E noʻonoʻo ʻoe he kanaka olakino maikaʻi ʻoe, me ka ʻole o kekahi maʻi a ʻeha paha, e hana ana i kāu hana maʻamau i kēlā me kēia lā. Hoʻoikaika kino ʻoe, ʻai maikaʻi, a inu. Akā i ka manawa koke, me ka manaʻo ʻole ʻia, manaʻo ʻoe i kahi ʻeha nui ma kou umauma, he ʻūlū. Hoʻomaka ʻoe e hou, paʻakikī iā ʻoe ke hanu, a manaʻo ʻoe i ka ʻeha e iho ana i lalo o kou lima. He aha ka mea mua e hiki mai ana i kou manaʻo? "Auē, ke loaʻa nei iaʻu kahi hōʻeha puʻuwai?" ʻAʻole anei kēlā ka makaʻu? Akā, ʻaʻole like kēia mau hōʻailona me nā hōʻailona o ka hōʻeha puʻuwai maʻamau a mākou i ʻike ai. I kēia lā, e kamaʻilio mākou e pili ana i kahi pilikia olakino e like ke ʻano, akā he ʻokoʻa iki, ʻoi aku hoʻi i waena o nā wahine ʻōpio olakino. Kāhea mākou i kēia 'Spontaneous Coronary Artery Dissection' a i ʻole '(SCAD)' no ka pōkole.
I ka ʻōlelo maʻalahi, he aha ka SCAD?
ʻOiai paha he mea paʻakikī iki ke kani ʻana o ka inoa, he mea maʻalahi loa ke hoʻomaopopo i ka mea e hana nei. E noʻonoʻo i ko kākou puʻuwai e like me kahi motika e hana mau ana. Pono kēia motika i ka lako mau o ke koko, ʻo ia hoʻi ka oxygen a me nā meaʻai, e hana. Lawe ʻia kēia koko i nā ʻiʻo o ka puʻuwai e nā kīʻaha koko e like me kahi ʻōnaehana paipu liʻiliʻi. ʻO kēia nā mea a mākou e kapa nei he mau aʻa coronary.
I kēia manawa, ʻoiai ua like kēia aʻa coronary me kahi paipu, ua hana ʻia kona paia me ʻekolu mau papa i hoʻopili ʻia. E like me kahi keke papa. I ke ʻano o SCAD, ʻo ka mea e hana ʻia ana, me ke kumu ʻole, ua hana koke ʻia kahi haehae liʻiliʻi ma kekahi o nā papa ma loko o kēia paia aʻa.
E noʻonoʻo i ka mea e hana ʻia ke haehae iki ʻia ka loko o kahi paipu wai. ʻO ke kaomi wai ke kumu o ka wai e kahe ma o ka haehae a paʻa ma waena o nā paia ʻelua o ka paipu. Pēlā nō, i ka wā e haehae ai i loko o ke aʻa, e kahe ana ke koko e kahe ana ma lalo o ke kaomi kiʻekiʻe ma waena o kēia mau membrane ʻelua a hōʻiliʻili. Ke paʻa ke koko ma kēia ʻano, e puʻupuʻu ia i loko o ka paia o ke aʻa ma ia wahi, e ālai ana i ke kahe ʻana o ke koko. Ua kapa ʻia kēia he "hematoma". Ke emi a paʻa loa paha ke kahe ʻana o ke koko ma kēia ʻano, e emi ana ka nui o ke koko e hiki aku ana i ka ʻiʻo puʻuwai. ʻO ia ka manawa e ʻike ʻia ai nā hōʻailona o ka hōʻeha puʻuwai a mākou i kamaʻilio ai ma mua.
ʻO ka mea nui, ʻaʻole ʻo SCAD he hōʻeha puʻuwai, ka mea i hoʻokumu pinepine ʻia e nā waihona cholesterol (atherosclerosis) e ālai ana i nā aʻa. He hana ʻokoʻa loa kēia.
He aha nā hōʻailona o kēia? Pehea ʻoe e ʻike ai?
Ua like loa nā hōʻailona o SCAD me nā hōʻailona o ka hōʻeha puʻuwai maʻamau, no laila he mea maʻalahi ke huikau i nā mea ʻelua. Akā inā ʻike ʻoe i kekahi o kēia mau hōʻailona, he mea nui e mālama iā ia ma ke ʻano he pilikia olakino .
