Yu at nɔ de gɛt inof blɔd? Lɛ wi lan bɔt Ischemic Cardiomyopathy, we de mek di at mɔsul wik!

Wi at tan lɛk wɔndaful mashin we nɔ de stɔp, nɔto so? Bɔt wetin kin apin if dis at nɔ gɛt inof blɔd, dat na di ɔksijɛn ɛn it we i nid? Dɔn di at mɔsul kin bigin fɔ wik ɛn gro smɔl smɔl. Dat na siriɔs kɔndishɔn, bɔt wan we wi nid fɔ tɔk bɔt ɛn fɔ no bɔt na in dɛn kɔl `(Ischemic Cardiomyopathy)` . Mek wi tok abaut dis in mo ditel tide, okay?

Wetin na `(Ischemic Cardiomyopathy)`? Fɔ tɔk am simpul wan...

Fɔ tɔk am simpul wan, `(Ischemic Cardiomyopathy)` min se di at mɔsul na yu at nɔ de gɛt inof blɔd, we de mek i wik ɛn nɔ ebul fɔ pɔmp blɔd fayn fayn wan. Dɔktɔ dɛn kin kɔl dis bak `(ischemia)`, we min se blɔd sapɔt dɔn ridyus.

Imajin, wetin go apin if wata motoka fɔ rɔn we nɔ gɛt wata? Na so i bi. We di vein dɛn we de kɛr blɔd go na di at, dat na di korona at , blok, ɔ we at atak apin, di blɔd we de flɔ to di at kin ridyus dis we.

dis kin mek di lεft vεntrikl , we na di men pכmp chεmba we de na di lεft say na di at, wik εn i de big sכmtεm. Dɔn di at nɔ kin ebul fɔ pɔmp blɔd fayn fayn wan ɔlsay na di bɔdi. Dis na wan pan di kayn hat sik wae kin pasmak wae dɛn kɔl Dilated Cardiomyopathy ɛn na di big tin wae kin mek pɔrsin gɛt systolic hat fail na di wɔl. Dis sik kin apin to 60 pasɛnt pan di wan dɛn we sik.

Yu gɛt dɛn sik ya bak?

Pɔsin wae gɛt `(Ischemic Cardiomyopathy)` kin gɛt sɔm kayn sik lɛk dis. Bɔt mɛmba se sɔm pipul dɛn kin gɛt dis sik ɛn nɔr kin gɛt ɛni sayn.

• Yu kin fil se yu nɔ gɛt bɛtɛ briz? Yu kin fil diziz we yu waka smɔl ɔ we yu klaym sɔm stej dɛn?
• Yu leg ɛn anklɛ dɛn dɔn swel (ɛdima)? I tan lɛk se dɛn ful-ɔp wit wata.
• Yu kin fil taya kwik ivin afta yu dɔn du smɔl wok? Yu kin fil so taya dat yu nɔ ebul fɔ ivin du di wok dɛn we yu de du ɛvride?
• Yu kin fil pen na yu chɛst, yu kin tayt, ɔ yu kin gɛt prɛshɔn? Dɛn kɔl dis ``Angina.`` Bɔt dis nɔto sayn we de afɛkt ɔlman.
• Yu bɔdi de fil ebi ɛn ebi, lɛk se i ful-ɔp wit wata? Dis kin apin we wata gɛda na yu lɔng.
• Yu kin fil lɛk se yu at de bit nɔmal wan, lɛk se sɔntin de flɔt na yu chɛst, ɔ i de bit tumɔs? Wi kin kɔl dis ``arithmia`` ɔ irɛgyula at ritm.
• Yu kin fil diziz , yu yay de tɔn blu, ɔ yu kin fil fɔdɔm?
• Sɔntɛnde, yu kin ivin fɔdɔm .

If yu gɛt wan ɔ mɔ pan dɛn sik ya, i go mɔs bi se yu go to dɔktɔ ɛn aks fɔ advays.

Wetin mek dis de apin? Wetin na di rizin dɛn?

