Ischemia yentliziyo: yintoni, iimpawu eziphambili kunye nonyango

Umxholo

• Iindidi zesifo senhliziyo
• Unyango lwenziwa njani
• Iimpawu zeschemia yentliziyo
• Oonobangela ischemia yentliziyo
• Uxilongo lwenziwa njani

Ischemia yentliziyo, ekwabizwa ngokuba yi-myocardial okanye i-myocardial ischemia, ibonakaliswa kukuhla kwegazi ngee-coronary arteries, ezizizitya ezihambisa igazi ziye entliziyweni. Kuhlala kubangelwa bubukho bamacwecwe amanqatha ngaphakathi, athi, xa enganyangwa kakuhle, aqhekeze kwaye avale inqanawa, ibangele iintlungu kwaye kwandise amathuba okuhlaselwa sisifo sentliziyo.

Unyango lwayo lwenziwa ngamachiza ukuphucula ukuhamba kwegazi kwezi nqanawa, ezimiselwe ngugqirha wezentliziyo, njenge-metoprolol, simvastatin kunye ne-AAS, umzekelo, ukongeza ekulawuleni i-cholesterol kunye netyuwa ekudleni nasekusebenzeni komzimba.

Iindidi zesifo senhliziyo

Ukuhamba kwegazi kwiCoronary kunokwenzeka ngeendlela ezahlukeneyo:

• Angina ezinzile: luhlobo lwe-ischemia engapheliyo, kodwa edlulayo, kuba iintlungu zesifuba zivela xa umntu esenza umgudu, esiba noxinzelelo loxinzelelo okanye emva kokutya, kwaye aphucule kwimizuzu embalwa okanye xa ephumla. Ukuba ayinyangwa, inokuba sisifo sentliziyo kwixa elizayo.
• Angina engazinzanga: ikwaluhlobo lwe-ischemia engapheliyo, kodwa iintlungu zesifuba zinokubonakala nangaliphi na ixesha, zihlala ngaphezulu kwemizuzu engama-20, aziphucuki ngokuphumla, kwaye, ukuba ayinyangwa ngokukhawuleza, iya kuba sisifo sentliziyo. Ukuqonda ngcono ukuba yintoni i-angina, oonobangela bayo kunye nendlela yokuyinyanga.
• I-infarction echanekileyo ye-myocardial: infarction inokwenzeka emva kotshintsho lwe-angina, okanye ngequbuliso, ivele ngaphandle kwesilumkiso sangaphambili. Ibonakaliswa ziintlungu eziqatha okanye ukutshisa esifubeni, esingaphuculiyo, kwaye kufuneka sinyangwe ngokukhawuleza kwigumbi likaxakeka. Funda indlela yokuchonga isifo sentliziyo.
• Cwaka ischemia: kukuncipha kokuhamba kwegazi kwimithambo yegazi engabangeli zimpawu, ukufunyanwa rhoqo kwiimviwo zesiqhelo, kwaye kubangela umngcipheko omkhulu wokuqhubela phambili kuhlaselo lwentliziyo okanye ukubanjwa kwentliziyo ngesiquphe.

Ezi ntlobo ze-ischemia zibangela ukuphazamiseka kwempilo yentliziyo, ngenxa yoko kufuneka bafunyaniswe kwaye baphathwe ngokukhawuleza, kokubini ngokwenza uhlolo lonyaka, kunye nokufuna ukhathalelo lonyango okanye ugqirha wezentliziyo nanini na xa kuvela iimpawu zentlungu. esifubeni.

Unyango lwenziwa njani

Unyango lwe-cardiac ischemia lunokwenziwa kusetyenziswa amayeza:

• Nciphisa ukubetha kwentliziyo, njengepropranolol, atenolol okanye metoprolol;
• Lawula amanqanaba oxinzelelo lwegazi, njenge-enalapril, i-captopril okanye i-losartan;
• Nciphisa iiplati zegrisi, Njenge-simvastatin kunye ne-atorvastatin;
• Nciphisa ukwenziwa kwamahlwili egazi, ezinje nge-AAS okanye i-clopidogrel, yokonakaliswa kwamacwecwe amanqatha;
• Hlaziya izitya zentliziyo, ezinje nge-isordil kunye ne-monocordil.

