Coronary Angiogram (CAG): Zimene Zimaonetsa, Momwe Zimachitikira, ndi Zimene Sizingakuuzeni

Njira zazikulu

• Cholinga: Angiogram ya mtima imawonetsa bwino mkati mwa mitsempha ya mtima kuposa mayeso ena aliwonse osakhudza mtima.
• Malire: Angiogram imasonyeza lumen yokha, siimayesa momwe minofu ya mtima imagwirira ntchito, momwe imakhalira, kapena kuneneratu nthawi yomwe plaque idzaphulika.
• Zosokoneza: Mosiyana ndi mayeso a echo kapena mayeso a treadmill, angiogram ya mtima imaphatikizapo kubowoledwa kwa mitsempha, kusiyana kwa mitsempha ndi kuwala kwa dzuwa, kotero zimakhala ndi chiopsezo chochepa koma chenicheni.
• Sizofanana ndi angioplasty: Angiography ndi njira yodziwira matenda; angioplasty (PTCA yokhala ndi stent) ndi njira yochizira, nthawi zina imachitidwa nthawi imodzi.
• Kutanthauzira: Zomwe zapezeka ziyenera kuwerengedwa pamodzi ndi zizindikiro, ECG, ma echo ndi mayeso ogwira ntchito ndi dokotala wa mtima amene anapempha kafukufukuyu. Zotsatira zimasiyana malinga ndi momwe matenda alili.

Pang'onopang'ono

Amadziwikanso monga

• CAG
• Kuyeza kwa catheter ya mtima (angiography ndi gawo limodzi la kafukufuku wa cath)
• Coronary angiography
• "Heart ki angiography", "angio test", "dye test", "heart pipe check", mawu omwe amagwiritsidwa ntchito kwambiri ndi odwala ndi mabanja ku India
• Kuyeza mtima kumanzere pogwiritsa ntchito angiography ya mtima

Kodi angiogram ya mtima ndi chiyani

Kuyeza mtima (coronary angiogram) ndi njira imene dokotala wa mtima amaboola mtsempha wamagazi, nthawi zambiri mtsempha wamagazi wozungulira pachikhatho, ndikupititsa catheter yofewa komanso yosinthasintha mpaka pomwe mitsempha yamagazi imayambira. Kusiyanitsa kwa ayodini kumabayidwa ndipo zithunzi za X-ray (kuthamanga kwa cine) zimajambulidwa kuchokera mbali zosiyanasiyana.

Popeza kusiyana kumadzaza lumen (njira yomwe magazi amadutsa), zithunzi zikuwonetsa komwe njirayo yachepa, yosakhazikika, kapena yotsekedwa, komanso momwe matenda amafikira. Angiogram imasonyezanso mitsempha yamagazi, kupitirira kwa graft patency mwa odwala omwe adadwala CABG, komanso kusintha kwa thupi monga chiyambi cha mtima chosazolowereka.

Kuyeza magazi m'mitsempha ya mtima nthawi zambiri kumaphatikizidwa ndi kuyeza kuthamanga kwa magazi m'mitsempha ya kumanzere, komanso kugwiritsa ntchito zida zowonjezera: FFR/iFR (ma waya okakamiza kuti awone ngati kuchepa pang'ono kumaletsa kuyenda kwa magazi) ndi IVUS/OCT (ma catheter ojambulira omwe amayang'ana khoma la mitsempha yokha). Zowonjezerazi zilipo chifukwa chakuti angiogram yodziwika bwino ili ndi malire.

Chifukwa chiyani angiogram ya mtima imachitidwa

• Acute coronary syndrome: Mu ST-elevation myocardial infarction, angiography yofulumira yokhala ndi primary angioplasty ndiyo njira yodziwika bwino yowonjezerera magazi komwe labu yothandiza imapezeka panthawi yake. Mu ST yopanda ST-elevation ACS yomwe ili pachiwopsezo chachikulu, kuwunika koyambirira kwa matendawa kumachitika nthawi zambiri.
• Angina yosalamuliridwa ndi mankhwala: Kufotokozera kapangidwe ka thupi ndi kusankha njira yogwiritsira ntchito stenting kapena bypass.
• Mayeso osazolowereka kapena oopsa kwambiri osavulaza: Kuyesedwa kwa kupsinjika maganizo komwe kwapezeka, kuchepa kwa magazi m'thupi kwakukulu pa echo ya kupsinjika maganizo kapena kujambula kwa nyukiliya, kapena stenosis yayikulu yomwe ikuganiziridwa pa CT coronary angiography.
• Musanachite opaleshoni ya mtima: Mwachitsanzo, musanachite opaleshoni ya valavu, kuti mudziwe ngati matenda a mtima ayenera kuthetsedwa nthawi yomweyo.
• Kufooka kwa minofu ya mtima kosamveka bwino: Kuwona ngati kuchepa kwa ntchito yopopera madzi m'thupi ndi chifukwa cha matenda a mtima.
• Kutsatira zomwe zinachitika kale: Zizindikiro zobwerezabwereza pambuyo pobayidwa kapena kudulidwa.

