Kuvharika kwemoyo wako kwakavharika here? (Kuvharika kwepakati) Ngatikurukurei izvi!

Nhasi tichataura nezvechimwe chinhu chakakosha kuvanhu vazhinji, asi pamwe havachizivi zvakanyanya. Dzimwe nguva unonzwa chipfuva chakabatikana, kunetseka kufema here? Kana kuti wakambonzwa shamwari yako ichitaura nezvechirwere chemwoyo here? Panguva dzakadaro, chimwe chezvinetso zvatinonzwa nezvacho idambudziko rine chekuita netsinga dzeropa dzemwoyo rinonzi 'Bifurcation Blockage'. Zvichitaurwa zviri nyore, uku kuvharika kunoitika panzvimbo apo bazi retsinga rinopa ropa kumatavi emwoyo. Ngatizvitarisei zvakadzama, handiti?

Chii chinonzi 'Bifurcation Blockage' iyi?

Zvakanaka, ngationei kuti 'Bifurcation Blockage' iyi chii zviri nyore. Fungidzirai, mwoyo wedu wakaita sepombi yemvura. Kuti pombi iyi irambe ichishanda, inoda ropa rinogara richiwanikwa. Ropa iroro rinoendeswa kutsandanyama dzemwoyo nehurongwa hwakakosha hwetsinga dzeropa hunonzi Coronary Arteries . Mitsipa mikuru yeropa iyi inopatsanurana kuita matavi madiki pane dzimwe nzvimbo, semapazi emuti mukuru anobuda. Kana, unogona kuiona senzira yekuyambuka mugwagwa inopatsanurana kuita maviri.

Nzvimbo iyo tsinga huru inopatsanura kuita bazi diki inonzi 'bifurcation' . Saka, kana kupatsanurwa uku, kutaura chokwadi, kuri panzvimbo yakaita se 'Y'-shaped junction, uye kuvharika kukaitika mukati metsinga nekuda kwekuunganidzwa kwemafuta (tinoti iyi 'plaque' ), saka iyo inonzi 'bifurcation blockage' . Iyi 'plaque' idura rakagadzirwa necholesterol, mafuta, uye calcium. Vanachiremba vanodanawo idzi tsinga diki dzebazi 'side-branch vessels' . Mafuta anokonzera kuvharika uku anonziwo 'bifurcation lesions' . Unonzwisisa here? Zvakafanana nekuzara kwemotokari panzvimbo inoungana mugwagwa.

Pane mhando dzezvidziviriro izvi here?

Ehe, kuvharika uku kunogonawo kuva kwemhando dzakasiyana. Kureva kuti, vanachiremba vanoona kuoma kweizvi zvichienderana nekuti tsinga yacho yavharika zvakadii. Kana tsinga ikava diki, tinoidaidzawo kuti 'Stenosis' mukurapa. Kune mhando mbiri dze'Bifurcation Blockage':

• Kuvharika kuri nyore: Izvi zvinoitika kana dhayamita yemukati metsinga iri pasi pe70% yakavharwa. Izvi zvinoreva kuti kufamba kweropa kuchiri kushoma, asi panogona kunge paine kuvharika.
• Kuvharika kwakaoma: Apa ndipo panonyanya kukonzera dambudziko. Zvinopfuura 70% yetsinga, kana kuti zvinopfuura zvikamu zvitatu muzvina zvemukati metsinga, zvinogona kuvharika. Dzimwe nguva panogona kuva nekuvharika kunopfuura kamwe chete munzvimbo dzakasiyana-siyana. Kana kuti ropa rinogona kuvharika, kana kuti calcium deposits inogona kunge yaumbwa (tinoidaidza kuti 'calcification').(ngatitii) Madziro etsinga anogona kunge akaomarara uye asingachinjiki zvakanyanya. Chimwe chinhu ndechekuti, dzimwe nguva kuvharika uku kunogona kunge kuri panzvimbo apo tsinga diki yebazi inodhonzwa pakona yakapinza (inopfuura madhigirii makumi manomwe). Kana izvozvo zvikaitika, zvinonetsa kurapa, nekuti zvinonetsa kurapa nemidziyo yekurapa.

