Omwana wo omuto alina ekizibu ky’omutima eky’ekika kino? Ka tuyige ku Endocardial Cushion Defect!

Omwana wo bw’azaalibwa, weeraliikirira nnyo buli kimu ekimukwatako, si bwe kiri? Oluusi abaana abato bayinza okuba n’obulema ku mutima obuzaalibwa. Emu ku mbeera z’omutima ng’ezo, wadde nga nzibu katono, era nga kikulu nnyo okukimanya eyitibwa Endocardial Cushion Defect (ECD) . Erinnya lino liyinza okuwulikika ng’eritiisa katono naye teweeraliikiriranga. Ka twogere ku kino mu ngeri ennyangu, mu ngeri gy’osobola okutegeera, okay?

Kino Endocardial Cushion Defect kye ki?

Mu ngeri ennyangu, kino kizibu mu mitima gy’abaana baffe abato, nga kino kizaalibwa , kwe kugamba, ekikyamu ekibaawo nga bakyali mu lubuto lwa maama. Lowooza ku mutima gwaffe ng’ennyumba erimu ebisenge bina. Ku mwaliiro ogw’okungulu kuliko ebisenge bibiri (bye tuyita atria), n’ebisenge bibiri ku mwaliiro ogwa wansi (nga bino bye bitundu by’omubiri ebiyitibwa ventricles). Ebisenge bino byawuddwamu ebisenge (septums). Olw’ebisenge bino, omusaayi gukulukuta mu ngeri entegeke, mu ludda lumu lwokka.

Ate era wakati w’ebisenge bino waliwo obuuma obulinga ekikomera obuyamba omusaayi okutambula mu ludda lumu lwokka. Okusingira ddala, vvaalu ya tricuspid ne vvaalu ya mitral, ezisangibwa wakati w’ebisenge ebya waggulu (atria) n’ebisenge ebya wansi (mitral chambers), birina okutondebwa obulungi.

Wabula mu mwana alina ekikyamu kino eky’omutima (ECD), ebitundu by’omutima ebiyitibwa endocardial cushions – ebitundu ebikulu ebikola ebisenge bino ne vvaalu – tebikula bulungi. N’ekyavaamu, ebisenge ebyawula ebisenge by’omutima biyinza obutakula bulungi, oba biyinza obutabaawo ddala. Valiva ebbiri enkulu ze twayogeddeko (tricuspid ne mitral) nazo ziyinza obutakula bulungi.

Kati teebereza, kiki ekibaawo ng’enjawukana zino mu mutima, ebisenge bino, tebikola bulungi, ate nga ne vvaalu, okufaananako emiryango, tezikola bulungi? Ensengeka omusaayi gye gukulukuta munda mu mutima etaataaganyizibwa.

• Omusaayi ogusinga ku gwa bulijjo gukulukuta mu mawuggwe g’omwana , ekivaako puleesa mu misuwa egiri munda mu mawuggwe (pulmonary high blood pressure).
• Olw’okuba puleesa eno eri mu mawuggwe, omusaayi gutandika okukulukuta mu kkubo erikyamu. Olwo , omusaayi omungi, omuyonjo ogulimu omukka gwa oxygen n’omusaayi omucaafu ogutaliimu oxygen gutandika okutabula wamu .
• Omutima gulina okukola ennyo okukuba omusaayi n’okutambula kw’omusaayi kuno okutaataaganyizibwa. Kiba ng’okulinnya olusozi. Ekiseera bwe kigenda kiyitawo, kino kiyinza okunafuya ebinywa by’omutima gw’omwana.

Waliwo ebika eby’enjawulo eby’obulema mu mutto gw’omutima (ECD)?

Yee, waliwo ebika by’embeera eno ebiwerako, okusinziira ku bunene bw’okwonooneka. Abalongo abamu bayinza okufuna obuzibu ku bbugwe yekka wakati w’ebisenge ebya waggulu eby’omutima (atria). Abalala bayinza okuba n’obuzibu ku bbugwe wakati w’ebisenge ebya wansi (ventricles). Oluusi ebizibu byombi biyinza okubaawo awamu. Ate era, obulema mu vvaalu za mitral ne tricuspid busobola okwawukana.

Embeera eno eyitibwa endocardial cushion defect (ECD), era emanyiddwa nga atrioventricular septal defect (AVSD) oba atrioventricular canal defect .

