Aia kekahi mau waihona calcium i loko o nā aʻa o kou puʻuwai? (Coronary Artery Calcification)

Ua noʻonoʻo paha ʻoe inā hiki i nā waihona calcium liʻiliʻi ke hōʻiliʻili i loko o nā aʻa nui e lawe ana i ke koko i kou puʻuwai? Ua like ia me ka limescale i loko o nā paipu wai i ka hala ʻana o ka manawa. ʻO kēia ka mea a mākou e kapa nei ma ke ʻano lapaʻau he coronary artery calcification (CAC) . I kekahi manawa, hiki ke hana ʻia kēia me ka ʻole o nā hōʻailona ʻike ʻia. Akā, he mea nui loa ka ʻike ʻana i kēia no ke olakino o kou puʻuwai.

He aha ka Calcification o ke Ala Coronary?

I ka ʻōlelo maʻalahi, ʻo ia ka manawa e hōʻiliʻili ai ka calcium i loko o nā paia o nā aʻa nui ʻelua e hoʻolako ana i ke koko i kou puʻuwai, i kapa ʻia ʻo nā aʻa coronary . ʻAʻole kēia e hana i ka pō hoʻokahi. ʻO ka maʻamau, he ʻelima mau makahiki no ka hōʻiliʻili ʻana o ka calcium i loko o kou mau aʻa, ma hope o kekahi manawa ke loaʻa iā ʻoe kahi hōʻiliʻili o ka plaque (i kapa ʻia ʻo atherosclerosis ). E noʻonoʻo iā ia e like me ka paipu i loaʻa kahi hōʻiliʻili o ka lepo a me ka grime, a laila e mānoanoa ana kēlā hōʻiliʻili.

ʻO nā waihona kalipuna i loko o kēia mau aʻa he hōʻailona koʻikoʻi ia o ka maʻi aʻa coronary . Hiki i kāu kauka ke loiloi i kou pilikia no ka maʻi puʻuwai.

Ke hōʻiliʻili kēia mau waihona momona i loko o nā aʻa, hoʻemi ia i ke kahe o ke koko. ʻIke ʻoe, hoʻolako nā aʻa coronary i ka ʻiʻo puʻuwai me ke koko momona i ka oxygen. No laila, inā ua ālai ʻia ke kahe o ke koko ma o kēia mau aʻa, hiki iā ʻoe ke loaʻa i ka ʻeha umauma (angina) , a i ʻole ka ʻino, kahi hōʻeha puʻuwai .

ʻElua mau ʻano nui o nā waihona calcium:

ʻIke nā kauka i kēia ma nā ʻano nui ʻelua, ma muli o ka papa o ka calcium i waiho ʻia ma ka paia o ke aʻa:

1. Ka waiho ʻana o ka intimal: Hana ʻia kēia ma ka papa o loko o ka paia o ke aʻa. ʻIke pinepine ʻia kēia ʻano ma nā aʻa coronary.

2. Ka waiho ʻana o ka waihona medial: Hana ʻia kēia ma ka papa waena o ka paia arterial.

He aha ka pilina ma waena o nā waihona calcium i loko o nā aʻa a me ka atherosclerosis?

Aia kahi pilina nui ma waena o nā mea ʻelua. Hiki i ka nui o ka calcium i loko o kou mau aʻa ke hāʻawi iā ʻoe i kahi manaʻo o ka nui o ka atherosclerosis āu, ʻo ia hoʻi ka hōʻiliʻili ʻana o nā waihona momona i loko o kou mau aʻa. ʻO Atherosclerosis ka wā e hōʻiliʻili ai nā waihona momona i loko o kou mau aʻa, e hoʻohaiki ana iā lākou. Hoʻolilo ia i mea paʻakikī no ke kahe pono ʻana o ke koko. Hiki i ka calcium ke hoʻonui i kēia kūlana.

ʻO wai ka mea i hoʻopilikia nui ʻia e kēia kūlana?

ʻIke pinepine ka poʻe me ka maʻi puʻuwai i nā waihona calcium i loko o kēia mau aʻa.