Kuvharika uku kwe "bifurcation blockage" kwakajairika sei?

Ungave uchishamisika kuti izvi zvakajairika sei. Kutaura zvazviri, zvinofungidzirwa kuti pakati pe15% ne20% yezvirwere zvese zve coronary artery disease (CAD) zvinoda kurapwa, kana kuti munhu mumwe chete pavashanu, zvinokonzerwa ne'bifurcation blockage' iyi. Saka, kunyange zvazvo zvingasava zvakajairika kudaro, chirwere chinogona kukanganisa vanhu vazhinji.

Chii chinokonzera izvi?

Chii chinonyanya kukonzera kuvharika uku? Sezvandambotaura kare, chikonzero chikuru cheizvi kuunganidzwa kwemafuta nemafuta, kureva kuti, 'plaque' , mukati memadziro etsinga dzedu dzeropa. Zvakafanana nepombi yekare yemvura iyo nekufamba kwenguva inokora uye inounganidza tsvina uye inovharika mupombi. Nekufamba kwenguva, 'plaque' iyi inoungana uye inotetepa nzira iri mukati metsinga. Ipapo huwandu hweropa hunodiwa nemoyo, kureva okisijeni nezvinovaka muviri, hahufambi zvakanaka. Iyi 'Bifurcation Blockage' ndeyechikamu chimwe chete chechirwere chemwoyo (CAD) .

Ndiani ari panjodzi huru yekuva nechirwere ichi?

Iye zvino ngationei kuti ndiani angangosangana nechirwere ichi, kana kuti zvinhu zvinokonzera njodzi ndezvipi. Zvakakosha kuziva izvi, nekuti zvimwe zvinhu zvatinogona kudzora.

Kazhinji, vakadzi vane mukana mukuru wekuva neCAD uye Bifurcation Blockage mushure mekuguma kuenda kumwedzi , zvinoreva kuti vanorega kuenda kumwedzi, uye varume vane mukana mukuru wekuva neCAD mushure memakore makumi mana nemashanu.

Pamusoro pezvo, kune zvimwe zvinhu zvakawanda zvinokonzera njodzi:

• Chirwere cheshuga: Vanhu vane chirwere cheshuga vanowanzova nematambudziko etsinga dzeropa nekuti chirwere cheshuga chinogona kukuvadza madziro etsinga dzeropa.
• Kufuta zvakanyanya kana kuti kufutisa: Kana uremu hwemuviri hukawedzera, zvinova zvakaoma kuti moyo uzvigone uye unofanira kushanda nesimba zvakanyanya.
• Nhoroondo yemhuri yechirwere chemwoyo: Dzimwe nguva izvi zvinogona kukonzerwa nekukanganiswa kwemajini.
• Kukwira kweropa (Hypertension): Kukwira kweropa zvinoreva kuti pane kumanikidzwa kusingakoshi patsinga. Izvi zvinogona kukuvadza tsinga.
• Cholesterol yakakwira: Cholesterol ndiyo inonyanya kukonzera kuumbwa kweplaque , kunyanya huwandu hwakawanda hwe "cholesterol" yakaipa (LDL).
• Kusaita maekisesaizi:Kana muviri usingaite maekisesaizi, une mukana wekuunganidza mafuta uye hutano hwemwoyo hunodererawo.
• Kudya kusina kunaka: Kana ukadya chikafu chine mafuta akawanda, shuga, nemunyu nguva dzose, njodzi yacho yakakura. Funga nezvechikafu chisina kunaka chatinodya, chikafu chinokurumidza, zvinwiwa zvine shuga, uye chikafu chakakangwa... Kana ukaramba uchidya izvi, matambudziko anogona kumuka.
• Kusvuta kana kushandisa zvigadzirwa zvefodya: Kusvuta ndeimwe yevavengi vakuru vemwoyo. Makemikari ari mufodya anokuvadza zvakananga mitsipa yeropa.

Ndezvipi zviratidzo zveizvi?

