Angina paʻa

ʻO ka angina paʻa ka ʻeha o ka umauma a hōʻoluʻolu ʻole paha e hana pinepine ʻia me ka hana a me ke kaumaha kaumaha.Loaʻa ʻo Angina i ke kahe o ke koko maikaʻi ʻole ma o nā kīʻaha koko i ka puʻuwai.

Pono i kou puʻuwai puʻuwai i kahi lako o ka oxygen. Hāpai nā aʻa coronary i ke koko waiwai oxygen i ka puʻuwai.

Ke pono e hana ka puʻuwai puʻuwai, pono ka nui o ka oxygen. Hana ʻia nā ʻōuli o ka angina ke hoʻemi ʻia ka lako o ke koko i ka puʻuwai puʻuwai. Hana ʻia kēia i ka wā e hoʻopili ʻia ai nā aʻa ākea e ka atherosclerosis a i ʻole ke kōkō o ke koko.

ʻO ke kumu maʻamau o ka angina ka maʻi o ke aʻa coronary. ʻO Angina pectoris ka manawa olakino no kēia ʻano ʻeha o ka umauma.

ʻOi aku ka koʻikoʻi o ka angina paʻa ma mua o ka angina kūpaʻa, akā hiki ke hōʻeha a hōʻoluʻolu ʻole paha.

Nui nā kumu pilikia no ka maʻi o ke aʻa coronary. Pili pū kekahi:

• Diabetes
• Piʻi koko kiʻekiʻe
• Kolesterol kiʻekiʻe LDL
• Kolesterol HDL haʻahaʻa
• Nohona sedentary
• Puhipaka
• ʻO ka makahiki e neʻe nei
• Moekolohe kāne

ʻO kēlā me kēia mea e pono ai ka puʻuwai puʻuwai e pono i ka oxygen a hoʻēmi paha i ka nui o ka oxygen e loaʻa iā ia ke kumu i ka hōʻeha angina i kekahi me ka maʻi puʻuwai, e like me:

• Ke anu anuanu
• Hoʻoikaika kino
• Kaha kaumaha
• Nā meaʻai nui

ʻO nā kumu ʻē aʻe o ka angina e:

• Nā ritme puʻuwai maikaʻi ʻole (kuʻi wikiwiki kou puʻuwai a i ʻole maʻamau ʻole kou puʻuwai puʻuwai)
• Anemia
• Spasm artery spasm (i kapa ʻia ʻo Prinzmetal angina)
• Hewa puʻuwai
• Maʻi maʻi puʻuwai
• Hyperthyroidism (overactive thyroid)

ʻO nā ʻōuli o ka angina kūpaʻa e wānana pinepine ʻia. ʻO kēia ke kumu o ka nui o ka hoʻoikaika kino a hana paha i kumu e loaʻa ai kāu angina. Pono e hoʻomaikaʻi a hele aku paha kāu angina ke kū ʻoe a hoʻolohi paha i ka hoʻoikaika kino.

ʻO ka ʻōuli maʻamau ka ʻeha o ka umauma e kū ma hope o ka umauma a i ʻole ma ka hema o kāna. ʻO ka ʻeha o ka angina paʻa e hoʻomaka pinepine a hele a ʻoi aku ka maikaʻi ma mua o nā minuke e hiki mai ana ma mua o ka haʻalele.

ʻO ka maʻamau, manaʻo ka ʻeha o ka umauma e like me ka paʻa, kaomi nui, kaomi ʻana, a i ʻole ka haki ʻana i ka manaʻo. Hoʻolahalaha paha ia i ka:

• Lima (ʻo ka hapanui pinepine ka hema)
• Hope
• Iwi
• ʻĀʻī
• Poohiwi

Wahi a kekahi poʻe ua like ka ʻeha me he kinoea a i ʻole indigestion.

Hiki i nā ʻōuli liʻiliʻi o angina ke hoʻopili pū i:

• Ka luhi
• Pokole o ka hanu
• Nawaliwali
• ʻO ka puʻupuʻu a i ʻole ka uila
• ʻO Nusea, ka luaʻi, a me ka hou
• Palpitations

ʻEha mai angina paʻa:

• ʻO ka hapanui e hele mai me ka hana a koʻikoʻi paha
• Lōʻihi ka awelika o 1 a 15 mau minuke
• Hoʻomaha ʻia me ka maha a i ʻole ka lāʻau i kapa ʻia ʻo nitroglycerin

Hiki i nā hōʻeha Angina ke hana i kēlā me kēia manawa i ka lā. Kū pinepine ia ma waena o ka hola 6 o ke awakea a me ke awakea.

