Okudingeka ukwazi nge-Acute Coronary Syndrome!

Wake wazizwa ngokuzumayo ukuqina okungajwayelekile, ubuhlungu, noma ukuphelelwa umoya esifubeni sakho? Noma wake wambona umuntu omaziyo enza kanjalo? Lezi zimpawu ngezinye izikhathi zingaba uphawu lwesifo senhliziyo esiyingozi kakhulu. I-Acute Coronary Syndrome (ACS) igama elivamile lezimo eziningana ezenzeka ngokuzumayo futhi ezibangelwa ukuvaleka kwemithambo yegazi ehambisa igazi enhliziyweni.

Iyini i-acute coronary syndrome (i-ACS)?

Kalula nje, i-Acute Coronary Syndrome (ACS) yisimo esiphuthumayo esenzeka lapho imithambo yenhliziyo ethwala igazi enhliziyweni ivaleka ngokuzumayo, ivimbela inhliziyo ekutholeni umoya-mpilo eyidingayo. Cabanga uma into ethile inamathela ngokuzumayo epayipini elithwala amanzi liya epompo yamanzi endlini yakho. Khona-ke amanzi awagelezi kahle epompo. Kwenzeka into efanayo nasenhliziyweni. Lesi akusona isifo esisodwa, kodwa inhlanganisela yezinhlobo ezintathu zesifo senhliziyo. Konke lokhu kungaba yingozi empilweni, ngakho-ke ukunakekelwa kwezokwelapha okusheshayo kubaluleke kakhulu.

Yiziphi izinhlobo zesifo senhliziyo eziwela ngaphansi kwe-ACS?

Kulungile, yiziphi izinhlobo zesifo senhliziyo eziwela ngaphansi kwe-ACS? Kunezinhlobo ezintathu eziyinhloko. Lezi ziyahlukahluka kuye ngokuthi iphi inhliziyo lapho umthambo wegazi uvalekile khona, ukuthi uvalekile isikhathi esingakanani, nokuthi kungakanani umonakalo owenzekile enhliziyweni.

1. I-Angina Engazinzile: Lokhu kwenzeka lapho uzwa ubuhlungu besifuba noma ukuqina ngokuzumayo, ngisho nalapho uphumule. Kungase kuzwakale sengathi othile ucindezela isifuba sakho. Empeleni lokhu kuyisibonakaliso esiyisixwayiso sokuhlaselwa yinhliziyo . Kungenzeka futhi lapho ubuhlungu besifuba obukhona ngaphambili (i-angina ezinzile) buba bukhulu.

2. I-NSTEMI (i-Non-ST-elevation myocardial infarction): Lolu futhi uhlobo lokuhlaselwa yinhliziyo. Kodwa-ke, kulokhu , ukuhlolwa kwe-EKG (Electrocardiogram) , okulinganisa umsebenzi kagesi wenhliziyo, akubonisi mehluko omkhulu. Kodwa-ke, ukuhlolwa kwegazi kungabona umonakalo emisipheni yenhliziyo. Lapha, umthambo wenhliziyo awuvalekile ngokuphelele, noma uma uvalekile, uvalekile isikhathi esifushane nje.

3. I-STEMI (ST-elevation myocardial infarction): Lolu uhlobo olubi kakhulu lokuhlaselwa yinhliziyo . Lungabonakala ngokucacile nge-EKG kanye nokuhlolwa kwegazi. Okwenzekayo lapha ukuthi umthambo ohlinzeka ngegazi enhliziyweni uvalekile ngokuphelele isikhathi eside, okubangela umonakalo endaweni enkulu yenhliziyo.

Ubani ongathuthukisa lesi simo se-ACS?

Manje ungase uzibuze ukuthi ubani ongaba ne-ACS. Empeleni, noma ubani angayithuthukisa. Kodwa-ke, abantu abanezici ezithile eziyingozi banamathuba amaningi okuba nayo.

Ubudala nendlela yokuphila:

• Ubudala: Amadoda angaphezu kweminyaka engu-45 ubudala kanye nabesifazane abaye badlula esikhathini sokunqamuka kokuya esikhathini basengozini enkulu.
• Ukukhuluphala ngokweqile/ukukhuluphala ngokweqile.
• Ukusetshenziswa kwezidakamizwa ezifana ne-cocaine.
• Ukuntuleka kokuzilolonga ngokomzimba.
• Ukubhema.
• Ukudla okungenampilo (ukudla okunamafutha amaningi, usawoti, ushukela).

