Ke "hiamoe" nei kou ʻiʻo puʻuwai a i ʻole "paʻa"? (Myocardium Hibernating a me Myocardium Stunned) E aʻo kākou e pili ana i ia mea!

Ua lohe paha ʻoe i nā ʻāpana o ka puʻuwai e "hiamoe" ana? A i ʻole "paʻa" koke? ʻOiai paha e like me nā huaʻōlelo ʻē kēia, ʻo ia hoʻi ʻelua mau maʻi olakino e hoʻopilikia nei i ko kākou mau puʻuwai. Mai hopohopo, e kamaʻilio mākou e pili ana iā lākou ma ke ʻano maʻalahi a maʻalahi hoʻi e hoʻomaopopo. E nānā mākou i ke ʻano o lākou, no ke aha lākou e hana ai, pehea e ʻike ai iā lākou, a inā hiki ke ho'ōla ʻia.

He aha ka "hibernating" puʻuwai puʻuwai? (Hibernating Myocardium)

I ka ʻōlelo maʻalahi, ke hoʻonele ʻia ke kahe koko i kahi ʻāpana o kou ʻiʻo puʻuwai (kapa mākou iā ia ʻo `(Myocardium)`), e hōʻemi mālie ia i kāna hana a pau i ka hopena. Ua like ia me ka hiamoe no ka mea ua luhi. ʻO kēia ka mea a mākou e kapa nei ʻo `(Hibernating Myocardium)` a i ʻole "moe ʻana o ka ʻiʻo puʻuwai." Hiki ke hana kēia no nā mahina, a hiki paha i nā makahiki.

E noʻonoʻo, i ka pau ʻana o ka wai o kekahi mau mea kanu i loko o kāu māla, ʻōwili lākou a me he mea lā e mae ana, ʻeā? Pēlā nō ia me kēia. Pono nui ka ʻiʻo puʻuwai i nā waikawa momona e hana (ʻo ia hoʻi e ʻūlū). Akā i ka wā ʻaʻole lawa ke koko, hoʻomaka kēia ʻiʻo e hoʻohana i ka glucose (ʻo ia hoʻi ke ʻano o ke kō) e ola ai kona mau ʻāpana. Eia naʻe, ʻaʻohe ona ikehu e pamu i ke koko i ka puʻuwai i kēia manawa. No laila, ʻaʻole kōkua kēia ʻiʻo "hiamoe" i ke kaʻina hana pamu o ka puʻuwai.

He aha ke ʻano o ka wā e "kūʻia" ai ka ʻiʻo o ka puʻuwai a i ʻole "hele i loko o ka coma"? (Stunned Myocardium)

He ʻokoʻa iki kēia kūlana mai ke kūlana hiamoe i ʻōlelo ʻia ma mua. Hiki ke hana koke ʻia, i loko o kekahi mau minuke a i ʻole kekahi mau hola. Inā emi koke a oki paha ke kahe ʻana o ke koko i ka ʻiʻo puʻuwai, oki ka hana a ka ʻiʻo, me he mea lā ua "paʻa" a "paralyzed" paha. Ua kapa ʻia kēia ʻo `(Stunned Myocardium)`.

ʻO ka mea kupanaha, i kekahi manawa ʻoiai ke mālama nei nā kauka i ka mea paʻa (no ka laʻana, ma ke kau ʻana i kahi stent, ka hoʻonui ʻana i ke aʻa paʻa me kahi balloon, a i ʻole ka hoʻoheheʻe ʻana i kahi clot koko) e hoʻihoʻi i ke kahe ʻana o ke koko, ʻaʻole e hoʻi koke kēia mau ʻāpana ʻiʻo "paʻa" i ka maʻamau. Hiki ke hala nā lā, a i ʻole nā ​​​​hebedoma, no kēlā mau ʻiʻo e hoʻomaka hou e ʻaelike pono.

Pehea ka ʻokoʻa o kēia mau kūlana mai ka hāʻule puʻuwai?

