Ingabe une-calcium deposits emithanjeni yenhliziyo yakho? (Coronary Artery Calcification)

Wake wazibuza ukuthi ingabe ama-calcium deposit amancane anganqwabelana ngaphakathi kwemithambo emikhulu ethwala igazi enhliziyweni yakho? Kufana ne-limescale emapayipini amanzi ngokuhamba kwesikhathi. Lokhu yilokho esikubiza ngokwezokwelapha ngokuthi i-coronary artery calcification (CAC) . Ngezinye izikhathi, lokhu kungenzeka ngaphandle kwezimpawu ezibonakalayo. Kodwa ukuqaphela lokhu kubaluleke kakhulu empilweni yenhliziyo yakho.

Kuyini i-Coronary Artery Calcification?

Kalula nje, lokhu kwenzeka lapho i-calcium inqwabelana ngaphakathi kwezindonga zemithambo emibili emikhulu enikeza igazi enhliziyweni yakho, ebizwa ngokuthi imithambo ye-coronary . Lokhu akwenzeki ngobusuku obubodwa. Ngokuvamile kuthatha iminyaka emihlanu ukuthi i-calcium inqwabelane ngaphakathi kwemithambo yakho, ngemva kwesikhathi lapho unqwabelana khona i-plaque (ebizwa ngokuthi i-atherosclerosis ). Cabanga ngayo njengepayipi elinqwabelana ngokungcola nokungcola, bese lokho kwakheka kuba kukhulu.

Ukufakwa kwe-calcium kule mithambo kuyisibonakaliso esibalulekile sesifo semithambo yenhliziyo . Lokhu kuvumela udokotela wakho ukuthi ahlole ubungozi bakho besifo senhliziyo.

Uma la mafutha enqwabelana ngaphakathi kwemithambo yegazi, kunciphisa ukugeleza kwegazi. Uyazi, imithambo yegazi yenhliziyo inikeza imisipha yenhliziyo igazi elinomoya-mpilo omningi. Ngakho-ke, uma ukugeleza kwegazi kule mithambo yegazi kuvimbekile, ungathola ubuhlungu besifuba (i-angina) , noma okubi nakakhulu, ukuhlaselwa yinhliziyo .

Kunezinhlobo ezimbili eziyinhloko zama-calcium deposits:

Odokotela babona lokhu ngezindlela ezimbili eziyinhloko, kuye ngokuthi i-calcium ibekwe odongeni lwemithambo yegazi:

1. Ukufakwa kwe-Intimal: Lokhu kwenzeka engxenyeni engaphakathi yodonga lwemithambo yegazi. Lolu hlobo luvame ukubonakala emithanjeni yenhliziyo.

2. Ukufakwa kwe-medial: Lokhu kwenzeka engxenyeni ephakathi yodonga lwemithambo yegazi.

Buyini ubudlelwano phakathi kokufakwa kwe-calcium emithanjeni yegazi kanye ne-atherosclerosis?

Kukhona ukuxhumana okukhulu phakathi kwalokhu okubili. Inani le-calcium emithanjeni yakho lingakunikeza umbono wokuthi une -atherosclerosis engakanani, okuyiqoqo lamafutha emithanjeni yakho. I-atherosclerosis yilapho amafutha enqwabelana ngaphakathi kwemithambo yakho, iwanciphise. Kwenza kube nzima ukuthi igazi ligeleze kahle. I-calcium ingenza lesi simo sibe sibi kakhulu.

Ubani othinteka kakhulu yilesi simo?

Abantu abanesifo senhliziyo ngokuvamile babona ama-calcium deposits kule mithambo yegazi.

• Njengoba uneminyaka:Uma sibheka abantu abangaphezu kweminyaka engama-70 ubudala, amadoda angaphezu kwama-90% kanye nabesifazane abangama-67% banalesi simo. Ngaphambi kokunqamuka kokuya esikhathini, abesifazane bavikelekile kancane engcupheni yokuthola lesi sifo (i-atherosclerosis) ngenxa ye-hormone i-estrogen . Yingakho abesifazane beba nalesi simo ngemva kweminyaka eyi-10-15 kunabesilisa.
• Uhlanga/Ubuzwe: Ezinye izifundo zithole ukuthi abantu abamhlophe banamathuba amaningi okuthola lesi simo kunezinye izinhlanga.
• Kwabesilisa: Amadoda asengozini enkulu yokuthola lokhu (i-Coronary Artery Calcification).

