Chenjera coronary syndrome.

Chenjera coronary chirwere - kunzwisisa pathophysiological siyana. The chirwere zvinosanganisira chakasimba myocardial infarction (zvose zvavo uye panyaya chaiyo siyana - kana pasina munhu anosimudza vachisimudza ST chidimbu) uye kusagadzikana angina.

Saka, tinogona kutaura kuti rikwanise coronary urwere, tsanangudzo wakapiwa kumusoro, haisi chirwere asi kunzwisisa pfungwa kuti rinounza pamwechete yakakura boka zvemwoyo chirwere pamwe mifananidzo kuratidzwa kwayo (mwoyo kurwisa uye angina).

Symptomatology ACS Hakuna mumwe kunze zviratidzo ichi kunyanya chirwere. Kureva, nokuti kunoratidzwa zvose zvaidiwa runotikurudzira chirwere. Zvisinei, pane zvimwe zviratidzo zvakafanana kuti kuitika zvikuru chakasimba zvirwere kumwoyo. Pakati kuratidzwa izvi vaitungamirira chinzvimbo sezvo kakawanda kuwanika uye nesimba kuratidzwa, zvinoda marwadzo. Chenjera coronary chirwere inowanzopiwa akaratidza simba kubaya, achicheka kana nokupisa marwadzo seri breastbone munzvimbo mwoyo. Bad marwadzo kutorerwa nokuda nitroglycerin kana mabiko inenge yakamira. Kazhinji, marwadzo kurwisa anotora pamusoro porutivi maminitsi anopfuura 15. Nokuti vanhu vane angina inozivikanwa destabilization chirwere (enhancement kurwadziwa, uyewo kuwedzera urefu dzavo, kushaya pakupindura kushanda nitroglycerin). Vanhu makumi maviri nemashanu - makore makumi mana, uyewo vakwegura (vakuru makumi manomwe nemakore) vanogona atypical localization kurwadziwa - pleural, epigastric uye nevamwe. Apo neapo akacherechedza nyarara siyana kuti kuonekwa benzi kupfupika mweya, wenyonganyonga pamusoro nemudumbu.

Chenjera coronary chirwere chinogona kuonekwa munguva inotevera chirwere maitirwo ezvinhu:

- panyama kuongororwa (kureva, nhoroondo kupinza uye kuongorora murwere, mufambiro palpation, percussion nezvimwe zviitiko)

- kurekodha unonzi, electrocardiograph kuti asimbise cardiac zvokurwara uye achisiya zvimwe zvirwere (nokuti ECG yakaratidza maitiro zviri mumwoyo tsandanyama rinenge ischemia - vachisimudza «ST» kana "T" pamusoro isoline)

- kuziva nokukanganisika zvezvinangwa ose cardiac kukuvara tsandanyama - troponin uye tropomyosin, uyewo Kutsunga yakawedzera kwevari creatine phosphokinase MB uye myoglobin zvikamu zviduku.

- Achipa evanhu echocardiography, migumisiro izvo kutongwa pamusoro dzichipfekeka kusagadzikana mwoyo (pachiyero kutyorwa systolic kushanda mumwoyo)

Kunze inokosha tsvakurudzo, chenjera coronary chirwere chinogona yasimbiswa uye achiita mamwe, wechitatu bato nzira dzakadai coronary angiography uye Holter zvichiongororwa. Coronary angiography rinoitwa kuzosimbisa zvokurwara of vascular pamubhedha tsandanyama rinenge mwoyo. Holter zvichiongororwa rinoshandiswa nokuda kuziva miedzo chenjera (pfupi uye kusagadzikana) nenyonganiso mumwoyo achishandisa ECG kurekodha panguva imwe kana dzakawanda mazuva. Kakawanda achishandisa nzira iyi yakaratidza zvinopfuura vachivavhiringidza nomwoyo mutinhimira - arrhythmia.

Kufanana zviratidzo, uye zvimwe zvinetso zviri Implementation uye kududzirwa mumuviri rabhoritari zvidzidzo asike prerequisites kuti zvakadzama kudzidza differential nechirwere.

chirwere kwakadaro kubva chakasimba coronary chirwere rakanga raitwa pulmonary embolism, pericarditis, kutsemuka aneurysm (zvikurukuru, kwaro exfoliating), hypothyroidism uye myocarditis rwarisa etiology.

Chenjera coronary syndrome. Vabatwe ichi rinoitwa, zvinganaka kushandisa nitroglycerin (rokuwedzera vascular zvinyama mumwoyo tsandanyama), asipurini (pamwe chinangwa kuderedza uye ropa thinners mugove ischemia), B-blockers (atenolol, metoprolol). Uyezve, antihypertensive kurapa akaita BP panguva pamatunhu prices.