E nānā kāu kauka olakino iā ʻoe a nānā i kou kaomi koko. ʻO nā hoʻāʻo e hana ʻia ana paha:

• Angiography Coronary
• Kaha kōkō koko
• ECG
• Hōʻike hoʻomanawanui hoʻomanawanui (hoʻāʻo koʻikoʻi a hoʻāʻo paha treadmill)
• Hōʻike nukelea (thallium) hoʻāʻo koʻikoʻi
• Strocch echocardiogram
• Scanner CT Heart

Hoʻomaopopo pū ʻia ka hana no ka angina:

• Hoʻololi ka nohona
• Nā Lapaʻau
• Nā hana e like me ka angiography coronary me ka stent kau ʻana
• ʻOki kino by Coronary artery bypass

Inā loaʻa iā angina, ʻoe a me kāu mea hāʻawi e hoʻolālā i kahi hoʻolālā mālama i kēlā me kēia lā. Pono e hoʻopili i kēia hoʻolālā:

• Lawe pinepine ʻoe i nā lāʻau e pale i ka angina
• Nā hana i hiki iā ʻoe ke hana a me nā mea āu e hōʻalo ai
• ʻO nā lāʻau e pono ai ʻoe e ʻai ke loaʻa iā ʻoe ka maʻi angina
• ʻO nā hōʻailona ʻoi aku ka ʻino o ka angina
• Ke hea ʻoe i ke kauka a i ʻole e loaʻa i ke kōkua olakino pilikia

NA LAAU LAPAAU

Pono ʻoe e ʻai i hoʻokahi a ʻoi paha nā lāʻau e mālama ai i ke koko, ka maʻi kō, a i ʻole nā ​​kiʻekiʻe o ke kolesterol. E hāhai pono i nā kuhikuhi a kāu mea hāʻawi e pale aku ai i kāu angina mai ka ʻino.

Hiki ke hoʻohana ʻia nā huaale Nitroglycerin a i ʻole ka ʻehu e hoʻōki i ka ʻeha o ka umauma.

ʻO nā lāʻau anti-clotting e like me aspirin a me clopidogrel (Plavix), ticagrelor (Brilinta) a i ʻole prasugrel (Effient) hiki ke pale aku i ke koko mai nā mea i hana ʻia i loko o kāu mau aʻa a hoʻemi i ka makaʻi o ka puʻuwai. E noi i kāu mea hāʻawi inā ʻoe e lawe i kēia mau lāʻau.

Pono paha ʻoe e lawe i nā lāʻau hou aʻe e pale aku iā ʻoe mai ka loaʻa ʻana o ka angina. Pākuʻi ʻia kēia mau mea:

• Hiki i nā mea pāpā ACE ke hoʻohaʻahaʻa i ke koko a pale i kou puʻuwai
• Nā beta-blockers e hoʻohaʻahaʻa i ka helu o ka puʻuwai, ke kahe o ke koko, a me ka oxygen e hoʻohana ai i ka puʻuwai
• ʻO nā mea kalaiwa kalipuna e hoʻomaha ai i nā aʻa, hoʻohaʻahaʻa i ke koko, a hoʻemi i ke kanana ma ka puʻuwai
• Nā Nitrates e kōkua i ka pale ʻana i ka angina
• Ranolazine (Ranexa) e mālama i ka angina mau

KA HALE HOPE I KA LAWE ANA I KEKAHI MAU LAAU LOA MA KOU KANA. E kamaʻilio mau i kāu mea hāʻawi. Ke kū nei i kēia mau lāʻau i hiki koke ke hōʻino i kāu angina a i ʻole ke kumu o ka hōʻeha puʻuwai. Heʻoiaʻiʻo loa kēia no nā lāʻau anti-clotting (aspirin, clopidogrel, ticagrelor a me prasugrel).

Koi paha kāu mea hāʻawi i kahi papahana hoʻoponopono naʻau e kōkua i ka hoʻomaikaʻi ʻana i ke olakino o kou puʻuwai.

LAPAAU ANA ANA

Hiki i kekahi poʻe ke kaohi i ka angina me nā lāʻau a ʻaʻole pono ke ʻoki. Pono nā poʻe ʻē aʻe i kahi kaʻina i kapa ʻia angioplasty a me ka stent hoʻonohonoho (i kapa ʻia ʻo percutaneus coronary interven) e wehe i nā aʻa a i ʻole nā ​​ʻaoʻao liʻiliʻi e hāʻawi i ke koko i ka puʻuwai.

ʻO nā ālai i hiki ʻole ke mālama ʻia me ka angioplasty pono paha i ka ʻoki ʻana i ka naʻau e hoʻohuli i ke kahe o ke koko a puni nā kīʻaha koko i hoʻopili ʻia a i ʻole nā ​​poloka.

Hoʻonui pinepine ka angina paʻa i ka lawe ʻana i nā lāʻau.

E kiʻi koke i ke kōkua lapaʻau inā loaʻa iā ʻoe ka ʻeha o ka umauma hou a wehewehe ʻole ʻia. Inā loaʻa iā angina ma mua, e kāhea i kāu mea hāʻawi.

