Angina

I-Angina yisifo senhliziyo esivamile esithinta izigidi emhlabeni wonke futhi sisebenza njengophawu oluyisixwayiso lwezinkinga Isifo senhliziyo. I-Angina ibonakala njengobuhlungu obuqinile, obucindezelayo esifubeni sakho futhi kwenzeka lapho inhliziyo ingatholi igazi eligcwele umoya-mpilo elanele, ngokuvamile ngenxa yemithambo emincane noma evalekile. Ukuqonda izimpawu ze-angina, izimbangela, kanye nezinketho zokwelapha kubalulekile ekulawuleni lesi simo nokuvimbela izinkinga ezinkulu zenhliziyo.

Iyini i-Angina?

I-angina, ngokwezokwelapha eyaziwa ngokuthi i-angina pectoris, uhlobo lwe-angina ubuhlungu besifuba noma ukungaphatheki kahle futhi kwenzeka lapho inhliziyo ingatholi igazi eligcwele umoya-mpilo elanele. Igama elithi 'angina' livela egameni lesiLatini elisho 'ukuklinywa' noma 'ukuklinya', elichaza kahle ukuzwa iziguli eziningi ezikuzwayo.

Izinhlobo ezahlukene ze-angina

I-Angina ibonakala ngezindlela ezihlukahlukene, ngayinye inezici ezihlukile kanye nezimbangela. Ukuqonda lezi zinhlobo kusiza ekuboneni izimpawu nasekufuneni ukwelashwa okufanele.

• I-Angina ezinzile: I-angina ezinzile, uhlobo oluvame kakhulu, inephethini ebikezelwayo. Ngokuvamile kwenzeka ngesikhathi sokusebenza ngokomzimba noma ukucindezeleka ngokomzwelo lapho inhliziyo idinga igazi eligcwele umoya-mpilo. Ubuhlungu buvamise ukuthatha imizuzu embalwa bese buphela nokuphumula noma imithi. Abantu bavame ukuyichaza njengokumpintsha noma ukucindezela esifubeni. 
• I-Angina engazinzile: I-angina engazinzile inzima kakhulu futhi ayilindeleki. Kungenzeka ngisho uphumule futhi akulandeli iphethini. Ubuhlungu bungase buqine noma buhlale isikhathi eside kune-angina ezinzile. Lolu hlobo luphumela ekuncipheni kungazelelwe kokugeleza kwegazi kuya emcupheni wenhliziyo, ngokuvamile ngenxa yokwakheka koqweqwe emithanjeni yenhliziyo.
• I-Angina Ehlukile (i-Prinzmetal's Angina): Lolu hlobo olungavamile lwe-angina lwenzeka ngenxa ye-spasms emithanjeni ye-coronary. Ngokuvamile kwenzeka lapho uphumule, ngokuvamile phakathi kwamabili nasekuseni kakhulu. Ubuhlungu bungaba nzima futhi angeke buphendule emithini ejwayelekile ye-angina. I-angina ehlukile ingathinta noma ubani futhi ivame kakhulu kubantu abancane, abanempilo enhle uma kuqhathaniswa nezinye izinhlobo ze-angina.
• I-Microvascular Angina: I-Microvascular angina ihilela ubuhlungu esifubeni obungaba namandla futhi buhlale isikhathi eside kune-angina ezinzile. Kungenzeka kokubili ngesikhathi sokuphumula nangemva kokuzivocavoca. Lolu hlobo luthinta imithambo emincane yenhliziyo futhi ingase ingaphenduli kahle njalo ekwelashweni okujwayelekile kwe-angina.
• I-Refractory Angina: I-Refractory angina ibhekisela ezimpawini ze-angina eziphikelelayo ezihlala izinyanga naphezu kwenhlanganisela yemithi nokushintsha kwendlela yokuphila. Lolu hlobo lungathinta kakhulu izinga lempilo yomuntu futhi ludinga amasu okuphatha akhethekile.