Dis kin kam bikɔs ɔf ɛni sik we de mek di blɔd nɔ go na di at mɔsul ɛn pwɛl am. Di men tin dɛn we kin mek i apin na:

• Koronari Atɛri Disizin:Dis na di men ɛn kɔmɔn tin we kin mek pɔsin gɛt dis sik . dis kכndyushכn de apin bikoz fכ di fεt we de kכmכt insay di at dεm we de gi bכdi to di at.
• At Atak: We at atak apin, di blɔd we de go na wan pat pan di at kin kɔt kpatakpata, ɛn dis kin mek di tisu we de na da pat de day.
• Coronary Vasculitis: Na wan inflammatory kondishɔn we kin apin na di at dɛn na di at.
• Coronary Artery Dissection: I de te di wɔl na wan at na di at.
• Coronary Microvascular Disease: Prɔblɛm dɛn we de na di rili smɔl blɔd vesel dɛn na di at.
• Fibromuscular Dysplasia: Na abnɔmal growth na di wɔl dɛm na di blɔd vesel dɛm.
• `(Prinzmetal Angina)`: di chεst de pen we di korona atεri dεm de sכdεn.

Udat dɛn kin gɛt dis sik mɔ? (Di tin dɛn we kin mek pɔsin gɛt prɔblɛm)

Sɔm pipul dɛn kin gɛt dis sik (Ischemic Cardiomyopathy). Dat min se sɔm tin dɛn de we kin mek pɔsin gɛt prɔblɛm. Si if dɛn tin ya apin to yu:

• Wan famili histri bɔt at sik: If yu mama ɛn papa ɔ yu brɔda ɛn sista dɛn gɛt at sik, yusɛf kin gɛt bɔku prɔblɛm.
• Ay Blɔd Prɛshɔn: Ay blɔd prɛshɔn na wan big tin we kin mek pɔsin gɛt dis sik.
• Yuz tin dɛn we dɛn mek wit tabak: Yuz tin dɛn lɛk sigrɛt ɛn bidis.
• Dayabitis: Pipul dɛm wae gɛt shuga kin gɛt mɔ risk bak.
• Ay kɔlɔstrel: Di bad bad kɔlɔstrel we de na di blɔd kin bɔku .
• Bɔdi Mas Indeks (BMI) we pas 30: Fɔ tɔk am simpul wan, fɔ gɛt bɔku bɔku bɔdi pas di wet we fit fɔ yu ayt.
• Bikɔs i bin dɔn gɛt at atak bifo tɛm.
• Nɔ fɔ du tin wit yu bɔdi: Dis min se yu nɔ fɔ du ɛksɛsayz fayn.

If yu gɛt wan ɔ mɔ pan dɛn tin ya we kin mek yu gɛt prɔblɛm, i rili impɔtant fɔ kɔntrol dɛn.

Us ɔda prɔblɛm dɛn dis kin mek pɔsin gɛt?

If dɛn nɔ trit Ischemic Cardiomyopathy fayn, i kin mek yu gɛt ɔda siriɔs wɛlbɔdi prɔblɛm. Dɛn tin ya na:

• Di Ritm fɔ di At we Nɔ Nɔmal
• Congestive Heart Failure (at nɔ kin ebul fɔ pɔmp blɔd fayn fayn wan, we kin mek wata bɔku na di bɔdi) .
• Pulmonari Ɛdima
• Mitral Valv Rigurjiteshɔn
• Blɔd klɔt (if dɛn tin ya travul go na di bren, i kin mek pɔsin gɛt kɔndishɔn lɛk strok) .
• Di Kadiak Arest
• Day we pɔsin kin day wantɛm wantɛm na di at

Pan ɔl we dɛn prɔblɛm ya kin tan lɛk se dɛn denja, dɛn kin avɔyd dɛn bɔku tɛm if dɛn no di sik kwik kwik wan ɛn trit am fayn.

Aw di dɔktɔ kin no bɔt dis? (Diagnosis) .

We yu go to dɔktɔ, i go du tin dɛn lɛk dis fɔ no if yu gɛt dis sik:

• Aks bɔt yu mɛdikal histri: tin dɛm lɛk sik dɛm wae yu bin dɔn gɛt bifo ɛn mɛrɛsin wae yu bin de tek.
• a de lisin gud gud wan to di simptom dem we yu de diskraib.
• Aks bɔt sik dɛm na yu famili: mɔr lɛk at sik.
• Dɛn go du wan ɛgzam fɔ di bɔdi: dɛn go lisin to di at, chɛk di lɔng dɛn, ɛn luk fɔ si if i dɔn swel.
• Dɛn go aks yu fɔ du sɔm spɛshal tɛst dɛn.

