Ingabe umthambo osenhliziyweni yakho ungaqhuma ngokuzumayo? Ake sifunde konke mayelana ne-SCAD (Spontaneous Coronary Artery Dissection)!

Wake wazibuza ukuthi umuntu ophilile nozivocavoca kahle angathola kanjani isifo senhliziyo ngokuzumayo? Noma ukuthi owesifazane osemusha ophilile osanda kuba ngumama angazizwa kanjani ubuhlungu besifuba ngokuzumayo? Namuhla sizokhuluma ngesimo senhliziyo esingajwayelekile, kodwa esibaluleke kakhulu. Lokhu yilokho esikubiza ngokuthi i-SCAD, noma i-Spontaneous Coronary Artery Dissection .

Kuyini i-SCAD (Spontaneous Coronary Artery Dissection)? Masiyiqonde kalula.

Kalula nje, i-SCAD ukudabuka noma ukuhlukana okungazelelwe phakathi kwezingqimba ezimbili odongeni lwemithambo yenhliziyo ethwala igazi liye enhliziyweni yethu. Cabanga ngale ndlela: umthambo wegazi ufana nepayipi elincane. Udonga lwale payipi lwakhiwe izingqimba eziningana. Ku-SCAD, enye yalezi zingqimba iyadabuka bese igazi livuza phakathi kwazo. Kwenzekani-ke? Lelo gazi liyaqoqana bese livuza emthanjeni. Liyakhukhumala njengebhaluni. Ngenxa yalokho, ukugeleza kwegazi enhliziyweni kuyavinjelwa, noma kuqala ukuhamba kancane kakhulu.

Lokhu kufana nesimila esincane esikhula ngaphakathi kwepayipi lamanzi bese silivimba. Bese inhliziyo ingatholi umoya-mpilo nezakhamzimba ezidingayo.

I-SCAD yandisa ingozi yakho yesimo esibizwa ngokuthi i-Acute Coronary Syndrome (ACS) . Lolu futhi uhlobo lwesifo semithambo yenhliziyo. Lokhu kungabangela ubuhlungu besifuba, noma i-angina . Kungaholela nasekuhlaselweni yinhliziyo, okungaba yingozi empilweni.

Asho ukuthini la magama?

Uma sibheka incazelo yala magama amathathu athi SCAD ngokwehlukana, uzosiqonda kangcono lesi sifo.

• Okuzenzekelayo: Lokhu kusho ukuthi kwenzeka ngokuzumayo, ngaphandle kwesixwayiso .
• Imithambo Yenhliziyo: Lena yimithambo yegazi eyinhloko enikeza inhliziyo yethu igazi elihlanzekile neligcwele umoya-mpilo. Sinemithambo emibili eyinhloko yenhliziyo, eyesobunxele neyokudla. Ihlukana ibe amagatsha amancane.
• Ukuhlukaniswa: Kwezokwelapha, leli gama libhekisela ekuhlukanisweni kwezicubu zibe yizingqimba, njengokudabuka.

Uyaqonda? Lokho kusho ukuthi, lokhu sikubiza ngokuthi i-SCAD lapho umthambo wegazi enhliziyweni uqhuma ngokuzumayo ngaphakathi ngaphandle kwesizathu esibonakalayo.

Iyini i-Acute Coronary Syndrome?

Lesi akusona isifo esisodwa. Yigama elijwayelekile lezimo eziningana ezahlukene lapho ukugeleza kwegazi enhliziyweni kuncipha khona ngokuzumayo. Lokhu kuvame ukwenzeka lapho i-plaque, okuyiqoqo lamafutha ngaphakathi kwemithambo yegazi (eyaziwa nangokuthi i-atherosclerosis noma "ukuqina kwemithambo yegazi") iqhuma ngokuzumayo. Lokhu kungaholela ezimweni ezisongela ukuphila njengokwehluleka kwenhliziyo , ukuhlaselwa yinhliziyo, noma isifo sohlangothi .

Sivame kangakanani lesi simo esibizwa ngokuthi i-SCAD?

Ochwepheshe bezokwelapha bathi i-SCAD yisimo esingahlolwanga kahle. Kulinganiselwa ukuthi cishe abantu abane kwabayikhulu abathola i-acute coronary syndrome (ACS) (4%) bane-SCAD. Ngaphezu kwalokho, i-SCAD iyimbangela yecala elilodwa kwabane (25%) le-ACS kwabesifazane abangaphansi kweminyaka engu-50! Lokhu kusho ukuthi kungase kuvame kakhulu kwabesifazane abasebasha kunokuba ucabanga.

