Xa i-Spasm kwi-Aron Coronary iholele kwi-Paint Pain
I-Prinzmetal angina , ebizwa ngokuba yi-vasospastic angina okanye i-angina ehlukileyo, yinto ebangela ukuba intlungu ibe yinto engavamile. Kuyenzeka xa i-spasm ixabela kwenye yeerterotic coronary - iirriyiti ezinika igazi entliziyweni yakho. I-spasm ibangela inxalenye yentliziyo ye-muscle ukuba ilahlekelwe igazi layo, kwaye i-angina ivela. Ngelixa i-Prinzmetal angina ingaba nemiphumo ebalulekileyo, kuquka ukuhlaselwa kwentliziyo kunye neentsholongwane ezisongela ubomi be- cardiac arrhythmias , inokuhlala iphathwa ngokukhawuleza xa ichongiwe kakuhle.
Ayikho Intlungu Yentliziyo, Kodwa Ingavakalelwa Ngayo
Intlungu yesifuba abantu abajamelana nayo ne-Prinzmetal angina ayifani ncamnye ukusuka kwikhosikiyali, efana ne-angina ebangelwa yi- atherosclerosis . Njengokuba nge-angina efana neyo, abantu abane-Prinzmetal angina baya kuthi baxube umxube weempawu, kubandakanya ukuqina kwesifuba, ukucinezela, uxinzelelo, ukuzaliseka, ubunzima okanye iphothi kwisifuba, ukugubha okanye ukuvutha. Isifo esifanelekileyo "sihlaziyekile" sinokuhamba kunye ne- dyspnea , i-nausea, okanye i-sweating, kunye ne- palpitations . Ezi zimpawu zihlala ziqhubeka imizuzu engama-15 okanye ngaphezulu. Kwaye ngokuchasene ne-angina eqhelekileyo, edla ngokubakho ngexesha lokunyamezela okanye ukuxinezeleka, i-Prinzmetal angina ngokuqhelekileyo iqhubeka xa iphumla. Enyanisweni, abantu baninzi bafumana i-Prinzmetal angina ngexesha elincinci lomhla-phakathi kobusuku bobusuku nokusa.
Ukuhlanganiswa kweempawu ngezinye izihlandlo kubangela abantu abane-Prinzmetal angina ukuba bakholelwe ukuba banesifo senhliziyo.
Ngendlela, oku kungabi yinto embi, kuba abantu abacinga ukuba banesifo senhliziyo banokufumana uncedo lwezonyango. Kwaye i-Prinzmetal angina ifumaneka ngokukhawuleza, kungekudala ingaphathwa kakuhle.
Izizathu
Nabani na onokuyihlakulela le meko, kodwa ixhaphake kakhulu kubafazi. Abantu abahlakulela i-Prinzmetal angina bahlala bebancinci, bephilile kwaye banesimo esichengeni sengozi yesifo senhliziyo - ngaphandle kokutshaya.
Ukubhema kudla ngokuba yinto ebalulekileyo ekukhuseni i-angina kule meko kuba iimveliso zecuba zingabangela ukuhlaselwa kwe-armial spasm.
Ukongeza kokubhema, ukusebenzisa i-cocaine okanye i-amphetamines kunokukhupha i-Prinzmetal angina. Abahlukumezi beziyobisi kunye ne-Prinzmetal angina banakho amathuba okuba bahlupheke ngokusisigxina (okanye babulalayo) kwintliziyo kunokuba bengabenzi beziyobisi.
Kwezinye iimeko, i-Prinzmetal angina icingelwa ukuba ibangelwa " ukungasebenzi ngokugqibeleleyo," imeko apho ingxube yangaphakathi (oko kukuthi, i-endothelium) yeetriyiti ayisebenzi ngokuqhelekileyo. I-Endothelial dysfunction idibaniswa ne- cardiac syndrome x , isifo sikaRaynaud, kunye nentloko ye-migraine . Enyanisweni, abantu abane-prinzmetal's angina kaninzi nabo banesifo sengqondo se-migraine.
