Loaʻa iā ʻoe kekahi 'alahaka' e like me kēia i loko o kou puʻuwai? (Myocardial Bridge) E aʻo kākou e pili ana i ia mea.

I kekahi manawa i loko o ko kākou ola, hiki mai ka mea hiki ʻole ke noʻonoʻo ʻia, ʻeā? ʻOiai i ka wā e pili ana i ko kākou olakino kino, aia kekahi mau maʻi olakino a kākou i lohe ʻole ai. Akā, he mea nui loa ia e makaʻala iā lākou. I kēia lā, e kamaʻilio kākou e pili ana i kahi maʻi puʻuwai he mea ʻē iki, akā hiki ke hoʻopilikia i kekahi poʻe. Ua kapa ʻia kēia ʻo (Myocardial Bridge). ʻAʻole paha ʻoe i lohe i kēia inoa, akā e kamaʻilio maʻalahi mākou e pili ana iā ia, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

He aha kēia alahaka myocardial?

I ka ʻōlelo maʻalahi, aia nā kīʻaha koko o kou puʻuwai e hoʻolako ana i ke koko, a mākou e kapa nei he mau aʻa coronary . Aia kēia mau aʻa ma luna o ka ʻiʻo puʻuwai. ʻO ia hoʻi, hele lākou ma luna o ka ʻili o ka puʻuwai. Eia naʻe, ma kēia kūlana i kapa ʻia ʻo (Myocardial Bridge), ʻo ka mea e hana ʻia, ma kahi o ka hele ʻana ma luna o ka ʻiʻo puʻuwai, hele kekahi hapa o kēia aʻa coronary i loko o kou puʻuwai ma lalo o ka ʻiʻo. Ua like ia me kahi tunnel liʻiliʻi, a i ʻole e like me ke hele ʻana ma lalo o kahi alahaka. ʻO ia ka mea a nā kauka e kapa ai i ka ʻāpana o ka ʻiʻo puʻuwai e noho ana ma luna o ke kīʻaha koko (Myocardial Bridge).

I kēia manawa, e noʻonoʻo, i kekahi manawa, i ka wā e paʻi ai ka puʻuwai, ʻo ia hoʻi, i ka wā e ʻūlū ai ka ʻiʻo o ka puʻuwai, hiki i ke alahaka ʻiʻo ma luna ke kaomi i ke kīʻaha koko ma lalo. Ua like ia me ka wā e hehi ai kekahi i kahi paipu wai, e lohi ana ke kahe ʻana o ka wai. He aha ka mea e hana ai inā ʻoe e kaomi ma luna o ia mea pēlā? Hiki i kēlā kaomi ke ālai i ke kahe ʻana o ke koko. A laila, ʻaʻole paha e loaʻa i ka ʻiʻo o ka puʻuwai ke koko waiwai i ka oxygen e pono ai.

ʻIke ʻoe, ʻo nā aʻa coronary he mau kahawai e hana ana i kahi hana koʻikoʻi loa. Pono ko mākou mau ʻiʻo puʻuwai, e like me nā ʻāpana ʻē aʻe o ko mākou kino, i ka oxygen. Lawe ʻia mai kēia oxygen iā mākou e kēlā mau aʻa coronary. No laila, inā ua ālai ʻia kēia kahe koko, hiki ke kū mai nā pilikia.

ʻO ka hapa pinepine, ʻike ʻia kēia ʻano (Myocardial Bridge) ma ka ʻaoʻao hema o ka puʻuwai, ke aʻa nui e iho ana i lalo (Left Anterior Descending Artery) , a i ʻole e like me ka kapa ʻana a nā kauka (LAD) . He aʻa nui kēia e hoʻolako i ke koko i ka paia mua o ka puʻuwai a me nā ʻāpana koʻikoʻi ʻē aʻe. Eia nō naʻe, hiki ke loaʻa kēia ʻano ma kekahi aʻa e lawe mai i ke koko i ka puʻuwai, i kahi nui a liʻiliʻi paha.

Ua kapa ʻia kēia kūlana he (Myocardial Bridge) he mea weliweli? Pehea ka maʻamau?

