Ingabe imithambo yegazi ehambisa igazi enhliziyweni yakho ivaliwe? Ake sifunde ngesifo semithambo yegazi!

Namuhla sizokhuluma ngesimo senhliziyo esivamile kodwa esingaba sibi kakhulu. Kungenzeka ukuthi uke wezwa ngaso, noma othile emndenini wakho angaba naso. Ake sibheke ukuthi siyini isifo semithambo yegazi yenhliziyo (CAD) , ukuthi kungani senzeka, nokuthi singazivikela kanjani. Kufana nombulali othule, ngakho-ke kubalulekile ukuqaphela.

Kuyini Isifo Semithambo Yenhliziyo?

Kalula nje, kuyisimo lapho imithambo yenhliziyo , ehlinzeka ngegazi elinomoya-mpilo enhliziyweni yakho, incipha noma ivaleke. Ngokuhamba kwesikhathi , i-plaque , ikakhulukazi i-cholesterol, inqwabelana kule mithambo, inciphisa inani legazi elifinyelela emisipheni yenhliziyo.

Cabanga nje, kunemizila emibili yezimoto emgwaqweni, futhi ngokuzumayo umgwaqo uyakhiwa, ngakho-ke wehliswa waba umzila owodwa. Khona-ke izimoto zizohamba kahle, akunjalo? Yilokho okwenzekayo. Ungase ungaboni lutho kuze kube yilapho le plaque yakhe i-blood clot futhi ivimbe ngokuphelele umthambo. I-blood clot ifana nesithiyo sikakhonkolo phakathi komgwaqo. Khona-ke izimoto zima ngokuphelele. Ngokufanayo, ukuhlaselwa yinhliziyo kwenzeka lapho igazi lingakwazi ukugeleza liye enhliziyweni.

Lesi simo singaqhubeka iminyaka eminingi ngaphandle kwezimpawu, kuze kube yilapho kuvela isifo senhliziyo ngokuzumayo. Yingakho sibizwa ngokuthi "umbulali othule."

Kubizwa nangokuthi i-Coronary Heart Disease (CHD) kanye ne-Ischemic Heart Disease . Lokhu yilokho abantu abaningi abakubiza ngokuthi "inkinga yenhliziyo."

Ingabe zikhona izinhlobo eziyinhloko zalokhu?

Yebo, kunezinhlobo ezimbili eziyinhloko zesifo semithambo yenhliziyo:

1. Isifo Senhliziyo Esizinzile Se-Ischemic: Lolu uhlobo oluhlala isikhathi eside, noma oluhlala isikhathi eside. Imithambo yakho yenhliziyo iyancipha kancane kancane eminyakeni eminingi. Ngokuhamba kwesikhathi, inani legazi elicebile ngomoya-mpilo elitholwa yinhliziyo yakho liyancipha. Ungase ube nezimpawu ezithile, kodwa uyakwazi ukuqhubeka nokuphila kwakho kwansuku zonke ngokujwayelekile.

2. I-Acute Coronary Syndrome: Lesi yisimo esiyingozi esenzeka ngokuzumayo futhi esidinga ukunakekelwa kwezokwelapha okusheshayo. I-plaque emthanjeni wenhliziyo iyaqhuma ngokuzumayo, yakha i-blood clot evimba ukugeleza kwegazi enhliziyweni. Lokhu kuvinjelwa okungazelelwe kubangela ukuhlaselwa yinhliziyo.

Sivame kangakanani lesi simo?

Isifo semithambo yenhliziyo sivame kakhulu . E-United States kuphela, abantu abadala abangaphezu kwezigidi ezingu-18 banalesi sifo. Kubonakala sengathi lesi simo siyanda usuku nosuku ezweni lethu. Isifo semithambo yenhliziyo siyimbangela ehamba phambili yokufa emhlabeni jikelele.

Ziyini izimpawu?

Ungase ungabi nazimpawu zesifo semithambo yenhliziyo isikhathi eside. Lokhu kungenxa yokuthi kuthatha iminyaka, ngisho namashumi eminyaka, ukuthi le plaque yakheke. Kodwa njengoba imithambo yakho iqala ukuncipha, ungase uqale ukuqaphela izimpawu ezicashile. Lezi izimpawu zokuthi inhliziyo yakho isebenza kanzima kunokujwayelekile ukupompa igazi elinomoya-mpilo emzimbeni wakho.

