Puas yog cov hlab ntsha hauv koj lub plawv tam sim ntawd tawg tau? Cia peb kawm txhua yam txog SCAD (Spontaneous Coronary Artery Dissection)!

Koj puas tau xav txog tias ib tug neeg noj qab nyob zoo thiab ua si zoo yuav ua li cas thiaj li mob plawv? Los yog ib tug poj niam hluas noj qab nyob zoo uas nyuam qhuav los ua niam yuav ua li cas thiaj li mob hauv siab? Hnub no peb yuav tham txog ib qho mob plawv uas txawv txawv, tab sis tseem ceeb heev. Qhov no yog qhov peb hu ua SCAD, lossis Spontaneous Coronary Artery Dissection .

SCAD (Kev Phais Mob Hlwb Los Ntawm Tus Kheej) yog dab tsi? Cia peb nkag siab yooj yim heev.

Hais yooj yim xwb, SCAD yog ib qho kev tawg lossis kev sib cais ntawm ob txheej hauv phab ntsa ntawm cov hlab ntsha hauv lub plawv uas nqa cov ntshav mus rau peb lub plawv. Xav txog nws li no: cov hlab ntsha zoo li ib lub raj nyias nyias. Phab ntsa ntawm lub raj no yog ua los ntawm ntau txheej. Hauv SCAD, ib qho ntawm cov txheej no rhuav thiab ntshav ntws ntawm lawv. Tom qab ntawd yuav ua li cas? Cov ntshav ntawd sau thiab ntws mus rau hauv cov hlab ntsha. Nws nthuav dav zoo li lub npas. Yog li ntawd, cov ntshav ntws mus rau lub plawv raug thaiv, lossis nws pib txav qeeb heev.

Qhov no zoo li ib lub qog me me uas loj hlob hauv cov kav dej thiab thaiv nws. Ces lub plawv tsis tau txais cov pa oxygen thiab cov as-ham uas nws xav tau.

SCAD ua rau koj muaj feem yuav mob hu ua Acute Coronary Syndrome (ACS) . Qhov no kuj yog ib hom kab mob ntawm cov hlab ntsha hauv lub plawv. Qhov no tuaj yeem ua rau mob hauv siab, lossis angina . Nws kuj tuaj yeem ua rau mob plawv nres, uas tuaj yeem ua rau tuag taus.

Cov lus no txhais li cas?

Yog tias peb saib lub ntsiab lus ntawm peb lo lus SCAD no sib cais, koj yuav nkag siab txog tus kab mob no zoo dua.

• Ua rau tshwm sim sai sai: Qhov no txhais tau tias nws tshwm sim sai sai, tsis muaj lus ceeb toom .
• Cov hlab ntsha hauv lub plawv: Cov no yog cov hlab ntsha tseem ceeb uas muab cov ntshav huv thiab muaj oxygen ntau rau peb lub plawv. Peb muaj ob lub hlab ntsha hauv lub plawv loj, sab laug thiab sab xis. Lawv faib ua cov ceg me me.
• Kev Phais: Hauv kev kho mob, lo lus no txhais tau tias yog kev sib cais ntawm cov ntaub so ntswg ua txheej, xws li kev rhuav.

Koj puas nkag siab? Qhov ntawd txhais tau tias, peb hu qhov no ua SCAD thaum cov hlab ntsha hauv lub plawv tawg tam sim ntawd los ntawm sab hauv yam tsis muaj laj thawj pom tseeb.

Mob Coronary Syndrome Mob hnyav yog dab tsi?

Qhov no tsis yog ib yam kab mob xwb. Nws yog ib lo lus dav dav rau ntau yam mob sib txawv uas cov ntshav ntws mus rau lub plawv tam sim ntawd txo qis. Qhov no feem ntau tshwm sim thaum cov plaque, uas yog cov rog sib sau ua ke hauv cov hlab ntsha (tseem hu ua atherosclerosis lossis "hardening of the arteries") tam sim ntawd tawg. Qhov no tuaj yeem ua rau muaj cov mob txaus ntshai xws li lub plawv tsis ua haujlwm, mob plawv nres, lossis mob stroke .