Embeera eno oluusi eyinza okukwatagana n’obulema obulala obw’omutima obuzaalibwa nabwo. Okugeza nga:

• Tetralogy ya Fallot
• Double outlet ventricle ya ddyo
• Okukyusa emisuwa eminene (okukyusa emisuwa emikulu ebiri mu bifo ebikyamu) .
• Patent ductus omusuwa gw’omusaayi
• Omusuwa gumu (omusuwa gumu) .

Embeera eno ya bulijjo etya?

Bw’otunuulira ebibalo ebiri mu nsi nga Amerika, abaana nga omu ku buli 1,800 abazaalibwa buli mwaka ayinza okuba n’ekizibu kino eky’omutima (ECD). Ekirala ekikulu kiri nti abantu nga 20% abalina obulwadde bwa Down syndrome balina embeera eno eya ECD.

ECD ekosa etya omubiri gw’omwana wange?

Singa embeera eno eya ECD teddukanyizibwa bulungi, eyinza okweyongera okubeera ey’amaanyi n’okuleeta obuzibu obw’amaanyi.

• Okwonooneka kw’amawuggwe: Nga bwe twayogeddeko emabegako, omusaayi oguyitiridde okutambula mu mawuggwe, puleesa okweyongera, era ekiseera bwe kigenda kiyitawo, kiyinza okwonooneka amawuggwe ag’olubeerera.
• Omutima ogutali gwa bulijjo: Amasannyalaze g’omutima gataataaganyizibwa, era omutima guyinza obutakuba bulungi.
• Okulemererwa kw’omutima okuzimba: Embeera omutima gye gunafuwa ne gutasobola kussa musaayi gumala mu mubiri.
• Obulwadde bwa Eisenmenger: Eno mbeera ya maanyi nnyo. Puleesa mu mawuggwe yeeyongera nnyo, ekivaako okutambula kw’omusaayi okudda emabega ddala, ekivaako omusaayi ogutaliimu mukka gwa oxygen okutambula mu mubiri gwonna.

Mu mbeera ezimu ez’amaanyi, embeera eno eyinza n’okuteeka obulamu mu matigga .

Ate era, ne bwe kiba nti ekikyamu ekyo kitereezeddwa ng’alongooseddwa, omwana wo ayinza okuba mu bulabe bw’okukwatibwa obulwadde bw’omutima obuyitibwa endocarditis . N’olwekyo, abasawo bayinza okukuwa amagezi okumira eddagala eritta obuwuka nga tonnalongoosa mannyo agamu.

Bubonero ki obulaga embeera eno?

Oluusi, abalongo abalina obuzibu mu kitundu ky’omutto gw’omutima bayinza obutalaga bubonero bwonna okutuusa nga bakyali bato nnyo. Wabula abalongo abalina obuzibu obujjuvu mu mutto gw’omutima (complete ECD) bayinza okufuna obubonero mu wiiki ntono nga bamaze okuzaalibwa. Kikulu okukuuma eriiso ku bubonero buno:

• Omutima okukuba amangu
• Olususu oluddugavu oba olwa bbululu:Noonya langi ya bbululu naddala ey’emimwa, olulimi n’engalo. Kino kiyitibwa cyanosis.
• Obuzibu mu kulya n’okugejja: Laba oba omwana wo alina akajagalalo, atuuyana oluvannyuma lw’okunywa amata oba nga tagejja bulungi.
• Obutaba na maanyi: Omwana wo bulijjo yeebase era nga tayagala kuzannya?
• Okussa amangu oba okukaluba: Kebera olabe oba ekifuba ky’omwana awulira nga kinywezeddwa, assa mangu oba ekifuba kigenda munda ng’assa.
• Obulwadde obutera okukwatibwa: Weegendereze yinfekisoni ezitera okukwatibwa naddala obulwadde bw’okussa.

Kiki ekivaako obuzibu buno mu mutto gw’omutima?

Ekituufu ekivaako obuzibu bw’omutto gw’omutima (ECD) tekinnamanyika. Kyokka, kizuuliddwa nti kikwatagana nnyo n’obulwadde bwa Down syndrome . Obulema buno bubaawo nga bukyali ku nkula y’omwana mu lubuto. Ekizibu ekikulu kiri nti ekitundu ekiyitibwa endocardial cushion kye twayogeddeko emabegako tekikula bulungi. Bino bye bisenge ne vvaalu oluvannyuma ebyawula ebisenge by’omutima.

Abasawo bazuula batya embeera eno?

Omusawo w'omwana wo ajja kusooka okukebera omwana wo omubiri gwonna . Olwo, singa eddoboozi eritali lya bulijjo (okwemulugunya kw’omutima) liwulirwa ng’owuliriza omutima n’ekyuma ekiwuliriza, kiyinza okuba ekiraga embeera eno.

