Isifo senhliziyo

Iningi lokuhlaselwa yinhliziyo kudalwa yisigaxa segazi esivimba omunye wemithambo yegazi. Imithambo yegazi iletha igazi ne-oxygen enhliziyweni. Uma ukugeleza kwegazi kuvinjiwe, inhliziyo ibulawa yindlala yomoya-mpilo namaseli enhliziyo ayafa.

Igama lezokwelapha lalokhu i-infarction ye-myocardial.

Into ebizwa ngokuthi i-plaque ingakha ezindongeni zemithambo yegazi yakho. Leli qweqwe lakhiwa yi-cholesterol namanye amaseli.

Ukuhlaselwa yinhliziyo kungenzeka lapho:

• Ukuphazamiseka ku-plaque kwenzeka. Lokhu kudala ama-platelet egazi nezinye izinto ukwakha ihlwili legazi esizeni esivimba kakhulu noma lonke igazi eliphethe umoya-mpilo ukuthi ligobhoze liye engxenyeni yemisipha yenhliziyo. Lesi yisona sizathu esivame kakhulu sokuhlaselwa yinhliziyo.

Imbangela yokuhlaselwa yisifo senhliziyo ayaziwa ngaso sonke isikhathi, kepha kunezici eziyingozi ezaziwayo.

Ukuhlaselwa yinhliziyo kungenzeka:

• Lapho uphumule noma ulele
• Ngemuva kokwanda okungazelelwe kokuvivinya umzimba
• Uma usebenza ngaphandle lapho kubanda
• Ngemuva kokucindezeleka okungazelelwe, okukhulu ngokomzwelo noma ngokomzimba, kufaka phakathi ukugula

Izici eziningi zobungozi zingaholela ekwakheni i-plaque buildup nokuhlaselwa yinhliziyo.

Isifo senhliziyo yisimo esiphuthumayo sezokwelapha. Uma unezimpawu zokuhlaselwa yisifo senhliziyo, shayela ku-911 noma inombolo yakho ephuthumayo yangakini khona manjalo.

• UNGAZAMI ukushayela ngemoto yakho esibhedlela.
• UNGALINDI. Usengozini enkulu yokufa ngokuzuma emahoreni okuqala okuhlaselwa yinhliziyo.

Ubuhlungu besifuba yisibonakaliso esivame kakhulu sokuhlaselwa yinhliziyo.

• Ungabuzwa ubuhlungu engxenyeni eyodwa kuphela yomzimba wakho NOMA
• Ubuhlungu bungasuka esifubeni buye ezingalweni, ehlombe, entanyeni, emazinyweni, emihlathini, endaweni yesisu, noma emuva

Ubuhlungu bungaba bukhulu noma bube mnene. Kungazizwa ngathi:

• Ibhande eliqinile esifubeni
• Ukugaya ukudla okungalungile
• Okuthile okusindayo okuhleli esifubeni sakho
• Ukucindezela noma ukucindezela okusindayo

Ubuhlungu buhlala isikhathi eside kunemizuzu engama-20. Ukuphumula nomuthi wokuphumuza imithambo yegazi (ebizwa nge-nitroglycerin) kungenzeka kungabudambisi ngokuphelele ubuhlungu besifo senhliziyo. Izimpawu nazo zingaphela futhi zibuye zibuye.

Ezinye izimpawu zesifo senhliziyo zingabandakanya:

• Ukukhathazeka
• Khwehlela
• Ukuquleka
• Ubumhlophe, isiyezi
• Isicanucanu nokuhlanza
• Ukushaya ngonyawo (ukuzwa sengathi inhliziyo yakho ishaya ngokushesha okukhulu noma ngokungajwayelekile)
• Ukuphelelwa umoya
• Ukujuluka, okungasinda kakhulu

Abanye abantu (kufaka phakathi abantu abadala asebekhulile, abantu abanesifo sikashukela, nabesifazane) bangaba nobuhlungu besifuba obuncane noma bangabi nabo nhlobo. Noma, bangaba nezimpawu ze-atypical ezifana nokuphefumula okuncane, ukukhathala nobuthakathaka. "Ukuhlaselwa yisifo senhliziyo buthule" yisifo senhliziyo esingenazo izimpawu ezingaphinde zivele.

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa ngokomzimba futhi alalele isifuba sakho esebenzisa i-stethoscope.

• Umhlinzeki angahle ezwe imisindo engajwayelekile emaphashini akho (abizwa ngama-crackles), ukububula kwenhliziyo, noma eminye imisindo engajwayelekile.
• Ungaba nokushaya ngamandla noma ngokungalingani.
• Umfutho wegazi lakho ungaba ojwayelekile, ophakeme, noma ophansi.

Uzoba ne-electrocardiogram (ECG) ukubheka ukulimala kwenhliziyo. Imvamisa, ushintsho oluthile ku-ECG lukhombisa ukuthi unesifo senhliziyo, noma ngabe isifo senhliziyo singenzeka ngaphandle kwezinguquko ze-ECG.

