Ua lohe paha ʻoe i ke `(Left Anterior Descending Artery)` a i ʻole `(LAD artery)`? Malia paha ua kamaʻilio kāu kauka e pili ana i ia mea, a ua heluhelu paha ʻoe e pili ana i ia mea ma kekahi wahi. He kīʻaha koko koʻikoʻi loa kēia no ko kākou puʻuwai. ʻOiaʻiʻo, ua like ia me ke koko ola o ko kākou puʻuwai. No laila, i kēia lā e kamaʻilio mākou e pili ana i kēia `(LAD artery)`, kāna hana, nā pilikia e hiki ai ke hana, a pehea e hiki ai iā mākou ke mālama iā ia ma ke ʻano maʻalahi e hiki ai iā ʻoe ke hoʻomaopopo.
He aha kēia `(Left Anterior Descending Artery)`? Ua like ia me ka palapala ʻāina o ka puʻuwai!
I ka ʻōlelo maʻalahi, ʻo kou `(Left Anterior Descending Artery)`, a i ʻole e kapa kākou iā ia he `(LAD)` no ka pōkole, ʻo ia kekahi o nā lālā ʻelua o ka `(left main coronary artery)` ma ka ʻaoʻao hema o kou puʻuwai.
ʻO ka huaʻōlelo ``Anterior'' ʻo ia hoʻi ``ma mua.'' ʻO ke ʻano o kēia, ʻo kēia kīʻaha koko ke hoʻolako nui nei i ke koko i mua o kou puʻuwai. E noʻonoʻo e pili ana iā ia, ʻo ke keʻena pamu nui ma ka ʻaoʻao hema haʻahaʻa o kou puʻuwai, ʻo ka `(ventricle),'' ʻo ia ka mea e loaʻa ai ke koko oxygenated nui loa mai kēia `(LAD). ʻAʻole wale ia, akā aia kekahi ʻiʻo e hoʻokaʻawale ana i nā paia o ka puʻuwai, kapa mākou iā ia he `(
Septum ),'' a ʻo kēia `(LAD)` hoʻi e hoʻolako i ke koko iā ia.
I kekahi manawa, kapa pū nā kauka i kēia kīʻaha koko ʻo ka "lālā interventricular anterior." ʻOiai paha he mea paʻakikī iki ka inoa, he maʻalahi loa kāna hana - e lawe i ke koko i ka puʻuwai!
Akā eia kekahi mea e makaʻala ai: Inā paʻa loa kēia aʻa `(LAD)`, hiki iā ia ke hana i ka hōʻeha puʻuwai.
Ua kapa pinepine ʻia kēia he `(widowmaker heart attack )`. Hiki ke hopohopo iki ka lohe ʻana i kēia inoa, no ka mea, hiki i kēia ʻano hōʻeha puʻuwai ke make pinepine. ʻO ia ke kumu e pono ai mākou e makaʻala loa e pili ana i kēia `(LAD)`.
He aha ka mea e hana nei me `(LAD)`? ʻO ka mea hoʻolako nui o ka puʻuwai!
E like me kā mākou i ʻōlelo ai ma mua, ʻo ka LAD
ke aʻa coronary nui loa i loko o kou puʻuwai. He ʻano kūikawā kēia o ke kīʻaha koko i loko o ka puʻuwai, ʻāpana o ka ʻōnaehana hoʻohele koko e lawe ana i ke koko ma o ko kākou kino. Hiki iā ʻoe ke noʻonoʻo,
kokoke i ka hapalua o ke koko e pono ai kou puʻuwai e lawe ʻia ma o kēia LAD! ʻO ia hoʻi, he mea nui ia no ka hana olakino o ka puʻuwai.
Aia i hea kēia `(LAD)`?
Ke ʻōlelo nei mākou ua māhele ʻia ke aʻa coronary nui ma ka ʻaoʻao hema o kou puʻuwai i ʻelua lālā. ʻO kēlā mau lālā ʻelua ʻo ia ka Left Anterior Descending Artery a me ka Circumflex Artery. E like me ke alanui e māhele ana i ʻelua, ua māhele pū kēia aʻa nui i ʻelua ʻāpana ma ʻaneʻi. Ua kapa pū nā kauka i kēia he bifurcation. Aia kēia aʻa LAD i loko o ka membrane pale ma waho o kou puʻuwai, ʻo ia ka epicardium. Holo ia ma ka septum o ka puʻuwai, e like me kahi kahawai liʻiliʻi, mai ke kumu o ka puʻuwai a i ka piko o ka puʻuwai.
He aha nā lālā ma `(LAD)`?
Ua māhele ʻia kēia ʻauwai `(LAD)` i ʻelua mau lālā liʻiliʻi:
- Nā lālā diagonal: Hāʻawi kēia mau lālā i ke koko i nā ʻaoʻao mua a me lalo o ka ventricle, aia ma ka ʻaoʻao hema hema o ka puʻuwai.
- (Nā lālā Septal): Hoʻolako kēia mau lālā i ke koko i nā hapakolu ʻelua mua o ka septum o ka puʻuwai.
