I ētahi wā i roto i ō tātou oranga, ka puta te mea kāore i whakaarohia, tika? Ina koa mō tō tātou hauora tinana, tera ētahi āhuatanga hauora kāore pea tātou i rongo. Engari he mea tino nui kia mōhio ki ēnei āhuatanga. I tēnei rā ka kōrero tātou mō tētahi āhuatanga ngākau he āhua rerekē, engari ka pā ki ētahi tāngata. Ko te ingoa o tēnei ko (Myocardial Bridge). Kāore pea koe i rongo mō tēnei ingoa, engari ka kōrerohia e tātou mōna i roto i te huarahi māmā noa iho, i roto i te huarahi e mārama ai koe.
He aha tēnei piriti myocardial?
I te whakarapopototanga, he uaua toto kei roto i tō ngākau e tuku toto ana, e kiia nei e tātou ko ngā uaua coronary . Kei runga ake i te uaua ngākau ēnei uaua. Arā, ka haere rātou i runga i te mata o te ngākau. Heoi, i roto i tēnei āhuatanga e kiia nei ko te (Myocardial Bridge), ko te mea ka tupu ko te kore e haere i runga i te uaua ngākau, engari ka haere tetahi wāhanga o tēnei uaua coronary i roto i tō ngākau ki raro i te uaua. He rite ki te kauhanga iti, ki te haere rānei i raro i te piriti. Koinei te ingoa o ngā tākuta ko te wāhanga o te uaua ngākau e noho ana i runga ake i taua uaua toto (Myocardial Bridge).
Whakaarohia, i ētahi wā, ina pā te manawa, arā, ina kōpiri te uaua o te manawa, ka pēhi te piriti uaua i runga ake i te uaua toto i raro. He rite ki te takahia e te tangata he paipa wai, ka pōturi te rere o te wai. He aha te mea ka tupu mēnā ka pēhia pērā? Ka ārai pea taua pēhanga i te rere o te toto. Kātahi ka kore pea te uaua o te manawa e whiwhi i te toto whai hāora e hiahiatia ana e ia.
Kei te mōhio koe, ko ngā uaua o te ngākau he awa e mahi ana i tētahi mahi tino nui. Me hiahia ō tātou uaua ngākau, pērā i ngā wāhanga katoa o tō tātou tinana, ki te hāora. Ka kawea mai tēnei hāora ki a tātou e aua uaua o te ngākau. Nō reira, ki te aukatia tēnei rere o te toto, ka puta pea ngā raruraru.
I te nuinga o te wā, ka kitea tēnei āhuatanga (Myocardial Bridge) i te taha maui o te ngākau, te uaua matua e heke ana ki raro (Left Anterior Descending Artery) , e kiia ana rānei e ngā tākuta ko (LAD) . He uaua nui tēnei e tuku toto ana ki te pakitara o mua o te ngākau me ētahi atu wāhanga nui. Heoi, ka taea tēnei āhuatanga te puta i roto i tētahi uaua e kawe toto ana ki te ngākau, ki te nui, ki te iti rānei.
He mea morearea tēnei āhuatanga (Myocardial Bridge)? He pēhea te noa o tōna tūponotanga?
I te nuinga o te wā, kāore he kino nui o te whai piriti uaua. He maha ngā tāngata e noho noa ana me te kore e mōhio kei a rātou tēnei mate, ā, kāore hoki he tohu. Koinei te pono.
Heoi, i ētahi wā, e ai ki te kōrero i mua ake nei, ki te kore e whiwhi hāora te uaua o te ngākau, ka pāngia pea koe e te mamae o te uma e kiia nei ko te angina . Ka puta tēnei i te nuinga o te wā ina tīmata te tere o te patu o tō ngākau, pērā i te wā e whakakorikori tinana ana.
