Plawv nres

Feem ntau ntawm lub plawv nres tshwm sim los ntawm cov ntshav txhaws uas yog ib qho ntawm cov hlab ntshav ntawm cov hlab ntshav. Lub cev ntawm cov hlab ntsha ua rau cov ntshav thiab cov pa oxygen rau lub plawv. Yog hais tias cov ntshav ntws yog txhaws, lub plawv yog starved ntawm oxygen thiab lub plawv tuag.

Lub sij hawm kho mob rau qhov no yog myocardial infarction.

Cov tshuaj hu ua quav hniav tuaj yeem tsim tsa hauv cov phab ntsa ntawm koj cov hlab ntsha cov hlab ntsha. Cov quav hniav no yog tsim los ntawm cov roj (cholesterol) thiab lwm cov cell.

Ib lub plawv nres yuav tshwm sim thaum:

• Qhov cuam tshuam ntawm cov quav hniav tshwm sim. Qhov no ua rau cov ntshav platelets thiab lwm yam tshuaj los tsim cov ntshav txhaws nyob rau ntawm qhov chaw uas txhaws feem ntau lossis tag nrho cov pa oxygen nqa ntshav tawm mus rau ib feem ntawm cov leeg plawv. Qhov no feem ntau ua rau lub plawv nres.

Qhov ua kom muaj mob plawv tsis yog tas li paub, tab sis muaj cov txiaj ntsig zoo paub txog.

Lub plawv yuav raug:

• Thaum koj so lossis pw tsaug zog
• Tom qab muaj kev tawm dag zog tam sim ntawd
• Thaum koj tseem ua si sab nraum cov huab cua txias
• Tom qab dheev, muaj kev ntxhov siab loj lossis lub cev nyhav, suav nrog ib qho mob

Ntau yam kev pheej hmoo yuav ua rau kev txhim kho quav hniav buildup thiab lub plawv nres.

Ib qho kev mob plawv yog mob ti tes ti taw. Yog tias koj muaj cov tsos mob ntawm lub plawv nres, hu 911 lossis koj tus lej kub ceev hauv nroog tam sim.

• TSIS TXHOB sim tsav koj tus kheej mus tom tsev kho mob.
• TXHOB NTSEEG. Koj muaj kev pheej hmoo siab tshaj plaws rau kev tuag sai sai thaum ntxov ntawm lub plawv nres.

Kev mob hauv siab yog qhov tshwm sim tshaj plaws ntawm kev mob plawv.

• Koj yuav hnov ​​mob hauv qee qhov ntawm koj lub cev LOSSIS
• Kev hnov ​​mob tuaj yeem txav los ntawm koj lub hauv siab mus rau koj ob txhais caj npab, xub pwg, caj dab, hniav, lub puab tsaig, lub plab, lossis rov qab

Qhov mob yuav ua tau mob hnyav lossis mob me. Nws tuaj yeem xav zoo li:

• Ib txoj hlua khi nyob ib ncig ntawm lub hauv siab
• Phaj plab tsis zoo
• Tej yam hnyav zaum koj lub hauv siab
• Nyem los yog hnyav tshuab

Qhov mob feem ntau tsuas kav ntev dua 20 feeb. So thiab ib cov tshuaj los daws cov hlab ntshav (hu ua nitroglycerin) yuav tsis daws tau qhov mob ntawm lub plawv nres. Cov tsos mob kuj yuav ploj mus thiab rov qab los.

Lwm cov tsos mob ntawm lub plawv nres tuaj yeem suav nrog:

• Ntxhov siab vim
• Hnoos
• Tsaus muag
• Lub teeb muag taub hau, kiv taub hau
• Xeev siab thiab ntuav
• Palpitations (zoo li koj lub siab ntaus nrawm lossis nrawm)
• Ua tsis taus pa
• Kev tawm hws, uas tej zaum yuav hnyav heev

Qee tus neeg (suav nrog cov laus, cov neeg mob ntshav qab zib, thiab poj niam) tuaj yeem muaj mob me lossis tsis muaj mob hauv siab. Los yog, lawv yuav muaj cov tsos mob atypical xws li ua tsis taus pa, nkees, thiab tsis muaj zog. Ib qho "ntsiag to lub plawv nres" yog lub plawv nres uas tsis muaj cov tsos mob uas tuaj yeem tshwm sim.

