Peb txhua tus paub tias lub plawv yog lub cev tseem ceeb tshaj plaws hauv peb lub cev. Ib yam li lub cav ntawm lub tsheb, yog tias lub plawv nres, txhua yam yuav tas. Yog li, rau lub plawv no kom ua haujlwm tas mus li, nws kuj xav tau cov ntshav zoo, uas yog, nws xav tau txais cov pa oxygen thiab cov as-ham. Ntawm cov hlab ntsha uas ua lub luag haujlwm tseem ceeb no, muaj ib txoj hlab ntsha tshwj xeeb, tseem ceeb heev. Qee zaum, yog tias qhov no raug thaiv, lub plawv nres uas tshwm sim yuav hnyav heev uas nws kuj hu ua "Tus Poj Ntxoog". Niaj hnub no peb tab tom tham txog cov hlab ntsha tseem ceeb tshaj plaws, Left Anterior Descending Artery (LAD).
Hais yooj yim xwb, tus LAD no yog dab tsi?
Xav txog peb lub siab zoo li ib lub tsev. Muaj ob lub kav dej loj uas coj dej mus rau lub tsev no. Lawv yog cov hlab ntsha tseem ceeb uas muab ntshav rau peb lub siab. Lub uas nyob rau sab laug ntawm ob lub hlab ntsha loj no (Left Main Coronary Artery) faib ua ob ceg tseem ceeb. Ib qho ntawm ob ceg ntawd, thiab qhov loj tshaj plaws thiab tseem ceeb tshaj plaws, yog Left Anterior Descending (LAD) Artery .
Cia peb piav qhia lub ntsiab lus ntawm lub npe no:
- Sab laug: Qhov ntawd txhais tau tias qhov no nyob rau sab laug.
- Anterior: Qhov no txhais tau tias nws muab cov ntshav mus rau pem hauv ntej ntawm lub plawv.
- Nqis Los: Qhov no txhais tau tias cov hlab ntsha no mus los ntawm sab saum toj ntawm lub plawv mus rau hauv qab.
Hais yooj yim xwb, LAD yog cov hlab ntsha tseem ceeb uas khiav mus rau sab laug ntawm lub plawv, nyob rau pem hauv ntej ntawm nws . Nws muab cov ntshav uas muaj oxygen ntau tshaj plaws rau lub plawv, lub plawv sab laug, thiab muab cov ntshav ntawd rau hauv lub plawv lub septum, uas yog phab ntsa ntawm cov leeg nqaij uas cais cov chav ntawm lub plawv.
Yog tias cov hlab ntsha LAD no raug thaiv tag, ib feem loj ntawm lub plawv yuav raug txiav tawm ntawm cov ntshav mus los. Qhov ua rau mob plawv nres tuaj yeem hnyav heev. Yog vim li ntawd cov kws kho mob thiaj hu qhov mob no ua "Widowmaker Heart Attack."
Lub luag haujlwm tseem ceeb thiab qhov chaw ntawm LAD
Cov hlab ntsha LAD yog ib feem ntawm peb lub cev txoj kev ncig ntshav. Qhov no yog cov hlab ntsha loj tshaj plaws uas xa cov ntshav mus rau peb lub plawv. Xav txog seb, yuav luag 50% ntawm tag nrho cov ntshav uas xa mus rau cov leeg nqaij plawv yog xa los ntawm cov hlab ntsha no. Koj xav seb qhov no tseem ceeb npaum li cas, puas yog?
Nws nyob hauv epicardium, uas yog txheej sab nraud tiv thaiv lub plawv. Nws khiav ntawm sab saum toj ntawm lub plawv mus rau hauv qab, ua ib ntu zoo li qhov zawj raws phab ntsa plawv.
Cov ceg twg tawm ntawm LAD?
Cov hlab ntsha loj no ceg tawm mus ua cov ceg me me uas nqa cov ntshav mus rau ntau qhov chaw ntawm lub plawv.
| Lub Npe Ceg | Thaj chaw muab ntshav |
|---|---|
| Cov ceg kab pheeb ces kaum | Nws muab cov ntshav mus rau sab pem hauv ntej thiab sab qis ntawm lub plawv sab laug, uas yog lub twj tso kua mis tseem ceeb ntawm lub plawv. |
| Cov ceg ntawm lub septum | Nws muab ntshav mus rau ob feem peb ntawm phab ntsa leeg (septum) uas cais cov chav ntawm lub plawv. |
Cov mob dab tsi cuam tshuam rau LAD?
Qhov teeb meem tseem ceeb thiab feem ntau uas cuam tshuam rau cov hlab ntsha LAD yog atherosclerosis . Hais yooj yim xwb, nws zoo li xeb uas tsim nyob rau hauv ib lub kav dej qub. Cov rog, xws li cholesterol, pom muaj nyob rau hauv cov zaub mov uas peb noj, sib sau ua ke rau ntawm phab ntsa ntawm cov hlab ntsha thiab ua tuab zuj zus. Peb hu qhov no ua 'plaque'. Thaum cov plaque no sib sau ua ke, cov ntshav ntws yuav nqaim zuj zus.
