Ukuqhekeka Kwe-Artery YeCoronary Okungalindelekile: Izimpawu, Izimbangela, Nokwelashwa

Ukuqhekeka kwe-artery ye-coronary okungalindelekile (SCAD) kwenzeka lapho kuqhekeka kuyi-wall ye-artery ye-coronary ngaphandle kokulimaza noma inqubo yezokwelapha. Lo mqhekeko udala umjelo wamanga ongabamba ukugeleza kwegazi emithanjeni yentliziyo yakho, okungenzeka kube yimbangela yokuhlukunyezwa kwentliziyo.

Nakuba lesi simo singase sibonakale sisoyikisa, ukuqonda i-SCAD kungakusiza ukuthi uqaphele izimpawu zayo futhi ufune ukunakekelwa okufanele. Kuvame kakhulu kubantu besifazane, ikakhulukazi labo abaneminyaka engaphansi kuka-50, futhi ngokuvamile kwenzeka ngezikhathi zengcindezi yomzimba noma yengqondo.

Iyini i-Spontaneous Coronary Artery Dissection?

I-SCAD yisimo sentliziyo lapho izingxenye yangaphakathi ye-artery ye-coronary iqhekeka noma ihlukaniswe ngokuzimela ezingxenyeni zangaphandle. Cabanga ngakho njengoba iphepha lodonga liqhekeka odongeni, lidala ipokotho phakathi kwezingxenye.

Uma leli qhekeko liqala, igazi lingagxuma kuleli pokotho lamanga esikhundleni sokuhamba kahle nge-artery. Lokhu kuphazamisa ukugeleza kwegazi okujwayelekile emithanjeni yentliziyo yakho, edinga ukunikezwa okuzinzile kwegazi elicebile nge-oksijini ukuze isebenze kahle.

Ngokungafani nokuhlukunyezwa kwentliziyo okuvamile okubangelwa ukwakheka kwe-plaque, i-SCAD ngokuvamile ithonya abantu abane-arteries ezempilo. Isimo singazilulama lodwa ezimweni eziningi, kodwa sidinga ukuqapha okunakekelayo kwezokwelapha nokuphathwa.

Ziyini Izimpawu Zokuqhekeka Kwe-Artery YeCoronary Okungalindelekile?

Isimpawu esivame kakhulu se-SCAD ubuhlungu obusengqabeni oluzwakala lufana nokuhlukunyezwa kwentliziyo. Lobu buhlungu ngokuvamile buqala ngokuzumayo futhi bungase buzwakale bucindezela, buqina, noma bushisa esifubeni sakho.

Nazi izimpawu eziyinhloko ongazihlangabezana nazo:

• Ubuhlungu obukhulu esifubeni noma ukucindezela, ngokuvamile buhlala isikhathi esingaphezu kwemizuzu engama-20
• Ubuhlungu obuya emahlombe, entanyeni, e-jaw, noma emuva
• Ukuqina komoya noma ukuqina kokuphefumula
• Ukuphefumula noma ukugabha
• Ukukhishwa izingqimba noma ukuzizwa uthambile
• Ukuzizwa ukhuluphuka noma ukhanya
• Ukukhathala okungavamile noma ubuthakathaka
• Ukushona kwenhliziyo noma ukushaya kwenhliziyo okungajwayelekile

Abanye abantu bahlangabezana nezimpawu ezilula eziya futhi ziye, kanti abanye bahlangabezana nobuhlungu obukhulu obuzwakala njengokuhlukunyezwa kwentliziyo okujwayelekile. Okubalulekile ukuthi lezi zimpawu ngokuvamile zivela ngokuzumayo kubantu ababephilile ngaphambili.

Ziyini Izinhlobo Zokuqhekeka Kwe-Artery YeCoronary Okungalindelekile?

I-SCAD ihlelwa ngezinhlobo ezahlukene ngokusekelwe ekuqhekekeni okuvela ekuhlolweni kwezithombe. Ukuqonda lezi zinhlobo kusiza odokotela ukuthi banqume indlela yokwelapha engcono kakhulu yesimo sakho esithile.

Uhlobo lwe-1 SCAD lubonisa ukuqhekeka okuqondile ngegazi eliqoqene phakathi kwezingxenye ze-artery. Lo mbono kulula ukubona ekuhlolweni kwezithombe futhi ubala cishe u-30% wezimangalo.

