Maʻi hohola

Hoʻokumu ʻia ka hapa nui o nā puʻuwai e ka pūpū koko e ālai ana i kekahi o nā aʻa coronary. Lawe ke aʻa koronaʻi i ke koko a me ka oxygen i ka puʻuwai. Inā kāohi ʻia ke kahe o ke koko, pōloli ka puʻuwai i ka oxygen a make nā hunaʻi puʻuwai.

ʻO ka lāʻau lapaʻau no kēia ka infoccial myocardial.

Hiki i kahi mea i kapa ʻia ke plake ke kūkulu i nā paia o kāu aʻa coronary. Hana ʻia kēia pālolo i ka kolesterol a me nā keena ʻē aʻe.

Hiki ke hana i kahi puʻuwai puʻuwai ke:

• Kūleʻa kahi disruption i ka pā. Hoʻopuka kēia i nā platelet koko a me nā mea ʻē aʻe e hana i kahi kōkō koko ma ka pūnaewele e ālai ana i ka hapa nui a i ʻole o nā kaʻi hāpai i ka oxygen mai ka holo ʻana i kahi ʻāpana o ka puʻuwai puʻuwai ʻO kēia ke kumu pinepine o ka hōʻeha puʻuwai.

ʻAʻole ʻike ʻia ke kumu o ka puʻuwai puʻuwai, akā aia kekahi mau mea weliweli maikaʻi.

Hiki paha ke hōʻeha puʻuwai:

• Ke hoʻomaha a hiamoe paha ʻoe
• Ma hope o ka piʻi koke o ka hoʻoikaika kino
• Ke hana ʻoe ma waho i ke anuanu
• Ma hope o ke kaumaha, ke kaumaha a me ke koʻikoʻi koʻikoʻi paha, me kahi maʻi

Hiki i nā kumuhana kūpilikiʻi ke alakaʻi i ka hoʻomohala ʻana i ka plake buildup a me ka puʻuwai puʻuwai.

ʻO ka hōʻeha puʻuwai kahi maʻi olakino. Inā loaʻa iā ʻoe nā hōʻailona o ka puʻuwai puʻuwai, e kāhea koke iā 911 a i ʻole kāu helu kūloko kūloko.

• Mai hoʻāʻo e holo iā ʻoe iho i ka haukapila.
• MAI KALIAHI. ʻO ʻoe ka makaʻu nui loa no ka make koke i nā hola mua o ka puʻuwai puʻuwai.

ʻO ka ʻeha o ka umauma ka hōʻailona maʻamau o ka puʻuwai puʻuwai.

• ʻIke paha ʻoe i ka ʻeha ma kahi ʻāpana o kou kino OR
• E neʻe paha ka ʻeha mai kou umauma i kou mau lima, poʻohiwi, ʻāʻī, niho, ʻāʻī, ʻūpū, a i hope paha

Hiki ke ʻeha a akahai paha ka ʻeha. Hiki iā ia ke manaʻo e like me:

• ʻO kahi paʻa paʻa a puni ka umauma
• Inigestion maikaʻi ʻole
• Mea kaumaha e noho ana ma kou umauma
• Kaomi ʻana a i ʻole kaomi koʻikoʻi

ʻOi aku ka lōʻihi o ka ʻeha ma mua o 20 mau minuke. Hoʻomaha a me kahi lāʻau e hoʻomaha ai i nā kīʻaha koko (i kapa ʻia ʻo nitroglycerin) ʻaʻole paha e hoʻomaha loa i ka ʻeha o ka puʻuwai puʻuwai. Hele paha nā ʻōuli a hoʻi hou.

