I-angina engaqinisekanga iyisibonelo se- angina esenzeka ngokungaqhelekanga okanye engaqinisekanga kwaye ayihambelani naluphi na uhlobo olubonakalayo olufana nokuzikhandla ngokomzimba okanye uxinzelelo lwengqondo. I-angina engaqinisekanga yindlela ye -coronary syndrome (ACS) , kunye ne-ACS, i-angina engaqinisekanga kufuneka ithathwa njengongxamiseko lwezonyango.
Sibanzi
U-Angina uthathwa njengento "engaqinisekanga" xa engasayi kulandela iipateni eziqikelelweyo eziqhelekileyo " zengqondo ezizinzile ." I-angina engaqinisekanga ihlelwe ngokuthi "ayizinzile" kwiimeko ezimbini.
Okokuqala, ngokungafani ne-angina ezinzileyo, iimpawu zenzeke ngendlela engafanelekiyo kwaye ingalindelekanga. Nangona i-angina ezinzileyo, iimpawu ziza kwenziwa ngokunyamezela, ukukhathala, umsindo, okanye olunye uhlobo lokuxinezeleka, kwiimpawu zengqondo ezingaqinisekanga (kwaye kaninzi ziyenzeka) zenzeke ngaphandle kwezinto ezibonakalayo. Enyanisweni, i-angina engaqinisekanga idla ngokuphindaphindiweyo, kwaye iyakwazi ukuvusa abantu ekuphumeni kokuphumula. Ngaphezu koko, kwi-angina engaqinisekiyo, iimpawu zihlala ziqhubeka ngaphezu kweminye imizuzu embalwa, kwaye i- nitroglycerin ayisoloko ihluleka ukunciphisa intlungu. Ngoko: i-angina engaqinisekiyo "ayizinzile" kuba iimpawu zingenzeka ngokuphindaphindiweyo kunesiqhelo, ngaphandle kwanoma yiyiphi inqaku elibonakalayo, kwaye linokuqhubeka ixesha elide.
Okwesibini, kwaye okubaluleke ngakumbi, i-angina engaqinisekiyo "ayizinzile" kuba, njengezo zonke iifom ze-ACS, zidla ngokubangela ukugqithwa kwe- plaque kwi- artery coronary . Kwi-angina engaqinisekanga, i-plaque ephukile, kunye ne-clot yegazi ephantse idibaniswa nokuqhekeka, ukuvelisa ngokukhawuleza umthamo.
Ukuthintelwa kwesikhashana kungathatha iphethini "yokuguqula" (njengoko i-blood clot ikhula kwaye iyancipha), ivelisa i-angina ezayo kwaye ihamba ngendlela engalindelekanga. Ukuba i-clot ingabangela ukuphazamiseka okupheleleyo komthamo (okwenzeka ngokuqhelekileyo), isisu senhliziyo esinikwe ngulo mzobo ochaphazelekayo usemngciphekweni omkhulu wokugcina umonakalo ongenakuguquka.
Ngamanye amazwi, umngcipheko osondeleyo wokuphela kwe- myocardial infarction uphezulu kakhulu kwi-angina engaqinisekanga. Kucacile ukuba, loo mqathango "ayizinzile," kwaye ngenxa yesi sizathu siphumo esiphuthumayo.
Iimpawu
Nawuphi na onomdla we-coronary artery disease kufuneka akrokre i-angina engaqinisekiyo xa i-angina yabo iqala ukuvela kumaqondo aphantsi okuzikhandla ngokwenyama xa kuqhubeka xa kuphumla xa kuqhubeka ixesha elide kunexesha eliqhelekileyo ukuba kunzima ukukhupha i-nitroglycerin, okanye ngakumbi ukuba libavusa ebusuku.
Abantu abangenayo nayiphi na imbali ye-coronary artery disease bangaphinda bahlakulele i-angina engaqinisekanga. Ngelishwa, aba bantu babonakala bengengozini enkulu yokuhlaselwa yintliziyo ngenxa yokuba, ngokubhekisayo, abaqapheli impawu njengengqondo. Iimpawu ze-classic ze-angina ziquka uxinzelelo lwesifuba okanye intlungu, ngezinye izihlandlo okanye "ezinzima" kumlingani, ngokukhawuleza kuphuma emlanjeni okanye nangengalo ekhohlo. Ngelishwa, ezininzi izigulane ezine-angina azikho iimpawu zakudala. Ukuphazamiseka kwabo kunokuba ngumnene kakhulu kwaye kungenziwa kwindawo yangasemuva, isisu, amahlombe, okanye nayiphi na ingalo zombini. Ukukhathazeka, ukuphefumla, okanye nje ukuvakalelwa kwintliziyo kungabonakali kuphela. Oko kuthetha oko, ngokukodwa, kukuba nabani na ophakathi kweminyaka okanye ngaphezulu, ngokukodwa nabani na unobungozi obuninzi okanye obuninzi obunobungozi be-coronary disease, kufuneka baqaphele iimpawu ezingabonakalisa i-angina.
