Tangoganizani kuti ndinu munthu wathanzi, wopanda matenda kapena ululu uliwonse, wochita zinthu zanu za tsiku ndi tsiku. Mumachita masewera olimbitsa thupi, mumadya bwino, ndipo mumamwa. Koma mwadzidzidzi, mosayembekezereka, mumamva kupweteka kwambiri pachifuwa panu, kupsinjika. Mumayamba kutuluka thukuta, mumavutika kupuma, ndipo mumamva kupweteka komwe kumatsika m'manja mwanu. Kodi chinthu choyamba chomwe chimabwera m'maganizo mwanu ndi chiyani? "O, kodi ndili ndi vuto la mtima?" Kodi si mantha amenewo? Koma zizindikiro izi nthawi zonse sizili zofanana ndi zizindikiro za vuto la mtima wamba lomwe timadziwa. Lero, tikambirana za ngozi yachipatala yomwe imawoneka yofanana, koma yosiyana pang'ono, makamaka pakati pa akazi achichepere, athanzi. Timatcha izi 'Spontaneous Coronary Artery Dissection' kapena '(SCAD)' mwachidule.
Mwachidule, kodi SCAD ndi chiyani?
Ngakhale dzinali lingamveke ngati lovuta pang'ono, kwenikweni n'zosavuta kumvetsetsa zomwe zikuchitika. Taganizirani mtima wathu ngati injini yomwe imagwira ntchito nthawi zonse. Injini iyi imafunika magazi nthawi zonse, zomwe zikutanthauza mpweya ndi zakudya, kuti igwire ntchito. Magazi awa amatengedwa kupita ku minofu ya mtima ndi mitsempha yamagazi yomwe ili ngati mapaipi ang'onoang'ono. Izi ndi zomwe timatcha mitsempha ya mtima.
Tsopano, ngakhale kuti mtsempha wa mtima uwu uli ngati chubu, khoma lake limapangidwa ndi zigawo zitatu zomwe zimamatiridwa pamodzi. Monga keke ya zigawo. Pankhani ya SCAD, chomwe chimachitika ndi chakuti, popanda chifukwa chomveka, kung'ambika pang'ono kumachitika mwadzidzidzi mu chimodzi mwa zigawo zomwe zili mkati mwa khoma la mtsempha uwu.
Tangoganizirani zomwe zimachitika mkati mwa chitoliro cha madzi mukang'ambika pang'ono. Kuthamanga kwa madzi kumapangitsa kuti madzi atuluke kudzera mu kung'ambikako ndikutsekeka pakati pa makoma awiri a chitolirocho. Mofananamo, pakakhala kung'ambika mumtsempha wamagazi, magazi omwe akuyenda pansi pa kuthamanga kwamphamvu amatuluka pakati pa nembanemba ziwirizi ndikusonkhana. Magazi akagwidwa motere, amatupa mu khoma la mtsempha wamagazi pamalopo, ndikutseka kuyenda kwa magazi. Izi zimatchedwa ``hematoma``. Pamene kuyenda kwa magazi kuchepetsedwa kapena kutsekeka kwathunthu mwanjira iyi, kuchuluka kwa magazi komwe kumafika ku minofu ya mtima kumachepa. Pamenepo ndi pomwe zizindikiro za matenda amtima zomwe tidakambirana kale zimawonekera.
Chofunika ndichakuti SCAD si matenda a mtima, omwe nthawi zambiri amayamba chifukwa cha mafuta m'thupi (atherosclerosis) omwe amatseka mitsempha yamagazi. Iyi ndi njira yosiyana kwambiri.
Kodi zizindikiro za izi ndi ziti? Kodi mumazindikira bwanji?
