Kanti enye indlela abesifazana abanokuba neentlungu zesifuba ngeempawu ze-coronary
Nangona i- coronary artery disease (i-CAD) ibalulekile kubasetyhini njengoko kusemadodeni, izinto ezininzi zingenza i-CAD ibe nzima ngakumbi ukuxilongwa kwabasetyhini. Enye yezi zinto "i-pattern pattern" yeCAD. Kwimizekelo ye-CAD yesifazana, i- coronary angiography - "imilinganiselo yegolide" yokufumanisa i-CAD - idlalwa ngokungaqhelekanga njengento eqhelekileyo.
- Umzekelo wesifazana I-CAD yenye yeemeko ezininzi ezinokuvelisa i-CAD ngeempawu ze-coronary. Funda apha malunga nabanye.
Ngethuba lenkqubo yesifo eyaziwa ngokuba yi- atherosclerosis , i-artery coralary yarner, i-elastic lining is hardened, iminyene, kwaye ivuvuke nazo zonke iintlobo ze "grunge" -kuquka i-calcium deposits, i-deposit deposits, kunye neeseli ezivuthayo ezingaqhelekanga. I-atherosclerosis ngokuqhelekileyo yinkqubo ecwangcisiweyo yendawo evelisa iiplati ezidibeneyo kunye nezendawo . Ezi zihlabazo, ezinokucingwa ngokuba "ziimpumlo" ezinkulu ezikhupha kwisitya somthi, ngokuqhelekileyo zibangele iiblockages zendawo ngaphakathi komda. (Ubume babo bendawo yinto eyenza ukuba bangenele unyango nge- angioplasty , i- stents okanye ukuhlinzwa ngokugqithisileyo .) Izigulane ezineCAD zinokuba neeplati enye okanye ezimbini, okanye zinokuba zininzi ezazisasazwa kwiimitha ze-coronary.
Kuyabasetyhini i-CAD yesifazana , i-atherosclerosis ayifaki iiplati ezidibeneyo, ngoko ke iindawo ezinqamlekileyo zingekho. Endaweni yoko, iiplati zala mabhinqa ziyahlukana, zibandakanya kwinqanaba elithile kwinqanaba le-artery, ukwenzela ukuba i-lining of artery ifuthe kuyo.
Nangona kungekho ziindawo ezinqamlekileyo zokucima, umda wangaphakathi we-artery uba yincinci. Kwi-catheterization ye-cardiac i-coronary arteries ibonakala ihamba kakuhle kwaye iqhelekileyo (nangona ihlala isenokubonakala "encinci" ububanzi).
Ukugxekwa kwabasetyhini abane-CAD yesifazana kucatshangelwa ukuba kungcono kuneCAD efanayo, kodwa oku akusiyo imeko yobunzima.
Ukuhlaselwa kwentliziyo kunye nokufa kwenzeka.
Ngokukodwa, i-CAD yesifazana yempesheni ingabangela i -coronary syndrome (ACS) . I-ACS iyenzeka ngenxa yokuba iiplati ezisasazekayo ziyakucima kwaye ziphule (njengamacwecwe adibeneyo kwiCAD ebonakalayo), okwenza ukuba igazi livale ngaphakathi komzobo kwaye livelise ukukhutshwa ngokukhawuleza kwamanzi. Ukuba i-clot iyancitshiswa ngezilwanyana ezihamba nge-clot, i-catheterization elandelayo yintliziyo ibonisa ukuba i-artery coronary "engokwemvelo" efana ne-CAD ye-female pattern, ngaloo ndlela iphazamisa i-cardiologist.
I-pattern-Female CAD yafunyanwa njani?
