Kutsekeka kwa mitsempha yamagazi ya mtima? Tiyeni tikambirane za izi (Kutsekeka kwa mitsempha yamagazi)

Kodi mudamvapo za matenda a mitsempha ya mtima? Ambiri aife tamvapo za izi. Mu nkhani zachipatala, izi zimatchedwa Matenda a Mitsempha ya Mtima ( CAD ). Mwachidule, ndi vuto lomwe mafuta ndi cholesterol zimasonkhana m'mitsempha yomwe imanyamula magazi kupita kumtima, zomwe zimapangitsa kuti magazi aziyenda pang'onopang'ono. Koma mitsempha iyi imatha kutsekeka m'njira zosiyanasiyana. Lero, tikambirana za vuto lovuta pang'ono lomwe limafuna chisamaliro chapadera. Izi zikutanthauza kuti, mafuta akamadzaza ndikutseka mitsempha yamagazi pomwe mitsempha yayikulu mumtima imagawikana kukhala nthambi yaying'ono. Tangoganizirani kuchuluka kwa magalimoto pamsewu wooneka ngati Y, pomwe misewu iwiriyi imagawikana. Madokotala amatcha izi kuti 'Bifurcation Blockage'.

Kodi kwenikweni chomwe chimatchedwa Bifurcation Blockage n'chiyani?

Chabwino, tiyeni tifotokoze izi m'njira yosavuta. Mtima wanu ndi minofu yomwe imagwira ntchito mosalekeza. Umalandira mphamvu ndi mpweya womwe umafunikira kuchokera ku mitsempha yamagazi yotchedwa mitsempha ya mtima. Mitsempha yayikulu iyi imagawikana kukhala nthambi zazing'ono kuti inyamule magazi kupita ku ziwalo zonse za mtima.

Tsopano, Bifurcation Blockage iyi imachitika pamene mafuta ochulukirapo (timawatcha plaque ) amapangika pomwe mtsempha waukulu umagawikana kukhala nthambi yaying'ono, kutanthauza, pa Y-junction. Plaque iyi imatseka kuyenda kwa magazi. Madokotala amatcha nthambi yaying'ono iyi kuti "mtsempha wa nthambi." Plaque iyi imatchedwanso "bifurcation lesion."

Malo awa ndi ovuta pang'ono kutsekeka kuposa madera ena. Popeza kuyenda kwa magazi ndi kuthamanga kwa magazi ndizosiyana pano, pali mwayi waukulu woti ma plaque azikungika m'malo awa. Ndipo zingakhale zovuta pang'ono kuchiza.

Kodi pali mitundu ikuluikulu ya kutsekeka kumeneku?

Inde, madokotala amagawa kutsekeka kumeneku malinga ndi kuopsa kwake, kutanthauza kuchuluka kwa mtsempha wamagazi womwe watsekeka. Izi zimatchedwa stenosis . Pali mitundu iwiri ikuluikulu.

Kodi vutoli ndi lofala bwanji m'dziko lathu?

Imeneyi ndi vuto lofala kwambiri. Ziwerengero zikusonyeza kuti pakati pa 15% ndi 20% ya milandu yonse ya matenda a mitsempha ya mtima (CAD) yomwe imafuna chithandizo chamankhwala imagwera m'gululi, lotchedwa bifurcation blockages. Mwachidule, mwa odwala 100 aliwonse omwe amabwera kuchipatala ndi mitsempha ya mtima yotsekedwa, pafupifupi 15-20 ali ndi vuto lotsekedwa pamalo awa. Chifukwa chake, ichi si chinthu choyenera kuonedwa mopepuka.

Chifukwa chiyani izi zikuchitika? Kodi chifukwa chenicheni cha izi ndi chiyani?

Chifukwa chachikulu cha izi ndi mafuta omwe amatchedwa plaque omwe tidakambirana kale. Izi zili ngati kudzikundikira kwa dzimbiri ndi dothi mu chitoliro cha madzi pakapita nthawi, zomwe zimapangitsa mabowo mu chitolirocho. Plaque iyi imapangidwa ndi kuchuluka kwa cholesterol, mafuta, ndi calcium m'makoma a mitsempha yathu yamagazi. Pakapita nthawi, plaque iyi imakula ndikuchepetsa kudutsa kwa magazi kudzera m'mitsempha. Pamapeto pake, mtima sulandira kuchuluka kofunikira kwa magazi. Tikutcha vutoli kuti atherosclerosis . Kutsekeka kwa bifurcation ndi chifukwa cha vutoli la atherosclerosis.

Ndani amene ali pachiwopsezo chachikulu?

