Yu at in bifurcation blok? (Bifurcation Blockage) Mek wi tok abaut dis!

Tide wi go tɔk bɔt sɔntin we impɔtant to bɔku pipul dɛn, bɔt sɔntɛm dɛn nɔ rili no bɔt am. Sɔntɛnde yu kin fil se yu chɛst tayt, i nɔ kin izi fɔ yu fɔ blo? Ɔ yu dɔn ɛva yɛri yu padi de tɔk bɔt at sik? na dεn kayn tεm ya, wan pan di prכblεm dεm we wi kin yεri bכt na wan prכblεm we de rilet to di bכdi vεsul dεm na di at we dεn kכl ‘Bifurcation Blockage’. Fɔ tɔk am simpul wan, dis na blɔk we kin apin na di say we wan branch pan wan vein we de gi blɔd to di at kin branch. Lɛ wi luk dis smɔl mɔ, nɔto so?

Wetin na dis ‘Bifurcation Blockage’?

Okay, naw mek wi si wetin dis ‘Bifurcation Blockage’ bi simpul. Imajin, wi at tan lɛk wata pɔmp. Fɔ mek dis pɔmp kɔntinyu fɔ wok, i nid fɔ gɛt blɔd ɔltɛm. Na wan spɛshal blɔd vesel dɛn we dɛn kɔl di Coronary Arteries de kɛr da blɔd de go na di at mɔsul dɛn . Dɛn men blɔd vesel dɛn ya kin sheb to smɔl smɔl branch dɛn na sɔm say dɛn, jɔs lɛk di branch dɛn na big tik we de branch. Ɔ, yu kin tink bɔt am lɛk krɔs rod usay rod split to tu.

di ples we wan men at de divayd to sכm sכm branch dεn kכl am ‘bifurcation’ . so, if dis divεlכpmεnt, fכ bi prεsis, de na wan pכynt lεk wan jכnkshכn we shep fכ ‘Y’, εn blכk de apin insay di at bikoz fכ di fεt we de bכku (wi kכl dis ‘plak’ ), den dεn kכl dat ‘bifurcation blockage’ . dis ‘plek’ na diposit we mek wit kכlestכl, fεt, εn kalsiכm. dכkta dεn kin kכl dεn sכm sכm branch atεri dεm ya bak ‘sayd-branch vεsεl dεm’ . di fεt dεposit dεm we de mek dis blכk dεn kכl dεm bak ‘bifurcation lesions’ . Yu ɔndastand? I tan lɛk se trafik jam na jɔnkshɔn na rod.

Sɔm kayn tin dɛn de we kin mek pɔsin blok?

Yɛs, dis blɔk kin bi difrɛn kayn bak. Dat min se, dɔktɔ dɛn kin no aw dis kin tranga bay aw di vein dɔn blok. we wan vein sכmtεm, wi kin kכl am bak ‘Stenosis’ insay mεdikal tεm dεm. Na tu kayn ‘Bifurcation Blockage’ de mɔ:

• simpul oklushכn: dis kin apin we less dan 70% pan di insay dayamita fכ di vein de blכk. Dis min se blɔd stil nɔ de flɔ smɔl, bɔt sɔm tin kin de we de ambɔg am.
• Kɔmpleks ɔklushɔn: Na dis say di prɔblɛm kin siriɔs smɔl. mכr dan 70% pan di vein, כ mכr dan tri-kwata pan di insay pat pan di vein, kin blכk. Sɔntɛnde, i kin pas wan ɔklushɔn na bɔku say dɛn. Ɔ blɔd klɔt kin stɔp, ɔ di kalsiɔm dɛposit dɛn kin dɔn fɔm (wi kin kɔl dis ‘kalsifikɛshɔn’).(say) di vein wכl kin stif εn i nכ kin fleksibul bכku. כda tin na, sכmtεm dis blכk kin de na ples we dεn dכn drכ di sכmכl branch vein pan wan rili shap angle (mכr dan 70 digri). We dat kin apin, i kin at fɔ trit am smɔl, bikɔs i nɔ kin izi fɔ trit am wit mɛrɛsin.

