Ukuhlaselwa kweschemic kwesikhashana

Ukuhlaselwa kweschemic okudlulayo (TIA) kwenzeka lapho ukugeleza kwegazi kuya engxenyeni yobuchopho kuyeka isikhashana. Umuntu uzoba nezimpawu ezinjenge-stroke kuze kube ngamahora angama-24. Ezimweni eziningi, izimpawu zihlala amahora angu-1 kuya kwangu-2.

Ukuhlaselwa yischemic okudlulayo kuyisixwayiso sokuthi isifo sohlangothi singahle senzeke ngokuzayo uma kungenziwa okuthile ukukuvimbela.

I-TIA yehlukile kunesifo sohlangothi. Ngemuva kwe-TIA, ukuvinjelwa kuqhekeka ngokushesha bese kuncibilika. I-TIA ayibangeli ukuthi izicubu zobuchopho zife.

Ukulahleka kokugeleza kwegazi endaweni yobuchopho kungabangelwa:

• Ihlule legazi emthanjeni wobuchopho
• Igazi elihamba liye ebuchosheni lisuka kwenye indawo emzimbeni (ngokwesibonelo, lisuka enhliziyweni)
• Ukulimala emithanjeni yegazi
• Ukuncipha kwesitsha segazi ebuchosheni noma okuholela ebuchosheni

Umfutho wegazi ophakeme ubungozi obukhulu bama-TIA nesifo sohlangothi. Ezinye izinto eziyingozi kakhulu yilezi:

• Ukushaya kwenhliziyo okungajwayelekile okubizwa ngokuthi i-atrial fibrillation
• Isifo sikashukela
• Umlando womndeni wesifo sohlangothi
• Ukuba owesilisa
• I-cholesterol ephezulu
• Ukukhula kweminyaka, ikakhulukazi ngemuva kweminyaka yobudala engama-55
• Ubuhlanga (abantu base-Afrika baseMelika kungenzeka ukuthi babulawe yisifo sohlangothi)
• Ukubhema
• Ukusetshenziswa kotshwala
• Ukusetshenziswa kwezidakamizwa zokuzijabulisa
• Umlando we-TIA yangaphambilini noma isifo sohlangothi

Abantu abanesifo senhliziyo noma ukugeleza kwegazi okungahambi kahle emilenzeni yabo okubangelwa imithambo emincane nabo banamathuba amaningi okuba ne-TIA noma isifo sohlangothi.

Izimpawu ziqala ngokuzumayo, zihlala isikhathi esifushane (kusuka emizuzwini embalwa kuye ku-1 kuya kumahora ama-2), bese ziyahamba. Zingaphinde zivele ngokuhamba kwesikhathi.

Izimpawu ze-TIA ziyefana nezimpawu zesifo sohlangothi, futhi zifaka:

• Shintsha ekuxwayeni (kufaka phakathi ukulala noma ukungazi)
• Izinguquko ezinzwa (njengokuzwa, ukubona, ukunambitha, nokuthinta)
• Izinguquko zengqondo (njengokudideka, ukulahleka kwememori, ukubhala kanzima noma ukufunda, ubunzima bokukhuluma noma ukuqonda abanye)
• Izinkinga zemisipha (njengobuthakathaka, inkinga yokugwinya, ukuhamba ngokuhamba kahle)
• Isiyezi noma ukulahlekelwa ibhalansi nokuxhumana
• Ukuntuleka kokulawula isinye noma amathumbu
• Izinkinga zemizwa (njengokundikindiki noma ukuncinza kolunye uhlangothi lomzimba)

Imvamisa, izimpawu nezimpawu ze-TIA zizobe sezisukile ngesikhathi ufika esibhedlela. Ukuxilongwa kwe-TIA kungenziwa ngokuya ngomlando wakho wezokwelapha wedwa.

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa okuphelele komzimba ukuhlola izinkinga zenhliziyo nemithambo yegazi. Uzobhekelwa nezinkinga zemizwa nezicubu.

Udokotela uzosebenzisa i-stethoscope ukulalela inhliziyo yakho nemithambo yegazi. Umsindo ongajwayelekile obizwa nge-bruit ungezwakala lapho ulalele umthambo we-carotid entanyeni noma komunye umthambo. I-bruit idalwa ukugeleza kwegazi okungajwayelekile.

Ukuhlolwa kuzokwenziwa ukukhipha isifo sohlangothi noma okunye ukuphazamiseka okungadala izimpawu:

• Kungenzeka ube ne-CT scan yekhanda noma i-MRI yobuchopho. I-stroke ingakhombisa ushintsho kulezi zivivinyo, kepha ama-TIA ngeke.
• Ungaba ne-angiogram, i-CT angiogram, noma i-MR angiogram ukubona ukuthi imuphi umthambo wegazi ovinjiwe noma opha.
• Ungaba ne-echocardiogram uma udokotela wakho ecabanga ukuthi ungaba negazi elivela enhliziyweni.
• ICarotid duplex (ultrasound) ingakhombisa ukuthi ngabe imithambo ye-carotid entanyeni yakho inciphile yini.
• Ungaba ne-electrocardiogram (ECG) kanye nokuhlolwa kokuhlolwa kwesigqi senhliziyo ukuhlola ukushaya kwenhliziyo okungajwayelekile.

Udokotela wakho angenza ezinye izivivinyo ukuhlola umfutho wegazi ophakeme, isifo senhliziyo, isifo sikashukela, i-cholesterol ephezulu, nezinye izimbangela, nezici zobungozi kuma-TIA noma isifo sohlangothi.

Uma uke waba ne-TIA emahoreni angama-48 adlule, kungenzeka ungeniswe esibhedlela ukuze odokotela bakwazi ukusesha imbangela futhi bakubheke.

Umfutho wegazi ophakeme, isifo senhliziyo, isifo sikashukela, i-cholesterol ephezulu kanye nokuphazamiseka kwegazi kuzophathwa njengoba kudingeka. Uzokhuthazwa ukwenza izinguquko endleleni yakho yokuphila ukunciphisa ubungozi bezinye izimpawu. Izinguquko zifaka ukuyeka ukubhema, ukuzivocavoca umzimba kakhulu, nokudla ukudla okunempilo.

Ungathola izinciphisi zegazi, njenge-aspirin noma i-Coumadin, ukunciphisa ukujiya kwegazi. Abanye abantu abavimbe imithambo yentamo bangadinga ukuhlinzwa (i-carotid endarterectomy). Uma unesifo senhliziyo esingajwayelekile (i-atrial fibrillation), uzokwelashwa ukugwema izinkinga ezizayo.

Ama-TIA awabangeli ukulimala okungapheli ebuchosheni.

Kepha, ama-TIA ayisibonakaliso sesixwayiso sokuthi ungahle ube nesifo sohlangothi ezinsukwini noma ezinyangeni ezizayo. Abanye abantu abane-TIA bazoba nesifo sohlangothi zingakapheli izinyanga ezintathu. Ingxenye yale mivimbo yenzeka phakathi kwamahora angama-48 ngemuva kwe-TIA. Isifo sohlangothi singavela ngalolo suku olufanayo noma kamuva. Abanye abantu bane-TIA eyodwa kuphela, kanti abanye bane-TIA engaphezu kweyodwa.

Unganciphisa amathuba akho okushaywa unhlangothi ngokuzayo ngokulandela umhlinzeki wakho ukuphatha izingcuphe zakho.

I-TIA iyisimo esiphuthumayo sezokwelapha. Shayela ku-911 noma inombolo ephuthumayo yendawo ngokushesha. Ungazinaki izimpawu ngoba nje ziyahamba. Zingaba yisixwayiso sohlangothi oluzayo.

Landela imiyalo yomhlinzeki wakho yokuthi ungavimbela kanjani ama-TIA nemivimbo. Uzotshelwa ukuthi wenze izinguquko endleleni ophila ngayo futhi uthathe nemithi yokwelapha umfutho wegazi ophakeme noma i-cholesterol ephezulu.

Unhlangothi Mini; I-TIA; Unhlangothi omncane; Isifo se-cerebrovascular - TIA; Umthambo weCarotid - TIA

• Ukubekwa kwe-Angioplasty kanye ne-stent - umthambo we-carotid - ukukhishwa
• I-Atrial fibrillation - ukukhishwa
• Ukuhlinzwa komthambo weCarotid - ukukhipha
• Ukushaywa unhlangothi - ukukhishwa
• Ukuthatha i-warfarin (Coumadin)

• I-Endarterectomy
• Ukuhlaselwa kwesikhashana kwe-Ischemic (TIA)

UBiller J, uRuland S, uSchneck MJ. Ischemic isifo se-cerebrovascular. KuDaroff RB, uJankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. IPhiladelphia, PA: Elsevier; 2016: isahluko 65.

UCrocco TJ, uMeurer WJ. Unhlangothi. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 91.

UJanuwari CT, uWann LS, uCalkins H, et al. I-2019 AHA / ACC / HRS igxile ekuvuseleleni umhlahlandlela we-2014 AHA / ACC / HRS wokuphathwa kweziguli ezine-fibrillation ye-atrial: umbiko we-American College of Cardiology / American Heart Association Task Force ngemikhombandlela yokusebenza kanye ne-Heart Rhythm Society. UJ Am Coll Cardiol. 2019; 74 (1): 104-132. I-PMID: 30703431 pubmed.ncbi.nlm.nih.gov/30703431/.

UKernan WN, Ovbiagele B, Black HR, et al. Imihlahlandlela yokuvinjelwa kwesifo sohlangothi ezigulini ezinesifo sohlangothi kanye nokuhlaselwa yischemic okwedlulayo: umhlahlandlela wabasebenzi bezempilo abavela e-American Heart Association / American Stroke Association. Unhlangothi. 2014; 45 (7): 2160-2236. I-PMID: 24788967 pubmed.ncbi.nlm.nih.gov/24788967/.

UMeschia JF, uBushnell C, uBoden-Albala B, et al. Imihlahlandlela yokuvimbela okuyinhloko ukushaywa unhlangothi: isitatimende sabasebenzi bezempilo abavela e-American Heart Association / American Stroke Association. Unhlangothi. 2014; 45 (12): 3754-3832. I-PMID: 25355838 pubmed.ncbi.nlm.nih.gov/25355838/.

URiegel B, uMoser DK, uBuck HG, et al; Umkhandlu Wenhlangano Yezinhliziyo ZaseMelika Wobuhlengikazi Benhliziyo Nemithambo Stroke; Umkhandlu wezifo zemithambo yegazi; kanye noMkhandlu Wocwaningo Lwekhwalithi Yokunakekelwa Nemiphumela. Ukuzinakekela ukuvimbela nokuphathwa kwesifo senhliziyo nemithambo yegazi: isitatimende sesayensi sabasebenzi bezempilo abavela e-American Heart Association. J Am Inhliziyo Assoc. 2017; 6 (9). pii: e006997. I-PMID: 28860232 pubmed.ncbi.nlm.nih.gov/28860232/.

U-Wein T, iLungu lePhalamende laseLindsay, uCôté R, et al. Izincomo zomkhuba ongcono kakhulu waseCanada: Ukuvinjelwa kwesifo sohlangothi, imihlahlandlela yokusebenza yesithupha, ukubuyekeza 2017. Int J Stroke. 2018; 13 (4): 420-443. I-PMID: 29171361 pubmed.ncbi.nlm.nih.gov/29171361/.

UWhelton PK, uCarey RM, u-Aronow WS, et al. I-2017 ACC / AHA / AAPA / ABC / ACPM / AGS / APhA / ASH / ASPC / NMA / PCNA Guideline yokuvimbela, ukuthola, ukuhlola nokuphatha umfutho wegazi ophezulu kubantu abadala: umbiko we-American College of Cardiology / American I-Heart Association Task Force kumihlahlandlela yokusebenza kwemitholampilo. UJ Am Coll Cardiol. I-2018; 71 (19): e127-e248. I-PMID: 29146535 pubmed.ncbi.nlm.nih.gov/29146535/.

UWilson PWF, uPolonsky TS, uMiedema MD, uKhera A, uKosinski AS, uKuvin JT. Ukubuyekezwa okuhlelekile kwe-2018 AHA / ACC / AACVPR / AAPA / ABC / ACPM / ADA / AGS / APhA / ASPC / NLA / PCNA umhlahlandlela wokuphathwa kwe-cholesterol yegazi: umbiko we-American College of Cardiology / American Heart Association Task Force ku-Clinical Practice Guidelines [ukulungiswa okushicilelwe kuvela ku-J Am Coll Cardiol. 2019 Juni 25; 73 (24): 3242]. UJ Am Coll Cardiol. 2019; 73 (24): 3210-3227. I-PMID: 30423394 pubmed.ncbi.nlm.nih.gov/30423394/.