Uhlobo lwe-2 SCAD lubonakala njengengxenye ende, ecindezelekile ye-artery ngaphandle kokubona ukuqhekeka. Lokhu kwenzeka lapho igazi liyasabalala phakathi kwezingxenye phezu kwesibalo eside, lidala ukubonakala okubizwa ngokuthi “umugqa we-sausages” ekuhlolweni kwezithombe.

Uhlobo lwe-3 SCAD lubonakala njengendawo emfushane, ecindezelekile engase iphazamiseke yi-atherosclerosis (ukwakheka kwe-plaque). Lo mbono kunzima kakhulu ukuwuxilonga futhi udinga ukuhlolwa ngokucophelela ngochwepheshe be-cardiologists.

Yini Ebambezele Ukuqhekeka Kwe-Artery YeCoronary Okungalindelekile?

Imbangela eqondile ye-SCAD ayicaci ngaso sonke isikhathi, kodwa abacwaningi bakholelwa ukuthi iphuma ekubeni khona kwezinto eziningi ezibuthakathaka i-wall ye-artery. Lezi zinto zingenza ukuthi i-blood vessel ibe nomkhuba wokuzidla ngokuzimela.

Izimo eziningi ezingaphansi nezici eziqalayo zingase zibe nomthelela ekukhuleni kwe-SCAD:

• I-Fibromuscular dysplasia (isimo esithinta ama-artery walls)
• Izifo ze-connective tissue njenge-Ehlers-Danlos syndrome
• Izimo ze-autoimmune njenge-lupus noma isifo sokuvuvukala esizileni
• Ukukhulelwa nesikhathi sokubeletha (ushintsho lwe-hormonal)
• Ukuzivocavoca okukhulu noma ukuzivocavoca okukhulu
• Ukuhlupheka okukhulu kwengqondo noma ukulimala
• Imithi ethile, ikakhulukazi i-hormones
• Ukugabha, ukukhokha, noma ukucindezela (ukwanda kokucindezela)

Ezimweni ezithile, i-SCAD ivela ngaphandle kwesici esibonakalayo noma isimo esingaphansi. Lokhu kungalindeleki kungase kuzwakale kungathandeki, kodwa kubalulekile ukwazi ukuthi ukuba ne-SCAD akusho ukuthi wenze into engafanele noma ungakwazi ukuyivikela.

Nini Okufanele Ubone Udokotela Ngokuqhekeka Kwe-Artery YeCoronary Okungalindelekile?

Kufanele ufune ukunakekelwa kwezokwelapha okusheshayo uma uhlangabezana nobuhlungu besifuba, ikakhulukazi uma buzwakala bukhulu noma buhambisana nezinye izimpawu zokuhlukunyezwa kwentliziyo. Ungalindi ukubona uma ubuhlungu buyaphela.

Shaya u-911 ngokushesha uma unebuhlungu besifuba kanye nokuqina komoya, ukuphefumula, ukukhishwa izingqimba, noma ubuhlungu obuya emahlombe, entanyeni, noma e-jaw. Lezi zimpawu zidinga ukuhlolwa okusheshayo, kungakhathaliseki iminyaka yakho noma ingozi yomuntu siqu yesifo sentliziyo.

Ngisho noma izimpawu zakho zibonakala zilula noma ziya futhi ziye, kungcono ukuhlolwa ngokushesha. I-SCAD ingathinta abantu abasebasha, abaphilile abangase bangacabangi ukuthi baphathekile yingozi yezinkinga zentliziyo.

Uma usuvele uxilongwe yi-SCAD, xhumana nodokotela wakho we-cardiologist uma uhlangabezana nokubuya kwebhlungu lesifuba, ukuqina komoya okusha, noma ezinye izimpawu ezikhathazayo. Ukulandelela njalo ukunakekelwa kubalulekile ekuqapheni isimo sakho.

Ziyini Izici Zengozi Zokuqhekeka Kwe-Artery YeCoronary Okungalindelekile?

I-SCAD inezici ezithile zengozi ezihlukile ezisuka esifweni sentliziyo esivamile. Ukuqonda lokhu kungakusiza wena nodokotela wakho ukuthi nihlose ingozi yenu siqu futhi nihlele ukunakekelwa okufanele.