Wetin na dɛn tɛst ya?

Fɔ no dis sik kɔrɛkt wan ɛn si aw i dɔn pwɛl di at, dɛn kin du dɛn tɛst ya:

• Blɔd Tɛst: Chɛk tin dɛn lɛk sɔm ɛnzaym dɛn we kin gɛda na di blɔd we di at dɔn pwɛl, di kɔlɔstrel lɛvɛl, ɛn di shuga lɛvɛl.
• Ilɛktrokardiogram (EKG): Na tɛst we de rayt di ilɛktrik wok we di at de du. Dis kin ɛp fɔ no tin dɛm lɛk at atak ɔr at bit we nɔr de bit ɔltɛm.
• Chɛst X-ray: Fɔ chɛk fɔ tin dɛn lɛk at we dɔn big ɛn wata we de na di lɔng dɛn.
• Transthoracic Echocardiogram (TTE): Dis tan lɛk ɔltra saund skan fɔ di at. i kin gi imכtant infכmeshכn bכt di at in chεmba dεm, aw di valv dεm de wok, εn aw bכku bכdi di at de pכmp (ejection fraction).
• Ɛksesaiz Strɛs Tɛst: Dɛn kin wach yu ECG ɛn blɔd prɛshɔn we yu de waka pan tredmil ɔ rayd baysikul. Dis kin no aw yu at kin wok tranga wan ɛn if ɛni prɔblɛm de wit di we aw yu blɔd de go.
• Cardiac Catheterization / Angiogram: Dis involv fɔ put smɔl tiub tru di groin ɔ an, injekt wan day insay di korona at na di at, ɛn tek ɛkstrem rayt. Dis kin mek di dɔktɔ si di rayt say usay di tin dɛn we de blok de na di at.
• CT Scan ɔ MRI Scan: Dɛn tin ya kin ɛp fɔ gɛt mɔ tin dɛn bɔt aw di at de mek ɛn aw i de wok.
• Nyuklia Mɛdisin Imajin: I de ɛp fɔ no di say dɛn we blɔd de kɔmɔt ɛn di say dɛn we di at dɔn pwɛl.
• Mayokardial Bayopsi: Na rare kes, dεn kin tek sכm sכm pat pan di at tisu εn egzamin am כnda maykroskכp. Dis kin ɛp fɔ no wetin kin mek pɔsin gɛt di sik we de mek pɔsin gɛt di sik we de mek pɔsin in at.

So, wetin na di tritmɛnt fɔ dis?

Dɔktɔ dɛn gɛt tri men gol dɛn we dɛn de trit dis sik (Ischemic Cardiomyopathy):

1. Tritmɛnt fɔ korona at sik.

2. Fɔ mek di at wok fayn.

3. Fɔ ridyus di sik dɛn we de sho se pɔsin gɛt at atak.

Bɔku men we dɛn de fɔ trit dis:

1. Di mɛrɛsin dɛn we dɛn kin yuz

Yu dɔktɔ kin gi yu wan ɔ mɔ pan dɛn mɛrɛsin ya:

• Beta-blɔka: Dɛn kin mek di at slo, dɛn kin kɔntrol di blɔd prɛshɔn, ɛn dɛn kin ridyus di wok we di at kin du.
• ACE inhibitors ɔ ARBs: Dɛn kin mek di blɔd vesel dɛn big, i kin mek di blɔd prɛshɔn go dɔŋ, ɛn mek i izi fɔ mek di at pɔmp blɔd.
• `(ARNI)`: Dis na nyu kayn mɛrɛsin bak we de mek di at wok fayn.
• Diuretics (wata pills): Dɛn kin ɛp fɔ pul di wata we pasmak na di bɔdi tru di urine, we kin mek yu nɔ swel ɛn nɔ blo shɔt.
• `(Aldosterone Antagonists)`: Dis na wan kayn diuretic bak we de protɛkt di at.
• Antiarrhythmics: Kɔntrol di at ritm irɛgyulariti if i apin.
• Anticoagulants: I nɔ de mek blɔd nɔ klɔt.
• Statin: I de ridyus di kɔlɔstrel we de na di blɔd.