Tus kws saib xyuas mob yuav kuaj mob lub cev thiab mloog koj lub hauv siab siv lub stethoscope.

• Tus kws kho mob yuav hnov ​​cov suab tsis zoo hauv koj lub ntsws (hu ua crackles), lub suab yws, lossis lwm yam suab txawv txav.
• Tej zaum koj yuav muaj lub vas nthiv lossis tsis xwm yeem.
• Koj cov ntshav siab tuaj yeem yog qhov qub, siab, lossis qis dua.

Koj yuav muaj electrocardiogram (ECG) txhawm rau saib lub plawv puas. Feem ntau, qee yam kev hloov ntawm ECG qhia tau tias koj tab tom muaj mob plawv, txawm hais tias lub siab tseem tuaj yeem tshwm sim yam tsis hloov ECG.

Kev kuaj ntshav tuaj yeem qhia tau yog tias koj muaj kab mob hauv lub plawv. Kev kuaj ntshav no tuaj yeem lees paub tias koj muaj lub plawv nres. Qhov kev sim no feem ntau rov qab ua raws sijhawm.

Coronary angiography tuaj yeem kho tam sim lossis tom qab lub sijhawm mob.

• Qhov ntsuas no siv cov xim zas tshwj xeeb thiab duab xoo hluav taws xob kom pom cov ntshav ntws los ntawm koj lub plawv.
• Nws tuaj yeem pab koj tus kws kho mob txiav txim siab txog hom kev kho mob twg koj xav tau txuas ntxiv.

Lwm txoj kev kuaj xyuas koj lub plawv uas yuav ua tau thaum koj nyob hauv tsev khomob:

• Echocardiography nrog lossis nrog ntsuas kev ntxhov siab
• Kev tawm tsam kev ntxhov siab
• Nuclear kev nyuab siab kuaj
• Lub Plawv CT scan lossis lub plawv MRI

TAM SIM NTAWD KEV KHO MOB

• Koj yuav raug txuas nrog lub plawv ntsuas, yog li pab pawg saib xyuas kev noj qab haus huv tuaj yeem pom tias koj lub siab ntaus npaum li cas.
• Koj yuav tau txais oxygen.
• Qhov tso ntshav kab (IV) yuav muab tso rau hauv ib qho ntawm koj cov leeg. Tshuaj thiab dej haus tuaj yeem dhau tus IV no.
• Koj tuaj yeem tau txais nitroglycerin thiab morphine pab txo qhov mob hauv siab.
• Koj tuaj yeem tau txais tshuaj aspirin, tshwj tsis yog nws yuav tsis zoo rau koj. Hauv qhov ntawd, koj yuav tau muab lwm cov tshuaj uas tiv thaiv kom ntshav txhaws.
• Kho tau lub plawv dhia tsis zoo (lub plawv dhia tsis xwm yeem) yuav kho nrog tshuaj lossis hluav taws xob.

CEEV CEEV CEEV

Angioplasty yog ib txoj kev los qhib kev nqaim lossis thaiv cov hlab ntshav uas xa ntshav mus rau lub plawv.

• Angioplasty feem ntau yog thawj qhov kev xaiv kho mob. Nws yuav tsum tau ua nyob rau hauv 90 feeb tom qab koj mus rau hauv tsev kho mob, thiab feem ntau tsis pub dhau 12 teev tom qab lub plawv nres.
• Lub stent yog qhov me me, hlau mesh raj uas qhib (nthuav dav) sab hauv txoj hlab ntshav. Lub stent feem ntau yog tso rau tom qab lossis lub sijhawm angioplasty. Nws pab tiv thaiv cov leeg ntawm kev kaw ib zaug ntxiv.

