MAUMIVU/CHEMBE YA MOYO ”ANGINA”

Maelezo ya jumla 

Chembe ya moyo (angina) ni aina ya usumbufu au maumivu ya kifua ambayo yanatokea kama matokeo ya upungufu wa damu inayopeleka okisijeni kwenye misuli ya moyo, okisijeni inapopungua inashindwa kukidhi mahitaji ya misuli ya moyo na kusababisha maumivu kifuani.

Maumivu haya ya kifua kwa kawaida yanatokea baada ya kufanya shughuli nzito na kisha yanapoa baada ya mapumziko na/au kumeza dawa. Maumivu haya ya moyo yanaweza kutabirika, kwa maana yanatokea baada ya kufanya shughuli au zoezi fulani, na dalili zake hujirudia kila wakati mgonjwa anapofanya shughuli hiyo. Chembe ya moyo ”angina” ni ishara ya onyo kuwa utapata ugonjwa wa moyo na unapaswa kumwona daktari.

Je, nini dalili za chembe ya moyo?

Ni muhimu kujua dalili za chembe ya moyo ”angina” na kutafuta msaada wa kimatibabu mapema. Dalili za chembe ya moyo zinaweza kujumuisha moja au zaidi ya yafuatayo:

  • Usumbufu/maumivu kwenye kifua
    • Jambo kubwa linalosababisha kujisikia vibaya kifuani ni kufanya shughuli ngumu/nzito. Sababu nyingine ni msongo wa mawazo, kula chakula kingi sana, na hali ya hewa ya ubaridi. Mara nyingi mgonjwa atauelezea usumbufu huu kama hisia ya kitu kizito kifuani, kufinywa, kukandamizwa, au kubanwa kifuani.
    • Adha/maumivu/usumbufu wa kifua unaosababishwa na chembe ya moyo ”angina”, kwa kawaida hutokea katikati ya kifua nyuma ya mfupa wa kidari (Breastbone) na huchukua kati ya dakika 1-15.
    • Maumivu  hupungua baada ya kupumzika au kwa kutumia dawa inayoitwa nitroglycerin.
    • Maumivu yanaweza kusambaa kutoka katikati ya kifua na kusambaa kuelekea mkono wa kushoto, bega, mgongo, shingo au taya.
  • Kutapia hewa: Unaweza kujisikia umechoka na kujihisi unaishiwa pumzi, kuhema na kupata shida kupumua.
  • Kutokwa jasho  
  • Kuhisi kizunguzungu
  • Kujihisi uchovu usioelezeka baada ya shughuli ndogo tu.
  • Unaweza kujisikia kama umevimbiwa au kuhisi tumbo lako limevurugika.
  • Unaweza pia kuhisi moyo wako ukipiga kwa haraka, kwa nguvu na kwa mapigo yasiyo kawaida.

Ni nini husababisha chembe ya moyo?

Chembe ya moyo ”angina” ni dalili ya ugonjwa wa mishipa ya moyo ”coronary artery disease” unaotokana na utando wa mafuta. Utando huu wa mafuta hutengenezwa kwa miaka mingi kwenye kuta za ndani za mishipa ya moyo (mishipa hii hutiririsha damu yenye oksijeni kwenye moyo wako).

Kwa sababu ya utando huu wa mafuta, upana wa mishipa hupungua na kiasi cha damu inayobeba okisijeni kwenda kwenye misuli ya moyo hupungua pia. Tatizo huwa kubwa zaidi moyo unapofanya kazi zaidi hasa wakati wa shughuli nzito au msongo wa mawazo, katika kipindi hiki cha shughuli nzito misuli ya moyo huhitaji okisijeni kwa wingi zaidi kuliko wakati wa mapumziko.

Nani yuko kwenye hatari zaidi ya kupata chembe ya moyo?

  • Sababu kadhaa huongeza hatari ya kupata ugonjwa wa mishipa ya moyo na hatimaye kupelekea mtu kupata chembe ya moyo ”angina”.
  • Sababu kubwa zinazoongeza hatari ya kupata chembe ya moyo zinazoweza kudhibitiwa ni pamoja na:
  • Sababu zinazoongeza hatari ya kupata chembe ya moyo ambazo haziwezi kubadilishwa/kudhibitiwa ni pamoja na:
    • Umri
    • Historia ya kuwepo kwa ugonjwa wa mishipa ya moyo kwenye familia.
    • Kuwepo kwa historia ya shambulio la moyo kwa mgonjwa.
    • Kuwa na magonjwa mengine yanayoathiri moyo.
  • Mambo fulani yanayoongeza hatari ya kupata magonjwa ya mishipa ya moyo hujitokeza kwa pamoja. Yanapojitokeza kwa pamoja, huitwa metabolic syndrome. Kwa ujumla, mtu mwenye ”metabolic syndrome” huwa na uwezekano mara mbili zaidi wa kupata ugonjwa wa moyo na mara tano zaidi kupata kisukari.

