Qaphela iingqondo ze-cardiologists ezicinga "ngendlela yendabuko"
Indlela esicinga ngayo ngeCoronary Artery Disease (CAD) kwaye unyango lwayo luphakathi kwenguqu enkulu, kwaye namhlanje, ezinye izazi ze-cardiologists zatshintshile ngokupheleleyo "kwindlela entsha" yokucinga, ngelixa abanye basabambelele 'kwindlela yendabuko . " Ukwahlukana phakathi kwezi zikolo zimbini zengcamango zicacisa kakhulu iingxoxo ezikhoyo ngoku phakathi kweengcali ze-cardiovascular about who will test for CAD, indlela yokuvavanya, abafuna ukuphathwa nge-CAD, nendlela yokuphatha ngayo.
Ngelishwa, oogqirha basoloko bexhamla ngendlela yendabuko yokulahleka bayaphonya isikhephe - kwaye ngenxa yoko, baxhomekeke kwizigulane zabo kwiimeko zombini kunye nokunyamekela.
Indlela yeNdlela yokuCinga ngeCAD
Ngokwesiko, i-CAD ithetha ukuba kukho enye into okanye izithintelo ezingaphezulu kwiimitha ze- coronary . Ezi zithintelo zingaphaya ukukhawuleza kwegazi, ezinokuvelisa i-angina (ukungazinzi esifubeni), kwaye, ukuba kunzima, i-blockages inokupheliswa ngokukhawuleza, kubangele intliziyo ye-muscle ihlinzekwe ngulo mzobo wokufa, obizwa ngokuba yi- "myocardial infarction" okanye isifo senhliziyo . Ekubeni ingxaki ephambili kukukhutshwa, unyango oluphambili lukunciphisa ukukhutshwa, okunokuthi kwenziwe ngokuhlinzwa ngonyango okanye ukugqithisa . Umbono wendabuko we-CAD, ngoko, ugxininise kwiimpawu zokubakho, oku kuthetha ukuba indawo ye-anatomic ecacileyo kunye neqondo lokubaluleka kubalulekile ekuhloleni i-CAD. Iimvavanyo zokuxilonga ezinganikezeli ngolu lwazi kunye nopilisi olungagqithisi izicwangciso zengqinqwane.
I-Cardiologist ezicinga ngokuqhelekileyo zifuna ukugxininisa kwi- catheterizations yenyama njengesivivinyo esaneleyo sokuxilonga kunye nokunyamezela njengonyango olwaneleyo kuphela, nangona kunjalo bayakuvumela ukuba ngamanye amaxesha ugqirha wezinyango kufuneka ube negalelo kwiindawo ezinqabileyo okanye ezinzima.
Indlela entsha yokucinga malunga neCAD
Ngoku siyazi ukuba i-CAD ingaphezulu kakhulu kunokuba i-blockages kuphela. I-CAD isifo esingasigxina, isifo esiqhubekayo esivame ukusabalalisa kakhulu kwiimitha ze-coronary arteries ngaphezu kokubonakaliswa kubukho okanye ukungabikho kwezicwangciso zangempela. Iiplanga zihlala zikhona kwimithambo ebonakalayo "eqhelekileyo" kwi- catheterization yenyama . Enyanisweni, ezinye izigulane, ingakumbi abasetyhini , zingaba ne-CAD ephakamileyo evelisa ukucuthwa kwemida ye-coronary. Ukongezelela koko, ukuhlaselwa kwentliziyo kuveliswa xa i-plaque iphuka kwaye ibangela i-clot ukuba yenze ngokukhawuleza ikhuphe i-artery-kwaye ngokuqhelekileyo oku kwenzeka kwiiplathi ezingabangela ukuba i-blockages ngaphambi kokuphuka kwayo kwaye ibiza kuthiwa "ayibalulekanga" kwi-catheterization yenyama. Isihluthulelo kwi-CAD asikho nokuba imimiselo ethile ikhona, kodwa ingaba iiponti zeeronta (eziqhelekileyo azibangeli iibhloko eziphambili) zikhoyo.