Tus mob no hu ua SCAD ntau npaum li cas?

Cov kws kho mob hais tias SCAD yog ib qho mob uas tsis tau kuaj pom zoo. Kwv yees li plaub ntawm txhua ib puas tus neeg uas muaj mob plawv dhia ceev (ACS) (4%) muaj SCAD. Tsis tas li ntawd, SCAD yog qhov ua rau muaj li ib ntawm plaub (25%) ntawm cov poj niam hnub nyoog qis dua 50 xyoo raug mob ACS! Qhov no txhais tau tias nws yuav tshwm sim ntau dua rau cov poj niam hluas dua li koj xav.

Vim li cas thiaj muaj SCAD? Dab tsi yog cov ua rau muaj?

Cov kws tshaj lij tseem tsis tau paub meej tias yog dab tsi ua rau muaj SCAD. Qhov xav tsis thoob yog tias muaj ntau tus neeg uas muaj tus mob no yog cov hluas, muaj zog, thiab noj qab nyob zoo. Lawv kuj tsis tau muaj mob plawv ua ntej.

Muaj ib txhia neeg mob SCAD nyuam qhuav yug me nyuam . Kuj pom tias SCAD yuav tshwm sim ntau dua thaum lub sij hawm muaj hli lossis tom qab muaj hli . Yog li ntawd, muaj kev xav tias kev hloov pauv ntawm cov tshuaj hormones poj niam yuav ua lub luag haujlwm rau qhov no.

SCAD tsis tshua muaj rau cov txiv neej, tshwm sim tsawg dua kaum feem pua ​​(10%). Rau cov txiv neej, qhov kev rhuav no feem ntau tshwm sim tom qab kev tawm dag zog hnyav (kev cob qhia lub zog) lossis tsa ib yam khoom hnyav . Qhov kev tawm dag zog no tuaj yeem rhuav phab ntsa ntawm cov leeg ntshav.

Tsis tshua muaj, ntuav heev lossis hnoos hnyav tuaj yeem ua rau phab ntsa ntawm cov hlab ntsha no tawg. Qee zaum, cov hlab ntsha hauv lub plawv tuaj yeem tawg thaum muaj xwm txheej raug mob lossis thaum lub sijhawm kho mob xws li kev siv catheter rau lub plawv . Txawm li cas los xij, muaj ib qho laj thawj rau qhov no.

Leej twg muaj feem yuav mob SCAD ntau dua?

Cov neeg uas muaj tej yam mob nkeeg muaj feem yuav mob plawv tawg ntau dua. Cia peb saib seb lawv yog dab tsi:

• Cov kab mob ntawm cov nqaij sib txuas - piv txwv li , Marfan syndrome .
• Ntshav siab (ntshav siab txaus ntshai).
• Fibromuscular Dysplasia (FMD) - Qhov no yog ib yam kab mob uas cuam tshuam rau cov hlab ntsha.
• Kev ua haujlwm ntawm cov thyroid qis dua ( Hypothyroidism ).
• Cov kab mob o - piv txwv suav nrog lupus , multiple sclerosis (MS) , thiab sarcoidosis .
• Kev siv tshuaj yeeb tsis zoo .

Cov tsos mob ntawm SCAD yog dab tsi? Yuav kuaj mob li cas?

Thaum cov ntshav ntws mus rau lub plawv txo qis vim yog SCAD, nws tuaj yeem ua rau mob plawv lossis mob hauv siab hu ua mob angina tsis ruaj khov . Hom mob angina no txaus ntshai heev vim nws ua rau muaj kev pheej hmoo ntawm kev mob plawv.