Ukuhlolwa kwegazi kungakhombisa uma ngabe unomonakalo wezicubu zenhliziyo. Lokhu kuhlolwa kungaqinisekisa ukuthi unesifo senhliziyo. Ukuhlolwa kuvame ukuphindwa ngokuhamba kwesikhathi.

I-Coronary angiography ingenziwa ngokushesha noma kamuva enkathini yokugula.

• Lokhu kuhlolwa kusebenzisa udayi okhethekile nama-x-ray ukubona ukuthi igazi ligeleza kanjani enhliziyweni yakho.
• Kungasiza udokotela wakho anqume ukuthi yiziphi izindlela zokwelashwa ozidingayo ngokulandelayo.

Olunye uvivinyo lokubheka inhliziyo yakho olungenziwa ngenkathi usesibhedlela:

• I-Echocardiography enayo noma enokuhlolwa kwengcindezi
• Ukuzivocavoca umzimba
• Ukuhlolwa kwengcindezi yenukliya
• I-Heart CT scan noma i-MRI yenhliziyo

UKWELASHWA NGOKUSHESHA

• Uzoxhunyaniswa nokuqapha inhliziyo, ukuze iqembu lokunakekelwa kwezempilo likwazi ukubona ukuthi inhliziyo yakho ishaya kangakanani.
• Uzothola i-oxygen.
• Umugqa ofakwa ngaphakathi (IV) uzofakwa komunye wemithambo yakho. Imithi noketshezi kudlula kule IV.
• Ungathola i-nitroglycerin ne-morphine ukusiza ukunciphisa ubuhlungu besifuba.
• Ungathola i-aspirin, ngaphandle kwalapho kungeke kuphephe kuwe. Uma kunjalo, uzonikezwa omunye umuthi ovimbela amahlule egazi.
• Ukushaya kwenhliziyo okuyingozi (arrhythmias) okuyingozi kungaphathwa ngemithi noma ngamagesi.

IZINQUBO ZESIMO ESIPHUTHUMAYO

I-Angioplasty inqubo yokuvula imithambo yegazi encishisiwe noma evinjiwe ehambisa igazi enhliziyweni.

• I-Angioplasty ivame ukukhetha ukwelashwa kokuqala. Kufanele kwenziwe kungakapheli imizuzu engama-90 ngemuva kokufika esibhedlela, futhi imvamisa kungakapheli amahora ayi-12 ngemuva kokuhlaselwa yinhliziyo.
• I-stent yishubhu elincane lensimbi elenza ukuthi livuleke (linwebe) ngaphakathi komthambo we-coronary. I-stent ivame ukufakwa ngemuva noma ngesikhathi se-angioplasty. Kuyasiza ukuvimbela umthambo ukuba ungavali futhi.

Unganikezwa izidakamizwa zokuqeda ihlwili. Lokhu kubizwa ngokuthi ukwelashwa kwe-thrombolytic. Kungcono kakhulu uma le mishanguzo inikezwa ngokushesha ngemuva kokuqala kwezimpawu, imvamisa kungakapheli amahora ayi-12 ngemuva kwayo futhi kungakapheli nemizuzu engama-30 ifikile esibhedlela.

Abanye abantu bangabuye bahlinzwe inhliziyo ukuvula imithambo yegazi encishisiwe noma evinjiwe ehambisa igazi enhliziyweni. Le nqubo ibizwa nangokuthi i-coronary artery bypass ngokuxhunyelelwa kanye / noma ukuhlinzwa kwenhliziyo okuvulekile.

UKWELASHWA EMVA KOKUHLASELWA YINHLIZIYO

Ngemuva kwezinsuku ezimbalwa, uzokhishwa esibhedlela.

Kuzodingeka ukuthi uphuze imithi, eminye impilo yakho yonke. Njalo khuluma nomhlinzeki wakho ngaphambi kokuma noma ukushintsha ukuthi uwuthatha kanjani umuthi. Ukumisa imithi ethile kungaba yingozi.

Ngenkathi ungaphansi kokunakekelwa kwethimba lakho lokunakekelwa kwezempilo, uzofunda:

• Ungayiphuza kanjani imithi yokwelapha inkinga yenhliziyo yakho nokuvikela ukuhlaselwa yinhliziyo okwengeziwe
• Ungakudla kanjani ukudla okunempilo enhliziyweni
• Ungasebenza kanjani futhi uvivinye umzimba ngokuphepha
• Okufanele ukwenze lapho unezinhlungu esifubeni
• Ungakuyeka kanjani ukubhema

Imizwelo enamandla ivamile ngemuva kokuhlaselwa yinhliziyo.