Indlela i-Prinzmetal Angina ichongwa ngayo
I-Prinzmetal angina iyenzeka xa indawo ephakathi kwelinye leemibhobho ezinkulu ze-coronary ishicilelwe ngokukhawuleza, ivalwe ixesha elide ukuphuma kwegazi ukuya kwisifo senhliziyo esinikezwa ngulo mzobo. Ngexesha lezi ziqendu, i- electrocardigram (ECG) ibonisa ukuphakama okuphawulekayo kwe " ST segment " - utshintsho olufanayo lweCGG luyabonakala ngokuhlaselwa kwentliziyo. Ama-nitrate avame ukukhulula ngokukhawuleza ngokukhawuleza, ukubuyisela i-coronary art to normal.
Ngoko, izinto oogqirha zifuna ukuxilonga i-Prinzmetal angina zi:
- ubuhlungu obuhlungu besifuba,
- ihamba kunye neenguqu ezinzulu kwi-ECG,
- ezikhutshwa ngulawulo lwe-nitrate,
- kunye nemibhobho ye-coronary "evamile" eboniswe kwi- catheterization yenyama .
Kwiimeko ezininzi, ugqirha akayi kubakho ngexesha lesiganeko se-angina. Okokuthi, umntu ophethe i-Prinzmetal angina uza kungena ukuvavanya emva kokuba i-angina ihambe. Kulezi zihlandlo, ukuvavanya ukuxilonga kungabandakanya ukuqwalasela kwe-ECG yexesha elide (ukukhangela iziganeko ze-angina ezihamba kunye neenguqu ze-ECG), okanye ukuhlolwa koxinzelelo . (Nangona i-prinzmetal angina idla ngokuphindaphindiweyo, malunga ne-20% yabantu abaneli meko banokuthi bavuthe ingqondo yabo ngexesha lokuvavanya.)
Ngamanye amaxesha, nangona kunjalo, i-catheterization ye-cardiac "yokuvavanya" kuyimfuneko ukuba ixilongwe. Ngenxa yokuba i-Prinzmetal angina ibangelwa i-coronary artery spasm kunokuba ikhutshwe ngokusemthethweni kwi-artery, i-catheterization ibonisa "iimeko eziqhelekileyo" zeeronta. Ukuqhubela phambili, kuba i-Prinzmetal angina ayilona uhlobo olulodwa lwe-angina olunokubonakala nangemibhobho ye-coronary eqhelekileyo , okwenza ukuxilongwa ngokuchanekileyo kungadinga ukubonisa ukuba i-coronary artery spasm ingacatshiswa.
Iindidi ezimbini "zokuqumbisa" zivame ukusetyenziswa ukuzama ukunyusa i-coronary artery spasm-hyperventilation, kunye nokuhlolwa kweziyobisi nge-acetylcholine okanye ergonovine.
Uvavanyo lwe-hyperventilation luvavanyo olungenakuvota. idla ngokusetyenzwa kusasa, xa i-spasm isenzeka kakhulu. Ngokuhlolwa kwe-hyperventilation, isigulane siyalwa ukuba siphefumle ngokukhawuleza kunye ngokukhawuleza imizuzu emithandathu egcweleyo-enzima kunokuba ingabonakali-ngelixa i-ECG ibhalwa ngokuqhubekayo, kwaye i- echocardiography eyenziwe ukujonga iimpawu ze-coronary artery spasm . Olu vavanyo luluncedo ngakumbi kubantu abanamaqhekeza amaninzi e-Prinzmetal's angina. Akulindeleki ukuba ibe luncedo kwii-episodes zazo zichanekile okanye zingapheliyo.
