Angina isina kugadzikana

Angina isina kugadzikana mamiriro ezvinhu ayo moyo wako usingawane yakakwana kuyerera kweropa uye oxygen. Zvinogona kutungamira pakurwara kwemoyo.

Angina rudzi rwekunetseka pachifuva kunokonzerwa nekusarongeka kweropa kuyerera kuburikidza nemidziyo yeropa (coronary vessels) yemoyo mhasuru (myocardium).

Coronary arteri chirwere nekuda kweatherosclerosis ndiyo inonyanya kukonzera angina isina kugadzikana. Atherosclerosis ndiko kuwedzera kwemafuta, anonzi plaque, pamadziro etsinga. Izvi zvinokonzeresa kuti tsinga dzive dzakatetepa uye dzisachinjike. Iyo yekudzikisira inogona kudzikisa kuyerera kweropa kuenda kumoyo, zvichikonzera kurwadziwa kwepfupa.

Vanhu vane angina vasina kugadzikana vari panjodzi huru yekuve nekurwadziwa kwemoyo.

Kazhinji zvikonzero zveangina ndeizvi:

• Basa risingaenzanisike remadiki madiki mabharari pasina kudzikira kweakakura arteri (anonzi microvascular dysfunction kana Syndrome X)
• Coronary tsinga spasm

Njodzi zvinhu zvecoronary arteri chirwere zvinosanganisira:

• Chirwere cheshuga
• Nhoroondo yemhuri yepakutanga coronary chirwere chemoyo (hama yepedyo senge mukoma kana mubereki aive nechirwere chemoyo asati ave nemakore makumi mashanu nemashanu mumurume kana asati asvika makore makumi matanhatu nemashanu mumukadzi)
• Kuwedzera kweropa
• Yakakwira LDL cholesterol
• Yakaderera HDL cholesterol
• Varume bonde
• Sedentary mararamiro (kusawana zvakakwana kurovedza muviri)
• Kufutisa
• Kukwegura
• Kusvuta

Zviratidzo zveangina zvinogona kusanganisira:

• Kurwadziwa pachifuva iwe kwaunogona kunzwawo mubendekete, ruoko, shaya, mutsipa, musana, kana imwe nzvimbo
• Kusagadzikana kunonzwa sekusunga, kusvina, kupwanya, kupisa, kudzipa, kana kurwadziwa
• Kusagadzikana kunoitika pakuzorora uye hakupere nyore kana iwe ukanwa mushonga
• Kufema kwekufema
• Kudikitira

Nainaina yakadzikama, kurwadziwa pachipfuva kana zvimwe zviratidzo zvinongoitika nehumwe chiitiko kana kushushikana. Iwo marwadzo haawanzo kuitika kazhinji kana kutonyanya kuwedzera nekufamba kwenguva.

Angina isina kugadzikana kurwadziwa kwepfupa kunoerekana kwaitika uye kunowanzoitika zvakanyanya kwenguva pfupi. Iwe unogona kunge uchikudziridza angina isina kugadzikana kana kurwadziwa kwepfupa:

• Inotanga kunzwa zvakasiyana, yakanyanya kuoma, inouya kazhinji, kana inoitika nebasa shoma kana iwe uchinge wakazorora
• Inotora kupfuura maminetsi gumi nemashanu kusvika makumi maviri
• Zvinoitika pasina chikonzero (semuenzaniso, paunenge wakarara kana kugara wakanyarara)
• Haapindure mushe kumushonga unonzi nitroglycerin (kunyanya kana mushonga uyu wakashanda kudzikamisa kurwadziwa kwepfupa munguva yakapfuura)
• Inoitika nekudonha kweropa kana kufema kwekufema

Angina isina kugadzikana mucherechedzo wekuti chirwere chemwoyo chinogona kuitika munguva pfupi uye chinoda kurapwa ipapo ipapo. Ona wako mupi wehutano kana iwe uine chero rudzi rwekurwadziwa kwepfupa.

Iye mupi achaita bvunzo dzepanyama uye ongorora yako BP. Iye mupi anogona kunzwa manzwi asina kujairika, senge kugunun'una kwemoyo kana kurova kwemoyo zvisina kujairika, kana uchiteerera pachipfuva chako ne stethoscope.

Miedzo ye angina inosanganisira:

• Kuongororwa kweropa kuratidza kana uine kukuvara kwemuviri kana uri panjodzi huru yekurwadziwa nemoyo, kusanganisira troponin I uye T-00745, creatine phosphokinase (CPK), uye myoglobin.
• ECG.
• Echocardiography.
• Stress bvunzo, senge kurovedza muviri shiviriro bvunzo (kushushikana bvunzo kana treadmill bvunzo), nyukireya kushushikana bvunzo, kana kushushikana echocardiogram.
• Coronary angiography. Uyu muedzo unosanganisira kutora mifananidzo yemwoyo arteri uchishandisa x-ray uye dhayi. Iyo ndiyo yakanyanya kuyedza kuongorora kuti arteri yemoyo yakatetepa uye nekuwana kugwamba.

