I-acute coronary syndrome

I-acute coronary syndrome iyigama leqembu lezimo eziyeka ngokungazelelwe noma zehlise kakhulu igazi ekubeni ligobhozele emisipheni yenhliziyo. Lapho igazi lingakwazi ukugeleza liye emsipheni wenhliziyo, imisipha yenhliziyo ingalimala. Ukuhlaselwa yinhliziyo kanye ne-angina engazinzile womabili la ma-coronary syndromes abucayi (ACS).

Into enamafutha ebizwa ngokuthi i-plaque ingakha emithanjeni eletha igazi elinomoya-mpilo enhliziyweni yakho. Uqwembe lwakhiwe nge-cholesterol, amafutha, amaseli nezinye izinto.

I-plaque ingavimba ukugeleza kwegazi ngezindlela ezimbili:

• Kungadala ukuthi umthambo ube mncane ngokuhamba kwesikhathi uze uvinjwe ngokwanele ukudala izimpawu.
• Uqweqwe lukhala ngokuzumayo bese kuba nehlule legazi elizungeze lona, ​​linciphise kakhulu noma livimbe umthambo.

Izici eziningi zobungozi besifo senhliziyo zingaholela ku-ACS.

Uphawu oluvame kakhulu lwe-ACS ubuhlungu besifuba. Ubuhlungu besifuba bungafika ngokushesha, buze buhambe, noma buba bukhulu ngokuphumula. Ezinye izimpawu zingabandakanya:

• Ubuhlungu ehlombe, engalweni, entanyeni, emhlathini, emuva, noma esiswini
• Ukungakhululeki okuzizwa njengokucindezela, ukucindezela, ukuchoboza, ukushisa, ukuklinya, noma ukuqaqamba
• Ukungakhululeki okwenzeka lapho uphumule futhi akusuki kalula lapho uphuza umuthi
• Ukuphelelwa umoya
• Ukukhathazeka
• Isicanucanu
• Ukujuluka
• Ukuzizwa unesiyezi noma unekhanda elikhanyayo
• Ukushaya kwenhliziyo okusheshayo noma okungajwayelekile

Abesifazane nabantu abadala bavame ukuhlangabezana nalezi ezinye izimpawu, yize ubuhlungu besifuba bujwayelekile nakubo.

Umhlinzeki wakho wokunakekelwa kwezempilo uzokwenza isivivinyo, alalele isifuba sakho nge-stethoscope, abuze ngomlando wakho wezokwelapha.

Ukuhlolwa kwe-ACS kufaka:

• I-Electrocardiogram (ECG) - I-ECG imvamisa isivivinyo sokuqala udokotela wakho azosisebenzisa. Ilinganisa umsebenzi kagesi wenhliziyo yakho. Ngesikhathi sokuhlolwa, uzoba namaphakethe amancane afakwe esifubeni sakho nakwezinye izindawo zomzimba wakho.
• Ukuhlolwa kwegazi - Okunye ukuhlolwa kwegazi kusiza ukukhombisa imbangela yobuhlungu besifuba nokubona ukuthi usengozini enkulu yokuhlaselwa yisifo senhliziyo. Ukuhlolwa kwegazi le-troponin kungakhombisa ukuthi ngabe amaseli asenhliziyweni yakho awonakele yini. Lokhu kuhlolwa kungaqinisekisa ukuthi unesifo senhliziyo.
• I-Echocardiogram - Lokhu kuhlolwa kusebenzisa amaza omsindo ukubheka inhliziyo yakho. Kukhombisa ukuthi inhliziyo yakho yonakele futhi ungathola izinhlobo ezithile zezinkinga zenhliziyo.

I-Coronary angiography ingenziwa ngokushesha noma lapho uzinzile ngokwengeziwe. Lokhu kuhlolwa:

• Isebenzisa udayi okhethekile nama-x-ray ukubona ukuthi igazi ligeleza kanjani enhliziyweni yakho
• Kungasiza umhlinzeki wakho anqume ukuthi imiphi imishanguzo oyidingayo ngokulandelayo

Ezinye izivivinyo zokubuka inhliziyo yakho ezingenziwa ngenkathi usesibhedlela zifaka:

• Ukuzivocavoca umzimba
• Ukuhlolwa kwengcindezi yenukliya
• Ukucindezela i-echocardiography

Umhlinzeki wakho angasebenzisa imithi, ukuhlinzwa, noma ezinye izinqubo zokwelapha izimpawu zakho nokubuyisela ukugeleza kwegazi enhliziyweni yakho. Ukwelashwa kwakho kuncike esimweni sakho kanye nenani lokuvinjelwa emithanjeni yakho. Ukwelashwa kwakho kungafaka:

• Imithi - Umhlinzeki wakho angakunika uhlobo olulodwa noma eziningi zemithi, kufaka phakathi i-aspirin, i-beta blockers, ama-statin, izinciphisi zegazi, izidakamizwa eziqothula amahlwili, i-Angiotensin eguqula i-enzyme (ACE) inhibitors, noma i-nitroglycerin. Le mithi ingasiza ekuvikeleni noma ekuqhekekeni kwegazi, yelaphe umfutho wegazi ophakeme noma i-angina, iqede izinhlungu zesifuba, futhi izinze inhliziyo yakho.
• I-Angioplasty - Le nqubo ivula umthambo ovalekile usebenzisa ithubhu ende, ezacile ebizwa ngokuthi i-catheter. Ishubhu lifakwa emthanjeni bese umhlinzeki efaka ibhaluni elincishisiwe elincishisiwe. Ibhaluni ligcwele ngaphakathi komthambo ukuze ulivule. Udokotela wakho angafaka ithubhu yocingo, ebizwa ngokuthi i-stent, ukugcina umthambo uvulekile.
• Ukuhlinzwa nge-Bypass - Lokhu ukuhlinzwa ukuhambisa igazi elizungeze umthambo ovinjiwe.

