Kodi chifuwa chanu chili ngati bulbu? (Chifuwa cha Aortic Aneurysm) - Tiyeni tikambirane izi!

Kodi nthawi zina mumamva kupweteka pachifuwa, pakhosi, kapena nsagwada? Kapena kuvutika kupuma pang'ono, kapena kumva kutsekeka mukameza? Nthawi zambiri, timaiwala zinthu izi, poganiza kuti ndi zachilendo, mwina monga gastritis. Komabe, nthawi zina izi zitha kukhala chizindikiro cha chinthu chomwe chimafunika chisamaliro pang'ono. Chifukwa chake, lero tikambirana za kutupa kofanana ndi baluni komwe kungachitike mumtsempha waukulu wamagazi pachifuwa chathu, aorta . Mu zamankhwala, timatcha izi kuti 'Thracic Aortic Aneurysm '.

Kodi 'Thracic Aortic Aneurysm' iyi ndi chiyani? Mwachidule...

Tangoganizani kuti nyumba yanu ili ndi njira yaikulu yopezera madzi. Umu ndi momwe mtsempha wamagazi m'thupi lathu umagwirira ntchito. Uwu ndi mtsempha waukulu komanso wofunika kwambiri womwe umanyamula magazi kuchokera pamtima kupita ku thupi lonse. Umaoneka ngati chubu.

Tsopano, `Thoracic Aortic Aneurysm` iyi ndi pamene khoma la mtsempha wanu wamagazi lomwe limadutsa pachifuwa chanu (ndichifukwa chake limatchedwa `Thorax` kapena chifuwa) limafooka ndikutuluka ngati baluni pamalo amodzi. Anthu ena amatchanso izi kuti ndi kukulitsa kapena kukulitsa kwa mtsempha wamagazi. Nthawi zambiri, ngati gawo la mtsempha wamagaziwo ndi lalikulu kuposa 50% ya m'lifupi mwake wamba, timaliona ngati `Aneurysm`, kapena bulge/bulge. ``Bulge` yabwinobwino iyi imatha kusiyana malinga ndi malo mu mtsempha wamagazi.

Kutupa kumeneku kumatha kuchitika kulikonse mu mtsempha wamagazi. Nthawi zambiri, kumachitika m'mimba (timatcha kuti `Abdominal Aortic Aneurysm`), koma pafupifupi munthu m'modzi mwa anayi aliwonse akhoza kukhala ndi vutoli pachifuwa.

Ma aneurysms ang'onoang'ono sangafunike chithandizo chachikulu. Mankhwala ndi mayeso okhazikika (monga ma scan) kuti athetse vuto lomwe limayambitsa matendawa angakhale okwanira. Komabe, ngati aneurysm yanu ndi yayikulu kapena ikukula mofulumira, opaleshoni ingafunike kuti mupewe mavuto omwe angakupheni . Madokotala adzasankha chithandizo chabwino kwambiri kwa inu komanso nthawi yochichitira, chifukwa akufuna kuti mupeze zotsatira zabwino kwambiri.

Kodi vutoli ndi lofala bwanji?

Matendawa, otchedwa `Thoracic Aortic Aneurysm`, nthawi zambiri amakhudza anthu pakati pa 6 ndi 10 pa anthu 100,000 aliwonse. Komabe, n'zovuta kunena chiwerengero chenicheni, chifukwa nthawi zambiri aneurysms awa sasonyeza zizindikiro zilizonse ndipo motero sapezeka. Pafupifupi 20% ya odwala omwe apezeka ndi matendawa ali ndi mbiri ya banja lawo, zomwe zikutanthauza kuti pali ubale wa majini.

Ku United States kokha, akuti anthu pafupifupi 30,000 amafa chaka chilichonse chifukwa cha kusweka kwa mtsempha wamagazi kapena kuphulika kwa mtsempha wamagazi, kotero ichi si chinthu chopepuka.

Kodi zizindikiro za Thoracic Aortic Aneurysm ndi ziti?

Nthawi zambiri, anthu omwe ali ndi "aneurysm" imeneyi sadziwa za izi, chifukwa nthawi zambiri palibe zizindikiro.Komabe, nthawi zina zizindikiro zingasonyeze izi:

• Kumva kupweteka m'nsagwada, khosi, pachifuwa, kapena kumbuyo kwanu .
• Kuvuta kumeza kapena kupweteka mukameza (ngati aneurysm ikukankhira pa mmero wanu).
• Mawu omveka bwino (ngati aneurysm iyi ikufinya mitsempha yomwe imalamulira mawu anu).
• Kutsokomola kapena kupuma movutikira (ngati aneurysm ikukanikiza njira yanu yopumira).