• Me ka makahiki:Inā mākou e nānā i nā kānaka ma luna o 70 mau makahiki, ʻoi aku ma mua o 90% o nā kāne a me 67% o nā wahine i loaʻa i kēia maʻi. Ma mua o ka menopause, ua palekana iki nā wahine mai ka pilikia o ka loaʻa ʻana o kēia (atherosclerosis) ma muli o ka hormone estrogen . ʻO ia ke kumu e loaʻa ai i nā wahine kēia maʻi ma kahi o 10-15 mau makahiki ma hope o nā kāne.
• Lāhui/ʻAno Lāhui: Ua ʻike ʻia kekahi mau noiʻi he ʻoi aku ka nui o ka poʻe keʻokeʻo e loaʻa i kēia maʻi ma mua o nā lāhui ʻē aʻe.
• No nā kāne: ʻOi aku ka nui o ka pilikia o nā kāne i ka loaʻa ʻana o kēia (Coronary Artery Calcification).

He aha nā kumu pilikia? (Inā loaʻa iā ʻoe kēia mau mea, hiki paha iā ʻoe ke pilikia)

ʻOi aku ka nui o ka loaʻa ʻana o kēia maʻi i kekahi poʻe. E nānā e ʻike inā loaʻa iā ʻoe kekahi o kēia mau mea pilikia:

• Inā he maʻi puʻupaʻa mau kou .
• Inā he mau pilikia kou me ke kō koko e like me ka maʻi diabetes mellitus .
• Inā kiʻekiʻe ka pae o ka cholesterol maikaʻi ʻole (LDL - Low-Density Lipoprotein) a haʻahaʻa ka pae o ka cholesterol maikaʻi (HDL - High-Density Lipoprotein) .
• ʻO ka waiwai BMI (Body Mass Index) , ʻo ia hoʻi, inā kiʻekiʻe ka helu o ke kino (momona).
• Inā loaʻa i kekahi o kou ʻohana kahi mōʻaukala o nā waihona calcium i loko o nā aʻa coronary (predisposition hoʻoilina).
• Inā he koko kiʻekiʻe kou.
• Inā he moʻolelo kou o ka puhipaka a i ʻole ka hoʻohana ʻana i nā huahana paka ʻē aʻe.
• Me ka piʻi ʻana o ka makahiki.
• Inā he mau hewa i loko o ka hormone parathyroid .
• Inā kiʻekiʻe ka pae phosphate i loko o ke koko.
• Inā kiʻekiʻe ka nui o ka calcium i loko o ke koko.

He aha ka hana a kēia i ke kino? Pehea kona hopena?

Ke hōʻiliʻili ka calcium i loko o kou mau aʻa coronary, e hoʻopaʻa ia iā lākou. Hoʻemi kēia i ko lākou hiki ke ʻaelike a hoʻonui pono. Hoʻonui kēia i kou pilikia o ka maʻi puʻuwai.

I ka ʻōlelo maʻalahi, hoʻemi kēia hōʻiliʻili calcium i ka nui o ke koko e hiki aku i kou ʻiʻo puʻuwai. E noʻonoʻo iā ia e like me kahi motika e hana mau ana. Inā nalowale kona lako koko, e loaʻa iā ia nā pilikia, ʻeā?

ʻO kekahi mea ʻē aʻe, ke loaʻa nā waihona kalipuna i loko o nā aʻa, lilo ia i mea paʻakikī i nā kauka ke hana i kekahi mau lāʻau lapaʻau, e like me ka Percutaneous Coronary Intervention (PCI) , a i ʻole e like me kā kākou e ʻike nei , ʻo Angioplasty, no ka mea, hiki i kēia mau waihona kalipuna ke hoʻopilikia i ka hoʻolaha pono ʻana o ka stent i kau ʻia i loko o ke aʻa.

He aha nā hōʻailona?

ʻO ka hapa nui o ka manawa, ʻaʻole hōʻike ka poʻe me kēia maʻi (Coronary Artery Calcification) i kekahi mau hōʻailona . ʻO ia ka mea weliweli loa. Akā i ka hala ʻana o ka manawa, i ka wā e ʻoi aku ka ʻino o kēia maʻi, hiki ke ʻike ʻia kekahi mau hōʻailona. ʻO lākou kēia:

• ʻAngina Paʻa: ʻO kēia ka ʻeha umauma a i ʻole ka ʻoluʻolu ʻole e kū pinepine ana i ka wā hoʻoikaika kino a i ʻole ke piʻi ʻana i nā alapiʻi. Hoʻomaha ia me ka hoʻomaha.
• Pōkole o ka hanu.
• He hōʻeha puʻuwai.

Mea nui: Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​e ʻimi pono i ke kōkua lapaʻau.