Kungani i-SCAD yenzeka? Ziyini izimbangela?

Ochwepheshe abakakazi kahle ukuthi yini ebangela i-SCAD. Okumangazayo ukuthi abantu abaningi abathola lesi simo basebasha, baphilile futhi banempilo. Futhi abanaso isifo senhliziyo ngaphambili.

Abanye abaguli be-SCAD basanda kubeletha . Kutholakale nokuthi i-SCAD ivame ukwenzeka ngesikhathi sokuya esikhathini noma ngemva kokuya esikhathini . Ngakho-ke, kukhona ukusola ukuthi izinguquko kuma-hormone abesifazane zingadlala indima kulokhu.

I-SCAD ayivamile kakhulu kwabesilisa, iyenzeka ngaphansi kwamaphesenti ayishumi (10%). Kwabesilisa, lokhu kudabuka kuvame ukwenzeka ngemva kokuzivocavoca okunamandla (ukuqeqeshwa kwamandla) noma ukuphakamisa into esindayo . Lokhu kuzikhandla ngokomzimba kungadabula udonga lomthambo.

Akuvamile kakhulu ukuthi lolu donga lwemithambo yegazi lungaqhekeka ngenxa yokuhlanza okukhulu noma amandla okukhwehlela. Ngezinye izikhathi, imithambo yegazi yenhliziyo ingaqhekeka ngenxa yengozi ebuhlungu noma ngesikhathi senqubo yezokwelapha efana nokufakwa kwe-catheter yenhliziyo . Kodwa-ke, kunesizathu salokhu.

Ubani osengozini enkulu yokuthola i-SCAD?

Abantu abanezimo ezithile zezokwelapha basengozini enkulu yokuqhuma kwemithambo yenhliziyo. Ake sibheke ukuthi bayini:

• Izifo zezicubu ezixhumeneyo - isibonelo , i-Marfan syndrome .
• Umfutho wegazi ophezulu (Umfutho wegazi ophezulu kakhulu).
• I-Fibromuscular Dysplasia (FMD) - Lesi yisifo esithinta imithambo yegazi.
• Ukwehla kokusebenza kwe-thyroid ( i-Hypothyroidism ).
• Izifo zokuvuvukala - izibonelo zifaka phakathi i-lupus , i-multiple sclerosis (MS) , kanye ne-sarcoidosis .
• Izinkinga zokusebenzisa izidakamizwa .

Ziyini izimpawu ze-SCAD? Zitholakala kanjani?

Uma ukugeleza kwegazi enhliziyweni kwehla ngenxa ye-SCAD, kungaholela ekuhlaselweni yinhliziyo noma uhlobo lobuhlungu besifuba olubizwa ngokuthi i-angina engazinzile . Lolu hlobo lwe-angina luyingozi kakhulu ngoba lwandisa ingozi yokuhlaselwa yinhliziyo.

I-SCAD iyisimo esiphuthumayo sezokwelapha esidinga ukwelashwa okusheshayo. Uma unezinye zezimpawu ezilandelayo zokuhlaselwa yinhliziyo, shayela u-911 ngokushesha (eSri Lanka, shayela i-1990 Suwaseriya Ambulance Service):

• Ukuzizwa unesizungu noma ukuphelelwa amandla ( syncope ).
• Ukujuluka ngokweqile ( i-Hyperhidrosis ) noma ukuzizwa ubanda.
• Ukushaya kwenhliziyo noma i-arrhythmia .
• Ubuhlungu bemisipha engalweni, ehlombe, noma endaweni yomhlathi.
• Ukucanuzela nokuhlanza, noma umuzwa wokuphazamiseka kwesisu ( ukungagayeki kahle kokudla ).
• Ukuphelelwa umoya.
• Ukuqina kwesifuba, ingcindezi, noma ubuhlungu.

Lezi zimpawu zifana ncamashi nezokuhlaselwa yinhliziyo. Ngakho-ke, uma uhlangabezana nento efana nale , ungalibali.

