So wopɛ sɛ wofa wo koma no fã ketewaa bi na wosɔ hwɛ? Momma yɛnka koma mu nhwehwɛmu yi ho asɛm!

Ebia wubesuro kakra bere a wote asɛmfua "koma mu nhwehwɛmu ." Nanso nokwarem no ɛyɛ sɔhwɛ a ɛsom bo yiye a ebetumi aboa ma wɔahu koma mu haw ahorow bi pefee. Enti, momma yɛnka ho asɛm nkɔ akyiri. Dɛn ne no, henanom na wohia, ɔkwan bɛn so na wɔyɛ, ne sɛ ebia nneɛma bi wɔ hɔ a ɛhaw adwene anaa.

Dɛn ankasa ne koma mu nhwehwɛmu?

Sɛ yɛbɛka no tiawa a, koma mu nhwehwɛmu yɛ adeyɛ a ɛhwehwɛ sɛ woyi ntini ketewaa bi fi wo koma ntini mu na wohwehwɛ mu. Eyi yɛ ɔkwan a wɔfa so hu yare no a wɔde hwehwɛ nea yare no yɛ ankasa. Susuw ho te sɛ ntama ketewaa bi a wobɛfa na woahwɛ sɛ ebia mfomso bi wɔ ho anaa.

Wɔde ntini a wɔde yɛ nhwɛso no kɔ baabi a wɔyɛ nhwehwɛmu. Ɔbenfo bi wɔ hɔ, yɛfrɛ no ``pathologist``. Ɔno na ɔde afiri a wɔde hwɛ nneɛma nketenkete hwɛ koma mu ntini asinasin yi na ɔhwehwɛ nsakrae, nneɛma a asɛe, anaa nneɛma a ɛnteɛ biara a ɛwɔ nkwammoaa no mu. Eyi boa yɛn ma yehu sɛ ɔhaw bi wɔ koma no mu a.

So edin afoforo wɔ hɔ a wɔde frɛ eyi?

Yiw, ɛtɔ mmere bi a nnuruyɛfo de din foforo frɛ no. Ebia woate din ahorow yi nso:

• `(Cardiac biopsy)` (Cardiac biopsy ) – "Koma" nso kyerɛ sɛ ɛfa koma no ho.
• `(Endomyocardial biopsy)` (Endomyocardial biopsy) – "Endo" kyerɛ mu, na "myocardial" kyerɛ koma ntini. Eyi kyerɛ sɛ wogye fi koma ntini no mu fã a ɛwɔ mu no mu.
• Myocardial biopsy – Biopsy a wɔfa fi koma ntini no mu tẽẽ.

Ɛmfa ho sɛnea wobɛka no, nea ɛkyerɛ no yɛ sɔhwɛ koro.

Henanom na ɛsɛ sɛ wɔyɛ wɔn koma mu nhwehwɛmu?

Ɛnyɛ obiara na ebehia sɛ ɔyɛ eyi, nanso nsɛm titiriw bi wɔ hɔ a eyi ho hia kɛse.

Wɔn a wɔayɛ wɔn koma foforo (Heart Transplant) .

Fa no sɛ obi anya koma foforo. Sɛ ɛba saa a, ɛsɛ sɛ wɔyɛ biopsy yi daa hwɛ sɛ nipadua no repo koma foforo no anaa ( organ rejection ). Ade a eye sen biara ne sɛ saa biopsy yi tumi hu pow ansa na ada sɛnkyerɛnne biara mpo adi. Na sɛ ɛba saa a, ebetumi nso ahu nea ɛde bae.

• Wɔ koma a wɔde ma akyi mfiase no, ebia ebehia sɛ wɔyɛ eyi pɛnkoro dapɛn biara.
• Ɛno akyi no, bɛyɛ afe biako no, wubetumi ayɛ no pɛnkoro adapɛn asia biara anaa pɛnkoro wɔ asram abiɛsa biara mu.

