Aw yu at in ‘supply’ de? Lɛ wi tɔk bɔt Koronari Flɔ Rizav (CFR)!

Yu dɔn ɛva tink if yu at de gɛt di ɛkstra blɔd we i nid we i strɛs, lɛk we yu de ɛksesaiz? Wi at na wan wɔndaful ɔgan. I nid gud blɔd fɔ mek i ebul fɔ wok fayn fayn wan. Na dat wi go tɔk bɔt tide, ɛn i de tɔk bɔku tin bɔt di wɛlbɔdi na yu at: `Coronary Flow Reserve` ɔ `CFR`. Nɔ wɔri, dɛn wɔd ya kin tan lɛk se dɛn kɔmplikt smɔl, bɔt lɛ wi kip am simpul.

Wetin na `Koronari Flɔ Rizav (CFR)`? Fɔ tɔk am simpul wan...

Tink bɔt yu at lɛk motoka injin. We i de rɔn nɔmal wan, di injin nid sɔm fiul. Bɔt we yu de go ɔp wan il, ɔ yu de go fast, di injin nid mɔ fiul, nɔto so? Na so wi at de. We wi de rɛst, di at nid sɔm blɔd. Bɔt we wi de du ɛksɛsayz, rɔn, jomp, es wet, ɔ we wi strɛs, di at nid mɔ ɔksijɛn ɛn tin dɛn we de mek wi gɛt tin fɔ it . Fɔ mek dɛn ebul fɔ du dis we aw pipul dɛn de aks fɔ am, di blɔd we de na di at nid fɔ go ɔp.

di men blɔd vesel dɛm we de kɛr blɔd go na di at na dɛn kɔl dɛn korona at . Korona Flɔ Rizav (CFR) na fɔ no aw yu korona at kin mek dɛn blɔd go ɔp we di at nid mɔ blɔd. I tan lɛk se yu de luk di at in ‘supply’ rizɔv.

dis dεn kכl am bak `Myocardial blood flow reserve`. biכs bכdi de fכlכ frכm dεn korona at dεm ya to yu at mכsul, dat na, to di at mכsul `(Myocardium)` . So tru dis CFR valyu, dɔktɔ dɛn kin asɛs if yu at mɔsul de gɛt inof blɔd we i nid am.

Aw dɛn kin kɔl dis CFR valyu?

Dis na rili simpul kɔlkyulɛshɔn. Bɔt i nid spɛshal tɛst fɔ du dis. Fɔ tɔk am simpul wan, di CFR na di maksimal blɔd we kin flɔ tru yu korona at , we dɛn sheb am wit di nɔmal blɔd we kin flɔ tru yu we yu de rɛst, we yu nɔ de tray tranga wan .

Fɔ ɛgzampul, we yu de rɛst, yu at de pɔmp X mililita blɔd fɔ wan minit. We yu de du maksimal ɛksɛsayz (ɔ we dɛn mek da kɔndishɔn de atifishal wan), yu at de pɔmp Y mililita blɔd. Dɔn CFR = Y / X.

Dis na aw yu at kin pɔmp mɔ blɔd pas aw i kin pɔmp.

Insay us kes dɛn dɛn kin du CFR tɛst?

Bɔku rizin dɛn de we mek dɔktɔ kin tɛl yu fɔ du CFR tɛst:

• Fɔ no if yu gɛt korona at sik (CAD): Sɔntɛnde yu kin gɛt pen na yu chɛst (angina), i nɔ kin izi fɔ yu fɔ blowe di simptom dεm lεk dis de apin, dis tεst de εp fכ kכnfכm if di kכz na di blכk na di korona at.
• Asɛs aw CAD siriɔs: Dis impɔtant fɔ ɔndastand aw bɔku pan di at dɛn kin afɛkt ɛn aw bɔku blɔd kin ambɔg pɔsin we dɔn ɔlrɛdi gɛt CAD.
• Prɛdikt di fiuja hat atak risk : As di CFR valyu de go dɔŋ, di risk fɔ gɛt at atak ɔ ɔda at sik tumara bambay kin go ɔp.
• Mekɔp di sakses we di tritmɛnt dɛn gɛt: Dɛn kin yuz dis tɛst bak fɔ si if blɔd dɔn kam bak to di at afta sɔm tritmɛnt dɛn (e.g. angioplasty, bypass surgery).

Wetin na wan avrej CFR valyu?

