So wo nan ne wo nansoaa hohoro bere nyinaa? So wote nka sɛ wo home yɛ wo yaw bere a wonantew anaa woaforo antweri mpo a? Ebia wubesusuw sɛ ɛyɛ asaabo mu haw anaasɛ tebea a ɛtaa ba a nsu hyɛ wo nipadua ma. Nanso so wunim sɛ ɔhaw bi a ɛwɔ wo koma mu nso betumi de saa nneɛma yi aba? Ɛnnɛ yɛreka tebea a ɛte saa biako ho asɛm, a wɔfrɛ no ‘Right-Sided Heart Failure’ . Ebia eyi bɛyɛ te sɛ asɛmfua a anibere wom, nanso mma ɛnhaw wo. Momma yɛnka ho asɛm tiawa.
Sɛ yɛbɛka no tiawa a, dɛn ne Koma a Ɛyɛ Nifa?
Fa no sɛ yɛn koma te sɛ ofie ketewa bi a ɛwɔ adan anan. Ofie yi afã abien, benkum ne nifa. Pia abien na ɛwɔ afã biara.
Afei, koma no fã nifa no adwuma titiriw ne sɛ ɛbɛboaboa mogya "a ɛho agu fĩ" a wɔde adi dwuma awie na oxygen a ɛwɔ yɛn nipadua nyinaa mu no ano, na ɛsan de akɔ ahurututu no mu ma wɔasan anya oxygen.
Nanso wɔ tebea bi a wɔfrɛ no ‘Right-Sided Heart Failure’ mu no, tumi a koma no nifa no tumi de pɔmpɛ no yɛ mmerɛw. Ɛte sɛ nea nsu pɔmpɛ bi asɛe na ɛnyɛ nsu. Dɛn na ɛba esiane eyi nti?
- Mogya a ehia sɛ wɔde kɔ ahurututu no mu no, wontumi nkɔfa no yiye.
- Esiane eyi nti, mogya boaboa ano wɔ ntini a ɛde mogya fi nipadua no mu kɔ koma no mu no mu, na ɛma kar sisi.
- Saa akisikuru yi ma nhyɛso a ɛwɔ ntini no mu no yɛ kɛse.
- Esiane saa nhyɛso a ɛkɔ soro no nti, nsu a ɛwɔ ntini no mu no fi ase kɔ ntini a atwa ho ahyia no mu nkakrankakra.
- Saa nsu yi pue na ɛboaboa ano wɔ mmeae te sɛ wo nan, wo nansoaa, ne wo yafunu, na ɛma wo hohoro (edema).
Sɛ yɛbɛka no tiawa a, ɛno ne asɛm no. Sɛ pɔmpɛ a ɛwɔ nifa so no yɛ mmerɛw a, mogya no mu yɛ ma na nsu hyɛ nipadua no ma.
Enti dɛn ne benkum fam komayare?
Koma no wɔ nifa ne benkum. Benkum fam no adwuma ne sɛ ɛbɛpam mogya a "ho tew" a oxygen wom afi ahurututu no mu akɔ nipadua no fã a aka no mu. Esiane sɛ ɛsɛ sɛ ɛbɔ mogya fa nipadua no nyinaa mu nti, benkum so no mu yɛ den na ɛsõ sen nifa no.
‘Left-Sided Heart Failure’ yɛ tebea a ɛma koma no benkum so pɔmpɛ dwumadi no sɛe. Anwonwasɛm ne sɛ, wɔ nsɛm pii mu no, ade titiriw a ɛma koma nifa di huammɔ ne koma no benkum a edi kan di huammɔ. Yɛbɛhwɛ saa asɛm no akɔ akyiri kakra.
Dɛn na ɛma koma no nifa yɛ mmerɛw?
Sɛnea yɛadi kan aka no, nea ɛde ba titiriw ne nea ɛtaa de ba ne Koma a Ɛyare Benkum. Nanso, ebia nneɛma afoforo nso wɔ hɔ a ɛde ba. Momma yenbubu nneɛma a ɛde ba yi mu.