Kyerɛ komayare afoforo

Wɔ koma a wɔde ma akyi no, saa nipadua mu nhwehwɛmu yi boa ma wohu komayare afoforo pii . Nhwɛso kakraa bi ni:

• `(ATTR (transthyretin) amyloidosis)`: Nea ɛba wɔ eyi mu ne sɛ protein bi a wɔyɛ wɔ yɛn nipadua mu no kɔ koma no mu na ɛsɛe no.
• `(Koma mu ntini mu yare)` (Koma mu ntini mu yare):Eyi kyerɛ nyarewa a ɛba koma ntini mu. Nhwɛsoɔ ne ``hypertrophic cardiomyopathy '', a ɛma koma no afasuo yɛ den dodo.
• Koma mu awuduru: Nnuru bi a wɔde sa yare no betumi asɛe koma no. Wɔyɛ eyi nso de hwɛ sɛ nneɛma a asɛe saa anaa.
• Koma mu kokoram : Ɛntaa nsi koraa, nanso kokoram nso betumi aba koma no mu.
• Koma a entumi nyɛ adwuma yiye: Bere a koma no yɛ mmerɛw na entumi mfa mogya nkɔ nipadua no mu yiye no.
• Koma mu yareɛ: Sɛ nhwɛsoɔ no, tebea bi a wɔfrɛ no ``myocarditis.`` Wɔ eyi mu no, koma ntini no ho yɛ hyew, a ɛkyerɛ sɛ ɛho ahonhon.
• Sarcoidosis : Eyi yɛ yare a ɛma akisikuru nketenkete (te sɛ akuru) ba nipadua no afã horow, a koma no ka ho.

So nnipa bi wɔ hɔ a wɔmpɛ sɛ wɔyɛ eyi?

Ɛwom sɛ mpɛn pii no eyi yɛ sɔhwɛ a ahobammɔ wom de, nanso ebetumi ayɛ asiane kakra ama nnipa binom. Sɛ nhwɛso no, nnipa a wɔwɔ koma mu ntini mu nyarewa ahorow bi no wɔ asiane mu kakra sɛ wobenya nsɛnnennen. Enti, ɛbɛyɛ papa sɛ wo ne wo duruyɛfo bɛkasa de asi gyinae sɛ ebia nhwehwɛmu yi fata wo anaa.

Hena na ɔyɛ koma mu nhwehwɛmu yi?

Koma ho ɔyaresafo bi na ɔyɛ eyi . Ɔwɔ ntetee soronko a ɔde bɛyɛ sɔhwɛ ahorow yi. Wɔfrɛ ɔkwan a wɔfa so yɛ eyi no koma mu catheterization. Sɛ yɛbɛka no tiawa a, wɔyɛ sɔhwɛ yi denam afiri (catheter) a ɛyɛ tratraa paa a ɛyɛ mmerɛw a wɔde fa mogya ntini bi mu kɔ koma no mu no so.

Ɔkwan bɛn so na ɛsɛ sɛ yesiesie yɛn ho ansa na yɛayɛ nipadua no mu nhwehwɛmu?

Sɛ wusi gyinae sɛ wobɛyɛ biopsy a, wo duruyɛfo bɛka nea edidi so yi ho asɛm akyerɛ wo:

• Ɛsɛ sɛ woka nnuru, vitamin, ne nnuru a wɔde ka ho a worenom mprempren nyinaa kyerɛ wo duruyɛfo.
• Ebia ɛho behia sɛ wogyae nnuru bi, titiriw nnuru a ɛma mogya tu no nna kakraa bi ansa na wɔayɛ nhwehwɛmu no.
• Wɔbɛka akyerɛ wo nso sɛ nnnidi anaa nnom biribiara (ntɛmntɛm) nnɔnhwerew kakraa bi ansa na wɔayɛ sɔhwɛ no.

Nea ɛho hia sen biara ne sɛ wubedi wo duruyɛfo akwankyerɛ akyi pɛpɛɛpɛ. Sɛ woante biribi ase a, bisa bio.

Dɛn na ɛba ansa na wɔayɛ biopsy?

Mpɛn pii no, eyi yɛ ayaresa a wɔde kɔ ayaresabea, a ɛkyerɛ sɛ wubetumi akɔ fie da koro no ara a ɛho nhia sɛ wotra ayaresabea. Adeyɛ no nyinaa gye bɛyɛ dɔnhwerew biako.

