Oko kufuneka ukwazi nge-Acute Coronary Syndrome!

Ngaba wakha waziva ngequbuliso uxinana, iintlungu, okanye ukuphefumla okungaqhelekanga esifubeni sakho? Okanye wakha wambona umntu omaziyo esenza njalo? Ezi mpawu ngamanye amaxesha zinokuba luphawu lwesifo sentliziyo esiyingozi kakhulu. I-Acute Coronary Syndrome (ACS) ligama eliqhelekileyo leemeko ezininzi ezenzeka ngequbuliso kwaye zibangelwa kukuvaleka kwemithambo yegazi ehambisa igazi entliziyweni.

Yintoni i-acute coronary syndrome (ACS)?

Ngamafutshane, i-Acute Coronary Syndrome (ACS) yimeko engxamisekileyo eyenzeka xa imithambo yegazi ehambisa igazi entliziyweni ivalekile ngequbuliso, ithintela intliziyo ekufumaneni ioksijini eyidingayo. Khawuthelekelele ukuba kukho into ebhajwe ngequbuliso kumbhobho ohambisa amanzi ukuya kwimpompo yamanzi endlwini yakho. Emva koko amanzi awahambi kakuhle kwimpompo. Kwenzeka into efanayo entliziyweni. Esi asisosifo sinye, kodwa sidibaniso lweentlobo ezintathu zesifo sentliziyo. Zonke ezi zinto zinokuba yingozi ebomini, ngoko ke unyango olukhawulezileyo lubaluleke kakhulu.

Zeziphi iintlobo zesifo sentliziyo eziwela phantsi kwe-ACS?

Kulungile, zeziphi iintlobo zesifo sentliziyo eziwela phantsi kwe-ACS? Kukho iintlobo ezintathu eziphambili. Ezi ziyahluka ngokuxhomekeke ekubeni umthambo wegazi uvalekile phi entliziyweni, ixesha elingakanani uvalekile, kwaye umonakalo owenziwe entliziyweni ungakanani.

1. I-Angina Engazinzanga: Oku kwenzeka xa ngequbuliso uva iintlungu zesifuba okanye ukuxinana, nokuba uphumle. Kungavakala ngathi kukho umntu ocinezela isifuba sakho. Oku luphawu lwesilumkiso sokuhlaselwa yintliziyo . Kunokwenzeka naxa iintlungu zesifuba ebezikho ngaphambili (i-angina eqinileyo) ziba nzima.

2. I-NSTEMI (Non-ST-elevation myocardial infarction): Olu luhlobo lokuhlaselwa yintliziyo. Nangona kunjalo, kule meko , uvavanyo lwe-EKG (Electrocardiogram) , olulinganisa umsebenzi wombane wentliziyo, alubonisi mahluko mkhulu. Nangona kunjalo, uvavanyo lwegazi lunokubona umonakalo kwimisipha yentliziyo. Apha, umthambo wentliziyo awuvalwanga ngokupheleleyo, okanye ukuba uvalwe, uvalwa ixesha elifutshane kuphela.

3. I-STEMI (ST-elevation myocardial infarction): Olu lolona hlobo lubi kakhulu lokuhlaselwa yintliziyo . Lunokuchongwa ngokucacileyo nge-EKG kunye novavanyo lwegazi. Okwenzekayo apha kukuba umthambo ohambisa igazi entliziyweni uvaleke ngokupheleleyo ixesha elide, nto leyo ebangela umonakalo kwindawo enkulu yentliziyo.

Ngubani onokuphuhla le meko ye-ACS?

Ngoku usenokuba uzibuza ukuba ngubani onokuba ne-ACS. Enyanisweni, nabani na angayihlakulela. Nangona kunjalo, abantu abaneempawu ezithile ezinobungozi banokuba nayo.

Ubudala kunye nendlela yokuphila:

• Ubudala: Amadoda angaphezu kweminyaka engama-45 ubudala kunye nabafazi abaye bafikelela kwixesha lokuya exesheni basengozini enkulu.
• Ukutyeba kakhulu/ukutyeba kakhulu.
• Ukusetyenziswa kweziyobisi ezifana ne-cocaine.
• Ukungazilolongi umzimba.
• Ukutshaya.
• Ukutya okungenampilo (ukutya okunamafutha amaninzi, ityuwa, iswekile).

