Yu at wik? Lɛ wi lan bɔt Systolic Heart Failure.

Sɔntɛnde, yu kin fil se yu nɔ ebul fɔ blo fayn? Yu kin fil taya ivin afta yu dɔn du smɔl wok? Ɔ yu leg dɛn kin swel? Dɛn tin ya kin bi sayn dɛn we de sho se yu at wik smɔl. Tide, wi go tɔk bɔt dis at sik, ‘Systolic Heart Failure’. Pan ɔl we dis na siriɔs tin smɔl, na sik we pɔsin kin kɔntrol if dɛn no am kwik ɛn trit am fayn.

Wetin na Sistolic Hat Failure?

Fɔ tɔk am simpul wan, yu at gɛt 4 men rum dɛn. di lכw chεmba na di lεft we dεn kכl di lεft vεntrikl de pכmp bכdi we gεt כksijεn כlsay na di bכdi. I de wok lɛk wata pɔmp. naw, insay dis kכndishכn we dεn kכl sistolik at fεil, di lεft vεntrikl de wik. Dat min se i nɔ kin ebul fɔ pɔmp blɔd fayn ɛn fayn fayn wan.

Wetin kin apin da tɛm de? Imajin if di wata motoka nɔ strɔng, di wata nɔ go flɔ fayn. Semweso, we di at nɔ de pɔmp blɔd fayn, wata kin gɛda na di lɔng dɛn. Na da tɛm de tin dɛn lɛk fɔ at fɔ blo ɛn fɔ taya kin apin. Ɔda pat dɛn na di bɔdi, mɔ di leg dɛn, di anklɛ dɛn, ɛn di bɛlɛ kin swel bak . Dis na bikɔs di wata we de na di bɔdi nɔ de rɔn fayn fayn wan.

So wetin na dis Ejection Fraction?

Naw lɛ wi tɔk bɔt wetin na Ejection Fraction (EF) . Dɛn kɔl dis ‘Ejection Fraction’ insay Sinhala. Pan ɔl we dis na smɔl wɔd we dɛn kin yuz fɔ mɛn pipul dɛn, i izi fɔ ɔndastand. Fɔ tɔk am simpul wan, dis na di pasɛnt pan ɔmɔs blɔd yu lɛft ventricle de pɔmp insay di bɔdi we i bit wan tɛm.

at we hεlty, we de wok fayn fכ gεt EF valyu bitwin 55% εn 70% . dis min se mכr dan af pan di bכdi we de go insay di lεft vεntrikl na di at de pכmp kכmכt insay wan bit. כltu, if dis EF valyu fכl dכn 40% , i kin bi sayn fכ sistolik at fεil. dis min se di at in pawa fכ pכmp dכn dכn. Na dat mek sɔm tɛm dɛn kin kɔl dis sik ‘Hat Failure with Reduced Ejection Fraction’ (HFrEF) .

Udat kin gɛt dis sik?

Sistolic hat fail kin afɛkt ɛnibɔdi, bɔt di risk kin go ɔp wit di ej. I kin kam bak pan pipul dɛm wae gɛt ɔda kayn hat sik, lɛk wae dɛn bin dɔn gɛt at atak ɔr ay blɔd prɛshɔn.

Wetin kin mek di sistolik hat fεil (HFrEF)?

bכku tεm, di sistolik at fεil kin apin we di lεft vεntrikl na di at dεn dכn pwεl wit כda sik. Tink bɔt dis we: di at mɔsul tan lɛk rɔba band. I de strɛch ɛn kɔntrakt. Bɔt if i pwɛl, i nɔ go ebul fɔ du da wok de fayn.