Aw kɔmɔn dis ‘bifurcation blockage’?

Yu go de wɔnda aw dis kin apin. infakt, dεn εstimat se bitwin 15% εn 20% pan כl di kεys dεm we gεt korona atεri sik (CAD) we nid mεdikal atεnshכn, כ lεk wan pan fayv, na dis ‘bifurcation blockage’ de kכz dεm. So, pan ɔl we e nɔr kin bi so kɔmɔn, na wan sik wae kin afɛkt bɔrku pipul dɛm.

Wetin kin mek dis apin?

Wɛl, wetin na di men tin we kin mek dis blɔk de blo? As a bin se bifo, di rut we de mek dis na di we aw ɔyl ɛn fat de gɛda, dat na da ‘plek’ , insay di wɔl dɛn na wi blɔd vesel. I tan lɛk ol wata paip we as tɛm de go, i kin rɔsti ɛn gɛda dɔti ɛn klos insay di paip. as tεm de go, dis ‘plek’ de bil εn i de sכmtεm di pasεj insay di at. Dɔn di blɔd we di at nid, dat na ɔksijɛn ɛn tin dɛn we de mek i gɛt tin fɔ it, nɔ de flɔ fayn. Dis ‘Bifurcation Blockage’ de insay di sem kategori bak fɔ korona at sik (CAD) .

Udat de pan denja fɔ gɛt dis sik?

Naw lɛ wi si udat kin gɛt dis sik, ɔr wetin kin mek i gɛt dis sik. I rili impɔtant fɔ no bɔt dɛn tin ya, bikɔs sɔm tin dɛn wi kin kɔntrol.

Jɛnɛral wan, uman dɛn kin gɛt CAD ɛn Bifurcation Blockage afta dɛn dɔn menopause , we min se dɛn kin stɔp fɔ gɛt prɛgnɛshɔn ɛvri mɔnt, ɛn man dɛn kin gɛt CAD afta dɛn dɔn ol 45 ia.

Apat frɔm dat, sɔm ɔda tin dɛn de we kin mek pɔsin gɛt dis sik:

• Dayabitis: Pipul dɛn we gɛt dayabitis kin gɛt prɔblɛm wit dɛn blɔd vesel bikɔs dayabitis kin pwɛl di wɔl dɛn na di blɔd vesel.
• Ovaweit ɔ Fat: We bɔdi wet de go ɔp, i kin at fɔ mek di at ebul fɔ handle am ɛn i kin gɛt fɔ wok tranga wan.
• Famili histri fɔ gɛt sik wae de kam pan pɔrsin in at ɛn blɔd: Sɔntɛnde dis kin bi bikɔs ɔf di jɛnɛtik inflɔwɛns.
• Ay blɔd prɛshɔn (Hypertension): Ay blɔd prɛshɔn min se prɛshɔn de ɔltɛm we nɔ nid fɔ de na di vein dɛn. Dis kin pwɛl di vein dɛn.
• di ay kכlestכl: Kכlestכl na di men tin we de mek di plek fכm , spεshal wan di hכy lεvεl fכ "bad" kכlestכl (LDL).
• We yu nɔ de du ɛksɛsayz:We di bɔdi nɔ de du ɛksɛsayz, i kin izi fɔ gɛda fat ɛn di at wɛlbɔdi sɛf kin wik.
• Nɔ it fayn: If yu de it tin dɛn we gɛt bɔku ɔyl, shuga, ɛn sɔl ɔltɛm, dat go mek yu gɛt bɔku prɔblɛm. Tink bɔt di junk fud we wi de it, fast fud, drink we gɛt shuga, ɛn fried it... If yu kɔntinyu fɔ it dɛn tin ya, prɔblɛm kin kam.
• Smok ɔ yuz tabak prodakt: Smok na wan pan di big ɛnimi dɛm fɔ di at. Di kemikal dɛn we de insay tabak kin pwɛl di blɔd vesel dɛn dairekt wan.

Wetin na di sayn dɛm fɔ dis?