| Nneɛma atitiriw a ɛde ba | Nkyerɛkyerɛmu a ɛnyɛ den |
|---|---|
| Benkum So Koma a Ɛyɛ Adwuma | Eyi ne ade titiriw nti a nipadua no fã nifa yɛ mmerɛw ma nnipa pii . Sɛ benkum so yɛ mmerɛw a, mogya a ɛkyere mogya no mu no ka nifa no nkakrankakra, na ɛma saa ɔfã no yɛ mmerɛw. |
| Ahurututu mu nyarewa | - Ahurututu mu yare a ɛtra hɔ kyɛ (e.g. COPD - Ahurututu mu Yare a Ɛkɔ Anim a Enni sabea ) . - mogya mmoroso a ewo ahurututu mu (Pulmonary Hypertension) . - pulmonary embolism (mogya a etu wo ahurututu mu) . |
| Koma mu nyarewa afoforo a ɛma benkum fam yɛ mmerɛw | - a ɛyɛ Coronary Artery Yareɛ - a ewo mogya mmoroso a wontumi nni so - a woadi kan anya komayare |
Nea ɛwom ara ne sɛ: Mpɛn pii no, akwantu yi fi ase wɔ tebea horow a wotumi di so te sɛ mogya mmoroso ne srade a ɛwɔ nipadua mu so. Sɛ wɔanhwɛ eyinom so a, ebetumi ama koma no benkum so de nkakrankakra ayɛ mmerɛw, na awiei koraa no aka nifa nso.
Ɔkwan bɛn so na ɔhaw bi a ɛwɔ benkum so ka nifa?
Afei ebia woredwene sɛ, "Okay, sɛ benkum so pɔmpɛ no yɛ mmerɛw a, ɛbɛyɛ dɛn na nifa so no atumi anya ɔhaw?" Ɛyɛ adwuma saa, susuw ho te sɛ kar akwan a ɛkyere so wɔ kwan so.
1. Sɛ koma no benkum yɛ mmerɛw a, mogya dodow a ebetumi de akɔ nipadua no mu no so tew.
2. Esiane eyi nti, mogya a anka ɛsɛ sɛ ɛsen kɔ benkum so no fi ase kyekyere na ɛboaboa ano wɔ ahurututu no mu.
3. Sɛ mogya boaboa ano wɔ ahurututu no mu a, mogya mmoroso a ɛwɔ ahurututu mu no kɔ soro.
4. Afei nifa no adwuma ne sɛ ɛbɛpopa mogya akɔ ahurututu no mu, baabi a nhyɛso yi kɔ soro.
5. Bere a koma no nifa kɔ so yɛ adwuma tia nhyɛso a ɛkɔ soro no, ɛte sɛ nea ɛreforo bepɔw. Bere kɔ so no, ɔfã nifa no yɛ mmerɛw nkakrankakra, entumi nnyina saa adesoa yi ano, na awiei koraa no, ɛhwere tumi a ɛde pɔmpɛ no.
Saa na ɔhaw bi a ɛwɔ benkum so no ka ɔfã nifa no.
Dɛn ne tebea yi ho sɛnkyerɛnne?
Tebea yi ho sɛnkyerɛnne titiriw ne ɔfe (edema) a nsu a ɛboaboa ano wɔ nipadua no mu de ba, sɛnea yɛadi kan aka ho asɛm no. Nanso, ebia sɛnkyerɛnne afoforo nso wɔ hɔ.
| Nsɛnkyerɛnne no fã | Nneɛma a wotumi hu |
|---|---|
| Nsɛnkyerɛnne titiriw: Ɛhohoro (Edema) . | |
| Mmeae a ɛho ahonhon | - nan, nan ne ananse. - se wogyina a, nsuo boaboa ano wo ase enam tumi a etwe ade ba fam nti. - se woda mpa so a, w'akyi ase betumi ahonhon. - se tebea no mu ye den no, nsuo betumi aboaboa ano wo yafunu mu na ahyɛ yafunu no ma ( ascites ). |
| Nneɛma afoforo a ɛtaa ba | |
| Ɔhome a ɛyɛ den | - a ɛyɛ den sɛ wobɛhome mpo sɛ wobɔ mmɔden kakra. - a ɛyɛ den sɛ wobɛhome bere a woada anadwo. |
| Nsɛnkyerɛnne a ɛfa koma ho | - koko mu yaw anaase ne ho ye. - a wote nka se wo koma rebɔ ntɛmntɛm (Heart Palpitations). |
| Digestive system ho sɛnkyerɛnne ahorow | - nsuo a eboaboa ano twa mmerɛboɔ ne yafunu ho hyia no tumi ma obi ho popo, ne ho popo, na ɔmpɛ aduane. |
| Nneɛma a ɛkɔ akyiri | Bere a tebea no mu yɛ den no, nipadua mu duru ne ntini mu duru betumi atew ntɛmntɛm. Wɔfrɛ eyi Koma mu Cachexia . |
Wobɛyɛ dɛn ahu eyi, Oduruyɛfo?
Sɛ wokɔ oduruyɛfo nkyɛn a ɔwɔ saa sɛnkyerɛnne ahorow yi a, obedi anammɔn pii akyi de ahu tebea no.