Ndani ayenera kuganizira mayeso awa

Kuyeza mtima si njira yoyezera matenda ndipo sikoyenera kwa anthu omwe alibe zizindikiro kapena kuwunika zoopsa zomwe zikusonyeza matenda oopsa a mtima. Nthawi zambiri amaganiziridwa pamene:

• Kupweteka pachifuwa kapena kupuma movutikira ndi vuto la angina ndipo limapitirirabe ngakhale mutalandira chithandizo chabwino kwambiri chamankhwala.
• Matenda a mtima akuchitika kapena achitika posachedwapa.
• Kuyezetsa kosavulaza kumasonyeza kuti gawo lalikulu la mtima lili pachiwopsezo.
• Zizindikiro zake ndi zosonyeza kuti munthu ali ndi matendawa koma mayeso osakhudza thupi sangakhale otsimikiza kapena sangatheke.
• Kapangidwe ka mtima ka mtima kayenera kudziwika bwino musanachite opaleshoni ya mtima kapena opaleshoni ina ya mtima.
• Pali vuto losadziwika bwino la kulephera kwa mitsempha ya kumanzere, kusokonezeka kwa kugunda kwa mtima, kapena vuto la mtima lomwe likuganiziridwa kuti ndi losazolowereka.

Kawirikawiri si njira yoyamba yoyenera yopezera ululu wokhazikika komanso wochepa pachifuwa, yotsimikizira popanda chizindikiro, kapena ngati njira yowunikira thanzi "paketi". Pazochitika ngati zimenezi, kuwunika kwachipatala, ECG, mayeso a echo ndi mayeso ogwira ntchito kapena a CT ndi malo oyambira oyenera. Kaya angiogram ndi yoyenera ndi chisankho cha dokotala wanu wa mtima.

Zimene angiogram ya mtima singazindikire kapena kuchotsa

Iyi ndi gawo lomwe nthawi zambiri silimaperekedwa pa chidziwitso cha wodwala, ndipo ndilofunika.

• Siziwonetsa khoma la mtsempha wamagazi. Angiogram imasonyeza lumen. Chikwangwani chomwe chasinthidwa kunja chingakhale chachikulu pomwe lumen ikuwonekabe yovomerezeka. Angiogram "yabwinobwino" sikutanthauza kuti palibe atherosclerosis.
• Sizingalosere matenda a mtima. Matenda ambiri a mtima amachokera ku ma plaque omwe sanali ochepa kwambiri. Angiogram yolimbikitsa masiku ano siimatsimikizira kuti palibe zochitika zamtsogolo, ndipo chithandizo cha zinthu zoopsa chikufunikabe.
• Sizitsimikizira matenda a angina ya m'mitsempha yamagazi kapena kutsekeka kwa mtima. Angina yokhala ndi mitsempha ya mtima yosaletsa (ANOCA/INOCA) ndi yofala kwambiri, makamaka mwa akazi. Kuzindikira matendawa kumafuna mayeso ena monga kufufuzidwa kwa matenda kapena maphunziro a physiology ya mtima, osati angiogram yokha.
• Sizimayesa momwe minofu ya mtima imagwirira ntchito kapena momwe imagwirira ntchito. Echocardiography, cardiac MRI kapena nuclear perfusion imaging zimayankha mafunso amenewo.
• Kuwerengera kwa kuopsa kwa masomphenya kumadalira momwe munthu akuonera. Opaleshoni awiri odziwa bwino ntchito amatha kugawa kuchuluka kofanana kwa kuchepa pang'ono mosiyana. Pa zilonda zapakati, kuwunika kwa waya wopanikizika kumakhala kothandiza kwambiri kuposa kuwona kuchuluka kwa zilonda.
• Sizikunena zambiri zokhudza mitsempha yaying'ono kwambiri yakutali, zomwe zingakhale zosawonekera bwino kapena zosatheka kuthetsedwa.
• Si mayeso a valve, pericardium kapena aorta. Amenewo amafunikira echo kapena kujambula kodzipereka.

Angiogram yooneka ngati yoipa kapena yooneka bwino imafotokoza zomwe zithunzizo zinawonetsa. Sizikutanthauza kuti yokha ndi yomwe imayambitsa matenda a mtima. Ngati zizindikiro zikupitirira kapena zikuipiraipira ngakhale zotsatira zake zili bwino, bwererani kwa dokotala wanu m'malo moganiza kuti mtima wachira.

