Wake wezwa ngesifo semithambo yenhliziyo? Iningi lethu selike lakuzwa. Ngokwezokwelapha, lokhu kubizwa ngokuthi i-Coronary Artery Disease ( CAD ). Kalula nje, kuyisimo lapho amafutha ne -cholesterol kwakheka khona emithanjeni ethwala igazi liye enhliziyweni, okunciphisa ukugeleza kwegazi. Kodwa le mithambo ingavinjelwa ngezindlela ezahlukene. Namuhla, sizokhuluma ngesimo esiyinkimbinkimbi kancane esidinga ukunakwa okukhethekile. Okusho ukuthi, lapho amafutha eqoqana futhi evimba umthambo lapho umthambo omkhulu enhliziyweni uhlukana khona ube yigatsha elincane. Cabanga ngokuminyana kwezimoto emgwaqweni ofana no-Y, lapho imigwaqo emibili ihlukana khona. Odokotela bakubiza lokhu ngokuthi 'Ukuvinjwa Kwe-Bifurcation'.
Kuyini ngempela lokhu okubizwa ngokuthi i-Bifurcation Blockage?
Kulungile, ake sikubeke ngendlela elula lokhu. Inhliziyo yakho iyisicubu esisebenza ngokungayeki. Ithola amandla nomoya -mpilo eyidingayo emithanjeni yegazi ebizwa ngokuthi imithambo yenhliziyo. Le mithambo eyinhloko ihlukana ibe amagatsha amancane ukuze ithwale igazi liye kuzo zonke izingxenye zenhliziyo.
Manje, lokhu Kuvimba Kwe-Bifurcation kwenzeka lapho kwakheka i-fat deposit (esiyibiza ngokuthi i-plaque ) lapho umthambo omkhulu uhlukana khona ube yigatsha elincane, okungukuthi, ekuxhumaneni kwe-Y. Le plaque ivimba ukuhamba kwegazi. Odokotela babiza leli gatsha elincane ngokuthi “isitsha segatsha eliseceleni.” Le plaque ibizwa nangokuthi “isilonda se-bifurcation.”
Le ndawo iyinkimbinkimbi kakhulu ukuvaleka kunezinye izindawo. Ngenxa yokuthi ukugeleza kwegazi kanye nomfutho kuhlukile lapha, kunethuba elikhulu lokuthi i-plaque ikhule kulezi zindawo. Futhi kungaba nzima kakhulu ukuyilapha.
Ingabe zikhona izinhlobo eziyinhloko zalokhu kuvinjelwa?
Yebo, odokotela bahlukanisa lokhu kuvinjelwa ngokobunzima, okungukuthi, ukuthi ingakanani imithambo yegazi evinjiwe. Lokhu kubizwa ngokuthi i-stenosis . Kunezinhlobo ezimbili eziyinhloko.
| Uhlobo lokuvinjelwa | Incazelo elula |
|---|---|
| Ukuvinjelwa okulula | Lokhu kwenzeka lapho umthambo wegazi uvalekile ngaphansi kuka-70%. Lokhu kusho ukuthi kusenendawo ethile yokugeleza kwegazi. Lokhu kulula kakhulu ukukwelapha. |
| Ukuvinjelwa okuyinkimbinkimbi | Lapha, umthambo wegazi uvalekile ngaphezu kuka-70%, okusho ukuthi uvalekile kakhulu. Ngezinye izikhathi kungaba nokuvaleka okungaphezu kokukodwa. Noma lokhu kuvaleka kungabangelwa ukuqhekeka kwegazi noma i-calcification. Enye into ukuthi, ngezinye izikhathi uma lelo gatsha elincane lihlukana nge-engeli ebukhali kakhulu (ngaphezu kwama-degrees angu-70), kunzima kakhulu ukufaka amathuluzi nokwelapha leyo ndawo. |
Sivame kangakanani lesi simo ezweni lakithi?
Lesi yisimo esivame kakhulu. Izilinganiso zisikisela ukuthi phakathi kuka-15% no-20% wazo zonke izimo zesifo semithambo yenhliziyo (CAD) ezidinga ukwelashwa ziwela kulesi sigaba, esaziwa ngokuthi ukuvinjelwa kwe-bifurcation. Kalula nje, kuzo zonke iziguli eziyi-100 eziza esibhedlela zinemithambo yenhliziyo evinjiwe, cishe ezingu-15-20 zinokuvimba kule ndawo yokuhlangana. Ngakho-ke, lokhu akuyona into okufanele ithathwe kalula.
Kungani lokhu kwenzeka? Iyini imbangela yangempela yalokhu?