• Ungase uzizwe udabukile
• Ungazizwa ukhathazekile futhi ukhathazekile ngokunakekela konke okwenzayo

Yonke le mizwa ijwayelekile. Ziya kubantu abaningi ngemuva kwamasonto amabili noma amathathu.

Ungase futhi uzizwe ukhathele lapho uphuma esibhedlela uya ekhaya.

Iningi labantu abaye bahlaselwa yisifo senhliziyo babamba iqhaza ohlelweni lokuvuselelwa kwenhliziyo.

Abantu abaningi bayazuza ngokubamba iqhaza emaqenjini okweseka abantu abanesifo senhliziyo.

Ngemuva kokuhlaselwa yinhliziyo, unethuba eliphakeme lokuhlaselwa esinye isifo senhliziyo.

Wenza kahle kangakanani ngemuva kokuhlaselwa yisifo senhliziyo kuncike ezintweni eziningana ezinjenge:

• Inani lomonakalo kumisipha yenhliziyo yakho namavalvu enhliziyo
• Lapho kutholakala khona lowo monakalo
• Ukunakekelwa kwakho kwezokwelapha ngemuva kokuhlaselwa yinhliziyo

Uma inhliziyo yakho ingasakwazi ukumpompa igazi emzimbeni wakho njengakuqala, ungaqala ukuhluleka kwenhliziyo. Izigqi zenhliziyo ezingajwayelekile zingenzeka, futhi zingasongela impilo.

Iningi labantu lingabuyela emuva kancane emisebenzini ejwayelekile ngemuva kokuhlaselwa yinhliziyo. Lokhu kufaka phakathi umsebenzi wezocansi. Khuluma nomhlinzeki wakho mayelana nokuthi umsebenzi omuhle kangakanani kuwe.

I-infarction ye-myocardial; MI; I-MI enamandla; ST - ukuphakama kwe-infarction ye-myocardial; I-non-ST - ukuphakama kwe-infarction ye-myocardial; NSTEMI; I-CAD - isifo senhliziyo; Isifo semithambo yegazi - isifo senhliziyo

• Ukukhishwa kwe-angioplasty ne-stent - inhliziyo
• I-cholesterol - ukwelashwa kwezidakamizwa
• Cholesterol - yini ongayibuza udokotela wakho
• Isifo senhliziyo - ukukhipha
• Isifo senhliziyo - okufanele ubuze udokotela wakho
• Ukwehluleka kwenhliziyo - okufanele ubuze udokotela wakho
• Umfutho wegazi ophakeme - okufanele ubuze udokotela wakho
• Ukuthatha i-warfarin (Coumadin, Jantoven) - okufanele ubuze udokotela wakho
• Ukuthatha i-warfarin (Coumadin)

• Inhliziyo - isigaba phakathi nendawo
• Inhliziyo - ukubuka kwangaphambili
• Ukuqhubeka kokwakhiwa kocwecwe emthanjeni we-coronary
• I-MI enamandla
• Thumela imikhondo yamagagasi we-ECG ye-myocardial infarction
• Imithambo yenhliziyo engemuva
• Imithambo yenhliziyo yangaphakathi
• Izimpawu zokuhlaselwa yinhliziyo
• Ubuhlungu bomhlathi nokuhlaselwa yinhliziyo

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U-Arnett DK, uBlumenthal RS, u-Albert MA, et al. Umhlahlandlela we-2019 ACC / AHA ekuvinjelweni okuyinhloko kwesifo senhliziyo: umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice Guidelines. Ukujikeleza. 2019; 140 (11): e596-e646. I-PMID: 30879355 pubmed.ncbi.nlm.nih.gov/30879355/.

I-Bohula EA, i-Morrow DA. I-ST-elevation infarction ye-myocardial: ukuphathwa. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 59.

IGiugliano RP, iBraunwald E. Non-ST ukuphakama kwama-syndromes abukhali we-coronary. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 60.

U-OGara PT, uKushner FG, u-Ascheim DD, et al. Umhlahlandlela we-ACCF / AHA ka-2013 wokuphathwa kwe-ST-elevation myocardial infarction: umbiko we-American College of Cardiology Foundation / American Heart Association Task Force on Guidelines Practice. UJ Am Coll Cardiol. 2013; 61 (4): 485-510. I-PMID: 23256913 pubmed.ncbi.nlm.nih.gov/23256913/.

Scirica BM, Libby P, Morrow DA. I-ST-elevation myocardial infarction: i-pathophysiology kanye nokuziphendukela kwemitholampilo. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 58.

UTamis-Holland JE, uJneid H, uReynolds HR, et al. Ukuxilongwa nokuphathwa kwesikhashana kweziguli ezine-infarction ye-myocardial lapho singekho isifo se-coronary artery esivimbelayo: isitatimende sesayensi esivela ku-American Heart Association. Ukujikeleza. 2019; 139 (18): e891-e908. I-PMID: 30913893 pubmed.ncbi.nlm.nih.gov/30913893/.