Bikɔs Bifurcation Blockage na wan kayn korona at sik bak (CAD) , di sayn dɛm na di sem. Bɔt sɔmtɛm dis sik kin de witout ɛni sayn. Bɔt di sayn dɛm wae kin kam pan pɔrsin na:

• Angina: Dis na wae yu de fil pen ɔr tayt na yu chɛst, wae yu de fil fɔ gɛt kɔnstrikt. Sɔm pipul dɛn kin tɔk se na wet na di chɛst, ɔ lɛk se dɛn de swɛt di chɛst. Dis pen kin wɔs we yu de du ɛksɛsayz, we yu de klaym stej, ɔ we prɛshɔn de pan yu at.
• Kol swet: Yu kin fil kol ɛn swet wantɛm wantɛm, mɔ we yu de fil pen na yu chɛst.
• Diziz ɔ fil layt ed: Fɔ fil lɛk se yu nɔ ebul tinap, yu yay de tɔn blu.
• Taya ɛn wik: Yu kin fil taya ɛn yu nɔ kin ebul fɔ du ɛnitin. Yu kin si am bak se i nɔ izi fɔ du wok dɛn we bin izi trade.
• At de bit: Fɔ fil lɛk se yu kin yɛri yu at de bit, ɔr yu at de bit fast fast, lɛk se yu chɛst de bit.
• Nɔs: Na fɔ fil lɛk se yu sik, sɔntɛm yu kin ivin vɔmit.
• Fɔ blo shɔt: Yu kin fil shɔt fɔ blo ivin afta yu dɔn du smɔl tin. Sɔntɛnde, yu kin gɛt prɔblɛm fɔ blo ivin we yu de slip.
• Sɔlda ɔ an pen: Sɔntɛnde dis pen kin bigin na di chɛst ɛn travul dɔŋ di nɛk, jaw, sholda, ɔ lɛft an.

Impɔtant: If yu gɛt wan ɔr mɔr pan dɛn kayn sik ya, nɔr jɔs tink se na sik na yu bɔdi. Si dɔktɔ wantɛm wantɛm.

Aw dɔktɔ dɛn kin no dis?

If yu gɛt dɛn sik ya, we yu go to dɔktɔ, i kin du bɔku tɛst fɔ no if dis na ‘bifurcation blockage’ ɔ ɔda at sik. Sɔm pan dɛn tin ya na:

• Kadyak kateshɔn ɛn angiogram:Dis min se yu fɔ pas wan smɔl tiub (kateta) tru wan blɔd vesel na yu an ɔ yu leg to di korona at na yu at, injɛkt spɛshal day insay, ɛn tek ɛkstrem pikchɔ dɛn. Dis kin mek yu si klia wan if ɛni blɔk de na di at ɛn aw bɔku.
• Coronary computed tomography angiogram (CCTA): Dis na spɛshal CT skan we de yuz tri-dimɛnshɔnal (3D) imej fɔ si aw blɔd de flɔ to di at ɛn if ɛni blɔk de na di at.
• Intravaskul optik kohεrεns tכmografi (IVOCT): Dis na wan tεknik we rili advans. As soon as dεn put di kateshכn, dεn pas כda tin instrכmεnt tru am εn dεn kin si di plek dεm we de insay wan blכd vεsεl, di layεr dεm na di vεsεl wכl, insay rili klia, hכy difinishכn imej dεm.
• Intravaskul ɔltrasɔund (IVUS): Dis na ɔltrasɔund tɛst bak we de luk insay di blɔd vesel dɛn. lεk IVOCT, i kin gi gud luk pan di kכndishכn fכ di wכl dεm na di vein dεm εn di nεchכr fכ di ‘plεk’.
• Fractional flow reserve (FFR): dis de mכsu di difrεns pan prεshכn insay wan bכdi vεsεl, na di tu say dεm na di blכk. I kin asɛs kɔrɛkt wan aw di blɔk dɔn blɔk ɛn no if dɛn nid tritmɛnt.

Wetin na di tritmɛnt dɛm fɔ dis?

Fɔ trit ‘bifurcation blockage’ kin bi smɔl chalenj sɔmtɛm. Bikɔs di sayd-branch vessel dɛn we a bin tɔk bɔt smɔl smɔl, ɛn di angle we dɛn branch ɔf frɔm di men at de afɛkt bak. So e kin tranga smɔl fɔ rich ɛn trit pas di men blɔd vesel dɛm.