Mayeso ofanana koma osiyana

Palibe mayeso aliwonse awa omwe ndi abwino kwambiri padziko lonse lapansi. Amayankha mafunso osiyanasiyana, ndipo chomwe chimabwera poyamba chimadalira momwe mukufotokozera: munthu amene ali ndi vuto la mtima lomwe likusintha amapita mwachindunji ku angiography yowononga, pomwe munthu amene ali ndi ululu wa pachifuwa komanso chiopsezo chochepa nthawi zambiri amathandizidwa bwino ndi mayeso osavulaza kaye.

Momwe mungakonzekerere

Malangizo okonzekera amakhazikitsidwa ndi labu ya cath yomwe ikuchita opaleshoni yanu ndipo amasiyana malinga ndi mayunitsi. Malangizo olembedwa omwe gulu lanu limapatsa nthawi zonse amakhala patsogolo kuposa zambiri.

• Mankhwala: Bweretsani mndandanda wathunthu, kuphatikizapo mankhwala ochepetsa magazi, mankhwala oletsa ma platelet, mankhwala a insulin ndi matenda a shuga omwa, okodzetsa, metformin, mankhwala azitsamba ndi AYUSH, ndi zowonjezera pa masewera olimbitsa thupi. Musasiye kapena kusintha mankhwala aliwonse omwe mwapatsidwa nokha, funsani dokotala kapena gulu la labu la cath zomwe mungachite patsikulo.
• Matenda: Nenani za momwe munachitira kale ndi kusiyana kwa ayodini, ndi vuto lililonse la mphumu kapena mankhwala osokoneza bongo. Njira zogwiritsira ntchito mankhwala okonzekera zimasiyana malinga ndi mayunitsi.
• Kusala kudya: Mayunitsi ambiri amapempha nthawi yosala kudya musanachite opaleshoniyi. Nthawi yake imasiyana malinga ndi yuniti komanso ngati akukonzekera kupereka mankhwala oletsa ululu.
• Mayeso oyambira: Kugwira ntchito kwa impso, hemoglobin, kuchuluka kwa ma platelet, mayeso oundana kwa magazi, ECG ndipo nthawi zina echo nthawi zambiri imapezeka isanayambe.
• Chitetezo cha Impso: Kumwa madzi okwanira musanayambe komanso mutatha kusiyanitsa ndi chinthu chachizolowezi, koma mtundu ndi kuchuluka kwa madzi ziyenera kusankhidwa payekhapayekha.
• Makonzedwe othandiza: Konzani mnzanu woti akuperekezeni kunyumba. Musayendetse galimoto nokha patsikulo. Chotsani zodzikongoletsera ndikusiya zinthu zamtengo wapatali kunyumba; bweretsani ma CD a angiogram, makadi a stent ndi chidule cha zotuluka m'thupi.

Ngati muli ndi matenda a shuga pa chithandizo chochepetsa shuga m'magazi

Kusala kudya pamene mukupitiriza kumwa mankhwala a insulin kapena sulfonylurea kungayambitse kuchepa kwa shuga m'magazi. Funsani dokotala wanu momwe mungasinthire mlingo m'mawa wa opaleshoni, ndipo tchulani ngati mwamwa metformin kapena SGLT2 inhibitor, chifukwa mayunitsi ali ndi njira zinazake zokhudzana ndi kusiyana kwa mankhwala ndi mankhwalawa.

Ngati muli ndi matenda a impso osatha

Kusiyanitsa kwa ayodini kumakhala ndi chiopsezo chovulala impso chifukwa cha kusiyanitsa, ndipo kumawonjezeka chifukwa cha kuchepa kwa eGFR, kusowa madzi m'thupi, matenda a shuga komanso kuchuluka kwa kusiyanitsa kwakukulu. Uzani gulu lanu kuti muli ndi creatinine kapena eGFR yatsopano. Kuchuluka kwa kusiyanitsa nthawi zambiri kumatha kuchepetsedwa, ndipo madzi amakonzedwa mosamala.

Ngati muli ndi vuto la mtima kapena muli ndi vuto la madzi m'thupi

Malangizo okhazikika okhudza kusamba madzi musanagwiritse ntchito mankhwalawa angakhale osatetezeka ngati muli ndi vuto la mtima lomwe silikutha kapena muli ndi malire okhazikika a madzi. Kuchuluka kwa madzi kuyenera kukhazikitsidwa ndi gulu lanu lochiza, osati ndi pepala lophunzitsira wamba.

Mimba

Kuyeza magazi m'mitsempha ya mtima kumagwiritsa ntchito ma radiation a ayonizing ndipo kumachitika pa nthawi ya mimba pokhapokha ngati pakufunika thandizo lachipatala, monga matenda a mtima pa nthawi ya mimba, ndi chitetezo cha m'mimba komanso kuchepetsa mlingo. Uzani gulu ngati muli ndi pakati kapena muli ndi pakati.