Ukuba ucinga ukuba kunokwenzeka ukuba unakho u-angina ongaqinisekanga, kufuneka uhambe ugqirha wakho, okanye kwigumbi eliphuthumayo, ngokukhawuleza.
Ukuxilongwa
Iimpawu zibaluleke kakhulu ekwenzeni ukuxilongwa kwe-angina engaqinisekanga, okanye ngokwenene, nayiphi na uhlobo lwe-ACS. Ngokukodwa, ukuba unomnye okanye ngaphezulu kweempawu ezintathu ezilandelayo, ugqirha wakho kufuneka athathe loo nto njengenqaku eliqinileyo elolu hlobo okanye enye ye-ACS eyenzekayo:
- U-Angina ekuphumleni, ngakumbi xa ihlala ngaphezu kwemizuzu engama-20 ngexesha
- I-angina entsha yokuqala ebonisa ngokukhawuleza ukukwazi kwakho ukubandakanya umsebenzi wokusebenza
- Ukwanda kwe-angina engaphambili, eneziqendu eziqhelekileyo, ezihlala zihlala ixesha elide, okanye zenzeke ngokunyanzelela kunokuba ngaphambili
Xa ugqirha wakho egxeka i-ACS, kufuneka afumane ngokukhawuleza i- ECG kunye nokuhlolwa kwegazi malunga nokuhlolwa kwe- enzyme ye- cardia .
Ukuba inxalenye ye-ECG eyaziwa ngokuba yi "ST segments" iphakanyisiwe (ebonisa ukuba umthamo uvinjiwe ngokupheleleyo), kwaye i-enzyme ye-cardiac yandisa (ebonisa umonakalo wentliziyo ye-cardiac), "inkulu" ye-myocardial infarction (MI) ifunyaniswa (ebizwa ngokuba yi "ST-section elevation MI," okanye i- STEMI ).
Ukuba i-ST segments ayinakuphakanyiswa (kubonisa ukuba i-artery ayigciniwe ngokupheleleyo), kodwa i-enzymes ye-cardiac yanda (ibonisa ukuba umonakalo weseli ukhona), i-MI "encinci" iyafunyanwa (ebizwa ngokuba yi "engekho-ST segment MI , "okanye i- NSTEMI ).
Ukuba ii-ST ezingenayo ziphakanyisiwe kwaye i-enzyme iyinto eqhelekileyo (ithetha ukuba umzobo awupheli ngokupheleleyo kwaye akukho monakalo welikhoyo), i-angina engaqinisekiyo ifunyenwe.
Ingqalelo, i-angina engaqinisekanga kunye ne-NSTEMI ziimeko ezifanayo. Kwimeko nganye, ukubhuka kweplathi kuye kwenzeka kwi-artery coronary, kodwa i-artery ayigciniwe ngokupheleleyo ubuncinane ukuhamba kwegazi . Kuzo zombini kwezi meko, iimpawu ze-angina ezinokuthi zikhoyo. Ukwahlukana kuphela kukuba kwi-NSTEMI ngokwaneleyo umonakalo wentliziyo eyenzekayo ukwenzela ukwandisa i-enzymes yenhliziyo. Ngenxa yokuba le miba mibini iyafana, unyango lwabo lufana.
Unyango
Ukuba unakho u-angina ongakhawulekanga okanye iNSTEMI, uya kunyangwa ngeendlela ezimbini ezilandelayo: a) unyame ngokugqithiseleyo ngamachiza ukuzinzisa imeko, kwaye uvavanye ngokungabonakaliyo okanye b) ukuphatha kakubi iziyobisi ukuzinzisa imeko, kwaye ishedyuli yokungenelela kwangaphambili (ngokuqhelekileyo, i- angioplasty kunye ne-stenting).
Imithombo:
Hamm, CW, Braunwald, E. Ukuhlelwa kwe-angina engaqinisekanga. Ukujikeleza 2000; 102: 118.
Meier, MA, Al-Badr, WH, Cooper, JV, et al. Inkcazelo entsha ye-infyoction ye-myocardial: Iziphumo zokuxilonga nokuchazwa kwezigulane ezine-syndromes ezinzulu. Arch Intern Med 2002; 162: 1585.