dhamani avrodh

dhamani avrodh ack aisee sthiti haye jisamen dhamani key madhyam seey rakt pravaah mein aanshik yaa poorna avrodh hotaa haye. dhamaniyan rakt vaahikaaen hain joe shareer key ootakon mein oxygen yukt rakt leey jaati hain. dhamniyon kaa ack avrodh ootakon koo oxygen aur rakt kii aapoorti koo baadhit kartaa haye, jisase ischemia hotaa haye. ischemia kii seema key aadhar parr, dhamani avrodh key lakshan sadharan dard aur dard seey laker aaraam seey raahat paane taka, samvedana yaa pakshaghat kii kamee taka hotey hain, jisake liye vichhedan kii aavashyakta hoe sakati haye.
dhamani avrodh koo ateology key aadhar parr teen prakaron mein vargeekrit kiya jaa sakata haih ambolism, thrombosis aur atherosclerosis. yeye teen prakaar key avrodh vibhinn samanya sthitiyon key antargat aatey hain, jinamen coronary dhamani roga, paridhiya dhamani roga aur fuffusiya ambolism shamil hain, jinhen jokhim karakon koo cumm karke rokaa jaa sakata haye. anuchit roktham yaa prabandhan key saath, yeye beemaariyaan myocardial inforction, gangreen, ischemic stroke kii jeevan-dhamki dene vaali jatilataon mein pragati curr sakati hain, aur gambhir mamalon mein, mastishk kii mrityu yaa hriday gati rukane seey samaapt hoe jaati hain.
dhamani avrodh kaa nidan vyayam pareekshan, ultrasonic duplexes pareekshan aur bahu-detector coronary tomography angiography dwara kiya jaataa haye. iss beach, upchaar cergical hastakshepon jaise kii bipass, endarterectomy aur ambolactomy seey laker rakt koo patala karane vaali dawa taka bhinn hoe sakata haye.
sanket aur lakshan.
dhamani avrodh key sanket aur lakshan kaee karakon parr nirbhar karate hain, jinamen sthaan, seema aur avrodh kii shuruat shamil haye. samanya taur parr, lakshan dhyaan dene yogya honey key liye avrodh lagbhag 70 pratishat dhamani koo prabhaavit karna chaahiye. dheere-dheere sankeern honey key dauran lakshan cumm gambhir hoe sakate hain, kyonki isase maujooda vaahikaon key chaude honey aur naee vaahikaon (sampaarshvik vaahikaon) key gathan key liye samay milata haye, jisase rakt abhee bhee usa kshetra taka pahunchata haye. iss mamle mein lakshan buss rook-rook curr claudication honge. sampaarshvik vaahikaon key badhane key liye samay kii kamee koo dekhate hue, achaanak sankeern honey seey adhik gambhir parinam hotey hain. jaise, thhand lagana, sunn honah yaa prabhaavit shareer key angon kaa lakwa bhee hoe sakata haye.
dhamani avrodh kaa sabse aam lakshan rook-rook curr claudication haye, jisamen prabhaavit maanspeshiyon mein dardanaak, dard kii samvedana hoti haye. yeh aksar shaaririk gatividhi key saath uksaayaa jaataa haye aur aaraam key saath raahat milati haye. dard aur maanspeshiyon mein dard chalane key saath badh sakata haye, aur halki jogging yaa oopar kii or chalane key saath teji seey badh sakata haye. aksar, kaee minaton key aaraam key baad dard seey raahat milati haye.  haalaanki, prabhaavit vyakti gatividhi key chhote utsaah taka seemit hain, jisase unake jeevan kii gunavatta kharaab hoe jaati haye.
