Wakambonzwa nezvechirwere chemwoyo here? Vazhinji vedu takambonzwa nezvazvo. Mukurapa, izvi zvinonzi Coronary Artery Disease ( CAD ). Zvichitaurwa zviri nyore, idambudziko apo mafuta necholesterol zvinoungana mutsinga dzinotakura ropa kuenda kumoyo, zvichiita kuti ropa riderere. Asi idzi tsinga dzinogona kuvharika nenzira dzakasiyana. Nhasi, tichataura nezvedambudziko rakaoma zvishoma rinoda kutariswa zvakanyanya. Kureva kuti, kana mafuta aungana ovhara tsinga apo tsinga huru mumoyo inopatsanura kuita bazi diki. Fungidzira kuzara kwemotokari mumugwagwa wakaita seY, ipapo chaipo migwagwa miviri inopatsanurana. Vanachiremba vanoti izvi 'Bifurcation Blockage'.
Chii chaizvo chinonzi Bifurcation Blockage ichi?
Zvakanaka , ngatizvitaure nenzira iri nyore. Mwoyo wako imhasuru inoshanda nguva dzose. Unowana simba neokisijeni yaunoda kubva mutsinga dzeropa dzinonzi coronary arteries . Mitsipa mikuru iyi inopararira kuita matavi madiki kuti iendese ropa kumativi ese emoyo.
Zvino, kuvharika uku kweBifurcation kunoitika kana mafuta aunganidzwa (tinoti plaque ) aumbwa apo tsinga huru inopatsanurana kuita bazi diki, ndiko kuti, panosangana Y. Plaque iyi inovhara kufamba kweropa. Vanachiremba vanodana bazi diki iri kuti "mudziyo wepadivi-pebazi." Plaque iyi inonziwo "bifurcation lesion."
Nzvimbo iyi yakaoma zvishoma kuvharika kupfuura dzimwe nzvimbo. Nekuti kuyerera kweropa nekumanikidzwa kwakasiyana pano, pane mukana wakakura wekuti plaque iungane munzvimbo idzi. Uye zvinogona kuoma kurapa.
Pane mhando huru dzekuvhara uku here?
Ehe, vanachiremba vanoisa muzvikamu kuvharika uku zvichienderana nekuoma, kureva kuti, huwandu hwetsinga dzakavharika. Izvi zvinonzi stenosis . Kune mhando mbiri huru.
| Rudzi rwekuvharika | Tsananguro iri nyore |
|---|---|
| Kuvhara kuri nyore | Apa ndipo apo tsinga yeropa inenge yakavharwa neasingasviki 70%. Izvi zvinoreva kuti kuchine mukana wekuti ropa rifambe. Izvi zviri nyore kurapa. |
| Kuvharika kwakaomarara | Pano, tsinga yeropa yakavharika neanopfuura 70%, zvichireva kuti yakavharika zvakanyanya. Dzimwe nguva panogona kuva nekuvharika kunopfuura kamwe chete. Kana kuti kuvharika uku kunogona kukonzerwa nekugwamba kweropa kana kuti calcification. Chimwe chinhu ndechekuti, dzimwe nguva kana bazi diki iroro rikatsemuka nekona yakapinza (inopfuura madhigirii 70), zvinonetsa kuisa zvishandiso nekurapa nzvimbo iyoyo. |
Mamiriro ezvinhu aya akajairika sei munyika medu?
Ichi chirwere chinowanzoitika. Zvinofungidzirwa kuti pakati pe15% ne20% yezvirwere zvese zve coronary artery disease (CAD) zvinoda kurapwa zvinowira muchikamu ichi, chinozivikanwa se bifurcation blockages. Zvichitaurwa zviri nyore, pavarwere zana vanouya kuchipatara vaine coronary artery yakavharika, vanenge 15-20 vane blocage panosangana iyi artery. Saka, ichi hachisi chinhu chekurerutsa.
Sei izvi zvichiitika? Chii chiri kukonzera izvi?
