Angina wosakhazikika

Angina wosakhazikika ndimomwe mtima wanu sulandila magazi okwanira komanso mpweya wabwino. Zingayambitse matenda a mtima.

Angina ndi mtundu wa kusapeza pachifuwa komwe kumachitika chifukwa chamagazi osayenda bwino kudzera mumitsempha yamagazi (mitsempha yoyenda bwino) ya minofu yamtima (myocardium).

Matenda a mitsempha yam'mimba chifukwa cha atherosclerosis ndiye chifukwa chofala kwambiri cha angina wosakhazikika. Matenda a atherosclerosis ndi mafuta, omwe amatchedwa plaque, m'mbali mwa mitsempha. Izi zimapangitsa kuti mitsempha ikhale yopapatiza komanso yosasinthasintha. Kuchepetsa kumatha kuchepetsa magazi kupita kumtima, kumayambitsa kupweteka pachifuwa.

Anthu omwe ali ndi angina osakhazikika ali pachiwopsezo chachikulu chodwala matenda amtima.

Zomwe zimayambitsa angina ndi izi:

• Ntchito yosazolowereka yamitsempha yaying'ono yama nthambi yopanda mitsempha yayikulu (yotchedwa microvascular dysfunction kapena Syndrome X)
• Mitsempha ya Coronary spasm

Zowopsa za mtsempha wamagazi ndi monga:

• Matenda a shuga
• Mbiri ya banja yamatenda amtima oyambira (wachibale wapafupi monga m'bale kapena kholo anali ndi matenda amtima asanakwanitse zaka 55 mwa mamuna kapena asanakwanitse zaka 65 mwa mkazi)
• Kuthamanga kwa magazi
• Cholesterol wambiri wa LDL
• Cholesterol Yotsika
• Kugonana kwamwamuna
• Moyo wongokhala (osachita masewera olimbitsa thupi)
• Kunenepa kwambiri
• Ukalamba
• Kusuta

Zizindikiro za angina zitha kuphatikiza:

• Kupweteka pachifuwa komwe kumamvekanso paphewa, mkono, nsagwada, khosi, kumbuyo, kapena madera ena
• Kusokonezeka komwe kumamverera ngati kukakamira, kufinya, kuphwanya, kuwotcha, kutsamwa, kapena kupweteka
• Zovuta zomwe zimachitika ndikupumula sizimatha mosavuta mukamamwa mankhwala
• Kupuma pang'ono
• Kutuluka thukuta

Ndi angina wokhazikika, kupweteka pachifuwa kapena zizindikilo zina zimangokhala ndi zochitika zina kapena kupsinjika. Kupweteka sikumachitika kawirikawiri kapena kumawonjezeka pakapita nthawi.

Angina wosakhazikika ndikumva kupweteka pachifuwa komwe kumachitika modzidzimutsa ndipo kumangowonjezereka kwakanthawi kochepa. Mutha kukhala ndi angina wosakhazikika ngati kupweteka pachifuwa:

• Iyamba kumverera mosiyana, imakhala yolimba, imabwera pafupipafupi, kapena imachitika ndikuchepetsa zochitika kapena mukakhala mukupuma
• Imatenga nthawi yayitali kuposa mphindi 15 mpaka 20
• Zimapezeka popanda chifukwa (mwachitsanzo, mukamagona kapena mukukhala mwakachetechete)
• Sichimayankha bwino mankhwala omwe amatchedwa nitroglycerin (makamaka ngati mankhwalawa adagwira ntchito kuti athetse kupweteka pachifuwa m'mbuyomu)
• Zimapezeka ndikutaya magazi kapena kupuma pang'ono

Angina wosakhazikika ndi chenjezo loti matenda amtima atha kuchitika posachedwa ndipo ayenera kuthandizidwa nthawi yomweyo. Onani omwe akukuthandizani ngati muli ndi vuto lililonse pachifuwa.

Wothandizira adzakuyesani ndikuyang'ana kuthamanga kwa magazi. Wothandizirayo akhoza kumva mawu osazolowereka, monga kung'ung'uza mtima kapena kugunda kwamtima mosamvera, mukamamvera pachifuwa ndi stethoscope.

Mayeso a angina ndi awa:

• Kuyezetsa magazi kuti muwonetse ngati muli ndi vuto la minofu yamtima kapena muli pachiwopsezo chachikulu cha matenda amtima, kuphatikiza troponin I ndi T-00745, creatine phosphokinase (CPK), ndi myoglobin.
• ECG.
• Zojambulajambula.
• Mayeso opsinjika, monga mayeso olekerera (kuyesa kupsinjika kapena kuyesa kupondaponda), kuyesa kupsinjika kwa zida za nyukiliya, kapena echocardiogram.
• Zowonera Coronary. Kuyesaku kumaphatikizapo kujambula zithunzi zamitsempha yamtima pogwiritsa ntchito x-ray ndi utoto. Ndiyeso yolunjika kwambiri yodziwitsa kuti mitsempha ya mtima imachepa ndikupeza kuundana.

