Ngaba unayo i-calcium deposits kwimithambo yentliziyo yakho? (Coronary Artery Calcification)

Ngaba wakha wazibuza ukuba ingaba iidipozithi ezincinci zecalcium zinokuqokelelana ngaphakathi kwimithambo ephambili ethwala igazi entliziyweni yakho? Kufana ne-limescale kwimibhobho yamanzi ngokuhamba kwexesha. Oku koko sikubiza ngokwezonyango ngokuba yi -coronary artery calcification (CAC) . Ngamanye amaxesha, oku kunokwenzeka ngaphandle kweempawu ezibonakalayo. Kodwa ukuqaphela oku kubaluleke kakhulu kwimpilo yentliziyo yakho.

Yintoni iCoronary Artery Calcification?

Ngamafutshane, oku kuxa i-calcium iqokelelana ngaphakathi kweendonga zemithambo emibini ephambili enika igazi entliziyweni yakho, ebizwa ngokuba yi-coronary arteries . Oku akwenzeki ngobusuku obunye. Ngokuqhelekileyo kuthatha iminyaka emihlanu ukuba i-calcium iqokelelane ngaphakathi kwemithambo yakho, emva kwexesha elithile xa une- plaque eqokeleleneyo (ebizwa ngokuba yi-atherosclerosis ). Cinga ngayo njengombhobho oqokeleleneyo wokungcola nokungcola, uze emva koko loo mxube ube mkhulu.

Ukufakwa kwecalcium kule mithambo yegazi luphawu olubalulekileyo lwesifo semithambo yegazi . Oku kuvumela ugqirha wakho ukuba ahlole umngcipheko wakho wesifo sentliziyo.

Xa la mafutha eqokelelana ngaphakathi kwimithambo yegazi, kunciphisa ukuhamba kwegazi. Uyazi, imithambo yegazi yentliziyo inika izihlunu zentliziyo igazi elinomoya-mpilo omninzi. Ngoko ke, ukuba ukuhamba kwegazi kule mithambo yegazi kuthintelekile, unokufumana iintlungu zesifuba (i-angina) , okanye okubi ngakumbi, ukuhlaselwa yintliziyo .

Kukho iintlobo ezimbini eziphambili ze-calcium deposits:

Oogqirha babona oku ngeendlela ezimbini eziphambili, kuxhomekeke kumaleko wecalcium ebekwe eludongeni lwemithambo yegazi:

1. Ukufakwa kwe-Intimal: Oku kwenzeka ngaphakathi kodonga lwemithambo yegazi. Olu hlobo lubonakala kakhulu kwimithambo yegazi yentliziyo.

2. Ukufakwa kwe-medial: Oku kwenzeka kumaleko ophakathi wodonga lwe-arterial.

Luluphi ulwalamano phakathi kwe-calcium deposits kwimithambo yegazi kunye ne-atherosclerosis?

Kukho unxibelelwano olukhulu phakathi kwezi zimbini. Ubungakanani bekhalsiyam kwimithambo yakho bunokukunika umbono wokuba ingakanani i-atherosclerosis onayo, nto leyo ethetha ukuqokelelwa kwamafutha kwimithambo yakho. I-atherosclerosis kuxa amafutha eqokelelana ngaphakathi kwimithambo yakho, iwanciphise. Kwenza kube nzima ukuba igazi lihambe kakuhle. Ikhalsiyam inokuyenza le meko ibe mandundu.

Ngubani ochaphazeleka kakhulu yile meko?

Abantu abanesifo sentliziyo badla ngokubona i-calcium deposits kule mithambo yegazi.

