Iingxube ze-coronary imigexo yegazi ehambisa igazi kwi-myocardium (intliziyo ye-muscle). Ngenxa yokuba kufuneka isebenze ngokuqhubekayo (ngokuchasene nezinye izisipha zomzimba, ezihlala ziphumla), isisu senhliziyo sinemfuno ephezulu kakhulu ye-oksijini kunye nezondlo kwaye ngoko ke kufuneka i-blood supply ethembekileyo, eqhubekayo. Iimpawu ze-coronary zenzelwe ukuhambisa ukunikezelwa kwegazi okuqhubekayo okufunekayo ukuba intliziyo isebenze ngokufanelekileyo.
Ukuba igazi eligeleza kwimithambo ye-coronary livaliwe ngokukodwa, intliziyo ye-muscle ingaba yi- ischemic (i-oksijini-ilambile), imeko edla ngokuvelisa i-angina kunye ne-drop-off in muscle function (ibonakaliswe bubuthathaka kunye ne- dyspnea ). Ukuba ukuphuma kwegazi kuphephe ngokupheleleyo, intliziyo yesifo esinikezelwa ngumthi ovaliweyo ungasifo okanye i-cell death. Oku kubizwa ngokuba yi- myocardial infarction, okanye ukuhlaselwa kwentliziyo .
I-Anatomy ye-Coronary Arteries
Iimitha zengxowankulu ezinkulu ze-coronary artery, i-coronary artery (RC) kunye ne-left-line (LM) ye-coronary artery, ephuma kwi-aorta (umthambo ophezulu womzimba) ngaphaya kwe-valve ye-aortic.
Umthamo we-LM ngokukhawuleza ngamasebe zibe yimibhobho emibini emikhulu - i-artery ephezulu yehla (LAD) kunye ne-circumflex artery (Cx). Intliziyo yesifo, ke, inikwe enye yile mithathu yamathambo e-coronary major: i-LAD, i-Cx, kunye ne-RC. Umfanekiso (ngentla) ubonisa iRC kunye neetriyari ze-LAD.
(Umthamo weCx uboniswa ngethunzi elifana nesimo senhliziyo emva kwentliziyo.)
Umzobo weRC uboniswe kwicala lasekhohlo lomfanekiso, ujikeleza ngaphaya kweentliziyo. Icandelo elide le-RC, kulo mfanekiso, iya kwinqanaba lentliziyo (inqaku) libizwa ngokuba yi-artery ye-posterior descending (PDA).
Kwinkoliso yabantu (malunga ne-75%) i-PDA iphuma kwi-RC, njengale mfanekiso. Oku kubizwa ngokuba "kukunene." Nangona kunjalo, kwi-25% i-PDA ivela kwi-CX, ebizwa ngokuba "ekhohlo ephezulu." Oku kwahlukileyo kubalulekile, kuba (umzekelo) ukuhlaselwa kwentliziyo ephuma kwi-Blockage kwi-RC. Intliziyo ephezulu iyakwenza umonakalo omkhulu kunokuba yayikuyo intliziyo ephezulu.
Umthamo weRC kunye namasebe awo unikezela igazi kwiindawo ezininzi ezifanelekileyo, i-ventricle efanelekileyo, i- sinus node , kunye (nakubantu abaninzi) i- AV node .
Ukubuyela emfanekisweni, i-LAD kunye namasebe ayo amaninzi aboniswa ehamba phambili ukuya kwinqanaba elivela phezulu entliziyweni. I-LAD inika i-atrium ekhohlo kunye neenxalenye ezinkulu ze-ventricle engasekhohlo-ikamelo elikhulu lokupompa. Ngoko ukuhlaselwa kwintliziyo ephuma kwi-blocking kwi-LAD phantse kubakho umonakalo omkhulu. Izixhobo ze-Coronary artery kwi-LAD zidla ngokubizwa ngokuba yi-cardiologists "njengabenzi bomhlolokazi."
Ukubaluleka komonakalo owenziwe kwisifo senhliziyo ngexesha lokuhlaselwa kwentliziyo akuxhomekekanga kuphela kwi-artery echaphazelekayo kodwa nakwiindawo zokucima ngaphakathi kwintsimbi. Ukukhutshwa okukufutshane nokususwa kwe-artery kuya kubangela umonakalo omkhulu kunokuba ukukhutshwa kuqhubeke phantsi komthamo, okanye kwelinye lamasebe amancinane.
Ukuba kukho ukuhlaselwa kwentliziyo, umonakalo ongunaphakade unokuthintela ngokufumana unyango olusisiseko, njengokuba izicwangciso eziliqela zifumaneka ngokukhawuleza ukuvula umthambo we-coronary.
Imithombo:
Farooq V, van Klaveren D, Steyerberg EW, et al. Impawu ze-Anatomical kunye neklinikhi zokukhokela ukuthatha izigqibo phakathi kokuhlinzwa kwe-coronary artery bypass and intervention intervention coronary kwizigulane ngamnye: ukuphuhliswa nokuqinisekiswa kwe-SYNTAX isiqendu II. Lancet 2013; 381: 639.
Abalobi / Amalungu eBasebenzi, i-Windecker S, uKolh P, et al. 2014 ESC / EACTS Izikhokelo kwi-myocardial revascularization: I-Task Force kwi-Myocardial Revascularization ye-European Society of Cardiology (ESC) kunye noMbutho waseYurophu weCrodio-Thoracic Surgery (EACTS) Iphuhliswe ngegalelo elikhethekileyo loMbutho we-European Association of Percutaneous Cardiovascular Interventions ( EAPCI). I-Eur Heart J 2014; 35: 2541.