Mu akuluakulu

Kufooka, kulemera pang'ono kwa thupi, kuchepa kwa magazi m'thupi komanso kuchepa kwa impso zomwe zimasungidwa kumawonjezera chiopsezo cha kutuluka magazi komanso kuvulala kwa impso chifukwa cha kusiyana kwa mitundu. Nthawi zambiri anthu amakonda kugwiritsa ntchito ma radiation ndi kusiyana kochepa kwa mitundu.

Mwa ana

Kujambula kwa coronary angiography mwa ana sikwachilendo ndipo nthawi zambiri kumachitika pa matenda obadwa nawo a mtima, matenda a Kawasaki kapena pambuyo poika mtima wina, m'malo ochitira matenda a mtima a ana komanso nthawi zambiri pansi pa anesthesia wamba.

Zomwe zimachitika panthawi ya ndondomekoyi

Mumagona patebulo lopapatiza lokhala ndi ma lead a ECG, chotsukira magazi ndi choyezera kuthamanga kwa magazi. Mzere wolumikizira m'mitsempha umayikidwa. Dzanja kapena chiuno chimatsukidwa ndikuchotsedwa ndi mankhwala oletsa ululu. Mungapatsidwe mankhwala ochepetsa ululu pang'ono.

Katswiri wa matenda a mtima amaika kachidutswa kakang'ono m'mitsempha yamagazi, kenako amapititsa ma catheter kumtima. Kuika ma catheter m'mitsempha yamagazi nthawi zambiri kumabweretsa kutentha pang'ono; anthu ena amamva kupweteka pachifuwa kwa masekondi angapo kapena kugwedezeka. Mungapemphedwe kuti muchepetse mpweya wanu, kutsokomola, kapena kukhala chete pamene chithunzicho chikujambulidwa.

Anthu ambiri amafotokoza za kupanikizika osati ululu. Uzani gululo nthawi yomweyo ngati mukumva kupweteka pachifuwa, kusamva bwino, kuyabwa, kupuma movutikira kapena nseru, izi zitha kuthetsedwa panthawi ya opaleshoniyi.

Pamapeto pake, ma catheter amachotsedwa. Kuti munthu alowe mu radial, bandeji yokakamiza imayikidwa padzanja; kuti munthu alowe mu femoral, amagwiritsa ntchito chipangizo chokakamiza kapena chotseka. Kupumula pabedi nthawi zambiri kumafunika munthu akalowa mu femoral, ndipo zochepa kwambiri akalowa mu radial.

Kodi zimatenga nthawi yayitali bwanji

• Kujambula zithunzi zokha: nthawi zambiri mphindi 20-45 kuti mupeze kafukufuku wosavuta wokhudza matenda.
• Ndi angioplasty ndi stenting pamalo amodzi: nthawi yayitali kwambiri, kutengera kuuma kwa zilondazo.
• Kuyang'anitsitsa pambuyo pake: maola angapo mutatha kugwiritsa ntchito radial m'mayunitsi ambiri; nthawi yayitali, nthawi zambiri ndi kugona usiku wonse, mutatha kugwiritsa ntchito femoral, mutatha kulowererapo, kapena ngati muli ndi mavuto ena azachipatala.

Nthawi yeniyeni imasiyana malinga ndi nthawi yomwe mwakhala mukuchita opaleshoni ndipo imadalira nthawi yomwe mwakhala mukuchita opaleshoni, nthawi yomwe mwakhala mukugwira ntchito, njira yolowera komanso momwe matenda anu alili.

Kumvetsa lipoti lanu

Lipoti la angiogram limafotokoza mtsempha uliwonse waukulu, waukulu kumanzere, wotsikira kumanzere (LAD), circumflex kumanzere, mtsempha wamtima wakumanja, ndi nthambi zawo, ndi kuyerekezera kwa kuchepa ngati peresenti ya m'mimba mwake wa lumen.

• Mitsempha ya mtima yachibadwa: Palibe kuchepa kwakukulu kwa lumen komwe kunawonedwa. Izi sizikutanthauza kuti palibe atherosclerosis, kapena kuti palibe chomwe chimayambitsa zizindikiro za mtima chomwe chachotsedwa.
• Matenda ofatsa/osalepheretsa: Chikwangwani chilipo koma kuyenda kwa madzi sikuchepa kwambiri. Nthawi zambiri chimachiritsidwa ndi mankhwala omwe angayambitse zoopsa, osati kupatsidwa scent.
• Kuchepetsa pang'ono: Kuyesa kwa maso sikodalirika pano. Kuwunika kwa waya wopanikizika (FFR/iFR) nthawi zambiri kumasankha ngati chithandizo chikufunika.
• Kuchepa kwakukulu: Matenda oletsa kuyenda kwa magazi omwe angachiritsidwe ndi angioplasty ndi stent kapena opaleshoni ya bypass, kutengera kapangidwe kake, kuchuluka kwa mitsempha yamagazi, matenda a shuga, ndi ntchito yopompa magazi.
• Kutsekedwa konse: Mitsempha yamagazi yatsekedwa kwathunthu. Mitsempha yamagazi ikhoza kukhala ikupereka malo ofunikira. Chithandizo chimadalira zizindikiro komanso ngati minofu yomwe ili kumbuyo kwake ikugwira ntchito.
• Zina zomwe zapezeka: Matenda a mtima otchedwa Coronary ectasia kapena aneurysm, kusweka kwa mitsempha yamagazi, kupindika kwa mitsempha yamagazi, kapena chiyambi chosazolowereka. Chilichonse chili ndi kasamalidwe kake ndipo chiyenera kufotokozedwa kwa inu mwachindunji.
• Ntchito ya mitsempha ya kumanzere Zingadziwike ngati ventriculography idachitidwa.