I ka hapanui o nā hihia, ʻaʻole nui ka pōʻino o ka loaʻa ʻana o kahi alahaka myocardial. Noho ka hapa nui o ka poʻe i ke ola maʻamau me ka ʻike ʻole he loaʻa iā lākou a me ka ʻole o nā hōʻailona. ʻO ia ka ʻoiaʻiʻo.

Eia nō naʻe, i kekahi manawa, e like me ka mea i ʻōlelo ʻia ma mua, inā nele ka ʻiʻo o ka puʻuwai i ka oxygen, hiki iā ʻoe ke ʻeha i ka umauma i kapa ʻia ʻo angina . Hana pinepine kēia i ka wā e hoʻomaka ai kou puʻuwai e kuʻi wikiwiki, e like me ka wā o ka hoʻoikaika kino.

I ka nīnau ʻia ʻana pehea ka maʻamau o kēia ʻano, ʻōlelo nā kānaka noiʻi he ʻoi aku ka maʻamau o ke alahaka myocardial akā ʻaʻole i ʻike ʻia ma mua o kou manaʻo. ʻO kēia no ka mea ʻokoʻa ka pakeneka ma muli o ke ʻano i hoʻohana ʻia e ʻike ai. Wahi a kekahi mau noiʻi, ma waena o 16% a me 30% o ka poʻe i ʻike ʻia me kēia ʻano ma o nā hoʻokolohua e like me nā angiograms, ʻōlelo lākou he nui paha kēia ʻano i loko o kahi helu nui o ka poʻe. ʻO ke ʻano kēia he nui paha ka poʻe i loaʻa iā ia ma mua o kou manaʻo.

He aha nā hōʻailona o kēia?

ʻAʻole hōʻike ka nui o ka poʻe me kahi alahaka myocardial i kekahi mau hōʻailona. Eia nō naʻe, i ko lākou ʻelemakule ʻana a i ʻole ka ulu ʻana o nā maʻi ʻē aʻe (e like me ke koko kiʻekiʻe a i ʻole ka maʻi diabetes), hiki i kekahi poʻe ke loaʻa nā hōʻailona. I kekahi manawa hiki ke hala nā makahiki no ka ʻike ʻia ʻana o nā hōʻailona.

ʻO ka hōʻailona nui ka ʻeha o ka umauma ((Angina)) . ʻO ka maʻamau kēia:

• I ka wā e hoʻoikaika kino ai, e holo ana, a e piʻi ana paha i nā alapiʻi
• Ke manaʻo ʻoe i ka nui o ke kaomi, ka hopohopo, a i ʻole ke kaumaha
• I kekahi manawa hiki ke hiki mai ma hope o kahi ʻaina nui.

ʻOkoʻa ke ʻano o ka wehewehe ʻana i kēia ʻeha mai kēlā kanaka a kēia kanaka. Manaʻo paha kekahi e like me ke ʻomi ʻia, ka ʻomi ʻia, a i ʻole ke kaumaha ʻia.

Hiki i nā hōʻailona ʻē aʻe ke like me nā hōʻailona o ka hōʻeha puʻuwai, no laila pono ʻoe e makaʻala i kēia mau mea:

• Pōkole o ka hanu : Manaʻo e like me ka pilikia o ka hanu ʻana me ka hoʻoikaika iki ʻana.
• Nā palpitations o ka puʻuwai : Manaʻo paha ka umauma e like me ke kuʻi ʻana a i ʻole ke kuʻi ʻana.
• Pōniuniu : Hiki paha iā ʻoe ke pōniuniu, a hiki paha ke hiolo.

He mea nui: Inā loaʻa iā ʻoe nā hōʻailona e hōʻike ana e loaʻa ana iā ʻoe kahi hōʻeha puʻuwai (ʻeha nui o ka umauma, ʻeha e pālahalaha ana i lalo o kou lima, hou, luaʻi), pono ʻoe e hele koke i kahi lumi pilikia. Mai hoʻopaneʻe.

No ke aha e hana ʻia ai kēia (Myocardial Bridge)?