Ungangoda kutarisa muchipatara kuti uwane zororo, uwane bvunzo, uye kudzivirira kunetseka.

Ropa rakapfava (antiplatelet zvinodhaka) zvinoshandiswa kurapa uye kudzivirira angina isina kugadzikana. Iwe unozogamuchira iyi mishonga nekukurumidza sezvazvinogona kana iwe uchigona kuinwa zvakanaka. Mishonga inosanganisira aspirin uye inonyorwa mushonga clopidogrel kana chimwe chinhu chakafanana (ticagrelor, prasugrel). Iyi mishonga inogona kukwanisa kudzora mukana wekurwadziwa kwemoyo kana kuomarara kwekurwadziwa kwemoyo kunoitika.

Munguva yechiitiko chisina kugadzikana cheangina:

• Iwe unogona kuwana heparin (kana imwe ropa yakatetepa) uye nitroglycerin (pasi perurimi kana kuburikidza neIV).
• Dzimwe nzira dzokurapa dzinogona kusanganisira mishonga yekudzivirira kukanganiswa kweropa, kushushikana, zvimiro zvisina kujairika zvemwoyo, uye cholesterol (senge statin drug).

Maitiro anonzi angioplasty uye stenting anogona kazhinji kuitwa kuvhura yakavharika kana yakamanikana tsinga.

• Angioplasty inzira yekuvhura yakatetepa kana yakavharika tsinga dzeropa dzinopa ropa kumoyo.
• A coronary arteri stent idiki, simbi mesh chubhu iyo inovhura (inowedzera) mukati mecoronary artery. Simba rinowanzoiswa mushure me angioplasty. Inobatsira kudzivirira tsinga kubva pakuvhara zvakare. Iyo inodhaka-inodhira stent ine mushonga mairi iyo inobatsira kudzivirira iyo arteri kubva pakuvhara pamusoro penguva.

Kuvhiya kwemoyo kwepashure kunogona kuitirwa vamwe vanhu. Sarudzo yekuvhiyiwa inoenderana ne:

• Ndeapi tsinga akavharika
• Ndeapi tsinga dzinobatanidzwa
• Ndeapi mativi etsinga dzekoniyoni dzakatetepa
• Kukomba kwacho kwakanyanya sei

Angina isina kugadzikana chiratidzo chechirwere chemoyo chakanyanya.

Unyatsoita sei zvinoenderana nezvinhu zvakawanda zvakasiyana, zvinosanganisira:

• Yakawanda sei uye ndeipi tsinga mumoyo mako yakavharika, uye kuti yakanyanya sei kuvharika
• Kana wakamborwara nemoyo
• Iko mushe wako wemwoyo unokwanisa kupomba ropa kunze kwemuviri wako

Kujairika kwemoyo mutinhimira uye kurwiswa kwemoyo kunogona kukonzera kufa kamwe kamwe.

Angina isina kugadzikana inogona kutungamira ku:

• Asina kujairika moyo mutsi (arrhythmias)
• Chirwere chemwoyo
• Kutadza kwemoyo

Tsvaga kurapwa kana uine nyowani, isingatsanangurwe chipfuva kurwadziwa kana kumanikidza. Kana iwe wakambove neangina kare, fonera mupi wako.

Fonera 911 kana iyo yemuno emergency emergency kana yako angina kurwadziwa:

• Hazvisi nani maminetsi mashanu mushure mekutora nitroglycerin (mupi wako anogona kukuudza kuti utore matatu madosi)
• Hazvibve mushure memadosi matatu e nitroglycerin
• Zviri kuwedzera
• Inodzoka mushure meiyo nitroglycerin yakabatsira pakutanga

Fonera mupiki wako kana:

• Iwe une angina zviratidzo kazhinji
• Iwe une angina pawakagara (zorora angina)
• Uri kunzwa kuneta kakawanda
• Uri kunzwa kupera simba kana kuvezwa musoro, kana kupfuura
• Mwoyo wako uri kurova zvishoma nezvishoma (pasi pemakumi matanhatu kurova paminiti) kana nekukurumidza zvakanyanya (anopfuura makumi matanhatu kurova paminiti), kana kuti haina kudzikama
• Iwe uri kunetseka kutora yako mwoyo mishonga
• Iwe une zvimwe zviratidzo zvisina kujairika

Kana iwe uchifunga kuti uri kurwara nemoyo, enda kunorapwa ipapo ipapo.