Ni wakati gani utafute matibabu ya haraka kama una chembe ya moyo?

  • Unapaswa kutafuta huduma ya matibabu ikiwa unapata dalili zifuatazo:
    • Maumivu mapya ya kifua yasiyoelezeka, kujisikia vibaya au maumivu ya mkono mmoja au yote ,maumivu ya mgongo, shingo, taya, au tumbo
    • Kuhema sana/kupata shida kupumua
    •  Kichefuchefu, kutapika
    •  Kizunguzungu au kupoteza fahamu.
    • Kutokwa kijasho chembachemba
  • Ikiwa dalili zilizotajwa hapo juu zitaendelea kwa zaidi ya dakika 15 hata baada ya kupumzika au baada ya kutumia dozi tatu za nitroglycerin au zinaongezeka, omba msaada haraka kwa maana dalili hizi zinaweza kuwa ishara ya shambulio la moyo.

Utambuzi kuwa una chembe ya moyo

  • Baadhi ya matatizo ya kiafya yanaweza kusababisha dalili zinazofanana na maumivu ya moyo. Kwa hiyo watu wenye dalili yoyote kati ya hizi wanapaswa kwenda kumwona daktari ili  kutibiwa mapema iwezekanavyo.
  • Daktari atafanya uchunguzi wa mwili wako na kupima shinikizo lako la damu na anaweza kupendekeza vipimo vifuatazo kutambua kama una chembe ya moyo ”angina”:
    • Electrocardiogram (ECG): Hiki ni kipimo muhimu sana, Daktari atakupima kuangalia shughuli ya umeme unaopita kwenye moyo wako. Hii itamsaidia kugundua kama kuna matatizo yoyote kwenye misuli na mapigo ya moyo. Kipimo hiki hakisababishi maumivu yoyote.
    • Vipimo vya damu: Vipimo vya damu hufanyika ili kuangalia viwango vya mafuta (lipid) mwilini na viwango vya glukozi katika damu. Vipimo vya kupima CK-MB na troponins vinaweza kufanywa na daktari wako ili kujua kama moyo wako umeharibika au la.
    •  Echocardiogram: Hiki ni kipimo kinachofanyika ili kuangalia kama moyo wako unapiga vyema, kipimo hiki hutumia mawimbi ya sauti kupiga picha vyumba vya moyo na kuona vinavyofanya kazi. Kipimo hiki pia hakisababishi maumivu yoyote.
    • Kupima ustahimilivu (stress testing): Jaribio hili hufanywa wakati wa mazoezi. Zoezi hili humsaidia daktari kutambua ugonjwa wa moyo kwa urahisi. Mgonjwa hufanyiwa kipimo hiki wakati akifanya zoezi gumu.
    • Coronary Angiography: kwenye kipimo hiki, rangi maalumu inayoweza kuonekana kwa x-ray huingizwa kwenye mishipa ya moyo,na kisha picha ya x-ray hupigwa ili kuchunguza sehemu ya ndani ya mishipa ya moyo,kipimo hiki husaidia kutambua kama kuna sehemu ya mishipa iliyoziba.