Mawu monga "matenda a mitsempha imodzi" kapena "matenda a mitsempha itatu" amafotokoza kuchuluka kwa mitsempha ikuluikulu yomwe imakhudzidwa kwambiri. Amafotokoza kapangidwe ka thupi, osati kuneneratu za matendawo okha. Katswiri wa mtima amene anachita kafukufukuyu, ali ndi zizindikiro zanu ndi mayeso ena m'manja, ndiye munthu woti afotokoze tanthauzo la zomwe zapezeka kwa inu.

Pamene zotsatira zingakhale zosokeretsa

Kuopsa kungaoneke ngati kwakukulu molakwika

• Kupindika koyambitsidwa ndi catheter, makamaka ya mtsempha wa mtima wakumanja, imatha kutsanzira kuchepa; imatha kutha ndi nitrate yamkati mwa coronary.
• Kufupikitsa ndi kuphatikana Kuchuluka kwa mitsempha yamagazi yomwe ili mu pulojekiti imodzi kungapangitse kuti kuchepa kwa mitsempha kuchuluke kwambiri, ndichifukwa chake ma angles angapo amatengedwa.
• Kuthamanga kwa magazi kotsika kapena kutsekeka kwa magazi panthawi yophunzira ingapangitse kuti mitsempha yamagazi iwoneke yaying'ono.
• Kutulutsa kosiyana kapena kulowetsa kosakwanira zimatha kupanga mawonekedwe a zolakwika zodzaza.

Kuopsa kungawoneke ngati kochepa molakwika

• Kukonzanso kwakunja (kwabwino) imasunga lumen ikuwoneka bwino ngakhale kuti pali plaque yambiri.
• Matenda ofalikira Popanda mfundo yopapatiza yosiyana, ikhoza kuwerengedwa mochepa, chifukwa kuyika kumadalira kufananiza ndi gawo "labwinobwino" lapafupi lomwe lingakhale ndi matenda.
• Kuchuluka kwa calcium m'thupi ndipo nyumba zokhuthala zolumikizana zimatha kubisa kuwala kwenikweni.
• Zilonda zazikulu zakumanzere ndi za m'maso ikhoza kuphonya ngati malo a catheter aphimba gawolo.
• Ziwiya zazing'ono zakutali ndi nthambi zam'mbali ikhoza kukhala yopanda kuwala mokwanira.

Zinthu zaukadaulo ndi odwala

• Kusuntha, kulephera kugwira mpweya, kunenepa kwambiri komanso kugunda kwa mtima kwambiri kapena kosasinthasintha kumawononga mawonekedwe a chithunzi.
• Kuchepa kwa kuchuluka kwa kusiyanasiyana kwa matenda a impso kungachepetse kuchuluka kwa anthu omwe amawona.
• Kuyika kwa mbolo m'malo obisika kungakhale kovuta ndipo kunganenedwe molakwika kuti kwatsekedwa ngati sikunawonetsedwe bwino.

Zoopsa ndi chitetezo

Kuyeza magazi m'mitsempha ya mtima ndi njira yodziwika bwino yomwe imachitika mochuluka, ndipo mavuto aakulu ndi osazolowereka. Sikoopsa, ndipo chiopsezocho chimadalira zaka zanu, ntchito ya impso, kufunikira kwa njirayi, njira yolowera komanso ngati chithandizocho chikuchitika nthawi imodzi. Zotsatira ndi zoopsa zimasiyana malinga ndi momwe matenda amachitikira.

