Apo Spasm muArion Coronary inotungamirira kuChipfuva Chirwere
Prinzmetal angina , iyo inonziwo vasospastic angina kana kuti angina yakasiyana, inowanzoita chikonzero chekurwadziwa kwepfupa. Izvo zvinoitika apo tsvina inowira mune rimwe remakoroniyria -arteri inopa ropa kumoyo wako. Iyo tsvina inokonzera chikamu chemitsipa yemwoyo kuti isarwe ropa rayo, uye angina inoitika. Kunyange zvazvo Prinzmetal angina inogona kuva nemigumisiro inokosha, inosanganisira kuora mwoyo kwemoyo uye kutyisa hupenyu hwemaridythmias , inogona nguva dzose kurapwa zvakanaka kana ichinyatsoongororwa.
Kwete Mwoyo Wokurwisa, Asi Unogona Kuda Kuita Sezvo
Chirwere chinosuruvarisa icho vanhu vanowanikwa neChriszmetal angina hachizivikanwi kubva kuchikoro, chinowanzoita angina chinokonzerwa ne atherosclerosis . Sezvakafanana neinofananidza angina, vanhu vane Prinzmetal angina vanowanzotsanangurira kusanganiswa kwezviratidzo, kusanganisira chifu chinomisa, kufema, kuwedzera, kuzara, kurema kana ruzi mubhokisi, kuputa, kana kuti kutsva. Chifuva chakadaro "chisina kunaka" chinogona kuendeswa ne dyspnea , neusea, kana sweating, uye / kana palpitations . Zviratidzo izvi zvinoramba zvichienderera kwemaminitsi gumi nemashanu kana kupfuura. Uye zvakasiyana nezvinoitwa angina, iyo inowanzoitika panguva yekuedza kana kushungurudzika, Prinzmetal angina kakawanda inowanzoitika panguva yekuzorora. Ichokwadi, vanhu vanowanzoona Prinzmetal angina panguva yakanyarara yezuva - pakati peusiku uye mangwanani-ngwanani.
Iko kusanganiswa kwezviratidzo dzimwe nguva kunoita kuti vanhu vane Prinzmetal angina vatende kuti vane chirwere chemwoyo.
Nenzira, izvi zvingasava chinhu chakaipa, nokuti vanhu vanofunga kuti vane chirwere chemwoyo vanowanzotsvaka rubatsiro rwechiremba. Uye nokukurumidza Prinzmetal angina inowanikwa, inokurumidza kuraswa zvakanaka.
Zvinokonzera
Chero ani zvake anogona kukudziridza chirwere ichi, asi chinonyanya kuwanikwa kuvakadzi. Vanhu vanokura Prinzmetal angina vanowanzova vaduku, vane utano hwakanaka, uye kazhinji vane mikana yakawanda yezvipingamupinyi zvechirwere chemwoyo - kunze kwekusvuta.
Kusvuta kunowanzoita chinhu chikuru mukutsamwisa angina mumamiriro ezvinhu aya nokuti mishonga yefodya inogona kukonzera kupisa kwemaitiro.
Mukuwedzera kune kusvuta, kushandiswa kwecocaine kana amphetamines kunogonawo kutsamwisa Prinzmetal angina. Vanoshungurudza zvinhu ne Prinzmetal angina vanowanzoshungurudzika (kana kuuraya) kukuvadza mwoyo kune vasiri vashandisi vese.
Mune zvimwe zviitiko, Prinzmetal angina inofungidzirwa kuti inokonzerwa ne " endothelial dysfunction ," mamiriro ayo mukati mekunamatira (kureva, endothelium) yemariti inoshanda musingaiti. Endothelial kusagadzikana kunobatanidzawo nehutano hwepfungwa x , Raynaud's phenomenon, uye migraine musoro . Zvechokwadi, vanhu vane Prinzmetal's angina kazhinji vanowanzobatwa nevanorwara.
Maitiro akadini Prinzmetal Angina Anoonekwa
Prinzmetal angina inowanikwa apo imwe nzvimbo mune imwe yemakoroni makuru emakoroni inotanga kupinda mumhepo, ichivhara ropa nguva pfupi kusvika pamwoyo musungo inopiwa neyeri iyo. Munguva dzezviitiko izvi, electrocardigram (ECG) inoratidza kukudzwa kunoshamisa kwe " ST segment " - iyo ECG imwechete inochinja inowanzoonekwa nekurwadziwa kwemoyo. Nitrate inowanzobvisa kupera kwechimbichimbi kwazvo, kudzorera mishonga yegononi kudzokera kune yakajairika.
Saka, zvinhu izvo vanachiremba vanotarisira kuongorora kuti Prinzmetal angina ndezvi:
- inowanzo "kurwadziwa" muchipfuva chepfu,
- pamwe chete nekuchinja kukuru kweEECG,
- iyo inonunurwa ne nitrate administration,
- ne "chimiro" chaiyo yerononi inoratidzirwa pane catheterization yemwoyo .
