Kei te āhua kuiti te rere o tō toto? Me kōrero tātou mō te ngoikore o te uaua!

Ka mamae ō waewae i ētahi wā ina hikoi koe? Ka pōuri rānei koe, ka ngoikore rānei i ētahi wāhi? Kaua e whakaaro he mea tūpono noa iho ēnei. He tohu pea tēnei kei te ngoikore te rere o te toto i roto i tō tinana. I tēnei rā ka kōrero tātou mō tētahi kaupapa nui anō hoki. Ko te hekenga o te rere o te toto i roto i ngā uaua, e kiia nei e ngā tākuta, ko te `(Arterial Insufficiency)`.

He aha te ngoikore o ngā uaua?

I te whakarapopototanga, koinei te wā e heke ai te nui o te toto e rere ana i roto i tētahi, i ētahi rānei o ngā uaua o roto i tō tātou tinana. He rite ngā uaua ki tētahi pūnaha ngongo e kawe ana i te toto whai rawa i te hāora puta noa i tō tātou tinana mai i te ngākau ki ngā whekau me ngā kiko katoa. Nō reira, he aha te mea ka puta mēnā ka āraia, ka whaiti rānei ēnei ngongo? Koinei te wā e heke ai te rere o te toto. Ko te take matua mō tēnei ko te kohikohinga ngako i roto i ngā pakitara o te uaua, he āhuatanga e kiia nei ko te "Atherosclerosis".

Me whiwhi toto whai hāora ngā wāhanga katoa o tō tātou tinana kia mahi ai. Nō reira, ki te kore e taea e ngā uaua te tuku toto tika, e kore e taea e ō tātou whekau me ō tātou kiko te mahi tika. Ka arahi pea tēnei ki ngā raruraru nui .

E rua ngā huarahi matua e pā ai tēnei āhuatanga (Te ngoikore o te uaua):

1. Te ngoikore o ngā uaua toto: Koinei te wā ka heke ohorere te rere o te toto , ka mutu katoa rānei nā tetahi take (he maha ngā wā he toto totoka). He āhuatanga tēnei e hiahia ana kia rongoatia wawetia.

2. Te ngoikore o ngā uaua toto: He āhuatanga tēnei e heke haere ana te rere o te toto nā te mate hauora o mua (ko te atherosclerosis kua whakahuatia ake nei). I roto i te wā, ka kino haere ngā tohu, ā, ka piki ake te tūponotanga o ngā raruraru.

Ko te mea nui, ki te kitea wawetia tēnei mate, ā, ka rongoatia tika, ka tino whakaitihia te mōrearea o ngā raruraru nui.

He aha te pānga o tēnei āhuatanga ki ō tātou tinana?

Ka whakaitihia te rere o te toto i roto i ngā uaua toto, ā, ka heke te rere o te toto ki ngā wāhanga rerekē o te tinana, inā koa ko ngā whekau me ngā peka nui. Ko te pānga o tēnei ki te tinana, kei te uaua toto toto kua whaiti, kua āraia rānei .

Whakaarohia pēnei:

• Ki te whaiti ngā uaua o tō kaki (ngā uaua carotid, ngā uaua vertebral rānei) , hei tauira i roto i te āhuatanga e kiia nei ko te mate uaua carotid, ka pā ki tō roro .
• Ka pā pea tētahi raruraru ki te aorta , pērā i te aneurysm aortic abdominal, ki tō uma, ki tō tuara, me tō puku .
• Mena he aukati kei roto i ngā uaua o te ngakau e tuku toto ana ki te ngākau , he āhuatanga e kiia nei ko te mate uaua o te ngakau, ka pā tika tonu ki tō ngākau .
• Mena he raruraru kei te uaua e tuku toto ana ki te whekau iti (te "Superior mesenteric artery") , he āhuatanga pēnei i te "Mesenteric artery stenosis", ka pā ki te mahi a tō whekau iti .
• Mena he raruraru kei ngā uaua e tuku toto ana ki ngā whatukuhu (ngā uaua tākihi) , he āhuatanga e kiia nei ko te mate uaua tākihi, ka pā ki ō whatukuhu .
• Ka pā pea ngā aukati i roto i ngā uaua o ō waewae , pērā i te mate uaua o te taha (PAD), ki ō waewae .
• Ka pā pea ki ō pukahukahu te mate e kiia nei ko te pulmonary embolism, he toto totoka e aukati ana i ngā uaua toto i roto i ō pukahukahu .