Ezinye izimo zezokwelapha onazo kanye nomlando womndeni:

• Ukube i -COVID-19 ibisiqalile.
• Isifo sikashukela.
• Uma kukhona emndenini wakho oke waba nezimo ezifana nobuhlungu besifuba, isifo senhliziyo, noma isifo sohlangothi.
• Izinga eliphezulu le-cholesterol egazini.
• Umfutho wegazi ophezulu (Umfutho wegazi ophezulu / umfutho wegazi ophakeme).
• Uma ubunomfutho wegazi ophakeme, i-preeclampsia, noma isifo sikashukela ngesikhathi sokukhulelwa.

Ezinye izimo ezibonisa izimpawu ezifanayo ne-ACS

Kodwa ungacabangi ukuthi i-ACS iyimbangela yobuhlungu besifuba. Kunezinye izimo eziningana ezingabangela izimpawu ezifana neze-ACS. Yingakho kubalulekile ukuthola ukuxilongwa okunembile nokuthola ukwelashwa okusheshayo . Ezinye zezimo ezingabangela izimpawu ezifanayo zifaka:

• I-stenosis ye-aorta.
• Isifuba somoya.
• I-embolism yamaphaphu.
• Izinkinga zokugaya ukudla, i-reflux ye-acid engapheli (i-GERD - Isifo se-Gastroesophageal Reflux) noma ukuqaqamba komphimbo.
• I-Pericarditis.
• Izinkinga zemisipha noma amathambo.
• Ukuphuka kwembambo.
• Inyumoniya.
• Izinkinga zesisu ezifana nezilonda.
• Ukucindezeleka, ukukhathazeka, noma ukucindezeleka.

Ivame kangakanani i-ACS?

Isifo Semithambo Yenhliziyo (i-CAD) yisifo senhliziyo esivame kakhulu emhlabeni futhi siyimbangela ehamba phambili yokufa. Ngakho-ke, i-ACS, isimo esihlobene ne-CAD, sibulala inani elikhulu labantu minyaka yonke. Le ngozi iphezulu kakhulu kwabesilisa nakulabo abanesifo senhliziyo esingaphansi kwaso.

I-ACS yenzeka kanjani?

Kulungile, manje ake sibone ukuthi lesi simo se-ACS senzeka kanjani.

Inhliziyo yethu iyimisipha. Ukuze isebenze kahle, idinga ukuhlinzekwa njalo kwegazi elinomoya-mpilo. Leli gazi linikezwa yimithambo yegazi yenhliziyo kanye nemithambo yegazi emincane ehlukana nayo.

Ngezinye izikhathi, ngokuhamba kwesikhathi, i-plaque iyanda ngaphakathi kwale mithambo, iyinciphise. Lokhu kubizwa ngokuthi i-atherosclerosis . Kufana nokugqwala okwandayo epayipini lamanzi ngokuhamba kwesikhathi.

I-ACS yenzeka ngokuzumayo uma lolu ngqimba lwamafutha oluqoqiwe (i-plaque) luqhuma noma luqhuma ngokuzumayo.

Uma lokho kwenzeka, kwakheka ihlule legazi endaweni ephukile.Lokhu kugoba kwegazi kunciphisa umthambo wegazi, noma kuwuvimbele ngokuphelele. Bese kuthi ingxenye yenhliziyo (i-myocardium) ingawutholi umoya-mpilo ewudingayo. Lokhu kuntuleka komoya-mpilo (ischemia) kulimaza imisipha yenhliziyo. Yilapho-ke i-angina engazinzile noma ukuhlaselwa yinhliziyo okukhulunywe ngayo ngaphambili kwenzeka khona.

Akuvamile kakhulu, i-ACS ingabangelwa ezinye izizathu:

• I-Coronary artery embolism ukuvaleka komthambo wenhliziyo nge-blood clot, i-air bubble, noma i-fat particle.
• Ukuqina kwemithambo ye-coronary.
• Ukuhlukaniswa kwemithambo yenhliziyo okuzenzekelayo (i-SCAD).

Ziyini izimpawu ze-ACS?

Izimpawu ze-ACS zingahluka kuye ngokuthi umthambo wegazi uvalekile kuphi, ubukhulu bokuvaleka kwawo, iminyaka yakho, ubulili, nokuthi unezinye izimo zezokwelapha, njengesifo sikashukela.

