Mob coronary syndrome.

Mob coronary syndrome - ib tug complex pathophysiological tshua. Tus kab mob muaj xws li mob heart attack myocardial infarction (ob leeg nyob rau general thiab nyob rau hauv cov ntaub ntawv ntawm kev ntaub ntawv - nrog los yog tsis muaj ib tug lifting lifting ST ya) thiab tsis ruaj tsis khov angina.

Yog li, peb yuav hais tias cov mob coronary syndrome, lub ntsiab txhais ntawm uas tau muab saum toj no, yog tsis yog ib tug kab mob tiam sis ib txoj tswvyim uas theem ua ke ib sab pab pawg neeg ntawm cov hlab plawv tus kab mob uas raug ces nws (lub plawv nres thiab angina).

Symptomatology ACS yog tsis muaj lwm yam tshaj li cov tsos mob ntawm no tej kab mob. Hais tias yog, nws yog yus muaj los ntawm tag nrho cov nta ntawm lub lwm tus kab mob. Txawm li cas los, muaj ib co ntau cov tsos mob uas tshwm sim feem ntau mob cov kab mob ntawm cov hlab plawv system. Cov no ces ua txoj hauj lwm raws li lub zaus ntawm tshwm sim, thiab nyob rau hauv lub hwj chim ntawm manifestation, nws yuav siv sij hawm mob. Mob coronary syndrome feem ntau yog manifested muaj zog stabbing, txiav los yog hlawv mob qab lub breastbone nyob rau hauv lub cheeb tsam ntawm lub plawv. Phem mob ntaug los ntawm nitroglycerin los yog txais tos yuav luag docked. Feem ntau, cov kev mob nres yuav siv sij hawm nyob rau hauv qhov ntev ntawm ntau tshaj 15 feeb. Rau cov tibneeg uas angina yus destabilization kab mob (li ntawm mob, raws li tau zoo raws li kom lawv ntev, tsis muaj cov lus teb rau daim ntawv thov ntawm nitroglycerin). Cov neeg nees nkaum-tsib - plaub caug xyoo, raws li zoo raws li nyob rau hauv cov neeg laus (hnub nyoog xya caum xyoo) tej zaum yuav muaj atypical localization mob - pleural, epigastric thiab lwm tus neeg. Qee zaus cai tsis mob cov ntaub ntawv uas yuav tshwm sim tsis tsim nyog ua tsis taus pa, teeb meem ntawm tus mob huam.

Mob coronary syndrome yuav yuav ntes tau thaum lub sij hawm nram qab no diagnostic cov txheej txheem:

- lub cev kev xeem (ie, keeb kwm kev thiab kev soj ntsuam ntawm tus neeg mob, kev coj cwj pwm palpation, percussion thiab lwm yam txheej xwm)

- rau cov ntaubntawv povthawj ntawm lub electrocardiogram kom paub meej tias mob pathology thiab cais tawm ntawm lwm yam kab mob (rau ECG qhia cov yam ntxwv nta ntawm lub plawv nqaij ischemia - lifting «ST» los yog "T" tshaj lub isoline)

- qhia kom paub txog biochemical markers ntawm mob nqaij puas tsuaj - troponin thiab tropomyosin, raws li zoo raws li kev txiav txim ntawm nce theem ntawm creatine phosphokinase MB thiab myoglobin fractions.

- tua ntawm manipulation echocardiography, cov kev tshwm sim ntawm uas yog txiav txim rau tej qhov mob ntawm lub plawv (cov theem ntawm kev ua txhaum ntawm systolic muaj nuj nqi ntawm lub plawv)

Dhau li yooj yim kev tshawb fawb, mob coronary syndrome yuav raug pom zoo thiab ua tau zoo ntxiv, peb tog kev ua xws li coronary angiography thiab Holter xyuas. Coronary angiography yog ua kom paub meej tias cov pathology ntawm lub vascular txaj nyob rau hauv tej nqaij ntawm lub plawv. Holter xyuas yog siv rau cov nrhiav kom tau ntawm mob (short-lived thiab tsis ruaj tsis khov) disturbances nyob rau hauv lub plawv los ntawm txoj kev ECG cov ntaubntawv povthawj siv thaum lub sij hawm ib los yog ob peb hnub. Feem ntau cov feem ntau los ntawm txoj kev no txoj kev qhia nraum teeb lub plawv atherosclerosis - arrhythmia.

Cov kev zoo sib thooj ntawm cov tsos mob, thiab ib co teeb meem nyob rau hauv qhov kev siv thiab kev txhais ntawm lub cev thiab kuaj cov kev tshawb fawb ua tau ib lub mus nkag tau ib qho nyob rau hauv-tob txog differential mob.

Xws li ib tug mob ntawm mob coronary syndrome twb nqa tawm pulmonary embolism, pericarditis, aortic aneurysm (nyob rau hauv particular, nyob rau hauv nws cov exfoliating), hypothyroidism thiab myocarditis kab etiology.

Mob coronary syndrome. Kev kho mob ntawm tus mob no yog nqa tawm, dua li siv nitroglycerin (los nthuav vascular cov ntaub so ntswg nyob rau hauv lub plawv mob), cov tshuaj aspirin (nrog lub aim ntawm kev txo thiab cov ntshav nyias feem ischemia), B-blockers (atenolol, metoprolol). Nyob rau hauv tas li ntawd, antihypertensive txoj kev kho tau cov ntshav siab nyob rau high school cov nqi.