ʻ .lelo echocardiography koʻikoʻi

ʻO ka stress echocardiography kahi hōʻike e hoʻohana ai i ke kiʻi ultrasound e hōʻike i ka maikaʻi o ka hana ʻana o kou puʻuwai puʻuwai e pīpī i ke koko i kou kino. Hoʻohana pinepine ʻia ia e ʻike i ka hōʻemi ʻana o ke kahe o ke koko i ka puʻuwai mai ka hoʻopili ʻana i nā aʻa coronary.

Hana ʻia kēia hōʻike ma kahi keʻena olakino a i ʻole ke keʻena lawelawe olakino.

E hana mua ʻia kahi echocardiogram hoʻomaha. ʻOiai ʻoe e moe ana ma kou ʻaoʻao hema me kou lima hema i waho, paʻa ʻia kahi mea liʻiliʻi i kapa ʻia he transducer i kou umauma. Hoʻohana ʻia kahi gel kūikawā e kōkua i nā nalu ultrasound i kou puʻuwai.

E hele ka hapa nui o ka poʻe ma kahi wili (a i ʻole hehi wāwae ma ke keke uila). Lohi (e pili ana i kēlā me kēia 3 mau minuke), e noi ʻia ʻoe e hele wāwae (a hehi wāwae paha) me ka wikiwiki a ma ka piʻo. Me he mea lā ua noi ʻia e hele wikiwiki a jogj paha i kahi puʻu.

I ka hapanui o nā hihia, pono ʻoe e hele wāwae a hehi wāwae paha ma kahi o 5 a 15 mau minuke, ke kaukaʻi ʻia i kou kiʻekiʻe o ke olakino a me kou makahiki. E noi ana kāu mea lawelawe iā ʻoe e haʻalele:

• Ke pāhaʻi nei kou puʻuwai i ka pae māka
• Ke luhi nui ʻoe e hoʻomau
• Inā loaʻa iā ʻoe ka ʻeha o ka umauma a i ʻole kahi loli i kou kaomi koko e hopohopo nei i ka mea lawelawe e lawelawe i ka hōʻike

Inā ʻaʻole hiki iā ʻoe ke hoʻoikaika kino, e loaʻa iā ʻoe kahi lāʻau lapaʻau, e like me dobutamine, ma o ke aa (laina intravenous). ʻO kēia lāʻau e hoʻokuʻi ai i ka puʻuwai me ka wikiwiki a paʻakikī hoʻi, e like me ka wā e hoʻoikaika kino ai.

E kiaʻi ʻia kou kaomi koko a me kou puʻuwai (ECG) i loko o ke kaʻina hana.

E kiʻi ʻia nā kiʻi echocardiogram hou aku ke hoʻonui nei ka nui o kou puʻuwai, a i kona hiki ʻana i kona piko. E hōʻike nā kiʻi inā ʻaʻole maikaʻi nā ʻāpana o ka puʻuwai puʻuwai ke piʻi ka nui o kāu puʻuwai. He hōʻailona kēia no ka lawa ʻole o ke koko a i ʻole ka oxygen ma ka ʻāpana o ka puʻuwai ma muli o nā aʻa ʻiki a paʻa paha.

E noi i kāu mea hāʻawi inā pono ʻoe e lawe i kekahi o kāu lāʻau maʻamau i ka lā o ka hoʻokolohua. Hoʻopilikia paha kekahi mau lāʻau i nā hopena hōʻike. Mai hōʻoki i ka lawe ʻana i nā lāʻau me ka ʻole e kamaʻilio mua me kāu kauka.

He mea nui e haʻi aku i kāu kauka inā ua lawe ʻoe i kekahi o nā lāʻau i lalo i loko o 24 mau hola i hala (1 lā).

• Sildenafil citrate (Viagra)
• ʻO Tadalafil (Cialis)
• Vardenafil (Levitra)

Mai ʻai a inu paha ma ka liʻiliʻi he 3 mau hola ma mua o ka hoʻāʻo.

E komo i nā lole leʻaleʻa a ʻoluʻolu. E noi ʻia ʻoe e kau inoa i kahi palapala ʻae ma mua o ka hoʻāʻo.

E kau ʻia nā electrodes (conductive patch) ma kou umauma, lima, a me nā wāwae e hoʻopaʻa ai i ka hana o ka puʻuwai.

E hoʻonui ʻia ke kīʻaha koko ma kou lima i kēlā me kēia minuke, e hoʻopuka nei i kahi naʻau e ʻūʻī paha.