Engari he mea nui anō hoki kia maumahara ko te whakahekenga o te rere o te toto i roto i ngā uaua ka pā kino ki ngā wāhanga katoa o te tinana. Tērā pea ka kite koe i ngā tohu i te wāhanga o te tinana e tata ana ki te uaua tino ārai. Heoi anō, ko ngā mea e whaiti ai ngā uaua i reira (pērā i te atherosclerosis) ka pā anō hoki ki ngā uaua i ētahi atu wāhi o te tinana. Hei tauira, ki te mea he whakahekenga tonu tō rere o te toto nā te atherosclerosis i roto i te uaua i tō waewae, kei te tūpono koe ki te pāngia e te mea kotahi i roto i tō ngākau.

Me whai hāora ia wāhanga o te tinana kia ora ai. Mēnā ka ngaro ohorere te hāora i tētahi okana, i tētahi kiko rānei, ka pakaru taua okana i roto i ngā hāora, i roto i te take o te 'Acute arterial insufficiency'. Ka taea e tēnei te arahi ki ngā āhuatanga ohorere e morearea ai te ora nā te hekenga o te rere o te toto i roto i ngā uaua:

• Te ischemia tino nui o ngā peka: Te aukati i te rere o te toto ki ngā ringa , ngā waewae, ngā waewae rānei.
• Te whakaeke ngakau: Te aukati i te rere o te toto ki te ngakau.
• Te embolism pūkahukahu: Te aukati i te rere o te toto ki ngā pūkahukahu.
• Te whiu: Te aukati i te rere o te toto ki te roro.

Ka mate pea tēnei mate mēnā kāore e rongoatia tika, koia te mea nui kia mōhio koe ki ōna tohu me te kōrero ki tō tākuta mō ō mōrearea.

He aha te rerekētanga i waenga i te ngaronga o te toto uaua me te ngaronga o te toto uaua?

He take e pā ana ēnei e rua ki te tohanga toto, engari he rerekētanga paku noa iho.

Ko te ngoikore o te uaua he raruraru o te rere o te toto i roto i ngā uaua. Ko te ngoikore o te uaua he raruraru o te rere o te toto i roto i ngā uaua (ngā oko toto e kawe ana i te toto poke ki te ngākau).

Hei whakarāpopototanga:

• Ko ngā uaua te mea e kawe ana i te toto ma, whai kiko i te hāora mai i te ngākau puta noa i te tinana.
• Ko ngā uaua te mea e whakahoki ana i te toto poke, kua pau te hāora ki te ngākau.

He rerekē ngā take o ngā āhuatanga e rua. Ko te tino take o te hekenga o te rere o te toto i roto i ngā uaua ko te kohikohinga o te ngako i roto i ngā pakitara o te uaua (atherosclerosis). Ko te hekenga o te rere o te toto i roto i ngā uaua ka puta mai i te kino o ngā uaua i ngā waewae.

Ka pā te ngoikore o te uaua ki tētahi uaua i ngā wāhi katoa o te tinana, engari ko te mate e kīia nei ko te ngoikore o te uaua ka pā nui ki ngā waewae.

Ka taea e ēnei āhuatanga e rua te whakararu i ngā waewae me te mamae. Mena kei te mamae tonu ō waewae, kei te taumaha, kei te pupuhi, kei te ngenge rānei, me toro atu ki te tākuta hei matapaki i ēnei tohu.

He aha ngā tohu o tēnei?

Kāore pea ētahi tāngata e pāngia e ngā tohu tae noa ki te kino rawa o te mate, tae noa ki te puta mai o tētahi āhuatanga ohorere. Heoi anō, ka pāngia pea ētahi tāngata e ngā tohu pēnei i:

• Whatiwhati: He āhua o te ngaro o te taurite.
• Te mamae o te waewae i te wā e hikoi ana koe, ā, ka memeha haere i te wā e okioki ana koe. Koinei te wā e pāngia ai koe e te mamae o tō waewae i a koe e mahi ana i tētahi mahi, inā koa ko te hikoi, ā, ka memeha haere te mamae i muri i te okiokinga poto.
• Mamae o ngā waewae, o ngā matimati rānei: He kare ā-roto e wera ana, e mamae ana hoki o ngā waewae, o ngā matimati rānei, ahakoa e okioki ana.
• Ngā panonitanga o te tae me te kakano o te kiri: He kiri unahi o ngā waewae me ngā waewae, he mākūkū, me ngā panonitanga o te tae o te kiri.
• Mamae puku: He mamae puku ka tīmata i muri i te 15-20 meneti i te kai, ka roa mō ētahi haora, kātahi ka memeha.
• Ngā mate pukupuku: He mate pukupuku kāore e ora i ngā waewae me ngā kapu waewae (ina koa ko ngā pona). He tohu ēnei o te koretake o te rere o te toto.
• Te whakahekenga taumaha: Te whakahekenga taumaha ohorere, kāore i te whakamaheretia.