• Xa uneminyaka:Ukuba sijonga abantu abangaphezu kweminyaka engama-70 ubudala, amadoda angaphezu kwama-90% kunye nabasetyhini abangama-67% banale meko. Ngaphambi kokuya exesheni, abafazi bakhuselekile kancinci kwingozi yokuba nale meko (i-atherosclerosis) ngenxa yehomoni ye -estrogen . Yiyo loo nto abafazi beba nale meko emva kweminyaka eli-10-15 kunamadoda.
• Uhlanga/Uhlanga: Ezinye izifundo zifumanise ukuba abantu abamhlophe banamathuba amaninzi okufumana le meko kunezinye iintlanga.
• Kumadoda: Amadoda asemngciphekweni omkhulu wokufumana oku (iCoronary Artery Calcification).

Zithini izinto ezibangela umngcipheko? (Ukuba unazo ezi zinto, nawe usenokuba semngciphekweni)

Abanye abantu banamathuba amaninzi okuba nale meko. Jonga ukuba unayo na enye yezi zinto ziyingozi:

• Ukuba unesifo sezintso esinganyangekiyo .
• Ukuba unengxaki yeswekile egazini efana neDiabetes Mellitus .
• Ukuba inqanaba le-cholesterol embi (LDL - Low-Density Lipoprotein) liphezulu kwaye inqanaba le-cholesterol elungileyo (HDL - High-Density Lipoprotein) liphantsi.
• Ixabiso le -BMI (Body Mass Index) , oko kukuthi, ukuba i-body mass index iphezulu (ukutyeba kakhulu).
• Ukuba kukho umntu kusapho lwakho onembali ye-calcium deposits kwimithambo yentliziyo efana nale (i-hereditary predisposition).
• Ukuba une- high blood pressure .
• Ukuba unembali yokutshaya okanye yokusebenzisa ezinye iimveliso zecuba.
• Ngokukhula kweminyaka.
• Ukuba kukho iingxaki kwi -hormone ye-parathyroid .
• Ukuba inqanaba le-phosphate egazini liphezulu.
• Ukuba inqanaba le-calcium egazini liphezulu.

Oku kwenza ntoni emzimbeni? Kuwuchaphazela njani?

Xa i-calcium iqokelelana kwimithambo yakho yentliziyo, ibangela ukuba iqine . Oku kunciphisa amandla ayo okufinyela nokukhula ngokufanelekileyo. Oku kwandisa umngcipheko wakho wesifo sentliziyo.

Ngamafutshane, oku kuqokelelana kwekhalsiyam kunciphisa inani legazi elifikelela kwizihlunu zentliziyo yakho. Yicinge njengenjini esebenza ngokungayekiyo. Ukuba ilahlekelwa ligazi layo, iya kuba neengxaki, akunjalo?

Enye into kukuba xa kukho iidipozithi zecalcium kwimithambo yegazi, kuba nzima koogqirha ukwenza unyango oluthile, olufana nePercutaneous Coronary Intervention (PCI) , okanye njengoko sonke sisazi , i-Angioplasty, kuba ezi dipozithi zecalcium zinokuphazamisana nokusasazwa ngokufanelekileyo kwe -stent ebekwe ngaphakathi kwimithambo yegazi.

Zithini iimpawu?

Ixesha elininzi, abantu abanale meko (Coronary Artery Calcification) ababonisi zimpawu . Leyo yeyona nto iyingozi kakhulu. Kodwa ngokuhamba kwexesha, njengoko le meko isiya isiba mandundu, ezinye iimpawu zinokuvela. Nazi:

• I-Angina ezinzileyo: Le yintlungu yesifuba okanye ukungakhululeki okuhlala kwenzeka ngexesha lokuzilolonga okanye xa unyuka izinyuko. Iyaphela xa uphumle.
• Ukuqhawukelwa ngumphefumlo.
• Uhlaselo lwentliziyo.

Kubalulekile: Ukuba unale mpawu, qiniseka ukuba ucela ingcebiso kugqirha.

Kutheni oku kusenzeka? Zithini izizathu?