Nyob rau lub sijhawm dhau mus, cov plaque no tuaj yeem tawg, tsim cov ntshav txhaws uas tuaj yeem thaiv cov hlab ntsha tag nrho . Yog tias qhov kev thaiv no tshwm sim hauv LAD, thaj chaw loj ntawm lub plawv yuav tsis muaj oxygen thiab cov leeg nqaij plawv pib tuag. Qhov ntawd yog qhov peb hu ua mob plawv nres. Kev mob plawv nres los ntawm kev thaiv hauv LAD tuaj yeem ua rau mob hnyav heev.
Qhov tseem ceeb yog tias, txawm hais tias lub npe "Widowmaker," qhov no tsis yog txwv rau cov txiv neej. Qhov mob plawv loj no tuaj yeem cuam tshuam rau txiv neej thiab poj niam sib npaug.
Tsis tas li ntawd xwb, qee tus neeg yug los muaj ib txoj hlab ntsha LAD nqaim heev lossis luv heev. Qhov mob no hu ua hypoplastic left anterior descending artery. Txawm hais tias qhov no yog ib qho mob tsis tshua muaj, nws tuaj yeem ua rau muaj kev pheej hmoo ntawm:
- Lub plawv dhia tsis xwm yeem (Arrhythmia)
- Mob plawv nres
- Cov ntshav tsis txaus mus rau cov leeg nqaij plawv (Myocardial ischemia)
- Kev tuag sai sai ntawm lub plawv
Cov tsos mob ntawm kev txhaws hauv LAD yog dab tsi?
Qhov uas cov hlab ntsha LAD nqaim los yog txhaws tuaj yeem ua rau mob hauv siab (angina). Tab sis nws yog ib qho tseem ceeb uas peb txhua tus yuav tsum paub txog cov tsos mob uas tshwm sim thaum muaj kev txhaws tag nrho, uas yog mob plawv nres.
Yog tias koj lossis ib tus neeg koj paub muaj ib lossis ntau yam ntawm cov tsos mob hauv qab no, suav tias nws yog xwm txheej ceev hauv kev kho mob. Hu rau 1990 Ambulance Service yam tsis muaj kev ncua sijhawm lossis mus rau chav kho mob ceev (ETU) tam sim ntawd.
| Cov tsos mob | Kev piav qhia |
|---|---|
| Mob hauv siab los yog tsis xis nyob (Angina) | Muaj ib qho mob uas zoo li nruj, nruj, zoo li muaj ib qho hnyav raug muab tso rau hauv nruab nrab ntawm lub hauv siab. |
| Qhov mob kis mus rau sab caj npab sab laug, xub pwg nyom, caj dab, lossis lub puab tsaig | Mob hauv siab tuaj yeem kis mus rau cov cheeb tsam no. |
| Sudden overexertion | Tawm hws tsis muaj laj thawj, zoo li lub cev txias. |
| Ua pa nyuaj | Xav tias tsis muaj zog, ua pa nyuaj. |
| Hnov mob taub hau los yog tsaus muag | Tus mob no tuaj yeem tshwm sim vim yog qhov txo qis ntawm cov ntshav siab. |
| Lub plawv dhia ceev (palpitations) | Zoo li koj lub plawv dhia ceev. |
| Xeev siab thiab ntuav | Cov tsos mob no feem ntau tshwm sim ntawm cov poj niam thiab cov neeg mob ntshav qab zib. |
| Kev qaug zog thiab tsis muaj zog ntau dhau | Nkees nkees heev tsis muaj laj thawj. |
Cov kws kho mob kuaj xyuas kev noj qab haus huv ntawm tus LAD li cas?
Nyob ntawm seb koj cov tsos mob zoo li cas, koj tus kws kho mob yuav xav kuaj xyuas koj cov hlab ntsha hauv lub plawv. Muaj ntau txoj kev kuaj rau qhov no.
| Kev Ntsuas | Hais yooj yim xwb... |
|---|---|
| Kev Siv Tshuaj Rau Lub Plawv (Angiogram) | Yuav muab ib lub raj nyias nyias tso rau hauv ib txoj hlab ntshav hauv caj npab lossis ceg, txhaj ib yam xim tshwj xeeb rau hauv, thiab thaij duab X-ray seb txoj hlab ntshav puas raug thaiv. |
| Kev Siv Tshuab Xam Xim Rau Lub Plawv (Coronary CT Angiogram) (CCTA) | Ib daim CT scan tshwj xeeb yuav thaij duab peb-seem (3D) ntawm cov hlab ntsha ntawm lub plawv. |
| Kev Siv Ultrasound Hauv Cov Hlab Ntsha (IVUS) | Muab ib lub cuab yeej me me uas ntsuas ntshav tso rau hauv cov hlab ntsha thiab kuaj sab hauv ntawm phab ntsa hlab ntsha. |
| Fractional Flow Reserve (FFR) | Ntsuas qhov siab hauv cov hlab ntsha kom pom tias qhov kev txhaws ntawd thaiv cov ntshav ntws npaum li cas. |
Cov kev kho mob rau LAD blockages yog dab tsi?