I-SCAD ihlolwa kanjani? (Ukuxilongwa)

Ukuxilonga i-SCAD kungaba yinselele. Uma unesifo esifubeni noma ezinye izimpawu zesifo senhliziyo, udokotela wakho angase acele ukuhlolwa okufana nalokhu ukuze ahlole i-SCAD:

• Ukuhlolwa kwezimpawu ze-enzyme: Kuhlola amazinga aphezulu ama-enzyme athile enhliziyo aqongelela egazini ngesikhathi sokuhlaselwa yinhliziyo.
• I-Angiogram: Lokhu kukuvumela ukuthi ubone ukugeleza kwegazi enhliziyweni yakho ngezithombe ezihambayo ezinezinhlangothi ezintathu (3D). Lokhu kungafaka i-Coronary Computed Tomography Angiogram (CCTA) noma i-Magnetic Resonance Angiogram (MRA) .
• I-Intravascular Optical Coherence Tomography (IVOCT): Lokhu kuvumela ukuthi umthambo uhlolwe kusukela ngaphakathi kuya ngaphandle.
• I-Intravascular Ultrasound (IVUS): Lokhu kungaveza izithombe ezicacile nezinemininingwane ngaphakathi kwemithambo yegazi.

Lezi zivivinyo yizo ezivumela odokotela ukuthi banqume ukuthi une-coronary artery edabukile noma esinye isifo senhliziyo.

Iphathwa kanjani i-SCAD?

Iningi labantu abane-SCAD, cishe izingxenye ezintathu kwezine (75%), bayalulama ngemithi. Lezi yizinhlobo zemithi ezinikeziwe:

• Imithi yokucindezela kwegazi (isib., ama-beta blockers ).
• Imithi elawula amazinga aphezulu e-cholesterol.
• Imithi evimbela ukujiya kwegazi ( imithi yokulwa nama-platelet ).

Kodwa-ke, cishe abantu abayi-14% abane-SCAD bangaba nesimo esibucayi. Abantu abanjalo kungadingeka bangeniswe esibhedlela futhi bathole ukwelashwa okuphuthumayo. Ukwelashwa okunjalo kuhlanganisa:

• Ukufakwa kwe-catheter kwenhliziyo , i-coronary angioplasty kanye nokufakwa kwe-stentLokhu kuhilela ukufutha umthambo wegazi ovinjiwe ngento efana nebhaluni nokubeka i-mesh encane (i-stent) ukuze ivinjwe futhi.
• I-Coronary Artery Bypass Grafting (CABG): Lokhu kuhilela ukudala indlela entsha yomthambo wegazi ovalekile.
• Ukufaka idivayisi yokusekela ukujikeleza kwegazi ngomshini, njenge-Left Ventricular Assist Device (LVAD) , noma i-Implantable Cardioverter Defibrillator (ICD) .
• Ukufakelwa inhliziyo - Lokhu akuvamile kakhulu.

Esikhathini esiningi, odokotela bazama ukuphatha lesi simo ngemithi, bevumela umthambo odabukile ukuthi ululame wodwa. Ukuhlinzwa kubhekwa njengokudingekile kuphela uma kudingeka ngempela.

Ingabe i-SCAD ingavinjelwa?

Uma wake waba nomthambo odabukile, kungadingeka unciphise imisebenzi ethile yomzimba enzima kanye nokuqeqeshwa kwamandla ukuze uvimbele ukuthi kungenzeki futhi. Udokotela wakho angakudlulisela ohlelweni lokuvuselela inhliziyo . Lokhu kungasiza ekuthuthukiseni impilo yenhliziyo yakho futhi kukufundise ukuthi ungazivocavoca kanjani ngokuphephile.

Nakuba kungekho ukuxhumana okuqondile okutholiwe phakathi kwe-SCAD nokulawula ukubeletha ngamahomoni, odokotela abaningi batusa ukuthi bacabangele izinketho zokulawula ukubeletha ezingezona ezehomoni kuqala. Isibonelo, i-vasectomy yamadoda noma i-tubal ligation yabesifazane. Buza udokotela wakho ukuthi iyiphi indlela engcono kakhulu kuwe.

Ungenza futhi lezi zinto ukunciphisa ingozi yakho yesifo senhliziyo:

• Yidla ukudla okunempilo kwenhliziyo ukuze wehlise amazinga e-cholesterol.
• Nciphisa ukudla usawoti futhi ulawule umfutho wegazi ophakeme.
• Nciphisa ukuphuza kwakho utshwala. Uma unenkinga yokusebenzisa utshwala, thola usizo.
• Qaphela izinhlobo zamafutha owadlayo futhi wehlise ukudla kwakho amafutha angenampilo.
• Uma unesifo sikashukela , silawule kahle.
• Uma ubhema, thola usizo lokuyeka.
• Hlala umatasa ngokomzimba futhi ugcine isisindo sakho siphilile.

Uyini umbono womuntu one-SCAD?