Dɛn mɛrɛsin ya kin ɛp fɔ mek di at wok fayn, kɔntrol di sayn dɛm, fɔ mek di prɔblɛm nɔ kam, fɔ stɔp di korona at sik fɔ wɔs, ɛn fɔ mek i nɔ gɛt at atak tumara bambay. Yu dɔktɔ go disayd di kayn mɛrɛsin ɛn di doz fɔ yu we go fayn fɔ yu. As i se, i rili impɔtant fɔ tek yu mɛrɛsin di rayt tɛm.

2. Di we aw pɔsin de liv in layf

Apat frɔm mɛrɛsin, sɔm chenj dɛn na yu layf ɛvride kin ɛp bɔku fɔ kɔntrol dis sik:

• Limit di sɔl we yu de ad to yu it: Tray fɔ it bitwin 2,000 ɛn 3,000 miligram sɔl fɔ wan de (dat nɔ pas wan ti spɔnj).
• Ɛksesaiz: Tɔk to yu dɔktɔ ɛn aks us ɛksesaiz dɛn we fayn fɔ yu ɛn aw lɔng yu fɔ du dɛn.
• Nɔ tek tin dɛn we dɛn kin yuz fɔ smok atɔl: If yu de smok, lɛf fɔ smok.
• It gud it we gɛt fayn fayn tin dɛn fɔ it: It mɔ vɛjitebul, frut, ligɛm, fish, ɛn it dɛn we gɛt fayv. Ridyus ɔyl, shuga, ɛn flawa. Dɛn se di Mɛditarenian Dayt rili fayn fɔ dɛn kayn sik pipul ya.

3. Divays dɛn we pɔsin kin put insay pɔsin in bɔdi

Sɔm pipul dɛn nid fɔ put spɛshal tin dɛn ɔnda dɛn skin fɔ ɛp fɔ mek dɛn at wok fayn.

• Cardiac Resynchronization Therapy (CRT): Dɛn kin kɔl am bak biventricular pacing, dis kin ɛp di at in chɛmba dɛn fɔ wok togɛda fayn fayn wan.
• Implantable Cardioverter Defibrillators (ICD): Dis divays kin no di denja at ritm abnɔmaliti ɛn gi smɔl ilɛktrik shɔk fɔ mek di at ritm nɔmal bak. Dis kin rili ɛp fɔ mek di at nɔ day wantɛm wantɛm.

Sɔntɛnde i pɔsibul fɔ instɔl wan divays we dɛn kɔl `(CRT-D)` we de jɔyn dɛn tu divays ya.

4. Intavɛnshɔnal Prosidyu ɛn Ɔpreshɔn

If di mɛrɛsin ɛn chenj dɛn layf nɔmɔ nɔ go du fɔ dɛn, dɔktɔ dɛn kin se dɛn fɔ du di wok ɔ ɔpreshɔn lɛk:

• Angioplasty ɛn stent ples: Dɛn kin blo di korona at we dɔn blok wit sɔntin lɛk balyɔn, ɛn put smɔl mɛsh (stɛnt) insay fɔ mek i nɔ blok bak.
• Coronary Artery Bypass Surgery (CABG): Dɛn kin mek nyu blɔd vesel bay we dɛn baypas di at we dɔn blok ɛn yuz wan pat pan di at we dɛn tek frɔm ɔda pat na di bɔdi.
• sכjεkshכnal Rimodεlin כ Rikכnstrכkshכn fכ di Lεft vεntrikl: dis prosid כs de kכrekt pat pan di shep εn saiz fכ di lεft vεntrikl we wik εn big.
• Lεft Ventrikulεr Volyum Ridכkshכn כpεrayshכn .
• Left Ventricular Assist Devices (LVAD): Na smɔl mashin we de ɛp di at fɔ pɔmp blɔd. Dɛn kin yuse dis fɔ sɔm tɛm fɔ pipul dɛm wae de wet fɔ gɛt at transplant, ɛn sɔm tɛm dɛn kin yuse am fɔ ɔltɛm.
• At Transplant: As las tin, if no ɔda tritmɛnt nɔ wok, dɛn kin transplant at we gɛt wɛlbɔdi frɔm pɔsin we dɔn day.
• Sɔm ɔspitul opshɔn dɛn de bak fɔ ɔda at sik dɛn.

Yu tink se tritmɛnt dɛn kin mek pɔsin gɛt bad bad tin dɛn?