Izinkinga ze-Angina

I-Angina yenzeka lapho imisipha yenhliziyo ingatholi igazi eligcwele umoya-mpilo elanele. Lokhu kuntuleka kokugeleza kwegazi, okwaziwa nge-myocardial ischaemia, kuthinta ikhono lenhliziyo lokusebenza ngendlela efanele. Izimo eziningana zingaholela ekunciphiseni ukugeleza kwegazi enhliziyweni, okubangela izimpawu zobuhlungu be-angina, njenge:

• Yenhliziyo Umthambo isifo (CAD): I-CAD ikhula lapho i-plaque, into enamafutha ne-waxy, yakheka emithanjeni yenhliziyo. Njengoba ungqimba lunqwabelana, luyancipha futhi luqinise imithambo, inqubo ebizwa ngokuthi i-atherosclerosis.
• I-Coronary Microvascular Disease: Lesi simo sithinta imithambo yegazi emincane ephuma emithanjeni yenhliziyo.
• I-Coronary Artery Spasms: I-Spasm noma ukuminyanisa okuphindaphindiwe kanye nokuxegiswa kwemithambo yenhliziyo kunganqanda ukugeleza kwegazi enhliziyweni okwesikhashana. 

Izimpawu ze-angina

I-Angina ibonakala ngezinhlobonhlobo zezimpawu, ngokuyinhloko ezigxile ekuphathekeni kwesifuba. 

• Uphawu oluvame kakhulu ubuhlungu besifuba noma ukucindezela, iziguli ezivame ukuchaza njengokuzwa okucindezelayo noma ukucinana. 
• Abanye abantu bakuqhathanisa nokungagayeki kahle kokudla, okuvame ukuvela ngemuva kwethambo lesifuba futhi kungase kusakazekele kwezinye izingxenye zomzimba ezingenhla.
• Ubuhlungu noma ukungaphatheki kahle kungabonakala ezindaweni ezihlukahlukene, njengentamo, umhlathi, amahlombe, izingalo, noma umhlane.
• Ukukhathala
• Ukuphelelwa umoya
• Ukujuluka ngokweqile

Kubalulekile ukuqaphela ukuthi abesifazane bangase babe ne-angina ehlukile kwabesilisa. Bangase babe:

• Ukungakhululeki entanyeni, emhlathini, amazinyo, noma emhlane
• Ukudabuka noma ukuhlanza
• Ukuphelelwa umoya
• Ubuhlungu bokugwaza esikhundleni sokucindezela kwesifuba
• Ubuhlungu besisu

Izingozi ze-angina

Kunezici eziningana ezingathuthukisa ingozi yomuntu yokuthuthukisa i-angina. Lokhu kungase kuhlanganise: 

• Iminyaka yobudala: Njengoba abantu bekhula, amathuba abo okuba ne-angina ayanda, abantu abadala abaneminyaka engu-60 nangaphezulu yibona abasengozini enkulu. 
• I-Genetic Predisposition: Abantu abanabazali noma izingane zakubo eziye zaba nesifo senhliziyo noma isifo senhliziyo banamathuba amaningi okuthuthukisa i-angina ngokwabo. 
• Izinqumo Zendlela Yokuphila: Ukusebenzisa ugwayi, ukungawuvivinyi umzimba, ukuphuza ngokweqile, nokukhuluphala - konke okwandisa ingozi ye-angina.
• Izimo Zezokwelapha: Uma ziyekwa zingelashwa, izimo ezithile zezokwelapha, njengesifo sikashukela, umfutho wegazi ophakeme, kanye i-cholesterol ephezulu ye-LDL kanye namazinga e-triglycerides egazini, angaholela ekwandeni kwengozi ye-angina. Ezinye izimo zezempilo eziphakamisa ingozi ye-angina zihlanganisa isifo sezinso esingamahlalakhona, isifo se-peripheral artery, i-metabolic syndrome, nomlando wokushaywa unhlangothi. 
• Izimo Zemvelo: Amazinga okushisa abandayo angase avuse i-Prinzmetal angina, kuyilapho ukuchayeka ekungcoleni kwezinhlayiyana ezivela emithonjeni ehlukahlukene efana nemigwaqo, amapulazi, nezindawo zokwakha kungaba nomthelela engozini ye-angina.
• Ukucindezeleka ngokomzwelo kanye nemithi ethile, ikakhulukazi ukwelashwa kwe-migraine, kungabangela izimpawu ze-angina. 

Izinkinga

Inkinga ebaluleke kakhulu ehlobene ne-angina ingozi eyandayo yokuhlaselwa yinhliziyo. Ngesikhathi sokuhlaselwa yinhliziyo, ukuncipha kokugeleza kwegazi isikhathi eside kuholela ekufeni kwezicubu zenhliziyo. Kungakho ukuqaphela izimpawu eziyisixwayiso, njengokucindezela noma ukukhama ubuhlungu esifubeni obuhlala ngaphezu kwemizuzu embalwa, ubuhlungu obukhiphayo, ukuphelelwa umoya, nokujuluka ngokweqile, kubalulekile.