Yiziphi izinto ezibangela ingozi? (Uma unalezi zinto, ungase ube sengozini)

Abanye abantu banamathuba amaningi okuthola lesi simo. Bheka ukuthi unazo yini lezi zinto eziyingozi:

• Uma unesifo sezinso esingamahlalakhona .
• Uma unezinkinga zikashukela egazini njenge -Diabetes Mellitus .
• Uma izinga le-cholesterol embi (LDL - Low-Density Lipoprotein) liphezulu kanti izinga le-cholesterol enhle (HDL - High-Density Lipoprotein) liphansi.
• Inani le -BMI (Body Mass Index) , okungukuthi, uma inkomba yesisindo somzimba iphezulu (ukukhuluphala).
• Uma othile emndenini wakho enomlando we-calcium deposits emithanjeni yenhliziyo kanje (ukuthambekela kwefa).
• Uma une -high blood pressure .
• Uma unomlando wokubhema noma ukusebenzisa eminye imikhiqizo kagwayi.
• Ngokukhula kweminyaka.
• Uma kukhona ukungahambi kahle kwe -hormone ye-parathyroid .
• Uma izinga le-phosphate egazini liphezulu.
• Uma izinga le-calcium egazini liphezulu.

Lokhu kwenzani emzimbeni? Kuwuthinta kanjani?

Uma i-calcium inqwabelana emithanjeni yakho yenhliziyo, iyenza iqine . Lokhu kunciphisa ikhono layo lokufinyela nokukhula kahle. Lokhu kwandisa ingozi yakho yesifo senhliziyo.

Kalula nje, lokhu kwakheka kwe-calcium kunciphisa inani legazi elifinyelela emisipheni yenhliziyo yakho. Cabanga ngakho njengenjini esebenza ngokungayeki. Uma ilahlekelwa ukuphakelwa kwegazi, izoba nezinkinga, akunjalo?

Enye into ukuthi uma kukhona ama-calcium deposits emithanjeni yegazi, kuba nzima ngodokotela ukwenza ezinye izindlela zokwelapha, njenge- Percutaneous Coronary Intervention (PCI) , noma njengoba sonke sazi , i-Angioplasty, ngoba la ma-calcium deposits angaphazamisa ukubekwa kahle kwe -stent efakwa ngaphakathi kwemithambo yegazi.

Ziyini izimpawu?

Esikhathini esiningi, abantu abanalesi simo (i-Coronary Artery Calcification) ababonisi zimpawu . Yilokho okuyingozi kakhulu. Kodwa ngokuhamba kwesikhathi, njengoba lesi simo siba sibi kakhulu, ezinye izimpawu zingase zivele. Lezi yizi:

• I-Angina Ezinzile: Lokhu ubuhlungu besifuba noma ukungakhululeki okuvame ukwenzeka ngesikhathi sokuzivocavoca noma lapho ukhuphuka izitebhisi. Kuyancipha ngokuphumula.
• Ukuphelelwa umoya.
• Ukuhlaselwa yinhliziyo.

Okubalulekile: Uma unalezi zimpawu, qiniseka ukuthi ufuna iseluleko sezokwelapha.

Kungani lokhu kwenzeka? Yiziphi izizathu?

Ngokuvamile ngemva kweminyaka engama-40, i-calcium egazini lethu ingaqala ukwakheka ezingxenyeni ezahlukene zomzimba. Ikakhulukazi, izindonga zemithambo yegazi ezilimele, ezivuvukele, noma ezilungiswayo yizona ezisengozini kakhulu yalezi zinsalela ze-calcium.

Le nqubo ingaqala ekuqaleni kweminyaka yakho engama-20 , kodwa udokotela uyibona kuphela uma inkulu ngokwanele ukuthi ingabonwa ekuhlolweni kwezithombe . Futhi, abantu abaningi abaseminyakeni yabo engama-20 nama-30 abayenzi njalo le nqubo.

Ama-calcium deposit aqala njengezinhlayiya ezincane kakhulu (0.5µm - micrometers). Ngokuhamba kwesikhathi, njengoba ama-fat deposit eqoqana, la ma-calcium deposit angakhula abe ngaphezu kwamamilimitha amathathu. Abacwaningi bakholelwa ukuthi la ma-calcium deposit amancane (i-microcalcification) ongqimbeni olungaphakathi kodonga lwemithambo yegazi aqala ngokufa kwamangqamuzana emisipha abushelelezi.

Ukuthola kanjani lokhu? Hlobo luni lokuhlolwa okwenziwayo?

Kunezivivinyo ezikhethekile zokuthwebula izithombe ezingabona lesi simo (i-Coronary Atherosclerosis), okungukuthi, ukugcinwa kwamafutha emithanjeni, ngaphambi kokuba sibe sibi kakhulu. Esinye salezi ezibaluleke kakhulu yi- (Computed Tomography - CT) scan, noma (i-Multidetector Computed Tomography - MDCT) .

Ukuhlolwa kwe-CT yenhliziyo kungabonisa ngokucacile ukuthi i-calcium ingakanani emithanjeni yakho yenhliziyo. Lokhu kubizwa ngokuthi ukuhlolwa kwe-calcium (CAC) yemithambo yenhliziyo . Kubheka kakhulu:

• Ingakanani i-calcium efakwa emzimbeni?
• Kungakanani ubuningi balawo madiphozithi?
• Zingakanani ?