La machiza kufuneka asetyenziswe kuphela phantsi kwesikhokelo esingqongqo esivela kugqirha wezentliziyo. Kuya kufuneka uphinde ulawule izifo ezinje ngecholesterol ephezulu, uxinzelelo lwegazi oluphezulu, ukutshaya, ukungasebenzi, isifo seswekile, ukuphefumla ngokulala kunye nohlaselo loxinzelelo, njengoko zinokwandisa umngcipheko wesifo senhliziyo.

Kwiimeko ezinzima kakhulu, xa ukusetyenziswa kwamayeza kungonelanga, ugqirha wezentliziyo unokucebisa ukuba kwenziwe utyando, okuyinkqubo ebuthathaka apho isiguli singeniswa esibhedlele ngaphezulu kweentsuku ezi-4 kwaye kufuneka sinyangwe ngokwasemzimbeni sisese Ukubetha kwentliziyo kwangoko. Ugqirha unokuyalela, umzekelo, i-angioplasty kunye okanye ngaphandle kokubekwa kwe-stent okanye i-coronary artery bypass graft, leyo endaweni ye-coronary yi-saphenous vein, umzekelo. Qonda ukuba kwenziwa njani ukugqitha kotyando.

Iimpawu zeschemia yentliziyo

Iimpawu zeschemia yentliziyo kunokuba:

• Ubuhlungu okanye ukutshisa esifubeni esinokuthi sikhuphe emva kwentamo, isilevu, amagxa okanye iingalo;
• Ukubetha kwentliziyo;
• Uxinzelelo esifubeni;
• Ukuphefumla kancinci okanye ukuphefumla nzima;
• Isicaphucaphu, ukubila okubandayo, ipallor kunye ne-malaise;

Nangona kunjalo, ischemia yentliziyo ayinakho ukubonisa iimpawu kwaye ifunyanwa kuphela kuvavanyo oluqhelekileyo okanye xa ivelisa isifo sentliziyo. Jonga ukuba zeziphi iimpawu ezili-12 ezinokubonisa iingxaki zentliziyo.

Oonobangela ischemia yentliziyo

Unobangela ophambili we-ischemia yentliziyo yi-atherosclerosis, kukuqokelelana kwamafutha ngaphakathi kwimithambo yegazi, ngenxa yesiphumo sexesha elide se-cholesterol ephezulu, iswekile ephezulu, ukungasebenzi, ukutshaya nokutyeba kakhulu.

Nangona kunjalo, ezinye izifo zinokukhokelela kwi-cardiac ischemia, enjenge-lupus, isifo seswekile, i-coronary embolism, i-syphilis, i-aortic stenosis, i-coronary spasm, i-hyperthyroidism eqatha kakhulu kunye nokusetyenziswa kweziyobisi ezifana ne-cocaine kunye ne-amphetamines.

Uxilongo lwenziwa njani

Ukuchonga ubukho be-ischemia entliziyweni, ezinye iimvavanyo zinokwenziwa, ezinokuthi zicelwe ngugqirha oqhelekileyo okanye ugqirha wentliziyo, onje:

• I-Electrocardiogram;
• Uvavanyo lomthambo okanye uvavanyo loxinzelelo;
• Echocardiogram;
• Iscrafigraphy yeMyocardial.

Uvavanyo lwegazi lwenziwa ukuchonga ubukho beenguqu ezibangela umngcipheko entliziyweni, njenge-cholesterol, iswekile yegazi, i-triglycerides kunye nokusebenza kwezintso, umzekelo. Xa kukrokreleka isifo sentliziyo, iimvavanyo zegazi zokuvavanya amanqanaba e-enzyme yentliziyo nazo zinokunceda ekuqinisekiseni. Khangela ukuba zeziphi iimvavanyo eziceliweyo ukuvavanya intliziyo.

Uvavanyo ngalunye oluyalelweyo luxhomekeke kwiimpawu ezithiwe thaca ngumntu, kwaye, ukuba kusekho ukuthandabuza, ugqirha wezentliziyo unokucela i-catheterization yentliziyo ukuqinisekisa ubukho be-ischemia yentliziyo. Yazi ukuba yenzelwe ntoni, yenziwa njani kunye nomngcipheko we-catheterization yentliziyo.