Ingabe imisipha yenhliziyo yakho "ilele" noma "ibambekile"? (I-Myocardium Ehlala Isikhathi Eside kanye ne-Stunned Myocardium) Ake sifunde ngakho!

Wake wezwa ngezingxenye zenhliziyo "ezilala"? Noma "ezibhajwe" ngokuzumayo? Nakuba lezi zingase zizwakale njengamagama angajwayelekile, empeleni lezi yizimo ezimbili zezokwelapha ezithinta izinhliziyo zethu. Ungakhathazeki, sizokhuluma ngazo ngendlela elula neqondakala kalula. Sizobheka ukuthi ziyini, ukuthi kungani zenzeka, ukuthi zingabonwa kanjani , nokuthi zingelapheka yini.

Iyini imisipha yenhliziyo "efihla ubusika"? (I-Myocardium Efihla ubusika)

Kalula nje, lapho ingxenye yemisipha yenhliziyo yakho (esiyibiza ngokuthi `(i-Myocardium)`) incishiswa ukugeleza kwegazi, kancane kancane inciphisa ukusebenza kwayo futhi ekugcineni iyeke. Kufana nokulala ngoba ikhathele. Lokhu yilokho esikubiza ngokuthi `(i-Hibernating Myocardium)` noma "imisipha yenhliziyo elele." Lokhu kungenzeka izinyanga, mhlawumbe ngisho neminyaka.

Cabanga nje, lapho ezinye izitshalo engadini yakho ziphelelwa amanzi, ziyagoba bese zibukeka sengathi ziyabuna, akunjalo? Kunjalo nangalesi. Imisipha yenhliziyo idinga kakhulu ama-fatty acid ukuze isebenze (okungukuthi, ifinyele). Kodwa uma kungekho igazi elanele, le misipha iqala ukusebenzisa i-glucose (okungukuthi uhlobo lukashukela) ukugcina amangqamuzana ayo ephila. Kodwa-ke, ayinawo amandla anele okupompa igazi liye enhliziyweni ngalesi sikhathi. Ngakho-ke, le misipha "elele" ayisizi inqubo yokupompa kwenhliziyo.

Kusho ukuthini uma imisipha yenhliziyo "ikhubeka" noma "iba kwi-coma"? (I-Stunned Myocardium)

Lesi simo sihluke kancane esimweni sokulala okukhulunywe ngaso ngaphambili. Singenzeka ngokushesha kakhulu, ngemizuzu embalwa noma amahora ambalwa. Uma ukugeleza kwegazi kuya emisipheni yenhliziyo kuncipha noma kuyeka ngokuzumayo, imisipha iyayeka ukusebenza, njengokungathi "ibambekile" noma "ikhubazekile." Lokhu kubizwa ngokuthi `(Stunned Myocardium)`.

Into exakile ukuthi, ngezinye izikhathi ngisho nalapho odokotela belapha ukuvaleka (isibonelo, ngokufaka i-stent, ukwandisa umthambo ovalekile ngebhaluni, noma ukuncibilikisa ihlule legazi) ukuze igazi liphinde ligeleze, lezi zingxenye zemisipha "ezinamathele" azibuyeli ngokushesha esimweni esijwayelekile. Kungathatha izinsuku, noma ngisho namasonto, ukuthi leyo misipha iqale ukuvaleka kahle futhi.

Lezi zimo zihluke kanjani ekuhlaselweni yinhliziyo?

Lona umbuzo obaluleke kakhulu. Ukuhlaselwa yinhliziyo uhlobo olubi kakhulu lwesifo semithambo yenhliziyo. Lokhu kwenzeka lapho imithambo eyodwa noma ngaphezulu ehlinzeka ngegazi enhliziyweni ivinjelwa ngokuphelele yinto enamafutha ebizwa ngokuthi i-plaque, okubangela ukuba amangqamuzana emisipha yenhliziyo afe. ​​Amangqamuzana emisipha yenhliziyo afile athathelwa indawo yizicubu zesibazi. Lezi zicubu zesibazi azikwazi ukusiza inhliziyo ukuthi ipompe kahle. Lokhu kungaholela ekuhlulekeni kwenhliziyo.