ʻO kēia mau lālā ke kuleana no ka hōʻoia ʻana e loaʻa ana i nā ʻāpana like ʻole o ka puʻuwai ka lako koko kūpono.
He aha ke ʻano o ka "kaʻapuni ʻana ma ka hema"?
He kumuhana hohonu iki kēia, akā e hoʻāʻo kākou e hoʻomaopopo maʻalahi. Aia kekahi aʻa i kapa ʻia ʻo ka "posterior descending artery (PDA)" e lawe ana i ke koko i nā ʻaoʻao haʻahaʻa a me hope o kou puʻuwai a i kahi ʻāpana o ka "septum".
- Ke kahe koko ʻākau: Inā ʻoe e lawe i ʻumi kānaka, ma kahi o ʻewalu o lākou e puka mai ana ke koko mai ke aʻa coronary nui ma ka ʻaoʻao ʻākau.
- Ke kahe koko ma ka hema: Eia nō naʻe, ma kahi o hoʻokahi o ka ʻumi o nā kānaka, loaʻa i kēia PDA ke koko mai kahi lālā o ke aʻa coronary nui hema (ʻo ka LAD a i ʻole ke aʻa circumflex).
- Ke kaʻapuni koko codominant: Ma kahi o ʻelua o ka ʻumi o nā kānaka, hoʻolako ʻia ka PDA e ka LAD a i ʻole ke aʻa circumflex, a me ke aʻa coronary ʻākau.
Hiki ke ʻokoʻa kēia mai kēlā kanaka a kēia kanaka. He kūlana maoli nō ia o ka puʻuwai.
He aha nā kūlana olakino e hoʻopilikia ai i ka `(LAD)`?
ʻO kēia kahi e pono ai mākou e kālele nui. I loko o kēia LAD, hiki i nā waihona momona, a mākou e kapa nei he plaque, ke hōʻiliʻili. Ua kapa ʻia kēia ʻano
he atherosclerosis . Ua like ia me ka ʻōpala e hōʻiliʻili ana i loko o kahi paipu wai. I kekahi poʻe, hōʻiliʻili nui kēia plaque a hiki i ka LAD ke ālai loa ʻia. He aha ka mea e hana ʻia a laila? ʻAʻole hiki i ke koko waiwai i ka oxygen ke hiki i ka puʻuwai. ʻO ia ka manawa
e loaʻa ai iā mākou ka hōʻeha puʻuwai widowmaker a mākou i kamaʻilio ai ma mua, he mea make pinepine ia. ʻOiai ʻo ka huaʻōlelo widowmaker e pili wale ana i nā kāne, hiki i kēia maʻi puʻuwai ke hoʻopilikia i nā kāne a me nā wahine.
E noʻonoʻo, he 50 paha makahiki o Nishantha. Ua kaumaha iki ʻo ia a he maʻi diabetes kona. I kekahi lā, ua hoʻomaka koke ʻo ia e hou me ka ʻeha nui o ka umauma. I kona lawe wikiwiki ʻia ʻana i ka haukapila, ua ʻike ʻia ua loaʻa iā ia kahi `(widowmaker heart attack)`. ʻO ka mea pōmaikaʻi, ua ola ʻo ia no ka mea ua loaʻa iā ia ka lāʻau lapaʻau koke. Hōʻike kēia i ke ʻano wikiwiki o kēia.
Eia kekahi, i loko o kahi heluna liʻiliʻi loa o ka poʻe, hiki ke hoʻohaiki iki ʻia a pōkole paha ke aʻa LAD i ka wā hānau. Ua kapa ʻia kēia ʻano he hypoplastic left anterior descending artery. Hoʻonui pū kēia i kekahi mau pilikia:
He aha nā hōʻailona o kahi poloka i ka LAD?
Inā ua haiki a ālai ʻia paha ka LAD, hiki iā ʻoe ke loaʻa i
ka ʻeha umauma (angina) . Hiki i kēia ke lilo i angina paʻa a i ʻole angina paʻa ʻole. ʻO ka hōʻeha puʻuwai he
pilikia olakino e pono ai ka mālama koke ʻana . Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, e kelepona koke i ka 911 (helu pilikia 1990 ma Sri Lanka):
- ʻEha a paʻa paha ka umauma (Angina)
- Ke anu nei a me ka hou ʻana
- ʻO ka dizziness, kahi manaʻo o ka milo ʻana i loko o ke poʻo
- Luhi a me ka nāwaliwali
- Nā palpitations o ka puʻuwai
- Ka luaʻi
- Paʻakikī ka hanu ʻana
- ʻEha ma ka poʻohiwi a i ʻole ka lima (ʻoi aku ka lima hema)
Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona,
mai hoʻowahāwahā iā lākou. Pehea e nānā ai nā kauka i ke olakino o kāu `(LAD)`?
Hoʻohana nā kauka i nā hoʻokolohua e like me kēia e nānā i ke kūlana o kou mau aʻa coronary, ʻoiai ka LAD:
- Catheterization cardiac: Nānā kēia no ka maʻi o ke aʻa coronary.