Zizindikiro za kuphulika kwa aneurysm (`Kuphulika`) kapena kudulidwa (`Kudulidwa`) - izi ndi zadzidzidzi!

Anthu ambiri alibe zizindikiro, kenako mwadzidzidzi aneurysm imatha kusweka kapena kusweka. Zonsezi ndi zadzidzidzi zachipatala zomwe zimafuna chithandizo chadzidzidzi! Zizindikiro zimatha kuyamba mwadzidzidzi ndipo zingakhale zoopsa kwambiri. Ngati inu kapena wina ali ndi zizindikiro izi , muyenera kupita kuchipatala nthawi yomweyo :

• Kupweteka kwadzidzidzi komanso kosapiririka pachifuwa kapena kumbuyo. Anthu ena amanena kuti ndi kubaya, kung'amba, kapena kuphulika.
• Chizungulire kapena kumva ngati ukuzungulira.
• Kuvuta kupuma.
• Kugunda kwa mtima kumawonjezeka.
• Kutuluka thukuta kwambiri.
• Chisokonezo.
• Kuvuta kulankhula.
• Kutaya masomphenya.
• Kufooka kapena dzanzi mbali imodzi ya thupi.

Mu mkhalidwe ngati uwu , ola lililonse ndi mphindi iliyonse zimawerengedwa. Mukachedwa kupeza chithandizo, mwayi wopulumutsa moyo wanu umakhala wochepa. Choncho musatengere zizindikirozi mopepuka.

Kodi ndi zifukwa ziti za 'Thracic Aortic Aneurysm'?

Chifukwa chachikulu cha Aneurysm ya Thoracic Aortic ndi matenda otchedwa Atherosclerosis. Mwachidule, izi zimachitika pamene mafuta amasonkhana mkati mwa makoma a mitsempha yathu yamagazi, zomwe zimawachepetsa pang'onopang'ono. Pakapita nthawi, mafuta amenewa amafooketsa makoma a mtsempha wamagazi, zomwe zimapangitsa kuti pakhale vuto la aneurysm.

Kawirikawiri, makoma a mtsempha wathu wamagazi amakhala olimba ndipo ayenera kukhala okhoza kukula ndikuchepa ngati pakufunika magazi akamayenda. Taganizirani izi, mtsempha uwu ndi komwe magazi amachokera mwachindunji mumtima. Chifukwa chake, uyenera kukhala wokhoza kupirira kupsinjika komwe kumachitika mtima ukamapopa magazi mwamphamvu.

Mtsempha wathanzi ungathe kuchita izi popanda vuto lililonse. Komabe, ngati makoma a mtsempha wamagazi afooka, kupanikizika kochokera mumtima kungapangitse gawo la mtsempha wamagazi kutukumuka kunja, ndikupanga aneurysm. Kutupa kumeneku sikwachilendo, kumasintha mawonekedwe a chubu cha mtsempha wamagazi. Pamene magazi akupitirira kuyenda kudzera mu kutukumuka kumeneku, kupanikizika kowonjezereka kumayikidwa pa makoma omwe ali kale ofooka, kuwafooketsa kwambiri. Zotsatira zake, makomawo amatukumuka kwambiri. Aneurysm ikakula, imakhala yoopsa kwambiri.

Kodi zinthu zoopsa ndi ziti?

Chilichonse chomwe chimafooketsa makoma a mtsempha wamagazi chimawonjezera chiopsezo chokhala ndi aneurysm. Kuwonjezera pa atherosclerosis, palinso zinthu zina zomwe zimayambitsa matendawa:

• 'Aortitis': Matenda otupa omwe amapezeka mu aorta.
• `Matenda a Bicuspid aortic valve` : Valavu ya aortic ya mtima ili ndi timabuku tiwiri (nthawi zambiri payenera kukhala titatu).
• Matenda a mitsempha ya mtima (CAD) : Matenda okhudzana ndi mitsempha ya mtima yomwe imapereka magazi ku minofu ya mtima.
• Kukhala ndi mbiri ya banja yokhala ndi aneurysm (mbiri ya banja).
• Kuthamanga kwa magazi kwambiri .
• Matenda a Loeys-Dietz : Matenda osowa kwambiri a majini okhudzana ndi minofu yolumikizana.
• Matenda a Marfan : Matenda ena a majini omwe amakhudza minofu yolumikizana.
• Kukhala ndi zaka zoposa 65.
• Kusuta kapena kugwiritsa ntchito fodya.
• `Turner syndrome` : Matenda a majini omwe amakhudza akazi okha.
• Matenda a Mitsempha ya Ehlers-Danlos : Matenda osowa kwambiri okhudza minofu yolumikizana omwe amakhudza mitsempha yamagazi.