Wenza kahle kangakanani ngemuva kwe-ACS kuya ngokuthi:

• Usheshe welashwe
• Inani lemithambo evinjelwe nokuthi kubi kangakanani ukuvinjelwa
• Ukuthi inhliziyo yakho ilimele noma cha, kanye nobukhulu nendawo okukhona kuyo umonakalo, nokuthi kuphi umonakalo

Ngokuvamile, lapho umthambo wakho uvuleka ngokushesha, kulimala kancane enhliziyweni yakho. Abantu bavame ukwenza kahle kakhulu lapho umthambo ovinjiwe uvulwa kungakapheli amahora ambalwa kusukela lapho kuqala izimpawu.

Kwezinye izimo, i-ACS ingaholela kwezinye izinkinga zempilo kufaka phakathi:

• Isigqi senhliziyo esingajwayelekile
• Ukufa
• Isifo senhliziyo
• Ukwehluleka kwenhliziyo, okwenzeka lapho inhliziyo ingakwazi ukumpompa igazi elanele
• Ukuqhekeka kwengxenye yemisipha yenhliziyo ebangela i-tamponade noma ukuvuza okukhulu kwe-valve
• Unhlangothi

I-ACS yisimo esiphuthumayo sezokwelapha. Uma unezimpawu, shayela ku-911 noma inombolo yakho ephuthumayo yasendaweni ngokushesha.

UNGENZI:

• Zama ukushayela ngokwakho esibhedlela.
• Linda - Uma uhlaselwa yisifo senhliziyo, usengozini enkulu yokufa ngokuzumayo ngezikhathi zokuqala.

Kuningi ongakwenza ukusiza ukuvimbela i-ACS.

• Yidla ukudla okunempilo enhliziyweni. Yiba nezithelo eziningi, imifino, okusanhlamvu okuphelele, nenyama engenamafutha. Zama ukunciphisa ukudla okunamafutha amaningi anele, ngoba iningi lalezi zinto lingavala imithambo yakho yegazi.
• Vivinya umzimba. Hlela ukuthola okungenani imizuzu engama-30 yokuvivinya umzimba ngokulingene izinsuku eziningi zesonto.
• Yehlisa isisindo, uma ukhuluphele ngokweqile.
• Yeka ukubhema. Ukubhema kungalimaza inhliziyo yakho. Buza udokotela wakho uma udinga usizo lokuyeka.
• Thola ukuhlolwa kokuvikela impilo. Kufanele ubone udokotela wakho ukuze ahlolwe i-cholesterol ejwayelekile kanye nomfutho wegazi futhi ufunde ukuthi ungazigcina kanjani izinombolo zakho zihloliwe.
• Phatha izimo zezempilo, ezifana nomfutho wegazi ophakeme, i-cholesterol ephezulu, noma isifo sikashukela.

Isifo senhliziyo - i-ACS; I-infarction ye-myocardial - i-ACS; I-MI - ACS; I-MI enamandla - i-ACS; I-ST elevation infarction ye-myocardial - ACS; I-infarction ye-non ST-elevation myocardial - i-ACS; I-angina engazinzile - i-ACS; Ukusheshisa i-angina - ACS; I-Angina - engazinzile-ACS; I-angina eqhubekayo

I-Amsterdam EA, uWenger NK, uBrindis RG, et al. Umhlahlandlela we-2014 AHA / ACC wokuphathwa kweziguli ezine-non-ST-elevation acute coronary syndromes: umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice. UJ Am Coll Cardiol. 2014; 64 (24): e139-e228. I-PMID: 25260718 pubmed.ncbi.nlm.nih.gov/25260718/.

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.

U-Eckel RH, uJakicic JM, u-Ard JD, et al. Umhlahlandlela we-2013 AHA / ACC wokuphathwa kwendlela yokuphila ukunciphisa ubungozi benhliziyo: umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice. Ukujikeleza. 2014; 129 (25 Suppl 2): ​​S76-S99. I-PMID: 24222015 pubmed.ncbi.nlm.nih.gov/24222015/.

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: isifinyezo esiphezulu: umbiko we-American College of Cardiology Foundation / American Heart Association Task Force on Guidelines Practice. Ukujikeleza. 2013; 127 (4): 529-555. I-PMID: 23247303 pubmed.ncbi.nlm.nih.gov/23247303/.

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.

USmith SC Jr, uBenjamin EJ, uBonow RO, et al. Ukwelashwa kwesibili kokuvikela nokunciphisa ubungozi kwe-AHA / ACCF kweziguli ezine-coronary nezinye izifo ze-atherosclerotic vascular: isibuyekezo se-2011: umhlahlandlela ovela ku-American Heart Association nase-American College of Cardiology Foundation. Ukujikeleza. 2011; 124 (22): 2458-2473. I-PMID: 22052934 pubmed.ncbi.nlm.nih.gov/22052934/.