Iintlobo ezi-3 zeeronta ezikhawulezayo
Ukuba wena okanye umthandayo unesifo se-coronary disease (CAD) , usenokuba ulivile igama elithi "i-coronary syndrome", ebizwa ngokuba yi-ACS. I-ACS iyona gama elitsha elisetyenziswa ngama-cardiologist, kwaye lingadideka kakhulu. Nangona kunjalo, kuba limela indlela entsha yokucinga malunga neCAD , kunokunceda ukuthatha imizuzu embalwa ukuyiqonda.
Isifo se-coronary syndrome esilungileyo sininzi kakhulu into evakalelwa ngayo.
Yimeko ephuthumayo echaphazela iiroriyali ze-coronary; ngxakeko. Kubonisa ukuba i-CAD yomntu ivele ibe engaqiniseki ngokukhawuleza, kwaye umonakalo ohlala unomdla wenyama unokwenzeka okwangoku okanye unokuthi uyenze naxa naliphi na ixesha.
Yintoni i-ACS?
I-ASC iyenzeka xa i-clot yegazi igqithisa ngokukhawuleza ngaphakathi kwintsimbi ye-coronary , ngokuqhelekileyo ngenxa yokuphuka koluhlu lwe- atherosclerotic plate . Ukuphuka kwe-Plaque kunokwenzeka nanini na, ngokuqhelekileyo ngokupheleleyo ngaphandle kwesixwayiso. I-clot yegazi ingabangela ukukhutshwa okukhethiweyo okanye okuphelileyo kwintsimbi, nokuba yintoni indlela yokubeka intloko yenhliziyo eyenziwa yilo mzobo ngokukhawuleza.
Naliphi na iplati kuyo nayiphi na i-coronary artery ixhomekeka, kunye neentlanzi ezincinci eziqhelekileyo ezingayinaki i-cardiologists ngexesha le- catheterizations ye-cardia . Yingakho udla ngokuva abantu abane- infyoction ye-myocardial (MI, okanye ukuhlaselwa kwentliziyo), kungekudala emva kokuba batshelwe i-CAD yabo "ayibalulekanga."
Iimpawu ze-ACS
Iimpawu ze-ACS zifana nezo zi- angina ezizinzile kodwa zihlala zikhulu kakhulu, zihlala ziqhubeka kwaye ziqhubeka. Ukungahambi kakuhle kwesifuba kwi-ACS kudla ngokuhambisana nezinye iimpawu eziphazamisayo ezifana nokukhupha, ukuxakeka, ukuxhalaba, ukuxhalabisa, kunye noko kudla ngokuchazwa "njengento evelayo." Intlungu yesifuba ayinakufunyanwa ngu- nitroglycerin (ngokuqhelekileyo ikhupha i-angina eqinile).
Ngakolunye uhlangothi, abanye abantu abane-ACS baya kuba neempawu ezichukumisayo kuphela, banokungakwazi ukuphawula nayiphi na impawu kuwo wonke - ubuncinane ekuqaleni.
Ngelishwa, umonakalo wentliziyo esisigxina ovame ukuphumela kwi-ACS, kungekudala okanye kamva, ivelise iimpawu.
Iintlobo ze-ACS
I-Cardiologists ihlula i-ACS kwiipatheni ezintathu zeklinikhi ezihlukileyo. Ezimbini zazo zimelela iintlobo ezahlukeneyo ze-MI, kwaye enye ibonisa uhlobo olubi kakhulu lwe-angina, ebizwa ngokuthi "angina engaqinisekanga." Zonke ezi zintathu zibangelwa amaqabunga egazi aphezulu kwiimitha ze-coronary.
Ukuba i-clot yegazi ikhulu ngokwaneleyo kwaye iqhubeka ingaphezu kwemizuzu embalwa, ezinye zeeseli zeentliziyo zithoma ukufa. Ukufa kwesisu senhliziyo yintoni ichaza i-MI. Iindidi ezimbini ze-MI ezinokuveliswa yi-ACS.
- I-ST-Elevation myocardial infarction (STEMI) , eqanjwe ngokuba igama elithi "ST segment" kwi- ECG ibonakala "liphakanyisiwe," lwenzeka xa i-artery coronary ivalwe ngokupheleleyo ukwenzela ukuba inxalenye enkulu yemisipha yenhliziyo ihlinzekwe ngulo mzobo uqala ukufa I- STEMI yindlela ephezulu kakhulu ye-ACS.
- Ukungena kwe-ST-Elevation myocardial infarction (NSTEMI) , apho "i-ST segment" engakhuphukiyo, kwenzeka xa ukucinywa kwintsimbi ye-coronary "kuphela" inxenye. Ukukhutshwa okwaneleyo kwenzeke ukulimaza ezinye zeeseli zentliziyo ezinikwa ngumzobo wesifo, kodwa umonakalo uhlala ungaphantsi kuneS STEMI. Enye ingxaki nge- NSTEMI , nangona kunjalo, kukuba ukunganyaniseki unyango luya kuzaliswa, kwaye i-NSTEMI iya kuba yi-STEMI.
- Maxa wambi i-ACS ivelisa i-clot yegazi engekabi ngokwaneleyo. okanye akaphiki ixesha elide, ukuvelisa nayiphi na umonakalo wentliziyo yesigxina. (Izindlela zokukhusela zomzimba zama ukuchitha iifom zegazi ezenza imithwalo yegazi.) Xa i-ACS ivelisa iimpawu ngaphandle kokwenza ukuba imisipha yintliziyo ife, ibizwa ngokuba yi- angina engaqinisekanga . Abantu abane-angina engaqinisekanga banomngcipheko omkhulu wokuqhubela phambili kwi-NSTEMI okanye kwi-STEMI.
Zombini i-NSTEMI kunye ne-angina engaqinisekanga ingaqwalaselwa njenge-"incomplete" yokuhlaselwa kwentliziyo. Ezi zimbini ze-ACS zifuna ukufana, ukulawulwa kwezobugulane ngenjongo yokunciphisa amathuba okuba baya kuqhubela phambili kwi-STEMI-abaphili be-cardiologists bahlala bebiza "i-MI".
Ukwenza ukuchongwa ngokuchanekileyo kwi-ACS
Ukufingqa, xa iifom zegazi zifakwe kwi-artery coronary, ukuba umonakalo omkhulu weentliziyo zenzeke kakade i-STEMI iyafunyanwa. Ukuba kukho umonakalo we-muscle "omncinci", kwenzeka i-NSTEMI. Ukuba akukho monakalo we-muscle okonakalayo, i-angina engaqinisekiyo ifunyenwe.
Ukuba unayo i-ACS, ngokuqhelekileyo iimpawu zakho, uvavanyo lomzimba, imbali yonyango kunye neemeko zengozi yomzimba ziza kutshintsha ugqirha ngokukhawuleza ukuba uxilongwe. Ukususela kuloo ndawo, uya kuphinda ahlolisise i-ECG yakho kwaye alinganise i-enzyme yakho ye-cardia. Ama-enzyme e-cardiac akhululwa egazini ngokufa kweentsimbi zeentliziyo ezifa, ngoko ukuphakama kwi-enzymes ye-cardiac kuthetha ukuba umonakalo wentliziyo yesimo senzeka.
Ngoko: Ukubonakala kwe-ECG (oko kukuthi, ubukho okanye ukungabikho "kokuphakama" kwi-ST segments) kuya kwahlula phakathi kwe-STEMI ne-NSTEMI. Kwaye ubukho okanye ukungabikho kwee-enzyme eziphezulu ze-cardiac ziya kwahlula phakathi kwe-NSTEMI kunye ne-angina engaqinisekanga.
Ukubaluleka kwe-ACS
Ezi zintathu iintlobo ze-ACS zimela imbonakalo yeemeko zeklinikhi ezinokuthi zenzeke xa i-plaque iphuka ngaphakathi kwimizi ye-coronary. Enyanisweni, akakho umgca ocacileyo ozahlula ngokwahlukileyo i-STEMI, i-NSSTEMI, kunye ne-angina engaqinisekanga. Apho i-cardiologists ibhala umgca phakathi kwe-STEMI kunye ne-NSTEMI, okanye phakathi kwe-NSTEMI kunye ne-angina engaqinisekanga, isigqibo esithintelayo. Enyanisweni, iinkcazo zezi zintathu iintlobo ze-ACS zitshintshile kakhulu kwiminyaka, njengoko ulwazi lwethu - ngokukodwa ukukwazi ukutolika i-ECG kunye nokubona umonakalo we-cell cell kunye neemvavanyo ze-enzyme - ziphucule.
Ingongoma ebalulekileyo kukuba zonke iimeko ze-ACS (kungakhathaliseki ukuba zihlelwe njani) zifuna ukhathalelo lwangonyango ngokukhawuleza ukuzama ukufezekisa izinto ezimbini: 1) ukunciphisa umonakalo wentliziyo yomonakalo owenziwe ngokucacileyo nge-clot yegazi ngaphakathi i-coronary artery, kunye no-2) ukunciphisa ukuba kungenzeka ukuba i-plaque-ngoku ibonakalisa ingazinzi kwaye ilungele ukuphulukana-iya kuphinda iphuke.
> Imithombo
> Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 I-AHA / ACC Isikhokelo soLawulo lwabaguli abanezintlu ezingezo-St-Elevation Ii-Syndromes eziphambili zeCoronary: Isishwankathelo seSigqeba: Ingxelo ye-American College of Cardiology / American Heart Association Task Force on Practice Guidelines. Ukuhamba ngo-2014; 130: 2354.
> I-Pollack CV Jr, iDercks DB, Roe MT; Peterson ED. 2004 I-American College of Cardiology / I-American Heart Association Izikhokelo zoLawulo lwezigulane ezine-St-Elevation Myocardial Infarction: Impembelelo yeSebe eliPhezulu. Ann Emerg Med 2005 Apr; 45 (4): 363-76.