ما هي الذبحة الصدرية

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الذبحة الصدرية

الذبحة الصدرية هو الشعور بألم شديد في الصدر، ويكون هذا الألم على هيئة نوبة الذبحة أو ألم عام في الصدر، وتختلف فترة نوبة الذبحة على حسب سوء الحالة عند المصاب، فإذا كانت الحالة بسيطة تكون مدة الذبحة في حدود دقيقة واحدة أو أكثر، ولكن في الحالات الشديدة قد تصل الذبحة الصدرية الى 15 دقيقة على التوالي.

والذبحة الصدرية ليست مرض مستقل ولكن يكون عرض من أعراض أمراض القلب، حيث تكون الذبحة نتيجة نقص الأكسجين الذي يصل إلى القلب، ومن الأعراض الشائعة لها هو الشعور بضيق شديد من التنفس، ولكن الذبحة لا تعتبر من الأمراض التي تسبب الوفاة حيث انها تنتهي من تلقاء نفسها في حدود 15 دقيقة في أقصى الحالات.

وتنقسم الذبحة الصدرية الى 3 أنواع أساسية وهم: ذبحة غير مستقرة، ذبحة مستقرة، وذبحة متغيرة.

والعلاج الشائع لهذه الحالة يمكن أن يكون عن طريق بعض التغييرات الأولية في أسلوب الحياة والابتعاد عن العادات الضارة، ولكن في الحالات السيئة يكون العلاج ضروري، ويوجد الكثير من الأدوية التي تعالج هذه الحالة ولكن بالتأكيد تصف على حسب الحالة، لذلك يجب ان يكون العلاج بالكامل تحت اشراف الطبيب.

وفي هذه المقالة سوف نوضح أعراض الذبحة الصدرية وكذلك تشخيص الحالة والعلاجات الشائعة لهذه الحالة فتابع القراءة معنا.

أعراض الذبحة الصدرية:

كما ذكرنا في المقدمة أن الذبحة الصدرية ليست مرض مستقل بذاته ولكن يكون نتيجة أمراض القلب، وفي الأغلب تكون أمراض القلب المرتبطة بالشريان التاجي لأنه المسؤول عن إمداد الاكسجين والمواد المغذية الى القلب. 

وعندما يصل إلى القلب كمية أقل من الأكسجين المطلوب، فسوف تشعر بألم شديد في الصدر، والتي تسمى نوبة الذبحة.

وتختلف أعراض الحالة على حسب نوع الذبحة الصدرية المصاب بها المريض فيوجد 3 أنواع للذبحة وهم:

  • الذبحة المستقرة: يكون هذا النوع مرتبط بنشاط معين خلال اليوم ويمكن التنبؤ بها بشكل منتظم قبل القيام بهذا الأنشطة، على سبيل المثال ممارسة الرياضة يمكن أن تسبب ارتفاع معدل ضربات القلب مما يجعل القلب يعمل بجهد أكبر من المعتاد، وعلاج هذه الحالة بسيط جداً وهو اخذ قسط من الراحة او تناول الأدوية المهدئة.
  • الذبحة الغير مستقرة: يعتبر هذا النوع عكس الذبحة الصدرية المستقرة تمامًا، وذلك لأنه يصيب المريض في حالات الراحة ولا يرتبط بنشاط معين، ولكن الإصابة به تكون بنسبة قليلة جداً مقارنتاً بالذبحة المستقرة، ولكن يعتبر من أشد الحالات خطورة ويمكن أن يسبب نوبة قلبية في فترة زمنية صغيرة من الإصابة به والدواء والراحة لا تقلل من الأعراض بشكل كبير.
  • الذبحة المتغيرة: هي تعتبر من الأنواع النادرة جداً من الذبحة الصدرية، وتحدث في الاغلب بدون مشاكل في الشريان التاجي في القلب، ولكن تنتج نتيجة استرخاء الاوعية الدموية بشكل غير طبيعي مما يسبب تقليل الدم الذي سوف يذهب إلى القلب، وهذه الحالة يمكن ان تعالج بواسطة الأدوية لذلك تعتبر أقل خطورة من الذبحة الغير مستقرة.

وأعراض الذبحة الصدرية الشائعة هي:

  • الشعور بالإرهاق.
  • ارتفاع او انخفاض ضغط الدم.
  • الشعور بثقل كبير وعدم القدرة على الحركة.
  • ألم شديد في الصدر.
  • انتشار ألم الصدر إلى أجزاء أخرى من الجسم مثل الرقبة أو الفك او الكتفين او الرجلين أو الذراعين أو الأسنان.
  • الإصابة بعسر الهضم.
  • الشعور بحرقة في المعدة.
  • التعرق الشديد والغثيان في الصباح.

وتختلف أعراض الذبحة الصدرية من شخص الى اخر حسب سوء الحالة.