Koj tuaj yeem yuav muab tshuaj kom txhawm rau txhaws. Qhov no hu ua kev kho thrombolytic. Nws yog qhov zoo tshaj yog tias cov tshuaj no tau muab sai sai tom qab pib ntawm cov tsos mob, feem ntau tsis pub dhau 12 teev tom qab nws thiab cov ntsiab lus tsis pub dhau 30 feeb tom qab tuaj txog hauv tsev kho mob.

Qee tus neeg kuj yuav muaj lub siab hla plawv phais kom qhib cov ntshav siab lossis thaiv cov hlab ntshav uas xa ntshav mus rau hauv lub plawv. Txoj kev ua no tseem hu ua kev mob plawv rau txoj kev mob leeg ntshav tes thiab / los yog qhib lub plawv phais.

TSHUAJ TOM QAB NOM QAB HUV TOM QAB

Tom qab ob peb hnub, koj yuav tau tawm hauv tsev kho mob.

Koj yuav zoo yuav tsum tau noj tshuaj, qee yam rau tas koj lub neej. Nco ntsoov nrog koj tus kws khomob tham uantej yuav tsum txiav lossis hloov koj txoj kev noj tshuaj. Nres qee yam tshuaj tuaj yeem tsim kev tuag taus.

Lub sijhawm koj nyob nrog pab saib xyuas mob nkeeg, koj yuav paub:

• Yuav siv tshuaj li cas kho mob plawv thiab tiv thaiv kev mob plawv ntau dua
• Kev noj zaub mov zoo plawv-noj qab nyob zoo
• Yuav ua li cas dhia thiab ua si kom nyab xeeb
• Yuav ua li cas thaum koj mob hauv siab
• Yuav txiav luam yeeb li cas

Cov cwj pwm txawv yog cov nquag muaj tom qab kev mob plawv.

• Tej zaum koj yuav xav tu siab
• Koj yuav muaj kev txhawj xeeb thiab txhawj xeeb txog kev xyuam xim rau txhua yam koj ua

Tag nrho cov kev xav no tsis muaj dab tsi. Lawv ploj mus rau feem ntau cov neeg tom qab 2 lossis 3 lub lis piam.

Koj yuav zoo siab thaum koj tawm hauv tsev kho mob mus tsev.

Feem coob ntawm cov neeg muaj lub plawv nres koom nrog txoj kev pab kom rov zoo mob.

Ntau cov neeg tau txais txiaj ntsig los ntawm kev koom tes hauv cov pab pawg txhawb nqa rau cov neeg muaj kab mob plawv.

Tom qab lub plawv nres, koj muaj feem ntau yuav muaj lwm lub plawv nres.

Koj yuav ua tau haujlwm zoo npaum li cas tom qab lub plawv nres nyob ntawm ntau yam xws li:

• Tus nqi ntawm kev puas tsuaj rau koj lub plawv cov leeg thiab lub plawv nres
• Qhov twg uas muaj kev puas tsuaj yog muaj
• Koj txoj kev kho mob tom qab lub plawv nres

Yog tias koj lub siab tsis tuaj yeem tso ntshav tawm mus rau koj lub cev ib yam li yav tas los, koj yuav muaj lub siab ua haujlwm. Kev mob plawv hauv lub ntsws tsis zoo tuaj yeem tshwm sim, thiab tuaj yeem ua rau lub neej neeg.

Cov neeg feem coob tuaj yeem maj mam rov qab mus rau cov haujlwm qub tom qab lub plawv nres. Qhov no suav nrog kev sib deev. Tham nrog koj tus kws kho mob hais txog kev ua si zoo npaum li cas rau koj.

