Iko 3 maitiro e coronary arteri inokurumidza
Kana iwe kana munhu waunoda ane chirwere chechirwere chirwere (CAD) , iwe ungangodaro wakanzwa izwi rokuti "acon coronary syndrome," zvakare rinonzi ACS. ACS iri izwi idzva rinoshandiswa nema cardiologists, uye rinogona kunge rakavhiringidza. Zvisinei, nokuti inomirira nzira itsva yekufunga pamusoro peCAD , zvinogona kubatsira kutora maminetsi mashoma kuti uzvinzwisise.
Acute coronary syndrome yakawanda chaizvo zvarinonzwa.
Iyo inokurumidza mamiriro ezvinhu anokonzera aroniconary arteries; dambudziko. Inoratidza kuti CAD yomunhu yakangoerekana isina kugadzikana, uye kukuvadza kwekuguma kwemwoyo kunogona kuitika ikozvino kana kuti kunogona kuitika chero nguva.
Chii chinonzi ACS?
ASC inoitika apo ropa rinoputika kamwe-kamwe mukati megeriyoni , kazhinji zvichienderana nekuputika kwepasitori ye atherosclerotic . Kuputika kunogona kuitika chero nguva, kazhinji zvachose pasina kunyeverwa. Ivhapa rega rinogona kukonzera kusagadzikana zvakakwana kana kukwana kwe arteri, chero nzira iyo kuisa mwoyo yemisvo inopiwa neyeri iyo munguva pfupi inopisa.
Chero ipi neipi mune chero ipi zvayo yeroponary inopera, kunyange zviduku zviduku zvinowanzoregererwa ne cardiologists munguva yenguva yecatheterizations yemwoyo . Ichi ndicho chikonzero iwe unowanzonzwa pamusoro pevanhu vane myocardial infarction (MI, kana kushaya mwoyo), nguva pfupi mushure mekunge vataurirwa CAD yavo "haina basa."
Zviratidzo zve ACS
Zviratidzo zveAACs zvakafanana neaya angina akachengetedza asi kazhinji anowedzera zvakanyanya, nguva dzose uye anopfuurira. Chifukidzo chechifu mu ACS chinowanzosangana nemamwe zviratidzo zvinokanganisa zvakadai sokuputika, chirwere, chirwere, kushungurudzika kukuru, uye chinowanzotsanangurwa se "kunzwa kwekuuya kwekuparadzwa." Chirwere chepfupa chingave chisingatauriki ne nitroglycerin (iyo inowanzobvisa angina yakasimba).
Kune rumwe rutivi, vamwe vanhu vane ACS vane zviratidzo zvishoma zvishoma, vangarega kukanganisa chero zviratidzo zvachose - kutanga pakutanga.
Zvinosuruvarisa, kusingaperi kwemwoyo kunowanzokonzera kubva kuAACS, nokukurumidza kana kuti gare gare, kunounza zviratidzo.
Aina dze ACS
Cardiologists inoparadzanisa ACS muzvikamu zvitatu zvakasiyana zvakasiyana-siyana zvemakiriniki. Maviri awo anomirira maitiro akasiyana eMM, uye imwe inomiririra chimiro chakanyanya chema angina, chinonzi "angina chisingachinji." Zvose izvi zvitatu zvinokonzerwa nehutachiona ropa muyoronary arteries.
Kana ropa rinenge rakakura zvakanyanya uye rinopfuurira kune zvinopfuura maminetsi mashomanana, mamwe emwoyo masero masero anotanga kufa. Rufu rwemitsipa yemwoyo ndiyo inotsanangura MI. Mhando mbiri dzeMM dzinogona kugadzirwa neAACS.
- ST-Elevation myocardial infarction (STEMI) , yakatumidzwa nokuti "ST segment" pane ECG inooneka "yakakwirira," inowanikwa apo artery inogadziriswa yakavharwa zvachose kuitira kuti rutivi rukuru rwemutsipa wemwoyo rugoverwa neyeri iyo inotanga kufa .. STEMI ndiyo inonyanya kuipa yeAACS.
- Kwete-ST-Elevation myocardial infarction (NSTEMI) , iyo "ST segment" haina kukwirira, inowanikwa apo kuvhara mukati megoni yerononi "ndeye" chete. Kuvhara zvakakwana kunoitika kukanganisa zvimwe zvemwoyo yemasero masero anopiwa nechirwere chinorwara, asi kukanganisa kunowanzove kusina kuderera kudarika ne STEMI. Chimwe chinetso neNSTEMI , zvisinei, ndechokuti nekushaya zvakakwana kurapwa kunogona kuzadzika, uye NSTEMI ichava STEMI.