Kodwa-ke, zombili izimo ``I-Hibernating Myocardium'' kanye ``I-Stunned Myocardium'' zingezesikhashana. Okwenzekayo lapha ukuthi imisipha yenhliziyo ayisebenzi kahle, kodwa amangqamuzana ayo asaphila.Uma igazi nomoya-mpilo kubuyiselwa, lezi zingxenye zemisipha "ezilele" noma "ezinamathele" zingaqala ukusebenza futhi. Yilokho okubaluleke kakhulu!

Yiziphi izimbangela ze-'Hibernating Myocardium'?

Lesi simo sibonakala kakhulu kubantu abanesifo esibi semithambo yegazi yenhliziyo. Kulesi sifo, ama-fatty deposits (esiwabiza ngokuthi "i-plaque") aqoqana ngaphakathi kwemithambo yegazi ethwala igazi eya enhliziyweni, okubangela ukuba ivaleke. Lapho umthambo uba mncane kakhulu, imisipha yenhliziyo ayitholi umoya-mpilo owanele kanye nezakhamzimba ukuze ihlale iphila futhi isize inhliziyo ukuthi ipompe igazi. Ngakho-ke, imisipha "iyalala" ukuze yonge amandla ukuze igcine imisebenzi yayo eyisisekelo yamaseli.

Yiziphi izimbangela ze-'Stunned Myocardium'?

Ukushaqeka kwemisipha yenhliziyo, okwaziwa nangokuthi "kunamathele" kwemisipha yenhliziyo, kungenzeka futhi ngesikhathi sokwelashwa kwesifo semithambo yenhliziyo. Ngisho noma ukwelashwa kubuyisela ukugeleza kwegazi, ezinye izingxenye zemisipha yenhliziyo azilulami ngokushesha. Ngaphezu kwalokho, lesi simo singavela ngenxa yezizathu eziningana:

• Ukuquleka (umsebenzi kagesi ongajwayelekile ebuchosheni).
• Ukucindezeleka I-Cardiomyopathy yisimo esithinta inhliziyo ngenxa yokucindezeleka.
• Isimo esifana nesohlangothi.
• Ukopha okuya ebuchosheni (i-Subarachnoid Hemorrhage).

Ziyini izimpawu zalezi zimo zombili?

Ngenxa yokuthi kuzo zombili izimo, ingxenye noma ingxenye enkulu yemisipha yenhliziyo kuphela ethintekayo, izimpawu zivame ukufana nalezo ezibonakala ekuhlulekeni kwenhliziyo. Zihlanganisa:

• Ubunzima bokuphefumula
• Ubuhlungu besifuba
• Ukuvuvukala kwemilenze

Uma unalezi zimpawu, kungcono ukubona udokotela bese uyahlolwa.

Indlela yokuxilonga 'i-Hibernating Myocardium'?

Ukuze kutholakale lesi simo ngokunembile, kudingeka izivivinyo eziningana eziyinkimbinkimbi. Lezi zivivinyo zingasiza ekuhlukaniseni phakathi kwezingxenye zemisipha yenhliziyo "ezilele" noma "ezinamathele" kodwa ezingavuselelwa , kanye nezingxenye ezifile nezinamanxeba futhi ezingenakuvuselelwa .

Ezinye zezivivinyo eziyinhloko odokotela abazisebenzisayo ngale njongo yilezi:

• `I-Dobutamine Stress Echocardiogram`: Lokhu kuhilela ukukunikeza umuthi (obizwa ngokuthi `(Dobutamine)`) ukuze uvuselele inhliziyo yakho njengokungathi uyazivocavoca. Udokotela wenhliziyo uzobe esebheka ukuthi inhliziyo yakho isebenza kanjani uma iphumule nokuthi isebenza kanjani uma umthamo womuthi ukhushuliwe. Uma ikhono lomsipha wenhliziyo lokusebenza likhula lapho umuthi unikezwa, kusho ukuthi unesifo esibizwa ngokuthi `(Stunned Myocardium)` noma `(Hibernating Myocardium)`. Uma umsipha unganciphi ngisho nangemva kokuba umthamo womuthi ukhushuliwe, kusho ukuthi umsipha usufile futhi unesibazi.
• I-MRI yenhliziyo:Lokhu kusebenzisa amagagasi anamandla kamagnethi kanye nomsakazo ukwenza izithombe ezicacile nezinemininingwane zemisipha yenhliziyo yakho. Ngokubheka ukubukeka nobukhulu bemisipha yenhliziyo kulezi zithombe, odokotela bangasho ngqo ukuthi yiziphi izicubu ezinezibazi (ezifile), ukuthi yini evamile, nokuthi yini "engalali" noma "ebhajwe."
• I-Cardiac Positron Emission Tomography (PET) scan: Lokhu kusebenzisa izinga eliphephile lezinto ezikhipha imisebe kanye nekhamera ekhethekile. Kubonisa ukuthi yiziphi izingxenye zemisipha yenhliziyo yakho ezisebenza kahle nokuthi yiziphi izingxenye ezinezicubu ezifile noma ezifile.

