Angina Ne Normal Coronary Arteries
Cardiac Syndrome X, kana microvascular angina, inoratidzwa apo munhu ane angina , ane uchapupu hwemwoyo ischemia mukuedzwa kwepfungwa , asi neyortin- cortaary arteries inoratidzika pamusoro pekushaya catheterization . Muzviitiko zvakawanda, microvascular angina inokonzerwa nehutano hwemazana mashomanana emakoronary artery umo aya maduku maduku anokundikana kuwedzera zvishoma, nokudaro nokuita kusakwana kweropa kunopinda kumwoyo wemisungo.
Sezvo dambudziko iri iye zvino rafungidzirwa kuti rinowanikwa kune mishonga duku, zita rekare remararamiro epamwoyo X rakanyanya kubviswa nezwi rinotsanangurwa, microvascular angina. Zvinoshamisika, zvakadaro, dzimwe nyanzvi dzinofunga kuti vanhu vane chirwere ichi vanogona kuva nekunzwisisika kwemazuva ekurwadziwa kwemwoyo.
Microvascular angina yakawanda zvikuru kuvarumekadzi (kazhinji, vakadzi ve postmenopausal) kupfuura varume. Pane zvikonzero zvinokonzera zviduku duku zvekusaita zvinofungidzirwa kuti zviripo mu microvascular angina, kusanganisira insulini kudzivisa , kuputika, kuwedzerwa adrenalin basa, estrogen kukwana, uye dysautonomia . Zvichida kuti varwere vakasiyana-siyana vane microvascular angina vanogona kunge vane zvikonzero zvakasiyana-siyana.
Kunyange zvazvo vanhu vazhinji vane microvascular angina vane maitiro akanaka - pakuti mungozi yemakononi yakaoma yakakonzerwa ne microvascular angina yakadzika kwazvo - hazvishamisi kuti marwadzo emapfupa anobudiswa nemamiriro ezvinhu aya ave akakosha, uye dzimwe nguva kudzivisa, dambudziko.
Kurapa Microvascular Angina
Chero pose paunoona rurefu rurefu rwekugona kurapwa kune mamwe mararamiro, chiratidzo chokuti kubata chirwere ichocho kunogona kuoma. (Zvichida, ndicho chikonzero mishonga dzakawanda dzakaedzwa kare.) Izvozvo ndizvo zvakaita microvascular angina.
Mishonga yakawanda inowanikwa inobatsira mune vamwe varwere vane microvascular angina.
Zvisinei, pakuwana "zvakanakisisa" kurapa kune chero munhu akapiwa, nzira yekuedza-uye-kukanganisa inowanzodiwa. Izvi zvinoreva kuti vose vane chirwere chinonzi microvascular angina uye chiremba angave achida kuva nemoyo murefu uye anoramba achida kuti awane kurapa kwakanakisisa.
Heino urongwa hwemishonga inowanzoshandiswa mukurapa microvascular angina:
Traditional Angina Zvinodhaka -
- Beta blockers - zvikurukuru atenolol
- Calcium channel blockers
- Nitrates - zvinyorwa zvisinganzwisisiki nitroglycerin zvinowanzobvisa angina yakawanda mu microvascular angina, asi kwenguva refu kuita nitrate hazvina kuratidzwa kuti ndeyekubatsira
Kwete-tsika dzeAngina Zvinodhaka -
- Ranolazine - yakanyatsoshanda mumakiriniki maduku
- ACE inhibitors - kunyanya kune varwere vane hypertension
- Ivabradine - inoshandawo mumakirini emakiriniki maduku
- Statins - kunyanya kune varwere vane high cholesterol mazinga
- Estrogens - mumashure-menopausal vakadzi
- Imipramine - kwete chirwere chema angina, asi inogona kubudirira nekurwadziwa kwekutambudzika
- l-arginine - inogona kubatsira kubatsiridza kushandiswa kwemashure maduku
- Sildenafil (Viagra) - kwete kunyatsodzidza nezve microvascular angina, asi inogona kunge yakabudirira mune vamwe vanhu
- Metformin - rubatsiro rwechirwere ichi mukurapa microvascular angina inongova anecdotal, uye haisimbiswi nemagariro echechi.
Non-Mishonga Therapy -
- EECP -inoratidzwa mune imwe chidzidzo chiduku kuti ibudirire kune microvascular angina
- Mutsara wesimbi kukurudzira - unoratidzwa kuti unobatsira kune vamwe varwere vane kurapwa kwemishonga kwakakundikana.
- Kudzidzira kudzidzisa kwakabatsira zvikuru, kunyanya kune varwere vanorondedzerwa.
Nzira Yakawanda Yokurapa Kwemakumbo Mashoma Angina
Zvichipa zvose izvi zvingaitika, vazhinji vanoongorora mapurisa vanoedza kuwedzera kurapwa kweiyo microvascular angina vachishandisa nzira yekudzidzira-nyanzvi. Kana kutonga kwakakwana kwezviratidzo zvisingawaniki nechinhanho chero chipi zvacho, chiremba uye murwere achaenderera kune imwe nhanho inotevera.
- Nhanho 1 inowanzoshandisa shanduro inonzi nitroglycerin kuti isunungure zviratidzo pose painoitika. Purogiramu yekudzidziswa mumuviri inowanzosimbiswa zvakasimba sechikamu chekutanga. Kana danho iri risingapi rubatsiro rwakakwana:
- Nhanho 2 inowanzowedzera beta blocker.
- Nhanho 3 kazhinji inomisa beta blocker uye inotsiva calcium channel blocker.
- Nhanho 4 inowanzoedza ranolazine, kana yoga kana ne beta blocker kana calcium blocker.
- Nhanho 5 ndeyekutarisa mamwe madhiragi kana kuwedzera kusina-drug therapy, ine musipinha tsvimbo stimulation kana EECP.
Mukuwedzera pane kutora matanho akadai, ACE inhibitor inofanirawo kunyatsofungidzirwa kana kuwedzera kwehutano kuchipo, uye chimiro chinofanirwa kunyatsofungidzirwa kana njodzi dzinokonzerwa nehutachiona hwehutachiona huripo. Madzimai avo vachangobva kuwanikwa menopausal, therogen therapy inogona kunge yakakodzera kufungisisa zvakare.
Nokushivirira-zvichida chinhu chakanaka chekushivirira-kutonga kwakakwana kwezviratidzo kunogona kuwanikwa muhuzhinji hwevanhu vane microvascular angina. Uye pavanenge vachifambira mberi kuburikidza nematanho aya, vanhu vane microvascular angina vanofanira kuchengeta mupfungwa kuti kushandiswa kwavo kwenguva refu kunowanikwa zvakanaka.
> Sources:
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> Mehta PK, Goykhman P, Thomson LE, et al. Ranolazine Inovandudza Angina muvakadzi nehuchapupu hweMyocardial Ischemia asi hapana chinoparadza Coronary Artery Disease. JACC Cardiovasc Imaging 2011; 4: 514.
> Task Force Members, Montalescot G, Sechtem U, et al. 2013 ESC Zvinyorwa pamusoro pekutungamirirwa kweSouth Coronary Artery Disease: Task Force pamusoro pekutonga kweStable Coronary Artery Disease yeEuropean Society of Cardiology. Eur Moyo J 2013; 34: 2949.