I te pātaitanga mō te whānui o tēnei mate, e kī ana ngā kairangahau he mate noa ake te piriti myocardial engari kāore i te tino kitea i tō whakaaro. Nā te mea he rerekē te ōrau i runga i te tikanga i whakamahia hei kimi. E ai ki ētahi rangahau, i waenga i te 16% me te 30% o te hunga kua kitea tēnei mate mā roto i ngā whakamātautau pēnei i te angiograms, e kī ana kei roto pea tēnei mate i te tini o te tangata. Ko te tikanga he nui ake te tokomaha o te tangata kei a ia i tō whakaaro.
He aha ngā tohu o tēnei?
He tokomaha ngā tāngata he piriti uaua o te ngākau kāore e whakaatu i ngā tohu. Heoi, i a rātou e pakeke haere ana, e pāngia ana rānei e ētahi atu mate hauora (pērā i te toto toto tiketike, te mate huka rānei), ka pāngia pea ētahi tāngata e ngā tohu. I ētahi wā ka roa pea ngā tau ka puta mai ngā tohu.
Ko te tohu matua ko te mamae o te uma ((Angina)) . Ka kitea tēnei i te nuinga o te wā:
- I te wā e whakakorikori tinana ana, e oma ana, e piki arawhata ana rānei
- Ina pāngia koe e te nui o te pēhanga, te manukanuka, te pouri rānei
- I ētahi wā ka puta mai i muri i te kai nui.
He rerekē te whakaahuatanga o tēnei mamae i ia tangata, i ia tangata. Tērā pea ka rongo ētahi me te mea kei te pēhia, kei te pēhia, kei te taumaha rānei.
Tērā pea he rite tonu ētahi atu tohu ki ērā o te mate manawa, nō reira me mōhio anō hoki koe ki ēnei:
- Te poto o te manawa : Te ahua nei he uaua ki te manawa ahakoa he iti noa te kaha o te manawa.
- Te tere o te manawa : Tērā pea ka rite te uma ki te mea e pā ana, e patupatu ana rānei.
- Pōuriuri : Tērā pea ka pōuriuri koe, ka hemo pea koe.
He mea nui: Ki te puta mai ngā tohu e tohu ana kei te pāngia koe e te mate manawa (mamae nui o te uma, te mamae e horapa ana ki raro i tō ringa, te werawera, te ruaki), me haere tonu koe ki te rūma whawhati tata. Kaua e whakaroa.
He aha tēnei (Ariti o te Ngākau) ka puta ai?
He pātai tēnei, he tino māmā te whakautu. He mate whānau te piriti ngākau. Arā, he mea nō te whānautanga mai . Ina whanake te ngākau i roto i te kukune, ka hangaia taua oko toto kia uru ki te uaua. Kāore he take motuhake mōna, ka puta noa mai.
He aha ngā raruraru ka pā mai i tēnei?
Ina hoki, he tino onge ngā raruraru nui mai i te piriti uaua o te ngākau. Heoi, i ētahi wā, ina koa ka honoa ki ētahi atu mate hauora, ka puta pea ēnei mea. Kaua e wehi i ēnei mea, engari kia tūpato ki ēnei:
- Te Ischemia o te Ngākau o te ngākau: E ai ki te kōrero i mua ake nei, ina aukatia te uaua toto, kāore pea e nui te hāora e whiwhi ana te uaua o te ngākau. Koinei te wā ka puta ai ngā āhuatanga pēnei i te mamae o te uma.
- Te Vasospasm o te Koronari: I ētahi wā ka whakawhāiti ohorere, ka tino whakawhāiti hoki ēnei uaua, ka whakararuraru hoki i te rere o te toto.
- Te hanga papaki toto i te taha o te piriti o te uaua ngākau: Kua kitea ka hanga papaki toto ki runga i ngā pakitara o te uaua toto e tata ana ki te piriti, ka nui ake te tūponotanga ka whaiti te uaua toto. Tērā pea nā te rerekētanga o te rere o te toto i roto i te piriti.
- Te Mate Koronari Āwhati: He mate manawa tēnei, he angina kore pumau rānei.