Ezinye iimeko zempilo onazo kunye nembali yosapho lwakho:

• Ukuba i-COVID-19 ibiqhambukile.
• Isifo seswekile.
• Ukuba kukho umntu kusapho lwakho okhe waba neemeko ezifana neentlungu zesifuba, isifo sentliziyo, okanye isifo sohlangothi.
• Inqanaba eliphezulu le-cholesterol egazini.
• Uxinzelelo lwegazi oluphezulu (Uxinzelelo lwegazi oluphezulu / uxinzelelo lwegazi oluphezulu).
• Ukuba ubunoxinzelelo lwegazi oluphezulu, i-preeclampsia, okanye isifo seswekile ngexesha lokukhulelwa.

Ezinye iimeko ezibonisa iimpawu ezifanayo neze-ACS

Kodwa ungacingi ukuba i-ACS yimbangela yeentlungu zesifuba. Kukho ezinye iimeko ezininzi ezinokubangela iimpawu ezifanayo neze-ACS. Yiyo loo nto kubalulekile ukufumana uxilongo oluchanekileyo kwaye ufumane unyango olukhawulezileyo . Ezinye zeemeko ezinokubangela iimpawu ezifanayo ziquka:

• I-stenosis ye-aorta.
• Isifuba.
• Ukuxhuzula kwemithambo yegazi.
• Iingxaki zokugaya ukutya, i-chronic acid reflux (GERD - Gastroesophageal Reflux Disease) okanye ukuqaqamba komlomo.
• I-Pericarditis.
• Iingxaki zemisipha okanye amathambo.
• Ukuqhekeka kwembambo.
• Ukukrala kwemiphunga.
• Iingxaki zesisu ezifana nezilonda.
• Uxinzelelo, ixhala, okanye ukudakumba.

Ixhaphake kangakanani i-ACS?

Isifo sentliziyo esibizwa ngokuba yiCoronary Artery Disease (CAD) sesona sifo sentliziyo sixhaphakileyo ehlabathini kwaye singunobangela ophambili wokufa. Ngoko ke, i-ACS, imeko enxulumene ne-CAD, ibulala inani elikhulu labantu minyaka le. Lo mngcipheko uphezulu kakhulu kumadoda nakwabo banesifo sentliziyo esingaphantsi kwesiseko.

I-ACS yenzeka njani?

Kulungile, ngoku masibone ukuba le meko ye-ACS yenzeka njani.

Intliziyo yethu sisihlunu. Ukuze isebenze kakuhle, ifuna ukunikezelwa rhoqo kwegazi elineoksijini. Eli gazi linikezelwa yimithambo yegazi yentliziyo kunye nemithambo yegazi emincinci ephuma kuyo.

Ngamanye amaxesha, ngokuhamba kwexesha, i-plaque iyanda ngaphakathi kwezi mithambo yegazi, iyenze inciphe. Oku kubizwa ngokuba yi-atherosclerosis . Kufana nomhlwa oqokelelana kumbhobho wamanzi ngokuhamba kwexesha.

I-ACS yenzeka ngequbuliso ukuba olu maleko lwamafutha (i-plaque) luqhuma okanye luqhekeke ngequbuliso.

Xa oko kusenzeka, igazi liyaqhekeka phezu kwendawo ephukileyo.Olu hlobo lwegazi lunciphisa umthambo wegazi, okanye luwuvale ngokupheleleyo. Emva koko, inxalenye yentliziyo (i-myocardium) ayifumani ioksijini eyidingayo. Oku kunqongophala kweoksijini (ischemia) konakalisa izihlunu zentliziyo. Kulapho ke kuvela khona i-angina engazinzile okanye uhlaselo lwentliziyo olukhankanyiweyo ngaphambili.

Kunqabile kakhulu, i-ACS inokubangelwa zezinye izizathu:

• I-Coronary artery embolism kukuvaleka kwe-coronary artery yi-blood clot, i-air bubble, okanye i-fat particle.
• Ukuqaqamba kwemithambo yegazi yeCoronary.
• Ukuqhaqha umthambo wentliziyo ozenzekelayo (SCAD).

Zithini iimpawu ze-ACS?

Iimpawu ze-ACS zinokwahluka ngokuxhomekeke kwindawo apho umthambo wegazi uvalekile khona, ubungakanani bokuvaleka kwawo, ubudala bakho, isini, nokuba unezinye izifo, ezifana nesifo seswekile.