Ngokuvamile lezi zimpawu zivela ngaphandle kwesixwayiso, ngisho noma uphumule. Uphawu oluvame kakhulu ubuhlungu besifuba noma ukungakhululeki (i-angina) . Lokhu kungazwakala kanje:

• Kuzwakala sengathi kubuhlungu.
• Njengokusha.
• Isifuba sizwakala sisinda.
• Ukuqina kwesifuba.
• Njengokucindezela, ukucindezela.
• Kufana nokubanjwa.

Lobuhlungu bungasakazekela ehlombe lesobunxele, phansi engalweni, entanyeni, emhlane, noma emhlathini. Kodwa-ke, abanye abantu bangase bangabi nazimpawu zesifuba.

Ezinye izimpawu ezivamile:

• Ukuzizwa unesizungu, ikhanda elikhanyayo, kanye nokuzizwa sengathi uzoquleka.
• Ukujuluka ngokweqile okungazelelwe (i-diaphoresis).
• Ukukhathala, ukukhathala.
• Ukuzwa sengathi inhliziyo yakho ishaya ngokushesha, uzizwa sengathi isifuba sakho siyashaya (ukushaya kwenhliziyo).
• Ubuhlungu esiswini esingaphezulu (abanye bangase bacabange ukuthi lokhu kungukungagayi kahle noma ukuvuvukala kwesisu).

Abesifazane, ikakhulukazi, banamathuba amancane okubhekana nezimpawu zesifuba ngesikhathi se-ACS. Bangase babe nezinye zalezi zimpawu:

* Ukucanuzela noma ukuhlanza.

* Ubuhlungu obuvela emahlombe, entanyeni, esiswini, noma emihlathini.

* Ubunzima bokuphefumula (ukuphelelwa umoya).

Uma lezi zimpawu ziqhubeka noma ziba zimbi kakhulu, tshela udokotela wakho ngokushesha okukhulu . Uma ucabanga ukuthi lokhu kungaba ukuhlaselwa yinhliziyo, thatha i-aspirin ngokushesha bese uya emnyangweni wezimo eziphuthumayo esibhedlela esiseduze, noma ushayele u-911.

Itholakala kanjani i-ACS?

Odokotela bayixilonga kanjani i-ACS?

Okokuqala, uzohlolwa ngokomzimba. Ngemuva kwalokho, uzohlolwa igazi bese kwenziwa i-EKG (i-Electrocardiogram).Kwenziwe okukodwa. I-EKG iqopha umsebenzi kagesi wenhliziyo. Kusukela kule miphumela yokuhlolwa, udokotela anganquma ukuthi unesifo senhliziyo noma i-angina engazinzile.

Ngaphezu kwalokho, ezinye izivivinyo zingenziwa ukuze kukhishwe ezinye izimo futhi kukhethwe ukwelashwa okufanele kakhulu. Isibonelo, isivivinyo sokucindezeleka kokuzivocavoca noma isivivinyo sokucindezeleka ngemithi kwandisa izinga lokushaya kwenhliziyo yakho futhi kulinganiswe ukuthi inhliziyo yakho isabela kanjani uma usebenza ngokugcwele.

Izifundo zokuthatha izithombe, njenge -CT scan noma i-heart MRI, nazo zisetshenziselwa ukuthola izithombe ezinemininingwane zenhliziyo. Ezinye izivivinyo zokuthatha izithombe zingafaka:

• Ukuhlolwa kwenhliziyo kwe-calcium-score.
• Ukufakwa kwe-catheter kwenhliziyo.
• I-Coronary computed tomography angiogram (CCTA).
• I-angiogram yenhliziyo.
• I-Echocardiogram.
• Izithombe zemithi yenuzi.

I-ACS iyisimo esiphuthumayo sezokwelapha. Uma ukuhlolwa kuqinisekisa ukuthi ukugeleza kwegazi enhliziyweni kuvinjiwe, uzokwelashwa ngokushesha . Uma unezimpawu ezinzima, njengokulahlekelwa ukwazi, ukwelashwa kungase kuqale ngisho nangaphambi kokuba kuqinisekiswe ukuthi unesifo.

Ingabe ikhona ikhambi eliphelele le-ACS?