Bɔku tɛm, dɔktɔ dɛn kin du wan tin we dɛn kɔl angioplasty . Dis min se yu fɔ mek di at we dɔn smɔl big. Dɔn, dɛn kin put wan smɔl waya mɛsh tiub we dɛn kɔl stent insay di at fɔ mek di blɔd kɔntinyu fɔ flɔ ɛn nɔ kɔnstrikt am igen. Dɛn kɔl ɔl tu di angioplasty ɛn stenting we dɛn kɔl percutaneous coronary interventions (PCI) .

Fɔ tɔk am simpul wan, dis na wetin kin apin we dɛn de du angioplasty ɛn put stent:

1. Di dɔktɔ kin kɔt smɔl na yu skin, ilɛksɛf na yu an ɔ na yu groin, ɛn put kateta (wan tin we tan lɛk tin we kin chenj chenj) tru am insay wan blɔd vesel.

2. Dɔn dɛn kin tek tɛm gayd dis kateshɔn tru di blɔd vesel dɛn to di say we di blɔk de na di at. Dɛn kin du dis ɔnda ɛkstrem rayt gayd.

3. Wan smɔl balyɔn de na di ɛnd pan di kateshɔn. We i rich na di say we i dɔn blok, we dɛn blo di balyɔn, di plek we stik na da vein de kin stɔp na di wɔl dɛn na di vein, ɛn di vein kin wayd.

4. Den na di stent de.wan (we de oba di balכn כ sεparat wan) dεn de put insay di vein, dεn de fכm di balכn, εn dεn de prεs di stent pan di vεn in wכl. Dɔn dɛn kin pul di balyɔn, ɛn lɛf di stent insay di vein, ɛn dis kin mek di vein nɔ smɔl bak.

Afta dis tritmɛnt, yu dɔktɔ go gi yu wan kayn mɛrɛsin we de mek yu blɔd tan we dɛn kɔl ‘dual antiplatelet therapy’ (lɛk aspirin ɛn klopidogrel) fɔ sɔm tɛm fɔ mek blɔd nɔ klɔt insay di stent. I rili impɔtant fɔ tek dis mɛrɛsin jɔs lɛk aw yu dɔktɔ tɛl yu, fɔ di wan ol tɛm.

Speshal stent teknik fɔ ‘bifurcation blockage’.

Tu kayn stent dɛn de we dɛn kin yuz fɔ mɛn korona at sik (CAD) . Wan na wan stent we dɛn mek wit mɛtal we nɔ gɛt natin . Di ɔda wan na stent we de pul drɔgs . dis stent we de eluyt di dכg de wok fכ ridyus di risk fכ di atεri sכmtεm bak (rεstenosis).

Bɔku men stent tɛknik dɛn de we dɛn kin yuz fɔ trit bifurcation blockages:

• Prɔvishɔnal stent: Insay dis, di dɔktɔ kin put stent na di men at nɔmɔ. Di sayd-branch vessel nɔ gɛt stent. Bɔt if di men at blɔk, ɔ if yu kɔntinyu fɔ gɛt sɔm sayn dɛn, dɛn kin put stent na da at de leta.
• Tu stent prosidur: Insay di blɔk we rili kɔmpleks, ɔ if di blɔk na di branch vein sɛf impɔtant, di dɔktɔ go put stent na di men blɔd vesel ɛn di smɔl branch vein. difrεn tεknik dεm de fכ dis (e.g., Culotte, T-stenting, Crush).

Naw, dɛn de du klinik trial pan dediket sayd-branch stent dɛn we dɛn mek fɔ fit insay dɛn smɔl branch vein dɛn de.

Yu tink se di tritmɛnt dɛn kin mek pɔsin gɛt prɔblɛm?