• Wɔbɛma wo aduru a ɛma wo ho dwo na aboa wo ma woagye w’ahome na woada kakra.
• Wɔma aduru a ɛma obi dwensɔ nso de ma baabi a wɔreyɛ biopsy no ayɛ mmerɛw.
• Woda, nanso biribiara nni hɔ a ɛsɛ sɛ wohaw wo ho, worente ɛyaw biara. Ebia wobɛte nka sɛ wɔrepia wo kakra.
• Wubetumi akɔ fie da koro no ara bere a sɔhwɛ no aba awiei no. Nanso, wubehia obi a ɔde kar bɛka wo akɔ fie na ɔne wo atra bere a wo ho atɔ wo no.

Dɛn na ɛba bere a wɔreyɛ biopsy no?

Sɛ wo duruyɛfo yɛ eyi a, ɔhwɛ wo koma ne wo mogya ntini ho mfonini. Wɔde fluoroscopy X-ray (X-ray a wotumi hu bere nyinaa) anaa transthoracic echocardiogram (TTE) ( koma no mu mfonini ) na ɛyɛ eyi.

Nea ɛkɔ so anammɔn biara ni:

1. Oduruyɛfo no de afiri ketewaa bi (catheter) fa mogya ntini kɛse bi a ɛwɔ wo nsa anaa wo nan mu mu hyɛ wo koma mu.

2. Afei, fa saa tube no mu no, wɔde adwinnade pa foforo (`bioptome`), te sɛ forceps ketewaa bi, kɔ koma no mu.

3. Sɛ wɔde ``bioptome'' di dwuma a, wotwa asinasin nketenkete paa pii (ebia nketewa te sɛ pin ti) fi koma ntini no mu.

4. Afei woyi bioptome ne ntini asinasin no na wɔde ntini no kɔ lab ma wɔyɛ mu nhwehwɛmu.

5. Awiei koraa no, yi catheter no na fa pressure bandage gu so na ama mogya no agyae.

Worente nka sɛ wo ho yeraw wo kɛse bere a eyinom nyinaa asi no.

Bere tenten ahe na egye ansa na wɔasa bere a wɔayɛ wɔn nipadua mu nhwehwɛmu awie no?

Sɛ wowie sɔhwɛ no a, nnuruyɛfo no bɛhwɛ wo yiye nnɔnhwerew kakraa bi ahwɛ sɛ ɔhaw bi wɔ hɔ anaa. Saa bere yi mu no, wɔbɛyɛ wo moma so X-ray de ahwɛ sɛ ebia nsɛnnennen biara te sɛ:

• Ahurututu mu yare
• Hemothorax (mogya a wɔboaboa ano wɔ ahurututu ne koko fasu ntam) .

Sɛ wokɔ fie wie a, ɛsɛ sɛ wokwati sɛ wobɛma nneɛma a emu yɛ duru so anaasɛ wobɛyɛ adwuma a emu yɛ den bɛyɛ nnɔnhwerew 24. Nanso, ɛsɛ sɛ wutumi kɔ adwuma na woyɛ wo da biara da dwumadi ahorow sɛnea ɛsɛ fi da a edi hɔ no.

So asiane bi wɔ eyi mu?

Koma mu nhwehwɛmu yɛ nhwehwɛmu a ahobammɔ nnim koraa.

• Nsɛnnennen nketenkete ba wɔ nsɛm a ennu 6% mu. Sɛ nhwɛso no, akuru ketewaa bi anaa mogya kakra a ɛbɛtɔ wɔ baabi a afiri no wɔ no. Mpɛn pii no, eyinom siesie wɔ nna kakraa bi mu.
• Nsɛnnennen a emu yɛ den ntaa mma, ennu 1%. Nanso, eye sɛ wubehu nsɛnnennen a ebetumi aba no. Eyinom bi ne:
• Koma a ɛbɔ a ɛnteɛ (Arrhythmia).
• Mogya a ɛtwetwe. Eyinom betumi ayɛ wɔ ahurututu mu (pulmonary embolism), wɔ nan no ntini mu (deep vein thrombosis - DVT), anaa amemene no mu na ama obi anya akisikuru.
• Mogya ntini a ɛsɛe anaasɛ ɛpaapae.
• Ahurututu a abubu.
• Mogya a ɛhyɛ koko mu ma (Hemothorax).
• Ɔyare mmoawa anaa mogya a ɛtɔ gu nipadua no mu wɔ baabi a wɔyɛɛ biopsy no.
• Ntini a ɛsɛe.
• Pericardial effusion a ɛkɔ nipadua no mu.
• Siw ketewaa bi a ɛwɔ koma no anyinam ahoɔden nsɛnkyerɛnne mu (right bundle branch block).
• Regurgitation yɛ mogya a ɛkɔ akyi fa koma no tricuspid valve no mu.