| Hōʻailona | Wehewehena |
|---|---|
| ʻEha a kaomi paha o ka umauma | ʻO kēia ka hōʻailona maʻamau. Hiki ke manaʻo ʻia e like me ka ʻūmiʻi a i ʻole ka ʻūmiʻi ʻana o kou umauma. |
| Paʻakikī ka hanu ʻana | E manaʻo paha ʻoe ua pōkole kou hanu a ua piha paha kou umauma. |
| ʻEha ma ka lima, poʻohiwi, ʻāʻī, a i ʻole ka ʻāʻī | Hiki ke hoʻolaha ʻia ka ʻeha o ka umauma i ka lima hema, poʻohiwi, a i ʻole ka ʻāwae. |
| Ka hou nui ʻana | Hiki paha iā ʻoe ke anu a hou me ke kumu ʻole. |
| Pōʻino a poʻo hina paha | Manaʻo puni a nāwaliwali paha. |
| Ka luaʻi a me ka luaʻi | Hiki i ka luaʻi ke hele pū me ka ʻeha ʻōpū. |
| Nā Palpitations | Manaʻo e kuʻi wikiwiki ana kou puʻuwai. |
Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, mai hoʻokaʻulua no kekahi kekona. E hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa a kāhea aku i kahi ambulance. ʻAʻole kēia kahi mea hiki iā ʻoe ke mālama ma ka home.
ʻO wai ka mea i pilikia nui loa no ka hoʻomohala ʻana i ka SCAD?
ʻO kēia ka mea kupanaha loa e pili ana i ka SCAD. ʻO ka maʻamau, hiki mai nā hōʻeha puʻuwai i ka poʻe ʻelemakule, he mau mea pilikia e like me ka maʻi diabetes, ke koko kiʻekiʻe, a me ka cholesterol. Akā, ʻaʻole like ʻo SCAD me ia.
- ʻO ka mea maʻamau i nā wāhine: Mai loko mai o 10 mau maʻi SCAD, he 9 nā wāhine.
- I ka wā ʻōpiopio: He mea maʻamau kēia ʻano, ʻoiai hoʻi i waena o nā wahine ma waena o 40-50 mau makahiki, he poʻe olakino a ʻaʻohe o lākou mau kumu pilikia maʻi puʻuwai ʻē aʻe.
- Pili i ka hāpai ʻana: Loaʻa paha i kekahi mau wahine kēia maʻi i ka wā hāpai a ma hope paha o ka hānau ʻana. Ua manaʻo ʻia ua hana ʻia e nā loli hormonal a me ke kaumaha o ka hānau ʻana.
- Ke kaumaha kino a noʻonoʻo paha: ʻO ka hāpai koke ʻana i nā kaumaha kaumaha, ka hoʻoikaika kino nui, a i ʻole ka ʻeha koʻikoʻi a i ʻole ke kaumaha nui hiki ke hoʻoulu i kahi kūlana SCAD.
- Nā kūlana olakino ʻē aʻe: ʻO ka poʻe me Fibromuscular Dysplasia (FMD) (kahi maʻi e hoʻonāwaliwali ai i nā paia o nā kīʻaha koko), nā maʻi pili i nā ʻiʻo e like me Marfan syndrome, a me ka lupus e pilikia pū kekahi.
Pehea e ʻike ai ke kauka i kēia?
Ke hele ʻoe i ka lumi pilikia, ʻo ka mea mua a nā kauka e hana ai, ʻo ia ke nānā inā loaʻa iā ʻoe kahi hōʻeha puʻuwai. Hana lākou i kekahi mau hoʻokolohua e hoʻoholo ai inā loaʻa iā ʻoe kahi hōʻeha puʻuwai. Pono kahi hoʻokolohua kūikawā e ʻike pololei i ka SCAD.
| Hoʻāʻo | I ka ʻōlelo maʻalahi... |
|---|---|
| ECG (Electrocardiogram) | Hoʻopaʻa ʻia ka hana uila o ka puʻuwai a nānā ʻia nā hōʻailona o ka hāʻule puʻuwai. |
| Nā hoʻāʻo koko | Hoʻopaʻa ʻia nā pae o nā enzymes e hōʻiliʻili i loko o ke koko ke hōʻino ʻia ka ʻiʻo o ka puʻuwai. |
| ʻO ka Angiogram Coronary | ʻO kēia ka hoʻāʻo nui a koʻikoʻi loa e ʻike ai i ka SCAD.Hoʻokomo ʻia kahi ʻōmole liʻiliʻi ma o kahi aʻa koko ma ka lima a i ʻole ka wāwae a hoʻokomo ʻia kahi kala kūikawā i loko o nā aʻa o ka puʻuwai. A laila lawe ʻia kahi X-ray e nānā i loko o nā aʻa. I ke ʻano o SCAD, hiki i kēia ke hōʻike maopopo i ke ʻano o ka haki ʻana o ke aʻa a me ke ālai ʻia ʻana o ke kahe koko. |
| IVUS a i ʻole ʻOkakopa | He mau scan kūikawā kēia i hana ʻia i ka manawa like me ka angiogram e ʻike maopopo aku i loko o ke aʻa. |
Pehea e mālama ʻia ai? Pehea ka lōʻihi e hoʻōla ai?
