Hiki ke haki koke kahi aʻa i loko o kou puʻuwai? E aʻo kākou i nā mea āpau e pili ana i ka SCAD (Spontaneous Coronary Artery Dissection)!

Ua noʻonoʻo paha ʻoe pehea e hiki ai i kahi kanaka olakino a hoʻoikaika kino maikaʻi ke loaʻa koke i ka hōʻeha puʻuwai? A i ʻole pehea e hiki ai i kahi wahine ʻōpio olakino i lilo i makuahine ke loaʻa koke i ka ʻeha umauma? I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi puʻuwai ʻano ʻē, akā he mea nui loa. ʻO kēia ka mea a mākou e kapa nei ʻo SCAD, a i ʻole Spontaneous Coronary Artery Dissection .

He aha ka SCAD (Spontaneous Coronary Artery Dissection)? E hoʻomaopopo maʻalahi kākou.

I ka ʻōlelo maʻalahi, ʻo SCAD kahi haehae koke a i ʻole ka hoʻokaʻawale ʻana ma waena o ʻelua mau papa i loko o ka paia o nā aʻa coronary e lawe ana i ke koko i ko kākou puʻuwai. E noʻonoʻo i kēia ʻano: ua like ke kīʻaha koko me kahi ʻōmole lahilahi. Hana ʻia ka paia o kēia ʻōmole me kekahi mau papa. I ka SCAD, haehae kekahi o kēia mau papa a kahe ke koko ma waena o lākou. He aha ka mea e hana ai? Hōʻiliʻili ke koko a kahe i loko o ke aʻa. Hoʻopiha ia e like me ka pōpō. ʻO ka hopena, ua ālai ʻia ke kahe koko i ka puʻuwai, a hoʻomaka paha e neʻe mālie loa.

Ua like kēia me kahi puʻupuʻu liʻiliʻi e ulu ana i loko o kahi paipu wai a ālai iā ia. A laila, ʻaʻole i loaʻa i ka puʻuwai ka oxygen a me nā meaʻai e pono ai.

Hoʻonui ka SCAD i kou pilikia o kahi maʻi i kapa ʻia ʻo Acute Coronary Syndrome (ACS) . He ʻano maʻi ʻaʻa coronary nō hoʻi kēia. Hiki i kēia ke hōʻeha i ka umauma, a i ʻole angina . Hiki iā ia ke alakaʻi i ka hōʻeha puʻuwai, kahi mea e hoʻoweliweli ai i ke ola.

He aha ke ʻano o kēia mau huaʻōlelo?

Inā mākou e nānā i ke ʻano o kēia mau huaʻōlelo ʻekolu ʻo SCAD ma kahi kaʻawale, e maopopo maikaʻi iā ʻoe kēia maʻi.

• Hana koke ʻole: ʻO ke ʻano kēia e hana koke ʻia, me ka ʻole o ka ʻōlelo aʻo .
• Nā ʻAʻa Coronary: ʻO kēia nā kīʻaha koko nui e hoʻolako i ko mākou puʻuwai me ke koko maʻemaʻe a waiwai i ka oxygen. Loaʻa iā mākou ʻelua mau ʻaʻa coronary nui, ka hema a me ka ʻākau. Māhele lākou i nā lālā liʻiliʻi.
• ʻOki ʻana: I ka lāʻau lapaʻau, pili kēia huaʻōlelo i ka hoʻokaʻawale ʻana o nā ʻiʻo i nā papa, e like me ka haehae ʻana.

Maopopo iā ʻoe? ʻO ia hoʻi, kapa mākou i kēia SCAD ke pohā koke kahi kīʻaha koko i loko o ka puʻuwai mai loko mai me ke kumu ʻole.

He aha ka Acute Coronary Syndrome?

ʻAʻole kēia he maʻi hoʻokahi. He huaʻōlelo laulā ia no kekahi mau kūlana like ʻole kahi e emi koke ai ke kahe o ke koko i ka puʻuwai. Hana pinepine ʻia kēia i ka wā e haki koke ai ka plaque, ʻo ia hoʻi ka hōʻiliʻili ʻana o ka momona i loko o nā aʻa (i ʻike ʻia hoʻi ʻo atherosclerosis a i ʻole "hardening of the arteries"). Hiki i kēia ke alakaʻi i nā kūlana hoʻoweliweli ola e like me ka hāʻule ʻana o ka puʻuwai , ka hōʻeha puʻuwai, a i ʻole ka hahau .