- ʻO ka angiogram tomography computed coronary (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 lawe i nā kiʻi maopopo loa a kiʻekiʻe hoʻi mai loko mai o kahi aʻa.
- Mālama kahe hapa (FFR): Ana kēia i ke kaomi o ke koko i loko o kahi aʻa, hiki ke kōkua i ka hoʻoholo ʻana i ke koʻikoʻi o kahi ālai ʻana.
Hiki i kēia mau hoʻokolohua ke hoʻoholo pololei inā he poloka a ʻūlū paha i kāu LAD.
Pehea e mālama ʻia ai nā kūlana e pili ana i ka `(LAD)`?
No ka wehe ʻana i kahi LAD i ālai ʻia, pono paha ʻoe e hana i ka catheterization cardiac, me nā kaʻina hana e like me
ka angioplasty a me ka hoʻokomo ʻana o ka stent .
- ʻO ka Angioplasty kahi hana e pili ana i ke kau ʻana i kahi pōpō liʻiliʻi i loko o kahi aʻa, e hoʻopiha iā ia e wehe i kahi i paʻa ʻia, a me ka hoʻonui ʻana i ke aʻa.
- ʻO kahi stent kahi ʻōmole uea liʻiliʻi e kōkua ai i ka pale ʻana i ke aʻa mai ka ʻūlū hou ʻana ma hope o ka angioplasty.
Hiki i kēia mau lāʻau lapaʻau ke hoʻihoʻi i ke kahe o ke koko i ka puʻuwai a hōʻemi i ka pilikia o ka hāʻule ʻana o ka puʻuwai.
Pehea e hiki ai iaʻu ke pale i koʻu aʻa LAD? Ke ala i kahi puʻuwai olakino!
Nui nā mea hiki iā ʻoe ke hana e mālama i kou ʻōnaehana hoʻopololei koko, me kāu (LAD) olakino. Eia nā mea nui loa:
- E ʻai i ka meaʻai olakino no ka puʻuwai: Hiki i kēia ke kōkua i ka hoʻohaʻahaʻa ʻana i nā pae cholesterol. He mea maikaʻi nā meaʻai haʻahaʻa i ka ʻaila, ka paʻakai, a me ke kō, a kiʻekiʻe i nā huaʻai a me nā mea kanu.
- E hōʻemi i kāu hoʻohana ʻana i ka waiʻona: Inā ʻoe e hoʻohana ana i ka waiʻona, e kiʻi i ke kōkua.
- E hoʻoikaika kino a mālama i ke kaumaha olakino: He mea maikaʻi nō hoʻi ka hele wāwae ʻana no 30 mau minuke ma ka liʻiliʻi i ka lā.
- E makaʻala i kou ʻano momona: E hōʻemi i nā momona maikaʻi ʻole (nā momona saturated a me nā trans).
- E hana i nā hana e kāohi ai i ka maʻi diabetes a me ke koko kiʻekiʻe: ʻO ka hōʻemi ʻana i ka ʻai paʻakai e kōkua pū me kēia.
- E noi i ke kōkua e hoʻōki i ka puhipaka: ʻO ka puhipaka kekahi o nā ʻenemi nui loa o ka puʻuwai.
Ma ka hana ʻana i kēia mau mea, hiki iā ʻoe ke mālama ʻaʻole wale i kou `(LAD)`, akā, i kou puʻuwai a me kou kino holoʻokoʻa.
ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)
I kēia manawa, ua maopopo paha iā ʻoe ʻo ke `(Left Anterior Descending Artery)` he kīʻaha koko ia e pono ai no ke olakino o ko kākou puʻuwai. ʻO ka paʻa ʻana i loko o kēia mea hiki ke alakaʻi i kahi maʻi make, ʻoiai hoʻi ka `(widowmaker heart attack)`. ʻO kēia no ka mea ʻo ia ke aʻa nui e hoʻolako i ka ʻaoʻao hema o ka puʻuwai me ka nui o ke koko. Nui ka manawa e hōʻiliʻili ai kēia `(LAD)` artery `(plaque)` a ulu aʻe `(atherosclerosis)`, hiki ke alakaʻi i ka maʻi artery coronary. Inā hana ʻia kēlā, pono ʻoe e hana i ka lāʻau lapaʻau e like me `(angioplasty)` a me `(stent)` e wehe i ke aʻa a hōʻemi i ka pilikia o ka hōʻeha puʻuwai. Akā ʻo ka mea maikaʻi loa, ʻo ia
ka pale ʻana i ia mau kūlana ma mua o ko lākou hiki ʻana mai. Ma ke kamaʻilio ʻana me kāu kauka a me ka hana ʻana i nā hoʻololi e pono ai i kou nohona a me kāu ʻai, hiki iā ʻoe ke mālama i kou puʻuwai, ʻo ia hoʻi, kou `(LAD)`, i olakino a hauʻoli.
E mahalo kou puʻuwai iā ʻoe!
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