Angina engazinzanga

I-angina engazinzanga yimeko apho intliziyo yakho ingafumani gazi laneleyo kunye neoksijini. Ingakhokelela kwisifo sentliziyo.

I-Angina luhlobo lwesifo esibuhlungu esifubeni esibangelwa kukungahambi kakuhle kwegazi kwimithambo yegazi (iinqanawa ze-coronary) zentliziyo yemisipha (myocardium).

Isifo se-Coronary disease ngenxa ye-atherosclerosis sisona sizathu esiqhelekileyo se-angina esingazinzanga. I-atherosclerosis yindawo yokwakha enamafutha, ebizwa ngokuba yi-plaque, ecaleni kweendonga zemithambo. Oku kubangela ukuba imithambo inciphe kwaye ingabi bhetyebhetye. Ukunciphisa kunokunciphisa ukuhamba kwegazi ukuya entliziyweni, kubangele intlungu yesifuba.

Abantu abane-angina engazinzanga basemngciphekweni omkhulu wokuhlaselwa sisifo sentliziyo.

Unobangela oqhelekileyo we-angina zezi:

• Umsebenzi ongaqhelekanga wemithambo yegatsha encinci ngaphandle kokunciphisa imithambo emikhulu (ebizwa ngokuba yi-microvascular dysfunction okanye i-Syndrome X)
• Umthambo weCoronary spasm

Izinto ezinobungozi besifo se-coronary disease zibandakanya:

• Seswekile
• Imbali yosapho yesifo sentliziyo sokuqala (isihlobo esisondeleyo esifana nomntakwenu okanye umzali wayenesifo sentliziyo ngaphambi kweminyaka engama-55 kwindoda okanye ngaphambi kweminyaka engama-65 emfazini)
• Igazi elonyukayo
• I-cholesterol ephezulu yeLDL
• I-cholesterol ye-HDL ephantsi
• Isini sendoda
• Ukuhlala nje kuphela (ukungafumani umthambo ngokwaneleyo)
• Ukutyeba kakhulu
• Ukwaluphala
• Ukutshaya

Iimpawu ze-angina zingabandakanya:

• Intlungu yesifuba onokuziva nayo egxalabeni, engalweni, emhlathini, entanyeni, ngasemva, okanye kwenye indawo
• Ukuphazamiseka okuziva ngathi kukuxinana, ukutywina, ukutyumza, ukutshisa, ukukrwitsha, okanye ukuqaqanjelwa
• Ukuphazamiseka okwenzeka xa uphumle kwaye kungahambi ngokulula xa usela amayeza
• Ukuqhawukelwa ngumphefumlo
• Ukubila

Nge-angina ezinzileyo, iintlungu zesifuba okanye ezinye iimpawu zenzeka kuphela kwinani elithile lomsebenzi okanye uxinzelelo. Intlungu ayenzeki rhoqo okanye iba mandundu ngokuhamba kwexesha.

I-angina engazinzanga yintlungu yesifuba ngequbuliso kwaye ihlala isiba mandundu kwixesha elifutshane. Unokuphuhlisa i-angina engazinzanga ukuba iintlungu zesifuba:

• Iqala ukuziva yahlukile, inzima kakhulu, iza rhoqo, okanye yenzeka ngomsebenzi omncinci okanye xa uphumle
• Ihlala ngaphezulu kwemizuzu eli-15 ukuya kwengama-20
• Ivela ngaphandle kwesizathu (umzekelo, ngelixa ulele okanye uhleli ngokuzolileyo)
• Ayiphenduli kakuhle kumayeza abizwa ngokuba yi-nitroglycerin (ngakumbi ukuba eli yeza lisebenze ukunciphisa iintlungu zesifuba kwixa elidlulileyo)
• Ivela ngokuhla koxinzelelo lwegazi okanye umphefumlo omfutshane

I-angina engazinzanga luphawu lwesilumkiso lokuba isifo sentliziyo singenzeka kungekudala kwaye kufuneka sinyangwe kwangoko. Jonga umboneleli wakho wezempilo ukuba unayo nayiphi na intlungu yesifuba.