Zizindikiro za SCAD zimafanana kwambiri ndi za matenda a mtima wamba, kotero n'zosavuta kusokoneza ziwirizi. Koma ngati mukukumana ndi zizindikiro izi, ndikofunikira kuziona ngati zadzidzidzi zachipatala .
| Chizindikiro | Kufotokozera |
|---|---|
| Kupweteka pachifuwa kapena kupanikizika | Ichi ndi chizindikiro chofala kwambiri. Zingamveke ngati chifuwa chanu chikulimba kapena chikuchepa. |
| Kuvuta kupuma | Mungamve ngati mukulephera kupuma ndipo chifuwa chanu chingamve ngati chadzaza. |
| Ululu m'manja, paphewa, pakhosi, kapena m'nsagwada | Ululu pachifuwa ukhoza kufika pa mkono wakumanzere, phewa, kapena nsagwada. |
| Thukuta kwambiri | Mungamve kuzizira komanso thukuta popanda chifukwa. |
| Chizungulire kapena mutu wopepuka | Kumva chizungulire kapena kukomoka. |
| Kusanza ndi kusanza | Kusanza kungabwere chifukwa cha kupweteka m'mimba. |
| Kugunda kwa mtima | Kumva ngati mtima wako ukugunda mofulumira. |
Ngati mukukumana ndi zizindikiro izi, musazengereze kaye. Pitani ku Dipatimenti Yothandiza Anthu Odwala Mwadzidzidzi (ETU) ya chipatala chapafupi nthawi yomweyo kapena imbani ambulansi. Ichi si chinthu chomwe mungasunge kunyumba.
Ndani amene ali pachiwopsezo chachikulu chotenga matenda a SCAD?
Ichi ndi chinthu chodabwitsa kwambiri pa SCAD. Matenda a mtima nthawi zambiri amapezeka mwa anthu okalamba, omwe ali ndi zinthu zoopsa monga matenda a shuga, kuthamanga kwa magazi, ndi cholesterol. Koma SCAD si choncho.
- Omwe amapezeka kwambiri mwa akazi: Mwa odwala 10 a SCAD, 9 ndi akazi.
- Ali aang'ono: Matendawa ndi ofala kwambiri, makamaka pakati pa akazi athanzi azaka zapakati pa 40-50 omwe alibe zinthu zina zomwe zimayambitsa matenda a mtima.
- Zokhudzana ndi mimba: Azimayi ena amatha kukhala ndi vutoli panthawi ya mimba kapena atabereka. Amakhulupirira kuti limayambitsidwa ndi kusintha kwa mahomoni ndi nkhawa yobereka.
- Kupsinjika kwakukulu kwa thupi kapena maganizo: Kukweza mwadzidzidzi zolemera zolemera, kuchita masewera olimbitsa thupi mwamphamvu, kapena kuvulala kwambiri kwamaganizo kapena chisoni kungayambitse matenda a SCAD.
- Matenda ena: Anthu omwe ali ndi Fibromuscular Dysplasia (FMD) (matenda omwe amafooketsa makoma a mitsempha yamagazi), matenda olumikizana ndi minofu monga Marfan syndrome, ndi lupus nawonso ali pachiwopsezo.
Kodi dokotala amazindikira bwanji izi?
Mukapita ku chipinda chodzidzimutsa, chinthu choyamba chomwe madokotala amachita ndikuwona ngati muli ndi vuto la mtima. Amachita mayeso angapo kuti adziwe ngati muli ndi vuto la mtima. Pamafunika mayeso apadera kuti mudziwe bwino matenda a SCAD.
| Mayeso | Mwachidule... |
|---|---|
| ECG (Electrocardiogram) | Kugwira ntchito kwa magetsi kwa mtima kumalembedwa ndipo zizindikiro za matenda a mtima zimayesedwa. |
| Mayeso a Magazi | Kuchuluka kwa ma enzyme omwe amasonkhana m'magazi minofu ya mtima ikawonongeka kumayesedwa. |
| Angiogram ya Mitsempha ya Mtima | Iyi ndiye njira yayikulu komanso yofunika kwambiri yodziwira matenda a SCAD.Kachubu kakang'ono kamalowetsedwa kudzera m'mitsempha ya m'dzanja kapena mwendo ndipo utoto wapadera umalowetsedwa m'mitsempha ya mtima. Kenako X-ray imatengedwa kuti ione mkati mwa mitsempha. Pankhani ya SCAD, izi zitha kuwonetsa bwino momwe mtsempha wamagazi waphulika komanso momwe magazi atsekekera. |
| IVUS kapena OCT | Izi ndi ma scan apadera omwe amachitidwa nthawi imodzi ndi angiogram kuti aone bwino mkati mwa mtsempha wamagazi. |
Kodi chimachiritsidwa bwanji? Zimatenga nthawi yayitali bwanji kuti munthu achire?