Akukho ukwelashwa kwe-ACS. Kodwa-ke, ukuxilongwa kusenesikhathi kanye nokwelashwa kungasiza ekuvimbeleni ukulimala okwengeziwe enhliziyweni yakho futhi kuqhubeke kusebenza kahle ngangokunokwenzeka. Udokotela wakho angakutshela okwengeziwe ngezindlela zokunciphisa izingozi zakho nokuvimbela izinkinga.

Iphathwa kanjani i-ACS?

Imigomo eyinhloko yokwelashwa kwe-ACS ukunciphisa ubuhlungu nokubuyisela ukugeleza kwegazi nokuthuthukisa ukusebenza kwenhliziyo ngokushesha okukhulu. Udokotela wakho uzokunikeza ukwelashwa okusekelwe esimweni sakho esithile. Ngokuvamile kuhilela inhlanganisela yemithi kanye nezinqubo zokuhlinzwa zokuvula umthambo nokubuyisela ukusebenza kwenhliziyo.

Yimiphi imithi udokotela angayinikeza udokotela ye-ACS?

Uhlobo lwemithi oyitholayo luzoncika esimweni sakho esithile. Kwezinye izimo, udokotela wakho angase akunike imithi ngaphambi kokuqinisekisa ukuxilongwa. Le mithi ingafaka:

• Ama-anticoagulant noma ama-blood thinner, njenge-aspirin noma i-heparin.
• Ama-inhibitor e-Angiotensin-converting enzyme (ACE), anciphisa umfutho wegazi.
• Ama-beta-blocker, alawula umfutho wegazi futhi anciphise izinga lokushaya kwenhliziyo.
• I-Nitroglycerin, ethuthukisa ukugeleza kwegazi futhi inciphise ubuhlungu besifuba.
• Imithi yokuqeda ubuhlungu.
• Ama-statin, anciphisa amazinga e-cholesterol egazini.
• Imithi ye-Thrombolytic emahoreni okuqala ayi-12 okuhlaselwa yinhliziyo .

Udokotela wakho angase futhi akunikeze imithi yezinye izinkinga zenhliziyo ezihlobene, njenge:

• I-cholesterol ephezulu.
• Umfutho wegazi ophezulu.
• Ukushaya kwenhliziyo okungajwayelekile (i-Arrhythmia).

Ingabe ngizodinga ukuhlinzwa kwe-ACS?

Umgomo wokwelashwa ngokuhlinzwa kwe-ACS ukuvula kabusha umthambo ovalekile nokubuyisela ukugeleza kwegazi okuvamile. Udokotela wakho angase ancome ukwelashwa okufana nalokhu:

• I-Angioplasty ene-stent: Ukufakwa kwe-mesh encane yensimbi (stent) ukuvula umthambo ovalekile.
• Ukuhlinzwa kwe-Coronary artery bypass (CABG): Ukudala indlela entsha yokugeleza kwegazi.
• Ukungenelela kwe-Percutaneous coronary (PCI): Ukuvula umthambo ovalekile.

Unganciphisa kanjani ingozi ye-ACS?

Ukwamukela indlela yokuphila enempilo yenhliziyo kunganciphisa ingozi yakho yokuthola i-ACS nezinye izifo zenhliziyo. Nazi ezinye izeluleko zokukusiza ukuthi wenze kanjalo:

• Gwema ukubhema: Uma ubhema noma usebenzisa imikhiqizo ye-nicotine, buza udokotela wakho ngezinhlelo nemithi engakusiza ukuthi uyeke ukubhema.
• Yidla ukudla okunempilo kwenhliziyo: Khuluma nodokotela wakho noma isazi sokudla esibhalisiwe mayelana nokudla okungakusiza ukuthi ugcine isisindo esinempilo futhi unciphise ingozi yakho yesifo senhliziyo. Ukudla kwaseMedithera kanye ne-DASH kuyizinhlobo ezimbili zokudla okunempilo.
• Nciphisa ukusetshenziswa kotshwala: Nciphisa abesifazane ekuphuzeni okukodwa ngosuku kanye nabesilisa ekuphuzeni okubili ngosuku.
• Phatha izinkinga zempilo ezifana ne-cholesterol ephezulu, umfutho wegazi ophakeme, isifo sikashukela, ukucindezeleka, ukucindezeleka, kanye nokukhathazeka. Udokotela wakho noma umeluleki wezempilo yengqondo angakunikeza ukwesekwa kanye nokwelashwa kwalokhu.
• Hlala umatasa: Ukuzivocavoca umzimba kungakusiza unciphise isisindo, kuthuthukise ukuqina komzimba wakho, futhi kunciphise ukucindezeleka. Khuluma nodokotela wakho ngaphambi kokuqala noma yiluphi uhlelo lokuzivocavoca.

