Hewa ka puʻuwai - nā lāʻau

ʻO ka hapa nui o ka poʻe i loaʻa ʻole ka puʻuwai e pono e ʻai i nā lāʻau. Hoʻohana ʻia kekahi o kēia mau lāʻau e mālama i kāu mau ʻōuli. Hiki i nā mea ʻē aʻe ke pale aku i ka hōʻeha o kou puʻuwai mai ka lilo ʻana i mea ʻoi aku ka maikaʻi a waiho iā ʻoe e ola lōʻihi.

Pono ʻoe e inu i ka hapa nui o kāu lāʻau o ka puʻuwai ʻole i kēlā me kēia lā. Lawe ʻia kekahi mau lāʻau i hoʻokahi manawa i ka lā. Pono e lawe i nā mea ʻē aʻe he 2 a ʻoi paha i kēlā me kēia lā. He mea nui ia e lawe i kāu lāʻau i ka manawa kūpono a me ke ala a kāu kauka i haʻi aku ai iā ʻoe.

Mai hōʻoki i ka lawe ʻana i nā lāʻau o kou puʻuwai me ke kamaʻilio ʻole ʻole ʻana me kāu kauka olakino. He mea kūpono kēia no nā lāʻau ʻē aʻe āu e lawe ai, e like me nā lāʻau no ka maʻi kō, ke koko kiʻekiʻe, a me nā kūlana koʻikoʻi ʻē aʻe.

E haʻi paha kāu mea lawelawe iā ʻoe e lawe i kekahi mau lāʻau a i ʻole hoʻololi i kāu mau kaha i ka wā e maikaʻi ai kāu mau ʻōuli. Mai hoʻololi i kāu mau lāʻau a i ʻole nā ​​lāʻau me ke kamaʻilio ʻole ʻana me ka mea lawelawe.

E haʻi mau i kāu mea hāʻawi ma mua o kou lawe ʻana i nā lāʻau hou. Hoʻopili kēia i nā lāʻau lapaʻau e like me ibuprofen (Advil, Motrin) a me naproxen (Aleve, Naprosyn), a me nā lāʻau e like me sildenafil (Viagra), vardenafil (Levitra), a me tadalafil (Cialis).

E haʻi pū i kāu mea hāʻawi ma mua o kou lawe ʻana i kekahi ʻano mea uliuli a mea hoʻohui paha.

Hana nā mea kāohi ACE (angiotensin e hoʻohuli nei i nā mea hoʻokele enzyme) a me nā ARB (angiotensin II receptor blockers) e ka wehe ʻana i nā kīʻaha koko a hoʻohaʻahaʻa i ke kaomi koko. Hiki i kēia mau lāʻau:

• E hoʻemi i ka hana a kou puʻuwai e hana ai
• Kōkua i kou puʻuwai puʻupuʻu puʻupuʻu ʻoi aku ka maikaʻi
• E mālama i ka maikaʻi ʻole o kou puʻuwai

ʻO nā hopena ʻaoʻao maʻamau o kēia mau lāʻau e:

• Mū maloo
• ʻĀlohilohi
• Ka luhi
• Opu hoʻowahāwahā
• ʻO Edema
• ʻEha poʻo
• Pohā

Ke lawe ʻoe i kēia mau lāʻau, pono ʻoe e hōʻoia i ke koko e nānā i ke ʻano o ka maikaʻi o kāu hana a me ke ana ʻana i kāu pae potassium.

ʻO ka hapa nui o ka manawa, e kuhikuhi ana kāu mea hāʻawi i kahi mea kāohi ACE a i ʻole he ARB. ʻO kahi papa lāʻau hou i kapa ʻia angiotensin receptor-neprilysin inhibitors (ARNI's) hui pū i kahi lāʻau ARB me kahi ʻano lāʻau hou. Hoʻohana ʻia paha ʻo ARNI e mālama ai i ka maikaʻi ʻole o ka puʻuwai.

Hoʻomaʻalohi nā beta blockers i ka helu o kou puʻuwai a hoʻoliʻiliʻi i ka ikaika e aelike ai kou puʻuwai puʻuwai i ka wā pōkole. Kōkua nā mea pale beta lōʻihi e mālama i kou puʻuwai ʻole i ka ʻino. Hiki i ka manawa ke kōkua pū i ka hoʻoikaika i kou puʻuwai.

Hoʻohana ʻia nā blockers beta maʻamau no ka pono ʻole o ka naʻau me carvedilol (Coreg), bisoprolol (Zebeta), a me metoprolol (Toprol).

Mai hōʻoki koke i ka lawe ʻana i kēia mau lāʻau. Hiki i kēia ke hoʻonui i ka makaʻu o ka angina a i ka puʻuwai puʻuwai. ʻO nā hopena ʻē aʻe e pili ana i ka lightheadedness, depress, luhi, a me ka nalo ʻana o ka hoʻomanaʻo.

