Mubvunzo kune general practitioner Maarten: Kushandiswa kwemishonga mushure memyocardial infarction uye diving.

Maarten Vasbinder anogara kuIsaan. Basa rake ndere general practitioner, basa raainyanya kudzidzira kuSpain. PaThailandblog anopindura mibvunzo kubva kuvaverengi vanogara muThailand uye anonyora nezvechokwadi chezvekurapa.

Iwe une mubvunzo kuna Maarten uye unogara muThailand here? Tumira izvi kumupepeti: www.thailandblog.nl/contact/ Zvakakosha kuti upe ruzivo rwakakwana senge: Zera, kwaunogara, mushonga, chero mapikicha, uye nhoroondo yekurapa iri nyore. Unogona kutumira mafoto ku [email inodzivirirwa] zvese zvinogona kuitwa zvisingazivikanwe, zvakavanzika zvako zvinovimbiswa.

Cherechedzo: Sarudzo yekupindura inovharwa nekusarudzika kudzivirira kuvhiringika nemazano asina kutsigirwa nemishonga nevaverengi vane vavariro yakanaka.

Wadiwa Martin,

Pana 20/07/2017 ndakaita chirwere chemoyo muNetherlands. Yakagamuchirwa pa25/7 uye 28/7 uye yakaendeswa kunoongororwa ngarava uye pamwe nekuisa stents. Izvi zvakaitikawo, 3 stents yakaiswa. Ndakapiwa mushonga ndikanzwa zvakanaka, asi ndakanzwawo saizvozvo ndisati ndarova mwoyo.

Ita mitambo yakawanda, kusanganisira diving, bhasikoro uye kufamba, makore 65. Uye idya utano. Huremu 75 kg. Kumanikidzwa kweropa 80/129 Cholesterol 4.2 gluc kutsanya ndizviyedze ndichitenderedza 7 pakuraira kwachiremba wangu chirwere cheshuga chinomhanya mumhuri. Uyewo kuora mwoyo. Mushonga wakapiwa:

• Acetylsalicylic acid 80 mg zita rechiratidzo Mylan
• Atorvastatin 40 mg zita rechiratidzo Mylan
• bisoprolol 2.5 MG
• Perindopril 4 mg
• Ticagrelor 90 mg zita rezita Brilique 2 x pazuva
• Pantoprazole 40 mg

Mushure mekutaura kwangu kwekutanga nachiremba wemwoyo, akandiudza: kudhivha zvakare mushure memwedzi mitanhatu (iyewo chiremba wekudhivha pachake). Pashure pekurukurirano yangu yokupedzisira ndisati ndaenda kuThailand kuchando, handifungi kuti akanga ari mukufara. Ndakanga ndine mimwe mibvunzo pamusoro pemishonga yangu uye nei ndaifanira kuishandisa, kusanganisira kuderedza BP uye cholesterol. Yakagamuchira mhinduro pfupi uye yakajeka: NOKUTI NDATI SO. Handina kunyatsofara nazvo, asi rakangopera zuva rimwe chete ndisati ndaenda kuThailand. Mhinduro yake pamusoro pekunyura yakanga yachinjawo: 'hauchazonyura zvakare chero ukatora mishonga iyi' uye ndakashamisika zvikuru.

Tsamba yandakagamuchira pakushanya kwangu kuna chiremba wemwoyo muThailand yaivawo muchiDutch. Bvunza kuti sei kwete muchirungu. Zvese zvirimo zvinhu izvo mumwe munhu muThailand anonzwisisawo. Ndakatanga kuzvitsvaga ndikasvika kumhedziso yokuti handidi kutora inopfuura hafu yemishonga (zvichida yakasindimara, asi ndinonzwa zvakanaka nezvazvo).

Iye zvino ndinongoshandisa Ticagrelor kaviri pazuva uye Acetylsalicylic acid 2 mg kamwe chete pazuva. Ini ndoda kuzviongorora mwedzi unouya cholesterol, nezvimwe.

Ndingade zano reimwe nzira yeTicagrelor uye Acetylsalicylic acid, asi ini ndanga ndichifunga nezve Aspirin 81.

Ndinoda kunzwa kwamuri kuti ndonwa here mishonga yangu kana kuti miviri iyi inokwana?

Kwazisai,

F.

*****
Anodiwa F.

Pasinei nokuti mubvunzo wacho unoratidzika sei wakaoma sei, hauna kuoma kudaro. Iwe uchagamuchira mishonga inonyatsoenderana nemirairo yekurapa mushure mekurwadziwa kwemoyo. Zano rekudhibha rinopindirana neizvi.

Maonero angu pamusoro pemitemo haisi iyo yakakosha munyaya iyi, nokuti iri pakati pe "zvinosungirwa" zviito zvechiremba. Chiremba asingateereri anopinda mungozi yokurangwa.

Mushure mekurwadziwa kwemoyo panguva iyo stents yakaiswa, iwe unenge uchingogara uchinyorerwa izvo zvaunenge warairwa.

• Iyo ACE inhibitor, yakadai seperindopril, kana ARB inhibitor. Kwete zvose.
• Beta-blocker, yakadai sebisoprolol
• anticoagulants, neTicagrelor 90mg iri kusarudzwa pamwe chete 
• 75-100 mg aspirin. Izvo zvakafanana neAcetylsalicylic acid
• A "High Intensity" Statin, yakadai seAtorvastatin. Chenjerera nePomelo negrapefruit.
• Mudziviriri wedumbu, sePantoprazole

Zvimwe zvinyorwa: 

• Muchidimbu, Ticagrelor inogona kumiswa mushure megore re1. Pane zviratidzo zvekuti izvi zvinogoneka mushure megore rehafu, asi zvakare kuti zviri nani kuenderera kwenguva yakareba nedosi yakaderera. Tevera mari?
• Anticoagulants ihama contraindication kune diving.  www.divemedicine.nl Relative munyaya iyi zvinoreva kuti ne theoretically pane njodzi, asi kuti hapana tsaona huru yakamboitika. Zvisinei, kana ukazvicheka padombo rakapinza pasi pemvura pane dambudziko, asi zvakafanana zvinoshanda pamusoro pemvura.
• Beta-blockers zvakare contraindication, nekuda kwekuderedzwa kwekuedza kunoitwa nemoyo. Idzo imhando yekumisa kumhanya. Izvi zvinogona kutsamwisa mumamiriro ezvinhu ekukurumidzira uko kuedza zvakanyanya kunodiwa.
• Kana iwe uchida kudya magrapefruit kana pomelo, unogona kutsiva atorvastatin ne rosuvastatin (Crestor)
• Kuti uwane rumwe ruzivo rwakakwana, ndinokurudzira kuti uverenge izvi: www.divemedicine.nl.

Hongu, iwe unoramba uine mhosva pane zvaunoita nemuviri wako. Tinopa mazano chete. Sachiremba, ini parizvino handikwanise kukupa rimwe zano kunze kwekusanyura kwenguva iripo. Pane kudaro, wedzera kusimba kwako. Zvino mushure memwedzi inenge mitanhatu hapachazovi nekupikisa zvakare. Woenda kuna chiremba chaiye anoita zvekudhivha kuti uzviongorore.

Ndakaperera,

Martin Vasbinder