Izici ezibaluleke kakhulu zengozi zihlanganisa:

• Ukuba owesifazane (cishe u-90% wezimangalo zenzeka kubantu besifazane)
• Iminyaka phakathi kweminyaka engama-30-50
• Ukukhulelwa okusheshayo noma ukubeletha (kuze kube amasonto angu-12 ngemuva kokubeletha)
• I-Fibromuscular dysplasia (ikhona cishe ku-50% yabantu abane-SCAD)
• Izifo ze-connective tissue
• Izimo ze-autoimmune
• Umlando womndeni we-SCAD
• Izinhlungu ze-migraine
• Umlando wokuhlupheka noma ukukhathazeka
• Ukukhulelwa okuningi (ukuba nokukhulelwa okuningi)

Ngokungafani nesifo sentliziyo esivamile, i-SCAD ayivamile kubantu abanezici ezivamile zengozi njenge-cholesterol ephakeme, ukubhema, noma isifo sikashukela. Lokhu kwenza kube kubalulekile ukuqaphela ukuthi izinkinga zentliziyo zingathinta noma ubani, kungakhathaliseki iphrofayili yabo yonke impilo.

Ziyini Izingozi Ezingase Zenzeke Ngokuqhekeka Kwe-Artery YeCoronary Okungalindelekile?

Nakuba abantu abaningi abane-SCAD balulama kahle, isimo ngezinye izikhathi lingabangela izingozi ezinkulu ezidinga ukunakekelwa kwezokwelapha okuqhubekayo. Ukuqonda lezi zinto ezingase zenzeke kusiza ukuthi uhlale uqaphile ngempilo yakho yentliziyo.

Izingozi eziqala ngokushesha zingabandakanya:

• Ukuhlukunyezwa kwentliziyo (myocardial infarction)
• Ukushona kwenhliziyo okungajwayelekile (arrhythmias)
• Ukwehluleka kwenhliziyo okuvela emithanjeni yentliziyo elilimalekile
• I-Cardiogenic shock (ukwehla okukhulu kokucindezela kwegazi)
• Ukufa kwenhliziyo ngokuzumayo
• Ukusabalala kokwahlukaniswa kwe-arteries

Izingozi zesikhathi eside zingase zikhule ngokuhamba kwesikhathi futhi zihlanganise izigameko ze-SCAD eziphindaphindayo, ezenzeka cishe ku-10-20% yabantu. Abanye abantu bangase bahlangabezane nobuhlungu besifuba obuqhubekayo noma bathuthukise ukukhathazeka ngempilo yabo yentliziyo.

Izindaba ezinhle ukuthi ngokunakekelwa kwezokwelapha okufanele nokuqapha, abantu abaningi abane-SCAD bangalindela ukuthola isiphetho esihle. Ithimba lakho lokukhathalela impilo lizosisebenza nawe ukuze linciphise lezi zingozi futhi likusize ugcine impilo yakho yentliziyo.

I-Spontaneous Coronary Artery Dissection Ixilongwa Kanjani?

Ukuzilonga i-SCAD kudinga ukuhlolwa kwezithombe okukhethekile okungabonisa ukuqhekeka kwi-artery yakho ye-coronary. Inqubo ngokuvamile iqala ekamelweni elijwayelekile lokuphuthuma uma unezimpawu ezibonisa ukuhlukunyezwa kwentliziyo.

Udokotela wakho uzoqala ngokuhlola okuyisisekelo njenge-electrocardiogram (EKG) ukuhlola umsebenzi womgogodla wentliziyo yakho kanye nokuhlola igazi ukubuka izimpawu zokulimala kwentliziyo. Lezi zivivinyo zisiza ekuqondeni ukuthi uhlangabezana yini nokuhlukunyezwa kwentliziyo kodwa azixilongi ngokuqondile i-SCAD.

Uvivinyo oluyinhloko lokuzilonga yi-coronary angiography, lapho i-tube encane ifakwa emagageni akho egazi futhi i-contrast dye isebenziswa ukubona i-coronary arteries yakho. Le nqubo ingabonisa ukubonakala okujwayelekile kwe-SCAD futhi isize ekuhlukaniseni ezinye izimbangela zokuhlukunyezwa kwentliziyo.