He nīnau koʻikoʻi loa kēia. ʻO ka hōʻeha puʻuwai ke ʻano koʻikoʻi loa o ka maʻi ʻaʻa coronary. Hana ʻia kēia i ka wā e ālai loa ʻia ai kekahi a ʻoi aku paha o nā aʻa e hoʻolako ana i ke koko i ka puʻuwai e kahi mea momona i kapa ʻia ʻo ka plaque, e make ai nā hunaola ʻiʻo puʻuwai. Hoʻololi ʻia nā hunaola ʻiʻo puʻuwai make e ka ʻiʻo ʻeha. ʻAʻole hiki i kēia ʻiʻo ʻeha ke kōkua i ka puʻuwai e pamu pono. Hiki i kēia ke alakaʻi i ka hāʻule ʻana o ka puʻuwai.

Eia nō naʻe, ʻo nā kūlana ʻelua ʻo "Hibernating Myocardium" a me "Stunned Myocardium" he mau manawa pōkole wale nō. ʻO ka mea e hana ʻia ma ʻaneʻi, ʻaʻole hana pono ka ʻiʻo puʻuwai, akā ke ola mau nei kona mau ʻāpana.Inā hoʻihoʻi ʻia ke koko a me ka oxygen, hiki i kēia mau ʻāpana ʻiʻo "hiamoe" a "paʻa" paha ke hoʻomaka hou e hana. ʻO ia ka mea nui loa!

He aha nā kumu o ka 'Hibernating Myocardium'?

ʻIke nui ʻia kēia ʻano maʻi i nā poʻe me ka maʻi ʻaʻa coronary koʻikoʻi. I kēia maʻi, hōʻiliʻili nā waihona momona (kapa mākou i kēia "plaque") i loko o nā aʻa e lawe ana i ke koko i ka puʻuwai, e hoʻopaʻa ana iā lākou. Ke haiki loa kahi aʻa, ʻaʻole lawa ka oxygen a me nā meaʻai i ka ʻiʻo o ka puʻuwai e ola ai a kōkua i ka puʻuwai e pamu i ke koko. No laila, "hiamoe" ka ʻiʻo e mālama i ka ikehu e mālama i kāna mau hana cellular kumu.

He aha nā kumu o ke ʻano o ka "Stunned Myocardium"?

ʻO ka myocardial stunning, i ʻike ʻia hoʻi he "stuck" o ka ʻiʻo puʻuwai, hiki ke hana ʻia i ka wā o ka mālama ʻana no ka maʻi coronary artery. ʻOiai ke hoʻihoʻi nei ka mālama ʻana i ke kahe koko, ʻaʻole e hoʻōla koke kekahi mau ʻāpana o ka ʻiʻo puʻuwai. Eia kekahi, hiki ke hana ʻia kēia kūlana no kekahi mau kumu ʻē aʻe:

• Nā hopu ʻana (hana uila maʻamau ʻole i loko o ka lolo).
• ʻO ka Stress Cardiomyopathy kahi maʻi e hoʻopilikia ai i ka puʻuwai ma muli o ke kaumaha.
• He ʻano maʻi e like me ka hahau ʻana.
• Ke kahe ʻana o ke koko i loko o ka lolo (Subarachnoid Hemorrhage).

He aha nā hōʻailona o kēia mau kūlana ʻelua?

No ka mea, ma nā kūlana ʻelua, ʻo ka hapa wale nō a i ʻole ka hapa nui o ka ʻiʻo puʻuwai i hoʻopilikia ʻia, ua like pinepine nā hōʻailona me nā mea i ʻike ʻia i ka hāʻule ʻana o ka puʻuwai. ʻO lākou kekahi:

• Paʻakikī ka hanu ʻana
• ʻEha umauma
• Pehu wāwae

Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​ʻoi aku ka maikaʻi o ke kipa ʻana i ke kauka a hoʻāʻo.

Pehea e ʻike ai i ka hibernating myocardium?

