Asi imwe nzira iyo vakadzi vanogona kuva nemarwadzo emapfupa ne "normal" coronary arteries
Kunyange zvazvo hutachiona hwehutano (CAD) hunokosha kune vakadzi sezvakunoita varume, zvimwe zvinhu zvinogona kuita kuti CAD iwedzere kuoma kuongororwa nevakadzi. Chimwe chezvinhu izvi "chikadzi-pattern" CAD. Muchikadzi-pattern CAD, coronary angiography - iyo "yegoridhe" yekutaridzirwa kweCAD - inowanzotsanangurirwa sechinhu chakajairika.
- Mukadzi-chimiro CAD ndechimwe chezviitiko zvakawanda zvinogona kubudisa CAD ne "normal" coronary arteries. Verenga pano nezvevamwe.
Munguva yehutachiona hunozivikanwa se atherosclerosis , marinary artery's smoothness, elastic stretch inowedzera, yakaoma, uye inoputika nemhando dzose dze "grunge" - kusanganisira calcium deposits, mafuta anoisa, uye masero asina kuvhiringidza asingawanzoitiki. Atherosclerosis inowanzoitwa nenzira inowanikwa munzvimbo inobudisa zvikwereti zvakajeka uye zvepasi . Aya mahwendefa, anokwanisa kufungidzirwa se "mashizha" makuru ayo anopinda mumugwagwa we arteri, kazhinji inokonzera kubviswa kwepakati mukati meyeri. (Nharaunda yavo ndiyo inoita kuti vagone kushandiswa pakurapa neangioplasty , stents kana kupfurikidza nekuvhiya .) Varwere vane CAD vangangodaro vaine imwe chete kana maviri mabheti, kana kuti ingave yakawanda yakagoverwa mumaroto ayo ega.
Madzimai ane vakadzi vechifananidzo cheCAD , atherosclerosis haisi ye discrete plaques, saka nzvimbo dzakasvibiswa dzisipo. Panzvimbo pezvo, mabheji aya muvakadzi ava anowedzera kupararira, achibatanidza kune imwe nguva denderedzwa rose reyeri, kuitira kuti chigadziko chetari chiwedzere mukati.
Kunyange zvazvo pasina nzvimbo dzakadzika dzekuvhara, mukati memukati we arteri inowanikwa zvakaderera. Pachine catheterization yemarayari inonzi coronary arteries inofadza uye inowanzogara yakakwana (kunyange inogona kuonekwa se "duku" muhupamhi).
Kufananidzira kwevakadzi nevakadzi-muenzaniso weCAD kunofungidzirwa kuva nani kupfuura yeCAD chaiyo, asi izvi hazvirevi mamiriro ezvinhu.
Mwoyo kurwisa uye rufu zvinoitika.
Kunyanya, chikadzi-pattern CAD inogona kukonzera acon coronary syndrome (ACS) . ACS inowanzoitika nokuti iyo inoparadzirwa inogona kuparadza uye kuparara (sezvinongoita mabheti akaoma anoita mune dzimwe dzakawanda dzeCAD), zvichiita kuti ropa rivhare mukati meyeri uye kuunza kuvhara kwechimbichimbi. Kana chivharo ichocho chichanyangarika nemishonga ye-clot-busting, iyo inotevera inonzi catheterization yemwoyo inowanzoonesa "maitiro" e "normal" emishonga inowanikwa nevakadzikadzi-CAD pattern, nokudaro inovhiringidza kadhidiologist.
Ndeapi Madzimai-muenzaniso CAD Akawanikwa?
Kuonekwa kwechikadzi-pattern CAD kunogona kugadziriswa netsika inoshandiswa inonzi intravascular ultrasound (IVUS) imaging. IVUS (iyo isiri iyo inowanzoitwa panguva yecatheterization, uye iyo isingatombowaniki mune zvipatara zvakawanda) inoda kuisa catheter chaiyo muyeri yerononi inoshandisa ultrasound (kureva, echocardiography ) kufungidzira kuti rusvingo rweteri runobva mukati. Izvo zvakapararira zvinowanikwa zvevakadzi-muenzaniso weCAD zvinogona kuonekwa nenzira iyi. Mune kumwe kuongorora kwechangobva kuitika, inopfuura hafu yevakadzi vane zviratidzo zve angina ne "normal" maronary arteries yakanga yakagadziriswa zvidimbu zvakashandiswa kushandisa IVUS.
Kuvapo kwechikadzi-pattern CAD kunogona kuderedzwa nekuyera kukwanisa kweyoroniyuta mishonga kuti iwedzere mukupindura kwechirwere chinonzi acetylcholine. Iyo mishonga yakaoma yakaonekwa mukadzi-pattern CAD inokundikana kuwedzera zvishoma.
Mukadzi-chimiro CAD inofanira kufungidzirwa mune chero mukadzi akamboita angina kana ACS, asi ndiani ane "maitiro" echirwere chetachiona checatheterization yemwoyo.
Ndeapi Mukadzi-muenzaniso CAD Wakaitwa?
Nemhaka yokuti kuderedza mishonga yegononary inowanikwa mumadzimai eCAD inopararira, kurapwa kwakagadziriswa kugadzirisa nzvimbo dzakasvibiswa - dzakadai seangioplasty, stents, uye chirwere chekuvhiya - kazhinji hachishandi.
Pane kudaro, kurapa kunofanirwa kuve kurapwa. Zvakanakisisa kurapwa kwechiitiko ichi hazvisati zvichitsanangurwa, asi nzira yakasiyana-siyana yakaita seyakanakisisa panguva ino, uye inofanira kusanganisira utsinye hunokonzerwa nechinetso chekuchinja , chirwere chekuderedza dambudziko rekuvhara (aspirin), nemishonga yekudzivirira mwoyo muscle pachako (beta blockers uye zvichida ACE inhibitors). Vatsvakurudzi vakatoisa pfungwa dzavo pamadzimai-muenzaniso CAD, uye kunzwisisa zviri nani zvechiitiko ichi uye kurapa kwayo kunowanikwa mune ramangwana risati ravapo.
Panguva ino, kana iwe uri mukadzi ane chirwere chenguruve-chinenge chepfu asi chiitiko chako chekushaya chirwere chepfungwa chakaratidza "chimiro" chinowanikwa mumakemikari, iwe uye chiremba wako unofanira kuziva kuti basa rako harina kupera. Mumamiriro ezvinhu aya, chiitiko che "chinowanzoitwa" angiography hachibvumi dambudziko remwoyo. Pane kudaro, zvinoreva kuti kuongorora kwakawedzerwa kunodiwa kuwana chikonzero chezviratidzo zvako.
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von Mering GO, Arant CB, Wessel TR, et al. Kusava nemafungiro evaronmalmal coronary sechiratidzo chekufananidzira kwezviitiko zvemoyo muvakadzi: migumisiro inobva kuNational Heart, Lung, uye Blood Institute yakatsigira Women's Ischemia Syndrome Evaluation (WISE). Kurongeka 2004; 109: 722-5.
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