He maʻi o nā kīʻaha koko liʻiliʻi loa o ka puʻuwai? E kamaʻilio kākou e pili ana i (Microvascular Coronary Disease)

Ke manaʻo nei ʻoe i kekahi manawa i kahi ʻeha ʻē a i ʻole ka manaʻo o ka paʻa i loko o kou umauma? Ke hana ʻia kēlā, makaʻu mākou a hele e ʻike i ke kauka. ʻOiai ma hope o ka hana ʻana i nā hoʻokolohua e like me ka ECG a me ke scan, ʻōlelo ke kauka, "ʻAʻohe mea e paʻa ai i loko o nā kīʻaha koko nui o ka puʻuwai." A laila e noʻonoʻo paha mākou, "A laila no ke aha kēia ʻeha umauma?" ʻO ka ʻoiaʻiʻo, i kekahi manawa ʻaʻole ke kumu o kēia nā kīʻaha koko nui o ka puʻuwai, akā ʻo nā kīʻaha koko liʻiliʻi loa e lālā ana mai o lākou. ʻO ia ke kūlana a mākou e kamaʻilio nei i kēia lā, ʻo ia hoʻi ka 'Microvascular Coronary Disease' a i ʻole ka 'Small Vessel Disease'.

He aha ka maʻi coronary Microvascular?

I ka ʻōlelo maʻalahi, he maʻi kēia e hoʻopilikia ana i nā kīʻaha koko liʻiliʻi loa i loko o ko kākou puʻuwai. E noʻonoʻo i ko kākou puʻuwai e like me ke kūlanakauhale nui. He mau alaloa nui ko kēia kūlanakauhale (ʻo ia nā aʻa coronary nui) e hoʻolako ana i ke koko a me ka oxygen. Akā, no ka haʻalele ʻana i kēlā mau alaloa a hiki i kēlā me kēia hale a me nā hale kūʻai ma ke kūlanakauhale, pono ʻoe i nā alanui ʻaoʻao liʻiliʻi, nā alanui cobblestone, ʻeā? Ma ke ʻano like, lawe ʻia mai ke koko, ka oxygen a me nā meaʻai i kēlā me kēia cell liʻiliʻi i loko o nā ʻiʻo o ko kākou puʻuwai e kahi pūnaewele o nā kīʻaha koko maikaʻi loa, ʻaʻole mānoanoa ma mua o kahi kaula lauoho. ʻO kēia ka mea a mākou e kapa nei he `(coronary microvasculature)`.

Ma ke ʻano i kapa ʻia ʻo `Microvascular Coronary Disease`, ʻoiai ke kūlana maikaʻi nei kēlā mau alaloa nui, ua hōʻino ʻia kēia mau ala liʻiliʻi a ʻaʻole hana pono. A laila, ʻaʻole loaʻa i ka ʻiʻo puʻuwai ka oxygen a me ka meaʻai e pono ai.

Aia kekahi mau inoa ʻē aʻe i hoʻohana ʻia no kēia ʻano. Hiki i kāu kauka ke hoʻohana i kekahi o kēia mau inoa:

• Maʻi ʻaʻa liʻiliʻi
• Maʻi kīʻaha koko liʻiliʻi
• ʻO ka maʻi puʻuwai X
• Maʻi microvessel
• ʻO ka maʻi puʻuwai coronary ʻaʻole keakea

Pehea ka ʻokoʻa o kēia mai ka maʻi puʻuwai maʻamau (Coronary Artery Disease)?

He nui ka poʻe e huikau nei i nā mea ʻelua no ka mea ʻo kēia mau maʻi ʻelua e hoʻonui i ka pilikia o ka hōʻeha puʻuwai. Eia nō naʻe, ʻokoʻa loa ka hana a nā mea ʻelua. E hoʻomaopopo pono kākou i kēia ʻokoʻa.

ʻO wai ka mea i pilikia nui i ka loaʻa ʻana o kēia maʻi?

ʻOi aku ka maʻamau o kēia ʻano i nā wahine ma mua o nā kāne, ʻoiai i ka wā a ma hope o ka menopause, i ka wā e emi ai ka nui o ka estrogen i loko o ke kino.