Angiography yokha yodziwira matenda

• Chofala komanso nthawi zambiri chaching'ono: kuvulala, kupweteka kapena kutuluka magazi pang'ono pamalo obayidwa; kutentha kwa kanthawi kochepa kapena kutuluka magazi kuchokera ku chosiyana; kusamva bwino pachifuwa kapena kusakhazikika kwa mtima panthawi yobayidwa.
• Zosazolowereka: Kutuluka magazi ambiri komwe kumafunika chithandizo, kutsekeka kwa mitsempha ya radial, pseudoaneurysm kapena arteriovenous fistula (yomwe imapezeka kwambiri ndi femoral access), kuvulala kwa impso komwe kumakhudzana ndi kusiyana kwa zizindikiro, kusintha kwa hypersensitivity, matenda pamalopo.
• Zosowa koma zowopsa: Matenda a mtima, sitiroko, kusweka kwa mtima, kusakhazikika kwa mtima, ziwengo zoopsa, komanso imfa. Chiwopsezo chimakhala chachikulu m'machitidwe adzidzidzi, mwa odwala osakhazikika komanso mwa omwe ali ndi matenda aakulu a kumanzere kapena matenda a impso opitirira muyeso.
• Magetsi: Mlingo umakhala wochepa momwe mungathere; mlingo wokwanira umakhala wofunika ngati mukuchita opaleshoni mobwerezabwereza.

Angiography yokhala ndi angioplasty ndi stenting

Kuwonjezera chithandizo kumawonjezera chiopsezo cha njira poyerekeza ndi angiography yokha, kuphatikizapo mwayi waukulu woti mitsempha yamagazi idulidwe, kubowoka, kusayendanso kwa magazi, kuvulala kwa mtima m'mitsempha, komanso kuwonekera kwakukulu kwa kuwala ndi kuwala. Kutupa kumakupangitsaninso kuti mugwiritse ntchito mankhwala awiri oletsa magazi, zomwe zimawonjezera chiopsezo cha kutuluka magazi. Izi ndi zokambirana zosiyana za mgwirizano.

Kufikira kwa radial motsutsana ndi femoral

Kulowa m'manja pogwiritsa ntchito radial (m'dzanja) nthawi zambiri kumagwirizanitsidwa ndi mavuto ochepa otuluka magazi pamalo olowera komanso kuyenda msanga kuposa kulowa m'manja pogwiritsa ntchito femoral, ndichifukwa chake mayunitsi ambiri amakonda. Kulowa m'manja pogwiritsa ntchito femoral kumafunikanso nthawi zina, mwachitsanzo pamene pakufunika zida zazikulu, kapena pamene njira yolowera m'manja si yoyenera.

Zinthu zapadera

Women

Azimayi nthawi zambiri amakhala ndi angina yokhala ndi mitsempha ya mtima yosaletsa. Angiogram "yabwinobwino" mwa mkazi yemwe ali ndi zizindikiro zodziwika bwino iyenera kuwathandiza kuganizira za kusokonekera kwa mitsempha yamagazi kapena kupindika m'malo mochotsa zizindikirozo.

shuga

Matenda a mtima mu matenda a shuga nthawi zambiri amakhala ofala kwambiri komanso a mitsempha yambiri. Izi zimakhudza kusankha pakati pa opaleshoni yopatsirana ndi opaleshoni ya bypass, ndipo chisankho chimenecho nthawi zambiri chimapangidwa ndi gulu la akatswiri a mtima.

Matenda a impso osatha komanso dialysis

Kuwona kusiyana kwa kuwala kumafunika kukonzekera bwino. Kwa anthu omwe ali kale pa dialysis, nkhawa imasintha kuchoka pa kuvulala kwa impso kupita ku kukhala ndi madzi okwanira komanso nthawi yoyeretsera kuwala panthawi ya opaleshoni.

Kulephera kwa mtima ndi matenda aakulu a valve

Kugona pansi kungakhale kovuta, ndipo mphamvu yosiyanitsa iyenera kuchepetsedwa. Muyezo wowonjezera wa hemodynamic ukhoza kupangidwa panthawi ya kafukufuku womwewo.

Opaleshoni ya bypass isanachitike

Kujambula kwa graft angiography kumatenga nthawi yayitali, kumagwiritsa ntchito kusiyana kwakukulu ndipo kumakhudza ma radiation ambiri kuposa kafukufuku woyamba. Bweretsani zolemba zanu zam'mbuyomu za opaleshoni kuti mudziwe chiwerengero ndi mtundu wa grafts.

Okalamba ndi odwala omwe alibe magazi okwanira

Kuopsa kwa magazi ndiye chinthu chofunika kuganizira. Nthawi yogwiritsira ntchito mankhwala oletsa magazi ozungulira njirayi iyenera kusankhidwa ndi dokotala, osati kusinthidwa kunyumba.