Kodi Aneurysm ya Thoracic Aortic Aneurysm ingapezedwe mwachibadwa?

Inde, Thoracic Aortic Aneurysm imatha kuchitika m'mabanja. Izi zikutanthauza kuti imatha kuperekedwa kwa mibadwomibadwo. Ofufuza apeza kusintha kwa majini angapo komwe kumawonjezera chiopsezo. Mwa izi, kusintha kwa majini a ACTA2 ndiko kofala kwambiri.

Jini ya ACTA2 imauza thupi lathu kuti lipange mapuloteni ena m'makoma a mitsempha yathu. Mapuloteni awa amathandiza makoma a mitsempha yathu kusunga mawonekedwe awo mwa kuthandizira kuthamanga kwa magazi kudutsa m'mitsempha. Ngati pali kusintha kwa majini a ACTA2, makoma a mitsempha yathu amatha kutambasuka kwambiri magazi akadutsa m'mitsempha.

Komabe, simunganene kuti mwalandira kusintha kwa majini chifukwa chakuti muli ndi aneurysm. Komabe, chiopsezo chake ndi chachikulu. Ngati wina m'banja mwanu (wogwirizana ndi zamoyo) wakhala ndi Thoracic Aortic Aneurysm, ndi bwino kulankhula ndi dokotala wanu. Angakulimbikitseninso kuyezetsa majini .

Kodi 'Thracic Aortic Aneurysm' iyi imachitika kuti?

Izi zimapangidwa pomwe makoma a msempha wamagazi amafooka. Zinthu monga `Atherosclerosis` (mafuta osungidwa) zomwe tidakambirana kale, kapena matenda olumikizana ndi minofu, zimafooketsa makoma a msempha wamagazi, zomwe zimapangitsa kuti `Aneurysm` ipangidwe mosavuta.

Kodi mukudziwa kuti mtsempha wamagazi (aorta) ndiye mtsempha waukulu kwambiri m'thupi lathu? Uli ngati ndodo yakale yoyendera. Umayamba pamtima, umapindika mmwamba, kenako umatsikira pachifuwa ndi m'mimba. Umathera pamwamba pa mchombo.

Kawirikawiri, Thoracic Aortic Aneurysm imayamba mu ascending aorta kapena descending aorta. Nthawi zambiri, imathanso kukula mu gawo lopindika la aorta - gawo lomwe limawoneka ngati chogwirira cha ndodo.

Kodi vuto la `Thracic Aortic Aneurysm` ndi loopsa bwanji?

Kutupa kwa mtsempha wamagazi m'khosi ndi vuto lalikulu lachipatala. Pali mavuto angapo omwe angachitike:

• Kuphulika kwa aneurysm.
• Kugawanika kwa mtsempha wamagazi .
• Magazi amaundana pamalo pomwe pali aneurysm ndipo amapita ku ziwalo zina za thupi (thromboembolism). Magazi amenewa amatha kuyambitsa matenda aakulu monga sitiroko kapena mesenteric ischemia .
• Kubwezeretsa kwa valve ya aorta .

Izi ndi matenda oopsa kwambiri. Ndicho chifukwa chake tiyenera kusamala ndi 'Aneurysm' iyi.

Kodi 'Thracic Aortic Aneurysm' iyi imapezedwa bwanji?

Kawirikawiri, Aneurysm ya Thoracic Aortic imapezeka mwangozi . Izi zikutanthauza kuti imapezeka madokotala akamayesa pazifukwa zina. Mwachitsanzo, X-ray ya pachifuwa ingasonyeze kuti pakati pa chifuwa chanu (mediastinum) pali ponseponse kuposa masiku onse. Ichi chingakhale chizindikiro cha aneurysm.