gambhir lakshnon key liye, sanket aamtaur parr dikhaai dete hain aur ischemia kii or leey jaate hain. ischemia kii naidaanik prastuti mein 6 pee. aiss. hotey hain, jinamen peelapan, dard, parasthesia, pakshaghat, naadiheentaa aur poechylothermia shamil hain. prabhaavit vyakti shuru mein prabhaavit kshetra kii peelapan koo dekhate hain aur gambhir dard mahsoos karate hain. jaise-jaise sthiti bigadati haye, kshetra neela aur sunn dikhaai detaa haye. charam mamalon mein, yeh pakshaghat aur poechylothermia kaa maarg prashast karega, sambhavatah prabhaavit anga key vichhedan kii aavashyakta hogi.
dhamani avrodh key prakaar.
aamtaur parr dekhe jaane vaale dhamani avrodh key prakaron mein ghanastrata, atherosclerosis aur ambolism shamil hain.
ambolism.
ack ambolism mein ack ambolus dwara rakt vaahikaon kaa avrodh shamil hotaa haye. ack ambolus dwara dhamani avrodh koo 'dhamani ambolism' kahaa jaataa haye. ambolus ack aisaa agent haye joe rakt vaahikaon koo shaaririk roop seey baadhit karke rakt pravaah koo avaruddh kartaa haye. isamen gais key bulbule, vasaayukt jamaa, amneotic drav, rakt key thakke aur videshi samagri shamil hain. dhamani amboli kabhi-kabhi praathamik sthalon seey alag hoe jaati haye aur maadhyamik dhamniyon koo rokane key liye parisancharan key madhyam seey yatra karati haye, jisase kaee ischemic saaiten hoti hain.
thrombosis.
thrombosis taba hotaa haye jaba thromby shareer mein vaahikaon koo rokta haye. thrombus, yaa rakt kaa thakka, rakt koshikaon kaa ack sangathit dravyamaan haye joe shareer key bheetar prasaarit hotaa haye. thromby nason (shiraparak ghanastrata) yaa dhamniyon (dhamani ghanastrata) koo roque sakata haye. thrombosis key kaaran kaa varnan varcho key tribhuj dwara kiya gayaa haye, jisamen haemostasis, samvahani deewaar kshati aur atee-cogulability shamil hain. dhamani ghanastrata kaafee sankeern yaa poori tarah seey dhamani rakt pravaah aur ootakon mein oxygen vitaran koo avaruddh karati haye.
atherosclerosis.
atherosclerosis mein, dhamniyon kii aantarik endothelial parat ack atheromatous plaak key jamaav seey kathor hoe jaati haye. atheromatous plake, jinhen atherosclerotic plake bhee kahaa jaataa haye, vasaa aur lipid seey bharey macrophage seey baney hotey hain. pattika kaa jamaav donon shaaririk roop seey ack dhamani koo sankeern curr detaa haye aur endothelial koshikaon key kaary koo baadhit kartaa haye, jisase dhamani lumen koo sankuchit karane key liye vesoconstrictive rasayanon kaa utpaadan shaktishali hoe jaataa haye. isase dhamniyon mein ashant rakt pravaah hotaa haye, joe ootakon koo oxygen kii aapoorti koo prabhaavit kartaa haye.
dhamani avrodh key roga.
dhamani avrodh key rogon kaa pathophysiology avrodh key prakaar, avrodh kii gambhirta aur avaruddh dhamani key sthaan parr nirbhar kartaa haye. dhamani avrodh kii samanya beemariyon mein coronary dhamani roga, paridhiya dhamani roga aur fuffusiya ambolism shamil hain.
coronary dhamani roga.
coronary dhamani roga (see. aeye. dee.) ack atherosclerotic pattika dwara coronary dhamniyon key stenosis key parinamswarup hotaa haye. coronary dhamaniyan myocardium key bheetar sthit cardiomyocytes koo sugandhit karati hain. cardiomyocytes koo hriday key pumping mein sahaayata key liye nirantar perfusion kii aavashyakta hoti haye. cadd mein, ack coronary dhamani mein atheromatous plaak kaa gathan cardiomyocytes koo oxygen kii aapoorti koo seemit kartaa haye, jisase hriday kii sankuchan kshamata mein kamee aatee haye.
