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Doença coronária

O que é? Qual é o tratamento?

A doença coronária é uma patologia que afeta especialmente as artérias que fornecem sangue ao coração. É produzida quando essas vias vão se estreitando, devido à acumulação de placa, formada pelo colesterol, pelos depósitos de gordura, cálcio ou outras substâncias. Esse depósito de placa também pode ser produzido nas artérias carótidas (que fornecem sangue e oxigênio ao cérebro) ou naquelas artérias que levam o sangue para as pernas, os braços e a pélvis.

Como é produzida?

Fatores como o tabagismo, o colesterol, a pressão alta ou a diabete podem produzir lesões nas paredes da artéria, provocando também rigidez arterial (conhecida como arteriosclerose). A partir dessas lesões, o corpo trata de se proteger, e provoca uma maior acumulação de placa nas artérias danificadas.

Com o tempo, a placa vai reduzindo ou bloqueando completamente a artéria, reduzindo o fluxo do sangue rico em oxigênio que deveria chegar ao músculo cardíaco. Às vezes, a placa se rompe e pode formar um coágulo de sangue, que reduz ou entope as artérias. Isso produz dor no peito (angina) ou um enfarte agudo de miocárdio (ataque cardíaco). Outros fatores que influem são a menopausa, o envelhecimento ou antecedentes familiares com problemas cardíacos.

Quais são os sintomas?

Duas de cada três pessoas que tiveram um enfarte lembram ter sofrido dores muito fortes no peito, dificuldades para respirar ou fadiga. O sintoma mais típico é a dor no meio do peito que se expande até as costas, a mandíbula, o braço esquerdo ou, às vezes, ao direito. Com menos frequência, a dor é notada no abdômen e pode ser confundida com uma indigestão. Em caso de ter esses sintomas, deve-se procurar atendimento médico o mais rápido possível.

Ao identificar esses sintomas, consulte seu médico.

Como é realizado o diagnóstico?

Existem várias maneiras, três delas são:

  • Com um eletrocardiograma, também conhecido como ECG, que mede a atividade elétrica do coração e pode mostrar se houve dano devido a um enfarte.
  • Com um exame de esforço, que mede a atividade elétrica do coração enquanto se realiza atividade física.
  • Com um angiograma coronário, que pode mostrar as obstruções ou estreitamentos das artérias (geralmente é injetado um líquido de contraste, que mostra o estado no qual estão essas artérias).

Qual é o tratamento?

O tratamento dependerá da gravidade do paciente, mas sempre deverá ser acompanhado de uma mudança de estilo de vida, que inclui exercício e dieta. Existem remédios que aliviam a dor no peito devido aos bloqueios, mas que não os tratam em si mesmos. Dentro dos procedimentos médicos podemos mencionar os seguintes:

  • A angioplastia: é um procedimento não cirúrgico, realizado em um hospital. O médico insere um tubo especial muito fino (o chamado cateter) através da virilha ou no braço, que depois passa através das artérias até chegar ao lugar onde foi detectada a obstrução. Na ponta do cateter há um pequeno balão, que é inflado lentamente e libera esse obstáculo.
  • Muitos pacientes que devem fazer uma angioplastia também podem colocar um stent, uma espécie de malha metálica que permite expandir de novo a artéria e conduzi-la ao seu tamanho normal. O stent permanece na artéria para ajudar a manter o fluxo do sangue e, com o tempo, a parede afetada é curada ao seu redor.
  • Finalmente, pode ser realizado um By Pass coronário, procedimento que requer uma cirurgia com o coração aberto, para reconstruir as artérias ou as veias afetadas, através de outras veias saudáveis que são tomadas de outras partes do corpo.
  • Em todos esses procedimentos há riscos e, portanto, é muito importante realizar consultas com um médico especialista.

Antes de iniciar o tratamento, consultar sempre um médico.

Prevenção  

Para prevenir a doença coronária, recomenda-se deixar de fumar, baixar o colesterol, realizar exercícios regularmente, comer de forma saudável, manter a pressão arterial em níveis adequados e o diabetes sob controle. Por último, mas não menos importante, deve-se visitar o médico de forma regular.