Na sɔm pan di men rizin dɛn we kin afɛkt dis:

• Korona at sik: Dis na de sik wae kin kam wit dis sik. di at dεm we de gi bכdi to di at (coronary arteries) kin sכmtεm כ blok bay fεt dεposit dεm, we de mek di at mכsul nכ de gεt di כksijεn εn nyutriεnt dεm we i nid. Dis kin mek di mɔsul wik.
• Ay blɔd prɛshɔn (Hypertension): We blɔd prɛshɔn ay fɔ lɔng tɛm, di at kin gɛt fɔ wok tranga wan fɔ pɔmp blɔd. I tan lɛk se yu de pɔmp wata insay wan at we dɔn blok. As tɛm de go, dis kin mek di at mɔsul big ɛn leta i kin wik.
• Previous Myocardial Infarction: At atak na we dɛn kɔt di blɔd we de flɔ to wan pat pan di at, we kin mek di mɔsul sɛl dɛn day. Dɔn di say we dɔn day kin gɛt skata, we kin mek di at nɔ ebul fɔ pɔmp.
• Dayabitis: Dayabitis kin pwɛl di blɔd vesel dɛn bak ɛn afɛkt di at mɔsul dairekt wan.
• Abnɔmal At Ritm: We di at nɔ de bit ɔltɛm, di at nɔ kin ebul fɔ pɔmp blɔd fayn fayn wan.
• At Valv Disease: We di valv dεm na di at nכ de wok fayn, bכdi kin fכlכ bak כ fכ fכd, we kin put כda strεs pan di at.
• Mayokarditis: Na inflamɛns na di at mɔsul. Dis kin kam wit tin dɛm lɛk vayral infɛkshɔn.

dis damej kin mek di at mכsul skata, dilayshכn, כ di vεntrikl dεm stif. כl dis tin dεm de wik di lεft vεntrikl εn de ridyus EF. Di gud nyus na dat, bɔku tɛm, if dɛn trit di tin we de mek pɔsin gɛt di sik fayn fayn wan, di at kin wok fayn smɔl.

Wetin na di sayn dɛm fɔ dis sik?

Wɛl, aw yu go no if yu go gɛt dis prɔblɛm? Na sɔm sayn dɛm wae yu fɔ wach fɔ:

• Shortness of breath (Dyspnea): Yu kin gɛt prɔblɛm fɔ blo, mɔ we yu de du ɛksɛsayz, klaym stej, ɔ ivin ledɔm na bed. If yu nid fɔ slip wit tu ɔ tri pilo na nɛt, dat na sayn bak.
• Taya ɛn wik ɔltɛm: If yu fil taya bad bad wan ivin afta yu dɔn du wok dɛn we bin izi trade.
• Swel na di leg, ankles, ɛn fut: Dis swel kin apin bikɔs ɔf di wata we de kɔntinyu fɔ de. Sɔntɛnde, di bɛlɛ kin swel bak.
• Hat de bit kwik kwik wan ɔ nɔ de bit ɔltɛm: If yu fil se yu at de bit chenj.
• Kɔf ɔ swɛt we nɔ de dɔn: Na kɔf we kin kam wit wayt mכkus mɔ.
• I nɔ ebul fɔ du ɛksɛsayz.
• Nɔs ɔ nɔ want fɔ it.
• Chɛst pen: Dis kin bi bikɔs ɔf wan tin lɛk korona at sik.
• Diziz we pɔsin kin gɛt.

If yu gɛt wan ɔ mɔ pan dɛn sayn ya, duya nɔ ignore dɛn ɛn go to dɔktɔ. Di kwik we yu no dɛn, na di mɔ i izi fɔ trit.

Aw dɔktɔ dɛn kin no dis?

We yu go to dɔktɔ, i go du bɔku tɛst fɔ no if yu gɛt sistolic hat failure. De tin wae impɔtant pas ɔl na fɔ no wetin de mek yu gɛt dis sik so dat yu go ebul fɔ trit am fayn fayn wan.