Jɔs lɛk ɛni ɔda tritmɛnt, dɛn tritmɛnt ya kin mek sɔm bad bad tin dɛn apin. Bɔt nɔto ɔlman kin gɛt dɛn, ɛn aw dɛn kin tranga kin difrɛn frɔm wan pɔsin to ɔda pɔsin.

• Frɔm mɛrɛsin: diziz , bɛlɛ at, taya, dray kɔf, ed we de at, blɔd prɛshɔn we de dɔŋ, ia we de lɔs, blɔd (bikɔs ɔf tin dɛn we de mek blɔd tan), ɛn ɔda tin dɛn.
• Frɔm divays dɛn we dɛn put insay: blɔd, infɛkshɔn, divays we nɔ wok, pulmonari ɛmbolizm, kadyak tamponade.
• Frɔm di prɔsidyu ɛn ɔpreshɔn: chɛst pen, blɔd, infɛkshɔn, at atak, blɔd klɔt, at ritm irɛgyulariti, strok, at transplant rijɛkt.

Nɔ wɔri bɔt dis. Yu dɔktɔ go tɔk to yu bɔt ɔl dis bifo i bigin ɛni tritmɛnt. If yu gɛt ɛni sayd ɛfɛkt, tritmɛnt dɛn de fɔ dɛn bak.

Aw lɔng i go tek fɔ mek i wɛl?

Fɔ wan mɛrɛsin, i kin tek sɔm wiks fɔ tek ful ɛfɛkt. Fɔ ɔda tritmɛnt dɛn, di tɛm we pɔsin kin wɛl kin kɔmɔt frɔm wan de, to sɔm wiks, ɔ ivin sɔm mɔnt. I dipen pan di kayn tritmɛnt ɛn yu ɔl wɛl bɔdi.

Wi nɔ go ebul fɔ avɔyd dis sik? (Prɛvenshɔn) .

Yɛs, i rili pɔsibul! Di men tin we kin mek pɔsin gɛt `(Ischemic Cardiomyopathy)` na korona at sik, so if yu nɔ gɛt am, yu kin avɔyd dis sik bak.

Aw fɔ ridyus di prɔblɛm?

Fɔ avɔyd korona at sik ɛn di kɔndishɔn we kin kɔmɔt frɔm am (Cardiomyopathy), du dɛn tin ya:

• Stay away frɔm tabak prodakt dɛn kpatakpata.
• Ɛksesaiz fɔ at le 5 dez insay di wik, fɔ at le 30 minit insay di de.
• Gɛt di slip we yu bɔdi nid.
• Mek yu gɛt wɛlbɔdi wet fɔ yu ayt.
• Kɔntrol di strɛs we pɔsin kin gɛt ɛvride.
• If yu gɛt tin dɛn lɛk dayabitis, ay kɔlɔstrel, ɔ ay blɔd prɛshɔn, kɔntrol dɛn fayn fayn wan. Tek di mɛrɛsin dɛn we yu dɔktɔ gi yu.
• It tin dɛn we go mek yu gɛt wɛlbɔdi. It mɔ vɛjitebul, frut, ɛn grɛn.
• If yu de drink rɔm, nɔ fɔ drink am.

Wetin na di fiuja fɔ pɔsin we gɛt `(Ischemic Cardiomyopathy)`?

Dipen pan yu kɔndishɔn, di damej na yu at kin smɔl ɔr kin rili bad. Mɛrɛsin kin mek yu at wok fayn ɛn i kin mek yu nɔ gɛt bɛtɛ sik. Bɔt if dɛn nɔ go du fɔ yu, yu dɔktɔ kin tɛl yu fɔ du ɔda tin dɛn ɔ fɔ yuz ɔda tin dɛn fɔ du.

Yu tink se dɛn go ebul fɔ mɛn dis sik kpatakpata?

If di blɔd we de flɔ to di at nɔmɔ fɔ shɔt tɛm nɔmɔ, di damej kin kam bak. Bɔt if di at mɔsul nɔ gɛt blɔd ɛn ɔksijɛn fɔ lɔng tɛm, lɛk we pɔsin gɛt at atak, di damej nɔ go ebul fɔ chenj.

