Ngaba ngamanye amaxesha uziva intlungu engaqhelekanga okanye uziva ngathi uxinezelekile esifubeni sakho? Xa oko kusenzeka, siyoyika size siye kugqirha. Nokuba emva kokwenza iimvavanyo ezifana ne-ECG kunye ne-scan, ugqirha uthi, "Akukho kuvalwa kwemithambo yegazi emikhulu yentliziyo." Emva koko sinokucinga, "Kutheni ke le ntlungu esifubeni?" Enyanisweni, ngamanye amaxesha imbangela yoku ayisiyomithambo yegazi emikhulu yentliziyo, kodwa yimithambo yegazi emincinci kakhulu ephuma kuyo. Leyo yimeko esithetha ngayo namhlanje, 'Isifo seMithambo yeCoronary' okanye 'Isifo seMithambo emincinci'.
Yintoni iMicrovascular Coronary Disease?
Ngamafutshane, esi sisifo esichaphazela imithambo yegazi emincinci kakhulu entliziyweni yethu. Khawuthelekelele intliziyo yethu njengesixeko esikhulu. Esi sixeko sineendlela ezinkulu (ezi ziimithambo yegazi emikhulu yentliziyo) ezibonelela ngegazi kunye neoksijini. Kodwa ukuze uphume kwezo ndlela ezinkulu uze ufike kuyo yonke indlu kwaye uthenge esixekweni, udinga iindlela ezincinci ezisecaleni, iindlela zelitye eliqinileyo, akunjalo? Ngendlela efanayo, yonke iseli encinci kwimisipha yentliziyo yethu iziswa igazi, ioksijini kunye nezondlo yinethiwekhi yemithambo yegazi emincinci kakhulu, engatyebanga ngaphezu kwentambo yeenwele. Oku sikubiza ngokuba yi-'(coronary microvasculature)'.
Kwimeko ebizwa ngokuba yi-'Microvascular Coronary Disease', nangona ezo ndlela zinkulu zikwimeko entle, ezi ndlela zincinci zonakele kwaye azisebenzi kakuhle. Emva koko izihlunu zentliziyo azifumani ioksijini kunye nesondlo esifunekayo.
Kukho amanye amagama aliqela asetyenziswayo kule meko. Ugqirha wakho angasebenzisa elinye lala magama:
- Isifo semithambo emincinci
- Isifo semithambo emincinci
- Isifo sentliziyo X
- Isifo seMicrovessel
- Isifo sentliziyo esingathinteliyo
Oku kwahluke njani kwisifo sentliziyo esiqhelekileyo (iCoronary Artery Disease)?
Abantu abaninzi bayabhidanisa ezi zifo zimbini kuba zombini ezi zifo zonyusa umngcipheko wokuhlaselwa yintliziyo. Nangona kunjalo, ukusebenza kwezi zifo zimbini kwahlukile ngokupheleleyo. Masiwuqonde kakuhle lo mahluko.
| Ingongoma yokuthelekisa | Isifo Esiqhelekileyo Semithambo Yentliziyo | Isifo seCoronary Microvascular |
|---|---|---|
| Imithambo yegazi echaphazelekayo | Ichaphazela imithambo emikhulu yentliziyo ephezu komphezulu wentliziyo. | Ichaphazela imithambo yegazi emincinci kakhulu, ethambileyo ephuma kwimithambo yegazi emikhulu. |
| Unobangela oyintloko wesifo | I-cholesterol kunye ne-oyile edityanisiweyo (i-plaque) ngaphakathi kwemithambo yegazi, nto leyo ebangela ukuvaleka. | Ukonakala kwemithambo yegazi emincinci okanye ukusebenza okungasebenzi kakuhle. Akukho kwakheka kweplaque . |
| Indlela ebonakala ngayo kwiimvavanyo | Ezi zithintelo zingabonakala ngokucacileyo kwiimvavanyo ezifana ne-angiogram. | Iingxaki ngezi mithambo mincinci azibonakali kwi-angiogram eqhelekileyo, ngoko ke kunokuba nzima ukufumanisa isifo. |
Ngubani osengozini enkulu yokuhlaselwa yile meko?
Le meko ixhaphake kakhulu kwabasetyhini kunamadoda, ingakumbi ngexesha nasemva kokuya exesheni, xa amanqanaba e-estrogen emzimbeni ehla.