He nīnau kēia me kahi pane maʻalahi loa. He maʻi hānau ʻia ʻo Myocardial Bridge. ʻO ia hoʻi, he mea ia i hānau ʻia me ʻoe. Ke ulu ka puʻuwai i loko o ka embryo, ua hana ʻia kēlā kīʻaha koko ma ke ʻano e komo ai i loko o ka ʻiʻo. ʻAʻohe kumu kikoʻī no ia mea, hana wale ia.

He aha nā pilikia e hiki ai i kēia ke hana?

ʻO kaʻoiaʻiʻo, he mea kakaikahi loa nā pilikia nui mai kahi alahaka myocardial. Eia nō naʻe, i kekahi manawa, ʻoiai ke hui pū ʻia me nā kūlana olakino ʻē aʻe, hiki ke hana ʻia kēia mau mea. ʻAʻole ʻoe e makaʻu i kēia mau mea, akā e makaʻala iā lākou:

• Myocardial Ischemia: E like me ka mea i ʻōlelo ʻia ma mua, i ka wā e ālai ʻia ai kahi kīʻaha koko, ʻaʻole paha e loaʻa i ka ʻiʻo puʻuwai ka oxygen lawa. ʻO kēia ka manawa e loaʻa ai nā mea e like me ka ʻeha o ka umauma.
• ʻO ka Vasospasm Coronary: I kekahi manawa hiki i kēia mau aʻa ke hoʻopili koke a koʻikoʻi, hiki ke hoʻopilikia i ke kahe koko.
• ʻO ka hōʻiliʻili ʻana o ka plaque Atherosclerosis kokoke i ke alahaka myocardial: Ua ʻike ʻia ua hōʻiliʻili ka plaque ma nā paia o ke kīʻaha koko kokoke i ke alahaka, e hoʻonui ai i ka pilikia o ka hāiki ʻana o ke kīʻaha koko. Malia paha no ka mea ua loli ke ʻano o ke kahe ʻana o ke koko ma o ke alahaka.
• ʻO ka maʻi coronary koʻikoʻi: Hiki i kēia ke lilo i ka hōʻeha puʻuwai a i ʻole ka angina paʻa ʻole.
• ʻO ka Arrhythmias Ventricular: Hiki ke hana ʻia nā puʻuwai puʻuwai kūpono ʻole e hoʻomaka ana ma nā keʻena haʻahaʻa o ka puʻuwai.
• ʻO ka Broken Heart Syndrome: He nāwaliwali kēia o ka puʻuwai no ka manawa pōkole e hiki ke kū ma hope o ke kaumaha nui.
• Hoʻouka Puʻuwai: ʻOiai he mea kakaikahi, hiki ke loaʻa ka hōʻeha puʻuwai inā ua ālai loa ʻia ke kahe o ke koko.
• Make koke ʻana o ka puʻuwai: He mea kākaʻikahi loa kēia, akā hiki nō.

E hoʻomanaʻo he mea kakaikahi loa kēia mau pilikia.

Pehea e ʻike ai nā kauka i ke alo o kēia (Myocardial Bridge)?

Hiki ke ʻike ʻia ma kahi ulia pōpilikia ke ʻike ʻoe i ke kauka no ka mea he mau hōʻailona kou, a i ʻole i ka wā o nā hoʻokolohua no kekahi kumu ʻē aʻe. Inā manaʻo kekahi kauka he alahaka myocardial kou, hiki iā lākou ke hana i kēia mau hoʻokolohua:

• ʻO ka angiogram coronary: ʻO kēia ka hoʻāʻo koʻikoʻi loa. Ma kēia hoʻāʻo, hoʻokomo ʻia kahi ʻōmole liʻiliʻi ma o kahi aʻa koko i loko o kou lima a i ʻole kou wāwae a alakaʻi ʻia i nā aʻa coronary o kou puʻuwai. A laila hoʻokomo ʻia kahi kala kūikawā i loko a lawe ʻia nā kiʻi X-ray. ʻAe kēia i ka ʻike maopopo ʻia ʻana o ka haiki o ke aʻa koko.
• ʻO ke Ultrasound Intravascular (IVUS): Ma kēia, i ka manawa like me ka angiogram, ua hoʻokomo ʻia kahi mea ultrasound liʻiliʻi i loko o ke aʻa e ʻike i ke ʻano o ka paʻa ʻana o nā paia o loko o ke aʻa a me ke alahaka.
• Optical Coherence Tomography (OCT): E like me IVUS, he ʻano hana holomua kēia e hoʻohana ana i ka mālamalama e ʻike i loko o ke aʻa.
• ʻO Coronary Computed Tomography Angiogram (CT Angiogram): He scan CT kēia. Hoʻohana pū kēia i ka dye e hana i nā kiʻi ʻekolu-dimensional o nā aʻa i loko o ka puʻuwai. Hiki i kēia ke kōkua i ka hoʻoholo ʻana inā he alahaka myocardial a pehea ka lōʻihi a me ka hohonu.

No laila aia kekahi lāʻau lapaʻau no kēia? Pehea ʻoe e hana ai?

ʻAe, aia nā lāʻau lapaʻau no ka poʻe i loaʻa nā hōʻailona. ʻAʻole pono nā kānaka a pau i ke ʻoki kino. Na kāu kauka e hoʻoholo i ka lāʻau lapaʻau kūpono loa iā ʻoe. E nānā kākou i kēia mau lāʻau lapaʻau:

• Nā lāʻau lapaʻau: ʻO nā lāʻau lapaʻau ka mea mua i koho pinepine ʻia. ʻO kēia mau mea (Beta-blockers) a me (Calcium Channel Blockers).Hoʻohana lākou i nā lāʻau lapaʻau i kapa ʻia ʻo "okari". Hoʻomalu iki kēia mau lāʻau lapaʻau i ka helu o ka puʻuwai, hoʻonui i ka manawa e hoʻomaha ai ke aʻa ma waena o nā puʻuwai, a hoʻemi i ke kaomi ma luna o ke kīʻaha koko. No kekahi poʻe, hāʻawi ʻia kekahi lāʻau i kapa ʻia ʻo (Ivabradine) ma ke ʻano he koho ʻē aʻe.
• ʻOki kino: No ka poʻe me nā hōʻailona koʻikoʻi i hiki ʻole ke kāohi ʻia me ka lāʻau lapaʻau, a inā he hohonu a lōʻihi ke alahaka, hiki ke ʻōlelo ʻia ke ʻoki kino.
• ʻO kekahi ʻano hana i kapa ʻia ʻo (Surgical Myotomy) . ʻO ia hoʻi, ʻo ka ʻoki ʻana a me ka wehe ʻana i ke alahaka ʻiʻo ma luna o ke kīʻaha koko (unroofing). Akā hana ʻia kēia inā he pōkole iki a pāpaʻu ke alahaka.
• ʻO ke ʻano hana ʻē aʻe i kapa ʻia ʻo Coronary Artery Bypass Surgery (CABG) . Pili kēia i ke kāpae ʻana i ka wahi i ālai ʻia a me ka hoʻohana ʻana i kahi ʻāpana o ke kīʻaha koko i lawe ʻia mai kahi ʻāpana ʻē aʻe o ke kino (mai ka wāwae a i ʻole ka ʻaoʻao o loko o ka umauma) e hana i kahi ala ʻē aʻe no ke kahe ʻana o ke koko. Hana pinepine ʻia kēia inā lōʻihi a hohonu ke alahaka.
• Ke kau ʻana o ka stent: ʻO kekahi koho ʻē aʻe, ʻo ia ke kau ʻana i kahi stent. He ʻōmole metala liʻiliʻi ka stent e like me ka ʻupena. Hoʻokomo ʻia i loko o ke kīʻaha koko i paʻa a hoʻopiha ʻia mai loko mai. A laila, inā ua paʻa ka ʻiʻo, mālama ka stent i ke kīʻaha koko e wehe ana, e ʻae ana i ke koko e kahe maʻalahi. Eia nō naʻe, aia nā manaʻo like ʻole e pili ana i ke kau ʻana i kahi stent i kēia hihia. I kekahi manawa, hiki i ka stent ke haki a paʻa hou paha, no laila hana nā kauka i kēia mau hoʻoholo me ke akahele loa.