Izimpawu ze-CAD engapheli zingafaka:

• I-Stable Angina: Lolu uphawu oluvame kakhulu. I-Stable angina ubuhlungu besifuba noma ukungakhululeki. Iyafika futhi idlule ngendlela efanayo. Ngokuvamile uyizwa ngesikhathi sokuzivocavoca umzimba, umsebenzi onzima, noma uma ucindezelekile. Iyaphela ngokuphumula noma uma uthatha i-nitroglycerin (umuthi osetshenziselwa i-angina).
• Ukuphelelwa umoya / Ukuphelelwa umoya: Abanye abantu bakuthola kunzima ukuphefumula ngisho nalapho benza imisebenzi elula.

Ngezinye izikhathi, uphawu lokuqala lwesifo semithambo yenhliziyo ukuhlaselwa yinhliziyo , ngakho-ke kudingeka uqaphele kakhulu ngalokhu.

Yini ebangela lokhu?

Imbangela eyinhloko yesifo semithambo yenhliziyo yisimo esibizwa ngokuthi i-atherosclerosis . I-atherosclerosis ukwakheka kancane kancane kwe-plaque ngaphakathi kwemithambo yomzimba wakho. Uma la ma-plaque evimba ukugeleza kwegazi ngemithambo yakho yenhliziyo, uba nesifo semithambo yenhliziyo.

Le plaque yenziwe ngezinto ezifana ne-cholesterol, imikhiqizo engcolile, i-calcium, ne -fibrin (into esiza ukujiya kwegazi). Uma lokhu kwakheka ezindongeni zemithambo yegazi, kuyancipha futhi kuqine.

Lokhu kufakwa kunganciphisa noma kulimaze imithambo yegazi. Lokhu kungavimbela noma kuvimbele ngokuphelele ukugeleza kwegazi engxenyeni yomzimba. Lapho lokhu kufakwa kwakheka emithanjeni yenhliziyo, imisipha yenhliziyo ayitholi igazi elanele. Lokhu kusho ukuthi inhliziyo ayitholi umoya-mpilo nezakhamzimba ezidingayo ukuze isebenze kahle. Lokhu kubizwa ngokuthi i-myocardial ischemia . Lokhu kungabangela ubuhlungu besifuba (i-angina) futhi kwandise ingozi yokuhlaselwa yinhliziyo.

Abantu abanesifo semithambo yenhliziyo bavame ukuba nama-plaque anqwabelene kwezinye izingxenye zomzimba, okungaholela ezimweni ezifana nesifo semithambo ye-carotid (esithinta imithambo entanyeni) kanye nesifo semithambo ye-peripheral (i-PAD) (esithinta imithambo engalweni nasemilenzeni).

Ingabe lokhu kuyinto evela ezizukulwaneni ngezizukulwane?

Ngezinga elithile, yebo. Umlando womndeni uthinta ingozi yakho yesifo semithambo yegazi yenhliziyo. Kodwa-ke, kunezinye izici eziningi eziyingozi ezingahlobene nezakhi zofuzo zakho. Izinqumo ozenzayo nsuku zonke zinomthelela omkhulu engcupheni yakho ye-CAD.

Yiziphi izinto ezibangela ingozi?

Kunezici eziningi eziyingozi zesifo semithambo yenhliziyo. Awukwazi ukuzishintsha zonke, kodwa ezinye zingalawulwa ngokushintsha indlela yokuphila noma ngemithi. Khuluma nodokotela wakho ngalokho ongakwenza ngalezi zinto eziyingozi:

• Uma uyindoda, uneminyaka engaphezu kwengu-45 ubudala, kanti uma ungowesifazane, uneminyaka engaphezu kwengu-55 ubudala.
• Ukuba nelungu lomndeni elinesifo senhliziyo (ikakhulukazi ubaba noma umfowabo ngaphambi kweminyaka engu-55, noma umama noma udadewabo ngaphambi kweminyaka engu-65).
• Ukudla amafutha agcwele kakhulu noma ama-carbohydrate acwengekile (njengesinkwa, ilayisi, i-pasta).
• Ukungawuvivinyi umzimba ngokwanele.
• Ukungalali ngokwanele.
• Ukubhema, ukubhema i-vaping, noma okunye ukusetshenziswa kukagwayi.
• Ukuba ne -atherosclerosis .
• Umfutho wegazi ophakeme .
• Amazinga aphezulu e-cholesterol embi (i-LDL cholesterol) .
• Ukwehla kwamazinga e -cholesterol enhle (i-HDL cholesterol) .
• Amazinga aphezulu e-triglyceride ( i-hypertriglyceridemia ).
• I-anemia .
• Izifo ezizenzakalelayo ezifana ne -lupus kanye ne-rheumatoid arthritis .
• Isifo sezinso esingamahlalakhona .
• Isifo Sikashukela (i-Diabetes Mellitus) .
• I-HIV/AIDS .
• I-Metabolic syndrome .
• Inkomba Yobunzima Bomzimba (BMI) engaphezu kuka-25.
• Izinkinga zokulala ezifana ne -sleep apnea .
• Ukunqamuka kokuya esikhathini kusenesikhathi (ngaphambi kweminyaka engama-40).
• I-Endometriosis .
• Ukuba nomlando wezimo ezifana nesifo sikashukela sokukhulelwa, i-eclampsia , noma i-preeclampsia .
• Ukusetshenziswa kwezindlela zokuvimbela inzalo zama-hormone.

Ingabe izinkinga zingaba khona?

Inkinga enkulu yesifo semithambo yenhliziyo ukuhlaselwa yinhliziyo . Lesi yisimo esiphuthumayo sezokwelapha esisongela impilo. Imisipha yenhliziyo iqala ukufa ngoba ayitholi igazi elanele. Ukuze usindise impilo yakho, udinga ukwelashwa okuphuthumayo ukuze ubuyisele ukugeleza kwegazi enhliziyweni yakho.

Ngokuhamba kwesikhathi, i-CAD ingenza inhliziyo ibe buthaka futhi ibangele izinkinga ezifana nalezi:

• I-Arrhythmias (ukushaya kwenhliziyo okungajwayelekile, isibonelo i-atrial fibrillation ).
• Ukufa ngokuzumayo ngenxa yokumiswa kwenhliziyo .
• Ukushaqeka kwenhliziyo .
• Ukwehluleka kwenhliziyo .

Lesi sifo sitholakala kanjani?

Odokotela baxilonga isifo semithambo yenhliziyo ngokuhlolwa ngokomzimba kanye nokuhlolwa okuhlukahlukene.

Ngesikhathi sokuhlolwa ngokomzimba, udokotela wakho:

• Umfutho wegazi lakho uyalinganiswa.
• Ukulalela inhliziyo nge-stethoscope.
• Bayabuza ukuthi yiziphi izimpawu onazo nokuthi usunesikhathi esingakanani unazo.
• Ukubuza ngomlando wakho wezokwelapha.
• Ngibuza ngendlela ophila ngayo.
• Buza ngomlando wezokwelapha womndeni wakho (ikakhulukazi uma abazali bakho noma izingane zakini zinesifo senhliziyo).

Lonke lolu lwazi lusiza udokotela wakho ukuthi anqume ingozi yakho yokuthola isifo senhliziyo.

Hlobo luni lokuhlolwa okwenziwayo?

Ukuze ahlole ukusebenza kwenhliziyo yakho futhi aqinisekise i-CAD, udokotela wakho angase ancome ukuhlolwa okukodwa noma ngaphezulu kwalokhu okulandelayo:

• Ukuhlolwa kwegazi .
• Ukufakwa kwe-catheter kwenhliziyo .
• I-CT coronary angiogram (i-computed tomography (CT) coronary angiogram) .
• I-MRI yenhliziyo (i-magnetic resonance imaging) .
• I-Coronary calcium scan .
• I-Echocardiogram (i-Echocardiogram - i-echo) .
• I-Electrocardiogram (EKG/ECG) .
• Ukuhlolwa kokucindezeleka kokuzivocavoca .
• I-X-ray yesifuba .

Iphathwa kanjani?

Ukwelashwa kwesifo semithambo yenhliziyo kuvame ukuhilela ukushintsha indlela yokuphila, ukuphathwa kwezici eziyingozi, kanye nemithi. Abanye abantu bangadinga nokuhlinzwa noma ezinye izinqubo zezokwelapha.