Dis tɛst prɔses kin inklud:

1. Fɔ ɛgzam fɔ yu bɔdi:

• Di dɔktɔ go aks yu bɔt yu sik dɛn (aw lɔng dɛn dɔn de, aw dɛn de fil).
• Dɛn kin aks yu bɔt di sik dɛn we yu bin dɔn gɛt trade, lɛk if ɛnibɔdi na yu famili gɛt at sik.
• stεtoskop dεn de yuz fכ lisin to di at εn di lכng dεm (fכ chεk fכ abnכmal sawnd dεm εn wata na di lכng dεm).
• Dɛn kin mɛzhɔ yu blɔd prɛshɔn.
• Dɛn go wej yu (fɔ si if yu dɔn gɛt wet wantɛm wantɛm, bikɔs ɔf di wata we de kɔntinyu fɔ de).

2. Blɔd tɛst (Blɔd wok): .

• Dɛn blɔd tɛst ya kin chɛk if ɔda pat dɛn (lɛk di kidni ɛn di liva) dɔn afɛkt dis wikɛd tin we de na di at.
• tipikli, dεn de mכsu tin dεm lεk `Albumin` (wan kayn protin), `Creatinine` (we de mכsu fכ di kidni fכ wok), εn sכdiכm εn potashכm (ilεktrolayt dεm).
• Wan spɛshal blɔd tɛst de we dɛn kɔl BNP (B-type Natriuretic Peptide). we di at strεs, di lεvεl fכ dis BNP na di bכdi de inkrεs. Dis kin rili ɛp fɔ no if pɔsin gɛt at prɔblɛm.

3. Imej tɛst fɔ di at:

• Dɛn tɛst ya kin chɛk bɔku tin dɛn lɛk aw di at shep ɛn saiz, aw tik di wɔl dɛn na di sɛl dɛn, if di valv dɛn de wok fayn, ɛn if i dɔn pwɛl bikɔs ɔf at atak we i bin dɔn gɛt bifo.
• Chɛst X-ray: Fɔ si if di at dɔn big ɔ if wata dɔn gɛda na di lɔng dɛn.
• `Echocardiogram (Echo)`: Dis na di tɛst we impɔtant pas ɔl. I tan lɛk we dɛn de du ɔltra saund skan fɔ di at. I kin mɛzhɔ di EF valyu kɔrɛkt wan. i kin si klia wan aw di at in chεmba dεm εn di valv dεm de wok.
• Ilɛktrokardiogram (EKG/ECG): Na tɛst we de rayt di ilɛktrik wok we di at de du. I kin no tin dɛm lɛk di ritm ɛn spid we di at bit, ɛn sayn dɛm fɔ hat atak bifo.
• sכmtεm, dεn kin du כda spεshal tεst dεm lεk `Kadyak MRI`, `Kadyak CT skan`, `Kadyak Katetarizεshכn` (Angiogram), `Eksεsayz Strεs Tεst` כ `Nyuklia εksεsayz Strεs Tεst`, `Multigated Acquisition Scan` (MUGA)` bak.

Aw dɛn kin trit dis?

Okay, naw lɛ wi luk aw fɔ trit dis kɔndishɔn we de mek pɔsin gɛt sistolik at pwɛl. Bɔku men gol dɛn de fɔ tritmɛnt:

• Fɔ ridyus di sayn dɛm (lɛk fɔ blo shɔt, fɔ swel).
• Fɔ stɔp ɔ kɔntrol di at fɔ mek i nɔ wik mɔ.
• Fɔ mek di kwaliti fɔ layf bɛtɛ.
• Fɔ ɛp fɔ mek pɔsin liv lɔng.

Dɛn kin sheb di we aw dɛn kin trit am to sɔm men kategori dɛn:

1. Di chenj dɛn we pɔsin de liv in layf

Dɛn tin ya rili impɔtant. I nɔ go du fɔ jɔs tek mɛrɛsin, yu nid fɔ du dɛn tin ya na yu sayd bak.