He aha kaʻu e manaʻo ai inā he myocardial bridge koʻu?

E like me nā poʻe he nui, loaʻa paha iā ʻoe kahi alahaka myocardial a ʻaʻohe ou hōʻailona. ʻAʻole pono kēlā poʻe i kahi lāʻau kūikawā. Inā he mau hōʻailona, ​​​​hiki ke hoʻomalu pinepine ʻia me ka lāʻau lapaʻau.

Inā ʻaʻole e hoʻomaikaʻi nā hōʻailona me ka lāʻau lapaʻau, pono e noʻonoʻo ʻia ke ʻoki ʻana (myotomy a bypass paha) a i ʻole ke kau ʻana o ka stent. Inā e wehe ʻia ana kahi alahaka myocardial ma ke ʻoki ʻana, he mea naʻauao ke koho ʻana i kahi haukapila me nā kauka ʻokiʻoki akamai e hana pinepine i ia mau ʻokiʻoki.

ʻAʻole kēia (Myocardial Bridge) kahi mea e ho'ōla pono'ī me ka ʻole o ka wehe ʻana i ke ʻoki kino. Akā, ʻaʻole pono ka hapa nui o ka poʻe i ke ʻoki kino.

Pehea e kū nei ka poʻe e noho nei me kēia maʻi?

Nui nā poʻe me Myocardial Bridge e ola lōʻihi a ʻoi aku ka maikaʻi o ko lākou olakino no ka wā lōʻihi.

Aia nā helu ola i ka loaʻa ʻana o nā maʻi ʻē aʻe. Ma kekahi noiʻi, ma kahi o 90% o ka poʻe me ka myocardial infarction e ola mau ana he 10 mau makahiki ma hope o ka hōʻoia ʻana. Eia nō naʻe, inā loaʻa iā lākou nā maʻi puʻuwai ʻē aʻe, e like me ka maʻi coronary artery (CAD), ua haʻahaʻa iki nā helu ola.

Pehea lā wau e mālama ai i koʻu olakino?

No ka mea, ua ʻike ʻia ka loaʻa ʻana o kahi alahaka myocardial e hoʻonui iki i ka pilikia o nā waihona momona i loko o nā aʻa (atherosclerosis), e aʻo paha kāu kauka iā ʻoe e kāohi i nā kumu pilikia ʻē aʻe e hiki ke kōkua i ia. He mea nui kēia inā loaʻa iā ʻoe nā hōʻailona a ʻaʻole paha.

• E Hōʻalo i ka Puhipaka: ʻO ka mea nui e pale aku ai i ka atherosclerosis, ʻo ia ka noho mamao loa mai nā huahana paka. Inā he mea puhipaka ʻoe, e noi i kāu kauka no ke kōkua i ka haʻalele ʻana.
• E kāohi i nā kumu pilikia ʻē aʻe: Inā he koko kiʻekiʻe kou, maʻi diabetes, a i ʻole nā ​​​​pae cholesterol kiʻekiʻe, e kāohi pono iā lākou.
• ʻAi olakino: E ʻai i ka ʻai haʻahaʻa i ka ʻaila, ke kō, a me ka paʻakai, a nui i nā huaʻai a me nā mea kanu.
• Hoʻoikaika kino mau: E kamaʻilio me kāu kauka e ʻike i nā hoʻoikaika kino kūpono iā ʻoe, a hana mau ia mau mea.
• E lawe pololei i kāu mau lāʻau lapaʻau i kuhikuhi ʻia: Inā loaʻa iā ʻoe ka maʻi artery coronary (CAD), he mea nui e lawe i kāu mau lāʻau antiplatelet (nā mea hoʻokahe koko) a me nā lāʻau hoʻohaʻahaʻa cholesterol (nā lāʻau hoʻohaʻahaʻa cholesterol) pololei a i ka manawa e like me ke kauoha a kāu kauka.