Chikonzero chikuru cheizvi imafuta anowanikwa anonzi plaque atakataura nezvawo kare. Izvi zvakafanana nekuunganidza kwengura netsvina mupombi yemvura nekufamba kwenguva, zvichikonzera maburi mupombi. Plaque iyi inoumbwa nekuunganidzwa kwecholesterol, mafuta, uye calcium mumadziro etsinga dzedu dzeropa. Nekufamba kwenguva, plaque iyi inokura uye inoita kuti ropa ripfuure nemutsinga. Pakupedzisira, moyo haugamuchire huwandu hweropa hunodiwa. Tinoti chirwere ichi chinonzi atherosclerosis . Kuvharika kwebifurcation kunokonzerwawo nechirwere ichi che atherosclerosis.
Ndiani ari panjodzi huru?
Kunyangwe chirwere ichi chichigona kuitika kune chero munhu, vamwe vanhu vari panjodzi huru. Kana uine chimwe kana zvimwe zvezvinhu izvi zvine njodzi, zvakanaka kuti uchenjerere zvishoma.
| Chinhu chine njodzi | Tsananguro iri nyore |
|---|---|
| Zera uye murume kana mukadzi | Njodzi yacho yakakura kuvakadzi mushure mekuguma kuenda kumwedzi uye kuvarume vane makore anopfuura 45. |
| Chirwere cheshuga | Chirwere cheshuga chinogona kukanganisa mitsipa yeropa, zvichiita kuti zvive nyore kuti plaque iungane. |
| Kufuta zvakanyanya kana kufuta | Sezvo huremu hwemuviri huchiwedzera, zvimwe zvinhu zvinokonzera njodzi zvakaita secholesterol neBP zvinowedzerawo. |
| Nhoroondo yemhuri | Kana mumwe munhu mumhuri yako (amai, baba, vanun'una nemadzikoma) aine chirwere chemwoyo, iwewo uri panjodzi huru. |
| Kukwira kweropa (BP) | Kana kumanikidzwa kwacho kwawedzera, madziro etsinga dzeropa anokuvara uye plaque inogona kuumbwa zviri nyore. |
| Kolesteroli yakakwira | Ichi ndicho chinhu chikuru chinoita kuti pave neplaque. Njodzi yacho yakakura kana paine cholesterol yakaipa (LDL) yakawanda muropa. |
| Kusaita maekisesaizi uye kudya zvisina kunaka | Vanhu vasingaite zvemuviri uye vanodya chikafu chine mafuta akawanda, shuga, uye munyu vari panjodzi huru. |
| Kusvuta | Kusvuta kunokanganisa zvakananga mitsipa yeropa uye kunowedzera njodzi yekugwamba kweropa. |
Ndezvipi zviratidzo zvaungaona?
Kuvharika kwetsinga dzeropa (bifurcation blockage) rudzi rwechirwere chemwoyo (CAD), saka zviratidzo zvakafanana. Kana uine chimwe chezviratidzo izvi kana kupfuura, enda kuna chiremba nekukasika.
- Kurwadziwa pachipfuva kana kumanikidzwa (Angina): Ichi ndicho chiratidzo chikuru. Chinogona kunzwa sekunge chiri kudzvinyirirwa kana kudzvinyirirwa pakati pechipfuva.
- Kushaya mweya: Kunzwa kushaya mweya kana waneta zvishoma, kana kuti paunenge uchikwira masitepisi.
- Kunzwa kuneta zvisina kujairika: Kunzwa kuneta zvakanyanya kana kushaya simba pasina chikonzero.
- Kurwadziwa kwepafudzi kana ruoko: Kurwadziwa kunofamba neruoko rweruboshwe, kunyanya.
- Dzungu (vertigo) kana kufenda: Kunzwa kutenderera uye kutadza kumira.
- Kusvotwa: Kunzwa kuda kurutsa.
- Kunzwa kutonhorwa uye kudikitira.
- Kunzwa kurova kwemoyo kusingawanzoitiki (Heart Palpitations).
Chinhu chakakosha ndechekuti havasi vese vanozosangana nezviratidzo izvi zvese. Vamwe vanhu vanogona kunge vaine chirwere ichi vasina zviratidzo zvachose. Saka, kuchenjera kugara uchiongororwa nachiremba kana uine zvinhu zvinokuvadza.
Chiremba anowana sei izvi?
Kana ukaudza chiremba wako nezvezviratidzo zvawataura pamusoro apa, achakuongorora uye achakutumira kuti unoongororwa kakawanda kuti asimbise chirwere ichi.
- ECG (Electrocardiogram): Izvi zvinoedza mashandiro emagetsi emwoyo kuti zvionekwe kana paine kukuvara kwemoyo.