No ke aha lā kēia e hana nei? He aha nā kumu?

ʻO ka maʻamau ma hope o ka piha ʻana o nā makahiki he 40, hiki i ka calcium i loko o ko kākou koko ke hoʻomaka e hōʻiliʻili ma nā wahi like ʻole o ke kino. ʻO ka mea nui, ʻo nā paia o nā aʻa i hōʻino ʻia, pehu, a i ʻole e hana hou ʻia ana, ʻo ia ka poʻe i maʻalahi loa i kēia mau waihona calcium.

Hiki i kēia kaʻina hana ke hoʻomaka i kou mau makahiki 20 , akā ʻike wale ke kauka ke lawa kona nui e ʻike ʻia ma kahi hoʻāʻo kiʻi . A, ʻaʻole hana pinepine ʻia kēia mau hoʻokolohua e ka nui o ka poʻe i ko lākou mau makahiki 20 a me 30.

Hoʻomaka nā waihona kalipuna ma ke ʻano he mau ʻāpana liʻiliʻi loa (0.5µm - micrometers). I ka hala ʻana o ka manawa, i ka hōʻiliʻili ʻana o nā waihona momona, hiki i kēia mau waihona kalipuna ke ulu nui aʻe ma mua o 3 millimeters. Manaʻo nā kānaka noiʻi e hoʻomaka kēia mau waihona kalipuna liʻiliʻi (microcalcification) i loko o ka papa intimal o ka paia o ke aʻa me ka make ʻana o nā pūnaewele ʻiʻo laumania.

Pehea ʻoe e ʻike ai i kēia? He aha ke ʻano o nā hoʻokolohua e hana ʻia ai?

Aia nā hoʻokolohua kiʻi kūikawā e hiki ke ʻike i kēia kūlana (Coronary Atherosclerosis), ʻo ia hoʻi, nā waihona momona i loko o nā aʻa, ma mua o ka lilo ʻana i mea koʻikoʻi. ʻO kekahi o nā mea nui loa o kēia ʻo ia ka (Computed Tomography - CT) scan, a i ʻole (Multidetector Computed Tomography - MDCT) .

Hiki i kahi scan CT cardiac ke hōʻike maopopo i nā waihona calcium i loko o kou mau aʻa coronary. Ua kapa ʻia kēia he hoʻāʻo calcium artery coronary (CAC) . ʻImi nui ia no:

• ʻEhia ka nui o ka calcium i waiho ʻia?
• He aha ka nui o kēlā mau waihona?
• Pehea ko lākou nui ?

Ma ka hoʻohana ʻana i kēia ʻike, helu kāu kauka i kahi waiwai i kapa ʻia ʻo ka helu Agatston . Hiki i kēia helu ke piʻi mai ka 0 a i ka 400 a ʻoi aku paha. ʻO ke kiʻekiʻe o ka helu, ʻo ka nui o kou pilikia o ka loaʻa ʻana o ka hōʻeha puʻuwai a i ʻole ka hahau ʻana i loko o nā makahiki he 10 e hiki mai ana.

Ua ʻike nā kauka hiki i kēia hoʻāʻo (CAC) ke wānana pololei i ka pilikia cardiovascular i ka wā e hiki mai ana. Eia nō naʻe, pono paha ʻoe e uku no kēia hoʻāʻo mai kāu ʻeke ponoʻī.

He aha ke ʻano o ka helu CAC (Agatston Score)?

Eia ke ʻano o ka wehewehe pinepine ʻana i kēlā mau hōʻailona:

• Helu 0: ʻAʻohe pilikia olakino.
• Helu 1 a 99: Maʻi iki.
• Nā helu mai 100 a 399: Pae maʻi waena.
• Ka helu ma luna o 400: Maʻi koʻikoʻi.

Ma waho aʻe o kēia hoʻāʻo (CAC), aia kekahi mau hoʻokolohua ʻē aʻe i emi iki ka invasive e hiki ke nānā i nā waihona calcium i loko o kou mau aʻa coronary:

• ʻO Cardiac Intravascular Ultrasound (IVUS): Hoʻohana kēia i kahi mea ultrasound me kahi catheter (ʻōmole lahilahi) i hoʻopili ʻia i ka hopena e nānā i loko o nā aʻa. Hoʻokaʻawale ʻia nā hopena mai ka Papa I a i ka Papa IV, me ka Papa IV e hōʻike ana i nā waihona calcium koʻikoʻi loa.
• ʻO ka Intravascular Optical Coherence Tomography (IVOCT): Hōʻike kēia i ka nui o ka calcium i waiho ʻia i loko o kou mau aʻa a me kona mānoanoa. Hoʻohana ia i ka mālamalama kokoke-infrared e hana i nā kiʻi o loko o nā aʻa.