Ngakhale kuti vutoli limatha kufalikira mwa aliyense, anthu ena ali pachiwopsezo chachikulu. Ngati muli ndi chimodzi mwa zinthuzi zomwe zingakubweretsereni chiopsezo, ndi bwino kukhala maso pang'ono.

Kodi ndi zizindikiro ziti zomwe mungakumane nazo?

Kutsekeka kwa mitsempha ya mtima (CAD) ndi mtundu wa matenda a mitsempha ya mtima (coronary artery blockage), kotero zizindikiro zake zimafanana. Ngati muli ndi chimodzi mwa zizindikirozi, pitani kuchipatala nthawi yomweyo.

• Kupweteka pachifuwa kapena kupanikizika (Angina): Ichi ndiye chizindikiro chachikulu. Chimamveka ngati kufinya kapena kufinya pakati pa chifuwa.
• Kupuma movutikira: Kumva kupuma movutikira mukatopa pang'ono, kapena mukakwera masitepe.
• Kutopa kwambiri: Kutopa kwambiri kapena kufooka popanda chifukwa.
• Kupweteka kwa phewa kapena mkono: Kupweteka komwe kumayenda pansi pa mkono wakumanzere, makamaka.
• Chizungulire (vertigo) kapena kukomoka: Kumva ngati mutu wako ukuzungulira ndipo sungathe kuyimirira.
• Kusanza: Kumva ngati ukufuna kusanza.
• Kumva kuzizira komanso thukuta.
• Kumva kugunda kwa mtima kosazolowereka (Heart Palpitations).

Kodi dokotala amapeza bwanji izi?

Mukauza dokotala wanu za zizindikiro zomwe mwatchula pamwambapa, adzakuyang'anirani ndikukutumizani kuti mukayesedwe kangapo kuti atsimikizire vutoli.

• ECG (Electrocardiogram): Izi zimayesa mphamvu yamagetsi ya mtima kuti zione ngati pali kuwonongeka kulikonse pamtima.
• Kuyesa Kupsinjika Maganizo: ECG imatengedwa mukamayenda pa treadmill, poyang'ana momwe mtima wanu umagwirira ntchito mukakhala ndi nkhawa.
• Echocardiogram: Kujambula mtima pogwiritsa ntchito ultrasound.
• Kuyeza kwa Catheterization ya Mtima (Coronary Angiogram): Iyi ndiye njira yayikulu yodziwira ngati pali kutsekeka kulikonse m'mitsempha yanu. Chubu chaching'ono chimalowetsedwa kudzera mu mwendo kapena mkono wanu, ndikulowetsedwa m'mitsempha ya mtima wanu, ndipo madzi apadera amalowetsedwa, ndipo zithunzi za X-ray zimatengedwa. Izi zimakupatsani mwayi wowona bwino komwe kutsekekako kuli.
• CCTA (Coronary Computed Tomography Angiogram): Ichi ndi chofanana ndi angiogram, koma ndi mayeso omwe amachitidwa pogwiritsa ntchito makina a CT scan popanda kulowetsa chubu m'thupi.

Mayeso awa athandiza dokotala wanu kudziwa ngati muli ndi vuto la bifurcation blockage komanso momwe lilili loopsa.

Kodi mankhwala ochizira izi ndi otani?

Kuchiza kutsekeka kwa mtsempha wa bifurcation kumakhala kovuta pang'ono chifukwa mtsempha wa m'mbali ndi wochepa kwambiri, zomwe zimapangitsa kuti zikhale zovuta kuchiza ndi zida kuposa mtsempha waukulu.

Chithandizo chachikulu ndi angioplasty ndi stent . Iyi si opaleshoni. Iyi imatchedwa Percutaneous Coronary Intervention (PCI).

Izi ndi zomwe zikuchitika apa:

1. Dokotala adzapangitsa khungu lanu kukhala losasangalatsa pa mkono kapena mwendo wanu, adzadula pang'ono, kenako adzalowetsa catheter kudzera mmenemo.Chubu chopyapyala kwambiri komanso chosinthasintha chotchedwa catheter chimayikidwa mu mtsempha wamagazi.

2. Kenako, poyang'ana chithunzi cha X-ray, chubucho chimatsogozedwa kumalo enieni omwe mtsempha wamagazi wotsekeka uli mumtima.

3. Pali kabaluni kakang'ono kumapeto kwa catheter. Kakafika pamalo otsekeka, baluniyo imadzaza. Kenako plaque imakanikiza khoma la mtsempha wamagazi, ndikutsegulanso njira yotsekeka.