No ka ʻike pololei ʻana i kēia kūlana, pono kekahi mau hoʻokolohua paʻakikī. Hiki i kēia mau hoʻokolohua ke kōkua i ka hoʻokaʻawale ʻana ma waena o nā ʻāpana o ka ʻiʻo puʻuwai e "hiamoe" a "paʻa" paha akā hiki ke hoʻāla hou ʻia , a me nā ʻāpana i make a ʻeha a ʻaʻole hiki ke hoʻāla hou ʻia .

ʻO kekahi o nā hoʻokolohua nui a nā kauka e hoʻohana ai no kēia kumu:

• ʻO ka `Dobutamine Stress Echocardiogram`: ʻO kēia ka hāʻawi ʻana iā ʻoe i kahi lāʻau lapaʻau (i kapa ʻia ʻo `(Dobutamine)`) e hoʻoulu i kou puʻuwai me he mea lā e hoʻoikaika kino ana. A laila e nānā ke kauka puʻuwai i ka hana ʻana o kou puʻuwai i ka wā e hoʻomaha ai a pehea e hana ai i ka wā e hoʻonui ʻia ai ka nui o ka lāʻau lapaʻau. Inā piʻi ka hiki o ka ʻiʻo puʻuwai ke hana i ka wā e hāʻawi ʻia ai ka lāʻau lapaʻau, ʻo ia hoʻi he maʻi kou i kapa ʻia ʻo `(Stunned Myocardium)` a i ʻole `(Hibernating Myocardium)`. Inā ʻaʻole e ʻūlū ka ʻiʻo ma hope o ka hoʻonui ʻia ʻana o ka nui o ka lāʻau lapaʻau, ʻo ia hoʻi ua make ka ʻiʻo a ua ʻeha.
• MRI o ka puʻuwai:Hoʻohana kēia i kahi magnet ikaika a me nā nalu lekiō e hana i nā kiʻi kikoʻī a maopopo loa o kou ʻiʻo puʻuwai. Ma ka nānā ʻana i ke ʻano a me ka mānoanoa o ka ʻiʻo puʻuwai i loko o kēia mau kiʻi, hiki i nā kauka ke haʻi pololei i ka ʻiʻo i ʻeha (make), ka mea maʻamau, a me ka mea "moe" a i ʻole "paʻa."
• ʻO ke scan Cardiac Positron Emission Tomography (PET): Hoʻohana kēia i kahi pae palekana o nā mea radioactive a me kahi kāmela kūikawā. Hōʻike ia i nā ʻāpana o kou ʻiʻo puʻuwai e hana maʻamau ana a me nā ʻāpana i loaʻa nā ʻeha a i ʻole nā ​​​​ʻiʻo make.

ʻOiai paha he mea paʻakikī iki kēia mau hoʻokolohua, he mea nui loa ia e hoʻomaopopo i kou kūlana pololei a koho i ka lāʻau lapaʻau kūpono loa iā ʻoe.

Hiki ke ho'ōla ʻia ka `Hibernating Myocardium` (ka ʻiʻo puʻuwai hiamoe)? He aha nā lāʻau lapaʻau?

ʻAe, ʻo kēia ka nūhou maikaʻi loa! Hiki ke ho'ōla ʻia kēia maʻi me ka lāʻau lapaʻau. ʻO ka mea nui e hana ai, ʻo ia ke hoʻihoʻi i ke kahe koko maikaʻi i ka ʻāpana o ka ʻiʻo puʻuwai i emi iho ke kahe koko. ʻElua mau lāʻau lapaʻau nui no kēia:

• Angioplasty: Pili kēia i ka hoʻohana ʻana i kahi ʻōmole lōʻihi a lahilahi (catheter) e komo i loko o ke kīʻaha koko i paʻa a hoʻopiha i kahi pōpō liʻiliʻi ma ka hopena o ka ʻōmole e wehe i ka plaque a hoʻonui i ke kīʻaha koko. I kekahi manawa, hiki ke kau ʻia kahi mea like me ka mesh (stent) i loko o ke kīʻaha koko e pale aku ai i ka pani hou ʻana.
• ʻO ke ʻoki ʻana i ke aʻa koko coronary (CABG): He ʻoki ʻana kēia e pili ana i ka lawe ʻana i kahi kīʻaha koko olakino mai kahi ʻāpana ʻē aʻe o kou kino (e like me kou wāwae a umauma paha) a hana i kahi ala hou no ke kahe ʻana o ke koko ma o ia mea, e pale ana i ke kīʻaha koko i paʻa i loko o kou puʻuwai. Ua like ia me ke kūkulu ʻana i kahi bypass ke paʻa ke alanui.