- Dzimwe nguva ACS inobvisa ropa rinenge risati rakakura zvakakwana. kana kuti haisi kuramba ichireba kwenguva yakareba, kuti ibudise chero hupenyu huno husingaperi hutsika hukuvara. (Nhengo dzekudzivirirwa kwemuviri dzinoedza kuputsa ropa rinogadzirisa mukati memidziyo yeropa.) Apo ACS iri kubudisa zviratidzo zvisati zvaita kuti mutsara wemwoyo ufe, inonzi isina yakasimba . Vanhu vane angina vasina kugadzikana vane njodzi huru yekufambira mberi kuNSTEMI kana STEMI.
Zvose zviviri NSTEMI uye angina isina kugadzikana zvinogona kuonekwa se "kusakwana" kwemwoyo. Iyi miviri miviri yeAACS inoda kufanana, kukanganisa kurapwa kweutano kuitira kuti kuderedze mikana yavanozoenderera mberi ku STEMI - iyo nyanzvi dzema cardiologist dzinowanzoti "yapera" MI.
Kuita Kuona Zvakarurama muAACS
Kutaura muchidimbu, kamwechete ropa rekuvhara muropa rinowanikwa mumatriconary artery, kana yakawanda mwoyo yemisitundu yakanganisa yakatoitika STEMI inowanikwa. Kana "nyanya" yemutsipa inokanganisa kuitika, NSTEMI inowanikwa. Kana pasina chimiro chepfungwa chinokanganisa misi inowanikwa, angina isina kugadzikana inowanikwa.
Kana iwe uine ACS, kazhinji zviratidzo zvako, kuongorora mumuviri, nhoroondo yezvokurapa uye mungozi yepfungwa zvinokonzera kuti chiremba arambe achinyatsofunga kuti anorwara. Kubva panguva iyoyo, iye achakurumidza kuongorora ECG yako uye kuenzanisa mapikisi emuviri wako. Mazwi emakemikari emakemikari anosunungurwa muropa remvura kuburikidza nekufa kwemasero emasero, saka kukwirira mumakemikari emwoyo kunoreva kuti mwoyo masero emuviri ari kuitika.
Saka: Kuonekwa kweEECG (kureva, kuvapo kana kusavapo kwe "kukwirira" mu ST sezvikamu) kuchasiyanisa pakati pe STEMI neNSTEMI. Uye kuvepo kana kusavapo kwemakemikari emukati emoyo kuchasiyanisa pakati peNSTEMI uye angina isina kugadzikana.
Kukosha kweAACS
Izvo zvitatu zve ACS zvinomirira maitiro emakiriniki anokwanisa kuitika apo bhokisi rinoputika mukati megoni. Mukati, pane chaizvoizvo mutsara wakajeka uyo unowanzoparadzanisa STEMI, NSSTEMI, uye angina isina kugadzikana. Pano ma cardiologist anotora mutsara pakati pe STEMI neNSTEMI, kana pakati peNSTEMI uye angina isina kugadzikana, inosarudzo isingaiti. Zvechokwadi, tsanangudzo dzemhando idzi zvitatu dzeAACS dzakashandura zvikuru pamusoro pemakore, sezvo ruzivo rwedu-kunyanya simba redu rokududzira maEGG uye kuona hutachiona hwemwoyo pamwe neyero enzyme - yakavandudzwa.
Nyaya inokosha ndeyokuti mamiriro ose eAACS (zvisinei kuti akaparadzaniswa sei) ndeyekukurumidzira kwechiremba, uye inoda kutarisirwa kuchipatara nokukurumidza kuedza kuita zvinhu zviviri: 1) kuderedza mwoyo musungo uipi huri kuitwa zvakajeka neropa rega mukati iyo yerinoni, uye 2) kugadzirisa kukanganisa kuti ibwe - iro rave razviratidza kuti risina kugadzikana uye rinowanzoitika - richaputsika zvakare.
> Sources
> Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA / ACC Nhungamiro yekutungamira kwevarwere nevasina-St-elevation zvakanyanya Coronary Syndromes: Executive Summary: Nhoroondo yeAmerican College of Cardiology / American Heart Association Task Force pamusoro pekushandisa mazano. Circulation 2014; 130: 2354.
> Pollack CV Jr, Diercks DB, Roe MT; Peterson ED. 2004 American College of Cardiology / American Heart Association Nhungamiro Yekutungamira Kwevarwere NeSt-Elevation Myocardial Infarction: Zvinokonzera Emergency Department Practice. Ann Emerg Med 2005 Apr; 45 (4): 363-76.