Isizathu esiyinhloko salokhu yizinsalela zamafutha ezibizwa ngokuthi i-plaque esikhulume ngayo ngaphambili. Lokhu kufana nokunqwabelana kokugqwala nokungcola epayipini lamanzi ngokuhamba kwesikhathi, okubangela izimbobo epayipini. Le plaque yakhiwa ukuqongelela kwe-cholesterol, amafutha, ne-calcium ezindongeni zemithambo yegazi yethu. Ngokuhamba kwesikhathi, le plaque ikhula ibe nkulu futhi inciphise ukudlula kwegazi emithanjeni. Ekugcineni, inhliziyo ayitholi inani elidingekayo legazi. Lesi simo sibizwa ngokuthi i-atherosclerosis . Ukuvaleka kwe-bifurcation nakho kungumphumela walesi simo se-atherosclerosis.
Ubani osengozini enkulu?
Nakuba lesi simo singakhula kunoma ubani, abanye abantu basengozini enkulu. Uma unesinye noma ngaphezulu salezi zici eziyingozi, kuwumqondo omuhle ukuba uqaphele kakhudlwana.
| Isici sengozi | Incazelo elula |
|---|---|
| Ubudala nobulili | Ingozi iphezulu kwabesifazane ngemva kokunqamuka kokuya esikhathini kanye nabesilisa abangaphezu kweminyaka engu-45. |
| Isifo sikashukela | Isifo sikashukela singalimaza imithambo yegazi, okwenza kube lula ukuthi i-plaque yakheke. |
| Ukukhuluphala ngokweqile noma ukukhuluphala ngokweqile | Njengoba isisindo somzimba sikhuphuka, ezinye izinto eziyingozi njenge-cholesterol kanye nomfutho wegazi ophakeme nazo ziyanda. |
| Umlando womndeni | Uma othile emndenini wakho (umama, ubaba, izingane zakini) enesifo senhliziyo, nawe usengozini enkulu. |
| Umfutho wegazi ophezulu (i-Hypertension) | Uma ingcindezi ikhuphuka, izindonga zemithambo yegazi ziyalimala futhi i-plaque ingakheka kalula. |
| I-cholesterol ephezulu | Lesi yisithako esiyinhloko sokwakheka kwe-plaque. Ingozi iphezulu uma kunezinga eliphezulu le-cholesterol embi (LDL) egazini. |
| Ukungawuvivinyi umzimba kanye nokudla okungenamsoco | Abantu abangazivocavoci ngokomzimba futhi abadla ukudla okunamafutha amaningi, ushukela, nosawoti basengozini enkulu kakhulu. |
| Ukubhema | Ukubhema kulimaza ngqo imithambo yegazi futhi kwandisa ingozi yokuqhekeka kwegazi. |
Yiziphi izimpawu ongase uzibone?
Ukuvaleka kwe-bifurcation uhlobo lwesifo semithambo yenhliziyo (CAD), ngakho-ke izimpawu ziyafana. Uma unesinye noma ngaphezulu salezi zimpawu, bona udokotela ngokushesha.
- Ubuhlungu besifuba noma ingcindezi (i-Angina): Lolu uphawu oluyinhloko. Kungazwakala sengathi umuzwa wokucindezela noma ukucindezela phakathi kwesifuba.
- Ukuphelelwa umoya: Ukuzizwa uphelelwa umoya uma ukhathele kancane, noma lapho ukhuphuka izitebhisi.
- Ukuzizwa ukhathele ngendlela engavamile: Ukuzizwa ukhathele kakhulu noma ubuthakathaka ngaphandle kwesizathu.
- Ubuhlungu behlombe noma bengalo: Ubuhlungu obuhamba ngengalo yesobunxele, ikakhulukazi.
- Isiyezi (i-vertigo) noma ukuquleka: Umuzwa wokuzungeza nokungakwazi ukuma.
- Isicanucanu: Ukuzizwa sengathi uhlanza.
- Ukuzizwa ubanda futhi ujuluka.
- Ukuzwa ukushaya kwenhliziyo okungajwayelekile (Ukushaya kwenhliziyo okungavamile).
Into ebalulekile ukuthi akubona bonke abantu abazobhekana nazo zonke lezi zimpawu. Abanye abantu bangase babe nalesi simo ngaphandle kwezimpawu nhlobo. Ngakho-ke, kuwukuhlakanipha ukuthola ukuhlolwa njalo kwezokwelapha uma unezici eziyingozi.
Udokotela ukuthola kanjani lokhu?
Uma utshela udokotela wakho ngezimpawu ozishilo ngenhla, uzokuxilonga futhi akuthumelele izivivinyo eziningana ukuqinisekisa lesi simo.
- I-ECG (i-Electrocardiogram): Lokhu kuhlola ukusebenza kukagesi kwenhliziyo ukuze kubonakale ukuthi kukhona yini umonakalo enhliziyweni.