Ma hope o kēia mau lāʻau lapaʻau, hiki ke kuhikuhi ʻia ʻoe i kahi papahana "Cardiac Rehabilitation" e kōkua i kou hoʻōla ʻana. He papahana hoʻoikaika kino kēia i mālama ʻia e ke kauka e kōkua iā ʻoe e hoʻonui i kou ikaika a me ke olakino, a hoʻomohala i nā ʻano olakino puʻuwai.

He aha nā lāʻau lapaʻau no ka 'Stunned Myocardium'?

ʻO ka mālama ʻana no ka ʻiʻo puʻuwai i ālai ʻia ua like ia me nā lāʻau lapaʻau maʻamau no ka maʻi puʻuwai coronary a me ka hāʻule ʻana o ka puʻuwai. ʻO kekahi o nā lāʻau lapaʻau i hoʻohana pinepine ʻia:

• ʻAspirina
• Nā mea pale beta
• Nā Statins (nā lāʻau hoʻohaʻahaʻa cholesterol)
• ʻO nā mea hoʻopaʻa ACE a i ʻole nā ​​mea pale Angiotensin II receptor (nā lāʻau lapaʻau e kaohi i ke koko a pale i ka puʻuwai)

E nānā ke kauka i kou kūlana a kuhikuhi i ka lāʻau lapaʻau kūpono loa nāu.

Pehea e pale ai iā ʻoe iho mai kēia mau kūlana?

ʻO ke ala maikaʻi loa e hōʻemi ai i ka pilikia o kēia mau kūlana, ʻo ia ka mālama pono ʻana i kou puʻuwai. ʻO ia hoʻi:

• Ma hope o kahi papaʻai olakino:He ʻai haʻahaʻa i ka ʻaila, ke kō, a me ka paʻakai, a nui i nā mea kanu a me nā huaʻai.
• Hoʻoikaika kino mau: ʻOiai he mea maʻalahi e like me ka hele wāwae no 30 mau minuke i ka lā he mea maikaʻi ia.
• E pale i ka puhipaka: He mea ʻino loa ka puhipaka no ka puʻuwai.
• Ke kaupalena nei i ka inu ʻana i ka waiʻona.
• Ka mālama ʻana i ke kaumaha olakino.
• Ke kāohi nei i ke kaumaha.
• Inā loaʻa iā ʻoe nā maʻi e like me ka maʻi diabetes, ke koko kiʻekiʻe, a i ʻole ka cholesterol kiʻekiʻe, e kaohi pono iā lākou.
• Inā ua kuhikuhi kāu kauka iā ia, e lawe i nā lāʻau lapaʻau e like me nā statins e hoʻohaʻahaʻa i ka cholesterol a i ʻole aspirin e pale ai i nā ʻōpū koko i kēlā me kēia lā.

Hiki iā ʻoe ke hoʻohana i nā mīkini helu pilikia mai nā hui e like me ke Kulanui ʻAmelika o Cardiology a i ʻole ka Hui ʻEulopa o Cardiology e hoʻoholo i kāu mau pono pilikino a me ka mālama ʻana. Eia nō naʻe, inā loaʻa iā ʻoe ka maʻi puʻuwai, ʻoi aku ka maikaʻi o ke kamaʻilio ʻana me kāu kauka e pili ana i kou pilikia. I kēia mau kūlana , ua hōʻike ʻia ka lāʻau lapaʻau i kuhikuhi ʻia e ke alakaʻi e hōʻemi nui i ka pilikia o ka hōʻeha puʻuwai, ka hāʻule ʻana o ka puʻuwai, a me ka make.