Ezi mpawu zihlala zivela ngaphandle kwesilumkiso, nokuba uphumle. Uphawu oluqhelekileyo ziintlungu zesifuba okanye ukungakhululeki (i-angina) . Oku kunokuvakala ngathi:

• Ivakala ngathi yintlungu.
• Njengokutsha.
• Isifuba sivakala sinzima.
• Ukuxinana kwesifuba.
• Njengokutyhala, ukucinezela.
• Kufana nokubanjwa.

Le ntlungu ingasasazeka iye egxalabeni lasekhohlo, iye ezantsi engalweni, entanyeni, emqolo, okanye emhlathini. Nangona kunjalo, abanye abantu basenokungabi nazo naziphi na iimpawu zesifuba.

Ezinye iimpawu eziqhelekileyo:

• Ukuba nesiyezi, ukuba nentloko ekhaphukhaphu, kunye nokuziva ngathi uza kufa isiqaqa.
• Ukubila okugqithisileyo ngequbuliso (diaphoresis).
• Ukudinwa, ukudinwa.
• Ukuziva ngathi intliziyo yakho ibetha ngokukhawuleza, ukuziva ngathi isifuba sakho siyabetha (ukubetha kwentliziyo).
• Intlungu esiswini esingaphezulu (abanye basenokucinga ukuba oku kukungagayi kakuhle okanye ukudumba kwesisu).

Abafazi, ingakumbi, abanakukwazi ukufumana iimpawu zesifuba ngexesha le-ACS. Banokufumana ezinye zezi mpawu:

* Isicaphucaphu okanye ukuhlanza.

* Intlungu ephuma emagxeni, entanyeni, esiswini, okanye kwiindawo zomhlathi.

* Ubunzima bokuphefumla (ukuphelelwa ngamandla).

Ukuba ezi mpawu ziyaqhubeka okanye ziyanda, xelela ugqirha wakho ngokukhawuleza . Ukuba ucinga ukuba oku kusenokuba sisifo sentliziyo, thatha i-aspirin ngoko nangoko kwaye uye kwicandelo lezonyango ezingxamisekileyo esibhedlele esikufutshane, okanye utsalele umnxeba ku-911.

Ifunyaniswa njani i-ACS?

Oogqirha bayixilonga njani i-ACS?

Okokuqala, uza kuhlolwa ngokwasemzimbeni. Emva koko, uza kwenziwa uvavanyo lwegazi kunye ne-EKG (i-Electrocardiogram).Kwenziwe enye. I-EKG irekhoda umsebenzi wombane wentliziyo. Ukusuka kwezi ziphumo zovavanyo, ugqirha unokufumanisa ukuba unesifo sentliziyo okanye i-angina engazinzile.

Ukongeza, ezinye iimvavanyo zingenziwa ukuze kuthintelwe ezinye iimeko kwaye kukhethwe unyango olufanelekileyo. Umzekelo, uvavanyo loxinzelelo lokuzivocavoca okanye uvavanyo loxinzelelo lwamayeza lunyusa izinga lentliziyo yakho kwaye lulinganise indlela intliziyo yakho esabela ngayo xa usebenza kakhulu.

Izifundo zokujonga imifanekiso, ezifana ne -CT scan okanye i-MRI yentliziyo, zikwasetyenziselwa ukufumana imifanekiso eneenkcukacha zentliziyo. Ezinye iimvavanyo zokujonga imifanekiso zingabandakanya:

• Uvavanyo lwe-calcium-score scan yentliziyo.
• Ukufakwa kwe-catheter kwintliziyo.
• I-angiogram ye-Coronary computed tomography (CCTA).
• I-angiogram yentliziyo.
• I-Echocardiogram.
• Imifanekiso yamayeza enyukliya.

I-ACS yingxamiseko yezonyango. Ukuba uvavanyo luqinisekisa ukuba ukuhamba kwegazi entliziyweni kuvaliwe, uya kunyangwa ngoko nangoko . Ukuba uneempawu ezinzima, ezifana nokulahlekelwa zingqondo, unyango lunokuqala kwanangaphambi kokuba kuqinisekiswe ukuba unesifo.

Ngaba ikho indlela epheleleyo yokuphelisa i-ACS?