Ukongeza, abantu abanezi zinto zilandelayo basengozini enkulu yokufumana esi sifo:
- Ukuba nesifo seswekile .
- Igazi elonyukayo .
- Ukuba namanqanaba aphezulu e-cholesterol egazini .
- Ukutyeba kakhulu kunye nokunyuka kobunzima.
- Ukutshaya .
- Ukuphila ubomi bokuhlala phantsi ngaphandle kokuzilolonga .
- Ukutya ityuwa eninzi, amafutha agcweleyo, kunye nokutya okucutshungulwayo .
- Ukuba nezifo ezihlasela umzimba ezifana ne-lupus okanye i-rheumatoid arthritis.
Kutheni esi sifo senzeka?
Kwintliziyo ephilileyo, izihlunu ezithambileyo ezindongeni zale mithambo yegazi mincinci zilawula ukuhamba kwegazi ngokuncipha nokuphumla njengoko kufuneka. Umzekelo, xa sizilolonga, intliziyo ifuna igazi elingakumbi, ngoko ke le mithambo iyanda kwaye ipompe igazi elingakumbi. Xa siphumle, ibuyela kwindawo yayo eqhelekileyo.
Kodwa kwimeko ye-'Microvascular Coronary Disease', iindonga zangaphakathi zale mithambo yegazi mincinci zonakele. Lo monakalo uphazamisa ukusebenza kwayo. Ngamanye amaxesha le mijelo inokufinyela ngamandla ngequbuliso (ukuxinana). Emva koko ukuhanjiswa kwegazi kwimisipha yentliziyo kuyaphazamiseka ngequbuliso, okubangela iimpawu ezifana neentlungu zesifuba.
Zithini iimpawu zesi sifo?
Uphawu oluphambili noluqhelekileyo lwesi sifo ziintlungu zesifuba ezibizwa ngokuba yi-angina . Nangona kunjalo, le ntlungu inokwahluka kancinci kwintlungu eyenzeka kwisifo sentliziyo esiqhelekileyo.
- Ihlala imizuzu eli-10 nangaphezulu .
- Le ntlungu inokwenzeka ngexesha lokuzilolonga kunye nokuphumla .
- Intlungu inganda xa kukho uxinzelelo lwengqondo .
- Kwabanye abantu, le ntlungu yenza kube nzima kubo nokwenza imisebenzi yemihla ngemihla ngokufanelekileyo.
Ukongeza kule ntlungu yesifuba, ezinye iimpawu zinokuvela:
- Ukuphefumla nzima kunye nobunzima bokuphefumla .
- Ukudinwa kakhulu ngaphandle kwesizathu .
- Iingxaki zokulala, kuquka nokungalali kakuhle .
Kubaluleke kakhulu: Iintlungu zesifuba zinokuba luphawu lokuhlaselwa yintliziyo. Ngoko ke, ukuba unentlungu yesifuba engapheliyo, ukuba iba mandundu, ukuba unengxaki yokuphefumla, okanye ukuba unentlungu esasazeka ingalweni yakho, entanyeni, okanye emqolo, yiya kwigumbi likaxakeka lesibhedlele elikufutshane (ETU) ngoko nangoko.
Indlela yokuxilonga ngokuchanekileyo isifo?
Inyaniso kukuba, ukufumanisa esi sifo kunokuba nzima kancinci kuba le mithambo yegazi mincinci incinci kakhulu ukuba ingabonwa ngovavanyo lwentliziyo oluqhelekileyo. Ngoko ke, ukuba unezi mpawu, kungcono ukubona ugqirha wentliziyo ogxile kwezi ntlobo zezifo.
Uvavanyo olusemgangathweni oluphezulu lokufumanisa esi sifo luvavanyo olukhethekileyo olubizwa ngokuba yi -'Cardiac catheterization with coronary flow reserve (CFR).' Olu vavanyo lulinganisa ukuba le mithambo yegazi mincinci inokwandiswa ngokukhawuleza kangakanani kwaye inike igazi elingakumbi kwiimfuno zomzimba.
Ukongeza, ugqirha unokucebisa ezinye iimvavanyo ezininzi:
- Uvavanyo loxinzelelo lwentliziyo lwenyukliya (i-PET scan)
- I-MRI yentliziyo ene-perfusion
Zithini iindlela zonyango zoku?