Udokotela wakho uzokhuluma nawe ngohlelo lokwelashwa olungcono kakhulu kuwe. Kubaluleke kakhulu ukulandela uhlelo lwakho lokwelashwa ngqo ukuze unciphise ingozi yakho yezinkinga ezinkulu ezivela ku-CAD.

Izinguquko zendlela yokuphila

Izinguquko zendlela yokuphila zidlala indima enkulu ekwelapheni isifo semithambo yenhliziyo. Lokhu kufaka phakathi:

• Ungabhemi, ungasebenzisi i-vape, noma usebenzise noma yimiphi imikhiqizo kagwayi .
• Yidla ukudla okunempilo kwenhliziyo okune-sodium ephansi (usawoti), amafutha agcwele, amafutha e-trans, kanye noshukela . Ukudla kwaseMedithera kuyindlela eqinisekisiwe yokunciphisa ingozi yokuhlaselwa yinhliziyo noma isifo sohlangothi.
• Ukuzivocavoca : Lwela ukuhamba (noma ukwenza omunye umsebenzi) imizuzu engama-30, izinsuku ezinhlanu ngesonto.
• Nciphisa utshwala .

Qiniseka ukuthi ukhuluma nodokotela wakho ngaphambi kokuqala uhlelo olusha lokuzivocavoca. Udokotela wakho angakuqondisa nganoma yiziphi izinguquko zendlela yokuphila ongase uzidinge. Bangase futhi bancome izindlela zokukusiza ukuthi uyeke ukubhema noma bakhulume nochwepheshe wezokudla mayelana nohlelo lokudla okunempilo.

Ukuphathwa kwezinto eziyingozi

Ukulawula izici zakho eziyingozi ze-CAD kungasiza ekuvimbeleni isimo sakho ukuba singabi sibi kakhulu. Sebenzisana nodokotela wakho ukuze uphathe lezi zimo:

• Isifo sikashukela .
• Umfutho wegazi ophakeme .
• I-cholesterol ephezulu .
• Ama-triglyceride aphezulu (i-hypertriglyceridemia) .
• Inani le-BMI elingaphezu kuka-25 .

Imithi

Imithi ingasiza ekulawuleni izici zakho eziyingozi futhi yelaphe izimpawu zesifo semithambo yenhliziyo. Udokotela wakho angase akunike umuthi owodwa noma ngaphezulu kwale mithi elandelayo:

• Lezo ezinciphisa umfutho wegazi.
• Labo abanciphisa i-cholesterol.
• Lezo ezilawula i-angina ezinzile, njenge- nitroglycerin ne -ranolazine .
• Lezo ezinciphisa ingozi yokuqhekeka kwegazi.

Ukuhlinzwa nezinye izinqubo

Abanye abantu bangadinga izinqubo noma ukuhlinzwa okufana nalokhu ukulawula isifo semithambo yenhliziyo:

• Ukungenelela Kwenhliziyo Okuhamba Ngesicubu (PCI): Lena inqubo engangenisi kakhulu, ebizwa nangokuthi i-coronary angioplasty . Umthambo wakho ovalekile uyavulwa futhi igazi ligeleza kahle. Kungase kufakwe ne -stent ukusiza ukugcina umthambo uvulekile.
• Ukufakelwa Kwemithambo Yenhliziyo Enemithambo Yenhliziyo (i-CABG): Lokhu kuhlinzwa kudala indlela entsha yokuthi igazi ligeleze eduze kokuvaleka. Lokhu "kudlula" kubuyisela ukugeleza kwegazi enhliziyweni. Ukuhlinzwa kwe-CABG kusiza abantu abanokuvaleka okukhulu emithanjeni eminingana yenhliziyo.

Ingabe ikhona imiphumela emibi yokwelashwa?

Ukwelashwa kwezifo zemithambo ye-coronary kungabangela izinkinga noma imiphumela emibi efana nalokhu:

• Ukopha.
• Uhudo.
• Isiyezi.
• Ukukhwehlela.
• Ukwakheka kwehlule legazi.
• Ukulimala kwemithambo ye-coronary.
• Izifo.
• Ukushaya kwenhliziyo okungavamile.
• I-tamponade yenhliziyo ( ukuqongelela koketshezi oluzungeze inhliziyo).

Kuthatha isikhathi esingakanani ukuphulukiswa?