cadd kii gambhirta coronary dhamani avrodh kii seema key aadhar parr bhinn hoti haye. 75 pratishat luminal sankeern honey parr, rogiyon koo cardiomyocytes key seemit perfusion seey judey lakshnon kaa anubhav hotaa haye, vishesh roop seey kathin sthitiyon mein. shaaririk parishram key tahat, cadd chhaati mein dard koo prerit kartaa haye, jise 'sthir enzyna' kahaa jaataa haye. sthir enzyna asthir enzyna mein bigad sakata haye, joe teevra coronary syndrome kii shuruat koo chihnit kartaa haye, joe aage myocardial inforction mein bigad sakata haye.  
cadd key liye jokhim karakon mein dhumrapan, uchch collestroll, motapa aur cadd kaa parivarik itihas shamil hain. mukhya roop seey, uchch vasaa vaale aahar seey raktapravaah mein collestroll key sanchay seey atherosclerotic avrodh aur isake naidaanik parinam hotey hain. isaliye, cadd key liye nivaarak upaayon mein mukhya roop seey aahar mein parivartan shamil hain. sabjiyon, falon aur anaaj kii prachurta key saath santript aur trance vasaa mein cumm aahar cadd kii ghatnaaon koo cumm curr sakata haye.
paridhiya dhamani roga.
paridhiya dhamani roga (paid), yaa anga ischemia, femoral, poplietal yaa iliac dhamniyon koo prabhaavit kartaa haye. paid atherosclerotic plake key kaaran hotaa haye joe charam seemaon taka rakt pravaah koo rokta haye. ack baar rakt pravaah baadhit honey key baad, ischemic maanspeshiyon kii koshikaaen oxygen kii kamee seey nipatane key liye aerobic seey avaayaviya chayapachaya mein badal jaati hain. avaayaviya chayapachaya, halanki, oorjaa-kushal haye, joe maanspeshiyon key bheetar antahkoshikiya oorjaa anu, aeye. tii. pee. kii sandrata koo cumm kartaa haye. aeye. tii. pee. mein kamee seey maanspeshiyon kii koshikaon mein calcium kaa risaav hotaa haye, jisase vibhinn maanspeshiyon key ghatak baadhit hotey hain aur antatah maanspeshiyon mein fiber necrosis hotaa haye.
paid key liye jokhim karakon mein vriddhavastha, dhumrapan, uchch raktchaap aur uchch collestroll shamil hain, jisamen dhumrapan sabse badaa yogdan kaarak haye. aisaa isaliye haye kyonki tambaku key dhuein mein shaktishali rasayan hotey hain joe paid kii ghatana koo gambhir roop seey badhaate hain. iss prakaar, dhumrapan bund karane key saath paid kii praathamik roktham praapt kii jaati haye.
fuffusiya ambolism.
fuffusiya ambolism (pee. ee.) mein ack ambolus dwara fuffusiya dhamani kaa avrodh shamil hotaa haye, joe aksar ack thrombus hotaa haye, joe fefadon mein rakt pravaah mein baadha daaltaa haye. fuffusiya parisancharan kii haani seey fefadon mein gambhir ventilation-perfusion asantulan hotaa haye, joe hypoxemia aur shwasan viphalata mein samaapt hoe jaataa haye. adhikansh pease gahari nus ghanastrata (dee. vee. tii.) kii uttar-dhaara hain, joe ack fefde kii dhamani mein charam seemaon key bheetar baney shiraparak ghanastrata key tootane aur prasaar key parinamswarup hoti hain.