Ukwelashwa kwe-angina

Indlela yokwelapha nokuphatha incike ohlotsheni nobukhulu be-angina.

Nge-angina ezinzile, izinguquko zendlela yokuphila kanye nemithi ngokuvamile ibonakala isebenza kahle. 

• Izinguquko Zendlela Yokuphila:
  • Ukwamukela ukudla okunempilo kwenhliziyo
  • Ukuzivocavoca njalo
  • Ukuyeka ukubhema
  • Ukulawula ukucindezeleka
• Imithi: Odokotela bangase banikeze imithi eminingana ngokusekelwe ezimpawu nobukhulu besimo: 
  • I-Nitrates 
  • I-Aspirin nezinye izidakamizwa ze-antiplatelet  
  • Ama-beta blockers 
  • Izitatimende 
  • Ama-block block wesiteshi seCalcium  
• Ukwelashwa Kwangaphandle Okuthuthukisiwe (i-EECP):
  • Ukwelashwa kwe-EECP kungathuthukisa ukugeleza kwegazi enhliziyweni. Lokhu kwelashwa okungahlaseli kuhlanganisa ukugoqa ama-cuffs okucindezela emilenzeni futhi uwavuthele ukuze avumelane nokushaya kwenhliziyo.
• I-Angioplasty nge-Stenting: 
  • Kuyinqubo evamile esiza ukugcina umthambo uvulekile futhi ithuthukise izimpawu ze-angina.
  • I-Coronary artery bypass grafting (CABG :)
  • Odokotela ngokuvamile batusa i-CABG ezimweni eziyinkimbinkimbi ze-angina ukuthi idlule umthambo wenhliziyo ovimbekile futhi yandise ukugeleza kwegazi enhliziyweni.

Uzoyibona Nini Udokotela

Ezinye izimo ezithile ezidinga ukunakekelwa kwezokwelapha ngokushesha yilezi:

• Ubuhlungu besifuba obuhlala isikhathi eside kunemizuzu embalwa futhi abuqediwe ukuphumula noma imithi ye-angina
• Ukungakhululeki kwesifuba okusha noma okungajwayelekile
• Izimpawu eziba zimbi kakhulu noma ezishintshayo kulabo abane-angina ezinzile

Prevention

Ukuvimbela i-angina kuhilela ukwamukela indlela yokuphila enempilo enempilo nokulawula izici eziyingozi, njenge:

• Ukudla okunempilo kwenhliziyo 
  • Yidla ukudla kwaseMedithera, okunothiswe ngemifino, izithelo, okusanhlamvu, amantongomane, okusanhlamvu nezinhlanzi.
  • Ukushintsha amafutha agcwele ongakhetha kukho okunempilo ethe xaxa e-monounsaturated kanye ne-polyunsaturated
• Ukunciphisa ukudla kwe-sodium 
• Umsebenzi Womzimba Ovamile 
  • Khomba okungenani imizuzu engu-150 yokuzivocavoca okunamandla okumaphakathi noma imizuzu engama-75 yemisebenzi eshuba ngamandla ngesonto. 
• Ukugcina Isisindo Esinempilo 
  • Abantu kufanele bazame ukuzuza nokugcina isisindo esinempilo ngokulawula ukudla noma ngokuzivocavoca. 
• Gwema Ugwayi 
  • Kuyingozi enkulu ye-angina. 
• Ukuphatha Izimo Eziyisisekelo
  • Ukunciphisa ukudla kwe-sodium kanye nokulandela ukudla kwe-DASH kunganciphisa kakhulu umfutho wegazi. 
• Thayipha i-2 yesifo sikashukela
  • Ukuphatha kuhlanganisa ukuguqulwa kokudla, umsebenzi womzimba, nokuncipha kwesisindo uma kudingeka. 

Yini engingayenza ekhaya ukuze ngilawule i-angina?

Ukulawula i-angina ekhaya kuhilela ukwamukela izinguquko zendlela yokuphila enempilo enempilo. 

• Khetha ukudla okusiza ukuvimbela noma ukwehlisa umfutho wegazi ophezulu kanye namazinga aphezulu e-cholesterol.
• Nciphisa ukusetshenziswa kotshwala 
• Ukuvivinya umzimba njalo ngemva kokubonisana nodokotela wabo  
• Gcina isisindo esinempilo 
• Umuntu ngamunye kufanele azame ukugwema noma ukunciphisa izimo ezicindezelayo. 
• Ukuyeka ukubhema
• Ukulala ngokwanele kwekhwalithi kuyasiza ekwelapheni nasekulungiseni inhliziyo nemithambo yegazi. 
• Gwema izimo ezishisa kakhulu noma ezibandayo. 
• Ukudla izingxenye ezincane zokudla usuku lonke kungasiza uma ukudla okukhulu kubangela ubuhlungu besifuba.