Sezvo Bifurcation Blockage iriwo rudzi rwechirwere chemwoyo (CAD) , zviratidzo zvakafanana. Zvisinei, dzimwe nguva chirwere ichi chinogona kuvapo pasina zviratidzo. Zvisinei, zviratidzo zvakajairika ndeizvi:

• Angina: Uku kunzwa kurwadziwa kana kubatwa muchipfuva, kunzwa kwekuvharika. Vamwe vanhu vanokutsanangura sekurema pachipfuva, kana sekunge chipfuva chiri kudzvanywa. Kurwadziwa uku kunowanzo wedzera panguva yekurovedza muviri, kukwira masitepisi, kana kana paine kumanikidzwa pamoyo.
• Kudikitira nechando: Ungangoerekana wanzwa kutonhora uye kudikitira, kunyanya nekurwadziwa kwechipfuva.
• Kunzwa dzungu kana kunzwa musoro wakareruka: Kunzwa sekunge haugone kumira, maziso ako ari kuita bhuruu.
• Kuneta uye kushaya simba: Unganzwa kuneta uye usingakwanise kuita chero chinhu. Ungawanawo zvakaoma kuita mabasa aimbova nyore.
• Kurova kwemoyo: Kunzwa sekunge uri kunzwa moyo wako uchirova, kana kuti moyo wako uchirova nekukurumidza, sekunge chipfuva chako chiri kurova.
• Kusvotwa: Kunzwa sekunge uri kurwara, pamwe kutorutsa.
• Kushaya mweya: Unonzwa kushaya mweya kunyangwe mushure mekuita zvimwe zvinhu zvishoma. Dzimwe nguva, unogona kunetseka kufema kunyangwe wakarara.
• Kurwadziwa kwepafudzi kana ruoko: Dzimwe nguva kurwadziwa uku kunogona kutanga muchipfuva uye kunofamba nepamutsipa, shaya, pafudzi, kana ruoko rweruboshwe.

Zvakakosha: Kana uine chimwe chezviratidzo izvi kana kupfuura, usafunge kuti chirwere chacho chiripo. Enda kuna chiremba nekukasika.

Vanachiremba vanoona sei izvi?

Kana uine zviratidzo izvi, paunoona chiremba, anogona kuita bvunzo dzakawanda kuti aone kana izvi zviri 'kuvharika kweropa' kana chimwe chirwere chemwoyo. Zvimwe zvacho zvinosanganisira:

• Kuongororwa kwemoyo ne angiogram:Izvi zvinosanganisira kupinza chubhu diki (catheter) nepatsinga yeropa iri muruoko rwako kana gumbo kuenda kutsinga dzemwoyo wako, kuisa dhayi chaiyo mairi, uye kutora mifananidzo yeX-ray. Izvi zvinokubatsira kuona zvakajeka kana paine kuvharika kwetsinga uye kuti dzakakura sei.
• Coronary computed tomography angiogram (CCTA): Iyi iCT scan yakakosha inoshandisa mifananidzo yemativi matatu (3D) kuona kuti ropa rinoyerera sei kuenda kumoyo uye kana paine kuvharika kwetsinga dzeropa.
• Intravascular optical coherence tomography (IVOCT): Iyi inzira yepamusoro-soro. Kana catheter yangoiswa, chimwe chinhu chitete chinopfuudzwa mairi uye plaque inosara mutsinga yeropa, madziro etsinga, inogona kuonekwa mumifananidzo yakajeka uye ine tsananguro yepamusoro.
• Intravascular ultrasound (IVUS): Iyi bvunzo ye ultrasound inotarisa mukati metsinga dzeropa. Kufanana neIVOCT, inogona kupa ruzivo rwakanaka rwemamiriro emadziro etsinga uye hunhu hwe'plaque'.
• Chikamu chekuyerera kweropa (FFR): Izvi zvinoyera mutsauko wekumanikidzwa kweropa mukati metsinga yeropa, kumativi ese ekuvharika kwayo. Zvinogona kunyatsoongorora huwandu hwekuvharika kwayo uye kuona kana kurapwa kuchidikanwa.