• Limit salt intake: Salt (sodium) de mek di bodi kip di wata we pasmak. Dis kin mek di at swel ɛn put mɔ strɛs pan di at. Ridyus di sɔl we yu de it lɛk aw yu dɔktɔ tɛl yu. Jɛnɛral wan, i nɔ kin fayn fɔ it pas 1500-2000 miligram sɔdiɔm fɔ wan de.
• Fɔ stɔp fɔ drink wata: Dɛn kin tɛl sɔm pipul dɛn bak fɔ stɔp di wata we dɛn de drink fɔ wan de. Dis na sɔntin we yu fɔ tɔk to yu dɔktɔ ɛn disayd.
• Mek yu gɛt wɛlbɔdi: If yu fat pasmak, tray fɔ lɛf fɔ it bɔku bɔku it dɛn. I fayn fɔ mek yu wej yusɛf ɛvride. If yu gɛt wet wantɛm wantɛm (wan ɔ tu kilo insay wan de), i kin bi sayn fɔ se yu nɔ gɛt wata. If dis apin, tɛl yu dɔktɔ .
• Nɔ smok: Smok kin rili ambɔg di at ɛn di blɔd vesel dɛn.
• Limit ɔ stɔp fɔ drink: Rɔm kin mek di at mɔsul wik bak.
• Ɛksesaiz ɔltɛm: Tɔk to yu dɔktɔ bɔt us ɛksesaiz dɛn we fayn fɔ yu. Start smɔl ɛn smɔl smɔl yu fɔ du mɔ. Fɔ waka na fayn ɛksesaiz. I go fayn if yu ebul fɔ tek pat pan wan program fɔ mek yu at pwɛl.
• Ridyus strɛs, rɛst fayn, ɛn slip fayn.
• It fayn it: it vɛjitebul, frut, it dɛn we gɛt fayv, ɛn it dɛn we nɔ gɛt bɔku fat.

2. Mɛrɛsin (di kayn mɛrɛsin dɛn) .

Bɔrku fayn mɛrɛsin de fɔ trit sistolic hat failure. Dɛn mɛrɛsin ya kin mek yu EF, di sayn dɛm, ɛn ɔl di at wok fayn. Yu dɔktɔ kin gi yu wan ɔ mɔ pan dɛn mɛrɛsin ya togɛda.

• Beta-blok dεm: dεn ya de mek di at wok fayn bay we dεn de slo di at rεt, we de rεdכks di wok we di at gεt fכ du. Dɛn kin ɛp fɔ kɔntrol blɔd prɛshɔn, fɔ ridyus di risk fɔ gɛt at atak, ɛn fɔ kɔntrol di at bit we nɔ de bit ɔltɛm.
• Angiotensin-Converting Enzyme (ACE) inhibitors: Dɛn wan ya kin kɔntrol blɔd prɛshɔn, mek di blɔd vesel dɛn big, ɛn blok di strɛs ɔmon dɛn na di bɔdi, ɛn dis kin mek di at wok fayn as tɛm de go.
• Angiotensin-II Receptor Blockers (ARBs): Dɛn kin gi dɛn tin ya to pipul dɛn we gɛt sayd ɛfɛkt lɛk kɔf frɔm ACE inhibitor. Dɛn kin wok di sem we lɛk di wan dɛn we de stɔp di ACE.
• Angiotensin Receptor-Neprilysin Inhibitors (ARNIs): Dis na wan klas we rili nyu, we rili wok fayn. Dɛn tin ya kin mek bak di ɔmon dɛn we de mek pɔsin strɛs, i kin mek di blɔd vesel dɛn opin, ɛn i kin mek di at wok fayn.
• Aldosterone Antagonists (Mineralocorticoid Receptor Antagonists - MRAs): Dɛn wan ya de ridyus di strɛs ɔmon dɛm ɛn ɛp di kidni dɛm fɔ pul di wata ɛn sɔl we pasmak na di bɔdi. Yu nid fɔ tek tɛm wit di potashɔm lɛvɛl we yu de tek dɛn mɛrɛsin ya.
• Diuretics (wata pills): Dɛn tin ya kin pul di sik kwik kwik wan (especially swell and shortness of breath) bay we dɛn kin pul di wata ɛn sɔl we pasmak na di kidni. We di wata we de kɔmɔt na di at nɔ bɔku, i kin izi fɔ mek di at pɔmp blɔd.
• SGLT-2 inhibitors: Dɛn tin ya na fɔs wan kayn mɛrɛsin fɔ dayabitis. Bɔt leta dɛn kam fɔ no se dɛn rili fayn bak fɔ di wan dɛn we gɛt at pwɛl we nɔ gɛt dayabitis. Dɛn kin pul di wata we pasmak wit di shuga we de na di urine.

