Ingaba izihlunu zentliziyo yakho "zilele" okanye "zibambekile"? (I-Myocardium ehlala ixesha elide kunye ne-Stunned Myocardium) Masifunde ngayo!

Ngaba wakha weva ngendawo yentliziyo "elalayo"? Okanye "ebhajwe" ngequbuliso? Nangona la magama esenokuvakala ngathi ngamazwi angaqhelekanga, eneneni la magama mabini ezonyango achaphazela iintliziyo zethu. Ungakhathazeki, siza kuthetha ngawo ngendlela elula neqondakala lula. Siza kujonga ukuba ziyintoni na, kutheni zenzeka, indlela yokuzibona, kunye nokuba zinokunyangwa na.

Yintoni imisipha yentliziyo "efihla ubushushu"? (I-Myocardium efihla ubushushu)

Ngamafutshane, xa inxalenye yemisipha yentliziyo yakho (esiyibiza ngokuba yi-`(Myocardium)`) ingasebenzi kakuhle, iyancipha kancinci kancinci ukusebenza kwayo ize ekugqibeleni iyeke. Kufana nokulala kuba idiniwe. Oku sikubiza ngokuba yi-`(Hibernating Myocardium)` okanye "imisipha yentliziyo eleleyo." Oku kunokwenzeka kangangeenyanga, mhlawumbi neminyaka.

Khawucinge nje, xa ezinye izityalo emyezweni wakho ziphelelwa ngamanzi, ziyagoba zize zibonakale ngathi ziyabuna, akunjalo? Kunjalo ke ngale. Imisipha yentliziyo ifuna kakhulu ii-fatty acids ukuze isebenze (oko kukuthi, ukuze inciphe). Kodwa xa kungekho gazi laneleyo, le misipha iqala ukusebenzisa i-glucose (oko kukuthi, uhlobo lweswekile) ukugcina iiseli zayo ziphila. Nangona kunjalo, ayinawo amandla aneleyo okupompa igazi entliziyweni ngeli xesha. Ngoko ke, le misipha "ileleyo" ayincedi inkqubo yokupompa kwentliziyo.

Kuthetha ukuthini xa izihlunu zentliziyo "zikhubeka" okanye "zisiya kwi-coma"? (Stunned Myocardium)

Le meko yahlukile kancinci kwimeko yokungalali ekhankanyiweyo ngaphambili. Inokwenzeka ngokukhawuleza kakhulu, kwimizuzu embalwa okanye iiyure ezimbalwa. Ukuba ukuhamba kwegazi ukuya kwimisipha yentliziyo kuyehla ngequbuliso okanye kuyeka, imisipha iyeka ukusebenza, ngokungathi "ibambekile" okanye "ikhubazekile." Oku kubizwa ngokuba yi `(Stunned Myocardium)`.

Into engaqhelekanga kukuba, ngamanye amaxesha naxa oogqirha benyanga ukuvaleka (umzekelo, ngokufaka i-stent, ukwandisa umthambo ovalekileyo ngebhaluni, okanye ukunyibilikisa ihlwili legazi) ukuze igazi liphinde liphume, la macandelo emisipha "anamatheleyo" awabuyeli kwimeko eqhelekileyo ngoko nangoko. Kungathatha iintsuku, okanye iiveki, ukuba loo misipha iqale ukuvaleka kakuhle kwakhona.

Ezi meko zahluke njani kuhlaselo lwentliziyo?

Lo ngumbuzo obaluleke kakhulu. Uhlaselo lwentliziyo lolona hlobo lubi kakhulu lwesifo semithambo yegazi yentliziyo. Oku kwenzeka xa imithambo yegazi enye okanye ezingaphezulu ezihambisa igazi entliziyweni zivalwe ngokupheleleyo yinto enamafutha ebizwa ngokuba yi-plaque, nto leyo ebangela ukuba iiseli zemisipha yentliziyo zife. Iiseli zemisipha yentliziyo ezifileyo zithathelwa indawo ziiseli zemisipha. Ezi seli zemisipha azinakunceda intliziyo ipompe kakuhle. Oku kunokukhokelela ekusileleni kwentliziyo.