Coronary angiogram mu nkhani ya ku India

• Matenda oyamba msanga: Matenda a mitsempha ya mtima nthawi zambiri amapezeka ali aang'ono ku South Asia kuposa ku madera ambiri akumadzulo, ndipo chiopsezo cha kagayidwe kachakudya chimawonekera pamlingo wotsika wa thupi ku South Asia, kotero chiopsezo sichiyenera kunyalanyazidwa potengera kulemera "kwabwinobwino".
• Matenda a mtima a rheumatic: Matenda a Valvular akadali ofala ku India. Nthawi zambiri angiography ya mtima imachitika odwala okalamba kapena omwe ali ndi zoopsa asanachite opaleshoni ya valve, ndipo mayeso a echo amakhalabe kuwunika kwakukulu kwa valve.
• Nthawi yoti mulandire chithandizo: Pa matenda a mtima, kuchedwa kufika kuchipatala chomwe chingathe kuchitidwa opaleshoni ya cath-lab kumakhalabe vuto lalikulu. Ngati mukuvutika ndi kupweteka pachifuwa, imbani chithandizo chadzidzidzi m'malo mokonza nthawi yokumana ndi wodwalayo.
• Matenda a magazi m'thupi ndi thalassemia: Matenda a kuchepa kwa magazi chifukwa cha kusowa kwa ayoni ndi matenda a hemoglobinopathy ndi ofala kwambiri ku India. Kuchepa kwa magazi m'thupi kumawonjezera chiopsezo cha matenda opatsirana komanso kutuluka magazi ndipo kungayambitsenso kupuma movutikira komwe kumafanana ndi angina.
• Mankhwala ndi zowonjezera: Kugwiritsa ntchito mankhwala owonjezera a zitsamba, AYUSH ndi malo ochitira masewera olimbitsa thupi n'kofala ndipo nthawi zambiri sikunenedwa. Ululani chilichonse chomwe mumamwa, chifukwa mankhwala ena amakhudza kutuluka magazi ndi ntchito ya chiwindi kapena impso.
• Maganizo achiwiri: Muli ndi ufulu wopempha zithunzi ndi lipoti la angiogram, komanso kufunsa maganizo ena musanavomereze opaleshoni yopatsirana kapena yodutsa, pokhapokha ngati vutolo ndi ladzidzidzi.
• Chilolezo ndi deta: Chilolezo cholembedwa chikufunika, ndipo zambiri zanu zaumoyo, kuphatikizapo zithunzi za ndondomekoyi, ndi zambiri zaumwini zomwe zimasungidwa motsatira Digital Personal Data Protection Act, 2023. Zonena zotsatsa za machiritso a matenda a mtima ndizoletsedwa motsatira Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954.

Mtengo ndi inshuwalansi ku India

Ndalama zimasiyana kwambiri pakati pa zipatala za boma, trust ndi zachinsinsi, pakati pa mizinda, komanso pakati pa kafukufuku wokhudza matenda ndi njira yomwe imakhala yothandiza. Funsani kuti mulembe mtengo wowerengera musanalowe m'chipatala.

Zinthu zomwe zimakhudza mtengo:

• Kaya njira yodziwira matenda ikupitirirabe, kapena angioplasty ndi stents zimawonjezedwa nthawi imodzi.
• Njira yolowera, kuchuluka kwa ma catheter ndi kuchuluka kwa kusiyana komwe kwagwiritsidwa ntchito.
• Kugwiritsa ntchito zida zowonjezera monga mawaya opondereza, IVUS kapena OCT.
• Malo osamalira ana masana poyerekeza ndi malo ogona usiku wonse kapena okhala mu ICU; gulu la zipinda.
• Kufufuza za chithandizo chisanachitike komanso ndalama zofunsira chithandizo cha matenda a mtima.
• Njira zadzidzidzi zogwirira ntchito kunja kwa nthawi yogwira ntchito poyerekeza ndi nthawi yosankha.
• Mzinda, gawo la chipatala komanso ngati chipatalacho chakhazikitsidwa motsatira ndondomeko ya boma.

Mfundo za inshuwaransi: ngati ndondomeko yanu ikuphimba njira yosamalira ana kapena kulowa m'chipatala, nthawi yodikira matenda a mtima omwe alipo kale, malire a lendi ya chipinda ndi zigawo zochotsera zomwe zimafanana, ngati stents ndi zogwiritsidwa ntchito zimaphimbidwa, komanso ngati chilolezo chikufunika. Mitengo ya stent ku India imadalira mitengo yomwe yadziwitsidwa ndi National Pharmaceutical Pricing Authority; funsani invoice yosindikizidwa ya stent ndi stent card. Mapulani aboma monga Ayushman Bharat PM-JAY amaphimba ma phukusi a mtima m'zipatala zothandizidwa ndi anthu oyenerera.

Nthano ndi mfundo zenizeni

MAFUNSO OFUNSIDWA KAWIRIKAWIRI

Kodi angiogram ya mtima imapweteka?

Anthu ambiri amamva kupweteka kwakanthawi chifukwa cha mankhwala oletsa ululu kenako kupanikizika m'malo mopweteka. Kubayidwa kwa contrast kungayambitse kutentha kwa masekondi angapo kapena kusasangalala pang'ono pachifuwa. Siziyembekezeredwa kuti ululu waukulu uchitike, uzani gulu nthawi yomweyo ngati mukumva ululuwo, chifukwa ukhoza kuchiritsidwa panthawi ya opaleshoniyi.