Eia kekahi, ʻoi aku ka nui o ka pilikia o ka poʻe me kēia mau mea i ka hoʻomohala ʻana i kēia maʻi:

• Loaʻa i ka maʻi diabetes .
• Ke koko kiʻekiʻe .
• Loaʻa i nā pae cholesterol kiʻekiʻe i loko o ke koko .
• Ka momona a me ka piʻi ʻana o ke kaumaha.
• Puhipaka .
• Ke noho nei i kahi nohona noho me ka ʻole o ka hoʻoikaika kino .
• Ka ʻai nui ʻana i ka paʻakai, ka momona paʻa, a me nā meaʻai i hana ʻia .
• ʻO ka loaʻa ʻana o nā maʻi autoimmune e like me ka lupus a i ʻole ka rheumatoid arthritis.

No ke aha e loaʻa ai kēia maʻi?

I loko o ka puʻuwai olakino, nā ʻiʻo palupalu i loko o nā paia o kēia mau kīʻaha koko liʻiliʻi e kāohi i ke kahe o ke koko ma o ka ʻaelike a me ka hoʻomaha ʻana e like me ka mea e pono ai. No ka laʻana, i ka wā e hoʻoikaika kino ai kākou, pono ka puʻuwai i ke koko hou aku, no laila e ākea kēia mau kīʻaha koko a hoʻopuehu i ke koko hou aku. Ke hoʻomaha kākou, hoʻi lākou i ko lākou kūlana maʻamau.

Akā i ke ʻano o ka 'Microvascular Coronary Disease', ua hōʻino ʻia nā paia o loko o kēia mau kīʻaha koko liʻiliʻi. Hoʻopilikia kēia pōʻino i kā lākou hana. I kekahi manawa hiki i kēia mau kahawai ke ʻūlū koke me ka ikaika (spasms). A laila ua hoʻopilikia koke ʻia ka lako koko i ka ʻiʻo puʻuwai, e hana ana i nā hōʻailona e like me ka ʻeha o ka umauma.

He aha nā hōʻailona o kēia maʻi?

ʻO ka hōʻailona nui a maʻamau o kēia maʻi, ʻo ia ka ʻeha o ka umauma i kapa ʻia ʻo angina . Eia nō naʻe, ʻokoʻa iki paha kēia ʻeha mai ka ʻeha e kū mai ana i ka maʻi puʻuwai maʻamau.

• ʻO ka maʻamau he 10 mau minuke a ʻoi aku paha .
• Hiki ke ʻike ʻia kēia ʻeha i ka wā o ka hoʻoikaika kino a me ka hoʻomaha ʻana .
• Hiki ke hoʻonui ʻia ka ʻeha ke loaʻa ke kaumaha noʻonoʻo .
• No kekahi poʻe, ʻo kēia ʻeha ka mea e paʻakikī ai iā lākou ke hana pololei i nā hana o kēlā me kēia lā.

Ma waho aʻe o kēia ʻeha o ka umauma, hiki ke ʻike ʻia nā hōʻailona ʻē aʻe:

• Ka pōkole o ka hanu a me ka paʻakikī o ka hanu ʻana .
• Ka luhi nui me ke kumu ʻole .
• Nā pilikia hiamoe, me ka insomnia .

Pehea e ʻike pono ai i ka maʻi?

ʻO kaʻoiaʻiʻo, hiki ke paʻakikī iki ka ʻike ʻana i kēia maʻi no ka mea ua liʻiliʻi loa kēia mau kīʻaha koko liʻiliʻi e ʻike ʻia me nā hoʻokolohua puʻuwai maʻamau. No laila, inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​ʻoi aku ka maikaʻi o ke kipa ʻana i kahi kauka cardiologist nāna i loea i kēia ʻano maʻi.