Mma wo ho nnyɛ wo hu bere a wote asiane ahorow yi ho asɛm no. Wo duruyɛfo bɛka eyinom nyinaa ho asɛm akyerɛ wo. Hokwan a ɛwɔ hɔ sɛ eyinom besi no sua koraa.

Bere tenten ahe na egye ansa na obi nsa aka amanneɛbɔ no?

Mpɛn pii no, wonya nea efi koma mu nhwehwɛmu mu ba no wɔ nnɔnhwerew 24 kosi 48 mu, anaa bɛyɛ da koro anaa nnanu . Wo duruyɛfo bɛkyerɛkyerɛ nea ebefi mu aba no mu akyerɛ wo. Ɛdenam nea ebefi mu aba so no, ebia ebehia sɛ woyɛ nhwehwɛmu foforo.

Bere bɛn na ɛsɛ sɛ mefrɛ oduruyɛfo no?

Sɛ wokɔ fie wɔ biopsy akyi a, sɛ wuhu saa sɛnkyerɛnne yi bi a , ɛsɛ sɛ wofrɛ wo duruyɛfo ntɛm ara, anaasɛ wokɔ ayaresabea a ɛbɛn wo:

• Adwene a ɛyɛ basaa.
• Sɛ koma no bɔ ntɛmntɛm wɔ ɔkwan soronko so, ɛyɛ brɛoo yiye, anaasɛ ɛnte saa (Irregular pulse and heart rate).
• Ɔhome a ɛyɛ tiaa anaa ɔhome mu haw.
• Koko mu yaw, te nka sɛ ne koko mu ayɛ den (eyinom betumi ayɛ komayare ho sɛnkyerɛnne) .
• Nsɛnkyerɛnne a ɛkyerɛ sɛ obi anya akisikuru: Sɛ nhwɛso no, nipadua no fã biako yɛ mmerɛw, obi ntumi nkasa, n’ano twetwe kɔ ɔfã biako.
• Nsɛnkyerɛnne a ɛkyerɛ sɛ obi anya ɔyare no, te sɛ atiridiinini ne atiridiinini.

Enti, nneɛma bɛn na ɛsɛ sɛ yɛkae fi eyi mu?

Okay, enti momma yɛnsan nsusuw nsɛntitiriw a ɛho hia sen biara no ho mfi nea yɛaka ho asɛm no mu.

• Koma mu nhwehwɛmu yɛ ntini ketewaa bi a woyi fi koma no mu de yɛ nhwehwɛmu.
• Eyi yɛ sɔhwɛ a ɛho hia , titiriw ma wɔn a wɔde koma foforo ma wɔn, de hwɛ sɛ wɔapow na wɔahu komayare afoforo dodow bi (te sɛ koma ne ntini mu yare, koma mu kokoram, ne ɔyare mmoawa) .
• Koma ho oduruyɛfo na ɔyɛ eyi, na ɔde ɔkwan bi a wɔfrɛ no ``cardiac catheterization'' di dwuma.
• Eyi yɛ sɔhwɛ a mpɛn pii no wobetumi ayɛ a ɛho nhia sɛ wotra ayaresabea, na wubetumi ho atɔ wo ntɛm.
• Ɛwom sɛ asiane nketenkete bi wɔ hɔ de, nanso eyi mu dodow no ara yɛ nea asiane biara nni ho.

Enti, sɛ wo duruyɛfo ka kyerɛ wo sɛ yɛ koma mu nhwehwɛmu a, nsuro sɛ wobɛyɛ, ma saa nsɛm yi ntra w’adwenem, wo ne wo duruyɛfo nkasa yiye, na bisa nsɛm biara a ebia wowɔ. Eyi betumi ayɛ anammɔn a ɛho hia ma wo koma akwahosan!

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