Ngezinye izikhathi ukuhlola kwezithombe okwengeziwe njenge-intravascular ultrasound noma i-optical coherence tomography kudingeka ukuthola isithombe esicacile se-artery wall. Lezi zivivinyo zinikeza izithombe eziningiliziwe ezisiza ekuqinisekiseni ukuzilonga nokukhokhela izinqumo zokwelapha.

Iyini Ukwelashwa Kokuqhekeka Kwe-Artery YeCoronary Okungalindelekile?

Ukuphathwa kwe-SCAD kuncike ezintweni eziningi, kufaka phakathi indawo nobunzima bokuqhekeka, izimpawu zakho, nempilo yakho yonke. Indlela ngokuvamile iyaphuthuma kune ukwelashwa kokuhlukunyezwa kwentliziyo okuvamile.

Izimo eziningi ze-SCAD ziphathwa ngemithi kunokwenza izinqubo ngokushesha. Le ndlela yokwelapha ephansi ivumela i-artery ukuthi iphulukise ngokwemvelo ngenkathi ivikele intliziyo yakho futhi ivikela izingozi.

Imithi evamile ihlanganisa:

• I-Aspirin ukuvimbela ukwakheka kwegazi
• I-Beta-blockers ukunciphisa izinga lenhliziyo nokucindezela kwegazi
• I-ACE inhibitors noma i-ARBs ukuvikela intliziyo yakho
• I-Statins ukuqinisa ama-artery walls
• I-Clopidogrel (Plavix) yokuvimbela ukwakheka kwegazi okwengeziwe

Ezimweni ezinkulu lapho i-artery ivaliwe kakhulu, udokotela wakho angase akukhuthaze ukwenza i-percutaneous coronary intervention (PCI) noma i-stenting. Noma kunjalo, lezi zinqubo zinezingozi eziphakeme kubantu abane-SCAD ngoba i-artery wall isilimale kakade.

Ukuhlinzwa okuphuthumayo kwe-bypass akudingeki ngokuvamile kodwa kungase kubhekwe uma i-arteries eziningi zithintekile noma uma ezinye izindlela zokwelapha azaphumeleli. Udokotela wakho we-cardiologist uzoqala ukulinganisa izingozi nezinzuzo zanoma iyiphi inqubo.

Indlela Yokwelapha Ekhaya Ngesikhathi Sokuqhekeka Kwe-Artery YeCoronary Okungalindelekile?

Ukuphatha i-SCAD ekhaya kugxile ekusekweni inqubo yokwelapha yentliziyo yakho ngenkathi kuvinjelwa izingozi. Lokhu kuhlanganisa ukuthatha imithi njengoba kulotshwe udokotela wakho nokwenza ukulungiswa kwesitayela sokuphila okuthuthukisa impilo yemisipha.

Thatha yonke imithi ngokuqondile njengoba udokotela wakho eyalela, ngisho noma uzizwa kangcono. Le mithi idlala indima ebalulekile ekuvikeleni intliziyo yakho nokuvimbela ukwakheka kwegazi ngesikhathi senqubo yokwelapha.

Ukuguqula umsebenzi kubalulekile ngesikhathi sokuphulukisa kwakho. Udokotela wakho angase akukhuthaze ukugwema ukuzivocavoca okukhulu nokuthwala izinto ezinkulu amasonto ambalwa kuya ezinyangeni. Imisebenzi elula njengokuhamba ngokuvamile ikhuthazwa uma usuqinisile.

Ukuphathwa kwengcindezi kuba kubalulekile ngoba ingcindezi yengqondo ingase iqale i-SCAD. Cabanga ngokufunda amasu okuphumula, ukuzivocavoca ukuphefumula okujulile, noma ukusebenza nomxhumanisi uma uzizwa ukhathazekile ngokuxilongwa kwakho.

Qapha izimpawu zakho ngokucophelela futhi wazi nini okufanele ufune usizo. Gcina uhlu lwezimpawu zezexwayiso njengobhlungu besifuba, ukuqina komoya, noma ukukhathala okungavamile, futhi ungangabazi ukuxhumana nethimba lakho lokukhathalela impilo uma lokhu kwenzeka.

Ukuqhekeka Kwe-Artery YeCoronary Okungalindelekile Kungavikeleka Kanjani?

Ngeshwa, ayikho indlela eqinisekisiwe yokuvimbela i-SCAD ngoba ngokuvamile ivela ngokuzimela ngaphandle kokuxwayisa. Noma kunjalo, ungathatha izinyathelo zokunciphisa ingozi yakho nokuthuthukisa impilo yakho yonke yemisipha.

