Ukuhlolwa koxinzelelo lwe-cardiac, okubizwa ngokuba nokuvavanya umzimba, kunokuba luncedo ekuboneni izibhengezo ezincinci kwimibhobho yakho ye-coronary.
Amaxesha amaninzi, ubukho be- coronary artery disease (CAD) kulula ukuphoswa xa umntu ephumla, kuba ekuphumleni apho akubekho uphawu lweengxaki okanye kwi- ECG . Kule meko, ukungaqhelekanga kwimizimba kungabonakala kuphela xa intliziyo ibuzwa ukuba yenze ngokunyuka komsebenzi.
Uvavanyo loxinzelelo lusetyenziselwa ukuhlola intliziyo kunye neenkqubo ze-vascular ngexesha lokuzivocavoca. Inceda ukuphendula imibuzo emibili ngokubanzi: 1) Ngaba i-CAD ikhona kuphela ebonakalayo xa intliziyo igxininiswe ngumzimba? 2) Ukuba kukho isifo seentliziyo, sinokuba nzima kangakanani na?
Uvavanyo Lokuxinezeleka Lwenziwe Njani?
Okokuqala, uya kubakhokela (iifowuni) kumshini we- ECG unamathele esifubeni sakho, kwaye i-cox blood pressure ifakwe kwingalo yakho. Inzwa efana ne-dressspin ingafakwa kumnwe wakho ukulinganisa inani le-oksijini egazini lakho. Emva kokuba i-ECG isiseko, uya kucelwa ukuba uqale ukwenza umgangatho ophantsi wokuzilolonga, mhlawumbi ngokuhamba ngesitrasi okanye ukuhamba ngebhayisekile. Umsebenzo "ulungiswe" - oko kukuthi, nganye imizuzu emithathu, izinga loqeqesho lwandisiwe. Kwinqanaba ngalinye "lokuzivocavoca, i-pulse yakho, uxinzelelo lwegazi kunye ne-ECG kubhaliweyo, kunye nayo nayiphina impawu onokuyenza.
Uvavanyo lokuxininisa "oluninzi," umgangatho wokuzivocavoca unyuke kancinci uze ungakwazi ukuqhubeka uqhubeka ngenxa yokukhathala, okanye ude ufumane iimpawu ( intlungu yesifuba , ukuphefumula okufutshane , okanye ukukhanya okungapheliyo) okuthintela ukuqhubela phambili, okanye kude kube yintshintsho kwi-ECG yakho ibonisa ingxaki yesifo.
Iimvavanyo zokuxininisa eziphezulu kufuneka zenziwe xa injongo ijonge nawuphi na ubungqina beCAD.
Ngomvavanyo wokuxininisa "ophantsi" , uya kusebenzisana kuphela de kube kufikelelwe izinga lokuzivocavoca. Iimvavanyo ezisemgangathweni zisetyenziselwa kwizigulane ezine-CAD ezaziwayo, ukwenzela ukuba ulinganise ukuba ngaba umgangatho othile wokuzilolonga ungenziwa ngokukhuselekileyo. Olu hlobo lovavanyo luncedo kumgqirha ekucebiseni ngokuchanekileyo ukuba kusetyenziswe kangakanani umthambo umntu onokwenza iCAD ngokuphepha.
Emva kokuvavanywa, uza kuhlolwa kuze kube yiphina impawu elalayo, kwaye kude kube yipulse yakho, uxinzelelo lwegazi kunye ne-ECG ubuyele kwisiseko.
Ziziphi iintlobo zeengqondo zengqondo Ngaba ukuhlolwa koxinezelo kunceda ukuhlola?
Uvavanyo loxinzelelo lusetyenziswa ngokusisiseko ekuxilongweni kweCAD oluvelisa izithintelo kwimibhobho ye-coronary , iirridwe ezinika igazi entliziyweni yentliziyo. Ukuba ukukhutshwa okuyingcipheko kukhoyo, intliziyo yesisu ekhutshwe yilo khuselo oluyingcipheko lunokufumana lonke igazi elilifunayo kwimeko yokuphumla. Kodwa ukuba umntu onokuzikhusela ngokukhawuleza, i-artery ayinakukwazi ukubonelela zonke igazi intliziyo efuna ukuyenza kumgangatho ophezulu ngoku kufuneka.
Xa inxalenye yentliziyo ye-muscle ngokukhawuleza ingafumani ukuhamba kwegazi okwaneleyo, iba yiksijithali-ilambile, okanye i- ischemic .
I-Ischemic heart muscle ibangele ihlasele isifuba (isifo esibizwa ngokuthi " angina ") kunye neenguqu ezibonakalayo kwi-ECG. Ukuzivocavoca nako kunokubangela utshintsho kwisantya senhliziyo, okanye kwixinzelelo legazi. Ngoku "kugxininisa" intliziyo ngokuzivocavoca, uvavanyo loxinzelelo lunokuveza ukungaqhelekanga obangelwa yimingcipheko ekhethekileyo kwimibhobho ye-coronary - engafanelekiyo edla ngokungafaniyo nakwezinye.
Kubalulekile ukuba uqaphele ukuba uvavanyo loxinzelelo lunokukunceda kuphela ukuxilonga i-CAD eyenza i-block blockages - okubizwa ngokuba yi-CAD obstructive. I-CAD idla ngokuvelisa iiplati kwiimithambo ezingabangela ukuphazamiseka, kwaye ezi zixhobo ezingenako ukuphazamiseka zingenza (kwaye zenze) zenzeke, zenze i-blood clot form formation, evelisa ukukhutshwa kanzima komthamo, ngokuqhelekileyo kuholele ekuhlaselweni kwe-myocardial (intliziyo yesifo ).