1. Sɛ yebebisa wo nsɛm a ɛkɔ akyiri: Ade a edi kan a yɛyɛ ne sɛ yɛne wo bɛkasa yiye. Yebisa wo wo sɛnkyerɛnne ahorow, bere tenten a wode anya bi, ne sɛ ebia wowɔ ayaresa mu tebea afoforo te sɛ mogya mmoroso anaa asikreyare anaa.
2. Nipadua mu nhwehwɛmu: Afei, wɔbɛhwehwɛ wo mu.
- Wɔresusuw wo koma a ɛbɔ ne wo mogya mmoroso.
- Wɔde afiri a wɔde tie asɛm tie koko ne ahurututu.
- Hwɛ yiye sɛ ɛho ahonhon wɔ mmeae te sɛ nan ne yafunu mu anaa.
Aduruyɛ mu nhwehwɛmu a wɔhwehwɛ
Bere a wo duruyɛfo ahwɛ wo sɛnkyerɛnne ahorow no mu na woayɛ wo nipadua mu nhwehwɛmu awie no, ɔbɛkamfo akyerɛ sɛ wɔnyɛ nhwehwɛmu pii de si tebea no so dua na woahu nea ɛde ba.
- Chest X-ray: Wobetumi de eyi ahwɛ sɛ koma no ayɛ kɛse na nsu aboaboa ano wɔ ahurututu no mu anaa.
- ECG (Electrocardiogram): Ɛdenam anyinam ahoɔden dwumadi a ɛwɔ koma no mu a wɔkyerɛw so no, wobetumi ahu koma no bɔ a ɛnkɔ so pɛpɛɛpɛ ne komayare ho sɛnkyerɛnne ahorow.
- Echocardiogram (Echo): Eyi te sɛ koma no mu nhwehwɛmu. Ebetumi ahwɛ sɛnea koma no mu adan no kɛse te pɛpɛɛpɛ, sɛnea koma no mu ntini no reyɛ adwuma yiye, ne sɛnea koma no rebɔ yiye (ejection fraction). Eyi yɛ sɔhwɛ a ɛho hia yiye.
- Mogya mu Nhwehwɛmu: Eyinom susuw nnuru bi a wɔfrɛ no ``Natriuretic Peptides (NPs) dodow pɔtee.`` Saa nnuru yi kɔ soro wɔ mogya no mu bere a koma no te nka sɛ adwuma a ɛkɔ soro no.
Wɔ tebea horow bi mu no, wobetumi ayɛ nhwehwɛmu te sɛ MRI, CT scan, ne koma mu catheterization de asi nea wɔahu no so dua bio anaasɛ wɔayi nneɛma afoforo a ɛde ba no afi hɔ.
Dɛn ne ayaresa ahorow a wɔde sa eyi?
Ade a ɛho hia sen biara ne sɛ wobɛkae sɛ bere a wontumi nsa tebea yi koraa no, wobetumi adi so yiye na wubetumi atra ase a ɛyɛ nnam denam ayaresa a ɛfata ne asetra mu nsakrae ahorow so .
Botae atitiriw abien na ɛwɔ ayaresa mu: biako ne sɛ wobedi yare no ho sɛnkyerɛnne ahorow so, na biako nso ne sɛ wobesiw yare no ano.
1. Asetra mu Nsakrae
Eyi ne ayaresa fapem. Ɛnyɛ nea ɛdɔɔso sɛ wobɛnom nnuru kɛkɛ, ɛsɛ sɛ wo nso woyɛ saa nneɛma yi wɔ wo fam.
- Tew nkyene a wodi so: Bere a nkyene ma nsu a ɛwɔ nipadua no mu no yɛ kɛse no, tew nkyene dodow a wɔde ka aduan ho no so.
- Nsu a wɔnom ano hye:Wo duruyɛfo bɛkyerɛ wo nsu dodow a ɛsɛ sɛ wonom da biara. Mma nnnom nsen saa dodow no.
- Sigaretnom ne nsa a wobegyae koraa: N’abien nyinaa pira koma no paa.
- Aduan a ahoɔden wom: Di ngo ne asikre kakraa bi, di nhabannuru, nnuaba, ne nhabannuru pii.
- Mu duru a ɛfata a wobɛkɔ so akura mu: Sɛ obi mu duru boro so a, ɛde ɔhaw ba koma no so.
- Apɔw-mu-teɛteɛ: Bisa wo duruyɛfo na fa wo ho hyɛ apɔw-mu-teɛteɛ a ɛnyɛ den a ɛfata wo mu. Nantew mpo ye.