Ukuphathwa kwezimo ezingaphansi ezandisa ingozi ye-SCAD kubalulekile. Uma une-fibromuscular dysplasia, izifo ze-connective tissue, noma izimo ze-autoimmune, sisebenza eduze nethimba lakho lokukhathalela impilo ukuze ugcine lezi zimo zilawulwa kahle.

Cabanga ngokuguqula isitayela sokuphila esisekela impilo yentliziyo, njengokuzivivinya okujwayelekile okulinganiselwe, ukudla okunempilo yentliziyo, ukulala okwanele, nokuphathwa kwengcindezi. Nakuba lokhu ngeke kuvimbele i-SCAD ngokuqondile, kungasiza ukuthi i-cardiovascular system yakho ihlale iphilile ngangokunokwenzeka.

Uma usuvele une-SCAD ngaphambili, ukugwema izici ezaziwayo kuba kubalulekile. Lokhu kungase kuhlanganise ukuphatha amazinga engcindezi, ukugwema ukuzivocavoca okukhulu, nokuxoxa ngengozi nezinzuzo zemithi ye-hormonal nodokotela wakho.

Ukulandelela njalo ukunakekelwa nodokotela we-cardiologist oqonda i-SCAD kubalulekile. Bangase baqaphe isimo sakho, balungise imithi njengoba kudingeka, futhi bahlole ezinye izimo ezingase zande ingozi yakho.

Kufanele Uzilungiselele Kanjani Ukuya Kulodokotela?

Ukulungiselela i-appointment yakho kusiza ukuqinisekisa ukuthi uthola okuningi ngesikhathi sakho nethimba lakho lokukhathalela impilo. Qala ngokubhala zonke izimpawu zakho, kufaka phakathi ukuthi zaqala nini, zahlala isikhathi esingakanani, nokuthi ubenzeni lapho zenzeka.

Letha uhlu oluphelele lwemithi, izithasiselo, namavithamini owathathayo. Faka imithamo nokuthi uwaqhatha kangaki. Futhi, butha noma yimaphi amarekhodi ezokwelapha noma imiphumela yokuhlola evela kwabanye abahlinzeki bezokwelapha.

Bhala imibuzo yakho ngaphambi kwe-appointment ukuze ungakhohlwa ukubuza izinto ezibalulekile. Imibono evamile ingase ihlanganise ukuthi yini ebangela i-SCAD yakho, ukuthi yiziphi izinketho zakho zokwelapha, kanye nemisebenzi okufanele uyigweme.

Cabanga ngokuletha ilungu lomndeni noma umngani ukukusiza ukukhumbula ulwazi oluxoxwe ngesikhathi se-appointment. Bangase futhi banikeze ukwesekwa ngokomzwelo futhi basize ekumeleleni izidingo zakho.

Lungela ukuxoxa ngomlando womndeni wesifo sentliziyo, noma yimiphi imicimbi ekhathazayo yakamuva, kanye nezithelo zakho zesitayela sokuphila samanje. Lolu lwazi lusiza udokotela wakho ukuthi aqonde izici zakho siqu zengozi futhi athuthukise uhlelo lokwelapha oluhle kakhulu.

Iyini Iphuzu Eliyinhloko Ngokuqhekeka Kwe-Artery YeCoronary Okungalindelekile?

I-SCAD uhlobo oluhlukile lokuhlukunyezwa kwentliziyo oluthonya ikakhulukazi abesifazane abasebasha, abaphilile futhi lungase lube khona ngaphandle kokuxwayisa. Nakuba lokhu kungase kuzwakale kusoyikisa, ukuqonda ukuthi yisimo esiqondiwe esinezelapho ezimiswe kungase kunikeze ukuthula kwengqondo.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi i-SCAD iyakwelashwa, futhi abantu abaningi baqhubeka bephila impilo evamile, enempilo ngemuva kokuxilongwa. Ukusebenza eduze nodokotela we-cardiologist oqonda lesi simo kubalulekile ekunakekelweni kwakho okuqhubekayo.

Themba umzimba wakho futhi ufune ukunakekelwa kwezokwelapha uma uhlangabezana nobuhlungu besifuba noma ezinye izimpawu zokuhlukunyezwa kwentliziyo, kungakhathaliseki iminyaka yakho noma izici zakho zengozi. Ukuqaphela nokwelashwa okusheshayo kungenza umehluko omkhulu ekuphumeni kwakho.