He ʻokoʻa iki ka mālama ʻana no ka SCAD ma mua o ka mālama ʻana i ka hōʻeha puʻuwai maʻamau. ʻO ka mea kupanaha, ʻo ka hapa nui o nā hihia o ka SCAD e hoʻopau iā lākou iho i ka hala ʻana o ka manawa me ka lāʻau lapaʻau, me ka ʻole o ke ʻoki kino a i ʻole nā kaʻina hana nui. Hiki i ke kino ke ho'ōla i ke aʻa i haehae ʻia ma kāna iho.
Nā ʻano lapaʻau
- Lapaʻau lāʻau: ʻO nā lāʻau lapaʻau e like me ka aspirin e pale ai i nā ʻūpā koko, nā beta-blockers e kaohi i ka helu o ka puʻuwai a me ke koko a hoʻomaha i nā aʻa, a me nā lāʻau lapaʻau e kaohi ai i ka ʻeha o ka umauma he mea nui ia.
- Ka Hoʻokipa ʻia ʻana ma ka Halemai: Mālama ʻia ka mea maʻi ma ke keʻena mālama koʻikoʻi a i ʻole ke keʻena mālama nui o ka haukapila no kekahi mau lā, a nānā pono ʻia ka hana o ka puʻuwai.
- ʻO Angioplasty a me Stenting: Hana pinepine ʻole ʻia kēia. Inā wale nō ua paʻa loa ke aʻa a ua pilikia ke ola o ka mea maʻi, hoʻohana ʻia kahi pōpō e hoʻopiha i ke aʻa a hoʻokomo ʻia kahi mea like me ka mesh (stent) e mālama iā ia.
- ʻO ke ʻoki ʻoki alai: ʻAʻole hana pinepine ʻia kēia no SCAD.
ʻOkoʻa ka manawa hoʻōla mai kēlā kanaka a kēia kanaka. Pono ʻoe e noho ma ka haukapila no kahi o 3-5 mau lā. Hiki ke hala i kekahi mau pule a i ʻole he mau mahina no ka ho'ōla piha ʻana o ke aʻa i haehae ʻia. Eia nō naʻe, he mea nui loa e hahai pono i nā ʻōlelo a ke kauka i kēia manawa.
Ma hope o ka ho'ōla ʻana
ʻOiai ma hope o ka hoʻōla ʻana, pono ʻoe e hoʻomau i ka hele ʻana i ke keʻena lapaʻau ma lalo o ka nānā ʻana a kahi cardiologist.
- Hoʻōla Puʻuwai: He mea nui loa kēia. Kōkua kēia papahana iā ʻoe e hoʻoikaika kino me ka palekana ma lalo o ka nānā ʻana a ke kauka, e lawe i kahi papaʻai olakino no ka puʻuwai, a hoʻokele i ke kaumaha.
- Nā loli o ke ʻano o ka nohona: Hiki i kāu kauka ke aʻo aku iā ʻoe e pale i ka hāpai kaumaha a me nā hana e kau ai i ka nui o ke kaumaha ma kou kino.
Ke hana ʻia kahi SCAD, he mea maʻamau ke hopohopo a me ka hopohopo, me ka noʻonoʻo ʻana, "E hana hou ʻia anei kekahi mea e like me kēia?" E kamaʻilio ākea e pili ana i kēia me kāu kauka. E ʻimi i ke aʻo ʻana noʻonoʻo inā pono.
Leka Lawe-Home
- He kūlana ulia pōpilikia ka SCAD e kumu ai i ka haki koke ʻana o kahi aʻa i loko o ka puʻuwai, ʻoiai he like nā hōʻailona me ka hāʻule puʻuwai, akā he ʻokoʻa ia.
- ʻIke pinepine ʻia kēia maʻi i nā wahine ʻōpio olakino ʻaʻole i pilikia i nā maʻi puʻuwai ʻē aʻe.
- Inā ʻike ʻoe i nā hōʻailona e like me ka ʻeha o ka umauma, ka paʻakikī o ka hanu ʻana, a i ʻole ka hou nui ʻana, mai hoʻowahāwahā iā lākou. E hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila.
- Hoʻōla loa ka hapa nui o nā maʻi SCAD me ka lāʻau lapaʻau, a ʻaʻole koi pinepine ʻia ke ʻoki ʻana.
- Ma hope o ka ho'ōla ʻana, ʻo ka hahai ʻana i nā ʻōlelo a kāu kauka, ka hoʻomau ʻana i ka hele ʻana i ke keʻena lapaʻau, a me ke komo ʻana i nā papahana hoʻoponopono puʻuwai he mea nui loa ia no kou olakino i ka wā e hiki mai ana.
- Mai kānalua e kamaʻilio me kāu kauka e pili ana i nā makaʻu a me nā hopohopo āu e ʻike ai ma hope o ke kū ʻana i kēia kūlana a e ʻimi i ke kākoʻo noʻonoʻo e pono ai.
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