Mungafunike kupita kuchipatala kuti mupume pang'ono, kuyesedwa kwambiri, komanso kupewa zovuta.

Magazi ochepetsa magazi (antiplatelet drug) amagwiritsidwa ntchito kuchiza ndi kupewa angina wosakhazikika. Mudzalandira mankhwalawa posachedwa ngati mungathe kumwa mosamala. Mankhwala amaphatikizapo aspirin ndi mankhwala osokoneza bongo a clopidogrel kapena zina zotere (ticagrelor, prasugrel). Mankhwalawa amatha kuchepetsa mwayi wamatenda amtima kapena kuopsa kwa vuto la mtima lomwe limachitika.

Pa chochitika chosakhazikika cha angina:

• Mutha kupeza heparin (kapena magazi ena ochepera magazi) ndi nitroglycerin (pansi pa lilime kapena kudzera mu IV).
• Mankhwala ena atha kuphatikizira mankhwala ochepetsa kuthamanga kwa magazi, nkhawa, mayendedwe amtima osadziwika, komanso cholesterol (monga mankhwala a statin).

Njira yotchedwa angioplasty ndi stenting nthawi zambiri imachitika kuti atsegule mtsempha wotsekedwa kapena wopapatiza.

• Angioplasty ndi njira yotsegulira mitsempha yamagazi yopapatiza kapena yotseka yomwe imapereka magazi pamtima.
• Mitsempha yama coronary stent ndi chubu chaching'ono, chachitsulo chomwe chimatseguka (chimafutukuka) mkati mwa mtsempha wamagazi. Nthawi zambiri stent imayikidwa pambuyo pa angioplasty. Zimathandiza kuti mitsempha isatsekenso. Kachipangizo kogwiritsa ntchito mankhwala osokoneza bongo kamakhala ndi mankhwala omwe amathandiza kuti mitsempha isatseke pakapita nthawi.

Opaleshoni ya mtima ingachitike kwa anthu ena. Chisankho chochitidwa opaleshoniyi chimadalira:

• Ndi mitsempha iti yomwe yatsekedwa
• Ndi mitsempha ingati yomwe ikukhudzidwa
• Ndi magawo ati amitsempha yam'mimba yochepetsedwa
• Kuchepetsedwa kwake ndikokulira

Angina wosakhazikika ndi chizindikiro cha matenda owopsa amtima.

Momwe mumakhalira bwino zimatengera zinthu zambiri, kuphatikiza:

• Ndi mitsempha ingati komanso yomwe ili mumtima mwanu yatsekedwa, komanso kutsekeka kwake ndi koopsa
• Ngati mudakhalapo ndi vuto la mtima
• Minyewa yanu yamtima imatha kupopera magazi mthupi lanu

Malingaliro osazolowereka amtima komanso kupwetekedwa mtima kumatha kubweretsa imfa mwadzidzidzi.

Angina wosakhazikika atha kubweretsa ku:

• Nyimbo zosazolowereka (arrhythmias)
• Matenda a mtima
• Mtima kulephera

Funsani chithandizo chamankhwala ngati mukumva kupweteka pachifuwa, kosadziwika kapena kukakamizidwa. Ngati mudakhalapo ndi angina kale, itanani omwe akukuthandizani.

Imbani 911 kapena nambala yadzidzidzi yakomweko ngati ululu wanu wa angina:

• Sizingakhale bwino mphindi 5 mutatenga nitroglycerin (omwe amakupatsani akhoza kukuwuzani kuti mutenge miyezo itatu)
• Sichitha pambuyo pa mlingo wa 3 wa nitroglycerin
• Zikukulirakulira
• Kubwerera pambuyo poti nitroglycerin idathandizira poyamba

Itanani omwe akukuthandizani ngati:

• Mukukhala ndi zizindikiro za angina pafupipafupi
• Mukukhala ndi angina pomwe mwakhala (kupumula angina)
• Mukumva kutopa nthawi zambiri
• Mukumva kukomoka kapena ndi mutu wopepuka, kapena mumatha
• Mtima wanu ukugunda pang'onopang'ono (zosakwana 60 kumenyera mphindi) kapena mwachangu kwambiri (kuposa 120 kumenya mphindi), kapena sikukhazikika
• Mukuvutika kumwa mankhwala amtima wanu
• Muli ndi zizindikiro zina zachilendo

Ngati mukuganiza kuti mukudwala matenda a mtima, pitani kuchipatala nthawi yomweyo.