jaisa kii dee. vee. tii. aamtaur parr pee. ee. seey pahale hotaa haye, pee. ee. key liye jokhim kaarak dee. vee. tii. key liye jokhim karakon key saath overlap hotey hain. inmein ack gatiheen jeevan shally, poorv shalya chikitsa, aghaat, dee. vee. tii. kaa itihas aur uchch raktchaap shamil hain. ack gatiheen jeevan shally aur andolan kii kamee pee. ee. key liye mahatvapurna parivartaniya jokhim kaarak hain. sthairya pair kii maanspeshiyon key sankuchan kii darr koo cumm kartaa haye, bachhadon kii vaahikaon mein thrombus gathan koo badhaata haye joe fefadon mein fail sakata haye. iss prakaar, pee koo rokane key liye shaaririk gatividhi aavashyak haye.
jatilataaen.
dhamani avrodh kii beemaariyaan anuchit roktham yaa prabandhan key saath jeevan key liye khatarnak sthitiyon mein pragati curr sakati hain. myocardial inforction, gangreen aur ischemic stroke gambhir dhamani avrodh kii jatilataon mein seey hain. 
myocardial inforction.
ack myocardial inforction (aim. aaee.), yaa dill kaa daura, ack coronary dhamani key poorna avrodh seey utpann hotaa haye. mee kaa sabse adhik kaaran cadd mein bunny atherosclerotic pattika kaa tootana haye. plaak fatane seey plaak key neeche subendothalial matricks ujagar hoe jaataa haye, jisase vasculature key bheetar thrombus kaa nirmaan shuru hoe jaataa haye. hriday dhamani koo oxygen kii aapoorti koo rokte hue, coronary dhamani koo poori tarah seey avaruddh karane key liye tooty hui pattika parr thrombus jamaa hotaa haye. hypoxia key tahat, cardiomyocytes avaayaviya shwasan karate hain, jisase adhik lactate kaa utpaadan hotaa haye. avaruddh coronary parisancharan key saath, cardiomyocytes seey lactate nikasi bhee baadhit hoti haye. lactate sanchay sankuchan koo cumm kartaa haye aur antatah cardiomyocytes koo raktapravaah mein unake troponin bhandaran koo jaari kartaa haye. seeram troponin kii oonchaai mee kaa ack vishisht biomarker haye.
ischemia kii gambhirta key aadhar parr, miss koo nustimy yaa stame key roop mein vargeekrit kiya jaataa haye. anastemia 'gair-oonchaai myocardial inforction' key liye khadaa haye, joe ekg trace mein st-segment oonchaai kii kamee koo sandarbhit kartaa haye. aisaa isaliye haye kyonki systemy mein, myocardial deewaar kaa kewal ack hissa infarct hotaa haye, joe st-allevation key saath nidan key roop mein maujood naheen hotaa haye.
jaba poori myocardial deewaar koo fodaa jaataa haye tou systemy stame bunn jaataa haye. nidan key roop mein, stemai ekg trace mein lambe samay taka st-segment kii oonchaai pradarshit kartaa haye, aur iss prakaar ise 'st-elevation myocardial inforction' naam diyaa gayaa haye. stame key kuchh minut baad, ghaatak hriday gati rook sakati haye. yadi tatkaal refurfusion therapy shuru naheen kii jaati haye tou stemai jeevan key liye khatra haye.
gangreen.
gangreen, vishesh roop seey shushk gangreen, atherosclerotic yaa thromboembolic dhamani avrodh key kaaran hotaa haye. gangreen lambe samay taka chalane vaale paid kii ack jatilata haye, jisase paridhiya ootakon mein soojan, kalapan aur soojan hoe jaati haye, aamtaur parr charam seemaon mein. gambhir mamalon mein, prabhaavit anga kaa vichhedan aavashyak haye.
ischemic stroke.
ischemic stroke ack thrombotic haye, yaa shayed hii kabhi, mastishk kii aapoorti karane vaali dhamniyon kii thromboembolic yaa atherosclerotic jatilata haye. mastishk kii dhamniyon key avrodh seey neurons kii teji seey ischemic mrityu hoe jaati haye, donon infarct core aur ischemic penambra parr. cardiomyocytes key samaan, neurons koo uchit kaary key liye nirantar perfusion kii aavashyakta hoti haye. rakt aapoorti mein kissy bhee tarah kii rukawat key kaaran neurons avaayaviya chayapachaya mein badal jaate hain, jisase antahkoshikiya aeye. tii. pee. star samaapt hoe jaate hain. aeye. tii. pee. mein kamee neurons mein calcium catayan key pravaah aur atirikt glutamate key pravaah kaa kaaran banati haye, jisase neurons key apoptosis aur necroptosis koo trigger kiya jaataa haye.