Chithandizo cha SCAD n'chosiyana pang'ono ndi kuchiza matenda a mtima wamba. Chodabwitsa n'chakuti, milandu yambiri ya SCAD imatha yokha pakapita nthawi ndi mankhwala, popanda opaleshoni kapena njira zazikulu. Thupi limatha kuchiritsa mtsempha wosweka lokha.
Njira zochizira
- Chithandizo cha mankhwala: Mankhwala monga aspirin oletsa magazi kuundana, beta-blockers oletsa kugunda kwa mtima ndi kuthamanga kwa magazi ndikuchepetsa mitsempha yamagazi, komanso mankhwala oletsa kupweteka pachifuwa ndi ofunikira.
- Kugonekedwa m'chipatala: Wodwalayo amakhala m'chipinda chosamalira odwala kwambiri kapena m'chipinda chosungira odwala kwa masiku angapo, ndipo ntchito ya mtima imayang'aniridwa mosamala.
- Angioplasty ndi Stenting: Izi zimachitika kawirikawiri. Pokhapokha ngati mtsempha watsekeka kwathunthu ndipo moyo wa wodwalayo uli pachiwopsezo, baluni imagwiritsidwa ntchito kudzaza mtsempha ndipo chipangizo chonga mesh (stent) chimayikidwa kuti chikhale chotseguka.
- Opaleshoni Yodutsa: Izi sizimachitika kawirikawiri pa SCAD.
Nthawi yochira imasiyana malinga ndi munthu. Nthawi zambiri mumayenera kukhala m'chipatala kwa masiku pafupifupi 3-5. Zingatenge milungu ingapo kapena miyezi ingapo kuti mtsempha wong'ambikawo uchire bwino. Komabe, ndikofunikira kwambiri kutsatira malangizo a dokotala mosamala panthawiyi.
Pambuyo pochira
Ngakhale mutachira, muyenera kupitiriza kupita kuchipatala motsogozedwa ndi dokotala wa mtima.
- Kubwezeretsa Mtima: Izi ndizofunikira kwambiri. Pulogalamu iyi imakuthandizani kuchita masewera olimbitsa thupi mosamala moyang'aniridwa ndi dokotala, kudya zakudya zabwino komanso kuchepetsa nkhawa.
- Kusintha kwa moyo: Dokotala wanu angakulangizeni kuti mupewe kunyamula zinthu zolemera komanso kuchita zinthu zomwe zingakupangitseni kukhala ndi thupi lotopa kwambiri.
Pamene munthu ali ndi SCAD, n’zachibadwa kukhala ndi nkhawa komanso nkhawa, n’kumaganiza kuti, “Kodi chinthu chonga ichi chingachitikenso?” Kambiranani momasuka za izi ndi dokotala wanu. Funsani uphungu wa maganizo ngati pakufunika kutero.
Uthenga Wopita Nawo Kunyumba
- SCAD ndi matenda adzidzidzi omwe amachititsa kuti mtsempha wamagazi mumtima uphulike mwadzidzidzi, ngakhale kuti ali ndi zizindikiro zofanana ndi za matenda a mtima, koma ndi osiyana.
- Vutoli limapezeka kwambiri mwa atsikana athanzi omwe sali pachiwopsezo cha matenda ena a mtima.
- Ngati mukuona zizindikiro monga kupweteka pachifuwa, kuvutika kupuma, kapena kutuluka thukuta kwambiri, musanyalanyaze. Pitani ku Dipatimenti Yothandiza Anthu Odwala Mwadzidzidzi (ETU) ya chipatala nthawi yomweyo.
- Odwala ambiri a SCAD amachira kwathunthu ndi mankhwala, ndipo opaleshoni siifunikira kawirikawiri.
- Mukachira, kutsatira malangizo a dokotala wanu, kupitiriza kupita kuchipatala, komanso kutenga nawo mbali mu mapulogalamu ochiritsira matenda a mtima ndikofunikira kwambiri pa thanzi lanu lamtsogolo.
- Musazengereze kulankhula ndi dokotala wanu za mantha ndi nkhawa zomwe mumakumana nazo mutakumana ndi vutoli ndipo funsani thandizo lofunikira la maganizo.
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