- Ngā Arrhythmias Ventricular: Ka puta pea ngā pāorooro o te ngakau kāore i te tika, ka tīmata i ngā rūma o raro o te ngākau.
- Te Mate Ngākau Pakaru: He ngoikore te ngākau mō te wā poto ka puta i muri i te ahotea nui.
- Te whakaekenga o te ngakau: Ahakoa he onge, ka pā mai te whakaekenga o te ngakau mēnā ka āraia rawatia te rere o te toto.
- Te Matenga ohorere o te Manawa: He tino onge tēnei, engari ka taea.
Kia maumahara he tino onge ēnei raruraru.
Me pēhea te kite a ngā tākuta i te aroaro o tēnei (Myocardial Bridge)?
Tērā pea ka kitea noa iho i te wā e kite ana koe i te tākuta nā te mea he tohu kei a koe, i te wā rānei e whakamātautau ana mō tētahi atu take. Mēnā ka whakapae te tākuta he piriti uaua tōu, ka mahia pea e rātou ēnei whakamātautau e whai ake nei:
- Angiogram coronary: Koinei te whakamātautau tino nui. I tēnei whakamātautau, ka whakauruhia he ngongo iti mā roto i te uaua i roto i tō ringa, i tō waewae rānei, ka arahina ki ngā uaua coronary o tō ngākau. Kātahi ka werohia he tae motuhake ki roto, ā, ka tangohia he whakaahua hihi-X. Mā tēnei ka kitea mārama te whaiti o te uaua.
- Te Whakamātautau Ira-ā-roto (IVUS): I tēnei wā, i te wā kotahi e whakaatuhia ai te angiogram, ka tukuna he taputapu ultrasound iti ki roto i te uaua kia kite ai i te piri o ngā pakitara o roto o te uaua me te piriti.
- Tomography Whārite Ātaahua (OCT): He rite ki te IVUS, he tikanga matatau anō tēnei e whakamahi ana i te mārama hei tiro i roto i te uaua.
- Te Angiogram Tomography Rorohiko Koronari (CT Angiogram): He matawai CT tēnei. Ka whakamahia hoki te tae hei hanga whakaahua toru-ahu o ngā uaua o te ngākau. Ka āwhina tēnei ki te whakatau mēnā he piriti myocardial me tōna roa me tōna hohonu.
Nō reira, he rongoā kei reira mō tēnei? Me pēhea te mahi?
Ae, kei reira ngā maimoatanga mō te hunga e pāngia ana e ngā tohu. Kāore e hiahiatia ana te pokanga mō te katoa. Mā tō tākuta e whakatau ko tēhea maimoatanga te mea pai mōu. Me titiro tātou ki ēnei maimoatanga:
- Ngā Rongoā: Ko ngā rongoā te whiringa tuatahi. Kei roto i ēnei ko ngā (Beta-blockers) me ngā (Calcium Channel Blockers).Ka whakamahia e rātou ngā rongoā e kiia nei ko te "okari". Ka whakahaere ēnei rongoā i te tere o te manawa, ka whakanui ake i te wā e wātea ana te uaua i waenga i ngā pā o te manawa, ā, ka whakaiti i te pēhanga ki runga i te uaua toto. Mō ētahi tāngata, ka hoatu hoki he rongoā e kiia nei ko te (Ivabradine) hei whakakapi.
- Pokanga: Mō te hunga he nui ngā tohu kāore e taea te whakahaere mā te rongoā, mēnā rānei he hohonu, he roa rawa te piriti, ka tūtohutia pea te pokanga.
- Ko tētahi tikanga e kiia ana ko te (Myotomy Pokanga) . Arā, ko te tapahi me te tango i te piriti uaua i runga i te uaua toto mā te pokanga (te wete i te tuanui). Engari ka mahia anake tēnei mēnā he poto, he pāpaku hoki te piriti.