Ngati dokotala wanu akukayikira kuti muli ndi Thoracic Aortic Aneurysm, kaya kudzera mu X-ray kapena pazifukwa zina, adzalamula mayeso otsatirawa:

• `Computer tomography (CT) angiogram` : Iyi ndi njira yapadera yojambulira CT.
• `Echocardiogram (echo)` : Kujambula mtima ndi ultrasound.
• Magnetic resonance angiogram (MRA) : Kujambula komwe kumayang'ana mitsempha yamagazi pogwiritsa ntchito ukadaulo wa MRI.
• Ultrasound ya m'mimba : Kuyesa kwa ultrasound kuti muwone ngati pali aneurysm mu mtsempha wa m'mimba.

Kodi mankhwala a Thoracic Aortic Aneurysm ndi ati?

Opaleshoni ya mtsempha wamagazi (aorta) ndiyo njira yaikulu komanso yokhalitsa yothandizira matenda a mtsempha wamagazi otchedwa Thoracic Aortic Aneurysm. Madokotala amagwiritsa ntchito njira zosiyanasiyana zochitira opaleshoni. Zina mwa izo ndi izi:

• Opaleshoni yotseguka yachikhalidwe : Izi zimaphatikizapo kupanga kudula kwakutali pakati pa chifuwa, kuchotsa gawo lowonongeka la msempha wamagazi, ndikuyikanso chubu chopangira (graft). Njirayi imagwiritsidwa ntchito pochiza aneurysms mu aeroscending aorta, komanso aneurysms zovuta pachifuwa ndi m'mimba.
• Kukonza mtsempha wamagazi m'chifuwa (TEVAR) : Iyi ndi njira yochitira opaleshoni yomwe siivuta kwambiri . Izi zikutanthauza kuti imachitika popanda kuduladula kwakukulu. Imagwiritsidwa ntchito pochiza aneurysms mu mtsempha wotsika. Mu njira imeneyi, dokotalayo amaduladuladula ting'onoting'ono m'mimba mwanu, amagwiritsa ntchito mtsempha wamagazi (femoral artery) womwe umadutsamo, ndipo amagwiritsa ntchito catheter (chubu chopyapyala) kuti aike graft mu aneurysm.
• Kusintha mizu ya mtsempha wamagazi: Opaleshoni iyi imachitika pa `Aneurysm` pamalo pomwe aorta imalumikizana ndi mtima (`Aortic root`). Izi zingaphatikizeponso kusintha valavu yanu ya aortic. Kapenanso, `njira zosungira mavavu` zingagwiritsidwe ntchito kusunga valavu yanu yachilengedwe.

Nthawi zina, madokotala ochita opaleshoni amaphatikiza njira zingapo mwa izi (monga opaleshoni yotseguka ndi chithandizo cha endovascular) kutengera mtundu wa aneurysm. Kulandira chithandizo ku aorta center kumawonjezera mwayi wanu wopeza zotsatira zabwino.

Kodi ndifunika opaleshoni liti?

Dokotala adzasankha ngati mukufuna opaleshoni, ndipo ngati ndi choncho, nthawi yake, poganizira zinthu izi:

• Kukula ndi malo a aneurysm.
• Kuchuluka kwa aneurysm m'magazi kumakula mofulumira bwanji .
• Ngati aneurysm imayambitsa zizindikiro komanso momwe zimakhalira zoopsa .
• Matenda ena omwe muli nawo.

Ngati aneurysm ndi yayikulu kapena imayambitsa zizindikiro, opaleshoni ingafunike kuti isaphulike. Kukula kwa aneurysm ndikofunikira chifukwa ikakhala yayikulu, pamakhala mwayi waukulu wophulikira. Nthawi zambiri, madokotala amasankha kuchita opaleshoni ngati aneurysm ili pakati pa mainchesi 2 ndi 2.2 (pafupifupi masentimita 5 mpaka 5.5), kapena ngati ikukula pamlingo wa pafupifupi theka la sentimita pachaka.

Koma, si kukula kokha komwe kumawerengedwa. Ngati muli ndi vuto la minofu yolumikizana, valavu ya aorta ya bicuspid, kapena zinthu zina zomwe zimawonjezera chiopsezo chanu chophulika kapena kuphulika, dokotala wanu angasankhe kuchita opaleshoni mwachangu. Lankhulani ndi dokotala wanu za kukula kwa aneurysm yanu komanso nthawi yomwe opaleshoni ingafunike.