Ngemva kwe-PCI (angioplasty) , ungaphinde uqalise imisebenzi evamile zingakapheli isonto. Ngemva kwe-CABG (ukuhlinzwa kwe-bypass) , kuzodingeka uhlale esibhedlela isikhathi esingaphezu kwesonto. Ngemva kwalokho, kuzothatha cishe amasonto ayi-6 kuya kwayi-12 ukuze ululame ngokugcwele.

Lokhu akunakuvinjelwa?

Isifo semithambo yenhliziyo asikwazi ukuvinjelwa ngaso sonke isikhathi ngoba ezinye izinto eziyingozi zingaphezu kwamandla akho. Kodwa unganciphisa ingozi yakho yesifo semithambo yenhliziyo futhi usize ekuvimbeleni ukuthi ibe yimbi kakhulu ngokuthi:

• Yenza isinqumo sokuyeka ngokuphelele ukubhema nazo zonke izinhlobo zikagwayi .
• Yidla ukudla okunempilo kwenhliziyo.
• Lala ngokwanele.
• Gcina isisindo esinempilo esikufanele.
• Qaphela ingozi yokuthola isifo senhliziyo.
• Nciphisa ukusetshenziswa kotshwala.
• Thutha kakhulu, khuthala.
• Thatha imithi yakho njengoba uyalelwe.

Kwenzekani uma nginalesi sifo?

Udokotela wakho ungumuntu ongcono kakhulu ongakutshela ngesimo sakho. Imiphumela iyahlukahluka kuye ngomuntu nomuntu. Udokotela wakho uzocabangela konke kusukela eminyakeni yakho, ezinye izimo zezokwelapha, izici eziyingozi, kanye nezimpawu ukuze enze isinqumo. Ukushintsha indlela yokuphila kanye nezinye izindlela zokwelapha kungakusiza ukuthi uthuthukise amathuba akho okuba ngcono.

Ingabe lesi sifo singalapheka ngokuphelele?

Awukwazi "ukuyelapha" ngokuphelele isifo semithambo yenhliziyo. Kodwa ungasiphatha isimo sakho futhi usivimbele ukuthi singabi sibi kakhulu . Ngokusebenzisana nodokotela wakho nokulandela uhlelo lwakho lokwelashwa eduze, ungandisa amathuba akho okuphila unamandla futhi uphilile ngangokunokwenzeka.

Ngizinakekela kanjani?

Into ebaluleke kakhulu ongayenza ukulandela uhlelo lwakho lokwelashwa ngqo. Lokhu kungafaka phakathi izinguquko zendlela yokuphila kanye nemithi. Kungafaka futhi ukuhlinzwa noma ezinye izinqubo kanye nesikhathi esidingekayo sokululama ngemva kwalokho.

Kanye nokwelashwa, udokotela wakho angase ancome uhlelo lokuvuselela inhliziyo . Lolu hlobo lohlelo luwusizo kakhulu kubantu abalulama ekuhlaselweni yinhliziyo noma abaphila nokwehluleka kwenhliziyo. Lukusiza ngokuzivocavoca umzimba, ukushintsha ukudla, kanye nokulawula ukucindezeleka.

Isifo Semithambo Yenhliziyo Nempilo Yengqondo

Uma uthola ukuthi une-CAD, ungase uqale ukucabanga kakhulu ngenhliziyo yakho kanye nemithambo yegazi kunokuba ubungacabanga ngenye indlela. Lokhu kungaba yinto ekhathazayo futhi eqeda amandla. Ungase uzizwe ukhathazekile kakhulu ngezimpawu zakho noma ukuthi kuzokwenzekani kuwe. Abantu abaningi abanesifo semithambo yegazi yenhliziyo babhekana nokucindezeleka nokukhathazeka . Kuvamile ukuzizwa ukhathazekile lapho uphila nesimo esisongela ukuphila.

Kodwa ungavumeli lokho kukhathazeka kulawule impilo yakho yansuku zonke. Ungaphila impilo esebenzayo neyanelisayo ngisho noma unesifo senhliziyo. Uma ukuxilongwa kwakho kuthinta impilo yakho yengqondo, khuluma nomeluleki. Thola iqembu lokusekela lapho ungahlangana khona nabantu ababhekene nezinto ezifanayo nezakho. Akudingeki ukuthi ugcine konke lokhu kuwe, futhi akudingeki uzizwe sengathi kufanele ube namandla kwabanye. I-CAD iyisifo esishintsha impilo. Kubalulekile ukuqonda konke lokhu futhi uzinike isikhathi sokuthola izindlela zokuhlala uphilile, ngokomzimba nangokwengqondo.

