kou aʻa coronary e hoʻoholo ʻia e ka lālā aʻa nui e hoʻolako koko i kēia `(PDA)` i loko o kou puʻuwai.

Hiki ke hana i kēia ma ʻekolu mau ʻano nui:

• Kaʻapuni ʻākau: ʻO kēia ka mea i loaʻa i ka hapa nui o ka poʻe (ma kahi o 85 mai ka 100). Maanei, loaʻa i ka PDA ke koko mai ke aʻa coronary ʻākau.
• Ke kahe koko ma ka ʻaoʻao hema: Hana ʻia kēia ma kahi o 1 i loko o 10 mau kānaka. Maanei, hoʻolako ʻia ka PDA me ke koko mai ka Circumflex Artery a i ʻole ka LAD Artery.
• Kaʻapuni Codominant: Loaʻa kēia ʻano ma kahi o 2 o 10 mau kānaka. Loaʻa i ka PDA ke koko mai ke aʻa coronary ʻākau a me ke aʻa circumflex hema a i ʻole ke aʻa LAD.

E noʻonoʻo e like me ka paipu wai nui e hoʻolako ana i ka wai i kahi hale. Loaʻa i kekahi mau hale ka wai mai ka paipu ma ka ʻākau wale nō, kekahi mai ka hema, a kekahi mai nā ʻaoʻao ʻelua.

Aia kekahi mau aʻa ʻē aʻe o ke ʻano "Circumflex" i loko o ko kākou kino?

ʻAe, ma waho aʻe o ka "Circumflex Artery" i loko o ka puʻuwai, aia kekahi mau ʻano aʻa ʻē aʻe i loko o ko mākou kino i kapa ʻia ʻo ia ka inoa.

• ʻO nā ʻAteries Circumflex Femoral: ʻO kēia nā lālā hohonu ʻelua e lālā ana mai ke kīʻaha koko nui i loko o ko mākou ʻūhā, ʻo ia hoʻi ka Femoral Artery. Lawe ke Femoral Artery i ke koko mai ka ʻōpū i lalo i nā wāwae. I kekahi manawa, i ka wā o ke ʻoki ʻana i ke kīʻaha coronary artery, lawe nā kauka i kahi Circumflex Artery mai ka ʻūhā a hoʻohana iā ia ma ke ʻano he graft.
• Nā ʻAʻa Humeral Circumflex:Ua māhele ʻia kēia mau mea e ka `(Axillary Artery)` ma ko kākou ʻāpana ʻauwae. ʻO kēia `(Axillary Artery)` ka mea e lawe i ke koko mai ka umauma a i nā poʻohiwi a me nā lima. ʻO ke ʻano kūikawā, ʻo ko kākou iwi lima luna (`Humerus`) ka mea i hoʻolako nui ʻia me ke koko e kēia `(Posterior Humeral Circumflex Artery)`.

He aha nā maʻi e hoʻopilikia ai i ka 'Circumflex Artery'?

E like me nā aʻa coronary ʻē aʻe, hiki ke hoʻopilikia ʻia ke aʻa circumflex e kahi maʻi i kapa ʻia ʻo ka maʻi artery coronary (CAD). ʻO kēia ka wā e hōʻiliʻili ai nā waihona momona (plaque) i loko o ke aʻa, e ālai ana iā ia. Ua like ia me ka ʻōpala e pani ana i kahi paipu wai.

ʻO kēia hōʻiliʻili ʻana o ka plaque a me ka mānoanoa o nā paia o ke aʻa ua kapa ʻia ʻo atherosclerosis, ʻo ia hoʻi ke "paʻakikī o nā aʻa" a i ʻole "paʻakikī o nā aʻa." Inā ʻaʻole mālama pono ʻia kēia maʻi CAD, hoʻonui ia i ka pilikia o ka hoʻomohala ʻana i nā kūlana weliweli e like me ka hōʻeha puʻuwai, ka hāʻule ʻana o ka puʻuwai, a me ka hahau .

He aha nā hōʻailona o kahi poloka i loko o ka 'Circumflex Artery'?

Ke emi ke kahe o ke koko ma muli o ka haiki ʻana o nā aʻa koko, hiki ke loaʻa ka ʻeha o ka umauma. Ua kapa ʻia kēia he "Angina". Hiki i kēia ʻano "Angina" ke alakaʻi i ka hōʻeha puʻuwai. He pilikia olakino kēia, no laila pono ʻoe e kāhea koke i ka 911.

ʻOiai ʻo ka paʻa ʻana o ke aʻa circumflex kekahi ʻāpana o ka CAD, ua like nā hōʻailona. Hiki iā ʻoe ke ʻike i nā mea e like me:

• Angina - ʻO ke ʻano kēia o ka ʻeha o ka umauma a i ʻole ka paʻa.
• Hou anu.
• Ka poniuniu a i ʻole ke poʻo māmā.
• Ka luhi nui a me ka nāwaliwali.
• Ka puʻuwai wikiwiki a ʻano ʻole paha (Heart Palpitations).
• Ka luaʻi .
• Paʻakikī ka hanu ʻana .
• ʻEha ma ka poʻohiwi a i ʻole ka lima.
• ʻEha ma ka ʻāʻī a i ʻole ka ʻauwae.