Ndezvipi zvinorapwa izvi?

Kurapa 'kuvharika kwebifurcation' dzimwe nguva kunogona kuoma. Nekuti mitsipa yeropa yandataura midiki zvikuru, uye kona yainobuda nayo kubva patsinga huru inokanganiswawo. Saka zvinogona kuoma kusvika nekurapa kupfuura mitsipa mikuru yeropa.

Vanachiremba vanowanzoita oparesheni inonzi angioplasty . Izvi zvinosanganisira kuwedzera tsinga yakamanikana. Zvadaro, chubhu diki inonzi stent inopinzwa mutsinga kuti ropa rirambe richiyerera pasina kuivhara zvakare. Angioplasty ne stenting zvinonzi percutaneous coronary interventions (PCI) .

Zvichitaurwa zviri nyore, izvi ndizvo zvinoitika panguva ye angioplasty uye kuiswa kwe stent:

1. Chiremba anocheka ganda rako, paruoko rwako kana kuti pahudyu, uye anoisa catheter (chubhu diki, inochinjika) nepairi mutsinga yeropa.

2. Catheter iyi inozotungamirirwa nekungwarira kuburikidza netsinga dzeropa kusvika panzvimbo yakavharika mumoyo. Izvi zvinoitwa pasi pekutungamirirwa neX-ray.

3. Pane bharumu diki kumagumo kwecatheter. Kana rasvika panzvimbo yakavharika, kana bharumu razara mweya, plaque inonamira mutsinga iyoyo inonamira pamadziro etsinga, uye tsinga yacho inokura.

4. Ipapo ndipo pane stent.Rimwe (ringave riri pamusoro pebharumu kana kuti rakaparadzana) rinopinzwa mutsinga, bharumu rinofuridzirwa, uye stent inodzvanywa pamadziro etsinga. Bharumu rinozobviswa, stent ichisiyiwa iri panzvimbo yayo mukati metsinga, zvichidzivirira tsinga kuti isatete zvakare.

Mushure mekurapwa uku, chiremba wako achakupa mushonga wekuderedza ropa unonzi 'dual antiplatelet therapy' (wakaita seaspirin neclopidogrel) kwenguva yakati rebei kudzivirira kuumbwa kweropa mukati me stent. Zvakakosha kutora mushonga uyu sezvaunenge waudzwa nachiremba wako, kwenguva yese.

Maitiro ekushandisa stent chaiwo e'bifurcation blockage'

Kune mhando mbiri dzema stents anoshandiswa kurapa chirwere chemwoyo (CAD) . Imwe i stent yesimbi isina chinhu . Imwe i stent inobvisa mishonga . Iyi stent inobvisa mishonga inoshanda kuderedza njodzi yekuti tsinga yeropa itete zvakare (restenosis).

Kune nzira dzinoverengeka huru dzekushandisa stent dzinoshandiswa kurapa kuvharika kwebifurcation:

• Kuisa stent kwenguva pfupi: Muizvi, chiremba anoisa stent mutsinga huru chete. Mhepo yeropa iri padivi haina stent. Zvisinei, kana tsinga huru ikavharika, kana ukaramba uine zviratidzo, stent inogona kuiswa mutsinga iyoyo gare gare.
• Maitiro ekubvisa stent mbiri: Kana paine kuvharika kwakaoma, kana kana kuvharika kwetsinga yebazi kuchikoshawo, chiremba achaisa stent mutsinga huru yeropa netsinga diki yebazi. Kune nzira dzakasiyana dzekuita izvi (semuenzaniso, Culotte, T-stenting, Crush).

Miedzo yekiriniki iri kuenderera mberi parizvino pakushandiswa kwe side-branch stents dzakagadzirirwa kukwana mutsinga diki dzebazi.

Kurapwa kunogona kukonzera matambudziko here?