Injongo ephambili yonyango kukuphucula ukusebenza kwemithambo yegazi, ukulawula iimpawu, kunye nokunciphisa umngcipheko weengxaki ezifana nokuhlaselwa yintliziyo. Ugqirha wakho unokukunika amayeza aliqela ukukunceda wenze oku.
- Izithinteli ze-Angiotensin-converting enzyme (ACE): zinceda ukulawula uxinzelelo lwegazi ngokwandisa imithambo yegazi.
- Ii-Anticoagulants: Amayeza athintela ukujiya kwegazi.
- I-Aspirin: Ithintela iiplatelets zegazi ukuba zinganamatheli kwaye inciphisa ukwakheka kwamahlwili egazi.
- Ii-Beta-blockers: Zilawula izinga lentliziyo kunye noxinzelelo lwegazi oluphantsi.
- Izithinteli zeCalcium channel: Khulula izihlunu kwimithambo yegazi, ziyenze yande.
- I-Diuretics: Susa ulwelo olugqithisileyo kunye netyuwa emzimbeni, wehlise uxinzelelo lwegazi.
- IiStatins: Amayeza anciphisa amanqanaba e-cholesterol egazini.
Yintoni esifanele siyenze ukuthintela nokulawula esi sifo?
Kunye namayeza, utshintsho oluhle kwindlela esiphila ngayo lubaluleke kakhulu ekulawuleni esi sifo.
- Landela ukutya okunempilo kwentliziyo: Nciphisa ityuwa, ioyile, iswekile, kunye nokutya okucutshungulweyo, kwaye utye imifuno emininzi, iziqhamo, iimbotyi kunye nokutya okutyebileyo kwi-fiber.
- Zilolonge rhoqo: Fumana ubuncinci imizuzu engama-30 yokuzilolonga ngosuku, njengokuhamba okanye ukubaleka. Ukuba usandul' ukuqala ukuzilolonga, thetha nogqirha wakho kwaye ucinge ngenkqubo yokulungisa isifo sentliziyo ukuba kuyimfuneko.
- Gcina ubunzima bomzimba busempilweni.
- Gcina amanqanaba oxinzelelo lwegazi kunye neswekile egazini ekwinqanaba elifanelekileyo.
- Ukuba uyatshaya, yeka ngokupheleleyo.
Malunga nokuphila nesi sifo
Ukusebenzisa amayeza amaninzi nokwenza utshintsho kwindlela yokuphila ngolu hlobo kunokuba nzima ekuqaleni. Amanye amayeza anokubangela iziphumo ebezingalindelekanga ezifana nesiyezi.
Qiniseka ukuba uthetha ngokukhululekileyo nogqirha wakho malunga nokungonwabi okufumanayo. Usenokukwazi ukulungisa amayeza akho okanye akunike elinye icebiso.
Kunganceda kakhulu ukugcina idayari yeempawu zakho kunye noxinzelelo lwegazi, njengoko oku kuya kunceda ugqirha wakho ukuba afumane umfanekiso ocacileyo wemeko yakho kwaye alungiselele unyango lwakho ngokufanelekileyo.
Umyalezo Wokuya Ekhaya
- Isifo seMicvascular Coronary Disease asikho kwimithambo yegazi emikhulu yentliziyo, kodwa sikwimithambo yegazi emincinci nethambileyo.Isifo esikhoyo.
- Oku kwahlukile kwisifo sentliziyo esiqhelekileyo, apho i-cholesterol igcina khona (i-plaque) ivala imithambo yegazi.
- Le meko ixhaphake kakhulu phakathi kwabasetyhini .
- Uphawu oluphambili ziintlungu zesifuba ezingapheliyo eziya ziba mandundu xa uphumle kwaye uxinezelekile.
- Uvavanyo oluqhelekileyo alwanelanga ukufumanisa isifo, kwaye uvavanyo olukhethekileyo lunokufuneka.
- Utshintsho kumayeza nakwindlela yokuphila lunokukunceda ulawule iimpawu zakho, uthintele iingxaki, kwaye uphile ubomi obusempilweni. Kubalulekile ukuhlala unxibelelana nogqirha wakho rhoqo .
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