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حمله قلبی


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حمله قلبی زمانی رخ می‌دهد که جریان خون مملو از اکسیژن به بافت عضله قلب قطع شود. انسداد سرخرگ‌های کرونری (سرخرگ‌های تغذیه‌کننده عضلات قلب) باعث قطع جریان خون عضله قلبی می‌شود.

بدون اکسیژن و مواد مغذی، عضله قلب می‌میرد. مراقبت‌های فوری پزشکی ممکن است جریان خون را دوباره برقرارکرده و از آسیب بیشتر جلوگیری نمایند، ولی بافت مرده عضله قلبی را دیگر نمی‌توان احیا نمود. کاهش جریان خون،"ایسکمی" نامیده می‌شود. ایسکمی می‌تواند عضله قلب را تضعیف کرده و یا حرکت عضله قلب را کاملا متوقف نماید. اگر خون‌رسانی عضله قلب به شکل طولانی مدتی کاهش یابد، بافت عضله قلبی می‌میرد، بنابراین ایسکمی یک مورد اورژانس پزشکی تلقی می‌شود. شدت حمله قلبی به وسعت بافت قلبی صدمه دیده و محل آسیب دیدگی بستگی دارد.

علت بروز حمله قلبی

چند مکانیسم مختلف ممکن است باعث بروز حمله قلبی شوند:

  • در تصلب شرایین (آترواسکلروز) دیواره‌های سرخرگ‌ها ضخیم و سفت می‌شوند. در آترواسکلروز در دیواره سرخرگ‌ها پلاک تشکیل می‌شود. پلاک تجمع رسوبات چربی می‌باشد. پلاک‌ها ممکن است یک یا چند سرخرگ خون‌رسانی کننده بخشی از عضله قلب را تنگ یا مسدود نمایند و باعث بروز حمله قلبی شوند.
  • ممکن است یک لخته خون، در درون سرخرگ کرونری تشکیل شود و به دیواره‌های سرخرگ کرونری تنگ شده‌ای که از قبل توسط پلاک ضخیم شده است، بچسبد. ممکن است این لخته خون جلوی خون‌رسانی به بافت قلبی را گرفته و باعث بروز حمله قلبی شود.
  • ممکن است یک لخته‌خون در درون خود سرخرگ کرونری درنتیجه وجود یک پلاک آترواسکلروتیک ایجاد شود. ممکن است پلاک آترواسکلروتیک پاره شده و کلسترول و سایر محتویات خود را وارد جریان خون ‌کند و به این ‌وسیله باعث تشکیل لخته خون می‌شود. ممکن است این لخته‌خون جلوی خون‌رسانی به بافت قلبی را گرفته و باعث بروز حمله قلبی شود.
  • ممکن است یک سرخرگ کرونری دچار اسپاسم موقت شود. این اسپاسم‌ها بیشتر اوقات در سرخرگ‌های دچار تنگی رخ می‌دهند اما ممکن است در یک سرخرگ طبیعی نیز رخ دهند. سرخرگ دچار اسپاسم موقت، تنگ می‌شود و جریان خون کم یا متوقف می‌شود. اسپاسم‌های موقت با قطع خون‌رسانی به بافت عضلانی قلب باعث بروز حمله قلبی شوند.
  • شایع‌ترین علت بروز حمله قلبی می‌گردد، زمانی است که شکافی در درون پلاک رخ داده و داخل پلاک را در معرض جریان خون قرار می دهد. این حالت باعث می‌شود که پلاکت‌ها به محل پارگی چسبیده و منجر به تشکیل یک لخته خون شده و در نهایت سرخرگ را مسدود ‌نمایند. آسپرین باعث کاهش چسبندگی پلاکت‌ها می‌شود. این مکانیسم توضیح می‌دهد که چرا آسپرین در کاهش میزان خطر حمله قلبی موثر است.

هر ساله در ایران افراد زیادی دچار حملات قلبی می‌شوند و بیش از ۴۰درصد آنها قبل از رسیدن به بیمارستان جان می‌سپارند. آمار و ارقام مربوط به بیماری های قلبی عروقی وحشتناک می‌باشند.

امروزه می‌توان، اقداماتی را به منظور کاهش قابل توجه احتمال حملات قلبی انجام داد. پزشکان در درمان حمله‌ قلبی پیشرفت‌های زیادی نموده‌اند، امروزه احتمال زنده ماندن فردیکه به حمله قلبی دچار می‌شود و به سرعت درمان‌های پزشکی را دریافت می‌کند، خیلی بیشتر از گذشته است. در ضمن امروزه نسبت به گذشته احتمال بیشتری وجود دارد که فرد زنده مانده از حمله قلبی به زندگی طبیعی بازگردد. در سال‌های اخیر تعداد مردانی که پس از حملات قلبی زنده می‌مانند، بسیار بیشتر شده است، ولی این قضیه در مورد زنان چندان صادق نیست.

برای آشنایی با اقدامات درمانی حمله قلبی بر روی لینک کلیک کنید.

منبع: دکتر قلب

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