Pɔsin we gɛt wɛlbɔdi in CFR kin de bitwin 2.0 ɛn 2.5 ɔ pas dat . Dis min se we yu de wok tranga wan, yu at de gɛt at le tu tɛm pas di blɔd we de kɔmɔt we yu de rɛst. Pɔsin we gɛt wɛlbɔdi kin gɛt dis valyu we go rich 3. Dis min se dɛn kin ebul fɔ mek dɛn blɔd go ɔp tri tɛm.

Wan stɔdi dɔn sho se pipul dɛm wae gɛt CFR pas 2 kin gɛt bɛtɛ siks mɔnt wɛl afta dɛn gɛt at atak. If CFR nɔ rich 2, dat de sho se i gɛt ay risk fɔ gɛt at sik.

Bɔt i impɔtant fɔ ɔndastand se dis "nɔmal" valyu kin chenj wit di ej. Yɔŋ pɔsin we gɛt wɛlbɔdi kin gɛt CFR we na 5 ɔ ​​6. Bɔt ivin pɔsin we gɛt wɛlbɔdi we ol 80 ia kin gɛt CFR we nɔ rich 2. Dɔn bak, pikin we dɛn dɔn ɔpreshɔn fɔ in at prɔblɛm we dɛn bɔn wit kin gɛt CFR we smɔl. So, yu dɔktɔ go disayd if yu CFR nɔmal ɔ nɔto nɔmal, bay yu ɔl yu wɛlbɔdi ɛn ɔda tin dɛn.

Aw fɔ tek di CFR tɛst? Aw fɔ rɛdi fɔ am?

Tu men we dɛn de fɔ mɛzhɔ CFR. Wan na invasive method , we min fɔ put sɔntin insay di bɔdi. dis involv sכmtin we dεn kכl `Cardiac Catheterization`. di כda wan na nכn-invasiv mεtכd , we involv fכ yuz spεshal `Nyuklia Strεs Tεst`, we na `Rubidium-82 Positron Emission Tomography (PET) skan`. Na smɔl tɛm nɔmɔ dɛn kin yuz `Magnetic Resonance Imaging (MRI) scan` bak fɔ dis.

Naw lɛ wi si aw fɔ pripia fɔ dis tɛst ɛn wetin go apin di de we dɛn go du di tɛst.

Tin dɛn we yu fɔ no bifo yu du di tɛst

• Tɛl yu dɔktɔ bɔt di mɛrɛsin dɛn we yu de tek: lɛk di mɛrɛsin dɛn we dɛn kin gi yu, di mɛrɛsin dɛn we yu nɔ kin bay na kɔt, ɛn vaytamɛn dɛn.Yu fɔ tɛl yu dɔktɔ bak bɔt ɛni ɔyl we yu de tek, bikɔs sɔm mɛrɛsin dɛn kin afɛkt di we aw yu blɔd de go.
• Tɛl wi bɔt yu alɛji: If yu gɛt ɛni alɛji to ɛni mɛrɛsin, kɔntrast day we dɛn kin yuz fɔ tɛst, ɔ lɛtɛks, lɛ wi no bifo tɛm.
• Advays fɔ it ɛn drink: If yu de du kadiak kateshɔn ɔ PET skan, aks yu dɔktɔ ɔmɔs awa bifo di tɛst yu fɔ stɔp fɔ it ɔ drink. Tipikli, dɛn nɔ go alaw yu fɔ it ɔ drink ɛnitin fɔ 6 to 8 awa bifo di tɛst.

Wetin fɔ ɛkspɛkt pan tɛst de?

• Fɔ MRI skan: Yu nɔ fɔ gɛt ɛni mɛtal tin (lɛk jɔyri ɔ hairpin) na yu bɔdi. Sɔm mɛrɛsin dɛn (lɛk pesmɛka) nɔ kin wok wit MRI. So if yu gɛt dis kayn tin, aks yu dɔktɔ bifo tɛm fɔ mek shɔ se i nɔ bad fɔ MRI.
• Cardiac Catheterization: Insay dis prosidur, dɛn kin put wan rili tin tiub (catheter) tru wan blɔd vesel na yu nɛk, groin, ɔ an insay di korona at dɛn na yu at. Dɛn go gi yu wan mɛrɛsin we nɔ de mek yu fil fayn fɔ mek yu nɔ fil fayn.
• wan IV layn: I nכ mata aw di tεst mεtכd, wan ``Intravenכs layn (IV)`` go kכnekt to wan vein na yu an. dis IV na di say we dεn de gi mεdikeshכn (vasodilator) fכ mek di bכdi fכ fכlכ pasmak na di at εn sכmtεm dεn kin gi am ``Kכntrast day`` fכ mek di korona at dεm mכr fכ si. if yu de du ``PET skan``, dεn de gi yu wan redioaktiv sכbstans ``Radiotracer`` bak tru dis IV.

