I-angina engazinzile

I-angina engaqiniseki yisimo lapho inhliziyo yakho ingatholi khona ukugeleza kwegazi okwanele ne-oxygen. Kungaholela ekuhlaselweni yinhliziyo.

I-Angina wuhlobo lokungaphatheki kahle kwesifuba okubangelwa ukungahambi kahle kwegazi ngemithambo yegazi (imithambo yegazi) yesicubu senhliziyo (i-myocardium).

Isifo semithambo yegazi ngenxa ye-atherosclerosis siyimbangela evame kakhulu ye-angina engazinzile. I-atherosclerosis iyinqwaba yezinto ezinamafutha, ezibizwa ngokuthi i-plaque, eceleni kwezindonga zemithambo. Lokhu kubangela ukuthi imithambo yegazi inciphe futhi ingashintshi. Ukuncipha kunganciphisa ukugeleza kwegazi kuye enhliziyweni, kubangele ubuhlungu besifuba.

Abantu abane-angina engazinzile basengozini enkulu yokuhlaselwa yisifo senhliziyo.

Izimbangela eziningi ze-angina yilezi:

• Umsebenzi ongajwayelekile wemithambo yegatsha emincane ngaphandle kokuncipha kwemithambo yegazi emikhulu (ebizwa ngokuthi yi-microvascular dysfunction noma i-Syndrome X)
• Umthambo weCoronary spasm

Izici zobungozi besifo semithambo yenhliziyo zifaka:

• Isifo sikashukela
• Umlando womndeni wesifo senhliziyo sokuqala (isihlobo esiseduze esifana nengane yakini noma umzali wayenesifo senhliziyo ngaphambi kweminyaka yobudala engama-55 kumuntu noma ngaphambi kweminyaka engama-65 kowesifazane)
• Umfutho wegazi ophezulu
• I-cholesterol ephezulu ye-LDL
• I-cholesterol ephansi ye-HDL
• Ubulili besilisa
• Indlela yokuphila yokuhlala phansi (ukungatholi ukuzivocavoca umzimba ngokwanele)
• Ukukhuluphala ngokweqile
• Ukuguga
• Ukubhema

Izimpawu ze-angina zingafaka:

• Ubuhlungu besifuba ongabuzwa ehlombe, engalweni, emhlathini, entanyeni, emuva, noma kwenye indawo
• Ukungakhululeki okuzizwa njengokucindezela, ukucindezela, ukuchoboza, ukushisa, ukuklinya, noma ukuqaqamba
• Ukungakhululeki okwenzeka lapho uphumule futhi akusuki kalula lapho uphuza umuthi
• Ukuphelelwa umoya
• Ukujuluka

Nge-angina ezinzile, ubuhlungu besifuba noma ezinye izimpawu zenzeka kuphela ngenani elithile lomsebenzi noma ukucindezeleka. Ubuhlungu abubonakali kaningi noma buba bubi ngokuhamba kwesikhathi.

I-angina engaqiniseki ubuhlungu besifuba obuzumayo futhi obuhlala buba bubi ngaphezu kwesikhathi esifushane. Ungahle uhlakulele i-angina engazinzile uma ubuhlungu besifuba:

• Iqala ukuzizwa yehlukile, inzima kakhulu, iza kaningi, noma yenzeka ngomsebenzi omncane noma ngenkathi uphumule
• Ihlala isikhathi eside kunemizuzu engu-15 kuye kwengu-20
• Kuvela ngaphandle kwesizathu (isibonelo, ngenkathi ulele noma uhleli ngokuthula)
• Ayiphenduli kahle kumuthi obizwa nge-nitroglycerin (ikakhulukazi uma lo muthi ubusebenza ukudambisa ubuhlungu besifuba esikhathini esedlule)
• Kuvela ngokwehla kwengcindezi yegazi noma ukuphefumula okuncane

I-angina engazinzile iwuphawu oluyisixwayiso lokuthi isifo senhliziyo kungenzeka ngokushesha futhi sidinga ukwelashwa ngokushesha. Bheka umhlinzeki wakho wezokunakekelwa kwezempilo uma unanoma yiluphi uhlobo lobuhlungu besifuba.