Isiphetho

I-Angina isebenza njengophawu oluyisixwayiso olubalulekile lwezinkinga zenhliziyo, egcizelela ukubaluleka kokutholwa kusenesikhathi nokuphathwa ngendlela efanele. Ukuqonda izinhlobo ezahlukene ze-angina, izimpawu zayo, nezici zobungozi kungaba nomthelela ekhonweni lomuntu lokuqaphela nokubhekana nalesi simo ngempumelelo. Ukwamukela izinguquko zendlela yokuphila enempilo enempilo nokusebenza eduze nodokotela kungathuthukisa kakhulu izinga labo lempilo futhi kunciphise ingozi yezinkinga zenhliziyo ezimbi kakhulu.

FAQ sika

1. Ingabe ukuhlaselwa kwe-angina kubi?

Ukuhlaselwa kwe-angina kungaba yingozi futhi akufanele kunganakwa. Zisebenza njengophawu oluyisixwayiso lokuthi inhliziyo ayitholi igazi eligcwele umoya-mpilo elanele. 

2. Ingabe i-angina izohamba?

Izimpawu ze-angina zingaphathwa futhi zingathuthuka ngokwelashwa okufanele, kodwa isimo esibangela i-angina asipheli ngokuphelele.

3. Yiziphi izimpawu zokuqala ze-angina?

Izimpawu zokuqala ze-angina zihlanganisa ubuhlungu besifuba noma ukungakhululeki. Abantu abaningi bakuchaza njengokumpintsha, ukucindezela, noma ukuqina esifubeni. Lokhu kuphatheka kabi kuvame ukuqala ngemuva kwethambo lesifuba futhi kungase kudlulele kwezinye izingxenye zomzimba ezingenhla, okuhlanganisa intamo, umhlathi, amahlombe, izingalo, umhlane, noma isisu. 

4. I-angina iqala eminyakeni emingaki?

I-Angina ingenzeka kunoma ibuphi ubudala, kodwa ingozi iyanda njengoba abantu bekhula. Emadodeni, ithuba lokuba nesifo senhliziyo, okungaholela ku-angina, liqala ukuphakama eminyakeni engu-45. Kwabesifazane, ingozi iqala ukwanda ngemva kweminyaka engama-55.

5. Indlela yokuhlola i-angina ekhaya?

Nakuba kungenakwenzeka ukuxilonga i-angina ekhaya, kunezindlela ezithile zokuqapha impilo yenhliziyo yakho:

• Kala ukushaya kwenhliziyo yakho
• Ukuhlolwa kwezitebhisi: Zama ukugibela izitebhisi ezingaba zine (cishe izitebhisi ezingaba ngu-60) kumasekhondi angu-90. Uma ungakwenza lokhu kalula, kungase kubonise impilo enhle yenhliziyo.
• Gcina idayari yezimpawu: Qaphela lapho uzwa ubuhlungu besifuba, ukuthi bubangelwa yini, nokuthi buhlala isikhathi esingakanani.

6. Bukuphi ubuhlungu be-angina?

Ubuhlungu be-angina ngokuvamile buzwakala esifubeni. Abantu abaningi bakuchaza njengokucindezela, ukukhama, noma ukucinana ngemuva kwethambo lesifuba. 

7. Ingabe ubuhlungu be-angina kwesokunxele noma kwesokudla?

Abantu ngokuvamile bazwa ubuhlungu be-angina phakathi nendawo esifubeni, ngemuva kwethambo lesifuba. Kodwa-ke, ingakhanya ngakwesobunxele noma kwesokudla sesifuba noma kokubili. 

8. Yikuphi ukudla okufanele ngikugweme nge-angina?

Uma une-angina, kubalulekile ukulandela ukudla okunempilo enempilo. Ukudla okufanele ukugweme noma ukukhawulelwe kufaka phakathi:

• Ukudla okunamafutha agcwele kanye nama-trans
• Ukudla okuphezulu kwe-sodium
• Ukudla okugayiwe kanye nokuthosiwe
• Ukudla okunoshukela neziphuzo
• Utshwala ngokweqile

UDkt Jyotirmaya Sahoo

Umxhumanisi - I-Cardiology

CARE Medical Team