Beqaror stenokardiya sahifasining manbasini koʻrish

{{Tibbiy holat bilgiqutisi
| nomi                   = Beqaror stenokardiya
| tasvir                 = A man having a Heart Attack.png
| izoh                   =  
| soha                   = 
| belgilari               = Ko‘krak qafasidagi og‘riq yoki dam olish paytida ko‘krak qafasidagi noqulaylik, 
| asoratlari             = [[Yurak-qon tomir kasalliklari]]
| boshlanish vaqti       = 
| davomiyligi            = 
| turlari                = 
| sabablari              = 
| xavf omillari          = 
| tashxis                = 
| differensial tashxis   = 
| oldini olish           = 
| davolash               = 
| dorilar                =
| prognoz                = 
| takrorlanishi          =  
| oʻlim holati           = 
}}
'''Beqaror stenokardiya''' – [[stenokardiya]]ning<ref name="pmid10631280">{{Cite journal|vauthors=Yeghiazarians Y, Braunstein JB, Askari A, Stone PH |title=Unstable angina pectoris |url=https://archive.org/details/sim_new-england-journal-of-medicine_2000-01-13_342_2/page/100 |journal=N. Engl. J. Med. |volume=342 |issue=2 |pages=101–14 |date=January 2000 |pmid=10631280 |doi= 10.1056/NEJM200001133420207}}</ref> bir turi boʻlib muntazam boʻlmagan yoki osonlikcha qoʻzgʻatiladigan turlari qatoriga kiradi<ref>{{DorlandsDict|nine/000950385|unstable angina}}</ref>. Bu [[o‘tkir koronar sindrom]]ning bir turi sifatida tasniflanadi<ref name="AAFP2004">{{Cite journal |last1=Wiviott |first1=S. D. |last2=Braunwald |first2=E |year=2004 |title=Unstable Angina and Non–ST-Segment Elevation Myocardial Infarction: Part I. Initial Evaluation and Management, and Hospital Care |url=https://www.aafp.org/pubs/afp/issues/2004/0801/p525.html |journal=American Family Physician |volume=70 |issue=3 |pages=525–32 |pmid=15317439}}</ref>. Nostabil stenokardiyani ST-segmenti koʻtarilmagan (Q-tishchali boʻlmagan) miokard infarktidan farqlash qiyin boʻlishi mumkin<ref name="AHA2021">{{Cite journal |last1=Gulati |first1=Martha |last2=Levy |first2=Phillip D. |last3=Mukherjee |first3=Debabrata |last4=Amsterdam |first4=Ezra |last5=Bhatt |first5=Deepak L. |last6=Birtcher |first6=Kim K. |last7=Blankstein |first7=Ron |last8=Boyd |first8=Jack |last9=Bullock-Palmer |first9=Renee P. |last10=Conejo |first10=Theresa |last11=Diercks |first11=Deborah B. |last12=Gentile |first12=Federico |last13=Greenwood |first13=John P. |last14=Hess |first14=Erik P. |last15=Hollenberg |first15=Steven M. |display-authors=5 |date=2021-11-30 |title=2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines |journal=Circulation |language=en |volume=144 |issue=22 |pages=e368–e454 |doi=10.1161/CIR.0000000000001029 |pmid=34709879 |doi-access=free |issn=0009-7322}}</ref>. Ular asosan ishemiyaning [[Miokard|yurak miokardi]] oʻpka hujayralariga yetarli darajada zarar yetkazishi va shikastlanish belgisi, odatda [[troponin T]] yoki [[troponin I]] ning aniqlanadigan miqdorini chiqarishi bilan farq qiladi<ref name="ESC2020">{{Cite journal |last1=Collet |first1=Jean-Philippe |last2=Thiele |first2=Holger |last3=Barbato |first3=Emanuele |last4=Barthélémy |first4=Olivier |last5=Bauersachs |first5=Johann |last6=Bhatt |first6=Deepak L. |last7=Dendale |first7=Paul |last8=Dorobantu |first8=Maria |last9=Edvardsen |first9=Thor |last10=Folliguet |first10=Thierry |last11=Gale |first11=Chris P. |last12=Gilard |first12=Martine |last13=Jobs |first13=Alexander |last14=Jüni |first14=Peter |last15=Lambrinou |first15=Ekaterini |display-authors=5 |date=2021-04-07 |title=2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation |journal=European Heart Journal |volume=42 |issue=14 |pages=1289–1367 |doi=10.1093/eurheartj/ehaa575 |doi-access=free |issn=1522-9645 |pmid=32860058 |quote=Unstable angina is defined as myocardial ischaemia at rest or on minimal exertion in the absence of acute cardiomyocyte injury/necrosis. [...] Compared with NSTEMI patients, individuals with unstable angina do not experience acute cardiomyocyte injury/necrosis.}}</ref><ref name="ESC2020_QA">{{Cite journal |last1=Barthélémy |first1=Olivier |last2=Jobs |first2=Alexander |last3=Meliga |first3=Emanuele |last4=Mueller |first4=Christian |last5=Rutten |first5=Frans H. |last6=Siontis |first6=George C. M.|last7=Thiele |first7=Holger |last8=Collet |first8=Jean-Philippe | display-authors=3 |date=2021-04-07 |title=Questions and answers on workup diagnosis and risk stratification: a companion document of the 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation |journal=European Heart Journal |volume=42 |issue=14 |pages=1379–1386 |doi=10.1093/eurheartj/ehaa602 |pmid=32860030 |pmc=8026278 |doi-access=free |issn=1522-9645 |quote=NSTEMI is characterized by ischaemic symptoms associated with acute cardiomyocyte injury (=rise and/or fall in cardiac troponin T/I), while ischaemic symptoms at rest (or minimal effort) in the absence of acute cardiomyocyte injury define unstable angina. This translates into an increased risk of death in NSTEMI patients, while unstable angina patients are at relatively low short-term risk of death.}}</ref>. Oʻtkir koronar sindromga xos ishemik belgilari bor, ammo troponin darajasida oʻzgarishlar kuzatilmagan bemorlarda beqaror stenokardiya mavjud deb hisoblanadi. Bu holat [[elektrokardiogramma]]da ishemiyani koʻrsatuvchi oʻzgarishlar (masalan, ST segmentining pasayishi, vaqtinchalik koʻtarilishi yoki yangi T toʻlqin inversiyasi) boʻlishi yoki boʻlmasligidan qatʼi nazar kuzatilishi mumkin<ref name="ESC2020"/>.