Ngoko ngokuqinisekileyo kunokwenzeka ukuba uvavanyo oluqhelekileyo "oluqhelekileyo" ngelixa luneCAD.
Ngenxa yokuba umsebenzi uvusa amanqanaba e-adrenaline, iimvavanyo zengcinezelo zinokuba luncedo ekuhloleni ezinye i- arrhythmias zengqondo ezithe zenzeka ngezihlandlo xa amanqanaba e-adrenaline ayanda.
Iimvavanyo zoxinzelelo zisebenzisekile ekulinganiseni "amandla okusebenza" kwezigulane ezinesifo senhliziyo. Ukuba isigulane sine-CAD, umzekelo, uvavanyo loxinzelelo lunokukunceda ukuvavanya ukubaluleka kweenqanda zokukhetha. Ukuba iimpawu ze-ischemia zenzeka kwinqanaba eliphantsi lokuzivocavoca, i-blockages iyakubaluleke kakhulu. Kodwa ukuba i-ischemia ayiyenzeki, okanye ukuba iyenzeka kuphela kumanqanaba aphezulu kakhulu okusebenza, i-blockages ingabalulekanga kakhulu.
Ukuqhuba iimvavanyo zengcinezelo zengxaki kunokuba yindlela efanelekileyo yokubeka iliso inkqubela phambili yezigulane ezinokukhubazeka kwentliziyo . Ukuba izinga eliphakamileyo lokuzilolonga lunokugqithisa ngokuhamba kwexesha, nokuba isifo sesifo senhliziyo singase siphume ngakumbi, okanye unyango lwezonyango lusegulane lungadinga ukulungiswa kwakhona.
Utshintsho olwenziwe ngeengxaki zoxinzelelo
Ukuchaneka kovavanyo loxinzelelo ekufumaneni i-CAD landa kakhulu ngokuqhuba ukuqhutyelwa kwe- nyukliya ngokufunda kunye novavanyo loxinzelelo. Into e-radioactive ebizwa ngokuthi i-thallium (okanye into efana neyobizwa ngokuthi i-sestamibi okanye iCarololite) ifakwe kwi-vein ngexesha lomzimba. I-thallium iqokelela kwiindawo zeentliziyo ezinokuhamba kakuhle kwegazi. Imifanekiso yentliziyo ithathwa ngekhamera ekhethekileyo engayifumana imifanekiso ye-radioactivity ye-thallium. Kusuka kule mizobo, iincenye zeentliziyo ezingenakufumana ukuhamba kakuhle kwegazi (ngenxa yokucima kwiimitha ze-coronary) zingabonwa. Ucwaningo lwe-thallium lwandisa kakhulu ukuchaneka kovavanyo lokufunda ngokujonga i-CAD. Umlinganiselo wesigulane esivela kwi-thallium ungaphantsi kwelo xi-x-ray.
Ngamanye amaxesha ama- Echocardiograms asetyenziswa ngokubambisana novavanyo loxinzelelo. Uvavanyo lwe-echo lwenziwa ngokuphumla, kwaye emva kokuzivocavoca, ukukhangela utshintsho kwimisebenzi yesisu senhliziyo ngexesha lokuzivocavoca. Ukutshatyalaliswa komsebenzi we-muscle ngexesha lokuzivocavoca kunokubonisa ukugula kwesifo se-coronary .
Ngamanye amaxesha izigulane azikwazi ukwenza umsebenzi ngenxa yokunciphisa umzimba. Amachiza aPresantine kunye ne-dobutamine angasetyenziswe kwezi ziko ukulinganisa umphumo wokuzilolonga entliziyweni.
Imida
Kwezinye izigulane, iinguqu ze-ECG ezibonisa ukuba yi-ischemia ziyakwenzeka nangona kungekho CAD. (Ngamanye amagama, "iimvavanyo zokunyamezela ezingamanga." Kwezinye izigulane, akukho tshintsho oluphawulekayo lwe-ECG lubonakala nangaphambi kweCAD. (Ngoko ke, "iimvavanyo zengcinezelo ezingamanga" zingabonwa.) Izifundo ezimbi zobuxoki nezixokelelwano zobuxoki zinganciphisa kakhulu ukusetyenziswa kovavanyo lwexinzelelo kwizigulane ezininzi. Ngokufaka isifundo se-nyukliya kwi-test test, le mingcipheko iyancitshiswa, kwaye amandla okuxilongwa kovavanyo loxinzelelo luphuculwe kakhulu.
Mngcipheko
Uvavanyo loxinzelelo luye lwabonakalisa lukhuselekile ngokuphawulekayo. Ibeka inqanaba elifanayo lomngcipheko njengokuthabatha ukuhamba okanye ukuhamba entabeni. Nangona kunokwenzeka ukuba i-ischemia echukunyiswa ngongcinezelo olunjalo ingakhokelela kwisifo se-myocardial okanye ukuphazamiseka kwengqondo enzulu, ekusebenzeni kwesi siganeko. Ukongezelela, xa ezi ziganeko ezinzulu zenzeka ngexesha lokuvavanya uxinzelelo, zenzeka phambi kootitshala bezonyango abaqeqeshwe abanokuhlangabezana nazo ngokukhawuleza.
> Imithombo:
> Gibbons, RJ, Abrams, J, Chatterjee, K, et al. I-ACC / AHA 2002 ukuhlaziywa kwezikhokelo zokulawulwa kwezigulane ezine-angina ezingapheliyo.