Tērā pea kua whaiti, kua ārai rānei ō uaua toto i ngā wāhi maha o tō tinana. Hei tauira, ko te hunga e pāngia ana e te mate uaua toto peripheral (PAD) i roto i ngā waewae ka nui ake te tūponotanga ki te pāngia e te mate uaua coronary (CAD). Nō reira, tērā pea he huinga tohu kei a koe e pā ana ki ia raruraru. Koia te mea nui kia kōrero ki tō tākuta i te wā tonu ka kite koe i te tohu iti noa iho.

Ngā tohu o tētahi āhuatanga ohorere - kaua e warewarehia ēnei!

Mena kei a koe ētahi o ngā tohu e whai ake nei, waea atu ki te 911 (1990 i Sri Lanka) me haere rānei ki te hōhipera tata tonu atu. Tērā pea he tohu ēnei mō tētahi āhuatanga ohorere hauora:

• Te mamae o te uma, te kikī rānei.
• Te āhua nei kei te kite koe i ngā taha e rua, kei te ngaro rānei tō tirohanga.
• Te hemo.
• Te mate o ngā kiko (‘Gangrene`) (te mangu o te kiri, te haunga kino).
• He kiri mā, he werawera makariri, he kiri kikorangi rānei.
• Te pikinga ohorere o te tere o te pā o te manawa.
• Kōrero pōturi.
• Te mamae ohorere, te mamae nui i te uma, te ringa, te pakihiwi, te kaki, te kauae rānei.
• Te uaua ohorere ki te manawa, kāore he take.
• Te mamae ohorere, te kore whakamarie rānei i ngā pakihiwi, te kaki, te puku, me/ranei te tuara, kāore he take e kitea ana.

Mēnā kei te pāngia koe e ētahi tohu, tērā pea kāore e taea e koe te waea atu. Nō reira, ki te taea, me pupuri tonu he 'pūrere whakatūpato hauora' (pēnei i te hei whakakai). Me kōrero hoki ki tō whānau me ō hoa mō ēnei tohu. Kia taea ai e rātou te waea atu ki te 1990 ina kite wawe rātou.

He aha tēnei e tupu nei? He aha ngā take?

Ko ngā take matua e rua mō te heke o te rere o te toto i roto i ngā uaua:

• Atherosclerosis: Ngā putunga ngako i roto i ngā pakitara o te uaua (atherosclerosis): Ka pupū ake ngā putunga ngako, pērā i te cholesterol, i roto i te uaua, ka whaiti, ka ārai katoa rānei.
• Thrombosis: Ka puta he toto totoka i roto i te uaua, ka aukati i te rere o te toto.

Me pēhea te tautuhi i tēnei?

Ka tātaritatia tēnei mate e ngā tākuta mā te pātai atu ki a koe mō ō tohumate, te tango i tō hītori hauora, me te tirotiro tinana. Ka pātai atu tō tākuta ki a koe i ngā pātai maha hei ako i ngā mea katoa e taea ana mō tō mate. Hei tauira:

• He aha ō tohumate?
• Kia pēhea te roa o te kitea o ēnei tohu?
• Kei hea koe e rongo ana i te mamae?
• Ka puta mai, ka ngaro atu rānei ngā tohu? Mena koinā, āhea rātou ka puta mai ai?
• He aha ngā mea ka taea e koe te mahi hei whakaiti i ngā tohu?

Ka kōrero anō te tākuta ki a koe mō:

• Tō hītori hauora o mua.
• Ngā mate e pā ana ki tō whānau (e pā ana ki ngā ira).
• Ētahi atu āhuatanga hauora kei a koe i tēnei wā.
• Ngā rongoā e whakamahia ana e koe.

