I-Angina kunye neeArrion Corridary Arteries
I-Cardiac Syndrome X, okanye i-angina e-microvascular, ifumaneka xa umntu ene- angina , enobubungqina bentliziyo ye- heartchemical testing on the stress , kodwa kunye nemithambo ye-coronary artery - catheterization . Kwiimeko ezininzi, i-angina encinci ibangelwa yintlupheko yamasebe amancinci emithambo ye-coronary, apho ezi nqanawa ezincinci zingaphumeleli ngokuqhelekileyo, ngaloo ndlela zivelise ukungabikho kokuphuma kwegazi ukuya kwisifo senhliziyo.
Ekubeni i ingxaki ngoku icinga ukuba iyindawo yangasese emithambo emincinci, igama elidala le-syndrome syndrome X liye laxhaswa lixesha elichazayo, i-angina encinci. Nangona kunjalo, ezinye iingcali zikholelwa ukuba abantu abaneli meko kunokuba babe novelwano olungavamile kwintlungu yesifo senhliziyo.
I-angina ye-microvascular ixhaphake kakhulu kubasetyhini (ngokuqhelekileyo, abafazi be-postmenopausal) kunabantu. Kukho izimbalwa ezinokubangela ukuba kubekho umthamo omncinci obuthathaka obunokuthi ukhona kwi-angina encinci, kubandakanya ukunganyangeki kwe-insulin , ukuvutha, ukunyuka kwemisebenzi ye-adrenalin, ukusilela kwe-estrogen kunye ne- dysautonomia . Kungenzeka ukuba izigulane ezahlukeneyo ezine-microvascular angina zinokuba nezizathu ezahlukileyo.
Nangona abaninzi abantu abane-microvascular angina banesichengululo esifanelekileyo - ekubeni umngcipheko we -coronary syndrome obangelwa yi-microvascular angina iyinto ephantsi - akuqhelekanga ukuba intlungu yesifuba eyenziwa yilo meko ibe yinto ebalulekileyo, kwaye ngezinye izikhathi ikhubaza, ingxaki.
Ukunyanga i-Microvascular Angina
Nanini na xa ubona uluhlu olude lwezonyango ezinokwenzeka kwiimeko ezithile zonyango, luphawu lokuba unyango lube nzima. (Mhlawumbi, kutheni uninzi lwezonyango luye lwazanywa kwindawo yokuqala.) Kunje kunjalo nge-microvascular angina.
Amachiza amaninzi afumanekileyo ancedayo ubuncinane kwizigulane ezine-microvascular angina.
Nangona kunjalo, ekufumaneni unyango "olungcono" kunoma yimuphi umntu onikezelweyo, i-process-and-error method approach often. Oku kuthetha ukuba bobabini abanesifo se-angina ezincinci kunye noogqirha bangadinga ukuba babe nesineke kwaye baqhubeke befuna ukufumana unyango olufanelekileyo.
Nalu uluhlu lwezonyango oluqhelekileyo ezisetyenziselwa ukunyanga i-angina ye-microvascular:
I-Angina Izidakamizwa
- Beta-blockers - ngakumbi i-atenolol
- Abagcini bezithuthi zeCalcium
- Iitrotycerin ngeelwimi eziqhelekileyo zihlala zikhulula i-angina enamandla kwi-angina encinci, kodwa i-nitrate eqhubekayo ayilange iboniswe inzuzo
I-Angina yezidakamizwa ezingaqhelekanga -
- I-Ranolazine - iphumelele kwiinkqubo ezincinci zonyango
- ACE inhibitors - ingakumbi kwizigulane ezinegazi eliphezulu
- I-Ivabradine - nayo isebenzayo kwizilingo ezincinci zekliniki
- Iitatimins - ngakumbi kwizigulane ezinezinga eliphezulu ze-cholesterol
- I-Estrogens - kwindoda yabasetyhini abasemva
- Imipramine - kungekhona isicinga se-angina, kodwa sinokusebenza ngokulawulwa kwintlungu
- i-l-arginine - inokukunceda ukubuyisela ukuhlaziywa okuqhelekileyo kwemithambo encinane yegazi
- Sildenafil (i-Viagra) - engafundanga kakuhle kwi-angina encinci, kodwa inokuthi iphumelele kwabanye abantu
- I-Metformin - inkxaso yeli gciwane ekunyangeni i-angina ye-microvascular i-anecdotal, kwaye ayiqinisekiswa ngedatha yeklinikhi.