ʻO ka hoʻāʻo maʻamau gula no ka ʻike ʻana i kēia maʻi he hoʻāʻo kūikawā i kapa ʻia ʻo 'Cardiac catheterization with coronary flow reserve (CFR).' Ke ana kēia i ka wikiwiki o ka hoʻonui ʻana o kēia mau kīʻaha koko liʻiliʻi a hoʻolako i ke koko hou aku i nā pono o ke kino.

Eia kekahi, hiki i ke kauka ke ʻōlelo i kekahi mau hoʻokolohua ʻē aʻe:

• Hoʻāʻo koʻikoʻi puʻuwai nuklea (PET scan)
• MRI puʻuwai me ka perfusion

He aha nā lāʻau lapaʻau no kēia?

ʻO ka pahuhopu nui o ka mālama ʻana, ʻo ia ka hoʻomaikaʻi ʻana i ka hana o nā kīʻaha koko, kaohi ʻana i nā hōʻailona, ​​a me ka hōʻemi ʻana i ka pilikia o nā pilikia e like me ka hōʻeha puʻuwai. Hiki i kāu kauka ke kuhikuhi i kekahi mau lāʻau lapaʻau e kōkua iā ʻoe e hana i kēia.

• Nā mea hoʻopaʻa i ka angiotensin-converting-enzyme (ACE): kōkua i ke kaohi ʻana i ke koko ma o ka hoʻonui ʻana i nā kīʻaha koko.
• Nā Anticoagulants: Nā lāʻau lapaʻau e pale ai i ke kāpili ʻana o ke koko.
• ʻAspirin: Kāohi i ka pipili ʻana o nā platelets koko a hōʻemi i ke kūkulu ʻia ʻana o nā clot koko.
• Nā mea pale Beta: Hoʻomalu i ka helu o ka puʻuwai a hoʻohaʻahaʻa i ke koko.
• Nā mea pale o ke kahawai calcium: Hoʻomaha i nā ʻiʻo i loko o nā kīʻaha koko, e hoʻonui ana iā lākou.
• Diuretics: Wehe i ka wai keu a me ka paʻakai mai ke kino, e hoʻohaʻahaʻa ana i ke koko.
• Statins: Nā lāʻau lapaʻau e hoʻohaʻahaʻa i nā pae cholesterol koko.

He aha kā mākou e hana ai e pale aku a kāohi i ka maʻi?

Me nā lāʻau lapaʻau, he mea nui loa nā loli maikaʻi i ko kākou nohona i ke kaohi ʻana i kēia maʻi.

• E hahai i kahi papaʻai olakino no ka puʻuwai: E hōʻemi i ka paʻakai, ka ʻaila, ke kō, a me nā meaʻai i hana ʻia, a e ʻai i nā mea kanu, nā huaʻai, nā legumes, a me nā meaʻai waiwai i ka fiber.
• E hoʻoikaika kino mau: E hoʻomaʻamaʻa ma ka liʻiliʻi he 30 mau minuke o ka hoʻoikaika kino i ka lā, e like me ka hele wāwae a i ʻole ka holo wikiwiki. Inā he mea hou ʻoe i ka hoʻoikaika kino, e kamaʻilio me kāu kauka a e noʻonoʻo i kahi papahana hoʻoponopono puʻuwai inā pono.
• E mālama i ke kaumaha o ke kino olakino.
• E mālama i ke koko a me nā pae kō i loko o ka pae kūpono.
• Inā ʻoe e puhipaka, e hoʻōki loa.

E pili ana i ke ola ʻana me kēia maʻi

ʻO ka hoʻohana ʻana i nā lāʻau lapaʻau he nui a me ka hana ʻana i nā hoʻololi nohona e like me kēia hiki ke paʻakikī iki i ka wā mua. Hiki i kekahi mau lāʻau lapaʻau ke hana i nā hopena ʻaoʻao e like me ka poniuniu.

Hiki ke kōkua nui hoʻi ka mālama ʻana i kahi puke moʻolelo o kāu mau hōʻailona a me ke koko, no ka mea e kōkua kēia i kāu kauka e loaʻa i kahi kiʻi maopopo o kou kūlana a hoʻopilikino i kāu lāʻau lapaʻau e like me ia.