Kōkua nā diuretics i kou kino e hoʻopau i ka wai keu. Hiki ke kōkua i kekahi ʻano o diuretics i nā ʻano ʻē aʻe. Kāhea pinepine ʻia kēia mau lāʻau lapaʻau me "nā pila wai." Nui nā mana o diuretics. Lawe ʻia kekahi i hoʻokahi manawa i ka lā. Lawe ʻia nā mea ʻē aʻe i 2 manawa i ka lā. ʻO nā ʻano maʻamau nā:

• ʻO Thiazides. Chlorothiazide (Diuril), chlorthalidone (Hygroton), indapamide (Lozol), hydrochlorothiazide (Esidrix, HydroDiuril), a me metolazone (Mykrox, Zaroxolyn)
• Lohe diuretics. Bumetanide (Bumex), furosemide (Lasix), a me torasemide (Demadex)
• Nā mea mālama mālama potassium. Amiloride (Midamor), spironolactone (Aldactone), a me triamterene (Dyrenium)

Ke lawe ʻoe i kēia mau lāʻau, pono ʻoe i nā hoʻokolohua koko maʻamau e nānā i ke ʻano o ka maikaʻi o kāu mau puʻupaʻa a ana i kāu mau pae potassium.

Nui nā poʻe me ka maʻi puʻuwai e lawe i ka aspirin a i ʻole ka clopidogrel (Plavix). Kōkua kēia mau lāʻau i ka pale ʻana i nā kahe koko mai loko o kāu aʻa. Hiki i kēia ke hoʻohaʻahaʻa i kou makaʻi o ka hahau a i ʻole ka puʻuwai puʻuwai.

Paipai ʻia ʻo Coumadin (Warfarin) no nā mea maʻi me ka puʻuwai puʻuwai i ʻoi aku ka nui o ka makaʻu no ke koko koko.Pono ʻoe e hōʻoia hou i ke koko e hōʻoia i ka pololei o kāu mahele lāʻau. Pono paha ʻoe e hoʻololi i kāu papaʻai.

Hoʻohana ʻia nā lāʻau ʻino no ka maikaʻi ʻole o ka puʻuwai.

• Digoxin e kōkua i ka hoʻonui ʻana i ka ikaika o ka pumping o ka puʻuwai a hoʻolōʻihi i ka helu o ka puʻuwai.
• ʻO Hydralazine a me nā nitrates e wehe i nā aʻa a kōkua i ka puʻuwai puʻuwai puʻuwai maikaʻi. Hoʻohana nui ʻia kēia mau lāʻau e nā mea maʻi i hiki ʻole ke hoʻomanawanui i nā mea kāohi ACE a me nā angiotensin receptor blockers.
• Hoʻopili nā kahawai kalepona i ka kahe o ke koko a i ʻole angina (ʻeha o ka umauma) mai ka maʻi o ke aʻa coronary (CAD).

Hoʻohana ʻia nā Statins a me nā lāʻau hoʻohaʻahaʻa kolesterol i ka wā e pono ai.

Hoʻohana ʻia nā lāʻau antiarrhythmic i kekahi manawa e ka poʻe maʻi kū ʻole o ka puʻuwai i loaʻa i nā puʻuwai puʻuwai abnormal. ʻO amiodarone kekahi o ia ʻano lāʻau.

ʻO kahi lāʻau hou, ʻo Ivabradine (Corlanor), hana e hoʻohaʻahaʻa i ka helu o ka puʻuwai a kōkua paha i ka poʻe me ka puʻuwai puʻuwai ma o ka hōʻemi ʻana i ka hana o ka puʻuwai.

CHF - nā lāʻau lapaʻau; Hoka puʻuwai Congestive - nā lāʻau; Cardiomyopathy - nā lāʻau lapaʻau; HF - nā lāʻau

ʻO Mann DL. Ka mālama ʻana i nā mea maʻi me ka puʻuwai puʻuwai me ka hapa liʻiliʻi o ka eject. 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 Saunders; 2019: chap 25.

ʻO Yancy CW, Jessup M, Bozkurt B, et al. 2017 ACC / AHA / HFSA hoʻomōlele hou i ka 2013 ACCF / AHA alakaʻi no ka mālama ʻana i ka puʻuwai puʻuwai: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force on Clinical Practice Guide and the Heart Failure Society of America. J Hanakila ole. 2017; 23 (8): 628-651. PMID: 28461259 www.ncbi.nlm.nih.gov/pubmed/28461259.

ʻO Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF / AHA alakaʻi no ka mālama ʻana i ka puʻuwai puʻuwai: kahi hōʻike o ka American College of Cardiology Foundation / American Heart Association Task Force e pili ana i nā kulekele hana. Kaapuni. 2013; 128 (16): e240-e327. PMID: 23741058 www.ncbi.nlm.nih.gov/pubmed/23741058.

• Hoka Puʻuwai