== Belgilari ==
Beqaror stenokardiya belgilari stabil stenokardiya belgilariga oʻxshash namoyon boʻladi<ref name="MSD_ACS">{{Cite web |title=Acute Coronary Syndromes (Heart Attack; Myocardial Infarction; Unstable Angina) - Heart and Blood Vessel Disorders |url=https://www.msdmanuals.com/home/heart-and-blood-vessel-disorders/coronary-artery-disease/acute-coronary-syndromes-heart-attack-myocardial-infarction-unstable-angina |access-date=2023-02-12 |website=MSD Manual Consumer Version |language=en}}</ref>. Beqaror stenokardiyada yurakda qon oqimining pasayishi bilan bogʻliq alomatlar tinch holatda yoki minimal zoʻriqishda paydo boʻlishi mumkin<ref name="ESC2020"/>. Belgilar barqaror stenokardiyaga qaraganda uzoqroq davom etishi, dam olish yoki dori-darmonlarga chidamli boʻlishi va vaqt oʻtishi bilan yomonlashishi mumkin<ref name="MSD_ACS"/><ref>{{Cite web |publisher=American Heart Association |title=Unstable Angina |url=https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/unstable-angina |url-status=live |archive-url=https://web.archive.org/web/20230315022035/https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/unstable-angina |archive-date=2023-03-15 |access-date=2023-05-05 |website=www.heart.org |language=en}}</ref>. Yurakda qon oqimining keskin pasayishining asosiy belgisi siqilish, koʻkrakda kuyish shaklida kechuvchi ogʻriq hisoblanadi<ref name="AHA2021"/>. Ogʻriq koʻpincha koʻkrak atrofida yoki ustida boʻladi. Ogʻriq qoʻl, yelka, boʻyin, qorin yoki jagʻga tarqalishi yoki joylashishi mumkin<ref name="AHA2021"/>. Bu [[diaforez|terlash]], [[ko‘ngil aynishi]], yoki [[nafas qisishi]] bilan bogʻliq boʻlishi mumkin<ref name="AHA2021"/>.

== Patofiziologiyasi ==
Beqaror stenokardiyaning patofiziologiyasi haqida turli fikrlar mavjud. Avvallari beqaror stenokardiya [[Ateroskleroz|ateroskleroz plakasining]] yemirilishi natijasida yuzaga keladigan koʻkrak qafasi ogʻrigʻi deb hisoblanardi. Bu jarayonda qisman [[Tromboz (tibbiyot)|tromboz]] va ehtimol, [[emboliya]] yoki vazospazm ham kuzatilib, miokard ishemiyasiga olib keladi, deb taxmin qilingan edi<ref>{{Cite book |last=Robbins |year=2005 |title=Pathologic Basis of Disease |edition=7th}}</ref><ref>{{cite journal |last1=Braunwald |first1=E. |year=1998 |title=Unstable Angina: An Etiologic Approach to Management |url=https://archive.org/details/sim_circulation_1998-11-24_98_21/page/n30 |journal=Circulation |volume=98 |issue=21 |pages=2219–2222 |doi=10.1161/01.CIR.98.21.2219|pmid=9826306 |doi-access=free }}</ref>. Biroq, sezgir troponin tahlillari miokardning hatto yengil ishemiyasi holatlari bilan qon oqimida yurak troponinining oshishini koʻrsatadi<ref>{{Cite journal |last1=Sabatine|first1=M. S.|last2=Morrow|first2=R. W.|last3=de Lemos|first3=J.A.|last4=Jarolim|first4=P.|last5=Braunwald|first5=E.|year=2009 |title=Detection of acute changes in circulating troponin in the setting of transient stress test-induced myocardial ischaemia using an ultrasensitive assay: results from TIMI 35|journal=European Heart Journal |volume=30 |issue=2 |pages=162–169 |doi=10.1093/eurheartj/ehn504|pmid=18997177|pmc=2721709}}</ref>. Nostabil stenokardiya troponin ajralib chiqmagan oʻtkir miokard ishemiyasi sharoitida yuzaga keladi deb taxmin qilinganligi sababli, nostabil stenokardiya tushunchasi shubha ostiga olinadi va baʼzilar bu atamani butunlay olib tashlashga chaqiradi<ref>{{Cite journal |last1=Braunwald|first1=E.|last2=Morrow|first2=R. W.|year=2013 |title=Unstable Angina. Is It Time for a Requiem?|url=https://archive.org/details/sim_circulation_2013-06-18_127_24/page/n105|journal=Circulation |volume=127 |issue=24 |pages=2452–2457 |doi=10.1161/CIRCULATIONAHA.113.001258|pmid=23775194|doi-access=free}}</ref>.
== Manbalar ==
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[[Turkum:Yurak-qon tomir kasalliklari]]