I thinlunga thisen kalna kawng pawimawh tak hi i hria em? (Left Anterior Descending Artery) Kan sawi dun dawn nia!

`(Left Anterior Descending Artery)` emaw `(LAD artery)` emaw tih hi i hre tawh em? I doctor-in a sawi tawh emaw, khawi emaw laiah i chhiar tawh pawh a ni thei. Hei hi kan thinlung tan thisen kalna kawng pawimawh tak a ni. A nihna takah chuan kan thinlung nunna ang a ni. Chuvangin, vawiinah hian he `(LAD artery)` chungchang te, a thil tih te, harsatna a thlen theih dan te, i hriatthiam theih tur awlsam taka kan enkawl theih dan te kan sawi dawn a ni.

Hei hi eng nge ni `(Left Anterior Descending Artery)`? Thinlung map ang mai a ni!

A awlsam zawngin, i `(Left Anterior Descending Artery)` emaw, a tawi zawngin `(LAD)` ti ila, i thinlung veilam sir a `(left main coronary artery)` branch pahnih zinga pakhat a ni. ``Anterior'' tih thumal hi ``hma lam'' tihna a ni.He thisen kalna kawng hian i thinlung hmalam ah thisen a pe ber tihna a ni. Ngaihtuah teh, i thinlung veilam hnuai lam a pumping chamber lian ber, `(ventricle),'' hi he `(LAD) atanga thisen oxygen tam ber dawngtu hi a ni. Chu mai pawh ni lovin, thinlung bang hrang hrang then darhtu muscle tissue a awm a, chu chu `( Septum ),'' kan ti a, hei `(LAD)` hian thisen a pe bawk.

A châng chuan doctor-te chuan he thisen kalna hi ``anterior interventricular branch`` an ti bawk.`` A hming hi a buaithlak deuhin a lang thei a, mahse a hna chu a awlsam hle – thisen chu thinlung thlenga phurh chhuah a ni!

Mahse hei hi hriat tur pakhat a awm: He `(LAD)` artery hi a block vek chuan heart attack a thlen thei. Hei hi `(widowmaker heart attack )` an ti fo thin. He hming hriat hi a hlauhawm deuh thei a, a chhan chu he heart attack chi hi a thihpui fo thei a ni. Chuvang chuan he `(LAD)` hi kan fimkhur em em a ngai a ni.

`(LAD)` hi eng nge thleng tak tak? Thinlung supplier ber a ni!

Kan sawi tawh ang khan LAD hi i thinlunga coronary artery lian ber a ni. Hengte hi thinlunga thisen kalna kawng chi khat bik, kan taksa pum puia thisen phurtu, thisen kalna kawng (circulatory system) zinga mi an ni. I ngaihtuah thei em, i thinlung mamawh thisen chanve vel chu he LAD hmang hian a kal chhuak thin! Chu chu thinlung hrisel taka hnathawhna atan a pawimawh tihna a ni.

Khawiah nge he `(LAD)` hi a awm?

I thinlung veilam sir main coronary artery chu branch hnih ah a inthen kan ti a. Chu branch pahnih chu Left Anterior Descending Artery leh Circumflex Artery te an ni. Kawngpui chu pahnih a inthen ang bawkin he main artery pawh hi hetah hian hmun hnih ah a inthen bawk. Doctor-te pawhin hei hi bifurcation an ti bawk. He LAD artery hi i thinlung pawn lam, epicardium-a protective membrane chhungah a awm a. Thinlung septum-ah a kal a, canal te tak te ang maiin, thinlung bul atanga thinlung apex thlengin a kal a ni.

`(LAD)` ah hian eng branch te nge awm?

He `(LAD)` duct hi branch tenau zawk pahnih ah a inthen a:

• Diagonal branches: Heng branch te hian ventricle hmalam leh hnuai lamah thisen an pe a, chu chu thinlung veilam hnuai lam a awm a ni.
• (Septal branches): Heng branch te hian thinlung septum hmalam hmun thuma ṭhena hmun hnih-ah thisen an pe a.