Mek a ehksplehn likl mo boht aw dem de meja CFR...

Yu dɔktɔ go yuz difrɛn we dɛn fɔ tek pikchɔ fɔ no aw blɔd de flɔ na yu korona at we yu de rɛst ɛn we yu de tray tranga wan. Di men wan dɛn na:

• `PET scan`: insay dis, we wan `Radiotracer` we dεn gi tru IV rich di at, di signal dεm we i de kכmכt na spεshal kεmεra de kech, εn wit di εp fכ kכmpyuta, dεn de gεt klia imej dεm fכ di bכdi fכ fכlכ na di at.
• ` Cardiac MRI` : Dis na imej mεtכd bak. Bɔt dɛn nɔ kin yuz am bɔku tɛm fɔ mɛzhɔ CFR.

I rili impɔtant fɔ mek yu stil de du dis skan, ɔdasay di pikchɔ dɛn we yu gɛt nɔ go klia.

di `Cardiac Catheterization` mεtכd difrεnt sכmtεm. I gɛt fɔ du wit:

1. Afta dεn dכn put di kateshכn insay di korona at, dεn de pas wan spεshal waya tru am. na di tip pan dis waya na wan `Ultrasound transducer` (wan sכmכl divays we de kכmכt εn rεsכp ultrasound wev dεm). dis kin mכsu di spid we di bכdi de fכlכ insay di korona at.

2. pan dis prכsεs, dεn de gi wan mεdisin we dεn kכl `Heparin` tru di IV fכ mek bכdi nכ kכlכt.

3. Ɔda kayn waya dɛn de we de mɛzhɔ blɔd flɔ we dɛn de yuz tu tɛmpracha sɛns ɛn wan salin injɛkshɔn.

Wetin rili apin we dɛn de du di tɛst?

We dɛn de du yu ɛgzam, di mɛdikal tim go du dɛn tin ya:

1. Fɔs, dɛn kin mɛzhɔ di blɔd we de flɔ na yu korona at we yu de rɛst .

2. Dɔn, dɛn kin gi yu wan `Vasodilator` kayn mɛrɛsin (lɛk `Adenosine (Adenocard® ɔ Adenoscan®)`) tru yu IV, we kin mek yu at rit ɛn blɔd flɔ go ɔp. Dis mɛrɛsin de mek blɔd flɔ 4 to 5 tɛm we yu kɔmpia am to we yu de rɛst. I kin tek shɔt tɛm, lɛk tu to tri minit, fɔ mek dis mɛrɛsin bigin fɔ wok. dis dεn kכl am `Cardiac Catheterization`, εn sכmtεm dεn kin gi dis mεdisin tru di kateshכn insted כf di IV.

3. Afta dεn gi di dכg, dεn de mכsu di bכdi fכ fכlכ na di korona atεri dεm bak. Dis na di maksimal blɔd we de flɔ.

4. fכ finish, dεn kin kכl yu `Coronary Flow Reserve (CFR)` valyu bay we dεn kכmpεr dis maksimal bכdi fכ fכlכ εn yu rεst bכdi fכ fכlכ .

Wetin kin apin afta di tɛst?

• If yu put kateshɔn (espɛshali na di groin ɔ an), yu go nid fɔ kip di say we dɛn kɔt am tinap fɔ wan awa ɔ mɔ fɔ mek yu nɔ blɔd.
• Yu dɔktɔ kin tɛl yu fɔ drink mɔ wata fɔ ɛp fɔ pul di kɔntrast day kɔmɔt na yu bɔdi.
• If dɛn dɔn gi yu wan mɛrɛsin we de mek yu fil fayn, yu nɔ go ebul fɔ drayv fɔ da de de. So yu go nid fɔ kam wit pɔsin na os .

Wetin na di risk ɛn sayd ɛfɛkt dɛm fɔ dis CFR tɛst?

Bɔku tɛm, CFR tɛst na tin we nɔ bad, bɔt lɛk ɛni mɛrɛsin, sɔm smɔl smɔl prɔblɛm dɛn de.