- Ukuhlolwa Kokucindezeleka: I-ECG ithathwa ngenkathi uhamba nge-treadmill, kubhekwe ukuthi inhliziyo yakho isebenza kanjani uma ucindezelekile.
- I-Echocardiogram: Ukuhlolwa kwenhliziyo nge-ultrasound.
- Ukuhlolwa kwe-Catheterization Yenhliziyo (Coronary Angiogram): Lokhu kuhlolwa okuyinhloko kokubona ukuthi kukhona yini ukuvaleka kwemithambo yakho yegazi. Kufakwa ipayipi elincane ngomlenze noma engalweni yakho, lifakwe emithanjeni enhliziyweni yakho, bese kufakwa uketshezi olukhethekile, bese kuthathwa izithombe ze-X-ray. Lokhu kukuvumela ukuthi ubone ukuthi ukuvaleka kukuphi ngokucacile.
- I-CCTA (i-Coronary Computed Tomography Angiogram): Lokhu kufana ne-angiogram, kodwa kuwukuhlolwa okwenziwa kusetshenziswa umshini we-CT scan ngaphandle kokufaka ipayipi emzimbeni.
Lezi zivivinyo zizovumela udokotela wakho ukuthi anqume ukuthi une-bifurcation blockage nokuthi inzima kangakanani.
Yiziphi izindlela zokwelapha lokhu?
Ukwelapha ukuvaleka kwe-bifurcation kuyinselele kakhulu ngoba isitsha segatsha eliseceleni sincane kakhulu, okwenza kube nzima kakhulu ukwelapha ngamathuluzi kunomthambo oyinhloko.
Ukwelashwa okuyinhloko i-angioplasty kanye ne-stenting . Lokhu akusikho ukuhlinzwa. Lokhu kubizwa ngokuthi i-Percutaneous Coronary Intervention (PCI).
Nakhu okwenzekayo lapha:
1. Udokotela uzokonakalisa isikhumba sengalo noma umlenze wakho, ahlikihle kancane, bese efaka i-catheter kuyo.Ipayipi elincane kakhulu neliguquguqukayo elibizwa ngokuthi i-catheter lifakwa emthanjeni wegazi.
2. Ngemuva kwalokho, ngenkathi ubheka isikrini se-X-ray, ithubhu liqondiswa endaweni eqondile yomthambo ovalekile enhliziyweni.
3. Kukhona ibhaluni elincane ekugcineni kwe-catheter. Uma lifika lapho livalekile khona, ibhaluni liyakhukhumala. Bese i-plaque icindezela odongeni lomthambo, ivule futhi indlela evalekile.
4. Bese kuthi, ukuze kuvuleke imbobo futhi, kufakwa ithubhu elincane eline-mesh elibizwa ngokuthi i -stent kuleyo ndawo.
Ngemva kwalokhu kwelashwa, udokotela wakho uzokubhalela imithi ekhethekile (ukwelashwa okuphindwe kabili kwe-antiplatelet) ukuvimbela ukwakheka kwamahlule egazi ngaphakathi kwe-stent. Kubalulekile ukuthi uphuze le mithi isikhathi esinqunyiwe.
Yiziphi izindlela zokwelapha?
Kunezindlela ezimbili eziyinhloko zokuvinjelwa kwe-bifurcation nge-stenting.
- Ukufaka I-Stenting Yesikhashana: Kule ndlela, udokotela ubeka i-stent kuphela emthanjeni oyinhloko. Igatsha elincane alifakwa. I-stent ingafakwa egatsheni elincane ngosuku olulandelayo, kuphela uma uba nezimpawu futhi.
- Izinqubo Ezine-Stent Ezimbili: Uma ukuvaleka kuyinkimbinkimbi kakhulu, udokotela angase anqume ukubeka ama-stent kokubili emthanjeni oyinhloko kanye nasegatsheni elincane elihlumayo.
Ingabe zikhona izinkinga ezingase zivele ngemva kokwelashwa?
Nakuba i-angioplasty kanye ne-stenting kuyindlela yokwelapha ephumelelayo, izinkinga zingavela kubantu abambalwa kakhulu .
| Inkinga | Incazelo elula |
|---|---|
| I-In-stent Restenosis | Lokhu kusho ukuthi izicubu zesilonda zakheka ngaphansi kwe-stent, okubangela ukuthi umthambo unciphe futhi. Lokhu kuvame ukwenzeka zingakapheli izinyanga eziyisithupha zokwelashwa. Uma lokhu kwenzeka, kungadingeka ukuthi wenze olunye uhlinzwa lwe-angioplasty noma olunye ukwelashwa. |
| I-Stent Thrombosis | Lesi yisimo esibi kakhulu, kodwa esingavamile kakhulu, lapho kwakheka khona ihlule legazi ngaphakathi kwe-stent bese livimba umthambo ngokuzumayo. Ukuze uvimbele lokhu, udinga ukuthatha umuthi ovimba ukujiya kwegazi kahle. |
Ingabe lolu hlobo lwesimo alunakuvinjelwa?