Heng branch hrang hrangte hian thinlung hmun hrang hrangin thisen supply tling an dawn theih nan mawhphurhna an nei a ni.

"Left-dominant circulation" tih hi eng nge ni?

Hei hi thupui thuk deuh a ni a, mahse awlsam taka hriatthiam tum ila. Artery dang pakhat ``posterior descending artery (PDA)`` tih a awm a, chu chuan thisen chu i thinlung hnuai lam leh hnunglam leh ``septum`` hmun thenkhatah a phur a ni.

• Right-dominant circulation : Mi sawm i lak chuan an zinga pariat vel chu dinglam sir main coronary artery atanga thisen lo chhuak an ni.
• Left-dominant circulation: Mahse, mi sawm zinga pakhat velin he PDA hian left main coronary artery branch pakhat (LAD emaw circumflex artery emaw) atanga thisen a dawng thin.
• Codominant circulation: Mi sawm zinga pahnih vel ah chuan PDA hi LAD emaw circumflex artery emaw atanga supply a ni a, chubakah right coronary artery atanga supply a ni bawk.

Hei hi mi tin a inang lo thei. Thinlung dinhmun pangngai mai a ni.

`(LAD)` tichhe thei damdawi lam dinhmunte chu engte nge ni?

Hei hi kan ngaih pawimawh ber a ngai a ni. He LAD chhungah hian thau deposit, plaque kan tih chu a lo awm thei a ni. Hetiang dinhmun hi atherosclerosis an ti a . Tui pipe-a rust lo awm ang mai a ni. Mi thenkhatah chuan he plaque hi a lo pung nasa lutuk a, LAD chu a block vek thin. Chuti a nih chuan eng nge thleng? Oxygen tamna thisen hian thinlung a thleng thei lo. Chutah chuan a hmaa kan sawi tawh widowmaker heart attack kan nei a, chu chu thihna thlentu a ni fo. Hmeithai tih thumal hi mipa tan chauh hman ni mah se, he thinlung natna hian hmeichhia leh mipa a nghawng thei a ni.

Ngaihtuah teh, Nishantha hi kum 50 vel a ni tawh. A thau lutuk deuh a, zunthlum a vei bawk. Ni khat chu rang takin a rilru na tak nen a thawk a chhuak ta a. Damdawi in lama hruai nghal a nih chuan `(widowmaker heart attack)` a vei tih hmuhchhuah a ni. Vanneihthlak takin a damchhuak a, a chhan chu enkawl vat a nih vang a ni. Hei hian hei hi a hmanhmawhthlak zia a tilang chiang hle.

Tin, mi tlemte takah chuan LAD artery hi pian tirh lamah a zim deuh emaw, a tawi deuh emaw pawh a ni thei bawk. Hetiang dinhmun hi hypoplastic left anterior descending artery an ti a. Hei hian risk thenkhat a tipung bawk:

• Heartbeat mumal lo `(Arrhythmia a awm a ) .
• Lung natna
• Myocardial ischemia a awm thin
• Cardiac thihna rapthlak tak

LAD-a blockage awm hian eng symptoms nge a neih?

LAD chu a tawi emaw, a block emaw chuan i rilru natna (angina) i nei thei . Hei hi stable angina emaw unstable angina emaw a ni thei. Heart attack hi medical emergency a ni a , enkawl vat a ngai a ni . Heng symptoms te hi i neih chuan 911 (Sri Lanka rama emergency number 1990) ah call nghal rawh:

• Chhuak na emaw, tightness emaw (Angina) .
• Khua a vawt leh thawk hah
• Luak chhuak, lu chhunga inher chhuak ang maia awm
• Chauhna leh chak lohna
• Lung na tak tak
• Luhai
• Thâwk harsa
• A kekawrte emaw, kutphah emaw (a bik takin kut veilam) natna .

Heng symptoms pakhat emaw a aia tam emaw i neih chuan ngaihthah ngai suh.

Engtin nge doctor ten i `(LAD)` hriselna an enfiah thin?