SCAD yog ib qho xwm txheej ceev uas yuav tsum tau kho tam sim ntawd. Yog tias koj muaj ib qho ntawm cov tsos mob ntawm kev mob plawv nres hauv qab no, hu rau 911 tam sim ntawd (hauv Sri Lanka, hu rau 1990 Suwaseriya Ambulance Service):

• Kiv taub hau los yog tsaus muag ( syncope ).
• Hws ntau dhau ( Hyperhidrosis ) lossis xav tias txias.
• Lub plawv dhia ceev lossis arrhythmia .
• Mob pob txha thiab leeg ntawm caj npab, xub pwg, lossis lub puab tsaig.
• Xeev siab thiab ntuav, los yog mob plab ( mob plab zom mov tsis zoo ).
• Ua tsis taus pa.
• Lub hauv siab nruj, muaj kev nyuaj siab, lossis mob.

Cov tsos mob no zoo ib yam li cov tsos mob ntawm kev mob plawv nres. Yog li, yog tias koj ntsib qee yam zoo li no , tsis txhob ncua sijhawm.

Yuav kuaj mob SCAD li cas? (Kev kuaj mob)

Kev kuaj mob SCAD yuav nyuaj heev. Yog tias koj mob hauv siab lossis muaj lwm yam tsos mob ntawm kab mob plawv, koj tus kws kho mob yuav xaj kom kuaj xyuas SCAD li no:

• Kev kuaj mob enzyme: Xyuas seb puas muaj cov enzymes hauv lub plawv uas sib sau ua ke ntau hauv cov ntshav thaum lub sijhawm mob plawv nres.
• Angiogram: Qhov no cia koj pom cov ntshav ntws hauv koj lub plawv hauv cov duab peb-seem (3D). Qhov no yuav suav nrog Coronary Computed Tomography Angiogram (CCTA) lossis Magnetic Resonance Angiogram (MRA) .
• Intravascular Optical Coherence Tomography (IVOCT): Qhov no tso cai rau cov hlab ntsha kom kuaj xyuas los ntawm sab hauv mus rau sab nraud.
• Intravascular Ultrasound (IVUS): Qhov no tuaj yeem tsim cov duab meej heev thiab ntxaws ntxaws hauv cov hlab ntsha.

Cov kev kuaj no yog qhov uas tso cai rau cov kws kho mob txiav txim siab seb koj puas muaj cov hlab ntsha hauv lub plawv tawg lossis lwm yam mob plawv.

Yuav kho SCAD li cas?

Feem ntau cov neeg uas muaj SCAD, kwv yees li peb feem plaub (75%), rov zoo los ntawm kev siv tshuaj. Cov no yog cov tshuaj uas tau muab:

• Cov tshuaj kho ntshav siab (piv txwv li, beta blockers ).
• Cov tshuaj uas tswj cov roj cholesterol siab.
• Cov tshuaj uas tiv thaiv cov ntshav txhaws ( cov tshuaj antiplatelet ).

Txawm li cas los xij, kwv yees li ntawm 14% ntawm cov neeg uas muaj SCAD tuaj yeem muaj mob hnyav. Cov neeg zoo li no yuav tsum tau mus pw hauv tsev kho mob thiab tau txais kev kho mob thaum muaj xwm txheej ceev. Cov kev kho mob no suav nrog:

• Kev siv catheter rau lub plawv , kev phais plawv thiab kev tso stentQhov no suav nrog kev siv lub npas cua los ua kom cov hlab ntsha uas raug txhaws thiab muab ib daim ntaub me me (stent) tso rau kom tiv thaiv nws kom tsis txhob raug txhaws dua.
• Kev Hloov Pauv Ntawm Cov Hlab Ntshav Hauv Lub Cev (CABG): Qhov no suav nrog kev tsim ib txoj kev tshiab rau cov hlab ntshav uas raug thaiv.
• Txhim kho ib lub cuab yeej pab txhawb kev ncig ntshav, xws li Lub Tshuab Pab Sab laug ntawm Lub Plawv (LVAD) , lossis Lub Tshuab Defibrillator Uas Muab Tso Rau Hauv Lub Plawv (ICD) .
• Kev hloov plawv - Qhov no tsis tshua muaj.