Pehea e nānā ai nā kauka i ke olakino o ka `Circumflex Artery`?

Hoʻohana nā kauka i nā hoʻokolohua kiʻi like ʻole e nānā i ke olakino o kou mau aʻa coronary, me ke aʻa circumflex. ʻO kekahi o lākou:

• Catheterization Cardiac: Nānā kēia i nā poloka i loko o nā aʻa a me nā maʻi aʻa coronary.
• ʻO Coronary Computed Tomography Angiogram (CCTA): Hiki i kēia ke hana i nā kiʻi ʻekolu-dimensional (3D) o ke kahe koko i loko o ka puʻuwai.
• Intravascular Optical Coherence Tomography (IVOCT) a i ʻole Intravascular Ultrasound (IVUS):Hiki i kēia mau ʻano ke kiʻi i nā kiʻi wehewehe kiʻekiʻe o ka plaque i loko o kahi aʻa.
• Mālama Kahe ʻĀpana (Fractional Flow Reserve - FFR): Ke ana kēia i nā loli o ke koko i loko o kahi aʻa a hoʻoholo inā ua koʻikoʻi ka paʻa ʻana e hoʻopilikia i ka hana a ka puʻuwai.

Pehea e mālama ʻia ai nā kūlana e pili ana i ka `Circumflex Artery`?

No ka wehe ʻana i kahi aʻa circumflex i paʻa, hiki i kāu kauka ke hana i kahi catheterization cardiac a hana i nā kaʻina hana komo e like me ka angioplasty a me ke kau ʻana o ka stent. ʻO ka Angioplasty kahi kaʻina hana e hoʻohana ana i kahi mea like me ka balloon e hoʻonui i ke aʻa i paʻa. ʻO ka stent kahi paipu uea liʻiliʻi i hoʻokomo ʻia i loko o ke aʻa e kōkua i ka pale ʻana iā ia mai ka haʻahaʻa hou ʻana.

Pehea lā kākou e pale ai i ko kākou ʻōnaehana aʻa, me kēia `Circumflex Artery`?

Eia kekahi mau mea hiki iā ʻoe ke hana e mālama i kou mau aʻa a me ke olakino holoʻokoʻa o ke kahe koko:

• E hana kino i ka hapa nui o nā lā o ka pule a mālama i ke kaumaha olakino.
• E kāohi i kāu inu ʻona. E kiʻi i ke kōkua inā loaʻa iā ʻoe nā pilikia me ka hoʻohana ʻana i ka waiʻona .
• E ʻai i ka meaʻai olakino no ka puʻuwai . Hiki i kēia ke kōkua i ka hoʻohaʻahaʻa ʻana i nā pae cholesterol .
• E makaʻala i nā ʻano momona āu e ʻai ai a e hoʻāʻo e hōʻemi i nā momona maikaʻi ʻole.
• Inā loaʻa iā ʻoe ka maʻi diabetes , e kaohi pono iā ia.
• E hana i nā hana e kāohi ai i ke koko kiʻekiʻe, me ka hōʻemi ʻana i ka nui o ka sodium (paʻakai) i hoʻohui ʻia i kāu meaʻai.
• Inā ʻoe e puhipaka ana, e noi i ke kōkua e haʻalele .

E hoʻomanaʻo, ma ke ʻano he lālā o ke aʻa coronary nui hema, hiki i kou `(Circumflex Artery)` ke maʻalahi i ka `(Atherosclerosis)` a me ka `(Coronary Artery Disease)`. Inā hōʻiliʻili `(Plaque)` i loko o ka `(Circumflex Artery)`, hiki ke hoʻopilikia ʻia ke kahe koko i ka puʻuwai. Ua kapa ʻia kēia `(Bifurcation Blockage)`. Inā hana ʻia kēia, pono paha `(Angioplasty)` a me `(Stent)` e wehe i ke aʻa a hoʻomaikaʻi i ke kahe koko.

ʻO ka mea hope loa, he aha nā mea e hoʻomanaʻo ai! (Leka Lawe-Home)

Ke lana nei koʻu manaʻo ua maopopo iā ʻoe i kēia manawa ke ʻano o ka `(Circumflex Artery)`. He kīʻaha koko koʻikoʻi kēia no ke olakino o ko kākou puʻuwai. No laila, he mea nui loa ka hahai ʻana i nā loli o ke ʻano o ka nohona a kākou i kūkākūkā ai ma mua e mālama i ke olakino o kēia mau kīʻaha koko. Inā loaʻa iā ʻoe nā hōʻailona e like me ka ʻeha o ka umauma, ka paʻakikī o ka hanu ʻana, mai hoʻowahāwahā iā ia a e ʻimi koke i ke kōkua lapaʻau.E kamaʻilio me kāu kauka e pili ana i nā ala maikaʻi loa e pale aku ai i kou puʻuwai a me nā aʻa. ʻO ka puʻuwai olakino ke ʻano o ke ola olakino!