Zvimwe zvidzidzo zvakaratidza kuti kuita mashoma marongero ehupenyu kunogona kudzivirira blockages kubva pakuwedzera uye zvinogona kunyatso kuvandudza. Mararamiro ehupenyu anogona zvakare kubatsira kudzivirira kumwe kurwisa kweangina. Wako mupi anogona kukuudza iwe kuti:

• Deredza uremu kana iwe uri kufuta
• Rega kusvuta
• Rovedza muviri nguva dzose
• Inwa doro zvine mwero chete
• Idya chikafu chine hutano chakakwira mumiriwo, michero, zviyo zvese, hove, uye nyama isina mafuta

Wako mupi achakurudzirawo kuti uchengete mamwe mamiriro ehutano akadai sekukwira kweropa, chirwere cheshuga, uye huwandu hwecholesterol huri pasi pesimba.

Kana iwe uine imwe kana zvimwe zvinenjodzi zvehosha yemwoyo, taura nemupi wako nezvekutora aspirin kana mimwe mishonga kubatsira kudzivirira kurwara kwemoyo. Aspirin therapy (75 kusvika 325 mg pazuva) kana zvinodhaka zvakadai seclopidogrel, ticagrelor kana prasugrel zvinogona kubatsira kudzivirira kurwisa kwemoyo mune vamwe vanhu. Aspirin nedzimwe nzira dzeropa-dzinotetepa dzokurapa dzinokurudzirwa kana bhenefiti yacho ingangopfuudza njodzi yemhedzisiro.

Kufambisa angina; Angina nyowani; Angina - asina kugadzikana; Angina inofambira mberi; CAD - angina isina kugadzikana; Coronary arteri chirwere - isina kugadzikana angina; Chirwere chemwoyo - angina isina kugadzikana; Kurwadziwa pachifuva - kusagadzikana angina

• Angina - kubuda
• Angina - chii chekubvunza chiremba wako
• Angina - kana uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchirwara pachipfuva
• Angioplasty uye stent - moyo - kubuda
• Kurwadziwa kwemoyo - kubuda
• Kurwisa kwemoyo - chii chekubvunza chiremba wako

• Angina
• Coronary artery balloon angioplasty - akateedzana

Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA / ACC nhungamiro yevatungamiriri vevarwere vane isiri-ST-kukwirira kwakanyanya coronary syndromes: mushumo weAmerican College yeCardiology / American Heart Association Task Force pane Maitiro Ekudzidzira. [Yakagadziriswa kururamisa inowanikwa mu J Ndiri Coll Cardiol. 2014; 64 (24): 2713-2714. Kukanganisa kwedosi muchinyorwa chinyorwa]. J Ndiri Coll Cardiol. 2014; 64 (24): e139-e228. PMID: 25260718 pubmed.ncbi.nlm.nih.gov/25260718/.

Arnett DK, Blumenthal RS, Albert MA, uye al. 2019 ACC / AHA Nhungamiro pane yekutanga kudzivirira chirwere chemoyo: chirevo cheAmerican College yeCardiology / American Heart Association Task Force paKiriniki Yekudzidzira Maitiro. [rakaburitswa gadziriso rinowanikwa mu Kutenderera. 2019; 140 (11): e649-e650] [kururamisa kwakaburitswa kunoonekwa mukati Kutenderera. 2020; 141 (4): e60] [kururamisa kwakaburitswa kunoonekwa mu Kutenderera. 2020; 141 (16): e774]. Kutenderera. 2019 2019; 140 (11): e596-e646. PMID: 30879355. pubmed.ncbi.nlm.nih.gov/30879355/.

Bonaca MP. Sabatine MS. Iyo nzira kune murwere ane kurwadziwa pachipfuva. Mune: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Chirwere Chemwoyo cheBraunwald: A Chinyorwa cheCardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019: chitsuwa 56.

Giugliano RP, Braunwald E. Isiri-ST kukwirira kwakanyanya coronary syndromes. Mune: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Chirwere Chemwoyo cheBraunwald: A Chinyorwa cheCardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019: chitsiko 60.

Ibanez B, James S, Agewall S, et al. 2017 ESC Nhungamiro ye manejimendi yeacute myocardial infarction muvarwere vanopa ne ST-segment kukwirira: The Task Force for the Management of Acute Myocardial Infarction muvarwere Vanopa ne ST-chikamu Kukwira kweiyo European Society yeCardiology (ESC). Eur Moyo J. 2018; 39 (2): 119-177. PMID: 28886621 pubmed.ncbi.nlm.nih.gov/28886621/.

Jang JS, Spertus JA, Arnold SV, uye al. Mhedzisiro ye multivessel revascularization pane mamiriro ehutano mamiriro mune varwere vane ST-chikamu kukwirisa myocardial infarction uye multivessel coronary artery chirwere. J Ndiri Coll Cardiol. 2015; 66 (19): 2104-2113. PMID: 26541921 pubmed.ncbi.nlm.nih.gov/26541921/.

Lange RA, Mukherjee D. Acute coronary syndrome: angina isina kugadzikana uye isiri-ST kukwirisa myocardial infarction. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chits. 63.