He aha nā lāʻau lapaʻau no kēia?

ʻAʻohe lāʻau lapaʻau maʻamau a nā kauka no ka calcification o ke aʻa coronary. Eia nō naʻe, i nā hihia koʻikoʻi, ke hoʻohana nei kekahi mau kauka i kahi lāʻau lapaʻau hou i kapa ʻia ʻo intravascular lithotripsy . ʻO kēia ke komo ʻana i kahi mea hana ma o kahi catheter i loko o ke aʻa a hoʻohana iā ia e hāʻawi i nā nalu kaomi e wāwahi i nā waihona calcium i loko o ka paia o ke aʻa. A laila hiki ke kau ʻia kahi stent e mālama i ka wehe ʻana o ke aʻa.

ʻO kekahi mau lāʻau ʻē aʻe i hoʻohana ʻia e hoʻomaikaʻi i ke kahe koko i loko o nā aʻa:

• ʻO ka atherectomy rotational, orbital a i ʻole laser: Pili kēia i ka ʻoki ʻana a me ka wehe ʻana i nā waihona momona (plaque) a me ka calcium mai loko mai o ke aʻa.
• ʻO ka ʻoki ʻana, ka helu ʻana a i ʻole ka angioplasty balloon kiʻekiʻe: Pili kēia i ka hoʻopiha ʻana i kahi balloon e hoʻokuke i nā waihona momona a me ka calcium e kūʻē i nā paia o ke aʻa.

Hiki ke loaʻa nā pilikia i ka wā o ka mālama ʻana?

E like me nā lāʻau lapaʻau āpau, hiki ke loaʻa kekahi mau pilikia me kēia lāʻau.

Nā pilikia o ka Intravascular Lithotripsy:

• Arrhythmia ( ka helu puʻuwai kūpono ʻole)
• Aneurysm ( ka pehu ʻana a i ʻole ka nāwaliwali o ke kīʻaha koko)
• Nā pilikia koko
• Hahau
• Make (kākaʻikahi loa)

Nā pilikia o ka Rotational Atherectomy:

• ʻO ka ʻoki ʻana o ke aʻa
• Maʻi hohola
• Make (kākaʻikahi loa)
• ʻO ke kāpili ʻana o ke aʻa coronary ulia pōpilikia (CABG)

Nā pilikia o ka Angioplasty Coronary:

• Maʻi hohola
• Hahau
• ʻArrhythmia
• Ke kahe ʻana o ke koko
• Nā ʻūpā koko

ʻAʻole hiki kēia mau pilikia i nā kānaka a pau, akā he mea nui e makaʻala iā lākou. E wehewehe kāu kauka i kēia mau pilikia ke ʻōlelo lākou i kahi lāʻau lapaʻau nou.

Pehea e hiki ai iaʻu ke hōʻemi i kēia pilikia?

ʻO ka mea maikaʻi loa e hana ai, ʻo ia ke kāohi i nā pilikia e hoʻonui ai i ka pilikia o ka hoʻomohala ʻana i ka calcification o ke aʻa coronary. ʻO kēia mau mea:

• Inā loaʻa iā ʻoe ka maʻi diabetes, e kaohi pono iā ia.
• Inā ʻaʻole kūpono kou pae cholesterol , e hoʻāʻo e kāohi iā ia.
• Inā he koko kiʻekiʻe kou, e kaohi iā ia.
• Inā loaʻa iā ʻoe ka maʻi puʻupaʻa , e kiʻi i ka lāʻau kūpono no ia.

Ma waho aʻe o kēia mau mea, he mea nui loa ka hahai ʻana i kahi nohona olakino.

He aha ka mea e hana ʻia inā loaʻa iaʻu kēia maʻi? He aha kaʻu e manaʻo ai?

Inā ua ʻike ʻia ʻoe me ka Coronary Artery Calcification, ua nui kou pilikia o ka loaʻa ʻana o ka maʻi Coronary Artery a me nā hanana koʻikoʻi o ka Cardiovascular (MACE) .