Akukho nyango lwe-ACS. Nangona kunjalo, ukuxilongwa kwangoko kunye nonyango kunokunceda ukuthintela umonakalo ongakumbi entliziyweni yakho kwaye kuqhubeke kusebenza kakuhle kangangoko kunokwenzeka. Ugqirha wakho angakuxelela okungakumbi ngeendlela zokunciphisa iingozi zakho kunye nokuthintela iingxaki.

Iphathwa njani i-ACS?

Iinjongo eziphambili zonyango lwe-ACS kukunciphisa iintlungu nokubuyisela ukuhamba kwegazi kunye nokuphucula ukusebenza kwentliziyo ngokukhawuleza. Ugqirha wakho uya kukunika unyango olusekelwe kwimeko yakho ethile. Ngokuqhelekileyo kubandakanya indibaniselwano yamayeza kunye neenkqubo zotyando zokuvula umthambo kunye nokubuyisela ukusebenza kwentliziyo.

Ngawaphi amayeza ugqirha angawanikayo kwi-ACS?

Uhlobo lwamayeza oza kuwafumana luya kuxhomekeka kwimeko yakho ethile. Kwezinye iimeko, ugqirha wakho unokukunika amayeza ngaphambi kokuba aqinisekise ukuba unesifo. La mayeza angaquka:

• Izinto ezithintela ukopha kwegazi okanye izinto ezinciphisa igazi, ezifana ne-aspirin okanye i-heparin.
• Izithinteli ze-Angiotensin-converting enzyme (ACE), ezinciphisa uxinzelelo lwegazi.
• Ii-Beta-blockers, ezilawula uxinzelelo lwegazi kwaye zinciphise isantya sentliziyo.
• I-Nitroglycerin, ephucula ukuhamba kwegazi kwaye inciphise iintlungu zesifuba.
• Izithomalalisi zentlungu.
• Iistatins, ezinciphisa amanqanaba e-cholesterol egazini.
• Amayeza e-Thrombolytic kwiiyure ezili-12 zokuqala emva kokuhlaselwa yintliziyo .

Ugqirha wakho angakunika amayeza kwezinye iingxaki zentliziyo ezinxulumene noko, ezinje ngezi:

• I-cholesterol ephezulu.
• Igazi elonyukayo.
• Ukubetha kwentliziyo okungaqhelekanga (i-Arrhythmia).

Ngaba ndiza kufuna utyando lwe-ACS?

Injongo yonyango lotyando lwe-ACS kukuvula kwakhona umthambo ovalekileyo kunye nokubuyisela ukuhamba kwegazi okuqhelekileyo. Ugqirha wakho unokucebisa unyango olufana nolu:

• I-Angioplasty ene-stent: Ukufakwa kwe-mesh encinci yesinyithi (stent) ukuvula umthambo ovalekileyo.
• Utyando lwe-Coronary artery bypass (CABG): Ukudala indlela entsha yokuhamba kwegazi.
• Ukungenelela kwentliziyo okuhamba ngeenyawo (i-PCI): Ukuvula umthambo ovalekileyo.

Ungayinciphisa njani ingozi ye-ACS?

Ukwamkela indlela yokuphila enempilo yentliziyo kunokunciphisa umngcipheko wakho wokuba ne-ACS kunye nezinye izifo zentliziyo. Nazi ezinye iingcebiso zokukunceda wenze njalo:

• Kuphephe ukutshaya: Ukuba utshaya okanye usebenzisa iimveliso ze-nicotine, buza ugqirha wakho malunga neenkqubo kunye namayeza anokukunceda uyeke ukutshaya.
• Yitya ukutya okunempilo kwentliziyo: Thetha nogqirha wakho okanye ingcali yokutya ebhalisiweyo malunga nokutya okunokukunceda ugcine ubunzima obusempilweni kwaye unciphise umngcipheko wesifo sentliziyo. Ukutya kweMedithera kunye ne-DASH ziintlobo ezimbini zokutya okunesondlo.
• Nciphisa ukusetyenziswa kotywala: Nciphisa ukusela utywala kube kanye ngosuku kwabasetyhini, kwaye amadoda abe neziselo ezimbini ngosuku.
• Lawula iingxaki zempilo ezifana ne-cholesterol ephezulu, uxinzelelo lwegazi oluphezulu, isifo seswekile, uxinzelelo, ukudakumba, kunye nokuxhalaba. Ugqirha wakho okanye umcebisi wezempilo yengqondo unokubonelela ngenkxaso kunye nonyango koku.
• Hlala usempilweni: Ukuzilolonga kunokukunceda unciphise umzimba, kuphucule impilo yakho, kwaye kunciphise uxinzelelo. Thetha nogqirha wakho ngaphambi kokuba uqalise nayiphi na inkqubo yokuzilolonga.