anginaUchaguzi wa matibabu kama una chembe ya moyo

  • Chembe ya moyo inaweza kutibiwa  kwa kuchanganya moja au zaidi ya yafuatayo:
    • Kurekebisha mfumo wa maisha
    • Kutumia dawa kwa usahihi
    • Matibabu yanayohusisha kufanya upasuaji kwa mfano; angioplasty (kurekebisha mishipa ya damu), uwekaji wa stent (kimrija kidogo kinachowekwa kupanua mshipa ulioziba),au coronary artery bypass surgery.
  • Madawa yanayotumika kutibu shinikizo la juu la damu, ugonjwa wa kisukari, au lehemu yanaweza kutumika ili kuzuia maumivu ya moyo ”angina”:
    • ACE inhibitors: hupunguza shinikizo la juu la damu.
    • Beta-blockers: Hupunguza mapigo ya moyo, shinikizo la juu la damu na na kiasi cha oksijeni kinachotumiwa na misuli ya moyo.
    • Calsium channel blockers: husaidia mishipa kulegea na kupunguza shinikizo la juu la damu
    • Nitrates: hudhibiti chembe ya moyo ”angina”
    • Ranolazine: inatumika kudhibiti angina sugu/ya muda mrefu.
    • Aspirini na clopidogrel au prasugrel zinasaidia kuzuia madonge ya damu kutengenezeka kwenye mishipa ya damu, na kupunguza hatari ya kuwa na shambulizi la moyo.
  • Ukifuata maelekezo ya daktari wako vyema, itasaidia kuzuia dalili za chembe ya moyo kuwa mbaya zaidi. USIACHE KUTUMIA DAWA YOYOTE GHAFLA. Daima zungumza na daktari wako kwanza. Kuacha kutumia madawa ghafla kunaweza kusababisha angina yako kuwa mbaya zaidi au kusababisha shambulio la moyo. Daktari anaweza pia kupendekeza mpango wa ukarabati moyo (cardiac rehabilitation) ili kuimarisha misuli ya moyo.
  • Baadhi ya wagonjwa wanaweza kuhitaji upasuaji ili kuboresha mtiririko wa damu kwenye mishipa ya moyo.
    • ”Angioplasty” na uwekaji wa stent -ni utaratibu ambapo catheter (bomba ndogo) hupitishwa kwenye ateri ya mkono au paja la mguu na kusukumwa taratibu kufuatisha mfumo wa damu mpaka inapofika kwenye mishipa ya moyo. Kwenye moyo daktari wa upasuaji huweka kijibomba kidogo kwenye sehemu iliyoziba ya mshipa, ili kusaidia kuipanua na kuruhusu mtiririko wa damu kurejea.
    • Sio kila uzibe kwenye mishipa unaweza kutibiwa kwa angioplasty. Watu wengine wanahitaji upasuaji wa moyo ili kupata nafuu.

Madawa ya kuepuka ukiwa na angina 

Wagonjwa waliotambuliwa kuwa na maumivu ya moyo ya muda mrefu, wanapaswa kuepuka kutumia dawa zifuatazo:

  • ”Almotriptan”

Ikiwa umetambuliwa kuwa na chembe ya moyo ”angina” ya muda mrefu, wasiliana na daktari kabla ya kuanza au kuacha dawa hizo.

chembe ya moyoNitarajie nini baada ya kugunduliwa kuwa nina Angina?

Mgonjwa wa Angina kwa kawaida hupata nafuu baada ya kuboresha mtindo wake wa maisha na kutumia dawa zake kwa usahihi

Matatizo yanayoweza kumpata mgonjwa wa chembe ya moyo

  • Mshtuko/shambulizi la Moyo
  • Kifo cha ghafla
  • Angina isiyothabiti (Unstable angina): Aina hii ya maumivu ya kifua hutabiri kuwa kuna shambulio la moyo litampata mgonjwa hivi karibuni, kwa hiyo anahitaji matibabu haraka.

Kuzuia chembe ya moyo

  • Tumia dawa sahihi “nitroglycerin”kabla ya mazoezi au shughuli nzito kama ulivyoelekezwa na daktari wako.
  • Punguza hatari yako ya kupata magonjwa ya mishipa ya moyo kwa kufanya marekebisho ya mfumo wa maisha. Marekebisho hayo yanaweza kujumuisha:        
    • Mazoezi ya mara kwa mara
    • Kula chakula bora ambacho kinajumuisha kula matunda, mbogamoga na vyakula visivyokobolewa.
    • Kula chakula chenye mafuta kidogo.
    • Epuka hali na shughuli zinazosababisha msongo wa mawazo.
    • Ikiwa una kitambi/mnene punguza uzito.
    • Acha kuvuta sigara
    • Jitahidi kudhibiti hali yoyote uliyonayo, inayoongeza hatari ya kupata Angina, kama shinikizo la juu la damu, kisukari, na lehemu kwa kutumia dawa na kurekebisha mtindo wa maisha.
    • Acha/punguza kunywa pombe

Vyanzo

http://www.nlm.nih.gov/medlineplus/ency/article/000198.htm

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