I te wā o te whakamātautau tinana, ka taea e te tākuta te mahi i ēnei e whai ake nei:

• Ka mea atu rātou kia menemene koe kia kite ai mēnā kei te piko tetahi taha o tō mata.
• Ka tirohia ngā pātaki i ētahi wāhi o te tinana (pērā i te uma, te ringaringa, me te pona).
• Ka tangohia he tauira toto hei tirotiro mō ngā taumata rerekē e pā ana ki ngā mate uaua.
• Ka tirohia ō kanohi me tō tirohanga.
• Tirohia mēnā he huringa kei te tae, kei te kakano rānei o tō kiri.
• Tirohia mēnā he mate kiri.
• Ka inehia te toto toto i ngā ringa e rua.

He nui ngā mea ka taea e tēnei whakamātautau te whakamōhio atu ki tō tākuta. Heoi anō, ka whakahaerehia pea e rātou ētahi whakamātautau motuhake hei ako atu mō ō uaua.

Ngā whakamātautau anō

Anei ētahi whakamātautau hei āwhina i te kite i te hekenga o te rere o te toto i roto i ngā uaua i ngā wāhanga rerekē o te tinana:

• Taupū pona-puku (ABI): Ka whakataurite tēnei i te toto i ngā waewae o raro ki te toto i te ringa. Ka taea e tēnei te whakaatu i te pai o te rere o te toto i roto i ngā uaua o ngā waewae.
• CT Angiogram ('Computed tomography angiogram - CTA'): Ka tango pikitia 3D o ngā uaua e tuku toto ana ki te ngākau (ngā uaua coronary), ngā ringa, ngā waewae, ngā whekau rānei hei āwhina i te kimi i ngā ārai.
• Echocardiogram (`Echocardiogram - echo`): Ka whakamahi i ngā ngaru oro hei tirotiro i te mahi a te ngākau.
• E.C.G. (`Electrocardiogram - ECG/EKG`): Ka tuhi i ngā mahi hiko o te ngākau. Ka taea te kite i ngā raruraru o te rere o te toto me te pā o te ngakau kāore i te tika.
• Te tuhi i te rōrahi o te manawa: Ka ine i ngā panoni o te rōrahi toto i roto i ngā waewae. Ka taea te kite i ngā aukati.
• Te tirotiro oro-ā-uaua: Ka whakamahia ngā ngaru oro hei tango pikitia o ō uaua (tae atu ki ērā i roto i tō kaki) hei rapu i ngā ārai.

He aha ngā maimoatanga?

Ko te maimoatanga e whakawhirinaki ana ki te take me te kaha o te mate. Kōrero ki tō tākuta mō te maimoatanga pai rawa atu māu. Ko ētahi o ngā kōwhiringa maimoatanga ko:

• Atherectomy (pokanga hei tango i te paraka mai i ngā uaua).
• Te pokanga hei tango i ngā ārai i roto i ngā uaua o te kaki ('Carotid endarterectomy').
• Te tārai i te uaua koronari ('Coronary angioplasty').
• Te tārai i te uaua koronari (CABG).
• Ngā huringa āhua noho: te whakakori tinana, te kai hauora.
• Ngā rongoā: Whakahaere i te toto toto, te cholesterol, me ngā taumata huka toto.
• Ngā rongoā hei whakaiti i te mōrearea o te toto totoka (Ngā rongoā ārai toto).
• Ngā ngongo mata iti ('Stent') e whakamahia ana hei pupuri i ngā uaua kia tuwhera.

Ko wai kei te nui ake te mōrearea ki te pāngia e tēnei? (Ngā Take Mōrearea)

Ka pāngia te tangata e te 'koretake o te uaua'. Engari he nui ake te mōrearea o ētahi tāngata. Mena kei a koe tētahi o ēnei āhuatanga, he nui ake anō hoki tō mōrearea:

• Te pā o te manawa kāore i te tika ('Atrial fibrillation').
• Mate huka (‘Diabetes Mellitus’).
• Te nui o te cholesterol i roto i te toto (hyperlipidemia).
• Te toto toto tiketike (hypertension).
• Te korenga o te pūmua C.
• Te korenga o te pūmua S.
• Ngā āhuatanga e tere ai te toto te toto ('Thrombophilia').
• Ngā toto toto e pā ana ki te mate pukupuku ('Trousseau syndrome').

Ētahi atu āhuatanga mōrearea:

• Neke atu i te 60 tau te pakeke.
• Te haputanga.
• Te momi hikareti me te whakamahi tupeka.
• Te whakamahi i ngā pire ārai whānau kei roto ko te estrogen.