Kungenzeka impela. Isifo senhliziyo sihlobene kakhulu nendlela yethu yokuphila. Ngakho-ke, ukwamukela indlela yokuphila enempilo yenhliziyo kunganciphisa kakhulu ingozi yokuthola lesi simo.
- Yidla ukudla okunempilo kwenhliziyo. Nciphisa ukudla okunamafutha amaningi, usawoti, noshukela ngangokunokwenzeka. Faka izithelo, imifino, ubhontshisi, izinhlanzi ezincane, kanye nokudla okusanhlamvu okuphelele ekudleni kwakho.
- Uma ubhema, yeka namuhla. Ukubhema kungenye yezitha ezinkulu zenhliziyo.
- Vivinya umzimba njalo. Yenza okuthile okufana nokuhamba noma ukugibela ibhayisikili okungenani imizuzu engama-30 ngosuku.
- Lawula isisindo somzimba wakho. Kunesisindo esithile esifanele ubude bakho. Zama ukusilondoloza.
- Uma unesifo sikashukela, umfutho wegazi ophakeme, noma i-cholesterol, zilawule ngokuthatha imithi udokotela wakho akunike yona.
- Nciphisa ukucindezeleka. Kuhle kakhulu ukuzibandakanya ezintweni ezifana ne-yoga nokuzindla.
- Nciphisa ukusetshenziswa kotshwala.
Kufanele ubonane nodokotela ngokushesha nini?
Khumbula lokhu: Uma uzwa izimpawu zokuhlaselwa yinhliziyo, njengobuhlungu besifuba obungazelelwe, obukhulu, ukuphelelwa umoya, noma ukujuluka, ungalibali ngisho nomzuzwana. Shayela u-911 ngokushesha noma uthathe isiguli uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
Ngaphezu kwalokho, uma uhlangabezana nezimpawu ezilandelayo njalo, qiniseka ukuthi ubona udokotela ukuze akunike iseluleko.
- Ubuhlungu besifuba (i-angina), ubuhlungu bengalo noma behlombe
- Ukuzizwa ubanda futhi ujuluka
- Ubunzima bokuphefumula
- Ukukhathala noma ubuthakathaka obungachazeki
Imibuzo okufanele uyibuze udokotela wakho
Uma uthola ukuthi unalesi simo, kuyinto evamile ukuba nemibuzo eminingi engqondweni yakho. Ungagodli lutho, buza udokotela wakho bese uthola impendulo.
- Yini engenza ngizizwe ngibambeke kanje?
- Ingabe ikhona ingozi yokuvaleka okufanayo kweminye imithambo yegazi yami?
- Ingabe i-angioplasty kanye ne-stenting kungakuqeda ngokuphelele lokhu kuvinjelwa?
- Hlobo luni lwe-stent ongincomayo?
- Zingaki izinti engizodinga ukuzibeka?
- Yini okufanele ngiyenze ukuze ngivikele inhliziyo yami?
- Yiziphi izinkinga okufanele ngikhathazeke ngazo ngemva kokwelashwa?
Ngiyethemba ukuthi lolu lwazi luzokusiza ukuthi uqonde kangcono lesi simo. Khumbula, lokhu akuyona into okufanele uyesabe, kodwa into okufanele iphathwe kahle.
Umlayezo Wokuya Nawe Ekhaya
- Ukuvaleka kwe-bifurcation uhlobo oluthile lokuvaleka okwenzeka lapho umthambo wegazi enhliziyweni uhlukana ube amagatsha. Lokhu kuyinkimbinkimbi kakhulu kunokuvaleka okuvamile.
- Izimpawu zifana nezesifo senhliziyo esivamile. Ubuhlungu besifuba kanye nokuphelelwa umoya yizona eziyinhloko. Ungalokothi uzishaye indiva lezi.
- Ukufakwa kwe-stent kuyindlela yokwelapha ephumelelayo, kodwa kudinga ukungenelela kukadokotela onolwazi.
- Okubaluleke kakhulu kunokwelashwa ukushintsha indlela yakho yokuphila. Ukudla ngendlela efanele, ukuzivocavoca umzimba, nokugwema imikhuba emibi kubalulekile.
- Ubuhlungu obukhulu besifuba buyisimo esiphuthumayo. Yiya eMnyangweni Wezimo Eziphuthumayo wesibhedlela (ETU) ngokushesha.
Isifo Senhliziyo, Ukuvaleka Kwe-Bifurcation, Isifo Semithambo Yenhliziyo, Ukushiswa Kwemithambo, I-Angioplasty, Ubuhlungu Besifuba, Ukuhlaselwa Yinhliziyo
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