Hiki i nā ʻōuli ʻē aʻe o ka hōʻeha puʻuwai ke komo pū:

• Hopohopo
• Cough
• Mauleʻa
• ʻĀlohilohi, ʻōpuu
• ʻO Nusea a me ka luaʻi
• Palpitations (manaʻo e like me ka wikiwiki o ka puʻuwai a i ʻole kūlike ʻole o kou puʻuwai)
• Pokole o ka hanu
• ʻO ka hou, ka mea kaumaha loa paha

ʻO kekahi poʻe (e like me nā mākua makua, nā poʻe me ka maʻi diabetes, a me nā wahine) ʻaʻohe ʻeha iki o ka umauma. A i ʻole, loaʻa paha iā lākou nā hōʻailona atypical e like me ka pōkole o ka hanu, ka luhi, a me ka nāwaliwali. ʻO ka "puʻuwai puʻuwai hāmau" he puʻuwai puʻuwai me ka ʻole o nā ʻōuli i hiki ke loaʻa pū kekahi.

E hana kahi mea mālama ola i kahi hoʻokolohua kino a hoʻolohe i kou umauma me ka stethoscope.

• Lohe paha ka mea hāʻawi i nā kani kūpono ʻole i loko o kou mau māmā (i kapa ʻia nā crackles), kahi ʻōhumu o ka naʻau, a i ʻole nā ​​kani ʻē aʻe.
• Loaʻa paha ʻoe i ka pulse wikiwiki a kaulike ʻole paha.
• ʻO kāu kaomi koko he maʻamau, kiʻekiʻe, a haʻahaʻa paha.

E loaʻa iā ʻoe kahi electrocardiogram (ECG) e nānā no ka hōʻino o ka puʻuwai. I ka manawa pinepine, hōʻike kekahi mau hoʻololi i ka ECG ke loaʻa nei ʻoe i ka puʻuwai puʻuwai, ʻoiai ʻo ka puʻuwai puʻuwai hiki ke hana ʻia me ka loli ʻole o ECG.

Hiki i kahi hōʻoia koko ke hōʻike inā loaʻa iā ʻoe ka hōʻeha o ka puʻuwai. Hiki i kēia hoʻāʻo ke hōʻoia he maʻi puʻuwai kou. Hoʻomaʻa pinepine ʻia ka hoʻāʻo ma mua o ka manawa.

Hiki ke hana koke ʻia ka angiography coronary a i ʻole ma hope i ke ʻano o ka maʻi.

• Hoʻohana kēia hoʻokolohua i kahi kala makehewa a me nā kukuna x e ʻike ai i ke kahe ʻana o ke koko ma loko o kou puʻuwai.
• Hiki iā ia ke kōkua i kāu kauka e hoʻoholo i nā ʻano lāʻau āu e pono ai ma hope.

Nā hoʻokolohua ʻē aʻe e nānā i kou puʻuwai e hana ʻia ʻoiai ʻoe ma ka haukapila.

• ʻO Echocardiography me a i ʻole me ka hoʻāʻo koʻikoʻi
• Hōʻike hoʻohaʻahaʻa hoʻoikaika kino
• Hōʻike hoʻāʻo nuklear
• Heart CT scan a me ka puʻuwai MRI

LAAU IMPUHI

• E hoʻopili ʻia ʻoe i kahi nānā puʻuwai, no laila hiki i ka pūʻulu mālama olakino ke ʻike i ka maʻa mau o ka puʻuwai ʻana o kou puʻuwai.
• E loaʻa ʻoe i ka oxygen.
• E hoʻokomo ʻia kahi laina intravenous (IV) i hoʻokahi o kāu mau uaua. Hele nā ​​lāʻau a me nā wai i loko o kēia IV.
• Loaʻa iā ʻoe i nitroglycerin a me morphine e kōkua ai e hōʻemi i ka ʻeha o ka umauma.
• Hiki iā ʻoe ke loaʻa ka aspirin, ke ʻole palekana ia no ʻoe. I kēlā hihia, hāʻawi ʻia ʻoe i ka lāʻau ʻē aʻe e pale ai i nā kahe koko.
• Hiki ke mālama ʻia nā puʻuwai puʻuwai weliweli (arrhythmia) me ka lāʻau a i ʻole nā ​​uila uila.

OLELO HOOLAHA

ʻO Angioplasty kahi hana e wehe ai i nā kīʻaha koko ākea a i ʻole nā ​​poloka e hāʻawi i ke koko i ka puʻuwai.