Kāhea iā 911 a i ʻole ka helu pilikia kūloko inā ʻeha kou angina:

• ʻAʻole maikaʻi ʻo 5 mau minuke ma hope o kou lawe ʻana i ka nitroglycerin
• ʻAʻole hele aku ma hope o 3 mau kaha o nitroglycerin
• Ke hele nei a ʻino
• Hoʻi ma hope o ke kōkua o ka nitroglycerin i ka mua

Kāhea i kāu mea hāʻawi inā:

• Ke loaʻa pinepine nei ʻoe i nā hōʻailona angina
• Ke loaʻa nei ʻoe i ka angina ke noho ʻoe (hoʻomaha angina)
• Luhi pinepine ʻoe
• Ke maʻule a ʻālohilohi paha ʻoe
• Ke kuʻi lohi nei kou puʻuwai (ma lalo o 60 mau kuʻi i hoʻokahi minuke) a i ʻole wikiwiki loa (ʻoi aku ma mua o 120 mau kuʻi i hoʻokahi minuke), a i ʻole ʻaʻole paʻa (maʻamau)
• Ke pilikia nei ʻoe i ka lawe ʻana i nā lāʻau o kou puʻuwai
• Loaʻa iā ʻoe nā hōʻailona ʻokoʻa ʻē aʻe

E kiʻi i ke kōkua lapaʻau inā loaʻa ka manaʻo me ke kanaka me ka angina.

ʻO kahi mea pilikia kahi mea e pili ana iā ʻoe e hoʻonui ai i kou manawa o ka loaʻa ʻana i kahi maʻi a i ʻole loaʻa i kekahi ʻano olakino.

ʻO kekahi mau pilikia no ka maʻi puʻuwai ʻaʻole hiki iā ʻoe ke loli, akā hiki i kekahi hiki iā ʻoe. ʻO ka hoʻololi ʻana i nā mea pilikia e hiki ai iā ʻoe ke kaohi ke kōkua iā ʻoe e ola i kahi ola olakino.

Angina - kūpaʻa; Angina - maʻi mau; Angina pectoris; ʻEha o ka umauma - angina; CAD - angina; Maʻi maʻi aʻa coronary - angina; Maʻi maʻi puʻuwai - angina

• Angina - hoʻokuʻu
• Angina - he aha e nīnau aku ai i kāu kauka
• Angina - ke loaʻa iā ʻoe ka ʻeha o ka umauma
• Ka hōʻeha puʻuwai - he aha e nīnau aku ai i kāu kauka

• Puʻuwai - ʻike mua
• Angina paʻa

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 i kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force e pili ana i nā ʻōkuhi Clinical Practice. Kaapuni. 2019; 140 (11): e596-e646. PMID: 30879355 pubmed.ncbi.nlm.nih.gov/30879355/.

Boden WE. Angina pectoris a me ka maʻi puʻuwai ischemic paʻa. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 62.

ʻO MP MPaca. ʻO Sabatine MS. Ke hoʻokokoke ʻana i ka mea maʻi me ka ʻeha o ka umauma. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: kahi puke o ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 56.

Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC / AHA / AATS / PCNA / SCAI / STS nānā nui i ka papa kuhikuhi no ka ʻike a me ka mālama ʻana i nā mea maʻi me ka maʻi puʻuwai ischemic paʻa: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force ma nā Kūlana Kūpono, a me ka ʻAmelika Hui Pū ʻIa no ka ʻoki kino Thoracic, ʻAhahui kahu maʻi Cardiovascular Preventive, ʻAhahui no ka Angiography a me nā hana a Cardiovascular, a me ka Society of Thoracic Surgeons. ʻO J Am Coll Cardiol. 2014; 64 (18): 1929-1949. PMID: 25077860 pubmed.ncbi.nlm.nih.gov/25077860/.

ʻApōpō DA, de Lemos JA .. maʻi maʻi ischemic paʻa. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: kahi puke o ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 61.

Whelton PK, Carey RM, Aronow WS, et al. ʻO 2017 ACC / AHA / AAPA / ABC / ACPM / AGS / APhA / ASH / ASPC / NMA / PCNA alakaʻi no ka pale ʻana, ʻike, loiloi, a me ka mālama ʻana i ke kiʻekiʻe o ke koko kiʻekiʻe i nā mākua: hōʻuluʻulu mana: kahi hōʻike o ka American College of Cardiology / ʻAmelika Hui Pū ʻIa ʻAmelika Hui Pū ʻIa e pili ana i nā ʻōkuhi hoʻomaʻamaʻa lapaʻau. ʻO J Am Coll Cardiol. 2018; 71 (19) 2199-2269. PMID: 29146533 pubmed.ncbi.nlm.nih.gov/29146533/.