- Ko tētahi atu tikanga e kiia ana ko te Pokanga Ārai Arteri Koronari (CABG) . Ko tēnei ko te karo i te wāhi kua āraia, me te whakamahi i tētahi wāhanga o te uaua toto i tangohia mai i tētahi atu wāhanga o te tinana (mai i te waewae, i te roto rānei o te uma) hei waihanga i tētahi ara rerekē mō te rere o te toto. Ka mahia tēnei i te nuinga o te wā mēnā he roa, he hohonu hoki te piriti.
- Te whakatakotoranga o te stent: Ko tētahi atu kōwhiringa ko te whakatakotoranga o te stent. He ngongo whakarewa iti te stent e āhua rite ana ki te mata. Ka whakatakotoria ki roto i te oko toto kua āraia, ā, ka pupuhihia mai i roto. Kātahi, ahakoa kua āraia te uaua, ka noho tuwhera tonu te oko toto i te stent, ka ngāwari ake te rere o te toto. Heoi, he rerekē ngā whakaaro mō te whakatakotoranga o te stent i tēnei take. I ētahi wā, ka pakaru, ka āraia anō rānei te stent, nō reira ka tino tupato ngā tākuta ki te whakatau i ēnei whakatau.
He aha ngā mea me tumanako atu ahau mēnā he piriti myocardial tōku?
Pērā i te tini o te tangata, tera pea he piriti uaua o te ngākau, ā, kāore he tohu e pā ana ki a rātou. Kāore e hiahiatia he maimoatanga motuhake mō ēnei tāngata. Mena he tohu, he maha ngā wā ka taea te whakahaere mā te rongoā.
Ki te kore ngā tohu e pai ake mā te rongoā, me whakaaro ki te pokanga (myotomy, bypass rānei) me te whakatakotoranga stent rānei. Mēnā ka tangohia he piriti myocardial mā te pokanga, he mea whakaaro nui te whiriwhiri i tētahi hōhipera kei reira ngā taote pokanga mātau e mahi pinepine ana i aua pokanga.
Ehara tēnei (Myocardial Bridge) i te mea ka ora noa iho me te kore e tangohia e te pokanga. Engari ko te nuinga o te tangata kāore e hiahia ki te pokanga.
Kei te pēhea te tū atu a te hunga e noho ana me tēnei āhuatanga?
He maha ngā tāngata e pāngia ana e te Myocardial Bridge e ora roa ake ana, ā, he pai ake hoki tō rātou hauora mō te wā roa.
Ko ngā reiti oranga e whakawhirinaki ana ki te mea kei a koe ētahi atu mate hauora. I roto i tētahi rangahau, tata ki te 90% o te hunga i pāngia e te mate ngakau i ora tonu i ngā tau 10 i muri i te tātaritanga. Heoi, mēnā he mate ngakau anō hoki ō rātou, pērā i te mate uaua ngakau (CAD), he iti ake te reiti oranga.
Me pēhea taku tiaki i tōku hauora?
Nā te mea kua kitea he paku whakanui ake te whai piriti myocardial i te mōrearea o ngā putunga ngako i roto i ngā uaua (atherosclerosis), tera pea ka tohutohu tō tākuta i a koe kia whakahaere i ētahi atu āhuatanga mōrearea ka whai wāhi atu ki tēnei. He mea nui tēnei ahakoa he tohu kei a koe, kāore rānei.
- Kaua e kai hikareti: Ko te mea nui hei ārai i te atherosclerosis ko te karo rawa i ngā hua tupeka. Mena he kai hikareti koe, pātai atu ki tō tākuta kia āwhina koe ki te whakamutu.
- Whakahaerehia ētahi atu āhuatanga mōrearea: Mena he toto toto tiketike tōu, he mate huka, he taumata cholesterol teitei rānei, whakahaeretia pai aua āhuatanga.
- Kai hauora: Kai i ngā kai he iti te hinu, te huka, me te tote, engari kia nui ngā hua me ngā huawhenua.