Feem ntau, cov kws kho mob sim kho qhov mob no nrog tshuaj, kom cov hlab ntsha uas raug rhuav kho nws tus kheej. Kev phais tsuas yog suav tias tsim nyog yog tias tsim nyog tiag tiag.

Puas tiv thaiv tau SCAD?

Yog tias koj tau muaj cov hlab ntsha tawg ib zaug lawm, tej zaum koj yuav tsum txwv qee yam kev ua ub ua no thiab kev cob qhia lub zog kom tiv thaiv nws kom tsis txhob tshwm sim dua. Koj tus kws kho mob kuj tseem yuav xa koj mus rau qhov kev pab cuam kho lub plawv . Qhov no tuaj yeem pab txhim kho koj txoj kev noj qab haus huv ntawm lub plawv thiab qhia koj yuav ua li cas tawm dag zog kom muaj kev nyab xeeb.

Txawm hais tias tsis tau pom muaj kev sib txuas ncaj qha ntawm SCAD thiab kev tswj hwm kev yug me nyuam hormonal, ntau tus kws kho mob pom zoo kom xav txog cov kev xaiv tswj hwm kev yug me nyuam uas tsis yog hormonal ua ntej. Piv txwv li, kev phais vasectomy rau cov txiv neej lossis kev khi tubal rau cov poj niam. Nug koj tus kws kho mob seb txoj kev twg zoo tshaj plaws rau koj.

Koj tuaj yeem ua cov no kom txo koj txoj kev pheej hmoo ntawm kab mob plawv:

• Noj cov zaub mov zoo rau lub plawv kom txo cov roj cholesterol.
• Txo kev noj ntsev thiab tswj cov ntshav siab.
• Txwv koj txoj kev haus dej cawv. Yog tias koj muaj teeb meem nrog kev haus dej cawv, nrhiav kev pab.
• Paub txog cov rog uas koj noj thiab txo koj cov rog tsis zoo.
• Yog koj muaj ntshav qab zib , tswj nws kom zoo.
• Yog koj haus luam yeeb, nrhiav kev pab kom tso tseg.
• Ua kom lub cev nquag thiab tswj koj qhov hnyav kom noj qab nyob zoo.

Yuav ua li cas rau ib tus neeg uas muaj SCAD?

SCAD yog ib yam mob uas ua rau tuag taus. Kwv yees li 5% ntawm cov neeg uas muaj tus mob no tuag. Kev rhuav ib txoj hlab ntsha tuaj yeem ua rau muaj cov kev pheej hmoo hauv qab no:

• Mob angina ntev ntev: Muaj ib co neeg me me uas yuav mob hauv siab lossis mob siab tas li. Qhov no yuav tsis zoo rau cov tshuaj ib txwm muaj xws li nitroglycerin .
• Kab mob rov tshwm sim dua:Kwv yees li ib ntawm kaum tus neeg (10%) yuav rov qab muaj SCAD dua hauv peb xyoos tom qab kev kho mob thawj zaug. Koj tus kws kho mob yuav ua qhov kev kuaj mob tsis tu ncua kom sim nrhiav cov kua muag no thaum ntxov.
• Mob plawv o: SCAD tuaj yeem ua rau lub hnab ntshav nyob ib puag ncig lub plawv o, hu ua pericarditis . Koj tus kws kho mob yuav xaj kom kuaj xws li cardiac MRIs lossis angiograms los kuaj xyuas qhov teeb meem no.

Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum ua raws li cov lus qhia kho mob kom meej thiab kuaj mob raws sijhawm tom qab muaj SCAD.

Kuv yuav tsum mus ntsib kws kho mob thaum twg?