Injani imeko ye-ACS?

Ikamva le-ACS lixhomekeke kwimeko ethile obunayo, ubukhali bayo, kunye nomonakalo owenziwe kwimisipha yentliziyo. Ngokuchongwa nonyango ngexesha elifanelekileyo, kunye notshintsho kwindlela yokuphila, unokuba nethuba elihle lokuphila ubomi obusempilweni.

Landela iingcebiso zikagqirha wakho kwaye ugcine imikhwa enempilo yentliziyo. Bona ugqirha wakho ngexesha, gqiba naluphi na uvavanyo oluyalelwe ngugqirha wakho, kwaye uthethe ngonyango lwakho lwexesha elide ukuze uqonde into onokuyenza ukunciphisa iingozi zakho nokuthintela iingxaki.

Ukuba ukhe wahlaselwa yintliziyo, ugqirha wakho unokucebisa inkqubo yokulungisa isifo sentliziyo ukuze akuncede ufumane amandla kwakhona, unciphise iingozi zempilo, kwaye uphucule umgangatho wobomi bakho.

Ufanele ufune nini ingcebiso yezonyango nge-ACS?

Ukuba ufumana iimpawu ze-ACS , funa uncedo lwezonyango olungxamisekileyo ngokukhawuleza . Ukuba ufumana iimpawu ze-ACS ngequbuliso, okanye ukuba ucinga ukuba kukuhlaselwa yintliziyo, yiya kwicandelo lezonyango olungxamisekileyo kwisibhedlele esikufutshane nawe, okanye utsalele umnxeba ku-911. Musa ukuchitha ixesha!

Loluphi ulwazi olufanele lunikwe iqela lezonyango?

Xa usiya esibhedlele, iqela lezonyango liza kukubuza ngeempawu zakho, njengokuba ziqale nini kwaye zinzima kangakanani.

Okukhona unika iinkcukacha ezingakumbi, kokukhona kungcono. Cinga ngezi zinto:

• Ndaqala nini ukuva iimpawu?
• Ndenza ntoni ngelo xesha?
• Zithini iimpawu?
• Bahlala apho ixesha elingakanani?
• Ingaba ndineentlungu? Ziphi?
• Kwisikali esiqala kwi-1 ukuya kwi-10, ndiziva iintlungu ezingakanani?
• Ngaba ndinezinye iimeko zempilo?
• Ngawaphi amayeza endiwasebenzisayo ngoku?

I-Acute Coronary Syndrome sisifo sentliziyo esiqhelekileyo esifuna unyango olukhawulezileyo. Ungaziva ngathi unesifo sentliziyo. Fowunela u-1990 ngaphandle kokuthandabuza, okanye uye esibhedlele esikufutshane ngokukhawuleza. Ukuxilongwa ngokukhawuleza kunye nonyango kunokunceda intliziyo yakho ibuyele esiqhelweni kwaye ikuncede uphile.

Yeyiphi eyona nto ibalulekileyo esifuna ukuyithatha kweli bali? (Umyalezo Wokubuyela Ekhaya)

Kulula kakhulu. I-Acute Coronary Syndrome (ACS) yimeko eyenzeka ngequbuliso, inzima. Ukuba ufumana iimpawu ezifana neentlungu zesifuba, ukuphefumla kancinci, okanye ukubila ngequbuliso , ukufuna ingcebiso kagqirha ngokukhawuleza kunokusindisa ubomi. Oku kubaluleke kakhulu ukuba unezinto ezinobungozi ezifana nesifo seswekile, uxinzelelo lwegazi oluphezulu, okanye i-cholesterol ephezulu. Ukuphila ubomi obusempilweni, ukuyeka ukutshaya, kunye nokulandela ingcebiso kagqirha wakho zonke ezi ziindlela ezibalulekileyo zokuzikhusela kule meko. Lumka intliziyo yakho!

Isifo sentliziyo esibukhali , uhlaselo lwentliziyo, iintlungu zesifuba, i-angina, umthambo wentliziyo, isifo sentliziyo, unyango olungxamisekileyo