Sɔmtɛm kɔmplikeshɔn kin apin pan sɔm, bɔt nɔto ɔl, pipul dɛm wae dɔn gɛt angioplasty ɛn stent fɔ wan ‘Bifurcation Blockage’ . Tu men wan dɛn na:

• In-stent restenosis: Dis na we di ska tisu de fכm na di say we di stent de, כnda כ insay di stent, we de mek di atεri sכmtεm sכmtεm bak. Dis kin apin insay siks to twɛlv mɔnt afta dɛn put di stent. If dis apin, dɛn go nid fɔ mek di at big bak wit angioplasty ɔ ɔda tritmɛnt. Stent dɛn we de pul drɔgs dɔn ridyus dis risk bad bad wan.
• Stent thrombosis: Dis na we blɔd klɔt de fɔm na di say we di stent de ɛn insay di blɔd vesel. Dɛn kɔl dis ‘Trɔmbosis’.Dis na smɔl denja, bikɔs dis blɔd we de klɔt kin blok di at ɔlsay wantɛm wantɛm ɛn mek pɔsin gɛt at atak. If yu tek di ‘dual antiplatelet therapy’ kɔrɛkt wan i kin ridyus dis risk bad bad wan.

Dɛn nɔ go ebul fɔ stɔp dɛn kayn jam ya?

Fɔ tru, tin dɛn de we wi kin du fɔ mek dɛn kayn tin ya nɔ go blok? Rili! if yu fala dεn stεp dεm ya fכ protεkt yu at i kin ridyus yu risk fכ kכrona atεri sik (CAD) εn atεrosklεrosis – wan kכndyushכn we fεt dεposit dεm de bכlכp insay di at dεm, we de mek dεn tik εn lכs dεn elastik.

• Kɔntrol ay blɔd prɛshɔn: I impɔtant fɔ ridyus sɔl na yu it, tek yu mɛrɛsin lɛk aw yu dɔktɔ tɛl yu, ɛn mek dɛn chɛk yu blɔd prɛshɔn ɔltɛm.
• Nɔ drink rɔm: Ridyus rɔm as yu ebul. Nɔ drink rɔm ɛvride. If yu gɛt adikshɔn, gɛt ɛp.
• It tin we go ɛp yu at: Dis rili impɔtant fɔ mek yu nɔ gɛt bɔku kɔlɔstrel. Nɔ it tin dɛn we gɛt bɔku fat, we gɛt bɔku shuga, ɛn we dɛn dɔn prosɛs, ɛn it mɔ frut, vɛjitebul, ligɛm, it dɛn we gɛt fayv (lɛk brawn rays, ɔts, ɛn lentil), ɛn fish (espɛshali fish we gɛt bɔku omega-3 lɛk salmɔn ɛn makrɛl) .
• Yu fɔ no bɔt yu fat: Ridyus di it dɛn we yu de it we gɛt bɔku sɛtyuret ɛn trans fat (e.g., rɛd mit, prosɛs mit, bek guds, dip-fried it). Fɔ ɛgzampul, kokonat ɔyl nɔ fayn fɔ yu if yu pasmak. Yuz ɔyl dɛn we gɛt wɛlbɔdi lɛk ɔliv ɔyl ɛn kanola ɔyl insay mɔdareshɔn.
• Kɔntrol dayabitis: If yu gɛt dayabitis, i impɔtant fɔ kɔntrol am fayn fayn wan. Fɔ it, fɔ ɛksesaiz, ɛn fɔ tek mɛrɛsin we dɛn tɛl yu fɔ du impɔtant.
• Nɔ smok: If yu de smok, aks fɔ ɛp fɔ lɛf fɔ smok. Fɔ de nia pipul dɛm wae de smok (passive smoking) kin bad bak.
• Bi fyzikal aktif: If yu du ɛksɛsayz fɔ at le 30 minit insay di de, 5 dez insay di wik, i kin ɛp fɔ mek yu gɛt wɛl bɔdi ɛn mek yu at strɔng. Yu kin du tin dɛn lɛk fɔ waka, fɔ rayd baysikul, ɔ fɔ swim.
• Ridyus strɛs: Tray fɔ rilaks yu maynd tru tin dɛn lɛk yoga ɛn meditashɔn.