Umboneleli uya kwenza uvavanyo lomzimba kwaye ajonge uxinzelelo lwegazi. Umboneleli unokuva izandi ezingaqhelekanga, ezinje ngokumbombozela kwentliziyo okanye ukubetha kwentliziyo okungaqhelekanga, xa umamele isifuba sakho nge-stethoscope.

Uvavanyo lwe-angina lubandakanya:

• Uvavanyo lwegazi ukubonisa ukuba unokwenzakala kwithishu yentliziyo okanye usemngciphekweni omkhulu wokuhlaselwa sisifo sentliziyo, kubandakanya i-troponin I kunye ne-T-00745, creatine phosphokinase (CPK), kunye ne-myoglobin.
• ECG.
• Echocardiography.
• Uvavanyo loxinzelelo, njengokuvavanywa konyamezelo lovavanyo (uvavanyo loxinzelelo okanye uvavanyo lweetreadmill), uvavanyo loxinzelelo lwenyukliya, okanye uxinzelelo lwe-echocardiogram.
• I-Coronary angiography. Olu vavanyo lubandakanya ukuthatha imifanekiso yemithambo yentliziyo usebenzisa i-x-reyi kunye nedayi. Olu lolona vavanyo luthe ngqo lokufumanisa ukuba umthambo wentliziyo unciphile kwaye ufumane amahlwili.

Kuya kufuneka ujonge esibhedlele ukuze ufumane ukuphumla, kuvavanywe ngakumbi, kwaye uthintele iingxaki.

Izicoci gazi (iziyobisi ezichasene neplatelet) zisetyenziselwa ukunyanga nokukhusela i-angina engazinzanga. Uya kuwafumana la mayeza ngokukhawuleza ukuba unokuwathatha ngokukhuselekileyo. Amayeza afaka iasprini kunye necrafidogrel yamayeza amiselweyo okanye into efanayo (ticagrelor, prasugrel). La mayeza anokukwazi ukunciphisa amathuba okuhlaselwa sisifo sentliziyo okanye ubungqongqo besifo sentliziyo esenzekayo.

Ngexesha lomsitho we-angina ongazinzanga:

• Unokufumana i-heparin (okanye elinye igazi elincinci) kunye ne-nitroglycerin (phantsi kolwimi okanye nge-IV).
• Olunye unyango lunokubandakanya amayeza okulawula uxinzelelo lwegazi, unxunguphalo, izingqisho zentliziyo engaqhelekanga, kunye ne-cholesterol (enjengechiza le-statin).

Inkqubo ebizwa ngokuba yi-angioplasty kunye ne-stenting inokwenziwa rhoqo ukuvula i-artery evaliweyo okanye emxinwa.

• I-Angioplasty yinkqubo yokuvula imithambo yegazi emxinwa okanye evaliweyo ehambisa igazi entliziyweni.
• Umthambo we-coronary stent yityhubhu encinci, yentsimbi evulayo (eyandayo) ngaphakathi komthambo wecoronary. I-stent ihlala ibekwa emva kwe-angioplasty. Inceda ukuthintela umthambo ekuvaleni kwakhona. Ukunyanga iziyobisi kunamayeza kuwo anceda ukuthintela umthambo ekuvaleni ixesha elingaphezulu.

Utyando lwentliziyo olugqithisileyo lunokwenziwa kwabanye abantu. Isigqibo sokuba olu tyando luxhomekeke:

• Yeyiphi imithambo evaliweyo
• Zingaphi imithambo ebandakanyekayo
• Ngawaphi amalungu emithambo yenhliziyo ancitshisiweyo
• Zibukhali kangakanani ii-thinning

I-angina engazinzanga luphawu lwesifo sentliziyo esiqatha.

Uqhuba kakuhle kangakanani kuxhomekeke kwizinto ezininzi ezahlukeneyo, kubandakanya:

• Zingaphi kwaye yeyiphi imithambo esentliziyweni yakho evaliweyo, kwaye nokuba lukhulu kangakanani na uvalelo
• Ukuba ukhe wahlaselwa sisifo sentliziyo
• Imisipha yentliziyo yakho ikwazi njani ukumpompa igazi emzimbeni wakho

Isingqi sentliziyo esingaqhelekanga kunye nokuhlaselwa sisifo sentliziyo kunokubangela ukufa ngesiquphe.