I-SCAD iyisifo esisongela ukuphila. Cishe abantu abangu-5% abasitholayo bayafa. Ukudabuka komthambo kungaholela ezingozini ezilandelayo:

• I-angina engapheli: Inani elincane labantu lingase libe nobuhlungu besifuba obuqhubekayo noma ingcindezi. Lokhu kungase kungasabeli kahle emithini yendabuko efana ne -nitroglycerin .
• Ukuphinda kwesifo:Cishe umuntu oyedwa kwabayishumi (10%) uzophinde abe ne-SCAD zingakapheli iminyaka emithathu yokwelashwa kokuqala. Udokotela wakho uzokwenza izivivinyo ezivamile ukuze azame ukuthola lezi zinkinga kusenesikhathi.
• Ukuvuvukala kwenhliziyo: I-SCAD ingabangela ukuvuvukala kwesikhwama esizungeze inhliziyo, okubizwa ngokuthi i-pericarditis . Udokotela wakho angase acele ukuhlolwa okufana ne -cardiac MRIs noma i-angiograms ukuze kuhlolwe le nkinga.

Ngakho-ke, kubaluleke kakhulu ukulandela imiyalelo yezokwelapha ngqo futhi uhlolwe ngesikhathi ngemuva kokuthola i-SCAD.

Kufanele ngimbone nini udokotela?

Uma ucabanga ukuthi unesifo senhliziyo, shayela ku-911 (1990 eSri Lanka) ngokushesha.

Ngaphezu kwalokho, bona udokotela uma unezinye zalezi zimpawu:

• Ubuhlungu besifuba noma ingcindezi ( i-Angina ).
• Ukujuluka okubandayo.
• Ubuhlungu ezingalweni, emhlathini, noma emahlombe.
• Ubunzima bokuphefumula.
• Ukuzizwa ukhathele kakhulu, unesiyezi, noma ubuthakathaka ngaphandle kwesizathu.

Yini okufanele ngiyibuze udokotela wami?

Uma kutholakale ukuthi une-SCAD, ungase ufune ukubuza udokotela wakho le mibuzo:

• Yini eyangenza ngathuthukisa le SCAD?
• Ngingayithola yini i-SCAD futhi?
• Yini okufanele ngiyenze ukuze ngivikele impilo yenhliziyo yami?
• Ingabe kufanele ngikhathazeke ngezimpawu zezinkinga?

I-SCAD yisimo esibangela izimpawu ezifana nokuhlaselwa yinhliziyo kubantu abasengozini encane yesifo senhliziyo, ikakhulukazi abesifazane. Shayela izinsizakalo zezokwelapha eziphuthumayo ngokushesha uma unezimpawu zokuhlaselwa yinhliziyo. Uma ukuhlolwa kuqinisekisa ukuthi une-SCAD, udokotela wakho uzokhuluma nawe ngezinketho zokwelapha. Ngisho noma ukwelashwa kuqhubeka, kunengozi yokuthi umthambo uzophinde uqhume. Udokotela wakho uzoqapha impilo yenhliziyo yakho eduze ukuze anciphise leyo ngozi.

Umlayezo Wokuya Nawe Ekhaya

Kulungile, ngakho-ke sesikhulume kakhulu nge-SCAD, akunjalo? Nazi ezinye zezinto ezibaluleke kakhulu okufanele uzikhumbule:

• I-SCAD ukuhlaselwa yinhliziyo okungazelelwe, okungalindelekile okungathinta ikakhulukazi abesifazane abasebasha nabaphilile.
• Izimpawu zifana ncamashi nokuhlaselwa yinhliziyo. Uma unezinhlungu esifubeni, ubunzima bokuphefumula, noma ukujuluka, ungazinaki. Funa iseluleko sezokwelapha ngokushesha.
• Ukuxilonga i-SCAD kungaba nzima kancane, kodwa kungaqinisekiswa ngokuhlolwa okufanele.
• Ngokuvamile ingelapheka ngemithi, kodwa abanye abantu bangadinga ukuhlinzwa noma ezinye izindlela zokwelapha.
• Kubaluleke kakhulu ukwenza izinguquko endleleni yokuphila nokulandela iseluleko sezokwelapha ngemva kwe-SCAD. Lokhu kunganciphisa ingozi yokuphinda kwenzeke.

Uma wena noma othile omaziyo enalezi zimpawu, ungesabi futhi ubone udokotela ngokushesha. Uma usheshe utholakale ukuthi unalesi sifo, kulapho kungenzeka khona ukuthi ukwelashwa kuphumelele. Hlala uphilile!

Ukususwa Kwemithambo Yenhliziyo Okuzenzekelayo , i-SCAD, ukuhlaselwa yinhliziyo, ubuhlungu besifuba, umthambo wenhliziyo, impilo yabesifazane, ukunakekelwa okuphuthumayo