Ukuxilongwa kwe-CAD yesifazana kwindlela yokwenza i-CAD ingenziwa ngokucacileyo kunye nobuchule obutsha obubizwa ngokuba yi-intravascular ultrasound (IVUS). I-IVUS (engekho rhoqo eyenziwa ngexesha lokunyanga, kwaye leyo ayifumaneki nakwizibhedlele ezininzi) kufuneka ifake ikathetha ekhethekileyo kwi-coronary artery esebenzisa i-ultrasound (oko kukuthi, i- echocardiography ) ukucinga ngodonga lwe-artery ngaphakathi. Amacwecwe afana neefomati ze-CAD zowesifazane angabonwa ngale ndlela. Kuhlolisiso lwakutshanje, ngaphezu kwesigamu sabasetyhini abaneempawu ze-angina kunye nemithambo ye-coronary "eqhelekileyo" yayineeplates ezibonakalayo ezichongiweyo zisebenzisa i-IVUS.
Ubukho beefomathi ze-CAD zesibhinqa zingatshatyalaliswa ngokulinganisa ubuchule beetriyari ze-coronary ukuze zihluthwe ngokuphendula kwisilwanyana esibizwa ngokuba yi-acetylcholine. Iingcingo eziqinileyo ezibonwe kwi-CAD yesifazana yeefom zehluleka ukuhlaziya ngokuqhelekileyo.
Umzekelo wesifazana I-CAD kufuneka ikhunjulwe kuyo nawuphi na umfazi oye waba ne-angina okanye i-ACS, kodwa ngubani "oqhelekileyo" weempawu ze-coronary kwi-catheterization yenyama.
Uhlobo lwe-CAD lwentombi lugqithiselwa njani?
Kungenxa yokuba ukunciphisa imirhoxo ye-coronary kwi-CAD ye-female pattern, iyasasazeka, iindlela zokwelapha ezijoliswe ekunciphiseni iziphazamiso zendawo-ezifana ne-angioplasty, i-stents, kunye nokuhlinzwa ngokugqithiseleyo-ngokuqhelekileyo ayisebenzisi.
Kunoko, unyango kufuneka lube unyango. Inkqubo efanelekileyo yeli meko ayisayi kuchazwa, kodwa indlela eninzi ebonakalayo ibonakala iyona nto ibhetele, kwaye kufuneka ibandakanye ingozi yokuguqula isimo , unyango ukunciphisa umngcipheko wokucima (aspirin) kunye neziyobisi ukukhusela intliziyo yesisu ngokwayo (beta blockers kwaye mhlawumbi i-ACE inhibitors). Abaphandi ngoku baye bagxininisa ingqalelo kwi-CAD yabesifazane, kunye nokuqonda okungcono le meko kwaye unyango lwayo lunokwenzeka kwikamva elibonakalayo.
Okwangoku, ukuba ungowesifazane oye waba neentlungu zesifuba esinjenge-angina kodwa isifundo sakho se-cardiac catheterization siye saveza "imifuno" yesiqhelo somzimba, wena nodokotela wakho kufuneka uqaphele ukuba umsebenzi wakho awukapheli. Kule ndlela, isifundo "sokuqhelekileyo" sesifundo se-angiography asilawuli inkinga yesifo. Endaweni yoko, kuthetha ukuba uphando olongezelelweyo lufunekayo ukufumana isizathu seempawu zakho.
ImithomboShaw LJ, Sharaf BL, Johnson BD, et al., I-WISE Study Group.Iindleko zokunakekelwa kwempilo kwiintlobo zeentliziyo zentliziyo kubasetyhini abangenazo izifo zogonyamelo lwe-coronary; iziphumo ezivela kwiZiko leSizwe lezeMpilo-iNhliziyo yeSizwe, iMilung, kunye neZigqeba zeGazi-I-Women's Ischemia Syndrome Evaluation (i-WISE). J Am Coll Cardiol 2004; 43 I-Suppl A: 422A.
von Mering GO, Arant CB, Wessel TR, et al. I-coronary disomotion asormal indicator of events of cardiovascular events in a basetyhini: iziphumo kwiNational Heart, Lung, ne-Blood Institute ixhaswe i-Women's Ischemia Syndrome Evaluation (WISE). Ukuhamba ngo-2004; 109: 722-5.
I-CJ, i-Ischemic isifo senhliziyo kwabasetyhini: amaqiniso kunye nokucinga okunqwenelayo. J Am Coll Cardiol Pepine 43 (10): 1727.