"Kudikira molimbika"

Ngati aneurysm ndi yaying'ono ndipo ilibe zizindikiro, simungafunike opaleshoni nthawi yomweyo. M'malo mwake, dokotala wanu adzayang'anira vuto lanu (izi zimatchedwa kudikira mwatcheru). Akhozanso kukupatsani mankhwala ochepetsa chiopsezo cha zovuta.

Mwachitsanzo, ma scan ojambulira zithunzi angakonzedwe miyezi 6 mpaka 12 iliyonse kuti aone ngati pali kusintha kwa aneurysm. Mungapatsidwenso mankhwala ochepetsa kuthamanga kwa magazi anu ndikuchepetsa kuthamanga kwa magazi pa gawo lofooka la mtsempha wanu wamagazi. Dokotala wanu angakulangizeni opaleshoni pamene ubwino wa opaleshoniyo ndi woposa zoopsa zake .

Kodi Aneurysm ya Thoracic Aortic Angapewedwe?

Palibe njira yeniyeni yopewera vutoli. Komabe, mutha kuchepetsa chiopsezo chanu chokhala ndi atherosclerosis (chifukwa chachikulu cha aneurysms). Nazi zina zomwe mungachite:

• Yesetsani kuthamanga kwa magazi ndi kuchuluka kwa cholesterol m'magazi anu.
• Tsatirani zakudya zopatsa thanzi la mtima (monga zakudya za ku Mediterranean ).
• Pewani zinthu zonse zosuta fodya.
• Chitani masewera olimbitsa thupi osachepera mphindi 150 pa sabata (koma lankhulani ndi dokotala musanayambe pulogalamu yatsopano yolimbitsa thupi).
• Pita kukayezetsa matenda chaka chilichonse, ndipo pita ku misonkhano yonse yotsatira.

Kodi mungakhale ndi nthawi yayitali bwanji ndi Thoracic Aortic Aneurysm?

Nthawi yopulumuka imadalira zinthu zambiri, kuphatikizapo kukula kwa aneurysm komanso ngati imayambitsa mavuto. Ma aneurysm akuluakulu akhoza kukhala owopsa. Pafupifupi 65% ya anthu omwe ali ndi aneurysm yayikulu, yosachiritsidwa, amapulumuka chaka chimodzi atapezeka ndi matendawa. 20% okha ndi omwe amapulumuka zaka zisanu.

Komabe, mukalandira chithandizo choyenera, nthawi yanu ya moyo imatha kuwonjezeka kwambiri ndipo mutha kukhala ndi moyo wautali komanso wathanzi. Ichi ndichifukwa chake ndikofunikira kudziwa ngati muli pachiwopsezo chotenga Thoracic Aortic Aneurysm ndikugwira ntchito ndi dokotala wanu kuti muthane ndi vutoli.

Kodi ndimadzisamalira bwanji?

Ngati muli ndi aneurysm, dokotala wanu adzakupatsani upangiri wa momwe mungadzisamalire nokha. Anganene zinthu monga:

• Pewani kuchita masewera olimbitsa thupi otopetsa. Zinthu monga kunyamula zolemera kwambiri kapena kuchita masewera olimbitsa thupi a HIIT (high-intensity interval training) zingayambitse kupsinjika kwambiri m'mitsempha yanu yamagazi. Funsani dokotala wanu kuti ndi masewera olimbitsa thupi ati omwe ndi otetezeka kwa inu.
• Pewani kugwiritsa ntchito fodya. Kusuta fodya kumawonjezera chiopsezo cha matenda ambiri a mtima. Ngati mumasuta kapena mumagwiritsa ntchito zinthu zina za fodya, funani thandizo kuti musiye.
• Sinthani zakudya zanu. Mungafunike kuchepetsa kumwa mchere kapena kusintha zina zomwe zingathandize pa thanzi la mitsempha yanu yamagazi.
• Imwani mankhwala anu monga mwalangizidwira. Mungafunike mankhwala oletsa matenda omwe amabwera chifukwa cha matendawa. Funsani dokotala wanu ngati muli ndi mafunso okhudza momwe mungamwere mankhwala awa.
• Pewani zinthu zomwe zimawonjezera kugunda kwa mtima. Zitsanzo zake ndi monga cocaine, amphetamines, ndi zina zowonjezera ku zitsamba.

Ndiyenera kupita liti kwa dokotala wanga?