Ngokwesiqhelo emva kweminyaka engama-40, i-calcium egazini lethu inokuqala ukuqokelelana kwiindawo ezahlukeneyo zomzimba. Ngokukodwa, iindonga zemithambo yegazi eyonakeleyo, evuvukileyo, okanye elungiswayo zezona zichaphazeleka kakhulu zezi depositi ze-calcium.

Le nkqubo ingaqala kwangethuba xa uneminyaka engama-20 , kodwa ugqirha uyijonga kuphela xa inkulu ngokwaneleyo ukuba ingabonwa kuvavanyo lomfanekiso . Kwaye, abantu abaninzi abaneminyaka engama-20 kunye nama-30 abayenzi rhoqo le misebenzi yovavanyo.

Iidipozithi zecalcium ziqala njengeesuntswana ezincinci kakhulu (0.5µm - ii-micrometer). Ekuhambeni kwexesha, njengoko iidipozithi zamafutha ziqokelelana, ezi dipozithi zecalcium zinokukhula zibe ngaphezu kweemilimitha ezi-3. Abaphandi bakholelwa ukuba ezi dipozithi zecalcium zincinci (i-microcalcification) kumaleko ongaphakathi wodonga lwemithambo yegazi ziqala ngokufa kweeseli zemisipha ezithambileyo.

Uyifumana njani le nto? Luhlobo luni lovavanyo olwenziwayo?

Kukho iimvavanyo ezikhethekileyo zokujonga imifanekiso ezinokubona le meko (iCoronary Atherosclerosis), oko kukuthi, ukugcinwa kwamafutha kwimithambo yegazi, ngaphambi kokuba ibe nzima. Enye yezona zibalulekileyo zezi yi- (Computed Tomography - CT) scan, okanye (Multidetector Computed Tomography - MDCT) .

I-CT scan yentliziyo ingabonisa ngokucacileyo i-calcium deposits kwimithambo yakho yentliziyo. Oku kubizwa ngokuba luvavanyo lwe-calcium yemithambo yentliziyo (CAC) . Ijonga ikakhulu oku kulandelayo:

• Ingakanani i-calcium efakwayo?
• Ingakanani i-density yezo deposits?
• Zingakanani na?

Esebenzisa olu lwazi, ugqirha wakho ubala ixabiso elibizwa ngokuba yi-Agatston score . Eli nqanaba linokusukela kwi-0 ukuya kwi-400 nangaphezulu. Okukhona amanqaku ephezulu, kokukhona umngcipheko wakho wokuba nesifo sentliziyo okanye isifo sohlangothi uphezulu kwiminyaka eli-10 ezayo.

Oogqirha bafumanise ukuba olu vavanyo (CAC) lunokuqikelela ngokuchanekileyo umngcipheko wesifo sentliziyo kwixesha elizayo. Nangona kunjalo, kusenokufuneka uhlawulele olu vavanyo ngepokotho yakho.

Ithetha ukuthini inqaku le-CAC (inqaku le-Agatston)?

Nantsi indlela ezi mpawu eziqhele ukutolikwa ngayo:

• Amanqaku 0: Akukho ngxaki yempilo.
• Amanqaku 1 ukuya kuma-99: Isifo esingenamandla kangako.
• Amanqaku ukusuka kwi-100 ukuya kwi-399: Inqanaba eliphakathi lokugula.
• Amanqaku angaphezu kwama-400: Isifo esibi kakhulu.

Ukongeza kolu vavanyo (CAC), kukho ezinye iimvavanyo ezingangenisi kakhulu ezinokujonga iidipozithi zecalcium kwimithambo yakho yentliziyo:

• I-Cardiac Intravascular Ultrasound (IVUS): Le sixhobo sisebenzisa isixhobo se-ultrasound esine-catheter (ityhubhu encinci) eqhotyoshelwe ekupheleni ukuze ijonge ngaphakathi kwemithambo yegazi. Iziphumo zihlelwe ukusuka kwiKlasi yoku-1 ukuya kwiKlasi yesi-IV, apho iKlasi yesi-IV ibonisa ukuba kukho i-calcium eninzi kangakanani.
• I-Intravascular Optical Coherence Tomography (IVOCT): Oku kubonisa ukuba ingakanani i-calcium ebekwe kwimithambo yakho yegazi kunye nokuba ityebile kangakanani. Isebenzisa ukukhanya okukufutshane ne-infrared ukwenza imifanekiso yangaphakathi kwemithambo yegazi.