Umhlinzeki uzokwenza ukuhlolwa ngokomzimba futhi ahlole umfutho wegazi lakho. Umhlinzeki angahle ezwe imisindo engajwayelekile, njengokukhononda kwenhliziyo noma ukushaya kwenhliziyo okungajwayelekile, lapho ulalele isifuba sakho nge-stethoscope.

Ukuhlolwa kwe-angina kufaka:

• Ukuhlolwa kwegazi ukukhombisa ukuthi ngabe unokonakala kwezicubu zenhliziyo noma usengozini enkulu yokuhlaselwa yisifo senhliziyo, kufaka phakathi i-troponin I ne-T-00745, i-creatine phosphokinase (CPK), ne-myoglobin.
• ECG.
• I-Echocardiography.
• Ukuhlolwa kwengcindezi, njengokuhlolwa kokubekezelela ukuvivinya umzimba (ukuhlolwa kwengcindezi noma ukuhlolwa kwe-treadmill), ukuhlolwa kwengcindezi yenuzi, noma i-echocardiogram yokucindezela
• I-Coronary angiography. Lokhu kuhlolwa kuhilela ukuthatha izithombe zemithambo yenhliziyo usebenzisa ama-x-ray nedayi. Ukuhlolwa okuqonde kakhulu ukuthola ukuthi umthambo wenhliziyo uncipha futhi uthole amahlule.

Kungase kudingeke ukuthi ungene esibhedlela ukuze uthole ukuphumula, uvivinyeke kakhudlwana, futhi uvikele nezinkinga.

Ama-thinner egazi (izidakamizwa ze-antiplatelet) asetshenziselwa ukwelapha nokuvimbela i-angina engazinzile. Uzothola le mithi ngokushesha okukhulu uma ungakwazi ukuyiphuza ngokuphepha. Imithi ifaka i-aspirin kanye nomuthi kadokotela clopidogrel noma into efanayo (ticagrelor, prasugrel). Le mithi ingakwazi ukunciphisa amathuba okuhlaselwa yinhliziyo noma ukuqina kwesifo senhliziyo okwenzekayo.

Ngesikhathi somcimbi we-angina ongazinzile:

• Ungathola i-heparin (noma elinye igazi elinciphile) ne-nitroglycerin (ngaphansi kolimi noma nge-IV).
• Okunye ukwelashwa kungafaka imithi yokulawula umfutho wegazi, ukukhathazeka, isigqi senhliziyo esingajwayelekile, ne-cholesterol (njengesidakamizwa se-statin).

Inqubo ebizwa nge-angioplasty ne-stenting ingenziwa kaningi ukuvula umthambo ovinjiwe noma omncane.

• I-Angioplasty inqubo yokuvula imithambo yegazi encishisiwe noma evinjiwe ehambisa igazi enhliziyweni.
• Umthambo we-coronary stent uyishubhu elincane, lensimbi lensimbi elivula (likhule) ngaphakathi komthambo we-coronary. I-stent ivame ukufakwa ngemuva kwe-angioplasty. Kuyasiza ukuvimbela umthambo ukuba ungavali futhi. I-stent eluting stent inomuthi kuyo esiza ukuvimbela umthambo ukuthi ungavali ngokuhamba kwesikhathi.

Ukuhlinzwa kokudlula kwenhliziyo kungenziwa kwabanye abantu. Isinqumo sokwenza lokhu kuhlinzwa sincike ku:

• Yimiphi imithambo evinjiwe
• Mingaki imithambo ethintekayo
• Yiziphi izingxenye zemithambo yegazi encishisiwe
• Kunzima kangakanani ukuncishiswa

I-angina engazinzile iwuphawu lwesifo senhliziyo esibi kakhulu.

Wenza kahle kangakanani kuncike ezintweni eziningi ezahlukahlukene, kufaka phakathi:

• Mingaki futhi imiphi imithambo esenhliziyweni yakho evinjiwe, nokuthi ukuvinjelwa kuqine kangakanani
• Uma uke wahlaselwa yisifo senhliziyo
• Imisipha yenhliziyo yakho ikwazi kanjani ukumpompa igazi emzimbeni wakho

Isigqi senhliziyo esingajwayelekile nokuhlaselwa yinhliziyo kungadala ukufa okungazelelwe.

I-angina engazinzile ingaholela ku:

• Isigqi senhliziyo esingajwayelekile (arrhythmias)
• Isifo senhliziyo
• Ukwehluleka kwenhliziyo

Funa ukunakekelwa kwezokwelapha uma unezinhlungu ezintsha, ezingachazeki esifubeni noma ingcindezi. Uma uke waba ne-angina phambilini, shayela umhlinzeki wakho.

Shayela ku-911 noma inombolo ephuthumayo yendawo uma ubuhlungu bakho be-angina:

• Akungcono imizuzu emihlanu ngemuva kokuthatha i-nitroglycerin (umhlinzeki wakho angakutshela ukuthi uthathe amanani aphelele ama-3)
• Akusuki ngemuva kwemithamo emi-3 ye-nitroglycerin
• Kuya ngokuya kuba kubi
• Ibuyisa ngemuva kokuthi i-nitroglycerin isize ekuqaleni

Shayela umhlinzeki wakho uma:

• Unezimpawu ze-angina kaningi
• Une-angina uma uhleli (rest angina)
• Uzizwa ukhathele kaningi
• Uzizwa uphela amandla noma unekhanda elikhanyayo, noma uyadlula
• Inhliziyo yakho ishaya kancane (ishaya ngaphansi kwezingu-60 ngomzuzu) noma ishesha kakhulu (ukushaya okungaphezu kuka-120 ngomzuzu), noma ayizinzile
• Unenkinga yokuphuza imithi yakho yenhliziyo
• Unezinye izimpawu ezingavamile

Uma ucabanga ukuthi unesifo senhliziyo, thola ukwelashwa ngokushesha.

Olunye ucwaningo lukhombisile ukuthi ukwenza izinguquko ezimbalwa zendlela yokuphila kungavimbela ukuvimba ukuthi kungabi kubi kakhulu futhi kungathuthukisa empeleni. Izinguquko zendlela yokuphila zingasiza futhi ekuvikeleni ukuhlaselwa okuthile kwe-angina. Umhlinzeki wakho angakutshela ukuthi:

• Yehlisa isisindo uma ukhuluphele ngokweqile
• Yeka ukubhema
• Vocavoca umzimba njalo
• Phuza utshwala ngokulinganisela kuphela
• Yidla ukudla okunempilo okunemifino, izithelo, okusanhlamvu okuphelele, inhlanzi nenyama engenamafutha

Umhlinzeki wakho uzophinda ancome ukuthi ugcine ezinye izimo zezempilo ezifana nomfutho wegazi ophakeme, isifo sikashukela, namazinga aphezulu e-cholesterol alawulwa.

Uma unesici esisodwa noma eziningi zesifo senhliziyo, khuluma nomhlinzeki wakho mayelana nokuthatha i-aspirin noma eminye imithi ukusiza ukuvimbela isifo senhliziyo. Ukwelashwa kwe-Aspirin (75 kuya ku-325 mg ngosuku) noma izidakamizwa ezifana ne-clopidogrel, ticagrelor noma i-prasugrel kungasiza ekuvikeleni ukuhlaselwa yinhliziyo kwabanye abantu. Kunconywa i-Aspirin nezinye izindlela zokwelapha ezinciphisa igazi uma inzuzo ingase idlule ingozi yemiphumela emibi.

Ukusheshisa i-angina; I-angina entsha; U-Angina - akazinzile; I-angina eqhubekayo; I-CAD - i-angina engazinzile; Isifo semithambo yegazi - i-angina engazinzile; Isifo senhliziyo - i-angina engazinzile; Ubuhlungu besifuba - i-angina engazinzile

• I-Angina - ukukhishwa
• U-Angina - ukuthi ubuze ini kudokotela wakho
• I-Angina - lapho unezinhlungu esifubeni
• Ukukhishwa kwe-angioplasty ne-stent - inhliziyo
• Isifo senhliziyo - ukukhipha
• Isifo senhliziyo - okufanele ubuze udokotela wakho

• Angina
• I-Coronary artery balloon angioplasty - uchungechunge

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