Ingabe une-'bhuloho' elinjengaleli enhliziyweni yakho? (Ibhuloho le-Myocardial) Ake sifunde ngalo.

Ngezinye izikhathi ekuphileni kwethu, into engacabangeki iyenzeka, akunjalo? Ikakhulukazi uma kukhulunywa ngempilo yethu engokwenyama, kunezimo ezithile zezokwelapha okungenzeka ukuthi asikaze sizizwe. Kodwa kubaluleke kakhulu ukuziqaphela. Namuhla sizokhuluma ngesimo senhliziyo esingajwayelekile, kodwa esingathinta abanye abantu. Lokhu kubizwa ngokuthi (i-Myocardial Bridge). Kungenzeka ukuthi awukaze uzwe ngaleli gama, kodwa sizokhuluma ngalo kalula, ngendlela ongayiqonda.

Iyini le bhuloho le-myocardial?

Kalula nje, inhliziyo yakho inemithambo yegazi ehlinzeka ngegazi, esiyibiza ngokuthi imithambo yenhliziyo . Le mithambo ivame ukuba ngaphezu kwemisipha yenhliziyo. Okusho ukuthi, idlula phezu kobuso benhliziyo. Kodwa-ke, kulesi simo esibizwa ngokuthi (i-Myocardial Bridge), okwenzekayo ukuthi esikhundleni sokudlula phezu kwemisipha yenhliziyo, ingxenye yalo mthambo wenhliziyo enhliziyweni yakho iya ngaphansi kwemisipha. Kufana nomhubhe omncane, noma njengokuya ngaphansi kwebhuloho. Yilokho odokotela abakubiza ngokuthi ucezu lwemisipha yenhliziyo oluhlala ngaphezu kwalowo mthambo wegazi (i-Myocardial Bridge).

Manje cabanga, ngezinye izikhathi, lapho inhliziyo ishaya, okungukuthi, lapho imisipha yenhliziyo ifinyela, ibhuloho lemisipha elingenhla lingacindezela umthambo wegazi ongezansi. Kufana nalapho umuntu enyathela ipayipi lamanzi, ukugeleza kwamanzi kuyehla. Kwenzekani uma ulicindezela kanjalo? Lokho kucindezela kungavimba ukugeleza kwegazi. Khona-ke imisipha yenhliziyo ingase ingatholi igazi elicebile nge-oxygen eliyidingayo.

Uyazi, imithambo yenhliziyo iyiziteshi ezenza umsebenzi obaluleke kakhulu. Imisipha yenhliziyo yethu, njengazo zonke ezinye izingxenye zomzimba wethu, idinga umoya-mpilo. Lo moya-mpilo ulethwa kithi yileyo mithambo yenhliziyo. Ngakho-ke uma lokhu kugeleza kwegazi kuvimbekile, kungavela izinkinga.

Ngokuvamile, lesi simo (i-Myocardial Bridge) sibonakala ohlangothini lwesobunxele lwenhliziyo, umthambo oyinhloko owehlayo (i-Left Anterior Descending Artery) , noma njengoba odokotela besibiza kanjalo (i-LAD) . Lona umthambo omkhulu ohlinzeka ngegazi odongeni lwangaphambili lwenhliziyo nezinye izingxenye ezibalulekile. Kodwa-ke, lesi simo singavela kunoma yimuphi umthambo oletha igazi enhliziyweni, ngezinga elikhulu noma elincane.

Ingabe lesi simo esibizwa ngokuthi (i-Myocardial Bridge) siyingozi? Sivame kangakanani?

Ezimweni eziningi, ukuba ne-myocardial bridge akubangeli umonakalo omkhulu. Iningi labantu liphila impilo ejwayelekile ngaphandle kokwazi ukuthi banayo futhi bengenazo izimpawu. Yilokho iqiniso.

Kodwa-ke, ngezinye izikhathi, njengoba kushiwo ngaphambili, uma imisipha yenhliziyo ingenawo umoya-mpilo, ungase uzwe ubuhlungu besifuba obubizwa ngokuthi i-angina . Lokhu kuvame ukwenzeka lapho inhliziyo yakho iqala ukushaya ngokushesha, njengasesikhathini sokuzivocavoca.