Nangona kunjalo, zombini ezi meko ``Hibernating Myocardium'' kunye ``Stunned Myocardium'' zezexeshana. Okwenzekayo apha kukuba izihlunu zentliziyo azisebenzi kakuhle, kodwa iiseli zazo zisaphila.Ukuba igazi kunye neoksijini ziyabuyiselwa, la malungu emisipha "aleleyo" okanye "anamatheleyo" anokuqalisa ukusebenza kwakhona. Yiyo leyo into ebaluleke kakhulu!

Zithini izizathu ze-'Hibernating Myocardium'?

Le meko ibonakala kakhulu kubantu abanesifo esibi semithambo yegazi yentliziyo. Kwesi sifo, amafutha agciniweyo (esibizwa ngokuba yi "plaque") aqokelelana ngaphakathi kwimithambo yegazi ethwala igazi ukuya entliziyweni, nto leyo ebangela ukuba ivaleke. Xa umthambo wentliziyo usiba mxinwa kakhulu, imisipha yentliziyo ayifumani ioksijini eyaneleyo kunye nezondlo ukuze ihlale iphila kwaye incede intliziyo ipompe igazi. Ngoko ke, imisipha "iyalala" ukuze igcine amandla ukuze igcine imisebenzi yayo esisiseko yeseli.

Zithini izizathu ze-'Stunned Myocardium'?

Ukuqaqamba kwentliziyo, okwaziwa ngokuba "kukunamathela" kwemisipha yentliziyo, kunokubakho ngexesha lonyango lwesifo semithambo yegazi. Nangona unyango lubuyisela ukuhamba kwegazi, ezinye iindawo zemisipha yentliziyo aziphindi ziphile ngoko nangoko. Ukongeza, le meko inokwenzeka ngenxa yezizathu ezininzi:

• Ukuxhuzula (umsebenzi ongaqhelekanga wombane engqondweni).
• Uxinzelelo I-Cardiomyopathy yimeko echaphazela intliziyo ngenxa yoxinzelelo.
• Imeko efana nestroke.
• Ukopha igazi engqondweni (i-Subarachnoid Hemorrhage).

Zithini iimpawu zezi meko zombini?

Ngenxa yokuba kuzo zombini ezi meko, inxalenye okanye uninzi lwemisipha yentliziyo kuphela echaphazelekayo, iimpawu zihlala zifana nezo zibonakala ekusileleni kwentliziyo. Ziquka:

• Ubunzima bokuphefumla
• Iintlungu zesifuba
• Ukudumba kwemilenze

Ukuba unale mpawu, kungcono ukubona ugqirha uze uhlolwe.

Indlela yokuxilonga i-'Hibernating Myocardium'?

Ukuze kuchongwe ngokuchanekileyo le meko, kufuneka uvavanyo oluninzi oluntsonkothileyo. Olu vavanyo lunokunceda ukwahlula phakathi kwamalungu emisipha yentliziyo "aleleyo" okanye "abambekileyo" kodwa anokuvuselelwa , kunye namalungu afileyo kwaye anezibazi kwaye angenakuvuselelwa .

Ezinye zezona zilingo ziphambili ezisetyenziswa ngoogqirha kule njongo zezi:

• `I-Dobutamine Stress Echocardiogram`: Oku kuquka ukukunika iyeza (elibizwa ngokuba yi-`(Dobutamine)`) ukuze livuselele intliziyo yakho ngokungathi liyazilolonga. Ingcali yentliziyo iya kujonga indlela intliziyo yakho esebenza ngayo xa iphumle kwaye isebenza njani xa umthamo weyeza unyusiwe. Ukuba amandla emisipha yentliziyo okusebenza ayanda xa unikwa iyeza, kuthetha ukuba unesifo esibizwa ngokuba yi-`(Stunned Myocardium)` okanye `(Hibernating Myocardium)`. Ukuba umsipha awunciphisi nasemva kokuba umthamo weyeza unyusiwe, kuthetha ukuba umsipha ufile kwaye unezibazi.
• I-MRI yentliziyo:Oku kusebenzisa imagnethi enamandla kunye namaza erediyo ukwenza imifanekiso ecacileyo neneenkcukacha zemisipha yentliziyo yakho. Ngokujonga inkangeleko kunye nobukhulu bemisipha yentliziyo kwezi mifanekiso, oogqirha banokubona ngqo ukuba zeziphi izicwili ezinezikrweqe (ezifileyo), yintoni eqhelekileyo, kunye nento "engalaliyo" okanye "ebambekileyo."
• Iskeni seCardiac Positron Emission Tomography (PET): Oku kusebenzisa umgangatho okhuselekileyo wezinto ezinemisebe kunye nekhamera ekhethekileyo. Ibonisa ukuba zeziphi iindawo zemisipha yentliziyo yakho ezisebenza ngokuqhelekileyo kunye nokuba zeziphi iindawo ezinezicwili ezifileyo okanye ezifileyo.