Pitani kwa dokotala wanu kuti akakuwoneni chaka chilichonse, ndipo tsatirani nthawi zonse zomwe mukukumana nazo. Imbani dokotala wanu nthawi yomweyo ngati:

• Ngati muwona zizindikiro zatsopano kapena kusintha kwa zizindikiro zomwe zilipo kale .
• Ngati mankhwalawo ayambitsa zotsatirapo zosayembekezereka .
• Ngati muli ndi mafunso kapena nkhawa zokhudzana ndi dongosolo lanu la chithandizo.

Kodi ndiyenera kupita ku chipinda chadzidzidzi liti (ER)?

Zizindikiro za aneurysm yophulika kapena yophulikaNgati ndi choncho, imbani 911 (1990 ku Sri Lanka) kapena pitani ku chipinda chapafupi chadzidzidzi nthawi yomweyo. Izi ndi zadzidzidzi zachipatala zomwe zimafuna chithandizo chachangu kuti zipulumutse miyoyo.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala wanga?

Ngati dokotala wanu akukuuzani kuti muli ndi Thoracic Aortic Aneurysm, simungadziwe choti mufunse poyamba. Nazi mafunso ena oti muyambitse:

• Kodi aneurysm yanga ndi yaikulu bwanji?
• Kodi ndalama zimenezi ndi zofunika kuziganizira?
• Kodi n’chiyani chikanayambitsa `aneurysm` imeneyi?
• Kodi mukundilangiza chithandizo chamtundu wanji?
• Ndi kusintha kotani komwe ndiyenera kusintha pa moyo wanga?
• Kodi ndiyenera kubwera kangati kudzandiyesanso?

Kodi 'Thoracoabdominal aneurysm' iyi ndi chiyani?

Uwu ndi mtundu wa `Aneurysm`. Uwu ndi `Aneurysm` yomwe imafalikira pachifuwa chanu (`Chifuwa`) komanso m'mimba mwanu (`M'mimba`). Mtundu uwu umapanga pafupifupi 15% ya `Aneurysms` zonse zomwe zimachitika mu aorta.

Kupeza kuti muli ndi aneurysm pachifuwa chanu kungakhale koopsa. Mwina simunaganizirepo za thanzi la mitsempha yanu kapena momwe imagwirira ntchito. Kapena, mwina munabadwa ndi matenda a minofu yolumikizana, kotero mumadziwa bwino momwe thupi lanu limagwirira ntchito. Kaya mukudziwa chiyani, ino ndi nthawi yoti mudziwe zambiri za matenda anu ndikuchitapo kanthu kuti muchepetse chiopsezo cha zovuta.

Lankhulani ndi dokotala wanu za zomwe mungayembekezere kutengera vuto lanu. Iye adzatha kukonza dongosolo la chithandizo lomwe likugwirizana ndi zosowa zanu, kuyankha mafunso anu, ndikukupatsani chidziwitso chomwe mukufuna kuti mupite patsogolo.

Pomaliza, zinthu zoti muzikumbukira (Uthenga Wopita Nawo Kunyumba)

Matenda a Thoracic Aortic Aneurysm ndi vuto lalikulu. Komabe, mukazindikira msanga, mukamalandira upangiri woyenera wa dokotala, komanso mukalandira chithandizo choyenera, mumakhala ndi mwayi waukulu wokhala ndi moyo wathanzi komanso wautali.

• Samalani zizindikiro: Musanyalanyaze zinthu monga kupweteka kwadzidzidzi, kwakukulu pachifuwa kapena kumbuyo.
• Kayezetseni ngati muli ndi zinthu zomwe zingakuike pachiwopsezo: Ngati wina m'banja mwanu wakhala ndi vutoli, kapena ngati muli ndi kuthamanga kwa magazi kapena kusuta fodya, funsani upangiri kwa dokotala.
• Tsatirani malangizo a dokotala wanu molondola: imwani mankhwala omwe mwapatsidwa, tsatirani malangizo okhudza masewera olimbitsa thupi ndi zakudya, ndipo pitani ku mayeso ndi nthawi yokumana ndi dokotala.
• Pewani kusuta konse: Ichi ndi chimodzi mwa zinthu zofunika kwambiri zomwe mungachite.

Musadandaule, simuli nokha. Gulu lanu lachipatala lili okonzeka kukuthandizani. Chofunika kwambiri ndikudziwa za vutoli ndikusamalira thanzi lanu mwachangu.

` Aneurysm ya msempha wa thoracic, aorta, kupweteka pachifuwa, matenda a mtima, mitsempha yamagazi, aneurysm, opaleshoni