Dzimwe nguva matambudziko anogona kuitika kune vamwe, asi kwete vese, vanhu vakambovhiyiwa angioplasty uye vakanzwa stent nekuda kwe 'Bifurcation Blockage' . Matambudziko maviri makuru ndeaya:

• Kugara kwenguva refu kwetsvina: Apa ndipo panoumbwa mavanga panzvimbo yestent, pasi kana mukati mestent, zvichiita kuti tsinga itete zvakare. Izvi zvinowanzoitika mukati memwedzi mitanhatu kusvika gumi nemiviri kubva pakuisa stent. Kana izvi zvikaitika, tsinga inofanira kuwedzerwa zvakare ne angioplasty kana kumwe kurapwa. Ma stents asingashandise mishonga akadzikisa njodzi iyi zvakanyanya.
• Kugwinha kweropa: Apa ndipo panoumbwa madota eropa panzvimbo yestent uye mukati metsinga yeropa. Izvi zvinonzi 'Thrombosis'.Iyi inyaya ine njodzi, nekuti ropa rinogwamba rinogona kungoerekana ravhara tsinga yese yokonzera chirwere chemwoyo. Kutora 'dual antiplatelet therapy' nemazvo kunogona kuderedza njodzi iyi zvikuru.

Kujairira kwerudzi urwu hakugone kudzivirirwa here?

Pane zvinhu chaizvo zvatingaita here kudzivirira mhando idzi dzekuvharika? Zvechokwadi! Kutevera matanho aya ekudzivirira mwoyo wako kunogona kuderedza njodzi yako yechirwere chemwoyo (CAD) uye atherosclerosis - mamiriro ezvinhu apo mafuta anoungana mukati metsinga, zvichiita kuti dzikure uye dzisashande zvakanaka.

• Dzora BP yakakwira: Zvakakosha kuderedza munyu mukudya kwako, kunwa mishonga yako sezvawakarairwa nachiremba wako, uye kuongororwa BP yako nguva nenguva.
• Deredza kunwa doro: Deredza kunwa doro zvakanyanya sezvinobvira. Dzivisa kunwa doro zuva nezuva. Kana wakapindwa muropa, tsvaga rubatsiro.
• Idya chikafu chine hutano mumoyo: Izvi zvakakosha zvikuru kuderedza cholesterol. Rega kudya chikafu chine mafuta akawanda, shuga yakawanda, uye chikafu chakagadziriswa, uye idya michero yakawanda, miriwo, nyemba, chikafu chine fiber yakawanda (senge mupunga webrown, oats, ne lentils), uye hove (kunyanya hove dzakapfuma mu omega-3 dzakadai sesalmon ne mackerel) .
• Chenjerera mafuta ako: Deredza kudya kwako chikafu chine mafuta akawanda akazara uye ane trans (semuenzaniso, nyama tsvuku, nyama dzakagadzirwa, zvinhu zvakabikwa, chikafu chakakangwa). Semuenzaniso, mafuta ekokonati haana kunaka kwauri zvakanyanya. Shandisa mafuta ane hutano akadai semafuta emuorivhi nemafuta ecanola zvine mwero.
• Dzora chirwere cheshuga: Kana uine chirwere cheshuga, zvakakosha kuti uchidzore zvakanaka. Kudya, kurovedza muviri, uye kutora mishonga yakanyorerwa nachiremba zvakakosha.
• Dzivisa kusvuta: Kana uchisvuta, tsvaga rubatsiro kuti urege. Kuva nevanhu vanosvuta (kusvuta pasina kusvuta) kunogonawo kuva nengozi.
• Iva nemuviri unoshanda: Kurovedza muviri kwemaminitsi makumi matatu pazuva, mazuva mashanu pasvondo, kunogona kubatsira kuchengetedza huremu hwakanaka uye kusimbisa moyo wako. Unogona kuita zvinhu zvakaita sekufamba netsoka, kuchovha bhasikoro, kana kushambira.
• Deredza kushushikana: Edza kuzorodza pfungwa dzako kuburikidza nezvinhu zvakaita seyoga nekufungisisa.

Utano hwemunhu ane 'bifurcation blockage' hwakaita sei?