Pehea ka maʻamau o kēia kūlana i kapa ʻia ʻo SCAD?

Wahi a nā loea lapaʻau he maʻi i ʻike ʻole ʻia ka SCAD. Ua manaʻo ʻia he ʻehā o kēlā me kēia haneli o ka poʻe e loaʻa ana i ka maʻi coronary acute (ACS) (4%) he SCAD. Eia kekahi, ʻo SCAD ke kumu o kahi o hoʻokahi o kēlā me kēia ʻehā (25%) mau hihia ACS i nā wahine ma lalo o 50 makahiki! ʻO ke ʻano kēia he mea maʻamau paha ia i nā wahine ʻōpio ma mua o kou manaʻo.

No ke aha i hana ʻia ai ka SCAD? He aha nā kumu?

ʻAʻole maopopo loa i nā loea ke kumu o SCAD. ʻO ka mea kupanaha, he nui ka poʻe i loaʻa i kēia maʻi he ʻōpio, kūpono, a olakino. ʻAʻohe o lākou maʻi puʻuwai ma mua.

Ua hānau hou ʻia kekahi mau maʻi SCAD. Ua ʻike ʻia hoʻi he ʻoi aku ka nui o ka SCAD e hiki mai i ka wā o ka menstruation a i ʻole postmenopause . No laila, aia kahi kānalua e pili ana paha nā loli i nā hormones wahine i kēia.

He mea kākaʻikahi loa ka SCAD i nā kāne, ʻaʻole i loaʻa ma mua o ka ʻumi pakeneka (10%). I nā kāne, ʻike pinepine ʻia kēia haehae ma hope o ka hoʻoikaika kino nui (hoʻomaʻamaʻa ikaika) a i ʻole ka hāpai ʻana i kahi mea kaumaha . Hiki i kēia hoʻoikaika kino ke haehae i ka paia o ke aʻa.

I ka manawa kākaʻikahi loa, hiki i ka luaʻi nui a i ʻole ka ikaika o ke ʻū ʻana ke kumu o ka haki ʻana o kēia paia o ke aʻa. I kekahi manawa, hiki i kahi aʻa coronary ke haki i ka wā o kahi ulia pōpilikia a i ʻole i ka wā o kahi hana lapaʻau e like me ka catheterization cardiac . Eia nō naʻe, aia ke kumu no kēia.

ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i ka SCAD?

ʻOi aku ka nui o ka pilikia o ka poʻe me kekahi mau kūlana olakino i ka loaʻa ʻana o ka haki ʻana o ke aʻa coronary. E nānā kākou i ke ʻano o lākou:

• Nā maʻi pili pili - no ka laʻana , ʻo Marfan syndrome .
• Ke koko kiʻekiʻe (Ke koko kiʻekiʻe weliweli).
• ʻO ka Fibromuscular Dysplasia (FMD) - He maʻi kēia e hoʻopilikia ai i nā aʻa koko.
• Ka emi ʻana o ka hana thyroid ( Hypothyroidism ).
• Nā maʻi mumū - ʻo nā laʻana e komo pū me ka lupus , ka sclerosis maha (MS) , a me ka sarcoidosis .
• Nā maʻi hoʻohana ʻona .

He aha nā hōʻailona o SCAD? Pehea e ʻike ʻia ai lākou?

Ke emi nei ke kahe o ke koko i ka puʻuwai ma muli o SCAD, hiki iā ia ke alakaʻi i ka hōʻeha puʻuwai a i ʻole ke ʻano ʻeha umauma i kapa ʻia ʻo ka angina paʻa ʻole . He mea weliweli loa kēia ʻano angina no ka mea e hoʻonui ai i ka pilikia o ka hōʻeha puʻuwai.