التشخيص العام:

تشخيص الذبحة الصدرية المبكر هام جداً لأنه يحميك من المضاعفات المحتملة وخصوصاً يحميك من النوبة القلبية التي يمكن أن تسبب مشاكل عدة في الجسم ويمكن أن تسبب الوفاة، ولكن العلاج يكون فعال جداً ويمنع حدوث النوبة القلبية بشكل كامل، وهذا ما جعلنا نقول في المقدمة أن الذبحة الصدرية لا تسبب الوفاة في أسوأ الأحوال. 

يبدأ الطبيب التشخيص من خلال مناقشة الاعراض وعوامل الخطر وتاريخ الطبي السابق وكذلك التاريخ العائلي الطبي وبعد ذلك سيطلب من الطبيب ان تقوم ببعض الاختبارات حتى يستطيع التأكد من تشخيص الذبحة الصدرية، ولن يطلب منك جميع الاختبارات التالية ولكن يمكن ان يطلب منك واحد أو أكثر على حسب سوء الحالة ومدى جودة التشخيص ومن ضمن الاختبارات الشائعة هم:

  • اختبار رسم القلب الكهربائي(EKG): هذا يعتبر من الاختبارات الأساسية في تشخيص الذبحة الصدرية حيث يقوم بتسجيل نشاط القلب الكهربائي ويستطيع أن يكتشف متي يتم تقليل الدم الواصل الي القلب، الذي يسبب تقليل الاكسجين الواصل الى القلب.
  • اختبارات الجهد: يقوم الطبيب باختبار جسم المريض ولكن في حالة النشاط البدني، حيث سيطلب منه القيام بعدة تمارين رياضية ثم سيقوم باختبار رسم القلب الكهربائي وكذلك قياس ضغط الدم.
  • الأشعة السينية للصدر: هذا الاختبار يجعل الطبيب قادر على رؤية القفص الصدري بالكامل.
  • اختبارات الدم المختلفة: يقوم الطبيب بطلب اختبارات الدم الشاملة حتى يستطيع التحقق من مستويات الدهون في الجسم وكذلك مستويات السكر والكولسترول والبروتين.

علاج الذبحة الصدرية:

علاجات الذبحة الصدرية متعددة ومتنوعة وتبدأ من بعض التغيرات في نمط الحياة إلى تناول بعض الأدوية، ولكن جميع العلاجات تهدف الى تقليل الأعراض، وتقليل من ألم نوبة الذبحة وتجنب حدوث الذبحة الصدرية تمامًا وكذلك تجنب حدوث نوبة القلب إطلاقاً لأنها يمكن ان تؤدى إلى الوفاة.

وبعض النصائح التي تساعد في علاج الذبحة الصدرية بدون علاج تشمل:

  • التوقف عن التدخين او تقليل التدخين قدر الإمكان لأن له اضرار كبيرة على الذبحة وكذلك على باقي أعضاء الجسم، واعلم دائماً أن التدخين من أكثر أسباب الوفاة شيوعاً.
  • المحافظة على وزنك في حدود الوزن الصحي، حيث أن السمنة يمكن أن تسبب الكثير من المشاكل في الجسم وخصوصاً القلب.
  • الحفاظ على مستويات الكوليسترول في الدم في حدود المستويات الصحية.
  • بعد الأنشطة الشاقة مثل التمارين، يجب أن تأخذ قسط من الراحة.
  • لا تتناول الوجبات الدسمة بشكل كبير يومياً.
  • تعلم الاستراتيجيات التي تعمل على تقليل الإجهاد.
  • تناول نظام صحي وذلك يكون عن طريق تناول الخضروات والفواكه واستبدال الدهون الضارة بالدهون الصحية وتناول منتجات الألبان الخالية من الدسم ومحاولة تتبع السعرات الحرارية في الطعام الذي تتناوله.

وبعض الأدوية التي تساعد على تخفيف الأعراض:

  • يمكن أن تصف لك بعض الأدوية التي تعمل على تقليل شدة نوبة الذبحة الصدرية عن طريق توسيع الاوعية الدموية ومثال على هذه الادوية: أدوية النترات، مثل النتروجليسرين.
  • ويمكن استخدام أدوية أخرى مثل حاصرات بيتا، حاصرات قنوات الكالسيوم، مثبطات الإنزيم الذي يغطي الأنجيوتنسين، الأدوية المضادة للصفائح الدموية عن طريق الفم، مضادات التخثر.
  • ويوجد بعض الادوية الأخرى التي يمكن ان تصف لك وتقوم بعلاج الحالة الكامنة وراء الذبحة الصدرية مثل أدوية ارتفاع ضغط الدم، وأدوية خفض مستويات الكوليسترول في الدم، والأدوية التي تعمل على تقليل نشاط القلب، الادوية التي تمنع تجلط الدم.

وأحيانا يمكن اللجوء للعمليات الجراحية ولكن ذلك يكون في أقصى الحالات.

المصدر : medicalnewstoday.com , www.medicinenet.com

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146 comments on “ما هي الذبحة الصدرية

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