Lapho bebuzwa ukuthi lesi simo sivame kangakanani, abacwaningi bathi i-myocardial bridge iyisimo esivame kakhulu kodwa esingahlolwanga kahle kunalokho ongase ukucabange. Lokhu kungenxa yokuthi iphesenti liyahlukahluka kuye ngendlela esetshenziswayo ukusithola. Ngokwezinye izifundo, phakathi kuka-16% no-30% wabantu abatholakala benalesi simo ngokuhlolwa okufana ne-angiograms, bathi lesi simo singase sibe khona kubantu abaningi. Lokhu kusho ukuthi inani elikhulu labantu lingase libe naso kunalokho ongase ukucabange.

Ziyini izimpawu zalokhu?

Abantu abaningi abane-myocardial bridge ababonisi zimpawu. Kodwa-ke, njengoba bekhula noma beba nezinye izimo zezokwelapha (njengomfutho wegazi ophakeme noma isifo sikashukela), abanye abantu bangase babe nezimpawu. Ngezinye izikhathi kungathatha iminyaka ukuthi izimpawu zivele.

Uphawu oluyinhloko ubuhlungu besifuba ((i-Angina)) . Lokhu kuvame ukuzwakala:

• Uma uzivocavoca, ugijima, noma ukhuphuka izitebhisi
• Uma uzizwa ucindezelekile kakhulu, ukhathazekile, noma udabukile
• Ngezinye izikhathi kungafika nangemva kokudla okukhulu.

Indlela lobu buhlungu obuchazwa ngayo iyahlukahluka kuye ngomuntu nomuntu. Abanye bangase bazizwe sengathi buyacindezelwa, bucindezelwa, noma buyasindwa.

Ezinye izimpawu ngezinye izikhathi zingafana nezokuhlaselwa yinhliziyo, ngakho-ke kufanele uqaphele nalezi:

• Ukuphelelwa umoya : Ukuzizwa sengathi unenkinga yokuphefumula ngisho noma uzikhandla kancane.
• Ukushaya kwenhliziyo : Isifuba singase sizwakale sengathi siyashaya noma siyashaya.
• Ukuzungeza : Ungase uzizwe uzungeza, mhlawumbe uze uphelelwe amandla.

Okubalulekile: Uma unezimpawu ezibonisa ukuthi unesifo senhliziyo (ubuhlungu obukhulu besifuba, ubuhlungu obuphuma engalweni yakho, ukujuluka, ukuhlanza), kufanele uye ekamelweni eliphuthumayo ngokushesha. Ungakuhlehlisi.

Kungani lokhu (i-Myocardial Bridge) kwenzeka?

Lona umbuzo onempendulo elula kakhulu. I-Myocardial Bridge yisimo sokuzalwa . Lokho kusho ukuthi yinto ozalwa nayo . Lapho inhliziyo ikhula embungwini, lowo mthambo wegazi wakhiwa ngendlela engena emisipheni. Akukho sizathu esiqondile salokho, kuyenzeka nje.

Yiziphi izinkinga ezingabangelwa yilokhu?

Eqinisweni, izinkinga ezinkulu ezivela e-myocardial bridge azivamile. Kodwa-ke, ngezinye izikhathi, ikakhulukazi uma zihlanganiswa nezinye izimo zezokwelapha, lezi zinto zingenzeka. Akufanele uzesabe lezi, kodwa ziqaphele:

• I-Myocardial Ischemia: Njengoba kushiwo ngaphambili, lapho umthambo wegazi uvalekile, imisipha yenhliziyo ingase ingatholi umoya-mpilo owanele. Yilapho kuvela khona izinto ezifana nobuhlungu besifuba.
• I-Coronary Vasospasm: Ngezinye izikhathi le mithambo ingancipha ngokuzumayo nangokubi kakhulu, okungaphazamisa nokugeleza kwegazi.
• Ukwakheka kwe-plaque ye-atherosclerosis eduze kwebhuloho le-myocardial: Kutholakale ukuthi i-plaque yakhela ezindongeni zomthambo wegazi eduze kwebhuloho, okwenza umthambo ube mncane kakhulu. Lokhu kungenzeka ngoba indlela igazi eligeleza ngayo ebhulohweni iyashintsha.
• I-Acute Coronary Syndrome: Lokhu kungaba ukuhlaselwa yinhliziyo noma i-angina engazinzile.
• Ukushaya kwenhliziyo okungajwayelekile: Ukushaya kwenhliziyo okungajwayelekile kungenzeka okuqala emakamelweni aphansi enhliziyo.
• I-Broken Heart Syndrome: Lokhu ubuthakathaka benhliziyo besikhashana obungenzeka ngemva kokucindezeleka okukhulu.
• Ukuhlaselwa Yinhliziyo: Nakuba kungavamile, ukuhlaselwa yinhliziyo kungenzeka uma ukugeleza kwegazi kuvinjiwe ngokuphelele.
• Ukufa Okungazelelwe Kwenhliziyo: Lokhu akuvamile kakhulu, kodwa kungenzeka.

Khumbula ukuthi lezi zinkinga azivamile .

Odokotela bakubona kanjani ukuba khona kwalokhu (i-Myocardial Bridge)?

Kungase kutholakale ngengozi uma ubona udokotela ngoba unezimpawu, noma ngesikhathi sokuhlolwa ngesinye isizathu. Uma udokotela esola ukuthi une-myocardial bridge, angenza lezi zivivinyo ezilandelayo:

• I-Coronary angiogram: Lesi isivivinyo esibaluleke kakhulu. Kulesi sivivinyo, kufakwa ithubhu elincane ngomthambo ongalweni noma emlenzeni bese liqondiswa emithanjeni yenhliziyo yakho. Bese kufakwa idayi ekhethekile kulo bese kuthathwa izithombe ze-X-ray. Lokhu kuvumela ukuncishiswa komthambo kubonakale kahle.
• I-Intravascular Ultrasound (IVUS): Kulokhu, ngesikhathi esifanayo ne-angiogram, kudluliselwa idivayisi encane ye-ultrasound emthanjeni ukuze kubonakale ukuthi izindonga zangaphakathi zomthambo kanye nebhuloho kucindezelwa kangakanani.
• I-Optical Coherence Tomography (OCT): Njenge-IVUS, lena enye indlela ethuthukisiwe esebenzisa ukukhanya ukubona ngaphakathi kwemithambo yegazi.
• I-Coronary Computed Tomography Angiogram (CT Angiogram): Lokhu kuyi-CT scan. Lokhu kusebenzisa nodayi ukudala izithombe zemithambo yegazi enhliziyweni ezinobukhulu obuthathu. Lokhu kungasiza ekunqumeni ukuthi kukhona yini ibhuloho le-myocardial nokuthi lide futhi lijule kangakanani.

Ngakho-ke ikhona yini indlela yokwelapha lokhu? Ukwenza kanjani?

Yebo, kunezindlela zokwelapha labo abanezimpawu. Akuwona wonke umuntu odinga ukuhlinzwa. Udokotela wakho uzonquma ukuthi yikuphi ukwelashwa okungcono kakhulu kuwe. Ake sibheke ukuthi yiziphi lezi zindlela zokwelapha:

• Imithi: Imithi ivame ukuba yimithi yokuqala. Lokhu kufaka phakathi (ama-Beta-blockers) kanye (ama-Calcium Channel Blockers).Basebenzisa imithi ebizwa ngokuthi "i-okari". Le mithi ilawula ukushaya kwenhliziyo kancane, yandisa isikhathi umthambo ophumula ngaso phakathi kokushaya kwenhliziyo, futhi yehlisa ingcindezi emithanjeni yegazi. Kwabanye abantu, umuthi obizwa ngokuthi (i-Ivabradine) nawo unikezwa njengendlela ehlukile.
• Ukuhlinzwa: Kulabo abanezimpawu ezinzima ezingenakulawuleka ngemithi, noma uma ibhuloho lijulile kakhulu futhi lide, ukuhlinzwa kunganconywa.
• Enye indlela ibizwa ngokuthi (i-Surgical Myotomy) . Okusho ukuthi, ukusika nokususa ibhuloho lemisipha phezu komthambo wegazi (ukuvula uphahla). Kodwa lokhu kwenziwa kuphela uma ibhuloho lifushane futhi lingajulile.
• Enye indlela ibizwa ngokuthi i-Coronary Artery Bypass Surgery (CABG) . Lokhu kuhilela ukudlula indawo evinjiwe bese usebenzisa ucezu lomthambo wegazi oluthathwe kwenye ingxenye yomzimba (ngokuvamile oluvela emlenzeni noma ngaphakathi kwesifuba) ukudala enye indlela yokugeleza kwegazi. Lokhu kuvame ukwenziwa uma ibhuloho lide futhi lijulile.
• Ukubekwa kwe-stent: Enye indlela ukufaka i-stent. I-stent iyipayipi elincane lensimbi elibukeka njenge-mesh. Lifakwa ngaphakathi komthambo wegazi ovinjiwe bese lifuthwa lisuka ngaphakathi. Khona-ke, noma ngabe umsipha uvinjiwe, i-stent igcina umthambo uvulekile, okuvumela igazi ukuthi ligeleze kalula. Kodwa-ke, kunemibono ehlukene mayelana nokubeka i-stent kulokhu. Ngezinye izikhathi, i-stent ingaphuka noma ivinjwe futhi, ngakho odokotela benza lezi zinqumo ngokucophelela okukhulu.

Yini okufanele ngiyilindele uma ngine-myocardial bridge?

Njengabantu abaningi, ungase ube ne-myocardial bridge kodwa ungabi nazimpawu. Abantu abanjalo abadingi ukwelashwa okukhethekile. Uma kunezimpawu, zivame ukulawulwa ngemithi.

Uma izimpawu zingathuthuki ngemithi, kufanele kucatshangelwe ukuhlinzwa (i-myotomy noma i-bypass) noma ukufakwa kwe-stent. Uma kususwa ibhuloho le-myocardial ngokuhlinzwa, kuwukuhlakanipha ukukhetha isibhedlela esinodokotela abangochwepheshe abavame ukwenza ukuhlinzwa okunjalo.

Lokhu (i-Myocardial Bridge) akuyona into ezophola ngokwayo ngaphandle kokususwa ngokuhlinzwa. Kodwa abantu abaningi abadingi ukuhlinzwa.

Abantu abaphila nalesi simo babhekana kanjani naso?

Abantu abaningi abane-Myocardial Bridge baphila isikhathi eside futhi banempilo engcono yesikhathi eside.

Amazinga okusinda ancike ekutheni unezinye izimo zezokwelapha yini. Kokunye ukuhlola, cishe abantu abangu-90% abane-myocardial infarction babesaphila eminyakeni eyi-10 ngemuva kokuxilongwa. Kodwa-ke, uma babenezinye izimo zenhliziyo, njengesifo semithambo yenhliziyo (CAD), amazinga okusinda ayephansi kancane.

Kufanele ngiyinakekele kanjani impilo yami?

Ngenxa yokuthi ukuba ne-myocardial bridge kuye kwatholakala ukuthi kwandisa kancane ingozi yokugcwala kwamafutha emithanjeni (i-atherosclerosis), udokotela wakho cishe uzokweluleka ukuthi ulawule ezinye izici eziyingozi ezingaba nomthelela kukho. Lokhu kubalulekile kungakhathaliseki ukuthi unezimpawu noma cha.