I-angina engaqinisekiyo inokukhokelela ku:

• Iingqungquthela zentliziyo engaqhelekanga (arrhythmias)
• Ukuhlaselwa yintliziyo
• Ukumelwa yintliziyo

Funa unyango ukuba unentlungu entsha, engachazwanga yesifuba okanye uxinzelelo. Ukuba ukhe waba no-angina ngaphambili, tsalela umnikezeli wakho umnxeba.

Tsalela umnxeba kwi-911 okanye inombolo yongxamiseko yendawo ukuba unentlungu engapheliyo:

• Ngaba ayingcono imizuzu emi-5 emva kokuba uthathe i-nitroglycerin (umboneleli wakho unokukuxelela ukuba uthathe amanani ama-3 ewonke)
• Ayipheli emva kweedosi ezi-3 ze-nitroglycerin
• Iya isiba mandundu
• Ibuyisa emva kokuba i-nitroglycerin incede ekuqaleni

Fowunela umnikezeli wakho ukuba:

• Unempawu ze-angina rhoqo
• Uno angina xa uhleli (rest angina)
• Uziva udiniwe rhoqo
• Uziva utyhafile okanye unentloko encinci, okanye uyadlula
• Intliziyo yakho ibetha kancinci (ngaphantsi kwe-60 beats ngomzuzu) okanye ngokukhawuleza kakhulu (ngaphezulu kwe-120 beats ngomzuzu), okanye ayizinzanga
• Unengxaki yokuthatha amayeza entliziyo
• Unazo naziphi na ezinye iimpawu ezingaqhelekanga

Ukuba ucinga ukuba unesifo sentliziyo, fumana unyango ngokukhawuleza.

Olunye uphononongo lubonakalisile ukuba ukwenza iinguqu ezimbalwa kwindlela yokuphila kunokuthintela iibhloksi ekubeni mandundu kwaye kungaziphucula. Utshintsho kwindlela yokuphila lunokunceda ukuthintela uhlaselo lwe-angina. Umboneleli wakho unokukuxelela ukuba:

• Ukunciphisa umzimba ukuba utyebe kakhulu
• Yeka ukutshaya
• Zilolonge rhoqo
• Sela utywala ngobungcathu kuphela
• Yitya ukutya okusempilweni okuphezulu kwimifuno, iziqhamo, ukutya okuziinkozo, intlanzi kunye nenyama engenamafutha

Umboneleli wakho uya kuncoma ukuba ugcine ezinye iimeko zempilo ezinje ngegazi, isifo seswekile, kunye namanqanaba aphezulu e-cholesterol aphantsi kolawulo.

Ukuba unomngcipheko omnye okanye ngaphezulu kwesifo sentliziyo, thetha nomboneleli wakho malunga nokuthatha iasprini okanye amanye amayeza ukunceda ukuthintela isifo sentliziyo. Unyango lwe-Aspirin (75 ukuya kuma-325 mg ngosuku) okanye iziyobisi ezinje nge-clopidogrel, ticagrelor okanye iprasugrel inokunceda ukuthintela ukuhlaselwa yintliziyo kwabanye abantu. I-Aspirin kunye nolunye unyango olunciphisa igazi luyacetyiswa ukuba isibonelelo sinokuwongamela umngcipheko weziphumo ebezingalindelekanga.

Ukukhawulezisa i-angina; I-angina entsha; Angina - ayizinzanga; Inkqubela phambili ye-angina; CAD - angina engazinzanga; Imithambo yegazi yeCoronary - i-angina engazinzanga; Isifo sentliziyo - i-angina engazinzanga; Intlungu yesifuba-angina engazinzanga

• Angina - ukubhobhoza
• UAngina-yintoni oza kuyibuza ugqirha wakho
• UAngina - xa unentlungu esifubeni
• I-Angioplasty kunye ne-stent-heart-discharge
• Ukuhlaselwa yintliziyo - ukukhutshwa
• Ukuhlaselwa sisifo sentliziyo- ukubuza ugqirha

• UAngina
• I-Coronary artery balloon angioplasty - uthotho

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IGiugliano RP, iBraunwald E.I-non-ST yokunyusa ii-syndromes zecoronary. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 60.

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