- Te whakakori tinana auau: Kōrero ki tō tākuta kia mōhio ai koe ki ngā whakakori tinana e tika ana māu, ā, me mahi auau.
- Tangohia tika ō rongoā kua tohua: Mena kei a koe te mate uaua coronary (CAD), he mea nui kia tangohia ō rongoā antiplatelet (ngā rongoā whakangawari toto) me ngā rongoā whakaheke cholesterol (ngā rongoā whakaheke cholesterol) kia rite ki te wā tika me te wā i tohua e tō tākuta.
Āhea ahau me kite i te tākuta?
He mea tino nui kia mau tonu ō wā tirotiro me tō tākuta. Me toro atu tō tākuta ki a koe i ia wā, kia mōhio ai koe kei te tangohia e koe te nui o te rongoā tika, me te āhua o ō tohumate. He mea nui anō hoki kia haere koe ki ngā wā tirotiro i muri i te pokanga, i te whakaurunga rānei o te stent.
E ai ki te kōrero i mua ake nei, ki te pāngia koe e ngā tohu o te mate manawa (pēnei i te mamae nui o te uma, te uaua ki te manawa, te werawera), waea atu ki te 911 tonu atu, haere rānei ki te rūma whawhati tata.
He aha ngā pātai me pātai atu e au ki taku tākuta?
Ina kitea he piriti uaua tōu, he mea noa te maha o ngā pātai kei roto i tō hinengaro. Ka taea e koe te pātai atu ki tō tākuta i ēnei pātai:
- Kia pēhea te auau o taku haerenga mai mō te tirotiro whai muri?
- Me rongoā ahau, me pokanga rānei?
- He aha koe i tūtohu mai ai i tēnei maimoatanga ki ahau? He aha ngā painga mōku? He ngoikoretanga rānei?
- He aha ngā huringa me mahi e au ki taku kai me taku momo noho?
- Ka taea e au te whakakorikori tinana? He aha te momo whakakorikori tinana pai?
He mea noa te mataku me te manukanuka ina rongo koe kei te hē tetahi mea o tō ngākau. Engari kia maumahara, mō te nuinga o te tangata, ehara te piriti myocardial i te mea hei āwangawanga. Mena kei a koe ngā tohu, kōrero ki tō tākuta kia whakatauhia ai te maimoatanga pai rawa atu māu.
Hei whakamutunga, ngā mea hei maumahara (Karere hei tango ki te kāinga)
Āe, kua mārama ake koe ināianei ki tā tātou i kōrero ai (Myocardial Bridge). Hei whakarāpopototanga:
- Ko te piriti myocardial he mate whānau mai e puta ai he uaua coronary i roto i te ngākau mā roto i tētahi uaua.
- Mō te tini o te tangata, kāore he tohu e puta mai ana, ā, kāore hoki he kino.
- Tērā pea ka pāngia ētahi tāngata e ngā tohu pēnei i te mamae o te uma (angina), inā koa i te wā e ngenge ana rātou.
- He maha ngā wā ka taea te whakahaere i ngā tohu mā te rongoā. I ētahi wā, kāore pea e hiahiatia he pokanga, he stenting rānei.
- He mea nui ngā panonitanga o te āhua noho (te whakamutu momi hikareti, te kai hauora, te whakakori tinana) hei whakaiti i te mōrearea o te atherosclerosis.
- Ki te pāngia koe e te mamae nui o te uma, e ngā tohu rānei o te mate manawa, rapua tonutia he tohutohu hauora.
He mea nui kia tiakina tō ngākau. Mā te mōhio ki ēnei āhuatanga ka āwhina i a koe ki te rapu maimoatanga wawe mēnā e tika ana, ā, ka āwhina hoki i a koe ki te noho ora.
` Te piriti o te uaua ngākau, te mate ngākau, te angina, te uaua ngākau, te pokanga ngākau, te stent, te hauora ngākau











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