Kafukufuku wina wasonyeza kuti kusintha zina ndi zina pamoyo wanu kumatha kuteteza zoletsa kuti zisakule ndipo zitha kuwongolera. Kusintha kwa moyo kumathandizanso kupewa ma angina. Wopereka wanu akhoza kukuwuzani kuti:

• Kuchepetsa thupi ngati muli wonenepa kwambiri
• Lekani kusuta
• Chitani masewera olimbitsa thupi nthawi zonse
• Imwani mowa pang'ono
• Idyani chakudya chopatsa thanzi chokhala ndi masamba ambiri, zipatso, mbewu zonse, nsomba, ndi nyama zowonda

Wopezayo amakulimbikitsaninso kuti muzisunga zovuta zina monga kuthamanga kwa magazi, matenda ashuga, komanso kuchuluka kwama cholesterol.

Ngati muli ndi chimodzi kapena zingapo zomwe zingayambitse matenda amtima, lankhulani ndi omwe amakupatsani mwayi wokhudza kumwa aspirin kapena mankhwala ena kuti muteteze matenda a mtima. Mankhwala a aspirin (75 mpaka 325 mg tsiku) kapena mankhwala monga clopidogrel, ticagrelor kapena prasugrel atha kuthandiza kupewa anthu ena. Aspirin ndi mankhwala ena ochepetsa magazi amalimbikitsidwa ngati phindu lake lingapose chiopsezo cha zotsatirapo zake.

Kufulumizitsa angina; Angina watsopano; Angina - wosakhazikika; Angina wopita patsogolo; CAD - angina wosakhazikika; Mitima matenda - wosakhazikika angina; Matenda a mtima - angina osakhazikika; Kupweteka pachifuwa - angina wosakhazikika

• Angina - kumaliseche
• Angina - zomwe mungafunse dokotala wanu
• Angina - mukakhala ndi ululu pachifuwa
• Angioplasty ndi stent - mtima - kutulutsa
• Matenda a mtima - kutulutsa
• Matenda a mtima - zomwe mungafunse dokotala wanu

• Angina
• Coronary artery balloon angioplasty - mndandanda

Amsterdam EA, Wenger NK, Brindis RG, ndi al. Chitsogozo cha AHA / ACC cha 2014 pakuwongolera odwala omwe alibe ST-elevation acute coronary syndromes: lipoti la American College of Cardiology / American Heart Association Task Force on Practice Guidelines. [Kuwongolera kofalitsidwa kumawonekera J Ndine Coll Cardiol. 2014; 64 (24): 2713-2714. Cholakwika cha mlingo pamutu wazolemba]. J Ndine Coll Cardiol. 2014; 64 (24): e139-e228. PMID: 25260718 pubed.ncbi.nlm.nih.gov/25260718/.

Arnett DK, Blumenthal RS, Albert MA, ndi al. Ndondomeko ya 2019 ACC / AHA yokhudza kupewa koyambirira kwa matenda amtima: lipoti la American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines. [kukonza kofalitsa kumawonekera Kuzungulira. 2019; 140 (11): e649-e650] [kukonza kofalitsa kumawonekera Kuzungulira. 2020; 141 (4): e60] [kukonza kofalitsa kumawonekera Kuzungulira. Chizindikiro. 2020; 141 (16): e774]. Kuzungulira. 2019 2019; 140 (11): e596-e646. MAFUNSO: PM8: 30879355. Pubmed.ncbi.nlm.nih.gov/30879355/.

MP wa Bonaca. Sabatine MS. Njira yofikira wodwalayo ndi kupweteka pachifuwa. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: mutu 56.

Giugliano RP, Braunwald E. Non-ST kukwezeka kwambiri ma syndromes. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 60.

Ibanez B, James S, Agewall S, ndi al. Malangizo a 2017 ESC pakuwongolera kwa infarction ya myocardial mwa odwala omwe akukwera ndi ST-gawo: Task Force for the Management of Acute Myocardial Infarction in Patients Present with ST-segment Elevation of the European Society of Cardiology (ESC). Eur Mtima J. 2018; 39 (2): 119-177. (Adasankhidwa) PMID: 28886621 pubed.ncbi.nlm.nih.gov/28886621/.

Jang JS, Spertus JA, Arnold SV, ndi al. Zotsatira za ma multivessel revascularization pazotsatira zaumoyo wa odwala omwe ali ndi gawo la ST-election myocardial infarction ndi multivessel coronary artery disease. J Ndine Coll Cardiol. 2015; 66 (19): 2104-2113. PMID: 26541921 pubed.ncbi.nlm.nih.gov/26541921/.

Lange RA, Mukherjee D. Acute coronary syndrome: angina wosakhazikika komanso wosakhala wa ST kukwezedwa kwa myocardial infarction. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 63.