Di tin we impɔtant pas ɔl na fɔ tek di mɛrɛsin we yu dɔktɔ gi yu di rayt we, di tɛm ɛn di doz we dɛn gi yu. Nɔ ɛva stɔp fɔ tek di mɛrɛsin ɔ chenj di doz fɔ yusɛf.

3. Ikwipmɛnt ɛn ɔpreshɔn

Sɔm sik pipul dɛn nɔ kin ebul fɔ kɔntrol dɛn sik wit mɛrɛsin ɛn chenj dɛn layf nɔmɔ. Dɛn kin nid tin dɛn lɛk:

• ICD (Implantable Cardioverter-Defibrillator): Na smɔl tin we de no if di at de bit we nɔ de bit (arrhythmia) we denja ɛn i de gi smɔl ilɛktrik shɔk to di at fɔ mek i gɛt di nɔmal ritm bak. Dɛn kin put dis ɔnda di skin na di chɛst.
• CRT (Cardiac Resynchronization Therapy) / Biventricular Pacemaker: Dis divays de ɛp fɔ kɔrɛkt di imbalans bitwin di lɛft ɛn rayt chɛmba dɛn na di at. Dis kin mek bak di at ebul fɔ pɔmp.
• Koronari At Baypas Graftin (CABG) ɔ Angioplasty wit stent: Trit korona at dɛn if dɛn blok.
• Hat valv ripa ɔ riplesmɛnt ɔpreshɔn.
• Hat transplant ɔ LVAD (Left Ventricular Assist Device): Na dɛn tritmɛnt ya dɛn kin tink bɔt fɔ di wan dɛn we sik bad bad wan.

Aw dɛn go ridyus di risk fɔ dis sik?

Dɛn se: “Prɛvenshɔn bɛtɛ pas fɔ mɛn am.” So, tin dɛn de we yu kin du fɔ mek yu nɔ gɛt ɔ ridyus di risk fɔ gɛt sistolic hat failure. Gud wɛlbɔdi abit na di men tin.

• It it we balans fayn, we gɛt fayn fayn tin dɛn fɔ it (lɛs sɔl, smɔl ɔyl, mɔ vɛjitebul ɛn frut).
• Ɛksesaiz ɔltɛm.
• Mek yu gɛt wɛlbɔdi wet.
• Nɔ smok kpatakpata.
• Limit fɔ drink rɔm.
• If yu gɛt ɛni mɛrɛsin lɛk ay blɔd prɛshɔn, dayabitis, ɔ kɔlɔstrel, kɔntrol am fayn fayn wan. Fɔ fala yu dɔktɔ in instrɔkshɔn dɛn gud gud wan.
• Ridyus strɛs ɛn slip fayn.

Wetin yu kin op fɔ we yu de liv wit dis sityueshɔn?

Systolic hat fεil na wan krεse sik wae de kכlכs, lכng tεm, siriכs kכndyushכn. Sɔntɛm i nɔ go ebul fɔ mɛn am ɔl. Bɔt if dɛn gɛt di rayt tritmɛnt ɛn chenj dɛn layf, dɛn kin ebul fɔ kɔntrol di sik dɛn ɛn liv gud layf.