- Kuongororwa Kwepfungwa: ECG inotorwa paunenge uchifamba patreadmill, uchitarisa mashandiro anoita moyo wako paunenge wakaneta.
- Echocardiogram: Kuongororwa kwemoyo neultrasound.
- Kuongororwa kwemoyo (Coronary Angiogram): Uku ndiko kuongorora kukuru kwekuona kana paine kuvharika kwetsinga dzeropa. Kachubhu kadiki kanopinzwa nepagumbo kana ruoko, koiswa mutsinga dzemwoyo, uye mvura yakakosha inopinzwa, uye mifananidzo yeX-ray inotorwa. Izvi zvinokutendera kuti uone kuti kuvharika kwacho kuri papi zvakajeka.
- CCTA (Coronary Computed Tomography Angiogram): Izvi zvakafanana ne angiogram, asi bvunzo inoitwa uchishandisa muchina weCT scan pasina kuisa chubhu mumuviri.
Miedzo iyi ichabvumira chiremba wako kuti aone kana uine bifurcation blockage uye kuti yakanyanya sei.
Ndezvipi zvinorapwa izvi?
Kurapa kuvharika kwetsinga mbiri kwakaoma zvishoma nekuti tsinga yemusana iri padivi idiki zvikuru, zvichiita kuti zvive zvakaoma kurapa nemidziyo kupfuura tsinga huru.
Kurapa kukuru i angioplasty ne stenting . Uku hakusi kuvhiyiwa. Izvi zvinonzi Percutaneous Coronary Intervention (PCI).
Hezvino zviri kuitika pano:
1. Chiremba achabvisa ganda reruoko rwako kana gumbo, ocheka ganda diki, obva aisa catheter nepariri.Chubhu yakatetepa, inochinjika inonzi catheter inopinzwa mutsinga yeropa.
2. Zvadaro, panguva yekutarisa X-ray screen, chubhu inotungamirwa kunzvimbo chaiyo yetsinga yakavharika mumoyo.
3. Pane bharumu diki kumagumo kwecatheter. Kana yasvika pakuvharika, bharumu rinozara. Ipapo plaque inodzvanya pamadziro etsinga, ichivhura nzira yakavharika zvakare.
4. Zvadaro, kuti gomba risavharwe zvakare, chubhu diki inonzi stent inoiswa panzvimbo iyoyo.
Mushure mekurapwa uku, chiremba wako achakupa mishonga yakakosha (dual antiplatelet therapy) kudzivirira kuumbwa kweropa mukati me stent. Zvakakosha kuti utore mishonga iyi kwenguva yakatarwa.
Ndedzipi nzira dzekurapa?
Kune nzira mbiri huru dzekuvhara jira rinopisa.
- Kuisa stent kwenguva pfupi: Munzira iyi, chiremba anongoisa stent mutsinga huru yeropa. Bazi diki hariisirwi. Stent inogona kuiswa mubazi diki pane imwe nguva, chete kana ukava nezviratidzo zvakare.
- Maitiro Ekushandisa Stent Two: Kana kuvharika kwacho kwakaoma zvikuru, chiremba anogona kusarudza kuisa stents mutsinga huru yeropa nebazi diki rinobuda.
Pane matambudziko angangoitika mushure mekurapwa here?
Kunyange zvazvo angioplasty ne stenting zviri mishonga inobudirira, matambudziko anogona kuitika muvanhu vashoma kwazvo .
| Dambudziko | Tsananguro iri nyore |
|---|---|
| Kugadzikana kweIn-stent | Izvi zvinoreva kuti mavanga anoumbwa pasi pe stent, zvichiita kuti tsinga yeropa itetepe zvakare. Izvi zvinowanzoitika mukati memwedzi mitanhatu yekurapwa. Kana izvi zvikaitika, ungangoda kuitirwa imwe angioplasty kana imwe nzira yekurapa. |
| Kushungurudzika Kwepfungwa | Ichi chirwere chakakomba, asi chisingawanzoitiki, apo ropa rinogwamba mukati me stent uye rinovhara tsinga kamwe kamwe. Kuti udzivise izvi, unofanirwa kutora mushonga unomisa kugwamba kweropa zvakanaka. |
Mamiriro ezvinhu akadai haagone kudzivirirwa here?