• ʻO Angioplasty ka koho mua loa o ka lāʻau. Pono e hana i loko o 90 mau minuke ma hope o kou hōʻea ʻana i ka haukapila, a ma hope o 12 mau hola ma hope o ka hōʻeha puʻuwai.
• ʻO kahi stent kahi pahu liʻiliʻi, hao hao e wehe ai (hoʻonui) i loko o ke aʻa coronary. Hoʻokomo ʻia kahi stent ma hope a i ʻole ma ka manawa o ka angioplasty. Kōkua ia i ka pale ʻana i ke aʻa o ke pani hou ʻana.

Hāʻawi ʻia ʻoe i nā lāʻau e wāwahi i ka hāpau. Kapa ʻia kēia thrombolytic therapy. ʻOi aku ka maikaʻi inā hāʻawi ʻia kēia mau lāʻau i hope koke o ka hoʻomaka ʻana o nā ʻōuli, maʻamau ma hope o 12 mau hola ma hope o ia a maikaʻi loa i loko o 30 mau minuke o ka hōʻea ʻana i ka haukapila.

Loaʻa paha i kekahi poʻe i ka ʻoki bypass puʻuwai e wehe hāiki a i ʻole ālai ʻia nā kīʻaha koko e hāʻawi i ke koko i ka puʻuwai. Kāhea ʻia kēia kaʻina hana he coronary artery bypass grafting and / or open heart surgery.

LOA MAHOPE ANA O KA HOAU LOA

Ma hope o kekahi mau lā, e hoʻokuʻu ʻia ʻoe mai ka haukapila.

E ʻai paha ʻoe i nā lāʻau, kekahi no ke koena o kou ola. E kamaʻilio mau i kāu mea hāʻawi ma mua o ka hoʻomaha ʻana a hoʻololi paha i kāu lawe ʻana i nā lāʻau. Hiki ke make ke kū ʻana i kekahi mau lāʻau.

ʻOiai ma lalo o ka mālama a kāu hui mālama ola, e aʻo ʻoe:

• Pehea e lawe ai i nā lāʻau e mālama ai i kou pilikia puʻuwai a pale aku i nā hōʻeha puʻuwai hou aku
• Pehea e ʻai ai i ka papaʻai olakino puʻuwai
• Pehea e hana a hoʻoikaika kino ai
• He aha e hana ai inā ʻeha kou umauma
• Pehea e hooki ai i ka puhi baka ʻana

Kūleʻa nā manaʻo ikaika ma hope o ka puʻuwai puʻuwai.

• Minamina paha ʻoe
• Hiki paha iā ʻoe ke hopohopo a hopohopo paha e makaʻala i nā mea āpau āu e hana ai

Kūleʻa kēia mau manaʻo āpau. Hele lākou no ka hapanui o ka poʻe ma hope o 2 a 3 mau pule.

Luhi paha ʻoe i ka luhi ke haʻalele ʻoe i ka haukapila e hoʻi i kou home.

ʻO ka hapa nui o ka poʻe i loaʻa i ka puʻuwai puʻuwai e komo i kahi papahana hoʻoponopono naʻau.

Pōmaikaʻi ka poʻe he nui mai ka lawe ʻana i nā hui kākoʻo no ka poʻe me ka maʻi puʻuwai.

Ma hope o ka puʻuwai puʻuwai, loaʻa iā ʻoe kahi manawa kiʻekiʻe e loaʻa hou i ka puʻuwai hou.

Maikaʻi kāu hana ʻana ma hope o ka puʻuwai puʻuwai e pili ana i nā kumu like ʻole e like me:

• Ka nui o nā hōʻino i kou puʻuwai puʻuwai a me nā puʻuwai puʻuwai
• Kahi e loaʻa kēlā ʻino
• ʻO kāu mālama olakino ma hope o ka hōʻeha puʻuwai

Inā ʻaʻole hiki i kou puʻuwai ke paipū hou i ke koko i kou kino e like me ma mua, hiki iā ʻoe ke ulu i ka puʻuwai puʻuwai. Hiki ke hana i nā mele naʻau maʻamau, a hiki ke hoʻoweliweli i ke ola.