Yog koj xav tias koj muaj mob plawv nres, hu rau 911 (1990 hauv Sri Lanka) tam sim ntawd.

Tsis tas li ntawd xwb, mus ntsib kws kho mob yog tias koj muaj ib qho ntawm cov tsos mob no:

• Mob hauv siab los yog siab ( Angina ).
• Hws txias.
• Mob caj npab, lub puab tsaig, lossis xub pwg.
• Ua pa nyuaj.
• Xav tias nkees heev, kiv taub hau, lossis tsis muaj zog yam tsis muaj laj thawj.

Kuv yuav tsum nug kuv tus kws kho mob li cas?

Yog tias koj raug kuaj pom tias muaj SCAD, koj yuav xav nug koj tus kws kho mob cov lus nug no:

• Ua cas kuv thiaj tsim tau SCAD no?
• Kuv puas tuaj yeem tau txais SCAD dua?
• Kuv yuav tsum ua li cas los tiv thaiv kuv lub plawv kom noj qab haus huv?
• Kuv puas yuav tsum txhawj xeeb txog cov tsos mob ntawm cov teeb meem?

SCAD yog ib yam mob uas ua rau muaj cov tsos mob zoo li mob plawv nres rau cov neeg uas muaj feem yuav mob plawv tsawg, tshwj xeeb yog cov poj niam. Hu rau cov kev pab kho mob thaum muaj xwm txheej ceev tam sim ntawd yog tias koj muaj cov tsos mob ntawm mob plawv nres. Yog tias kev kuaj mob lees paub tias koj muaj SCAD, koj tus kws kho mob yuav nrog koj tham txog cov kev xaiv kho mob. Txawm tias kho tau los xij, muaj kev pheej hmoo tias cov hlab ntsha yuav tawg dua. Koj tus kws kho mob yuav saib xyuas koj lub plawv kom zoo kom txo qhov kev pheej hmoo ntawd.

Cov Lus Qhia Txog Kev Coj Mus Tsev

Zoo, yog li peb tau tham ntau txog SCAD, puas yog? Nov yog qee yam tseem ceeb tshaj plaws uas yuav tsum nco ntsoov:

• SCAD yog ib qho mob plawv nres uas tshwm sim sai sai, tsis tau xav txog uas tuaj yeem cuam tshuam rau cov poj niam hluas, tshwj xeeb tshaj yog cov poj niam noj qab haus huv.
• Cov tsos mob zoo ib yam li mob plawv nres. Yog tias koj mob hauv siab, ua pa nyuaj, lossis tawm hws, tsis txhob tsis quav ntsej lawv. Nrhiav kev pab kho mob tam sim ntawd.
• Kev kuaj mob SCAD tuaj yeem nyuaj me ntsis, tab sis nws tuaj yeem lees paub nrog kev kuaj mob zoo.
• Feem ntau nws kho tau los ntawm kev siv tshuaj, tab sis qee tus neeg yuav xav tau kev phais lossis lwm yam kev kho mob.
• Nws yog ib qho tseem ceeb heev uas yuav tsum hloov pauv txoj kev ua neej thiab ua raws li cov lus qhia kho mob tom qab SCAD. Qhov no tuaj yeem txo qhov kev pheej hmoo ntawm kev rov tshwm sim.

Yog koj lossis ib tug neeg koj paub muaj cov tsos mob no, tsis txhob ntshai thiab mus ntsib kws kho mob yam tsis ncua sijhawm. Thaum koj kuaj pom tias muaj tus kab mob sai npaum li cas, kev kho mob yuav zoo dua. Nyob kom noj qab nyob zoo!

Kev Phais Mob Hlwb Uas Tshwm Sim Los Ntawm Kev Phais Mob Hlwb, SCAD, mob plawv nres, mob hauv siab, mob hlab ntsha hauv lub plawv, kev noj qab haus huv ntawm cov poj niam, kev kho mob thaum muaj xwm txheej ceev