Zvinogoneka zvechokwadi. Chirwere chemwoyo chinonyanya kuenderana nemararamiro edu. Saka, kutora mararamiro ane hutano hwemwoyo kunogona kuderedza zvikuru njodzi yekubatwa nechirwere ichi.
- Idya chikafu chine hutano pamoyo. Deredza zvekudya zvine mafuta akawanda, munyu, uye shuga zvakanyanya sezvinobvira. Isa michero, miriwo, nyemba, hove diki, uye zviyo zvakakwana mukudya kwako.
- Kana uchisvuta, rega nhasi. Kusvuta ndeimwe yevavengi vakuru vemwoyo.
- Maekisesaizi nguva dzose. Ita chimwe chinhu chakadai sekufamba netsoka kana kutasva bhasikoro kwemaminitsi makumi matatu pazuva.
- Dzora huremu hwemuviri wako. Pane huremu hwakati hwakakodzera kureba kwako. Edza kuhuchengetedza.
- Kana uine chirwere cheshuga, BP yakakwira, kana cholesterol, dzora izvi nekutora mishonga yawakanyorerwa nachiremba.
- Deredza kushushikana. Zvakanaka kwazvo kuita zvinhu zvakaita seyoga nekufungisisa.
- Deredza kunwa doro.
Unofanira kuona chiremba nekukasika rini?
Yeuka izvi: Kana ukaona zviratidzo zvekurwara nemoyo, zvakaita sekurwadziwa kwechipfuva kamwe kamwe, kushaya mweya, kana kudikitira, usanonoka kwesekondi. Fonera 911 nekukasika kana kuendesa murwere kuEmergency Department (ETU) yechipatara chiri pedyo.
Pamusoro pezvo, kana ukasangana nezviratidzo zvinotevera kakawanda, iva nechokwadi chekuona chiremba kuti akupe mazano.
- Kurwadziwa pachipfuva (angina), kurwadziwa kweruoko kana pamafudzi
- Kunzwa kutonhora uye kudikitira
- Kuoma kufema
- Kuneta kana kushaya simba kusingatsananguriki
Mibvunzo yekubvunza chiremba wako
Kana ukaona kuti une chirwere ichi, zvakajairika kuva nemibvunzo yakawanda mupfungwa dzako. Usavanza chero chinhu, bvunza chiremba wako kuti uwane mhinduro.
- Chii chiri kundikonzera kubatwa seizvi?
- Pane njodzi here yekuvharika kwetsinga dzeropa dzangu dzimwe?
- Ko angioplasty ne stenting zvinogona kurapa zvachose kuvharika uku here?
- Unondikurudzira rudzii rwestent?
- Ndinofanira kuisa ma stents mangani?
- Chii chandinofanira kuita kuti ndidzivirire moyo wangu?
- Ndezvipi zvinetso zvandinofanira kunetseka nazvo mushure mekurapwa?
Ndinovimba ruzivo urwu ruchakubatsira kunzwisisa zviri nani chirwere ichi. Yeuka, ichi hachisi chinhu chekutya, asi chinhu chinofanira kutarisirwa nemazvo.
Mharidzo Yekuenda Nayo Kumba
- Kuvharika kweropa mumoyo (bifurcation blockage) rudzi rwakasiyana rwekuvharika kunoitika apo tsinga yeropa mumoyo inopatsanuka kuita matavi. Izvi zvakaoma kupfuura kuvharika kwakajairika.
- Zviratidzo zvakafanana nezvechirwere chemwoyo chinowanzoitika. Marwadzo echipfuva uye kushaya mweya ndizvo zvinonyanya kukosha. Usambofa wakafuratira izvi.
- Kuisa stent mu stent inzira yekurapa inobudirira, asi inoda kupindira kwachiremba ane ruzivo.
- Chinonyanya kukosha kupfuura kurapwa kuchinja mararamiro ako. Kudya zvakanaka, kurovedza muviri, uye kudzivisa tsika dzakaipa zvakakosha.
- Kurwadziwa kwakanyanya pachipfuva idambudziko guru. Enda kuchipatara kuEmergency Department (ETU) nekukasika.
Chirwere chemwoyo, Kuvharika kweBifurcation, Chirwere cheCoronary Artery, Kusviba kweStent, Angioplasty, Marwadzo echipfuva, Kurwiswa neMwoyo
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