Chikonzero nei kunyange "kurwadza" kwemwoyo kunogona kuva chinhu chikuru
Kwete-ST segment elevation myocardial infarction (NSTEMI) uye ST-segment elevation myocardial infarction (STEMI) zvose zvinowanzozivikanwa sehutano hwemwoyo. NSTEMI ndiyo inonyanya kufanana pairi mbiri, inotarisa kusvika makumi mapfumbamwe kubva muzana yekushungurudzika kwemwoyo.
NSTEMI, STEMI, uye chirwere chechitatu chinonzi angina chisingachinji chinokonzerwa nemhando dzakasiyana dzemakoroni (ACS) .
Kune chikamu chayo, ACS inotsanangurwa seimwe mamiriro ezvinhu akaunzwa nekuderedzwa kamwe kamwe kana kuvhara kwekuyerera kweropa kusvika pamwoyo.
Kunzwisisa Acute Coronary Syndrome
Mhando dzose dzeAACs dzinowanzokonzerwa nekuputika kwechivara mumatriconary artery , zvichiita kuti zvive zvisina kukwana kana zvakakwana kugadziriswa kwemudziyo. Zvichienderana nekuoma kwekudzivirira, ACS inogona kuiswa mumhando mitatu yakasiyana:
- Angina isina kugadzikana ndeye kuputika kwetari kunokonzera marwadzo emvere. Kusiyana nekusimudzira angina (inoitika kana iwe uchizviedza), angina isina kugadzikana inogona kuitika chero nguva uye inonzi yakanyanya kuoma. Pasinei nezviratidzo, angina isina kugadzikana haisi kukanganisa zvachose mwoyo.
- STEMI inoratidzika se "classic" yepfungwa yepamwoyo umo kuputika kwepakiti zvachose kana kuti pedyo kunodzima zvachose artery coronary, zvichiita kuti uwedzere kuora mwoyo.
- NSTEMI inonzi inonzi "yepakati" yeAACS umo kuvhara kunogona kuitika mune rimwe remitambo yakaoma kana kuti kunokonzera chigadziro chechikamu chigadzirwa chikuru chegoni. Kunyange zviratidzo zvingave zvakafanana ne STEMI, kukanganisa kwemwoyo kuchave kwakanyanya kuderera.
NSTEMI uye angina isina kugadzikana kazhinji inopfuurira kune "kukwana" kushaya mwoyo mukati memakore mashoma kana mwedzi. Sezvo zvakadaro, mumwe nomumwe anogona kutaridzirwa sechepamberi kune STEMI uye chiratidzo chekutanga chekuratidza kuti kupindira kwechirwere kunotyisa kunodiwa.
Kusiyanisa NSTEMI kubva ku STEMI
Kuongororwa kweNSTEMI kunowanzoitwa kana munhu ane zviratidzo zve angina isina kugadzikana.
Tinogona kusiyanisa STEMI kubva kuNSTEMI nekuverenga pa electrocardiogram (ECG) mune zvinonzi "ST-segment." Pasi pemamiriro ezvinhu akadai, iyo ST-chikamu inotsetseka inowanikwa pane ECG pakati pekushaya moyo. Munguva yekurwadziwa kwemoyo, ST-sekusimudzirwa. Sezvo zvakadaro, NSTEMI inodanwa nezita rayo nokuti hakuna humwe hutowo hwe ST sekumusoro.
Nemhaka yokuti NSTEMI inokonzera kukuvadza kumutsipa wemwoyo, vanachiremba vacharamba vachifunga kuti iri kurwisa mwoyo (vamwe vangati "ronda" mwoyo kurwisa). Nezvo zvichitaurirwa, NSTEMI inowirirana zvakafanana nema angina asina kugadzikana uye, saizvozvowo, kazhinji, ine migumisiro yakanaka.
Emergency Treatment yaNSTEMI
Kurapa kweNSTEMI kwakafanana neyey angina isina kugadzikana. Kana munhu akaonekwa ane zvirwere zvepfungwa (chifu chisimbiso, clamminess yeganda, kuputira marwadzo muruoko rworuboshwe, nezvimwewo), chiremba achatanga kurapa kwakasimba kuti agadzikane mwoyo uye kudzivirira zvimwe kukuvara.
Kusimbisa kunonyanya kuisa pfungwa pazvinhu zviviri:
- Kubvisa zvakanyanya ischemia , mamiriro umo mwoyo hauna kuwana oksijeni yakakwana, zvichiita kuti sero rufu. Izvi zvinoitwa, muchidimbu, nekupa beta blockers kudzivirira kukanganisa kunokonzerwa nekugadzirwa kwakanyanya kweAdrenaline uye nepamusoro-dose mitemo kuti kugadziriswe kuputsika kwemavara uye kuderedza kuputika kwechirwere. Kushandiswa kwemishonga iyi kunowanzopedza mwoyo wechem ischemia mukati memaminitsi. Oxygen uye morphine zvinowanzopiwa kupa rubatsiro uye kuderedza marwadzo.
- Kuchengeta ropa rekuvhara ropa kunosanganisira kushandiswa kweAspirin, Plavix, nemimwe mishonga kunopisa ropa uye kudzivirira kumira kweplatelets. Inosanganisirawo kudzivisa kwe "bhasiki", inowanzoshandiswa mu STEMI, iyo inogona kuita kuti zvinhu zviwedzere.
Chii Chichiitika Kana Chimwe Chete Chichigadziriswa
Kamwe kana murwere akasimbiswa, chiremba achaongorora kana kupindira kwakawedzerwa kuchidiwa. Nyanzvi dzakawanda dzechirwere dzinoshandisa TIMI (thrombosis mu myocardial infarction) purojekiti kuti ione kuti zvinoguma sei kune mumwe munhu.
Nhamba yeTIMI inotarisa kana kana munhu wacho ane chimwe chezviitiko zvinotevera zvinowanzoitika:
- Ane makore 65 kana kupfuura
- Kuvapo kwezvinhu zvitatu zvinokonzerwa nehutachiona hwemwoyo
- Pamberi koronary blockage yakawanda kupfuura 50 muzana
- ST-chikamu kuputsika pamubvumirano we ECG
- Pamwe maawa maviri angina episodes mumaawa 24 akapfuura
- Yakawedzera maperembudzi emwoyo
- Shandisa aspirin mukati memazuva manomwe akapfuura
Kana munhu ane maviri kana kuti mashoma ematambudziko aya (TIMI chikamu 0-2), kudiwa kwekupindira kwekuwedzera kunogona kudziviswa. Kana chikwata chacho chakakwirira, nyanzvi yezvematapi inogona kuda kuita catheterization yemwoyo neangioplasty uye inopisa .
Kune vanhu vanorambidza kurapwa kusingaiti, kuongororwa kwepfungwa kunowanzoitwa vasati vabuda. Kana pane zvimwe zviratidzo zvekuenderera mberi kwemoyo wechem ischemia, chirwere chinopisa chinenge chichirudzirwa zvakasimba.
> Source
- > Amsterdam, E ;; Wenger, N .; Brindis, R .; et al. "2014 AHA / ACC mutungamiri wehutungamiri hwevarwere nevasati vari ST-elevation acute coronary syndromes: gurukutukuro: chirevo cheAmerican College of Cardiology / American Heart Association Task Force pamitungamiri yeZviito." Circulation. 2014; 130: 2354.