He aha ka wānana?

ʻO ke olakino o ka wā e hiki mai ana o kekahi me kēia maʻi (kapa mākou i kēia "prognosis") e hilinaʻi ʻia ana i kekahi mau kumu. Eia kekahi laʻana:

• Ka nui o ka emi ʻana o ka hiki o ka puʻuwai ke pamu.
• Inā ʻoe e hoʻohana ana i ka lāʻau lapaʻau pololei i kuhikuhi ʻia e ke kauka.
• Inā paha ʻoe e kūpono no ke ʻoki ʻana `(Angioplasty)`/`(Stent)` a i ʻole `(CABG)`.

Loaʻa i ka poʻe me ka maʻi ʻaʻa coronary kahi pilikia no ko lākou ola a pau o ka loaʻa ʻana o nā pilikia puʻuwai i ka wā e hiki mai ana. Inā e ālai hou ʻia kou mau ʻaʻa coronary, hiki i kou ʻiʻo puʻuwai ke "hibernate" hou.

He mea nui: Hana ʻia ka Myocardium hiamoe i ka wā e kaupalena ʻia ai ke kahe o ke koko i ka ʻiʻo o ka puʻuwai no ka manawa lōʻihi ma muli o ka paʻa nui ʻana o ke aʻa coronary i nā poʻe me ka maʻi aʻa coronary. Hana ʻia ka Myocardium i ka wā e emi koke ai ke kahe o ke koko. Inā hoʻihoʻi ʻia ke kahe o ke koko, pono e hiki i kou ʻiʻo puʻuwai ke ʻūlū hou i loko o kahi manawa pōkole. Hiki ke mālama ʻia kēia mau kūlana ʻelua. He mea nui e mālama pono i kou puʻuwai e pale aku i ka hoʻi hou ʻana o kēia mau kūlana.

Nā mea nui e hoʻomanaʻo (Leka Lawe-Home)

ʻAe, e hōʻuluʻulu kākou i nā mea e pono ai ʻoe e hoʻomanaʻo mai nā mea a mākou i kamaʻilio ai:

• ʻO ka Hibernating Myocardium a me ka Stunned Myocardium ʻelua mau kūlana e kū mai ana ma muli o ka emi ʻana o ke kahe koko i ka ʻiʻo puʻuwai.
• Ma kēia mau kūlana ʻelua, ʻaʻole make ka ʻiʻo puʻuwai, akā ʻaʻole ia e hana pono. He ʻokoʻa kēia mai ka hōʻeha puʻuwai.
• Hiki ke ho'ōla pinepine ʻia kēia mau maʻi ʻelua! He mea nui e hoʻihoʻi i ke kahe koko a, inā pono, e ʻimi i ka lāʻau lapaʻau.
• Inā loaʻa iā ʻoe nā hōʻailona e like me ka paʻakikī o ka hanu ʻana, ka ʻeha o ka umauma, a i ʻole ka pehu ʻana i kou mau wāwae, e ʻimi i ke kōkua lapaʻau me ka hoʻonele ʻole i ka manawa.
• Hiki ke hoʻēmi ʻia ka pilikia o kēia mau kūlana ma o ka hahai ʻana i kahi nohona olakino a me ka mālama ʻana i nā kūlana olakino e like me kēia (e like me ka maʻi diabetes a me ke koko kiʻekiʻe).
• Inā loaʻa iā ʻoe ka maʻi puʻuwai, he mea nui loa ia e hahai pololei i nā ʻōlelo a kāu kauka a hana i nā hoʻokolohua maʻamau.

ʻO kou puʻuwai kou waiwai makamae loa. No laila e mālama pono iā ia. Lana koʻu manaʻo he mea pono kēia ʻike iā ʻoe!

ʻO ka maʻi puʻuwai, ka myocardium hoʻomaha, ka myocardium hoʻohoka, ka hōʻeha puʻuwai, ka maʻi ʻaʻai coronary, angioplasty, ke ʻoki bypass