Zithini iindlela zonyango zoku?

Oogqirha abakabi nalo unyango oluqhelekileyo lwe-coronary artery calcification. Nangona kunjalo, kwiimeko ezinzima, abanye oogqirha basebenzisa unyango olutsha olubizwa ngokuba yi-intravascular lithotripsy . Oku kubandakanya ukudlulisa isixhobo nge-catheter kwi-artery kwaye siyisebenzisele ukuhambisa amaza oxinzelelo ukuze kwahlulwe iidiphozithi ze-calcium eludongeni lwe-artery. Emva koko kunokufakwa i -stent ukuze i-artery ihlale ivulekile.

Ezinye iindlela zonyango ezisetyenziselwa ukuphucula ukuhamba kwegazi kwimithambo ziquka:

• Ukususwa kwe-rotational, orbital okanye i-laser atherectomy: Oku kuquka ukusika nokususa amanqatha (i-plaque) kunye ne-calcium ngaphakathi kwi-artery.
• Ukusika, ukufaka amanqaku okanye i-angioplasty yebhaluni enoxinzelelo oluphezulu: Oku kuquka ukufutha ibhaluni ukuze kutyhalelwe amafutha kunye ne-calcium eludongeni lwemithambo yegazi.

Ngaba iingxaki zinokwenzeka ngexesha lonyango?

Njengakwezinye iindlela zonyango, ezinye iingxaki zinokwenzeka ngolu hlobo lonyango.

Iingxaki ze-Intravascular Lithotripsy:

• I-Arrhythmia ( isantya sentliziyo esingaqhelekanga)
• I-Aneurysm ( ukudumba okanye ukuba buthathaka komthambo wegazi)
• Iingxaki zokopha
• Istroke
• Ukufa (kunqabile kakhulu)

Iingxaki zeRotational Atherectomy:

• Ukuqhaqhwa kwemithambo yegazi
• Ukuhlaselwa yintliziyo
• Ukufa (kunqabile kakhulu)
• I-Coronary Artery Bypass Graft eNgxamisekileyo (CABG)

Iingxaki zeCoronary Angioplasty:

• Ukuhlaselwa yintliziyo
• Istroke
• I-Arrhythmia
• Ukopha
• Amahlwili egazi

Ezi ngxaki azibafikeleli bonke abantu, kodwa kubalulekile ukuba uzazi. Ugqirha wakho uza kukuchazela ezi ngozi xa ecebisa unyango.

Ndingayinciphisa njani le ngozi?

Eyona nto ingcono onokuyenza kukulawula iingxaki ezandisa umngcipheko wokuba ne-coronary artery calcification. Ezi ziquka:

• Ukuba unesifo seswekile, silawule kakuhle.
• Ukuba inqanaba lakho le-cholesterol aliqhelekanga, lilawule.
• Ukuba une- high blood pressure , yilawule.
• Ukuba unesifo sezintso , fumana unyango olufanelekileyo.

Ukongeza kwezi zinto, kubaluleke kakhulu ukulandela indlela yokuphila enempilo.

Kuza kwenzeka ntoni ukuba ndinayo le meko? Ndingalindela ntoni?

Ukuba ufunyaniswe uneCoronary Artery Calcification, usemngciphekweni omkhulu wokufumana isifo seCoronary Artery Disease kunye neMajor Adverse Cardiovascular Events (MACE) .