Hiki i ka hapa nui o ka poʻe ke hoʻi lohi i nā hana maʻamau ma hope o ka puʻuwai puʻuwai. Hoʻopili kēia i ka hana moekolohe. E kamaʻilio i kāu mea hāʻawi e pili ana i ka maikaʻi o ka hana nāu.

Myocardial infarction; MI; Acute MI; ST - hoʻokiʻekiʻe myocardial infarction; Non-ST - hoʻokiʻekiʻe myocardial infarction; NSTEMI; CAD - hōʻeha puʻuwai; ʻO ka maʻi ahulau coronary - hōʻeha puʻuwai

• Angioplasty a me stent - puʻuwai - hoʻokuʻu
• Cholesterol - lāʻau lapaʻau
• Cholesterol - he aha e nīnau aku ai i kāu kauka
• Puʻuwai puʻuwai - hoʻokuʻu
• Ka hōʻeha puʻuwai - he aha e nīnau aku ai i kāu kauka
• Hewa ka puʻuwai - he aha e nīnau aku ai i kāu kauka
• Ke koko kiʻekiʻe - he aha e nīnau aku ai i kāu kauka
• Lawe iā warfarin (Coumadin, Jantoven) - he aha e nīnau aku ai i kāu kauka
• Lawe iā warfarin (Coumadin)

• Puʻuwai - ʻāpana ma waena o ka waena
• Puʻuwai - ʻike mua
• Ke kūkulu holomua ʻana o ka pāka i ke aʻa coronary
• Acute MI
• Kau ka myocardial infarction ECG nalu tracings
• Nā aʻa puʻuwai posterior
• Nā aʻa puʻuwai mua
• Nā hōʻailona hōʻeha puʻuwai
• ʻEha a me ka puʻuwai puʻuwai

Amsterdam EA, Wenger NK, Brindis RG, a me al. 2014 AHA / ACC alakaʻi no ka mālama ʻana i nā mea maʻi me ka ʻole ST-kiʻekiʻe kiʻekiʻe syndromes coronary: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force ma nā Kumu Alakaʻi. ʻO J Am Coll Cardiol. 2014; 64 (24): e139-e228. PMID: 25260718 pubmed.ncbi.nlm.nih.gov/25260718/.

Arnett DK, Blumenthal RS, Albert MA, et al. ʻO 2019 ACC / AHA kulekele e pili ana i ka pale mua ʻana i ka maʻi maʻi ʻōpū: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force on Clinical Practice Alakaʻi. Kaapuni. 2019; 140 (11): e596-e646. PMID: 30879355 pubmed.ncbi.nlm.nih.gov/30879355/.

Bohula EA, ʻApōpō DA. Infarction myocardial ST-kiʻekiʻe: hoʻokele. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 59.

Giugliano RP, Braunwald E. Non-ST kiʻekiʻe a me nā syndrome coronary. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 60.

O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF / AHA alakaʻi no ka mālama ʻana i ka infarction myocardial ST-kiʻekiʻe: kahi hōʻike o ka American College of Cardiology Foundation / American Heart Association Task Force ma nā Kumu Alakaʻi. ʻO J Am Coll Cardiol. 2013; 61 (4): 485-510. PMID: 23256913 pubmed.ncbi.nlm.nih.gov/23256913/.

Scirica BM, Libby P, Morrow DA. Infarction myocardial ST-kiʻekiʻe: pathophysiology a me ka hoʻomohala maʻi. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 58.

Tamis-Holland JE, Jneid H, Reynolds HR, et al. ʻIke a me ka mālama ʻana o nā mea maʻi me ka infoccial myocardial i ka loaʻa ʻole o ka maʻi ahulau coronary obstructive: kahi ʻōlelo ʻepekema mai ka American Heart Association. Kaapuni. 2019; 139 (18): e891-e908. PMID: 30913893 pubmed.ncbi.nlm.nih.gov/30913893/.