Nangona ezi mvavanyo zisenokubonakala zinzima kancinci, zibaluleke kakhulu ukuqonda imeko yakho ngqo nokukhetha unyango olulungele wena.

Ngaba i-'Hibernating Myocardium' (isihlunu sentliziyo esileleyo) inganyangeka? Zithini iindlela zonyango?

Ewe, le yindaba emnandi kakhulu! Le meko inganyangwa ngonyango. Eyona nto iphambili ekufuneka yenziwe kukubuyisela ukuhamba kwegazi kakuhle kwinxalenye yemisipha yentliziyo enciphise ukuhamba kwegazi. Kukho iindlela ezimbini eziphambili zokunyanga oku:

• I-Angioplasty: Oku kuquka ukusebenzisa ityhubhu ende, ebhityileyo (i-catheter) ukuze ingene kwimithambo yegazi evalekileyo kwaye ivuthele ibhaluni encinci ekupheleni kwetyhubhu ukuze kususwe i-plaque kwaye kwandiswe imithambo yegazi. Ngamanye amaxesha, isixhobo esifana ne-mesh (i-stent) sinokufakwa ngaphakathi kwimithambo yegazi ukuze singavaleki kwakhona.
• Utyando lweCoronary Artery Bypass (CABG): Olu lutyando olubandakanya ukuthatha umthambo wegazi ophilileyo kwenye indawo yomzimba wakho (njengomlenze okanye isifuba sakho) uze wenze indlela entsha yokuba igazi lihambe ngayo, udlule umthambo ovalekileyo entliziyweni yakho. Kufana nokwakha indlela edlulayo xa indlela ivalekile.

Emva kolu nyango, ungathunyelwa kwinkqubo ethi "Cardiac Rehabilitation" ukuze ikuncede ekuchacheni. Le yinkqubo yokuzilolonga elawulwa ngugqirha ekunceda ukonyusa amandla akho kunye nokomelela komzimba, kwaye uphuhlise imikhwa enempilo yentliziyo.

Ziziphi iindlela zonyango ze-'Stunned Myocardium'?

Unyango lwemisipha yentliziyo evalekileyo lufana kakhulu nonyango oluqhelekileyo lwesifo sentliziyo kunye nokusilela kwentliziyo. Amanye amayeza asetyenziswa kakhulu aquka:

• I-aspirin
• Ii-Beta-blockers
• Iistatins (amayeza okwehlisa i-cholesterol)
• Ii-ACE inhibitors okanye ii-Angiotensin II receptor blockers (amayeza alawula uxinzelelo lwegazi kwaye akhusele intliziyo)

Ugqirha uza kuhlola imeko yakho aze akunike amayeza afanelekileyo kuwe.

Ungazikhusela njani kwezi meko?

Eyona ndlela ilungileyo yokunciphisa umngcipheko wezi meko kukunyamekela intliziyo yakho kakuhle. Oko kuthetha ukuba:

• Ukulandela ukutya okunempilo:Ukutya okuneoyile encinci, iswekile, netyuwa encinci, kunye nokutya okunemifuno neziqhamo ezininzi.
• Ukuzilolonga rhoqo: Nokuba yinto elula njengokuhamba imizuzu engama-30 ngosuku ilungile.
• Kuphephe ukutshaya: Ukutshaya kubi kakhulu entliziyweni.
• Ukunciphisa ukusetyenziswa kotywala.
• Ukugcina ubunzima obusempilweni.
• Ukulawula uxinzelelo.
• Ukuba unezifo ezifana nesifo seswekile, uxinzelelo lwegazi oluphezulu, okanye i-cholesterol ephezulu, zilawule kakuhle.
• Ukuba ugqirha wakho ukunike umyalelo, thatha amayeza anjengee-statins ukunciphisa i-cholesterol okanye i-aspirin ukuthintela ukuqhekeka kwegazi yonke imihla.