Kodi ndidzakhala kuchipatala kwa nthawi yayitali bwanji?

Kujambula zithunzi nthawi zambiri kumatenga mphindi 20-45 kuti munthu adziwe matenda. Kuyang'anitsitsa pambuyo pake nthawi zambiri kumakhala maola angapo munthu akalowa m'chiwuno ndipo nthawi zina usiku wonse, munthu akalowa m'chiwuno, mutatha kuchita angioplasty, kapena ngati muli ndi matenda ena. Chipatala chanu chidzatsimikizira dongosolo lanu.

Kodi ndingathe kudya ndi kumwa mankhwala anga ndisanachite opaleshoni?

Nthawi yosala kudya ndi malangizo a mankhwala amakhazikitsidwa ndi chipinda chochitira opaleshoni ndipo zimasiyana malinga ndi zipatala. Musayimitse kapena kusintha mankhwala aliwonse omwe mwapatsidwa nokha, makamaka mankhwala ochepetsa magazi, mapiritsi a insulin kapena matenda a shuga. Funsani dokotala wanu kapena gulu la akatswiri a zachipatala zomwe muyenera kumwa patsikulo.

Kodi stent idzayikidwa pamalo omwewo?

Nthawi zina. Pakagwa ngozi monga matenda a mtima, chithandizo nthawi zambiri chimatsatira nthawi yomweyo. Pakachitika zinthu zokhazikika, dokotala wa mtima angakambirane kaye zomwe zapezeka ndi inu kapena gulu la mtima. Chilolezo cha angioplasty yomwe ingachitike nthawi zambiri chimatengedwa pasadakhale kotero chithandizo sichiyenera kuchedwa.

Kodi kusiyana pakati pa angiogram ya mtima ndi angiogram ya CT ndi kotani?

Kuyeza kwa mtima kwa CT sikovulaza ndipo n'kothandiza pochotsa kutsekeka kwakukulu pamene mwayi wa matenda uli wochepa mpaka wapakati. Kuyeza kwa mtima kowononga mtima kumapereka tsatanetsatane wabwino wa lumen, kumalola kupanikizika ndi kuwunika waya, komanso kulola chithandizo pamalo amodzi.

Kodi ma radiation ochokera ku angiogram ndi owopsa?

Njirayi imagwiritsa ntchito ma radiation a ionizing, ndipo mlingo umachepetsedwa pogwiritsa ntchito chitetezo, malo ochepa oyezera komanso nthawi yochepa yoyezera. Pa kafukufuku mmodzi woperekedwa kuchipatala, chiopsezo chake ndi chochepa poyerekeza ndi phindu la matenda. Uzani gululo za njira zam'mbuyomu za mtima kuti anthu athe kuganizira za kukhudzana ndi matenda.

Angiogram yanga inali yabwinobwino koma kupweteka pachifuwa kukupitirira. Kenako, bwanji?

Zizindikiro zomwe zikupitirira ziyenera kufufuzidwanso, osati kuchotsedwa ntchito. Mwayi wake ndi monga angina ya m'mitsempha yamagazi, kupindika kwa mtima, ndi zinthu zina zomwe sizili za mtima monga acid reflux, kupweteka kwa minofu ndi mafupa, kuchepa kwa magazi m'thupi kapena nkhawa. Bwererani kwa dokotala wanu wa mtima, yemwe angakonze zoyezetsa zina za mtima kapena kufufuza machitidwe ena.

Kodi ndingathe kuyendetsa galimoto kapena kubwerera kuntchito pambuyo pake?

Musayendetse galimoto tsiku lomwe opaleshoniyo inachitidwa ngati mwalandira mankhwala oletsa ululu. Anthu ambiri amayambiranso kuchita zinthu zopepuka pasanathe tsiku limodzi kapena awiri mutaphunzira za matenda awo, kupewa kunyamula katundu wolemera komanso kugwiritsa ntchito mwendo woboola kwambiri kwa masiku angapo. Nthawi ya opaleshoniyi imasiyana pambuyo pa angioplasty, tsatirani malangizo anu ochotsera ululu.

Kodi angiogram ya mtima ingabwerezedwe kangati?

Palibe nthawi yokhazikika. Kubwerezabwereza angiography kumachitika ngati pali chifukwa cha matenda, monga zizindikiro zobwerezabwereza kapena zoipiraipira, mayeso atsopano opsinjika maganizo, kapena njira yokonzedweratu yolowererapo. Kubwerezabwereza maphunziro kumapewedwa popanda umboni chifukwa cha kusiyana kwa kuwala ndi kuwala.

magwero

• Malangizo a 2021 ACC/AHA/SCAI a Coronary Artery Revasculari