Unyango Lonyango
- I-EECP- iboniswe kwisifundo esincinci esisodwa ukuba isebenze kwi-angina encinci
- Ukuvuselela intambo yomgca - kuboniswe ukuba luncedo kwezinye izigulane apho unyango lweziyobisi aluphumelelanga.
- Ukuqeqeshwa ukuqeqeshwa kuye kwaba luncedo kakhulu, ngakumbi kwizigulane ezithandwayo.
Indlela eSebenzayo yokuPhathwa kwe-Microvascular Angina
Ngenxa yokuba zonke ezi zinto zinokwenzeka, ininzi ye-cardiologists izakuzama ukuphucula ukwenziwa kwe-angina ezinokusetyenziswa kweendlela ezinobulumko. Ukuba ulawulo olwaneleyo lweempawu alufumaneki nangayiphi na inyathelo elinikeziweyo, ugqirha kunye nesigulane kuya kutshintshwa kwisinyathelo esilandelayo.
- Isinyathelo 1 sisoloko sisebenzisa i-nitroglycerin yesiqendu ukukhupha iimpawu xa zivela. Inkqubo yokuqeqeshwa ngokwenyama ikhuthazwa kakhulu njengenxalenye yesinyathelo sokuqala. Ukuba le nyathelo ayinikezeli uncedo olwaneleyo:
- Isinyathelo 2 sisoloko sinezela i-beta blocker.
- Inyathelo lesi-3 livame ukumisa i-beta blocker kwaye ithathe indawo ye-calcium channel blocker.
- Isinyathelo 4 sivame ukuzama i ranolazine, nokuba yedwa okanye nge-beta blocker okanye calcium blocker.
- Inyathelo lesi-5 kukuqwalasela ezinye iziyobisi okanye ukongeza uncedo olungekho lonyango, ngokuvuselela intambo yomgudu okanye i-EECP.
Ukongeza kokuthatha amanyathelo afana nalawa, i-ACE inhibitor nayo kufuneka iqwalaselwe ngamandla ukuba i-hypertension ikhoyo, kwaye imimiselo kufuneka iqwalaselwe ngamandla ukuba imingcipheko ye- coronary artery disease ekhoyo. Kubasetyhini abasandul 'ulwaphulo lwe-menopausal, unyango lwe-estrogen lunokuba lufanelekile ukuqwalasela kwakhona.
Ngomonde - mhlawumbi into emnandi yomonde - ulawulo olufanelekileyo lweempawu ekugqibeleni lunokufezekiswa kuninzi lwabantu abane-angina ene-microvascular. Kwaye ngelixa uqhubela phambili ngala ma nyathelo, abantu abane-micro-angcular angina kufuneka bahlale bekhumbula ukuba ukunyanzeliswa kwabo kwexesha elide kulungile kakhulu.
> Imithombo:
> Camici PG, Crea F. Coronary Microvascular Dysfunction. N Engl J Med 2007; 356: 830.
> Eriksson BE, uTyni-Lennè R, uSvedenhag J, et al. Ukuqeqeshwa koMzimba kwi-Syndrome X: UkuQeqesha koBuchule boMgaqo-nkqubo ukuchasana nokuPhupha kwi-Syndrome X. J Am Coll Cardiol 2000; 36: 1619.
> Kaski JC. I-Pathophysiology kunye nokuLawula izigulane ngeCheast Pain kunye neCoronary Arteriograms eziqhelekileyo (I-Cardiac Syndrome X). Uhambo luka-2004; 109: 568.
> Mehta PK, Goykhman P, Thomson LE, et al. I-Ranolazine Iphucula i-Angina kwaBasetyhini ngoBungqina beMyocardial Ischemia kodwa ayikho iCoronary Artery Disease. JACC Cardiovasc Imaging 2011; 4: 514.
Amalungu eBasebenzi, uMontalescot G, Sechtem U, et al. Izikhokelo ze-ESC ze-2013 kwi-Management of Stable Coronary Artery Disease: iQela leMisebenzi kwiCandelo leCononary Artery Disease ye-European Society of Cardiology. I-Eur Heart J 2013; 34: 2949.