Outlook

Yu wɛlbɔdi biznɛs tumara bambay go dipen pan sɔm tin dɛn:

• כl di bכdi we yu lεft vεntrikl kin pכmp wan tεm (ejection fraction).
• Di kayn we aw yu korona at sik kin tranga.
• Yu dɔn ɛva gɛt at atak bifo?

Bɔt mɛmba se, tritmɛnt kin mek yu sik bɛtɛ pasmak, so nɔ giv ɔp op.

Aw a kin kia fɔ misɛf? (Fɔ kia fɔ yusɛf) .

Bɔku tin dɛn de we yu kin du yusɛf fɔ mek yu gɛt wɛlbɔdi:

• Tray fɔ mek yu gɛt wɛlbɔdi wet.
• Limit fɔ drink rɔm.
• Slip fayn ɛvri nɛt.
• Ɛksesaiz ɔltɛm (as di dɔktɔ advays yu).
• It tin dɛn we go ɛp yu at. Fɔd dɛn we nɔ gɛt bɔku sɛtyuret fat ɛn sɔl.
• Stay away frɔm tabak prodakt dɛn kpatakpata.
• Kɔntrol yu strɛs.

Ustɛm a fɔ go to di dɔktɔ?

If yu gɛt dis sik, yu fɔ go to yu dɔktɔ bɔku tɛm insay di ia fɔ wach yu sik. We yu de du dɛn visit ya, yu dɔktɔ kin chɛk fɔ:

• Di mɛrɛsin we yu de tek de wok fayn?
• If yu gɛt divays we dɛn dɔn instɔl, yu tink se i de wok fayn?
• Aw yu kin wɛl afta dɛn dɔn du yu ɔpreshɔn ɔ ɔpreshɔn?

Insay dɛn dɔktɔ apɔntinmɛnt ya, if yu gɛt ɛni wan pan dɛn tin ya, tɛl yu dɔktɔ wantɛm wantɛm:

• If yu sik dɛn de wɔs.
• If yu gɛt nyu sik wae yu nɔr bin gɛt bifo.
• If yu fil se yu divays nɔ de wok fayn.
• If yu de gɛt sayd ɛfɛkt frɔm di mɛrɛsin we yu de tek.

Ustɛm yu fɔ go na ɔspitul wantɛm wantɛm? (ETU) .

If yu gɛt dɛn sik ya, yu fɔ go na imejensi rum wantɛm wantɛm :

• If i nɔ izi fɔ yu fɔ blo wantɛm wantɛm.
• If yu gɛt siriɔs pen na yu chɛst.
• If yu lɔs kɔnshɛns ɛn fɔdɔm.

Us kwɛstyɔn dɛn yu fɔ aks di dɔktɔ?

Na nɔmal tin fɔ fil smɔl frayd ɛn wɔri we yu kam fɔ no se yu gɛt `(Ischemic Cardiomyopathy)`. Bɔt i rili impɔtant fɔ tɔk to yu dɔktɔ ɛn ɔndastand yu sik klia wan. Yu kin aks kwɛstyɔn dɛn lɛk dɛn wan ya:

• Aw bɔku damej dɔn apin to mi at?
• Us tritmɛnt we bɛtɛ fɔ mi?
• Sɔpɔt grup dɛn de we go ɛp mi?
• Aw a fɔ tek tɛm wit it ɛn drink?
• Us ɛgzampul dɛn a kin du ɛn a nɔ kin du?

Nɔ fred fɔ aks di dɔktɔ bɔt ɛnitin we yu nɔ ɔndastand. I go ɛp yu.

Fɔ dɔn, tin dɛn fɔ mɛmba...

Ischemic Cardiomyopathy na siriɔs sik, bɔt dɛn kin kɔntrol am. Fɔ no am kwik kwik wan ɛn fɔ trit am fayn na di tin dɛn we impɔtant pas ɔl. Simpul chenj na yu layf kin mek big difrɛns. Fɔ fala yu dɔktɔ in instrɔkshɔn dɛn, tek yu mɛrɛsin dɛn di rayt tɛm, ɛn go fɔ chɛk-ap. Nɔto yu wan de, ɛn dɔktɔ dɛn ɛn pipul dɛn we yu lɛk de fɔ ɛp yu. So fes dis tin wit maynd.

` Ischemic Cardiomyopathy, Ischemic Cardiomyopathy, hat sik, korona at sik, hat atak, at mɔsul wik, at atak simptom dɛm