neuronal necrosis aparivartaniya mastishk kshati koo cumm kartaa haye. mastishk kshetra joe ischemic kshati key liye sabse atisamvedansheel hain, unamen bhaashan aur motor courtis shamil hain, jisase vipareet pakshaghat, bhaashan aur samajh kii haani hoti haye. gambhir yaa lambe samay taka chalane vaale aghaat komaa yaa mastishk mrityu mein samaapt hoe sakate hain. isaliye, ischemic stroke kaa nidan aur upchaar samay-nirbhar haye.
nidan.
dhamani avrodh kaa nidan karane key kaee tareeke hain, jaise kii vyayam pareekshan jaise seedhe setup seey laker ultrasonic duplexes scanning yaa multy-detector coronary tomography (aim. dee. tii.) angiography jaise unnat scanning upkaran taka.
vyayam pareekshan.
vyayam pareekshan rook-rook curr claudication kaa nidan karane kii ack saral, gair-aakramak vidhi haye. sandigdh kshetra mein raktchaap maap vyayam seey pahale aur baad mein liya jaa sakata haye, kyonki kuchh lakshan kewal kathin gatividhi key dauran dikhaai dete hain. aamtaur parr, 12 degree dhalaan key saath 2 meal prati ghante kii raftar seey ack trademill setting kaa upayog kiya jaataa haye. vishayon koo adhikatam 5 minut yaa madhyam dard mahsoos honey taka trademill parr chalane key liye kahaa jaataa haye. dard yaa adhikatam chalane kii avadhi darj kii jaati haye aur isaki tulanaa aadhar rekhaaon seey kii jaati haye.
swasth vyakti systolic raktchaap koo samanya seema mein banaae rakhate hain. ack baar jaba vyayam adhik teevra hoe jaataa haye, tou systolic dabaav mein asthaayi girawat hoe sakati haye, joe aaraam key saath jaldi seey samanya hoe jaataa haye. haalaanki, rook-rook curr claudication vaale loga systolic dabaav key maanak moolyon koo banaae rakhane key liye sangharsh karate hain, jabaki buniyaadi rekha parr vaapas aaney mein lambe samay taka lagata haye.
ultrasonic duplexes pareekshan.
ultrasonic duplexes scanning koo mukhya roop seey caroted dhamniyon mein atherosclerosis kii seema koo nirdhaarit karane key liye vikasit kiya gayaa thaa. taba seey, iska upayog angon mein dhamniyon koo shamil karane key liye vyaapak hoe gayaa haye. takneek ruchi key kshetra mein dhamniyon key bheetar pravaah disha aur wegg key drishya key liye uchch aavritti dhwani tarangon kaa upayog karati haye. duplexes shabd ultrasound scanning key 2 tarikon koo sandarbhit kartaa haye. bee-mode transducer pott kii chhavi praapt karane kii anumati detaa haye, joe avrodh kii seema parr drishya sanket pradaan kartaa haye. iss beach, doppler jaanch kaa upayog rakt pravaah key wegg aur disha parr detta praapt karane key liye kiya jaataa haye.
bahu-detector coronary tomography (aim. dee. tii. tii.) angiography.
paaramparik roop seey, angiography ack aakramak takneek haye jisamen ruchi kii dhamani mein ack lachila plastic catheter dalna shamil haye. ack radiodharmi vipareet rung koo taba catheter key madhyam seey inject kiya jaataa haye aur ack aiks-ray parr dekhaa jaataa haye. yeh vipareet samagri kissy bhee anga koo sthaayi roop seey vikrit naheen karati haye, lekin adhik sateek nidan karane key liye aiks-ray key saath baatchit karati haye.