- Adwennwen ano aduru: Fa nneɛma te sɛ yoga ne adwennwen so kura adwene mu yiyedi mu.
2. Nnuru a wɔde di dwuma
Ɛdenam wo tebea so no, wo duruyɛfo bɛkamfo nnuru ahorow pii akyerɛ wo.
- Nnuru a wɔde hyɛ nsu mu: Wɔsan frɛ eyinom "nsu aduru." Wɔboa ma nsu a ɛboro so fi nipadua no mu denam nsu mu.
- Mogya mmoroso nnuru: Nnuru te sɛ ACE inhibitors, ARBs, ne ARNIs brɛ nhyɛso a ɛwɔ mogya ntini mu no ase na ɛtew adwuma a ɛwɔ koma no so no so.
- Nnuru a ɛma koma bɔ so tew: Nnuru te sɛ `Beta-blockers` boa ma koma no bɔ so na ɛma koma no nya ahomegye.
- Nnuru afoforo: Sɛ ɛho hia a, wobetumi ama nnuru te sɛ nea ɛma mogya yɛ mmerɛw ne nnuru a ɛma mogya mu srade so tew.
3. Ayaresa afoforo
Sɛ tebea no mu yɛ den a, oduruyɛfo no betumi akamfo mfiri soronko anaa oprehyɛn akyerɛ.
- Nnwinnade titiriw: Sɛ koma no bɔ nyɛ pɛpɛɛpɛ a, wobetumi de afiri a ɛma koma no bɔ te sɛ `Implantable Cardioverter-Defibrillator (ICD)` anaa `Cardiac Resynchronization Therapy (CRT)` ahyɛ mu de adi so.
- Oprehyɛn: Sɛ biribi bi wɔ hɔ a wobetumi de oprehyɛn ayɛ, te sɛ koma no mu ntini ho haw anaasɛ koma ntini a asiw a, wobetumi de wo akɔ oprehyɛn te sɛ `Coronary Artery Bypass` anaa `Valve Replacement`.
- Koma a Wɔde Ma: Sɛ́ ɔkwan a etwa to no, wobetumi asusuw koma a wɔde bɛma obi foforo ho wɔ tebea horow a emu yɛ den a ayaresa foforo biara ntumi nni tebea no so no mu.
Bere bɛn na ɛsɛ sɛ wohwehwɛ aduruyɛ mu afotu ntɛm ara?
Sɛ wo moma so yɛ wo yaw mpofirim, wo home yɛ wo yaw kɛse, anaasɛ wotɔ piti a, ebetumi ayɛ komayare ho sɛnkyerɛnne. Sɛ ɛba saa a, frɛ ambulance ntɛm ara anaa kɔ ayaresabea a ɛbɛn wo no Emergency Department (ETU).
Bio nso, sɛ wunya sɛnkyerɛnne foforo anaa nea ɛreyɛ kɛse a edidi so yi mu biara a, kɔ wo duruyɛfo nkyɛn:
- Ɔhome a ɛyɛ den a ɛkɔ soro.
- Nan mu a ɛho ahonhon a ɛkɔ soro ntɛmntɛm wɔ nna kakraa bi mu.
- Koma a ɛbɔ a ɛnyɛ ne kwan so a wɔte nka.
- Ɔbrɛ anaa mmerɛwyɛ a wɔte nka soronko.
Nkrasɛm a Wɔde Kɔ Fie
- Right-Sided Heart Failure yɛ tebea a ɛma koma no fã a ɛwɔ nifa no ntumi nkɔ nsu mu yiye, na ɛma nsu kɔ nipadua no mu na ɛho ahonhon, titiriw nan ne yafunu no.
- Nea ɛde tebea yi ba titiriw ne koma no benkum so mmerɛwyɛ mfiase no. Mogya mmoroso ne komayare afoforo betumi de eyi aba.
- Sɛ wowɔ sɛnkyerɛnne ahorow te sɛ wo nan a ɛho ahonhon, ɛyɛ den sɛ wobɛhome bere a worebɔ mmɔden kakra mpo, ne aduan ho akɔnnɔ a ɛyera a, hwehwɛ aduruyɛfo afotu.
- Ɛwom sɛ wontumi nsa eyi koraa de, nanso wobetumi adi so yiye na wɔde nnuru, asetra mu nsakrae, ne aduruyɛ mu hwɛ a ɛfata abɔ asetra a ɛfata.
- Ɛho hia paa sɛ wudi wo duruyɛfo akwankyerɛ ne nnuru a wode di dwuma no akyi pɛpɛɛpɛ. Nnyae w’aduru nonom da anaasɛ w’ankasa nnsesa dodow a wode di dwuma no.
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