Nakuba ungakwazi ukuvimbela i-SCAD ngokuphelele, ungathatha izinyathelo zokusekela impilo yakho yentliziyo nokunciphisa ingozi yezingozi. Hlala uxhumene nethimba lakho lokukhathalela impilo, thatha imithi njengoba kulotshwe, futhi ungangabazi ukuxhumana uma unezinkinga.

Imibuzo Evamile Ngokuqhekeka Kwe-Artery YeCoronary Okungalindelekile

UMbuzo 1: Ingabe i-SCAD ingase ibe khona ngaphezu kwesikhathi esisodwa?

Yebo, i-SCAD ingabuya cishe ku-10-20% yabantu, ngokuvamile phakathi neminyaka embalwa yokuqala ngemuva kwesigameko sokuqala. Kungakho ukulandelela njalo ukunakekelwa nodokotela we-cardiologist kubalulekile kangaka. Udokotela wakho uzokuqapha eduze futhi angase akukhuthaze imithi yokunciphisa ingozi yokubuya. Uma usuvele une-SCAD ngaphambili, kubalulekile ukuqaphela izimpawu zezexwayiso nokufuna ukunakekelwa kwezokwelapha okusheshayo uma izimpawu zibuya.

UMbuzo 2: Kuphephile yini ukuzivocavoca ngemuva kokuba ne-SCAD?

Abantu abaningi bangabuyela ekuzivocavoca ngemuva kwe-SCAD, kodwa lokhu kufanele kwenziwe kancane kancane futhi ngaphansi kokunakekelwa kwezokwelapha. Udokotela wakho angase akukhuthaze ukugwema imisebenzi ephakeme ekuqaleni futhi angase akukhuthaze ukuphulukiswa kwenhliziyo ukukusiza ubuyele ekuhambeni komzimba ngokuphephile. Okubalulekile ukuthola ibhalansi efanele phakathi kokuhlala usebenza ngenxa yempilo yakho yentliziyo ngenkathi ugwema imisebenzi engase iqale esinye isigameko.

UMbuzo 3: Ngikwazi yini ukuba nokukhulelwa okujwayelekile ngemuva kwe-SCAD?

Abesifazane abaningi bangaba nokukhulelwa okuphumelelayo ngemuva kwe-SCAD, kodwa lokhu kudinga ukuhlela okucophelelayo nokuqapha nodokotela wakho we-cardiologist nodokotela wakho we-obstetrician. Ukukhulelwa kwenza ingozi yokubuya kwe-SCAD ibe khulu, ngakho-ke ithimba lakho lokukhathalela impilo lizodinga ukulinganisa izingozi nezinzuzo ngokucophelela. Uma ucabanga ngokukhulelwa, xoxa nalokhu nodokotela wakho we-cardiologist ngaphambi kokuba uzame ukuthola.

UMbuzo 4: Ingabe kukhona ukudla noma izithasiselo engingafanele ngizigweme nge-SCAD?

Ayikho ukudla okuqondile okufanele ukugweme, kodwa ukulandela ukudla okunempilo yentliziyo kuvame ukukhuthazwa. Abanye odokotela bayakhuthaza ukulinganisela i-caffeine nokugwema izithasiselo ezingase zithinte ukwakheka kwegazi, kodwa lezi zinqumo kufanele zibe ngezomuntu siqu. Xoxa njalo nganoma yiziphi izithasiselo zokudla noma izinguquko ezinkulu zokudla nodokotela wakho we-cardiologist ngaphambi kokuba uzithathe.

UMbuzo 5: Ingabe ngizodinga ukuthatha imithi yentliziyo impilo yami yonke?

Lokhu kuncike esimweni sakho siqu nokuthi uphulukisa kanjani nge-SCAD. Abanye abantu badinga imithi yesikhathi eside ukuvikela intliziyo yabo nokuvimbela izingozi, kanti abanye bangase bakwazi ukunciphisa noma ukuyeka imithi ethile ngokuhamba kwesikhathi. Udokotela wakho we-cardiologist uzoqala ukubuyekeza imithi yakho futhi ayilungise ngokusekelwe esimweni sakho sempilo esiqhubekayo nezici zengozi.