takniki pragati key kaaran, chikitsakon ney bahu-detector coronary tomography (aim. dee. tii. tii.) angiography naamak cumm aakramak drishtikon kaa upayog karna shuru curr diyaa haye. dhamani mein ack badaa catheter daalane key bajaay, iss takneek key liye ack maanak antahshira catheter kaa upayog karke vipareet rung key ack chhote seey injection kii aavashyakta hoti haye, joe ack niyamit injection kii tarah haath mein daala jaataa haye. aim. dee. tii. scanner taba dhamniyon key bheetar rukaavaton koo dikhaane key liye contrast dye kaa pataa lagaate hain. aim. dee. tii. angiography avarodhan aur baad kii beemariyon jaise kii cadd kaa pataa lagaane mein aakramak aiks-ray angiography kii tulanaa mein adhik samvedansheel haye.
upchaar.
dhamani avrodh kaa upchaar avrodh kii seema key aadhar parr bhinn hotaa haye. gambhir mamalon mein, prabhaavit dhamani seey rukawat koo hataane key liye shalya chikitsa kii aavashyakta hoti haye. vartamaan mein, cergical bipass, endarterectomy aur ambolectomy sahit 3 prakaar key cergical drishtikon hain. yadi shalya chikitsa kii aavashyakta naheen haye, tou rakt koo patala karane vaali dawa nirdhaarit kii jaa sakati haye.
cergical bipass.
ack cergical bipass cadd key ilaaj key liye kii jaane vaali ack prakriya haye. iss prakriya mein dhamani key avaruddh hisse koo shareer mein kaheen aur seey ack swasth pott key saath badalkar bipass karna shamil haye. shalya chikitsak nae paatr key ack chhor koo avrodh seey thheek pahale jodata haye, aur dusare chhor koo prabhaavit hisse key baad kshetra mein jodata haye. yeh vaanchhit kshetra kii or uchit rakt pravaah koo phir seey sthaapit kartaa haye.
endarterectomy.
endarterectomy ack hastakshep haye jiska uddeshya prabhaavit dhamani seey seedhe sanchit plake koo hataana haye. isamen prabhaavit dhamani kii gardan key kinare parr cheera lagaana shamil haye. taba pattika koo ujagar kiya jaataa haye aur tadnusar hataa diyaa jaataa haye, phir dhamani koo ack saath silvaya jaataa haye. pattika koo hataane key saath, rakt dhamani key madhyam seey binaa kissy baadha key yatra curr sakata haye.
ambolectomy.
ack ambolactomy ack prakriya haye joe taba kii jaati haye jaba ack avrodh apane mool sthaan seey shareer mein dusare sthaan parr chalaa jaataa haye, iss prakaar ack ambolus banata haye. ambolectomy karane key dou tareeke hain. pahali vidhi catheter ambolectomy haye, jisamen prabhaavit dhamani mein ack catheter kaa antahsthaapan aur baad mein ambolus koo hataana shamil haye. yeh vikalp nyuntam aakramak haye, aur iss prakaar jokhim aur punarpraapti key samay koo cumm kartaa haye. doosara vikalp ack paaramparik shalya chikitsa vikalp haye, jahan shalya chikitsak prabhaavit kshetra koo ujagar karega, rakt vahika koo kholega aur ambolus koo hataa dega.
rakt koo patala karane vaali dawa.
rakt koo patala karane vaali davaaen dhamani avrodh key prabandhan mein laabhkaari alpakaalik vikalp hain. warferrin aur antiplatelets jaise aspirin aur clopidograil jaise anticoagulant dhamniyon key madhyam seey rakt koo aasaani seey pravaahit karke thrombosis key jokhim koo cumm karate hain. dushprabhavon mein raktasraav mein vriddhi aur bhaari chot shamil hain.