He pilikia olakino ka SCAD e pono ai ka mālama koke ʻana. Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona o ka hōʻeha puʻuwai, e kāhea koke i ka 911 (ma Sri Lanka, e kāhea i ka 1990 Suwaseriya Ambulance Service):

• Ka poniuniu a i ʻole ka nāwaliwali ( syncope ).
• Ka hou nui ʻana ( Hyperhidrosis ) a i ʻole ke anu ʻana.
• Nā palpitations o ka puʻuwai a i ʻole arrhythmia .
• ʻEha musculoskeletal ma ka lima, poʻohiwi, a i ʻole ka ʻāwae.
• Ka luaʻi a me ka luaʻi ʻana, a i ʻole ka manaʻo o ka ʻōpū ʻeha ( ʻōpū ʻino ).
• Pōkole o ka hanu.
• Ka paʻa ʻana o ka umauma, ke kaomi ʻana, a i ʻole ka ʻeha.

Ua like loa kēia mau hōʻailona me nā hōʻailona o ka hāʻule puʻuwai. No laila, inā loaʻa iā ʻoe kekahi mea e like me kēia , mai hoʻokaʻulua.

Pehea e ʻike ʻia ai ka SCAD? (Diagnosis)

Hiki ke paʻakikī ka ʻike ʻana i ka SCAD. Inā loaʻa iā ʻoe ka ʻeha o ka umauma a i ʻole nā ​​​​hōʻailona ʻē aʻe o ka maʻi puʻuwai, hiki i kāu kauka ke kauoha i nā hoʻokolohua e like me kēia e nānā ai no ka SCAD:

• Hoʻāʻo māka enzyme: Nānā i nā pae kiʻekiʻe o kekahi mau enzymes cardiac e hōʻiliʻili ana i loko o ke koko i ka wā o ka hōʻeha puʻuwai.
• Angiogram: Hiki iā ʻoe ke ʻike i ke kahe o ke koko i loko o kou puʻuwai ma nā kiʻi neʻe ʻekolu-dimensional (3D). Hiki i kēia ke komo pū me kahi Coronary Computed Tomography Angiogram (CCTA) a i ʻole kahi Magnetic Resonance Angiogram (MRA) .
• ʻO ka Intravascular Optical Coherence Tomography (IVOCT): ʻAe kēia i ka nānā ʻana i ke aʻa mai loko a i waho.
• Intravascular Ultrasound (IVUS): Hiki i kēia ke hana i nā kiʻi maopopo loa a kikoʻī hoʻi i loko o nā aʻa.

ʻO kēia mau hoʻokolohua ka mea e hiki ai i nā kauka ke hoʻoholo pono inā he aʻa coronary i haehae ʻia kou a i ʻole kekahi maʻi puʻuwai ʻē aʻe.

Pehea e mālama ʻia ai ka SCAD?

ʻO ka hapa nui o ka poʻe me SCAD, ma kahi o ʻekolu hapahā (75%), e ho'ōla me ka lāʻau lapaʻau. Eia nā ʻano lāʻau lapaʻau i hāʻawi ʻia:

• Nā lāʻau lapaʻau koko (e.g., nā beta blockers ).
• Nā lāʻau lapaʻau e kaohi ai i nā pae cholesterol kiʻekiʻe.
• Nā lāʻau lapaʻau e pale ai i ke kāpili ʻana o ke koko ( nā lāʻau antiplatelet ).

Eia nō naʻe, ma kahi o 14% o ka poʻe me SCAD hiki ke loaʻa i kahi maʻi koʻikoʻi. Pono paha kēlā poʻe e lawe ʻia i ka haukapila a loaʻa ka lāʻau lapaʻau ulia pōpilikia. ʻO ia mau lāʻau lapaʻau:

• Ka catheterization cardiac , ka angioplasty coronary a me ke kau ʻana o ka stentʻO kēia ka hoʻopiha ʻana i ke kīʻaha koko i paʻa ʻia me kahi mea e like me ka pōpō a kau i kahi ʻupena liʻiliʻi (stent) e pale aku ai i ka paʻa hou ʻana.
• ʻO ke kāpili ʻana o ke ala coronary artery (CABG): Pili kēia i ka hana ʻana i ala hou no kahi kīʻaha koko i ālai ʻia.
• Ke hoʻokomo nei i kahi mea kākoʻo kahe koko mechanical, e like me kahi Left Ventricular Assist Device (LVAD) , a i ʻole kahi Implantable Cardioverter Defibrillator (ICD) .
• Hoʻoili puʻuwai - He mea kākaʻikahi loa kēia.