Yintoni oku kuthetha ngayo kuwe
Nangona iinjongo zangempela ziyakwenza kwaye zibangele i-angina kunye neentliziyo kwaye kunye nelokuba ukuphatha izibhengezo ezithile kubaluleke kakhulu, unyango olujoliswe ekupheni i-blockages kaninzi alukho mfuneko okanye alanele ukhathalela ngokwaneleyo i-CAD. Ubungqina bakha ukuba unyango olunzulu lwezokwelapha - ngokusekelwe kwiimimiselo kodwa kubandakanya ukuguqulwa kwezinto ezinobungozi -CAD inokunqanyulwa okanye ibuye iguqulwe, kwaye iipliti "zinokuzinza" ukunciphisa iingxaki eziza kutshabalalisa.
Kula bantu, uqeqesho , ukuyeka ukutshaya , ukulahleka kwesisindo, ukulawula uxinzelelo lwegazi kunye (ezininzi iingcali zikholelwa) ukulawulwa kwe-cholesterol kubaluleke kakhulu.
I-key, ke, kukuthatha isigqibo sokuba ngaba umntu unokuthi abe neCAD esebenzayo, oko kukuthi, nokuba iiplathi ziyakhona ukuba zikho, kwaye zize zitshintshe unyango ngokufanelekileyo. Kwinqanaba elincinane, ukugqiba ukuba ngaba iiplathi zinokwenzeka ukuba zikhona zingenziwa ngokungenasiphelo. Qalisa ngovavanyo olulula lomngcipheko wokuthatha isigqibo sokuba ingaba umngcipheko uphantsi, uphakathi okanye uphezulu. ( Nantsi indlela yokuvavanya umngcipheko wakho ngokulula nangokulula .) Abantu abakwiindawo ezinobungozi obuphantsi mhlawumbi abadingeki ukuba bangenelele ngoncedo.
Abantu abakwiindawo ezinobungozi obuphezulu kufuneka baphathwe kakubi (kunye nemimiselo ye-statins kunye nokuguqulwa kwezinto ezinobungozi), njengoko kunokwenzeka ukuba babe namacwecwe. Abantu abakwiqela elijongene nomngcipheko kufuneka baqwalasele ukuhlolwa okungenakuvakalayo kunye nokukhangela kwe-EBT (i-calcium scans) : ukuba i-calcium deposits ikhona kwiimitha ze-coronary, zineempawu kwaye kufuneka ziphathwe kakubi.
Nini ukufuna i-Blockages
Izibhengezo kwimibhobho ye-coronary isabalulekile. Uninzi lweengcali zicinga ukuba abantu abakwizinga eliphezulu kakhulu banokuxilongwa kovavanyo lwe-thallium . Ukuba olu vavanyo lubonisa ukukhutshwa okukhulu, ukucwitshiswa kwemizimba kufuneka kuqwalaselwe. Uvavanyo loxinzelelo okanye ukunyanyiswa komzimba kufuneka kuqwalaselwa ngokunyanisekileyo nakubani na umntu (nokuba yeyiphi inqanaba elibonakalayo lomngcipheko) onempawu ze-angina. Ukunciphisa izithintelo ngokuhlinzwa okanye ukugulisa kunokusebenza ngokugqithiseleyo ekuphatheni i- angina kwaye, kwezinye iimeko, kunokuphucula ukuphila.
Isishwankathelo
Ukucinga kwethu ngeCAD kuye kwatshintsha kakhulu kwixesha elidlulileyo elishumi elidlulileyo. Akusiyo nje isifo se-blockages esifanele siphathwe ngeentsholongwane. Unyango olujoliswe ekumisekeni okanye ekuguquleni i-CAD engapheliyo kunye nakwiindawo ezizinzileyo zokunciphisa iingxaki eziza kutshabalalisa, kubaluleke kakhulu, nokuba ngaba "iinjongo" ezikhoyo okanye zikhona.
Imithombo:
Igunya loKwenziwa kweeNkonzo ze-US. Ukuhlolwa kwesifo se-heart coronary: isitatimenti sokuphakamisa. Ann Intern Med 2004; 140 (7): 569.
Naghavi M, Falk E, Hecht HS, et al. Ukususela kwi-plaque engathintekiyo kwisigulane esinobuthathaka: Icandelo III. Ukuzisa iparadi entsha yokuthintela ukuhlasela kwentliziyo; ukuchongwa kunye nokunyangwa kwesigulane esichengeni. Ukujonga i-Heart Attack Ukukhusela kunye ne-Education (SHAPE) ingxelo yeqela lokusebenza. Isishwankathelo sebhunga. Ngaba uJ Cardiol 2006; INGXELO: 10.1016.