Kufanele ubonane nini nodokotela?

Udokotela wakho uzokutshela ukuthi kufanele uze kangaki ukuze uhlolwe futhi ulandelelwe. Ngaphezu kokubona udokotela wakho ojwayelekile, ungabona nochwepheshe (isibonelo , udokotela wenhliziyo ).

Khuluma nodokotela wakho kulesi simo:

• Uma ubona izimpawu ezintsha noma izinguquko ezimpawu.
• Uma kunemiphumela emibi evela emuthini.
• Uma unemibuzo noma ukukhathazeka ngesimo sakho noma uhlelo lokwelashwa.

Kufanele ufune nini ukwelashwa okuphuthumayo?

Uma unezimpawu zokuhlaselwa yinhliziyo noma isifo sohlangothi, shayela ku-1990 noma inombolo yakho yezimo eziphuthumayo yendawo. Lezi yizimo eziphuthumayo zezokwelapha ezisongela impilo ezidinga ukwelashwa okusheshayo. Kungasiza ukuphrinta uhlu lwezimpawu bese uzigcina lapho ungazibona khona. Futhi, tshela umndeni wakho nabangani ngalezi zimpawu ukuze bakwazi ukukushayela ku-1990 uma kudingeka.

Yini okufanele ngiyibuze udokotela/udokotela?

Uma ungakatholakali unesifo semithambo yegazi yenhliziyo, cabanga ngokuzibuza le mibuzo:

• Yiziphi izinto ezingenza ngibe sengozini yokuthola isifo semithambo yenhliziyo?
• Yini engingayenza ukuze nginciphise ingozi yami?
• Yiziphi izinguquko zendlela yokuphila ezibaluleke kakhulu kimi?
• Yimiphi imithi enganciphisa ingozi yami, futhi iyini imiphumela yayo emibi?
• Kufanele ngithathe lo muthi isikhathi esingakanani?

Uma unesifo semithambo yenhliziyo, le mibuzo ingase ibe usizo:

• Yini engingayenza ukuze ngilawule lesi sifo ukuthi singabi sibi kakhulu?
• Yiluphi uhlelo lokwelashwa olungcono kakhulu kimi?
• Yiziphi izinguquko zendlela yokuphila okudingeka ngizenze?
• Yimiphi imithi engiyidingayo futhi iyini imiphumela yayo emibi?
• Ingabe ngizodinga ukuhlinzwa noma ezinye izindlela zokwelapha? Ngizolulama kanjani?
• Ingabe kukhona amaqembu okusekela noma izinsiza ongazincoma?

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Ukuthola ukuthi unesifo semithambo yegazi kungaba yingxubevange yemizwa. Ungase udideke ngokuthi lokhu kwenzeke kanjani. Ungase uzizwe udabukile, noma ungase ufise sengathi ngabe wenze izinto ngendlela ehlukile ukuze ugweme lokhu kuxilongwa. Kodwa lesi akusona isikhathi sokucabanga ngesikhathi esidlule, kodwa sokucabanga ngekusasa. Yeka noma yiliphi icala noma ukusola ongase uzizwe. Kunalokho, qala ukwenza uhlelo lokusiza inhliziyo yakho namuhla.

Sebenza nodokotela wakho ukuze wenze izinguquko zendlela yokuphila ongazilawula. Funda ngezinketho zokwelapha, okuhlanganisa imithi, nokuthi ingasiza kanjani impilo yenhliziyo yakho. Tshela umndeni wakho nabangani ngemigomo yakho nokuthi ingakusiza kanjani. Lolu uhambo lwakho, kodwa akudingeki uhambe wedwa. Khumbula, ngolwazi olufanele, ukwesekwa, kanye nesimo sengqondo esihle, ungaphila kahle nalesi simo.

Isifo semithambo yenhliziyo, isifo senhliziyo, ukuhlaselwa yinhliziyo, i-angina, i-cholesterol, imithambo yenhliziyo evalekile, impilo yenhliziyo