Yog tias muaj kev txhaws loj heev hauv cov hlab ntsha LAD, cov kws kho mob yuav kho nws kom rov qhib dua. Txoj kev siv ntau tshaj plaws yog angioplasty thiab stent placement.
Qhov uas tshwm sim hauv qhov no yog, ib yam li kev kuaj angiogram, ib lub raj nyias nyias raug xa mus rau thaj chaw uas cov ntshav txhaws. Los ntawm kev tshuab lub pob me me ntawm qhov kawg ntawm lub raj, cov plaque uas raug txhaws raug nias rau ntawm phab ntsa ntawm cov hlab ntsha, ua rau cov ntshav ntws dav dua. Qhov no hu ua "Angioplasty"
Tom qab ntawd, txhawm rau kom thaj chaw dav dua tsis txhob nqaim dua, ib lub raj hlau me me (stent) ua zoo li lub mesh raug muab tso rau hauv qhov chaw ntawd. Lub "stent" no ua rau cov hlab ntsha qhib. Nyob ntawm seb qhov kev kho mob no ua tiav sai npaum li cas thaum muaj mob plawv nres, qhov kev puas tsuaj rau lub plawv tuaj yeem txo qis.
Kuv yuav ua li cas thiaj ua rau kuv lub plawv noj qab nyob zoo?
"Kev tiv thaiv zoo dua li kev kho mob," lawv hais. Yog li, muaj ntau yam uas peb txhua tus tuaj yeem ua tau los tiv thaiv peb lub plawv thiab cov hlab ntsha ua ntej muaj mob hnyav zoo li no tshwm sim.
- Noj zaub mov zoo rau lub plawv: Txo koj cov roj cholesterol thiab cov khoom noj uas muaj roj ntau (cov khoom noj kib, cov khoom noj ceev ceev, thiab cov nqaij uas muaj roj ntau). Noj txiv hmab txiv ntoo, zaub, taum pauv, ntses me, thiab txiv ntoo qhuav hauv koj cov zaub mov noj.
- Ua si nawv tsis tu ncua: Ua qee yam kev tawm dag zog, xws li taug kev, khiav, lossis caij tsheb kauj vab, tsawg kawg 30 feeb hauv ib hnub, 5 hnub hauv ib lub lim tiam. Qhov no yuav pab tswj koj qhov hnyav, roj cholesterol, thiab ntshav siab.
- Tswj koj qhov hnyav kom noj qab nyob zoo: Kev tswj koj qhov hnyav kom noj qab nyob zoo rau koj qhov siab yog ib qho kev pab zoo rau koj lub plawv.
- Tso tseg kev haus luam yeeb kiag li: Yog tias koj haus luam yeeb, nrhiav kev pab kom tso tseg hnub no. Nws yog qhov zoo tshaj plaws uas koj ua tau rau koj lub siab.
- Txwv kev haus dej cawv: Zoo tshaj plaws yog tsis txhob haus cawv kiag li.
- Tswj ntshav qab zib thiab ntshav siab: Yog tias koj muaj ntshav qab zib lossis ntshav siab, noj koj cov tshuaj raws li koj tus kws kho mob tau qhia. Txo koj cov ntsev noj.
- Txo kev ntxhov siab: Tswj kev noj qab haus huv ntawm lub hlwb los ntawm tej yam xws li yoga thiab kev xav.
Kev hloov pauv koj txoj kev ua neej no yuav pab kom koj lub cev noj qab nyob zoo, tsis yog tsuas yog koj cov hlab ntsha LAD xwb. Yog tias koj muaj kev txhawj xeeb txog koj txoj kev noj qab haus huv ntawm lub plawv, tsis txhob yig nrog koj tus kws kho mob hauv tsev neeg tham.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Cov hlab ntsha sab laug Anterior Descending (LAD) yog cov hlab ntsha tseem ceeb thiab tseem ceeb tshaj plaws uas xa cov ntshav mus rau peb lub plawv.
- Qhov kev thaiv no tuaj yeem ua rau mob plawv ("Widowmaker") uas tuaj yeem hnyav heev thiab muaj kev phom sij rau lub neej.
- Tsis txhob tso tseg cov tsos mob xws li mob hauv siab, ua pa nyuaj, lossis tawm hws ntau dhau. Nws yog ib qho xwm txheej ceev. Mus rau chav kho mob ceev (ETU) ntawm tsev kho mob tam sim ntawd.
- Koj tuaj yeem tiv thaiv koj lub plawv los ntawm kev noj zaub mov zoo, tawm dag zog tsis tu ncua, tsis txhob haus luam yeeb, thiab tswj tus kab mob ntshav qab zib/ntshav siab.
- Yog tias koj muaj kev txhawj xeeb txog koj lub plawv kev noj qab haus huv lossis cov yam ntxwv uas ua rau muaj kev pheej hmoo, tsis txhob yig nrog koj tus kws kho mob tham.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus