I-Coronary artery disease (i-CAD) yimeko apho i- plaque ikwakhiwa kwiindonga zeetriyari ze- coronary (izitya ezinikezela igazi kwi-muscle ye-heart). Ezi zihlabayi zinganciphisa intsimbi ngokukhawuleza, okanye zikwazi ukuphazamiseka ngokukhawuleza, kubangele ukuba kubekho umqobo onzima. Ngenxa yokuba isisu senhliziyo sidinga ukunikezela ngokuqhubekayo kwe-oxygen kunye nezondlo ukuze kuphile, ukuphazamiseka komthambo we-coronary ngokukhawuleza kukhokelela kwiingxaki ezibalulekileyo.
I-CAD ibangelwa yi- atherosclerosis . I-atherosclerosis yimizimba engapheliyo, eqhubekayo yeemithwayilo apho iifomethi ze-cholesterol, i-calcium, kunye neeseli ezingaqhelekanga (oko kukuthi, iiplates) zakha kwi-lining inside yeetriyri.
Iimpembelelo zeAtrosclerosis
Ezi zifake ziyakwenza ukuba kube nzima ukunyanzelisa umthamo, kwaye ngenxa yoko, ukuphuma kwegazi kumbindi kuya kuba nzima. Xa ukukhutshwa kuba nzima ngokwaneleyo, isigulane sinokufumana i-angina.
U-Angina ubhekisela kwiimpawu onokuzifumana naluphi na ixesha i-heart muscle ayifumana ukuhamba kwegazi okwaneleyo kwiimitha ze-coronary. U-Angina uvame ukuziva ehlelekile (ngokuqhelekileyo intlungu enjengexinzelelo) ngaphakathi okanye ejikeleze esifubeni, amahlombe, intamo okanye iingalo.
I-angile ene-stina yinto engumngeni eyenzeka kwimoya eqikelelwa, ngokukodwa, ngokuzikhandla okanye emva kokutya okukhulu. U-angina ozinzile ngokubanzi uthetha ukuba i-plaque iye yaba enkulu ngokwaneleyo ukuvelisa umqobo wecala lomthambo.
Xa umntu ogxininisiweyo angina ephumla, umthamo ovalwe ngokukodwa unako ukuhlangabezana neemfuno zesisu senhliziyo. Kodwa xa loo mntu eqhuba, (okanye unomnye uxinzelelo olwenza intliziyo isebenze nzima), ukukhutshwa kuthintela ukwanda okwaneleyo ekuphumeni kwegazi ukuya kwisifo senhliziyo, kwaye i-angina ivela.
U-angina ozinzile ngokuqhelekileyo uthetha apho kukho i-plaque ebalulekileyo kwi-coronary artery ephazamisa ngokukhawuleza ukuhamba kwegazi.
Ukongezelela kokubangela ukuphazamiseka ngokunyuka okuthe ngcembe ngobukhulu babo, iiplathi nazo ziyaxhomekeka ngokukhawuleza, ezinokuvelisa ngokukhawuleza. Izimo zonyango ezibangelwa ukuphuka kweplathi zibhekiswa njenge- Acute Coronary Syndrome (ACS). I-ACS ihlala ixakeka kwizonyango .
I-angina engaqinisekanga yinto enye ye-ACS. I-angina engaqinisekanga iyenzeka xa i-plaque iphukile ngokukhawuleza, kubangele ukuqhubeka ngokukhawuleza kokucinywa kwintsimbi. Ngokwahlukileyo kwi-angina ezinzileyo, iimpawu zengqondo engaqinisekanga zenzeke ngokungaqinisekiyo, (oko kukuthi, abaxhomekeke ngokukodwa ekusebenziseni okanye ukuxinezeleka), kwaye ngokukodwa, bavame ukuba khona. (Elinye igama le-angina elingaqinisekiyo "liphumla i-angina.") Izigulane ezingenazinyathelo ezingaqinisekiyo zisengozini enkulu yokuphuhliswa kobungozi be-coronary artery, okukhokelela kwisifo se-myocardial infarction .
I-infyoction ye-Myocardial , okanye ukuhlaselwa kwentliziyo, yindlela ebaluleke kakhulu ye-ACS. Apha, i-plaque ephuliweyo ibangela i-totality (okanye i-total totality) ye- artery coronary , ukwenzela ukuba intlungu yesifo esinikezwa yilo mzobo uyafa. Ngoko ke, ukuhlaselwa kwentliziyo, ukufa kwesisu senhliziyo.
Ubungakanani be- infyoction ye-myocardial buxhomekeka ngokukodwa malunga nokuba isifo senhliziyo sisweleke kangakanani. Ukuhlaselwa kwentliziyo encinci yinto enye inxalenye encinci yesifo senhliziyo esifa. Ukuhlaselwa kwenhliziyo enkulu yinto apho inxalenye enkulu yeesifo senhliziyo ifa.
Ukuba isigulane sithobela ingqalelo kwizonyango kwiiyure ezimbalwa zokuqala kwesifo senhliziyo, ubukhulu beentliziyo zancitshiswa ngokulawula " izidakamizwa ezitshatyalaliswayo ," okanye ngokwenza i- angioplasty esheshayo (kwaye idla ngokukhawuleza) ukuvula umzobo ovaliweyo.
Emva kokusinda kwesifo senhliziyo, isiguli sisasengozini. Ukuhlaselwa kweentliziyo ezininzi kunokwenzeka ukuba ezinye iiplati zikhona kwiimitha ze- coronary .
Kananjalo, kuxhomekeke kwisixa senhliziyo esonakele, isigulane sinokuphuhliswa kwentliziyo . Ukongezelela, isisu senhliziyo esonakalisiweyo singabangela ukungazinzi ngokusisigxina kwinkqubo yamandla kagesi , oku kunokukhokelela ekubanjweni kwantliziyo ngokukhawuleza . Ngoko emva kokuhlaselwa kwentliziyo, zonke ezo mngcipheko kufuneka zihlolwe ngenyameko, kwaye kufuneka amanyathelo athathwe ukuze anciphise nganye yile mngcipheko kunokwenzeka kakhulu. Nantsi ingcaciso engakumbi ekunciphiseni umngcipheko emva kokusinda kwenhliziyo .
Ukuthintela NgumGcisa
Indlela efanelekileyo yokujongana nesifo somgubo , ngokuqinisekileyo, kukukhusela. Sonke kufuneka senze konke esinakho ukunciphisa iimeko zeengozi zeCAD .
Kwabo sele benako i-CAD, ukunciphisa loo mingcipheko mngcipheko kubaluleke ngakumbi, ukwenzela ukunciphisa ukuqhubela phambili kwesi sifo. Ukongezelela, kukho iindlela ezininzi zokuphatha i-CAD, kubandakanywa ukwelashwa kweziyobisi , unyango ophuculwayo, kunye ne-angioplasty kunye ne-stenting. Unyango lweCAD luhlala ludinga ukuba lube ngumntu ngamnye, kwaye unyango olufanelekileyo luxhomekeke ekuqwalaselweni ngononophelo kwazo zonke iindlela, ngoogqirha kunye nesigulane.
> Imithombo
> McGovern, PG, Pankow, JS, Shahar, E, et al. Iimpawu zangoku kwiiNtliziyo zeCoronary Heart Acute - Ukufa, ukuNgcwaba, ukunakekelwa kwezonyango, kunye neengxaki zobungozi. Uphando lweeNtsholongwane zeNhliziyo yaseMinnesota. N Engl J Med 1996; 334: 884.
> Rosamond, WD, Chambless, LE, Folsom, AR, et al. Iintlobo zeNkcazo yeMyocardial Infarction kunye nokufa ngenxa yeCoronary Heart Disease, ngo-1987 ukuya ngo-1994. N Engl J Med 1998; 339: 861.