Nakuba lezi zivivinyo zingase zibonakale ziyinkimbinkimbi kancane, zibaluleke kakhulu ukuqonda isimo sakho esiqondile nokukhetha ukwelashwa okukulungele.

Ingabe i-'Hibernating Myocardium' (imisipha yenhliziyo elele) ingelapheka? Yiziphi izindlela zokwelapha?

Yebo, lezi yizindaba ezinhle kakhulu! Lesi simo singelapheka ngokwelashwa. Into eyinhloko okufanele uyenze ukubuyisela ukugeleza kwegazi okuhle engxenyeni yemisipha yenhliziyo eyehlise ukugeleza kwegazi. Kunezindlela ezimbili zokwelapha eziyinhloko zalokhu:

• I-Angioplasty: Lokhu kuhilela ukusebenzisa ipayipi elide nelincane (i-catheter) ukuze lingene emthanjeni wegazi ovinjiwe bese lifutha ibhaluni elincane ekugcineni kwepayipi ukuze kususwe i-plaque futhi kwandiswe umthambo. Ngezinye izikhathi, idivayisi efana ne-mesh (i-stent) ingafakwa ngaphakathi komthambo ukuze ingavaleki futhi.
• Ukuhlinzwa Kwemithambo Yenhliziyo (i-CABG): Lena inqubo yokuhlinzwa ehilela ukuthatha umthambo wegazi ophilile kwenye ingxenye yomzimba wakho (njengomlenze noma isifuba sakho) bese udala indlela entsha yokuthi igazi ligeleze ngayo, udlule umthambo ovalekile enhliziyweni yakho. Kufana nokwakha indawo yokudlula lapho umgwaqo uvalekile.

Ngemva kwalokhu kwelashwa, ungathunyelwa ohlelweni "lokuvuselelwa kwenhliziyo" ukuze lukusize ngokululama. Lolu uhlelo lokuzivocavoca oluqondiswa ngokwezokwelapha olukusiza ukwandisa amandla akho nokuqina komzimba, futhi uthuthukise imikhuba enempilo yenhliziyo.

Yiziphi izindlela zokwelapha i-'Stunned Myocardium'?

Ukwelashwa kwemisipha yenhliziyo evalekile kufana kakhulu nokwelashwa okujwayelekile kwesifo senhliziyo kanye nokwehluleka kwenhliziyo. Eminye yemithi esetshenziswa kakhulu ihlanganisa:

• I-aspirini
• Ama-Beta-blocker
• Ama-statin (imithi yokwehlisa i-cholesterol)
• Ama-ACE inhibitors noma ama-Angiotensin II receptor blockers (imithi elawula umfutho wegazi futhi ivikele inhliziyo)

Udokotela uzohlola isimo sakho bese ekubhalela imithi efanele kakhulu.

Ungazivikela kanjani kulezi zimo?

Indlela engcono kakhulu yokunciphisa ingozi yalezi zimo ukunakekela inhliziyo yakho kahle. Lokho kusho ukuthi:

• Ukulandela ukudla okunempilo:Ukudla okunamafutha amancane, ushukela, nosawoti, kanye nemifino nezithelo eziningi.
• Ukuvivinya umzimba njalo: Ngisho nento elula njengokuhamba imizuzu engama-30 ngosuku ilungile.
• Gwema ukubhema: Ukubhema kubi kakhulu enhliziyweni.
• Ukunciphisa ukusetshenziswa kotshwala.
• Ukugcina isisindo esinempilo.
• Ukulawula ukucindezeleka.
• Uma unezifo ezifana nesifo sikashukela, umfutho wegazi ophakeme, noma i-cholesterol ephezulu, zilawule kahle.
• Uma udokotela wakho ekunikezile, thatha imithi efana nama-statin ukuze wehlise i-cholesterol noma i-aspirin ukuze uvimbele ukuqhekeka kwegazi nsuku zonke.