Ukuvavanya nge- acetylcholine okanye ergonovine kwenziwa ngexesha lokunyanyiswa komzimba. Olu hlobo lokuvavanya luvelisa ukuxilongwa ngokuchanekileyo ngakumbi kunokuhlolwa kwe-hyperventilation. Kule vavanyo, enye yeziyobisi ijojowe nge-intravenously (ergonovine) okanye ngqo kwi-artery coretyary (acetylcholine). Kubantu abane-Prinzmental angina, oku kudla ngokubangela ukuba kuqhutywe i-artery spasm efana neyona ndawo eyabangela iimpawu zabo. Esi sithuba se-spasm sendawo singabonwa ngethuba lenkqubo ye-catheterization. Njengamanje, ukuvavanya nge-acetylcholine kuthathwa njengokhuselekileyo kunokuba kuhlolwe i-ergonovine kwaye luvavanyo olukhethiweyo olunyuselayo.
Outlook kunye neziphumo
Nangona ngokubanzi imbono yezigulane ezine-Prinzmental angina zilungile, le meko ingabangela iingxaki ezinzulu. Ingabangela iingozi zokubulala i-cardiac arrhythmias, ingakumbi i-fibrillation ye-ventricular. Yaye nangona uhlaselo lweentliziyo aluqhelekanga nge-Prinzmetal angina, ngokwenene luyakwenzeka, luvelise umonakalo ongunaphakade kwintliziyo yesisu. Ukunyanga okwaneleyo kwe-Prinzmental angina kunciphisa kakhulu umngcipheko weengxaki ezinjalo. Enyanisweni, kanye xa unyango olusebenzayo, abantu abaneli meko bangalindela ukukhokelela ngokupheleleyo, ubomi obuphilileyo.
Unyango
Ukuba unayo i-Prinzmetal angina, kuya kubaluleka kuwe (njengoko kunjalo nayo yonke into) ukulawula yonke into enobungozi bomzimba wakho. Kodwa kwimeko yakho, kubaluleke kakhulu ukukhusela iimveliso zecuba, ezivuselelekayo ezinamandla ezinqabileyo ze-coronary.
Kungenzeka ukuba wena kunye nogqirha wakho baya kukwazi ukufumana ulawulo oluhle kwiindawo zakho ze-angina kunye ne- nitrates kunye / okanye i- calcium channel blockers . Kananjalo, unokuxoxa kunye nodokotela wakho ukusetyenziswa kwe- statin - iklasi leziyobisi ezinganciphisi nje i- cholesterol kodwa iphinde iphucule umsebenzi wokugqibela-njengokuba idatha yakutshanje ibonisa ukuba i-statins inokukunceda ukukhusela i-coronary artery spasm.
Iziyobisi ezinokuthi zenze i-coronary artery spasm kwaye okufuneka uyenze ukuyiphepha kufuneka kubandakanye nabaninzi be- beta blockers kunye nezinye izidakamizwa zemigraine- ngokukodwa, i- Imitrex (sumatriptan).
> Imithombo:
> IBeltrame JF, Crea F, uKaski JC, et al. Ukumiselwa kwamazwe ngamazwe okuQinisekisa ukuThengiswa kweVasospastic Angina. I-Eur Heart J 2015.
> Kusama Y, Kodani E, Nakagomi A, et al. Uhlobo lwe-Angina kunye neCoronary Artery Spasm: I-Spectm ye-Clinical, i-Pathophysiology, kunye noLawulo. J Nippon Med Sch 2011; 78: 4.
> Ong P, Athanasiadis A, uBorgulya G, et al. Ukusetyenziswa kwezonyango, ii-Angiographic Characteristics, kunye noVavanyo loKhuseleko lwe-Intracoronary Acetylcholine. Ukuhamba ngo-2014; 129: 1723.
> Stern S, Bayes de Luna A. I-Coronary Artery Spasm: Uhlaziyo luka-2009. Ukuhamba ngo-2009; 119: 2531.