Esebenzisa lolu lwazi, udokotela wakho ubala inani elibizwa ngokuthi i-Agatston score . Leli phuzu lingasukela ku-0 liye ku-400 noma ngaphezulu. Uma amaphuzu ephezulu, kulapho ingozi yakho yokuba nesifo senhliziyo noma isifo sohlangothi inkulu khona eminyakeni eyi-10 ezayo.

Odokotela bathole ukuthi lokhu kuhlolwa (i-CAC) kungabikezela ngokunembile ingozi yesikhathi esizayo yesifo senhliziyo. Kodwa-ke, kungase kudingeke ukhokhele lokhu kuhlolwa ngemali yakho.

Kusho ukuthini ukuthi amaphuzu e-CAC (Agatston Score) asho ukuthini?

Nansi indlela lezo zimpawu ezivame ukuhunyushwa ngayo:

• Isilinganiso 0: Akukho simo sezokwelapha.
• Isilinganiso 1 kuya ku-99: Isifo esincane.
• Amaphuzu asukela ku-100 kuya ku-399: Izinga lokugula eliphakathi nendawo.
• Amaphuzu angaphezu kuka-400: Isifo esibi kakhulu.

Ngaphezu kwalokhu kuhlolwa (i-CAC), kunezinye izivivinyo ezingangenisi kakhulu ezihlola ukufakwa kwe-calcium emithanjeni yakho yenhliziyo:

• I-Cardiac Intravascular Ultrasound (IVUS): Lokhu kusebenzisa idivayisi ye-ultrasound ene-catheter (ithubhu elincane) enamathiselwe ekugcineni ukuze ibheke ngaphakathi kwemithambo yegazi. Imiphumela ihlelwe kusukela ku-Class I kuya ku-Class IV, kanti i-Class IV ikhombisa ama-calcium deposits anzima kakhulu.
• I-Intravascular Optical Coherence Tomography (IVOCT): Lokhu kukhombisa ukuthi ingakanani i-calcium ebekwe emithanjeni yakho nokuthi ijiyile kangakanani. Kusebenzisa ukukhanya okuseduze kwe-infrared ukudala izithombe zangaphakathi kwemithambo.

Yiziphi izindlela zokwelapha lokhu?

Odokotela abakabi nayo indlela ejwayelekile yokwelapha i-coronary artery calcification. Kodwa-ke, ezimweni ezimbi kakhulu, abanye odokotela basebenzisa indlela entsha yokwelapha ebizwa ngokuthi i-intravascular lithotripsy . Lokhu kuhilela ukudlulisa idivayisi nge-catheter iye emthanjeni bese isetshenziselwa ukuletha amagagasi okucindezela ukuze kuhlukaniswe amadiphozithi e-calcium odongeni lomthambo. I- stent ingabekwa ukuze kugcinwe umthambo uvulekile.

Ezinye izindlela zokwelapha ezisetshenziswa ukuthuthukisa ukugeleza kwegazi emithanjeni zihlanganisa:

• Ukususwa kwe-rotational, orbital noma nge-laser: Lokhu kuhilela ukusika nokususa ama-fatty deposits (i-plaque) kanye ne-calcium ngaphakathi kwemithambo yegazi.
• I-angioplasty yokusika, ukufaka amagoli noma ukucindezela okuphezulu kwebhaluni: Lokhu kuhilela ukufutha ibhaluni ukuze kusunduzwe amafutha kanye ne-calcium ezindongeni zemithambo yegazi.

Ingabe izinkinga zingaba khona ngesikhathi sokwelashwa?

Njenganoma yikuphi ukwelashwa kwezokwelapha, ezinye izinkinga zingavela ngalokhu kwelashwa.

Izinkinga ze-Intravascular Lithotripsy:

• I-Arrhythmia ( isilinganiso senhliziyo esingajwayelekile)
• I-Aneurysm ( ukuvuvuka noma ukuba buthaka komthambo wegazi)
• Izinkinga zokopha
• Isifo sohlangothi
• Ukufa (okungavamile kakhulu)

Izinkinga Zokuhlinzwa Kwe-Rotational Atherectomy:

• Ukusikwa kwemithambo yegazi
• Isifo senhliziyo
• Ukufa (okungavamile kakhulu)
• I-Coronary Artery Bypass Graft Ephuthumayo (CABG)

Izinkinga ze-Coronary Angioplasty:

• Isifo senhliziyo
• Isifo sohlangothi
• I-Arrhythmia
• Ukopha
• Amahlule egazi

Lezi zinkinga azenzeki kuwo wonke umuntu, kodwa kubalulekile ukuziqaphela. Udokotela wakho uzochaza lezi zingozi uma encoma ukwelashwa kwakho.