Me pēhea te tiaki i a koe mai i tēnei? (Ārai)

Mā te whakarerekē i te āhua o te noho ka āwhina nui ki te whakaiti i tēnei mōrearea. Anei ētahi mea ka taea e koe te mahi:

• Whakakorikori tinana i ia rā. Ngāna kia hikoi mō te 30 meneti pea i te rā, e rima ngā rā o te wiki. Me kōrero ki tō tākuta i mua i te tīmatanga o tētahi mahi whakakorikori tinana hou.
• Kati rawa te momi hikareti me te whakamahi tupeka. Kei roto i tēnei ko te hikareti hiko me te ngaungau tupeka.
• Whāia he kai hauora mō te ngākau.
• Whakawhāitihia te inu waipiro. Mō ngā tāne, kaua e neke atu i te rua inu i te rā. Mō ngā wāhine, kaua e neke atu i te kotahi inu i te rā.
• Whakahaerehia tō taumaha. Pātai atu ki tō tākuta he aha te taumaha hauora mōu.
• Tangohia te rongoā kua tohua i te wā tika.
• Me tirotiro hauora i te iti rawa kotahi i te tau.

Me pēhea te noho me tēnei āhuatanga?

I te wā e noho ana me te ngoikore o ngā uaua, kia maumahara ki ēnei mea:

• Hangaia he mahere whakakori tinana. Kāore e rite te katoa. Kōwhiria he whakakori tinana e pai ana ki a koe. Ka taea te kanikani, te reti retihuka, te hikoi i te pāka. Kimihia hoki he huarahi hei tāpiri i ētahi atu mahi ki tō mahinga o ia rā. Pātai atu ki tō tākuta he aha ngā whakakori tinana e haumaru ana māu.
• Tirohia ngā kōwhiringa kai hauora. Tirohia ngā mea pēnei i te kai Mediterranean me te kai DASH.
• Kia ma tō kiri. He mea nui tēnei mēnā he PAD tōu, he neuropathy e pā ana ki te mate huka, he neuropathy ā-taha rānei. Horoia ō waewae me ō waewae i ia rā, ka pania he hinu whakamākū. Tirohia mēnā he rerekē te tae o te kiri, he pakaru, he mate pukupuku rānei.
• Kati te momi hikareti me te whakamahi tupeka. Pātai atu ki tō tākuta mō te āwhina.
• Me mau ngā hū whakamarie. Me tautoko ngā hū, ā, me tau pai hoki.

Hei whakamutunga, ngā mea hei maumahara

Puritia ō wā whakarite me ngā tirotirohanga katoa a tō tākuta. Mā tō tākuta koe e kī atu ki te auau o tō hokinga mai.

Waihoki, ki te kite koe i ētahi tohu hou, i ētahi huringa rānei o ō tohu, waea atu ki tō tākuta tonu. He mea āwhina hoki te tā i tētahi rārangi o ō tohu, me te pupuri tonu i aua tohu. He ngāwari te ngaro i tētahi tohu i roto i te pukumahi o te ao o ia rā, te whakaaro rānei, "He aha tēnei?" Nō reira, kia tūpato ki ngā mea me tūpato koe. Tohaina ēnei mōhiohio ki ō whanaunga.

Ina kitea e koe he 'Arterial insufficiency' tōu, tera pea koe e whakaaro, "Me pēhea taku whakatika i tēnei?" Koinei te mea tuatahi ka whakaarohia e tātou ina mate tātou. Tērā pea koe e hiahia ana kia hoki whakamuri te wā, kia rerekē ai te mahi i ngā mea. Engari ehara tēnei i te wā hei titiro whakamuri, engari hei titiro whakamua.

Arotahi ki tāu e whai nei ināianei. He aha ngā huringa ka taea e koe te mahi tonu? He aha ngā mea tino nui? Tikina he aratohu mai i tō tākuta mō ngā huringa āhua noho me ngā maimoatanga. Ko te mea nui, kāore koe e hiahia ki te haere ko koe anake i tēnei haerenga. Kei konei tō tākuta me tō rōpū hauora katoa hei āwhina i a koe ki te whakapai ake i te hauora o ō uaua.

` Te aukati i te uaua toto, te heke o te rere o te toto, te mate ngakau, ngā uaua toto, te hauora, te whiu, te cholesterol