Iyini inhloso yesimo se-ACS?

Umbono we-ACS uncike esimweni esithile owawunaso, ubunzima baso, kanye nomonakalo omningi emisipheni yenhliziyo. Ngokuhlonza nokwelashwa ngesikhathi esifanele, kanye nokushintsha kwendlela yokuphila, ungaba nethuba elihle kakhulu lokuphila impilo enempilo.

Landela iseluleko sikadokotela wakho futhi ulondoloze imikhuba enempilo yenhliziyo. Bona udokotela wakho ngesikhathi, uqedele noma yikuphi ukuhlolwa okuyalelwe udokotela wakho, bese ukhuluma ngokunakekelwa kwakho kwesikhathi eside ukuze uqonde ukuthi yini ongayenza ukuze unciphise izingozi zakho futhi uvimbele izinkinga.

Uma uke waba nesifo senhliziyo, udokotela wakho angase akuncome uhlelo lokuvuselela inhliziyo ukuze akusize uthole amandla, unciphise izingozi zempilo, futhi uthuthukise ikhwalithi yokuphila kwakho.

Kufanele uthole nini iseluleko sezokwelapha se-ACS?

Uma uzwa izimpawu ze-ACS , funa usizo lwezokwelapha oluphuthumayo ngokushesha . Uma uzwa izimpawu ze-ACS ngokuzumayo, noma uma ucabanga ukuthi ukuhlaselwa yinhliziyo, iya emnyangweni wezimo eziphuthumayo wesibhedlela esiseduze nawe, noma ushayele u-911. Ungachithi isikhathi!

Yiluphi ulwazi okufanele lunikezwe ithimba lezokwelapha?

Uma uya esibhedlela, ithimba lezokwelapha lizokubuza ngezimpawu zakho, njengokuthi zaqala nini nokuthi zimbi kangakanani.

Uma unganikeza imininingwane eminingi, kuba ngcono. Cabanga ngalezi zinto:

• Ngiqale nini ukuzwa izimpawu?
• Ngangenzani ngaleso sikhathi?
• Ziyini izimpawu?
• Sekuyisikhathi esingakanani belapho?
• Ingabe nginobuhlungu? Bukuphi?
• Esikalini esisuka ku-1 kuya ku-10, ngizizwa ubuhlungu obungakanani?
• Ingabe nginezinye izimo zezokwelapha?
• Yimiphi imithi engiyithathayo njengamanje?

I-Acute Coronary Syndrome yisifo senhliziyo esivamile esidinga ukunakekelwa kwezokwelapha ngokushesha. Ungase uzizwe sengathi unesifo senhliziyo. Shayela ku-1990 ngaphandle kokungabaza, noma uye esibhedlela esiseduze ngokushesha. Ukuxilongwa okusheshayo nokwelashwa kungasiza inhliziyo yakho ukuthi ibuyele esimweni sayo esijwayelekile futhi kukusize ukuthi ululame.

Yini into ebaluleke kakhulu esifuna ukuyithatha ekhaya kule ndaba? (Umyalezo Wokuya Ekhaya)

Kulula kakhulu. I-Acute Coronary Syndrome (ACS) yisimo esiphuthumayo nesibucayi. Uma uhlangabezana nezimpawu ezifana nobuhlungu besifuba, ukuphelelwa umoya, noma ukujuluka okungazelelwe , ukufuna iseluleko sezokwelapha ngokushesha kungasindisa impilo. Lokhu kubaluleke kakhulu uma unezici eziyingozi ezifana nesifo sikashukela, umfutho wegazi ophakeme, noma i-cholesterol ephezulu. Ukuphila impilo enempilo, ukuyeka ukubhema, nokulandela iseluleko sikadokotela wakho konke kuyizindlela ezibalulekile zokuzivikela kulesi simo. Nakekela inhliziyo yakho!

I- Acute Coronary Syndrome, Ukuhlaselwa Yinhliziyo, Ubuhlungu Besifuba, I-Angina, I-Coronary Artery, Isifo Senhliziyo, Ukwelashwa Okuphuthumayo