Ungasebenzisa futhi ama-racks calculator avela ezinhlanganweni ezifana ne-American College of Cardiology noma i-European Society of Cardiology ukuze unqume ukuthi udinga usizo olungakanani ngengozi yakho kanye nokwelashwa. Kodwa-ke, uma usuvele unesifo senhliziyo, kungcono ukukhuluma nodokotela wakho ngengozi yakho. Kulezi zimo , ukwelashwa kwezokwelapha okuqondiswa yisiqondiso kuye kwabonakala kunciphisa kakhulu ingozi yokuhlaselwa yinhliziyo, ukwehluleka kwenhliziyo, ngisho nokufa.

Iyini iphrojekthi?

Impilo yesikhathi esizayo yomuntu onalesi simo (esikubiza ngokuthi "isibikezelo") incike ezintweni eziningana. Isibonelo:

• Ukuthi ikhono lokushaya kwenhliziyo lehle kangakanani.
• Kungakhathaliseki ukuthi usebenzisa umuthi oqondile ochazwe udokotela.
• Kungakhathaliseki ukuthi uyakufanelekela yini ukuhlinzwa kwe-`(Angioplasty)`/`(Stent)` noma `(CABG)`.

Abantu abanesifo semithambo yenhliziyo basengozini yokuphila konke yokuba nezinkinga zenhliziyo esikhathini esizayo. Uma imithambo yakho yenhliziyo ivinjelwa futhi, imisipha yenhliziyo yakho ingaphinde "ilale" futhi.

Okubalulekile: I-Myocardium ehlala isikhathi eside iyenzeka lapho ukugeleza kwegazi kuya ezicutshini zemisipha yenhliziyo kunqunyelwe isikhathi eside ngenxa yokuvaleka okukhulu kwemithambo yenhliziyo kubantu abanesifo semithambo yenhliziyo. I-Myocardium exakile iyenzeka lapho ukugeleza kwegazi kwehla ngokuzumayo. Uma ukugeleza kwegazi kubuyiselwa, imisipha yenhliziyo yakho kufanele ikwazi ukufinyela futhi esikhathini esifushane. Zombili lezi zimo zingelapheka. Kubalulekile ukunakekela inhliziyo yakho kahle ukuze uvimbele lezi zimo ukuthi zingaphinde zibuye.

Izinto ezibalulekile okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ake sifingqe izinto okudingeka uzikhumbule kulokho esikhulume ngakho:

• I-Myocardium ehlala isikhathi eside kanye ne-Stunned Myocardium yizimo ezimbili ezenzeka ngenxa yokuncipha kokugeleza kwegazi emisipheni yenhliziyo.
• Kuzo zombili lezi zimo, imisipha yenhliziyo ayifi, kodwa ayisebenzi kahle. Lokhu kuhlukile ekuhlaselweni yinhliziyo.
• Zombili lezi zimo zingalapheka kaningi! Kubalulekile ukubuyisela ukujikeleza kwegazi futhi, uma kudingeka, funa ukwelashwa.
• Uma unezimpawu ezifana nobunzima bokuphefumula, ubuhlungu besifuba, noma ukuvuvukala emilenzeni yakho, funa iseluleko sezokwelapha ngaphandle kokuchitha isikhathi.
• Ingozi yalezi zimo ingancishiswa ngokulandela indlela yokuphila enempilo nokuphatha izimo zezokwelapha ezikhona (njengesifo sikashukela kanye nomfutho wegazi ophakeme).
• Uma unesifo senhliziyo, kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo futhi uthole ukuhlolwa njalo.

Inhliziyo yakho iyimpahla yakho eyigugu kakhulu. Ngakho-ke yinakekele. Ngiyethemba ukuthi lolu lwazi luwusizo kuwe!

Isifo senhliziyo, i-myocardium ehlala isikhathi eside, i-stun myocardium, ukuhlaselwa yinhliziyo, isifo semithambo yenhliziyo, i-angioplasty, ukuhlinzwa kwe-bypass