Kākaʻikahi wale, ʻike ka poʻe i ka hōʻoluʻolu o ka umauma, keu a i ʻole ka hōʻalo ʻia i nā puʻuwai puʻuwai, dizziness, headache, nausea a me ka pōkole o ka hanu i ka wā o ka hoʻāʻo.

Hana ʻia ka hoʻāʻo e ʻike inā lawa ka kahe o kou puʻuwai puʻuwai a me oxygen i ka wā e hana ikaika nei (ma lalo o ke koʻikoʻi).

E kauoha paha kāu kauka i kēia hoʻokolohua inā ʻoe:

• Loaʻa i nā hōʻailona hou o ka angina a i ʻole ka ʻeha o ka umauma
• Loaʻa angina e ʻinoʻino ana
• I kēia manawa ua loaʻa i kahi puʻuwai puʻuwai
• E hele ana ʻoe i kahi keʻoki a hoʻomaka paha i kahi papahana hoʻoikaika kino, inā nui kou makaʻu no ka maʻi puʻuwai
• Loaʻa i nā pilikia puʻuwai puʻuwai

Hiki i nā hopena o kēia hoʻāʻo koʻikoʻi ke kōkua i kāu mea hāʻawi:

• E hoʻoholo pehea ka maikaʻi o ka mālama ʻana o ka naʻau a hoʻololi i kāu lāʻau, inā pono
• E hoʻoholo pehea ka maikaʻi o ka pauma ʻana o kou puʻuwai
• Nānā i ka maʻi o ke aʻa aʻa
• E ʻike inā nui loa kou puʻuwai

ʻO ka hoʻāʻo maʻamau e hōʻike pinepine ʻia ua hiki iā ʻoe ke hoʻoikaika kino inā lōʻihi a ʻoi aku paha ma mua o ka hapa nui o ka poʻe o kāu makahiki a me ka moekolohe. ʻAʻole nō ʻoe i loaʻa nā hōʻailona a pili paha i nā loli i ke kahe o ke koko a me kāu ECG. Hōʻike kāu mau kiʻi puʻuwai i nā ʻāpana āpau o kou puʻuwai e pane i ka hoʻonui i ke koʻikoʻi ma o ka pumping ʻana.

ʻO kahi hopena maʻamau ke ʻano o ke kahe o ke koko ma o nā aʻa coronary he maʻamau paha.

Aia ke ʻano o kāu hopena hopena ma ke kumu o ka hoʻāʻo, kou makahiki, a me kou mōʻaukala o ka puʻuwai a me nā pilikia olakino ʻē aʻe.

Nā hopena kūpono ʻole ma muli o:

• Hoʻoemi ke kahe o ke koko i kahi ʻāpana o ka puʻuwai. ʻO ke kumu kūpono paha ka hoʻopili ʻana a i ʻole ka paʻa ʻana o nā aʻa e hoʻolako i kou puʻuwai puʻuwai.
• ʻO ka scarring o ka puʻuwai puʻuwai ma muli o ka hōʻeha puʻuwai i hala.

Ma hope o ka hoʻāʻo pono ʻoe:

• Hoʻonohonoho Angioplasty a me stent
• Nā loli i nā lāʻau o kou puʻuwai
• Angiography Coronary
• ʻOki kino bypass

Haʻahaʻa loa nā makaʻi. E mālama nā ʻoihana mālama ola iā ʻoe i ka wā o ke kaʻina holoʻokoʻa.

Pākuʻi ʻia nā pilikia laulaha:

• Rhythm puʻuwai maʻamau
• Pahu (sinkope)
• Maʻi hohola

Hōʻike koʻikoʻi echocardiography; Hōʻaʻo koʻikoʻi - echocardiography; CAD - pilikia echocardiography; Maʻi Coronary artery - stress echocardiography; ʻEha o ka umauma - echocardiography koʻikoʻi; Angina - echocardiography koʻikoʻi; Maʻi maʻi puʻuwai - stress echocardiography

• Puʻuwai - ʻāpana ma waena o ka waena
• Puʻuwai - ʻike mua
• Ke kaʻina hoʻomohala o atherosclerosis

Boden WE. Angina pectoris a me ka maʻi puʻuwai ischemic paʻa. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 25th hua. Piladelapia, PA: Elsevier; 2020: chap 71.

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 www.ncbi.nlm.nih.gov/pubmed/25077860.

ʻO Fowler GC, ʻo Smith A. Stress echocardiography. I: Fowler GC, hoʻoponopono. ʻO Pfenninger a me Fowler's Procedures no ka mālama mua. ʻEhā ed. Piladelapia, PA: Elsevier; 2020: chap 76.

ʻO Solomon SD, Wu JC, Gillam L, Bulwer B. Echocardiography. 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 14.