Eia nō naʻe, i ka wā e pili ana i ka holomua o nā ʻano lapaʻau, ua holomua ʻo Intravascular Lithotripsy ma mua o 92% o nā hihia. Pēlā nō, ua hōʻike pū ʻo Rotational Atherectomy i ka holomua o 90%.

Eia nō naʻe, hoʻonui ka waiho ʻana o ka calcium i loko o nā aʻa i ka pilikia o ka hāʻule ʻana o nā lāʻau lapaʻau e like me ka balloon angioplasty . Hiki ke paʻakikī ke kau pono i kahi stent i loko o ke aʻa.

Pehea e hiki ai iaʻu ke mālama iaʻu iho? He aha kaʻu e hana ai?

Inā loaʻa iā ʻoe ka calcification o ke aʻa coronary, he mea nui e hahai i kahi nohona olakino puʻuwai. ʻO ia hoʻi:

• E ʻai i nā meaʻai haʻahaʻa momona (e hōʻemi i ka ʻaila, nā meaʻai palai, a me nā meaʻai wikiwiki e like me ka hiki).
• E hoʻōki loa i ka hoʻohana ʻana i nā huahana paka (nā sikaleka, beedis, a pēlā aku).
• E hoʻoikaika kino mau (e like me ka hele wāwae no 30 mau minuke ma ka liʻiliʻi i ka lā).
• E mālama i kou koko a me nā pae cholesterol ma ke ʻano maʻamau (e lawe i ka lāʻau lapaʻau e like me ke kuhikuhi a kāu kauka a kāohi i kāu ʻai).

Āhea wau e ʻike ai i ke kauka?

Inā he koko kiʻekiʻe kou a/a i ʻole nā ​​pae cholesterol kiʻekiʻe, e ʻike pinepine i ke kauka e hōʻoia i ka mālama maikaʻi ʻia o kēlā mau kūlana.Inā makemake ʻoe i kahi hoʻolālā e hoʻomaikaʻi ai i kou olakino cardiovascular, he manaʻo maikaʻi e hālāwai me ke kauka e kamaʻilio e pili ana.

Āhea wau e hele koke ai i ka haukapila (ETU) ?

Inā ʻike ʻoe i nā hōʻailona o ka hōʻeha puʻuwai, e like me ka ʻeha nui o ka umauma, ka nausea a me ka luaʻi ʻana, a me ka pōkole nui o ka hanu , e kāhea koke i ka 911 a i ʻole e hele i ka haukapila kokoke loa . Hiki i ka manawa ke ʻokoʻa ma waena o ke ola a me ka make i ka manawa e like me kēia.

He aha nā nīnau e pono iaʻu e nīnau aku i ke kauka?

Ke hele ʻoe e ʻike i ke kauka, he mea kōkua ke nīnau i kēia mau nīnau:

• Pono anei au e hoʻāʻo ʻia no ka calcification o ke aʻa coronary?
• Pehea ke koʻikoʻi o koʻu maʻi (Coronary Artery Calcification)?
• He aha ka lāʻau lapaʻau āu e ʻōlelo ai no koʻu maʻi?
• He aha nā pilikia a me nā pono o kēia lāʻau lapaʻau?
• He aha nā hoʻololi e pono iaʻu e hana i koʻu nohona?

E hoʻomanaʻo kākou i ka hōʻuluʻulu manaʻo (Leka Lawe-Home)

He mea nui i kāu kauka ke ʻike inā he mau waihona calcium kou i loko o kou mau aʻa coronary e hoʻomohala i kahi hoʻolālā e kōkua iā ʻoe. Pono paha ʻoe i ka lāʻau lapaʻau e wehe i ka calcium mai kou mau aʻa, a i ʻole pono paha ʻoe e hoʻokomo i kekahi mau hana olakino puʻuwai i kou ola. ʻOiai inā ʻaʻohe ou pilikia cardiovascular, ʻo ka ʻai ʻana i ka meaʻai haʻahaʻa-momona, ka hoʻoikaika kino, a me ka noho ʻana mai nā huahana paka hiki ke kōkua iā ʻoe e olakino. E hoʻomanaʻo, ʻo ka puʻuwai olakino ke kī i ke ola olakino!

ʻO ke kalipuna i loko o nā aʻa o ka puʻuwai, ka calcification o ke aʻa coronary, ka maʻi puʻuwai, ka cholesterol, ke koko kiʻekiʻe, ka maʻi diabetes, ka hōʻeha puʻuwai, ka atherosclerosis