Nangona kunjalo, xa kufikwa kwinqanaba lempumelelo yeendlela zonyango, i-Intravascular Lithotripsy iye yaphumelela kwiimeko ezingaphezu kwama-92%. Ngokufanayo, i-Rotational Atherectomy ikwabonise izinga lempumelelo lama-90%.

Nangona kunjalo, ukugcinwa kwekhalsiyam kwimithambo yegazi kwandisa umngcipheko wokungaphumeleli konyango olufana ne -balloon angioplasty . Kunokuba nzima nokubeka i -stent ngokufanelekileyo ngaphakathi kwemithambo yegazi.

Ndingazinyamekela njani? Ndingenza ntoni?

Ukuba une-coronary artery calcification, kubalulekile ukulandela indlela yokuphila enempilo yentliziyo. Oko kuthetha ukuba:

• Yitya ukutya okunamafutha aphantsi (nciphisa ioyile, ukutya okuqhotsiweyo, kunye nokutya okukhawulezayo kangangoko unako).
• Yeka ukusebenzisa iimveliso zecuba (iicuba, ii-beedis, njl.njl.) ngokupheleleyo.
• Zilolonge rhoqo (njengokuhamba ubuncinane imizuzu engama-30 ngosuku).
• Gcina uxinzelelo lwegazi kunye namanqanaba e-cholesterol yakho eqhelekileyo (thabatha amayeza njengoko uyalelwe ngugqirha wakho kwaye ulawule ukutya kwakho).

Ndifanele ndimbone nini ugqirha?

Ukuba une-high blood pressure kunye/okanye amanqanaba aphezulu e-cholesterol, bonana nogqirha rhoqo ukuqinisekisa ukuba ezo meko zilawulwa kakuhle.Ukuba ufuna isicwangciso sokuphucula impilo yakho yentliziyo, kungcono ukudibana nogqirha ukuze nithethe ngaso.

Ndingaya nini esibhedlele ngokungxamisekileyo (ETU) ?

Ukuba ufumana iimpawu zokuhlaselwa yintliziyo, ezinje ngeentlungu eziqatha esifubeni, isicaphucaphu nokuhlanza, kunye nokuphelelwa ngumphefumlo , fowunela u-911 ngoko nangoko okanye uye esibhedlele esikufutshane . Ixesha linokuba ngumahluko phakathi kobomi nokufa ngexesha elinje.

Ndingayibuza yiphi imibuzo ugqirha?

Xa usiya kugqirha, kuyanceda ukubuza le mibuzo:

• Ngaba kufuneka ndivavanywe i-coronary artery calcification?
• Ingxaki yam imbi kangakanani (iCoronary Artery Calcification)?
• Luluphi unyango olucebisayo kwimeko yam?
• Zithini iingozi kunye neenzuzo zolu nyango?
• Zeziphi iinguqu ekufuneka ndizenze kwindlela endiphila ngayo?

Masikhumbule ngokufutshane (Umyalezo Wokubuyela Ekhaya)

Ukwazi ukuba unayo na i-calcium deposits kwimithambo yakho yentliziyo kubalulekile ukuba ugqirha wakho enze isicwangciso sokukunceda. Ungadinga unyango lokususa i-calcium kwimithambo yakho yentliziyo, okanye ungadinga nje ukufaka imikhwa enempilo yentliziyo kwindlela yakho yokuphila. Nokuba awunazo iingxaki zentliziyo, ukutya ukutya okunamafutha aphantsi, ukuzilolonga, kunye nokuhlala kude neemveliso zecuba kunokukunceda uhlale uphilile. Khumbula, intliziyo esempilweni sisitshixo sobomi obusempilweni!

I- calcium kwimithambo yentliziyo, i-coronary artery calcification, isifo sentliziyo, i-cholesterol, uxinzelelo lwegazi oluphezulu, isifo seswekile, uhlaselo lwentliziyo, i-atherosclerosis