• Bikɔs dɛn kin put kateshɔn ɛn waya insay di korona at, i nɔ kin izi fɔ mek blɔd klɔt, di at dɛn kin spam, ɔ blɔd kin kɔmɔt.
• Na smɔl risk de fɔ mek di blɔd vesel pwɛl. If dis apin, dɛn kin nid fɔ du ɔpreshɔn fɔ mek i fayn , ɛn i nɔ kin apin so ɔltɛm.

We dɛn gi sɔm pipul dɛn di drɔg `Adenosine`, dɛn kin gɛt dɛn sayd ɛfɛkt ya, we kin las fɔ sɔm sɛkɔn nɔmɔ:

• Di at ritm we nɔmal
• Lɔw blɔd prɛshɔn (Hypotension) .
• Shot we yu de blo
• Diskɔmfɔt na di chɛst

Impɔtant: Dɛn nɔ kin gi dis `Adenosine` mɛrɛsin to pipul dɛm wae gɛt asma. Bikɔs i kin mek pɔsin gɛt brɔnkospasm. If na so i bi, di dɔktɔ kin yuz ɔda IV mɛrɛsin lɛk `Dobutamine`.

Aw di tin dɛn we kin apin kin tan lɛk? Wetin dɛn de tɛl wi?

Yu CFR tɛst de gi yu wan nɔmba. Dis nɔmba de tɛl yu aw yu korona at kin mek yu blɔd flɔ mɔ we yu de tray tranga wan.

As wi bin dɔn tɔk bifo tɛm, dis valyu kin go dɔŋ wit di ej. Yɔŋ pɔsin we gɛt wɛlbɔdi kin gɛt CFR valyu we na 5 ɔ ​​6. Bɔt wan ol pɔsin we gɛt wɛlbɔdi kin gɛt CFR valyu we nɔ rich 2.

di ridyus bכdi fכ fכlכ (i.e., wan risk fכktכ) kin apin pan eni CFR valyu bitwin 1.6 εn 3.3. Wetin nɔmal fɔ wan pɔsin nɔ kin bi nɔmal fɔ ɔda pɔsin. So, na yu dɔktɔ nɔmɔ go ebul fɔ ɛksplen di rizɔlt dɛn kɔrɛkt wan. I go tek tɛm tink bɔt bɔku tin dɛn lɛk yu ej, yu wɛlbɔdi biznɛs, ɛn di sayn dɛn we yu de si, fɔ mek i go ebul fɔ tɔk.

Aw lɔng i kin tek fɔ no di tin dɛn we kin apin?

I kin tek sɔm dez fɔ mek yu dɔktɔ analayz di rizɔlt fɔ yu CFR tɛst ɛn mek yu no. If yu rizɔlt na bɔda, yu dɔktɔ kin want fɔ tɔk bɔt am wit ɔda dɔktɔ dɛn. If yu rizɔlt sho se yu kin gɛt at sik, yu dɔktɔ go tɔk to yu bak bɔt wan plan fɔ ridyus yu risk.

Ustɛm a fɔ kɔntak di dɔktɔ?

If yu gɛt ɛni kwɛstyɔn bifo di CFR tɛst bigin, aks yu dɔktɔ. Dɔn bak, if yu gɛt ɛni ɔda kayn sik, sayd ɛfɛkt, ɔ nɔ fil fayn afta di tɛst , tɛl yu dɔktɔ wantɛm wantɛm.

Mɛsej we dɛn kin kɛr go na os

`Coronary Flow Reserve (CFR)` test na test we de gi valyu infכmeshכn bכt di hεlth fכ di korona atεri dεm we de gi bכdi to yu at. I kin chɛk if yu at de gɛt di ɛkstra blɔd we i nid we i de wok tranga wan.

If CFR valyu smɔl kin bi sayn fɔ korona at sik. I kin gi yu bak wan aidia bɔt yu risk fɔ gɛt at atak tumara bambay.

If ɛnitin de we yu nɔ ɔndastand bɔt dis tɛst, nɔ fred fɔ aks yu dɔktɔ. Dɛn go ɛksplen ɔltin to yu ɛn ɛp yu fɔ mek di tɛst izi fɔ yu. Mɛmba se fɔ kia fɔ yu at rili impɔtant!

`At sik, korona at, blɔd saplai, CFR tɛst, at atak, at wɛlbɔdi, mɛdikal tɛst