4. Kenako, kuti khomo lisatsekekenso, chubu chaching'ono chotchedwa stent chimayikidwa pamalopo.

Pambuyo pa chithandizochi, dokotala wanu adzakupatsani mankhwala apadera (dual antiplatelet therapy) kuti magazi asaundane mkati mwa stent. Ndikofunikira kuti mumwe mankhwalawa kwa nthawi yomwe mwapatsidwa.

Kodi njira zochiritsira ndi ziti?

Pali njira ziwiri zazikulu zotsekereza ma stenting bifurcation blockages.

• Kuika stent ya nthawi yochepa: Mu njira iyi, dokotala amaika stent mu mtsempha waukulu wamagazi. Nthambi yaying'ono siyikidwa. Stent ikhoza kuyikidwa mu nthambi yaying'ono mtsogolo, pokhapokha ngati mutakhala ndi zizindikiro kachiwiri.
• Njira Zopangira Ma Stent Awiri: Ngati kutsekekako kuli kovuta kwambiri, dokotala angasankhe kuyika ma sten mu mtsempha waukulu komanso nthambi yaying'ono yomwe imaphuka.

Kodi pali mavuto aliwonse omwe angachitike mutalandira chithandizo?

Ngakhale angioplasty ndi stenting ndi njira zochizira bwino, mavuto amatha kuchitika mwa anthu ochepa kwambiri .

Kodi mkhalidwe woterewu sungapewedwe?

Ndizotheka ndithu. Matenda a mtima amagwirizana kwambiri ndi moyo wathu. Chifukwa chake, kukhala ndi moyo wathanzi kungathandize kuchepetsa chiopsezo cha matendawa.

• Idyani zakudya zopatsa thanzi pamtima. Chepetsani zakudya zokhala ndi mafuta ambiri, mchere, ndi shuga momwe mungathere. Phatikizani zipatso, ndiwo zamasamba, nyemba, nsomba zazing'ono, ndi tirigu wonse muzakudya zanu.
• Ngati mukusuta, siyani lero. Kusuta ndi mdani wamkulu wa mtima.
• Chitani masewera olimbitsa thupi nthawi zonse. Chitani zinthu monga kuyenda pansi kapena kukwera njinga kwa mphindi zosachepera 30 patsiku.
• Yang'anirani kulemera kwa thupi lanu. Pali kulemera kwina komwe kukugwirizana ndi kutalika kwanu. Yesetsani kukupitirizabe.
• Ngati muli ndi matenda a shuga, kuthamanga kwa magazi, kapena cholesterol, chepetsani izi mwa kumwa mankhwala omwe dokotala wanu wakupatsani.
• Kuchepetsa nkhawa. Ndi bwino kwambiri kuchita zinthu monga yoga ndi kusinkhasinkha.
• Chepetsani kumwa mowa.

Kodi muyenera kupita kwa dokotala nthawi yomweyo liti?

Kuphatikiza apo, ngati mukumana ndi zizindikiro zotsatirazi pafupipafupi, onetsetsani kuti mwawonana ndi dokotala kuti akupatseni upangiri.

• Kupweteka pachifuwa (angina), kupweteka kwa mkono kapena phewa
• Kumva kuzizira komanso thukuta
• Kuvuta kupuma
• Kutopa kapena kufooka kosamveka bwino

Mafunso oti mufunse dokotala wanu

Mukazindikira kuti muli ndi vutoli, ndi zachilendo kukhala ndi mafunso ambiri m'maganizo mwanu. Musabise chilichonse, funsani dokotala wanu ndipo mudziwe.

• Kodi n’chiyani chikundipangitsa kumva ngati ndili ndi vuto lotere?
• Kodi pali chiopsezo chofanana ndi kutsekeka kwa mitsempha ina yamagazi yanga?
• Kodi angioplasty ndi stenting zingachiritse kwathunthu kutsekeka kumeneku?
• Kodi ndi mtundu wanji wa stent womwe mukundipangira?
• Kodi ndifunika kuika ma stents angati?
• Kodi ndiyenera kuchita chiyani kuti nditeteze mtima wanga?
• Ndi mavuto ati omwe ndiyenera kuda nkhawa nawo nditatha kulandira chithandizo?

Ndikukhulupirira kuti izi zikuthandizani kumvetsetsa bwino vutoli. Kumbukirani, ichi si chinthu choopa, koma chinthu choyenera kusamalidwa bwino.

Matenda a Mtima, Kutsekeka kwa Bifurcation, Matenda a Mitsempha ya Mtima, Kutupa kwa Mtsempha, Angioplasty, Kupweteka pachifuwa, Kuukira kwa Mtima