• Gwema Ukubhema: Into ebaluleke kakhulu yokuvimbela i-atherosclerosis ukuyeka ngokuphelele imikhiqizo kagwayi. Uma ubhema, cela udokotela wakho akusize ekuyekeni.
• Lawula ezinye izinto eziyingozi: Uma une-high blood pressure, isifo sikashukela, noma amazinga aphezulu e-cholesterol, zilawule kahle.
• Ukudla okunempilo: Yidla ukudla okunamafutha amancane, ushukela, nosawoti, kanye nezithelo nemifino eminingi.
• Ukuzivocavoca njalo: Khuluma nodokotela wakho ukuze uthole ukuthi yikuphi ukuzivocavoca okufanele, futhi ukwenze njalo.
• Thatha imithi yakho oyinikezwe udokotela ngendlela efanele: Uma usuvele unesifo semithambo yegazi yenhliziyo (CAD), kubalulekile ukuthatha imithi yakho yokulwa nama-platelet (imithi yokunciphisa igazi) kanye nemithi yokwehlisa i-cholesterol (imithi yokwehlisa i-cholesterol) ngesikhathi esifanele njengoba udokotela wakho ekuyalele.

Kufanele ngimbone nini udokotela?

Kubaluleke kakhulu ukugcina ama-aphoyintimenti akho okulandelela nodokotela wakho. Udokotela wakho kuzodingeka akubone njalo ukuqinisekisa ukuthi uthatha inani elifanele lemithi nokuthi izimpawu zakho zinjani. Kubalulekile futhi ukuya kuma-aphoyintimenti okulandelela ngemva kokuhlinzwa noma ukufakwa kwe-stent.

Njengoba kushiwo ngaphambili, uma unezimpawu zokuhlaselwa yinhliziyo (njengobuhlungu obukhulu besifuba, ubunzima bokuphefumula, ukujuluka), shayela u-911 ngokushesha noma uye egumbini lezimo eziphuthumayo eliseduze.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma uthola ukuthi une-myocardial bridge, kuvamile ukuba nemibuzo eminingi engqondweni yakho. Ungabuza udokotela wakho imibuzo efana nale:

• Kukangaki ngidinga ukuza ukuzolandelelwa?
• Ingabe ngidinga imithi noma ngidinga ukuhlinzwa?
• Kungani ungincoma lolu khetho lokwelashwa? Yiziphi izinzuzo kimi? Ingabe kukhona okungalungile?
• Yini okudingeka ngiyishintshe ekudleni kwami ​​​​nasendleleni yami yokuphila?
• Ngingakwazi yini ukuzivocavoca? Hlobo luni lokuzivocavoca oluhle?

Kuvamile ukuzizwa wesaba futhi ukhathazekile kancane uma uzwa ukuthi kukhona okungahambi kahle enhliziyweni yakho. Kodwa khumbula, kubantu abaningi, i-myocardial bridge akuyona into okufanele ukhathazeke ngayo. Uma unezimpawu, khuluma nodokotela wakho ukuze anqume ukuthi iyiphi indlela engcono kakhulu yokwelapha.

Okokugcina, okufanele ukukhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, manje usunokuqonda okungcono ngalokho esikhulume ngakho (i-Myocardial Bridge). Ngamafuphi:

• Ibhuloho le-myocardial yisimo sokuzalwa lapho umthambo wenhliziyo enhliziyweni udlula khona emisipheni.
• Kwabaningi, lokhu akubangeli zimpawu futhi akubangeli monakalo.
• Abanye abantu bangase babe nezimpawu ezifana nobuhlungu besifuba (i-angina), ikakhulukazi uma bekhathele.
• Izimpawu zivame ukulawulwa ngemithi. Akuvamile ukuthi kudingeke ukuhlinzwa noma ukufuthwa nge-stenting.
• Izinguquko zendlela yokuphila (ukuyeka ukubhema, ukudla okunempilo, ukuvivinya umzimba) zibalulekile ekunciphiseni ingozi ye-atherosclerosis.
• Uma uzwa ubuhlungu obukhulu esifubeni noma izimpawu zokuhlaselwa yinhliziyo, funa iseluleko sezokwelapha ngokushesha.

Kubalulekile ukunakekela inhliziyo yakho. Ukuqaphela lezi zimo kuzokusiza ukuthi ufune ukwelashwa kusenesikhathi uma kudingeka futhi kukusize uphile impilo enempilo.

Ibhuloho le - myocardial, isifo senhliziyo, i-angina, umthambo wenhliziyo, ukuhlinzwa kwenhliziyo, i-stent, impilo yenhliziyo