I ka hapa nui o ka manawa, hoʻāʻo nā kauka e mālama i ke kūlana me ka lāʻau lapaʻau, e ʻae ana i ke aʻa i haehae ʻia e ho'ōla iā ia iho. Manaʻo ʻia ke ʻoki ʻana he mea pono wale nō inā pono loa.

Hiki ke pale ʻia ka SCAD?

Inā ua haehae ʻia kou aʻa i hoʻokahi manawa, pono paha ʻoe e kaupalena i kekahi mau hana kino ikaika a me ka hoʻomaʻamaʻa ikaika e pale aku ai i ka hana hou ʻana. Hiki i kāu kauka ke kuhikuhi iā ʻoe i kahi papahana hoʻoponopono puʻuwai . Hiki i kēia ke kōkua i ka hoʻomaikaʻi ʻana i ke olakino o kou puʻuwai a aʻo iā ʻoe pehea e hoʻoikaika kino ai me ka palekana.

ʻOiai ʻaʻohe pilina pololei i loaʻa ma waena o SCAD a me ka kaohi hānau hormonal, nui nā kauka e paipai nei e noʻonoʻo mua i nā koho kaohi hānau nonhormonal. No ka laʻana, he vasectomy no nā kāne a i ʻole ka tubal ligation no nā wahine. E nīnau i kāu kauka i ke ʻano hana kūpono loa iā ʻoe.

Hiki iā ʻoe ke hana i kēia mau mea e hōʻemi i kou pilikia o ka maʻi puʻuwai:

• E ʻai i ka meaʻai olakino no ka puʻuwai e hoʻohaʻahaʻa i nā pae cholesterol.
• E hōʻemi i ka ʻai ʻana i ka paʻakai a kaohi i ke koko kiʻekiʻe.
• E hōʻemi i kāu inu ʻona. Inā he pilikia kou me ka hoʻohana ʻana i ka waiʻona, e kiʻi i ke kōkua.
• E makaʻala i nā ʻano momona āu e ʻai ai a e hoʻēmi i kāu lawe ʻana i nā momona maikaʻi ʻole.
• Inā loaʻa iā ʻoe ka maʻi diabetes , e kaohi pono iā ia.
• Inā ʻoe e puhipaka ana, e ʻimi i ke kōkua e haʻalele ai.
• E hoʻomau i ka hana kino a mālama i ke kaumaha olakino.

He aha ka manaʻolana no kekahi me SCAD?

He maʻi hoʻoweliweli ola ka SCAD. Ma kahi o 5% o ka poʻe e loaʻa ana iā ia e make. ʻO ka haehae ʻana i kahi aa koko hiki ke alakaʻi i nā pilikia penei:

• ʻAngina mau loa: Hiki i kekahi poʻe liʻiliʻi ke loaʻa i ka ʻeha mau o ka umauma a i ʻole ke kaomi. ʻAʻole paha kēia e pane maikaʻi i nā lāʻau lapaʻau kuʻuna e like me ka nitroglycerin .
• Ka hoʻi hou ʻana o ka maʻi:Ma kahi o hoʻokahi o ka ʻumi kānaka (10%) e loaʻa hou iā SCAD i loko o ʻekolu mau makahiki o ka lāʻau mua. E hana kāu kauka i nā hoʻokolohua maʻamau e hoʻāʻo e ʻike mua i kēia mau waimaka.
• ʻO ka mumū o ka puʻuwai: Hiki i ka SCAD ke hoʻoulu i ka mumū o ka ʻeke a puni ka puʻuwai, i kapa ʻia ʻo pericarditis . Hiki i kāu kauka ke kauoha i nā hoʻokolohua e like me nā MRI cardiac a i ʻole angiograms e nānā i kēia pilikia.