Ngingayinciphisa kanjani le ngozi?

Into engcono kakhulu ongayenza ukulawula izinkinga ezandisa ingozi yokuthola i-coronary artery calcification. Lezi zifaka:

• Uma unesifo sikashukela, silawule kahle.
• Uma izinga lakho le-cholesterol lingajwayelekile, lilawule.
• Uma unomfutho wegazi ophakeme , lawula lokho.
• Uma unesifo sezinso , thola ukwelashwa okufanele ngaso.

Ngaphezu kwalezi zinto, kubaluleke kakhulu ukulandela indlela yokuphila enempilo.

Kwenzekani uma nginalesi simo? Yini engingayilindela?

Uma kutholakala ukuthi une-Coronary Artery Calcification, usengozini enkulu yokuthola isifo se-Coronary Artery Disease kanye ne-Major Adverse Cardiovascular Events (MACE) .

Kodwa-ke, uma kukhulunywa ngesilinganiso sempumelelo yezindlela zokwelapha, i-Intravascular Lithotripsy iphumelele ezimweni ezingaphezu kuka-92%. Ngokufanayo, i-Rotational Atherectomy nayo ibonise izinga lempumelelo elingu-90%.

Kodwa-ke, ukufakwa kwe-calcium emithanjeni kwandisa ingozi yokwehluleka kokwelashwa okufana ne -balloon angioplasty . Kungaba nzima futhi ukubeka i -stent kahle ngaphakathi kwemithambo yegazi.

Ngingazinakekela kanjani? Kufanele ngenzenjani?

Uma une-coronary artery calcification, kubalulekile ukulandela indlela yokuphila enempilo yenhliziyo. Lokho kusho ukuthi:

• Yidla ukudla okunamafutha aphansi (nciphisa amafutha, ukudla okuthosiwe, kanye nokudla okusheshayo ngangokunokwenzeka).
• Yeka ukusebenzisa imikhiqizo kagwayi (ugwayi, ama-beedis, njll.) ngokuphelele.
• Vivinya umzimba njalo (okufana nokuhamba okungenani imizuzu engama-30 ngosuku).
• Gcina amazinga akho omfutho wegazi kanye ne-cholesterol ejwayelekile (thatha imithi njengoba kuqondiswe udokotela wakho bese ulawula ukudla kwakho).

Kufanele ngimbone nini udokotela?

Uma une-high blood pressure kanye/noma amazinga aphezulu e-cholesterol, bona udokotela njalo ukuqinisekisa ukuthi lezo zimo zilawulwa kahle.Uma udinga uhlelo lokuthuthukisa impilo yakho yenhliziyo nemithambo yegazi, kuwumqondo omuhle ukuhlangana nodokotela ukuze nixoxe ngalo.

Kufanele ngiye nini esibhedlela ngokushesha (ETU) ?

Uma uzwa izimpawu zokuhlaselwa yinhliziyo, njengobuhlungu obukhulu besifuba, isicanucanu nokuhlanza, kanye nokuphelelwa umoya okukhulu , shayela u-911 ngokushesha noma uye esibhedlela esiseduze . Isikhathi singaba umehluko phakathi kokuphila nokufa ngesikhathi esinjengalesi.

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Uma uya kudokotela, kuyasiza ukubuza le mibuzo:

• Ingabe ngidinga ukuhlolwa kwe-coronary artery calcification?
• Ingakanani inkinga yami (i-Coronary Artery Calcification)?
• Yikuphi ukwelashwa okuncomayo ngesimo sami?
• Yiziphi izingozi nezinzuzo zalokhu kwelashwa?
• Yiziphi izinguquko okudingeka ngizenze endleleni yami yokuphila?

Masikhumbule ngamafuphi (Umyalezo Wokuya Ekhaya)

Ukwazi ukuthi une-calcium deposits emithanjeni yakho yenhliziyo kubalulekile kudokotela wakho ukuthi ahlele uhlelo lokukusiza. Ungadinga ukwelashwa ukuze ususe i-calcium emithanjeni yakho, noma ungadinga nje ukufaka imikhuba ethile enempilo yenhliziyo endleleni yakho yokuphila. Ngisho noma ungenazo izinkinga zenhliziyo, ukudla ukudla okunamafutha amancane, ukuzivocavoca, kanye nokugwema imikhiqizo kagwayi kungakusiza ukuthi uhlale uphilile. Khumbula, inhliziyo enempilo iyisihluthulelo sempilo enempilo!

I- calcium emithanjeni yenhliziyo, i-coronary artery calcification, isifo senhliziyo, i-cholesterol, umfutho wegazi ophakeme, isifo sikashukela, ukuhlaselwa yinhliziyo, i-atherosclerosis