Doctor-te chuan hetiang test hi hmangin i coronary arteries, a bik takin LAD dinhmun an enfiah thin:

• Cardiac catheterization: Hei hian coronary artery disease a awm leh awm loh a enfiah thin .
• Coronary computed tomography angiogram (CCTA): Hei hian thinlung chhunga thisen kal dan chu three-dimensional (3D) image a siam thei a ni.
• Intravascular optical coherence tomography (IVOCT) emaw intravascular ultrasound (IVUS): Heng hmanrua te hian artery chhung atang hian thlalak chiang tak tak, resolution sang tak a la thei a ni.
• Fractional flow reserve (FFR): Hei hian artery chhunga thisen pressure a teh a, hei hian blockage a nasat dan hriat theihna a pui thei a ni.

Heng test te hian i LAD ah hian blockage emaw narrowing emaw a awm leh awm loh dik takin a hriat theih a ni.

`(LAD)` nghawng thei dinhmunte hi engtin nge enkawl an nih?

LAD blocked hawn tur chuan cardiac catheterization i neih a ngai mai thei a, chubakah angioplasty leh stent dahna ang chi procedure te pawh i nei thei bawk .

• Angioplasty hi thisen kalna kawng (artery) chhungah balloon te tak te dahin, a block-na hmun hawn nan inflate-in, thisen kalna (artery) chu a zau zawka tihzauh a ni.
• Stent hi wire mesh tube te tak te a ni a, angioplasty hnuah artery a zim leh tawh loh nan a pui thin.

Heng enkawlnate hian thinlungah thisen a kal leh thei a, heart attack hlauhawmna a ti tlem thei bawk.

Engtin nge ka LAD artery hi ka humhim theih ang? Thinlung hrisel neihna kawng!

I circulatory system, i (LAD) telin, hrisel taka awm theih nan thil tam tak i tih theih a ni. Hengte hi a pawimawh ber berte chu:

• Lung hrisel ei rawh: Hei hian cholesterol level a tihniam thei a ni. Ei tur hriak, chi, leh sugar tlem, leh thei leh thlai tamna ei hi a tha.
• Zu in tlem zawk rawh: Zu ruih hmang i nih chuan tanpuina la rawh.
• Exercise la, taksa rihna hrisel tak vawng reng rawh: Ni khata minute 30 tal kea kal pawh hi thil ropui tak a ni.
• I thau chi hrang hrangte hre reng ang che: Thau hrisel lo (saturated leh trans fats) tihtlem.
• Zunthlum leh thisen sang control nan hma la rawh: Chi ei tlem hian hei hi a pui bawk.
• Meizial zu bânsan tûrin ṭanpuina dîl rawh: Meizial zuk hi thinlung hmêlma lian ber pakhat a ni.

Heng thilte i tih hian i `(LAD)` chauh ni lovin, i thinlung leh taksa pumpui hrisel takin i vawng thei a ni.

A tawp berah chuan hriat reng tur (Take-Home Message) .

Tunah chuan `(Left Anterior Descending Artery)` hi kan thinlung hriselna atana pawimawh tak thisen kalna kawng a ni tih i hre tawh mai thei. Hei hi blockage chuan thihna thlen thei dinhmun a thlen thei a, a bik takin `(widowmaker heart attack)` a thlen thei. Hei hi a chhan chu hei hi thinlung veilam atanga thisen tam ber petu main artery a nih vang a ni. He `(LAD)` artery `(plaque)` hi a pungkhawm a, `(atherosclerosis)` a lo awm theihna chance a sang hle a, chu chuan coronary artery disease a thlen thei a ni. Chutiang a nih chuan `(angioplasty)` leh `(stent)` ang chi enkawlna i neih a ngai dawn a, chu chuan thisen kalna kawng hawn a, heart attack hlauhawmna a tihziaawm ang. Mahse a tha ber chu chutiang dinhmun a lo thlen hmaa ven hi a ni. Doctor nena inbia a, i nunphung leh ei leh in lama a tul anga tihdanglamna hmang hian i thinlung, chu chu i `(LAD)` chu hrisel leh hlim takin i vawng thei a ni. I thinlungin lawmthu a sawi ang che!