Āhea wau e ʻike ai i ke kauka?

He mea nui loa ka mālama ʻana i kāu mau manawa hoʻopaʻa me kāu kauka. Pono kāu kauka e ʻike pinepine iā ʻoe e hōʻoia i ka lawe ʻana i ka nui kūpono o ka lāʻau lapaʻau a pehea kou mau hōʻailona. He mea nui hoʻi e hele no nā manawa hoʻopaʻa ma hope o ke ʻoki ʻana a i ʻole ke kau ʻia ʻana o kahi stent.

E like me ka mea i ʻōlelo ʻia ma mua, inā loaʻa iā ʻoe nā hōʻailona o ka hōʻeha puʻuwai (e like me ka ʻeha nui o ka umauma, ka paʻakikī o ka hanu ʻana, ka hou ʻana), e kāhea koke i ka 911 a i ʻole e hele i ka lumi pilikia kokoke loa.

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

Ke ʻike ʻoe he alahaka myocardial kou, he mea maʻamau ka nui o nā nīnau ma kou manaʻo. Hiki iā ʻoe ke nīnau i kāu kauka i nā nīnau penei:

• ʻEhia pinepine e pono ai iaʻu e hele mai no ka nānā ʻana?
• Pono anei au i ka lāʻau lapaʻau a i ʻole pono anei au i ke ʻoki kino?
• No ke aha ʻoe e paipai mai nei i kēia koho lapaʻau iaʻu? He aha nā pono noʻu? Aia kekahi mau hemahema?
• He aha nā hoʻololi e pono iaʻu e hana i kaʻu meaʻai a me ke ʻano o ka nohona?
• Hiki iaʻu ke hoʻoikaika kino? He aha ke ʻano o ka hoʻoikaika kino maikaʻi?

He mea maʻamau ke manaʻo iki i ka makaʻu a me ka hopohopo ke lohe ʻoe he hewa kekahi mea me kou puʻuwai. Akā e hoʻomanaʻo, no ka hapa nui o nā kānaka, ʻaʻole he mea e hopohopo ai ka alahaka myocardial. Inā loaʻa iā ʻoe nā hōʻailona, ​​e kamaʻilio me kāu kauka e hoʻoholo i ka lāʻau maikaʻi loa nāu.

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

ʻAe, i kēia manawa ua ʻoi aku kou maopopo i ka mea a mākou i kamaʻilio ai (Myocardial Bridge). I ka hōʻuluʻulu manaʻo:

• ʻO ke alahaka myocardial kahi maʻi hānau kahi e hele ai kahi aʻa coronary i loko o ka puʻuwai ma o kahi ʻiʻo.
• No nā kānaka he nui, ʻaʻohe hōʻailona o kēia a ʻaʻohe pōʻino.
• Hiki i kekahi poʻe ke ʻike i nā hōʻailona e like me ka ʻeha o ka umauma (angina), ʻoiai ke luhi lākou.
• Hiki ke hoʻomalu pinepine ʻia nā hōʻailona me ka lāʻau lapaʻau. I kekahi manawa, pono paha ke ʻoki kino a i ʻole ka stenting.
• He mea nui nā hoʻololi ʻana i ke ʻano o ka nohona (ka hoʻōki ʻana i ka puhipaka, ka ʻai olakino, ka hoʻoikaika kino) no ka hōʻemi ʻana i ka pilikia o ka atherosclerosis.
• Inā loaʻa iā ʻoe ka ʻeha nui o ka umauma a i ʻole nā ​​hōʻailona o ka hōʻeha puʻuwai, e ʻimi koke i ke kōkua lapaʻau.

He mea nui e mālama i kou puʻuwai. ʻO ka ʻike ʻana i kēia mau kūlana e kōkua iā ʻoe e ʻimi koke i ka lāʻau lapaʻau inā pono a kōkua iā ʻoe e ola i kahi ola olakino.

ʻO ke alahaka myocardial, maʻi puʻuwai, angina, aʻa coronary, ʻoki puʻuwai, stent, olakino puʻuwai