No laila, he mea nui loa e hahai pololei i nā ʻōlelo lapaʻau a hana i nā hoʻokolohua i ka manawa ma hope o ka hoʻomohala ʻana i ka SCAD.

Āhea wau e ʻike ai i ke kauka?

Inā manaʻo ʻoe e loaʻa ana iā ʻoe kahi hāʻule puʻuwai, e kāhea koke i ka 911 (1990 ma Sri Lanka).

Eia kekahi, e ʻike i ke kauka inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona:

• ʻEha a kaomi paha o ka umauma ( Angina ).
• Hou anu.
• ʻEha ma nā lima, ka ʻauwae, a i ʻole nā ​​poʻohiwi.
• Paʻakikī ka hanu ʻana.
• Manaʻo luhi loa, poniuniu, a nāwaliwali paha me ke kumu ʻole.

He aha kaʻu e nīnau aku ai i kaʻu kauka?

Inā ua ʻike ʻia ʻoe me SCAD, makemake paha ʻoe e nīnau i kāu kauka i kēia mau nīnau:

• He aha ke kumu i hoʻomohala ai au i kēia SCAD?
• Hiki iaʻu ke loaʻa hou iā SCAD?
• He aha kaʻu e hana ai e mālama i ke olakino o koʻu puʻuwai?
• Pono anei au e hopohopo e pili ana i nā hōʻailona o nā pilikia?

ʻO ka SCAD kahi maʻi e hoʻoulu ai i nā hōʻailona like me ka hōʻeha puʻuwai i nā poʻe i loaʻa ka pilikia haʻahaʻa o ka maʻi puʻuwai, ʻoi aku hoʻi nā wahine. E kāhea koke i nā lawelawe lapaʻau ulia pōpilikia inā loaʻa iā ʻoe nā hōʻailona o ka hōʻeha puʻuwai. Inā hōʻoia nā hoʻokolohua he SCAD kou, e kamaʻilio kāu kauka me ʻoe e pili ana i nā koho lapaʻau. ʻOiai me ka mālama ʻana, aia kahi pilikia e haki hou ke aʻa. E nānā pono kāu kauka i ke olakino o kou puʻuwai e hōʻemi i kēlā pilikia.

Leka Lawe-Home

ʻAe, ua kamaʻilio nui kākou e pili ana i ka SCAD, ʻeā? Eia kekahi o nā mea nui e hoʻomanaʻo ai:

• He hōʻeha puʻuwai koke a manaʻo ʻole ʻia ka SCAD e hiki ke hoʻopilikia i nā wahine ʻōpio olakino.
• Ua like loa nā hōʻailona me ka hōʻeha puʻuwai. Inā loaʻa iā ʻoe ka ʻeha o ka umauma, ka paʻakikī o ka hanu ʻana, a i ʻole ka hou ʻana, mai hoʻowahāwahā iā lākou. E ʻimi koke i ke kōkua lapaʻau.
• Hiki ke paʻakikī iki ka ʻike ʻana i ka SCAD, akā hiki ke hōʻoia ʻia me nā hoʻokolohua kūpono.
• Hiki ke ho'ōla pinepine ʻia me ka lāʻau lapaʻau, akā pono paha kekahi poʻe i ke ʻoki ʻana a i ʻole nā ​​​​lāʻau ʻē aʻe.
• He mea nui loa ia e hoʻololi i ke ʻano o ka nohona a hahai i nā ʻōlelo aʻoaʻo lapaʻau ma hope o ka SCAD. Hiki i kēia ke hōʻemi i ka pilikia o ka hoʻi hou ʻana.

Inā loaʻa iā ʻoe a i ʻole kekahi āu i ʻike ai kēia mau hōʻailona, ​​mai hopohopo a e ʻike koke i ke kauka. ʻO ka wikiwiki o ka ʻike ʻia ʻana, ʻo ka nui o ka kūleʻa o ka lāʻau lapaʻau. E noho olakino!

ʻO ka hoʻokaʻawale ʻana i ke aʻa coronary spontaneous, SCAD, hōʻeha puʻuwai, ʻeha umauma, aʻa coronary, olakino wahine, mālama ulia pōpilikia