Muzviitiko zvakawanda, chiremba haazovipo panguva chaiyo yechinyorwa che angina. Izvi zvinoreva kuti munhu ane Prinzmetal angina achauya kuti aongorore mushure mokunge angina aenda. Muzviitiko izvi, kuongororwa kwekuongororwa kunogona kusanganisira kuvhara kweEGG kwemavhiki mashomanana (kutsvaga zvikamu zvepakati zvema angina pamwe chete neEGG kuchinja), kana kuedza kuongorora . (Kunyange zvazvo Prinzmetal angina kazhinji inowanikwa pazororo, vanenge 20% yevanhu vane chirwere ichi vanogona kunge vaine angina avo vakatsamwisa panguva yekuedzwa kwekuvhiya.)
Dzimwe nguva, zvisinei, catheterization yemwoyo ne "kuedza kupedza" inodiwa kuti iongororwe. Nemhaka yokuti Prinzmetal angina inokonzerwa nekoniyuta yemaarita spasm pane kuti ichengetedzwe mukati meyeri, catheterization inowanzoratidza "zvakakwana" maronary arteries. Uyezve, nokuti Prinzmetal angina haisi yega yerinina iyo inogona kuonekwa nemarayari ezvakanaka , zvichiita kuti kuongororwa kwakarurama kungadikanwa kuratidza kuti chirwere chetari chinokanganisa chinogona kutsamwiswa.
Mhando mbiri dze "kutsamwirwa" dzinowanzoshandiswa kuedza kuita kuti chironga chemarita chisarudze - hyperventilation, uye kuongorora zvinodhaka neacetylcholine kana ergonovine.
Hyperventilation test is test noninvasive. inowanzoitwa mangwanani-ngwanani, apo kupisa kunowanzoitika. Nechiratidzo che hyperventilation, murwere anorayirwa kufema uye nekukurumidza kwemaminitsi matanhatu azere-izvo zvakaoma zvikuru kupfuura zvinganzwisisika- nepo ECG iri kuramba ichinyorwa, uye echocardiography yakaitwa kutarisa zviratidzo zvegonta yeroparasi . Uyu muedzo unonyanya kukosha kune vanhu vanogara vaine zvikamu zveHerzmetal's angina. Inotarisa kusava inenge inobatsira kune avo vane zvikamu zvepasode zviri zvishoma nezvishoma kana zvisingabviri.
Kuedzwa ne acetylcholine kana ergonovine kunoitwa panguva yekushaya catheterization yemwoyo. Iko rudzi rwekuedza runobereka zvakakodzera kuongororwa zvakatendeseka kupfuura chirwere che hyperventilation. Muchiyero ichi, chimwe chezvinodhaka izvi chinokonzerwa mukati-kati (ergonovine) kana zvakananga mumatriconary artery (acetylcholine). Mune vanhu vane Prinzmental angina, izvi zvinowanzotambudza nzvimbo imwecheteyo yeconary artery spasm inokonzera zviratidzo zvavo. Iyi tsvina yemunharaunda inogona kuonekwa pane imwe nzira ye catheterization. Pari zvino, kuedza neacetylcholine kunofungidzirwa kuchengeteka kudarika kuongororwa ne ergonovine uye ndiyo inoshandiswa yakavhiringidzika inopisa.
Outlook nemigumisiro
Kunyange zvazvo muchiitiko maonero evarwere vane Prinzmental angina zvakanaka kwazvo, izvi zvinogona kukonzera zvinetso zvakakomba. Inogona kukonzera ngozi uye inogona kunge inouraya chirongwa chemwoyo, kunyanya ventricular fibrillation. Uye kunyange zvazvo kushaya mwoyo kusinganzwisisiki ne Prinzmetal angina, zvechokwadi vanogona kuitika, vachigadzira kukuvara kwekusingaperi kumutsipa wemwoyo. Kunyatsokodzera kurapwa kweChriszmental angina kunoderedza zvikuru njodzi yezvinetso zvakadaro. Muzvokwadi, kamwe chete pahutano hwakanaka, vanhu vane chirwere ichi vanogona kutarisira kutungamirira zvizere, hutano hupenyu.
Kurapa
Kana iwe uine Prinzmetal angina, zvichave zvakakosha kwauri (sezvazviri kune vose) kuti uchengetedze muviri wako wose panjodzi. Asi iwe iwe, zvinonyanya kukosha kuti urege kushandiswa kwefodya, izvo zvinokurudzira zvine simba zvekoniyuta yeropa.
Zvichida iwe uye chiremba wako uchakwanisa kuwana hutano hwakanaka pane zvikamu zvako zve angina ne nitrates uye / kana calcium channel blockers . Uyewo, unogona kukurukura nachiremba wako kushandiswa kwechimiro-kirasi yemishonga iyo isingori kuderedza cholesterol asiwo inovandudza endothelial basa - sezvinoitwa kare zvinyorwa zvinoratidza kuti mitemo inogona kubatsira kudzivirira maronary artery spasm.
Zvinodhaka zvinogona kukonzera chirwere chetayari uye izvo iwe unowanzofanira kudzivisa zvinosanganisira vazhinji beta blockers uye mamwe migraine zvinodhaka - kunyanya, Imitrex (sumatriptan).
> Sources:
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