Ungasebenzisa nezixhobo zokubala umngcipheko ezivela kwimibutho efana ne-American College of Cardiology okanye i-European Society of Cardiology ukuze ubone ukuba ufuna umngcipheko kunye nonyango olunjani. Nangona kunjalo, ukuba sele unesifo sentliziyo, kungcono ukuthetha nogqirha wakho malunga nomngcipheko wakho. Kwezi meko , unyango olukhokelwa yisikhokelo luye lwabonakala lunciphisa kakhulu umngcipheko wokuhlaselwa yintliziyo, ukusilela kwentliziyo, kwanokufa.

Ithini ingqikelelo?

Impilo yexesha elizayo yomntu onesi sifo (esikubiza ngokuba yi-"prognosis") ixhomekeke kwizinto ezininzi. Umzekelo:

• Indlela amandla okumpompa kwentliziyo anciphe ngayo.
• Nokuba usebenzisa amayeza achanekileyo achazwe ngugqirha.
• Nokuba ufanelekile na kutyando lwe-`(Angioplasty)`/`(Stent)` okanye `(CABG)`.

Abantu abanesifo semithambo yegazi emithanjeni yegazi basengozini yobomi bonke yokuba neengxaki zentliziyo kwixesha elizayo. Ukuba imithambo yegazi emithanjeni yegazi emithanjeni yegazi ivalekile kwakhona, izihlunu zentliziyo yakho zinokuphinda "zilale" kwakhona.

Kubalulekile: I-Myocardium ehlala ixesha elide yenzeka xa ukuhamba kwegazi ukuya kwizicubu zemisipha yentliziyo kuthintelwe ixesha elide ngenxa yokuvaleka okukhulu kwemithambo yegazi kubantu abanesifo semithambo yegazi. I-Myocardium ephazamisekileyo yenzeka xa ukuhamba kwegazi kwehla ngequbuliso. Ukuba ukuhamba kwegazi kubuyiselwe, imisipha yentliziyo yakho kufuneka ikwazi ukufinyela kwakhona kwixesha elifutshane. Zombini ezi meko ziyanyangeka. Kubalulekile ukuyinyamekela kakuhle intliziyo yakho ukuze uthintele ukuba ezi meko zingaphindi zibuye.

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, masishwankathele izinto ekufuneka uzikhumbule koko sithethe ngako:

• I-Myocardium ehlala ixesha elide kunye ne-Stunned Myocardium ziimeko ezimbini ezenzeka ngenxa yokuncipha kokuhamba kwegazi kwimisipha yentliziyo.
• Kuzo zombini ezi meko, izihlunu zentliziyo azifi, kodwa azisebenzi kakuhle. Oku kwahlukile kuhlaselo lwentliziyo.
• Zombini ezi meko zinokunyangwa rhoqo! Kubalulekile ukubuyisela ukujikeleza kwegazi kwaye, ukuba kuyimfuneko, funa unyango.
• Ukuba uneempawu ezifana nobunzima bokuphefumla, iintlungu zesifuba, okanye ukudumba kwemilenze yakho, funa ingcebiso kagqirha ngaphandle kokuchitha ixesha.
• Umngcipheko wezi meko ungancitshiswa ngokulandela indlela yokuphila esempilweni nokulawula iimeko zonyango ezikhoyo (ezifana nesifo seswekile kunye noxinzelelo lwegazi oluphezulu).
• Ukuba unesifo sentliziyo, kubaluleke kakhulu ukulandela imiyalelo kagqirha wakho ngokuchanekileyo kwaye ufumane uvavanyo rhoqo.

Intliziyo yakho yeyona nto ixabisekileyo kuwe. Ngoko ke yinyamekele. Ndiyathemba ukuba olu lwazi luza kukunceda!

Isifo sentliziyo , i-myocardium ehlala ifiphale, i-stun myocardium, uhlaselo lwentliziyo, isifo semithambo yegazi emithanjeni yegazi, i-angioplasty, utyando lwe-bypass