Dzimwe ongororo dzinoratidza kuti mwero wekubudirira kwekurapa bifurcation blockage ne angioplasty uye stenting ungangoita 40%. Zvisinei, izvi zvinogona kusiyana kubva kumurwere kuenda kumurwere, zvichienderana nerudzi rwe blockage. Izvi zvinoreva kuti vamwe vanhu vanogona kunge vachiri nezviratidzo zvemwoyo mushure mekurapwa. Saka, zvakakosha kuramba uchichengetedza moyo wako nekudya chikafu chine hutano hwemoyo, kuderedza huremu kana zvichidikanwa, uye kutora mishonga yawakanyorerwa. Zvakakoshawo kugara uchionana nachiremba wako uye kuita bvunzo dzinodiwa.

Unofanira kuona chiremba rini?

Kana uchifunga kudaro, iweKana uri kurwara nemoyo (semuenzaniso kurwadziwa kwakanyanya muchipfuva, kunetseka kufema, kudikitira, kurutsa), fonera 911 kana amburenzi iri pedyo newe (semuenzaniso 1990 Suwaseriya) nekukasika. Usatambisa nguva!

Uyezve, ona chiremba kana uine chimwe chezviratidzo izvi chinoramba chiripo kana kuti chinowanzoitika:

• Kurwadziwa pachipfuva (angina) , kurwadziwa paruoko kana pamafudzi.
• Kudikitira kunotonhora.
• Kutadza kufema zvakanaka.
• Kuneta zvakanyanya kana kushaya simba pasina chikonzero.
• Kunzwa dzungu kana kunzwa kurova kwemoyo nekukurumidza.

Chii chandinofanira kubvunza chiremba?

Zvakanaka kubvunza mibvunzo iyi kana waenda kuna chiremba wako. Izvi zvichakubatsira kunzwisisa zviri nani mamiriro ako ezvinhu:

• Chii chingave chikonzero chakaita kuti ndive nepfungwa iyi yekuti 'Bifurcation Blockage' ?
• Ndiri panjodzi here yekuvharika kwetsinga dzeropa dzakafanana nedzimwe?
• Ndeapi marapirwo andinokurudzirwa? Kuvhiyiwa kwe angioplasty ne stenting zvichabatsira sei kuvharika uku?
• Nderudzii rwestent rwamunokurudzira? (semuenzaniso, stent inobvisa zvinodhaka?)
• Ndichada ma stents mangani?
• Ndezvipi njodzi uye mabhenefiti ekurapwa?
• Ndinofanira kutora mishonga kwenguva yakareba sei mushure mekurapwa?
• Ndezvipi zvandinofanira kuchinja muhupenyu hwangu kuti ndidzivirire moyo wangu?
• Ndezvipi zvinetso zvinogona kuitika mushure mekurapwa, uye ndinofanira kuzvigadzirisa sei?

Chinhu chakakosha chatinogona kudzidza kubva pane izvi (Mharidzo Yekuenda Kumba)

Kuvharika kweropa mumoyo (bifurcation) Kuvharika kweropa mumoyo (cardiovascular brain blockage) kunoitika panosangana tsinga yemoyo, zvichivharira kuyerera kweropa kuenda kumoyo. Kunyangwe dzimwe nguva zvichigona kuoma kurapa, kune nzira dzepamusoro dzakadai se angioplasty ne stent.

Zvisinei, chinhu chinonyanya kukosha ndechekuedza kudzivirira chirwere ichi kuti chisaitike uye, kunyangwe nekurapwa, kuchengetedza moyo wako nekuchinja mararamiro ako zvakanaka (kudya zvakanaka, kurovedza muviri, uye kurega kusvuta). Kana uine zviratidzo zvakaita sekurwadziwa pachipfuva kana kushaya mweya, zvakakosha kutsvaga mazano echiremba usingazviregeredze. Yeuka, moyo wako ndiwo pfuma yako inokosha! Ibasa rako kuutarisira.

Chirwere chemwoyo , kuvharika kwemapfupa maviri, CAD, angioplasty, stent, kurwadziwa kwechipfuva, moyo