Myocardial infarction; MI; Mob MI; ST - kom siab myocardial infarction; Tsis-ST - nce myocardial infarction; NSTEMI; CAD - plawv nres; Coronary artery disease - plawv nres

• Angioplasty thiab stent - lub siab - tso tawm
• Roj Cholesterol - tshuaj kho mob
• Roj Cholesterol - qhov yuav tsum nug koj tus kws kho mob
• Plawv nres - tso tawm
• Plawv nres - dab tsi yuav nug koj tus kws kho mob
• Lub plawv tsis ua hauj lwm - yuav tsum nug koj tus kws kho mob li cas
• Ntshav siab - yuav tau nug dab tsi ntawm koj tus kws kho mob
• Noj tshuaj warfarin (Coumadin, Jantoven) - dab tsi yuav nug koj tus kws kho mob
• Noj warfarin (Coumadin)

• Lub Plawv - seem ntawm ntu nruab nrab
• Plawv - saib ua ntej
• Zaus txhim kho-ua cov quav hniav hauv cov leeg txoj hlab ntshav
• Mob MI
• Tshaj tawm myocardial infarction ECG nthwv dej ntxiab
• Plab plawv mob txhaws
• Ua ntej ntawm cov hlab ntsha hauv plawv
• Cov tsos mob plawv nres
• Lub puab tsaig mob thiab lub plawv nres

Amsterdam EA, Wenger NK, Brindis RG, li al. Xyoo 2014 AHA / ACC cov txheej txheem rau kev tswj hwm cov neeg mob uas tsis yog-qib mob siab mob siab rau cov leeg ntshav nce siab: cov lus tshaj tawm ntawm American College of Cardiology / American Heart Association Task Force ntawm Kev Coj Qhia. J Am Coll CardiolCov. Xyoo 2014; 64 (24): e139-e228. PMID: 25260718 pubmed.ncbi.nlm.nih.gov/25260718/.

Arnett DK, Blumenthal RS, Albert MA, li al. 2019 ACC / AHA cov lus qhia txog kev tiv thaiv kab mob plawv thawj zaug: ib daim ntawv tshaj tawm ntawm Asmeskas College ntawm Cardiology / American Heart Association Task Force ntawm Kev Siv Tshuaj Ua Haujlwm. Kev ncigCov. 2019; 140 (11): e596-e646. PMID: 30879355 pubmed.ncbi.nlm.nih.gov/30879355/.

Bohula EA, MAY DA. ST-tsa myocardial infarction: kev tswj hwm. Hauv: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Plawv Lub Plawv: Phau Ntawv Qhia Txog Cov Tshuaj Mob plawvCov. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 59.

Giugliano RP, Braunwald E. Tsis yog-qib kev mob siab rau txoj kev mob ntshav siab. Hauv: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Plawv Lub Plawv: Phau Ntawv Qhia Txog Cov Tshuaj Mob plawvCov. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 60.

O'Gara PT, Kushner FG, Ascheim DD, li al. 2013 ACCF / AHA cov lus qhia rau kev tswj hwm ntawm ST-nce myocardial infarction: ib daim ntawv tshaj tawm ntawm American College of Cardiology Foundation / American Heart Association Task Force ntawm Kev Coj Qhia. J Am Coll CardiolCov. 2013; 61 (4): 485-510. PMID: 23256913 pubmed.ncbi.nlm.nih.gov/23256913/.

Scirica BM, Libby P, MAY DA. ST-nce myocardial infarction: pathophysiology thiab soj ntsuam evolution. Hauv: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Plawv Lub Plawv: Phau Ntawv Qhia Txog Cov Tshuaj Mob plawvCov. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 58.

Tamis-Holland JE, Jneid H, Reynolds HR, li al. Kev kuaj mob niaj hnub thiab kev tswj cov neeg mob myocardial infarction thaum tsis muaj kev cuam tshuam cov hlab ntshav ntawm txoj hlab ntshav: cov lus tshaj tawm scientific los ntawm American Heart Association. Kev ncigCov. 2019; 139 (18): e891-e908. PMID: 30913893 pubmed.ncbi.nlm.nih.gov/30913893/.