Wetin na di wɛlbɔdi stet fɔ pɔsin we gɛt ‘bifurcation blockage’?

sכm stכdi dεm sho se di sakses rεt fכ trit bifurkεshכn blכk wit angioplasty εn stεnt na bכt 40%. Bɔt dis kin difrɛn frɔm wan pɔsin to ɔda pɔsin, i kin dipen pan di kayn we aw di pɔsin blo. Dis min se sɔm pipul dɛn kin stil gɛt at sik afta dɛn dɔn trit dɛn. So, i rili impɔtant fɔ kɔntinyu fɔ protɛkt yu at bay we yu de it tin dɛn we go ɛp yu at, lɛf fɔ it bɔku bɔku it if nid de, ɛn tek di mɛrɛsin dɛn we dɛn dɔn tɛl yu fɔ du. I impɔtant bak fɔ kɔntinyu fɔ tɔk to yu dɔktɔ ɔltɛm ɛn mek dɛn du di tɛst dɛn we yu nid.

Ustɛm yu fɔ go to dɔktɔ?

If yu tink so, yuIf yu gɛt at atak (e.g. bad bad pen na yu chɛst, i nɔ izi fɔ blo, yu de swet, yu de vɔmit), kɔl 911 ɔ di imejensi ambulans savis we de nia yu (e.g. 1990 Suwaseriya) wantɛm wantɛm. Nɔ west tɛm!

Apat frɔm dat, go to dɔktɔ if yu gɛt ɛni wan pan dɛn sik ya we de kɔntinyu ɔ we de apin ɔltɛm:

• Chɛst pen (angina) , pen na yu an ɔ yu sholda.
• Kol swet dɛn.
• I nɔ kin izi fɔ yu fɔ blo.
• Taya pasmak ɔ wik fɔ natin.
• Diziz ɔ fil se yu at de bit kwik kwik wan.

Wetin a fɔ aks di dɔktɔ?

I fayn fɔ aks dɛn kwɛstyɔn ya we yu de go to yu dɔktɔ. Dis go ɛp yu fɔ ɔndastand yu sik fayn fayn wan:

• Wetin kin bi di rizin we mek a divɛlɔp dis ‘Bifurcation Blockage’ ?
• A de pan denja fɔ gɛt di sem kayn blɔk na ɔda blɔd vesel dɛn?
• Us tritmɛnt dɛn kin advays mi? Aw bɔku angioplasty ɛn stent go mek dis blɔk bɛtɛ?
• Us kayn stent yu kin advays? (e.g., stent we de eluyt drɔg?)
• Ɔmɔs stent dɛn a go nid?
• Wetin na di prɔblɛm ɛn bɛnifit dɛn we di tritmɛnt kin gi?
• Aw lɔŋ a nid fɔ tek mɛrɛsin afta tritmɛnt?
• Us chenj dɛn a fɔ mek na mi layf fɔ protɛkt mi at?
• Wetin na di prɔblɛm dɛn we kin apin afta dɛn dɔn trit mi, ɛn aw a fɔ kia fɔ dɛn?

Di impɔtant tin we wi kin lan frɔm dis (Take-Home Message) .

Bifurcation Blockage na blok we de apin na di jכnkshכn fכ wan korona at na di at, we de blok bכdi fכ fכlכ to di at. Pan ɔl we sɔntɛnde i kin at fɔ trit, advans tritmɛnt dɛn de lɛk angioplasty ɛn stent.

Bɔt di tin we impɔtant pas ɔl na fɔ tray fɔ mek dis sik nɔ apin ɛn ivin wit tritmɛnt, fɔ protɛkt yu at bay we yu de chenj yu layf fayn fayn wan (gud it, ɛksesaiz, ɛn lɛf fɔ smok). If yu gɛt sɔm sayn dɛn lɛk we yu de fil pen na yu chɛst ɔ yu nɔ de blo fayn, i impɔtant fɔ go to dɔktɔ we yu nɔ fɔ pe atɛnshɔn to dɛn. Mɛmba se yu at na yu prɔpati we gɛt valyu pas ɔl! Na yu wok fɔ kia fɔ am.

` At sik, bifurcation bloke, CAD, angioplasty, stent, chɛst pen, at