Di tin we kin apin kin dipen pan bɔku tin dɛn:

• Aw di at sik kin tranga.
• Yu ɔl wɛl bɔdi ɛn if yu gɛt ɛni ɔda sik (lɛk kidni sik, dayabitis).
• Aw yu kin biev we yu gɛt tritmɛnt.
• Wetin na di men rizin fɔ dis?

So, i rili impɔtant fɔ mek yu nɔ fred ɔ fil bad, bɔt yu fɔ fala di dɔktɔ in instrɔkshɔn dɛn gud gud wan ɛn ajɔst di we aw yu de liv yu layf. Wok togɛda wit yu mɛdikal tim.

Ustɛm yu fɔ go to dɔktɔ wantɛm wantɛm?

If yu gɛt ɛni wan pan dɛn sik ya, yu fɔ go to dɔktɔ wantɛm wantɛm, we min se kwik kwik wan :

• Chest pen we kin kam wantɛm wantɛm ɛn we kin rili bad.
• I nɔ kin izi fɔ yu fɔ blo wantɛm wantɛm ɛn bad bad wan.
• Faint ɔ wik pasmak.
• Chɛst pen, diziz, ɔ we yu nɔ de blo fayn wit at bit fast ɔ we nɔ de bit ɔltɛm.
• Di leg dɛn we de swel wantɛm wantɛm ɔ we yu gɛt bɔku bɔku wet.

Us kwɛstyɔn dɛn yu kin aks di dɔktɔ?

We yu go to yu dɔktɔ, yu kin aks kwɛstyɔn dɛn lɛk dis fɔ ɔndastand yu sik fayn fayn wan:

• Wetin na di rayt tin we kin mek mi sistolik at nɔ de wok fayn?
• Wetin na mi ejekshɔn frakshɔn (EF) valyu? Wetin i min?
• Dis sik dɔn afɛkt mi ɔda ɔgan dɛn (lɛk kidni, liva)?
• Us tritmɛnt dɛn we rayt fɔ mi? Wetin na di gud ɛn bad tin dɛn we de apin?
• Wetin na di impɔtant chenj dɛn we a nid fɔ mek na mi layf?
• Us kayn it ɛn drink a fɔ it ɛn wetin a fɔ avɔyd?
• Us ɛgzampul dɛn a kin du? Aw lɔng a fɔ du dɛn?
• Wetin a nɔ fɔ du?
• Wetin na di sayd ɛfɛkt dɛm we dis mɛrɛsin kin gɛt? Wetin a fɔ du if dɛn apin?
• Aw ɔltɛm a fɔ kam fɔ chɛk-ap? Ustɛm dɛn go chɛk mi EF skɔ bak?
• Wetin a fɔ du we ɛnitin apin we nɔ izi fɔ mi?

Di tin dɛn we impɔtant pas ɔl we wi nid fɔ mɛmba

di sistolik at fεil na wan siriכs, lכng tεm kכndyushכn we di lεft vεntrikl na di at nכ kin ebul fכ pכmp bכdi fayn fayn wan. If yu gɛt ɛni wan pan dɛn sayn ya, duya go to dɔktɔ. Di kwik we dɛn no am, na di mɔ i izi fɔ trit ɛn na di mɔ i go fayn.

If yu trit di rizin we mek yu gɛt dis sik, tek di mɛrɛsin we yu dɔktɔ gi yu, ɛn gɛt gud abit fɔ liv yu layf, yu go ɛp fɔ kɔntrol di sik dɛn we yu gɛt ɛn liv wɛlbɔdi, aktif, ɛn fɔ lɔng tɛm. Nɔ fred, kɔntinyu fɔ strɔng! Nɔto yu wan de, yu dɔktɔ dɛn, yu fambul dɛn, ɛn yu padi dɛn ɔl de fɔ ɛp yu.

` At atak, sistolik hat fεil, ejekshכn frakshכn, at wik, sכt brith, leg swεla, at simptom dεm