Okugatta ku ekyo, ebigezo ebirala ebiwerako bisobola okukolebwa:

• Electrocardiogram (EKG/ECG): Kino kikebera amasannyalaze g’omutima.
• Echocardiogram: Kino kye kigezo ekisinga obukulu. Ekozesa amaloboozi okukuba ekifaananyi ky’omutima. Kisobola okulaba bulungi buli kimu okuva ku nkula y’omutima, okutuuka ku bituli mu bisenge byagwo n’engeri vvaalu gye zikolamu.
• X-ray y’ekifuba: Kino kisobola okukebera obunene bw’omutima n’embeera y’amawuggwe.
• Heart MRI: Oluusi okukebera kuno kukolebwa singa kiba kyetaagisa okumanya ebisingawo.
• Okusiba omutima: Mu nkola eno, akatundu akatono (catheter) kayisibwa mu musuwa ne kayingira mu mutima okupima puleesa eri munda mu mutima n’okutwala omusaayi. Kino kiyinza okwetaagisa nga tonnalongoosebwa.

Ekisinga obukulu kwe kusigala ng’olaba omusawo ng’oli lubuto n’okukeberebwa ‘Ultrasound scans’.Okukifuna obulungi. Oluusi, ECD esobola okuzuulibwa nga omwana tannazaalibwa, okuyita mu sikaani ekolebwa ng’omwana akyali mu lubuto (fetal echocardiogram). Kino bwe kimanyibwa nga bukyali, kisoboka okuteekateeka obujjanjabi obwetaagisa okutandika amangu ddala ng’omwana amaze okuzaalibwa.

Kino kikwatibwa kitya?

Obujjanjabi obukulu era obusinga obulungi ku buzibu buno obw’omu mutima (ECD) kwe kulongoosa. Wabula okutuusa nga bamaze okulongoosebwa, eddagala erimu liyinza okuweebwa omwana omwana okweyongera amaanyi n’okugejja. Okugeza, eddagala erifulumya amazzi (era eriyitibwa ‘empeke z’amazzi’) erikendeeza ku mazzi agasukkiridde mu mubiri ne digoxin (Cardoxin® oba Lanoxin®) ayamba okulongoosa enkola y’omutima okutuuka ku ddaala eritali limu.

Kiki ekibaawo oluvannyuma lw’okulongoosebwa?

Mu kulongoosa, abasawo abalongoosa omutima baggalawo ebituli ebivaako omusaayi okukulukuta wakati w’ebisenge by’omutima. Kino bakozesa ‘patch’ ey’enjawulo. Ate era singa omwana aba n’ekisumuluzo emu yokka, bajja kugikolamu vvaalu bbiri ez’enjawulo eza mitral ne tricuspid. Oluusi, singa mitral valve y’omwana ekulukuta, nayo esobola okuddaabirizibwa oba okukyusibwa bwe kiba kyetaagisa.

Okulongoosa kuno kutera okukolebwa ku mwana ali wakati w'emyezi 3 ne 6 . Kyokka, omwana wo bw’aba alina obuzibu bwonna mu mutto gw’omutima, kikulu okulongoosebwa ng’omwana tannaweza mwaka gumu . Eno y’engeri yokka ey’okuziyiza amawuggwe okwonooneka enkalakkalira.

Oluusi omwana ayinza okuba ng’alwadde nnyo oba ng’azitowa nnyo n’atasobola kulongoosebwa mu bujjuvu. Mu mbeera eyo, abasawo bajja kusooka kulongoosa mu ngeri endala ennyangu okusobola okukendeeza ku musaayi ogugenda mu mawuggwe g’omwana. Kino kiyitibwa okusiba emisuwa gy'amawuggwe . Kino kiyinza okuyamba okufuga obubonero okutuusa omwana lw’afuna amaanyi n’okugejja. Oluvannyuma, mu kiseera ekituufu, okuddaabiriza mu bujjuvu kuyinza okukolebwa.

Waliwo ebizibu byonna ebiva mu bujjanjabi?

Nga bwe kiri ku kulongoosa kwonna, waliwo ebizibu ebimu ebiyinza okubaawo oluvannyuma lw’okulongoosebwa ECD. Kyokka ebiseera ebisinga, bino bisobola okuddukanyizibwa.

• Valiva ya mitral ekulukuta: Oluusi oluvannyuma lw’okulongoosebwa, mitral valve eyinza obutaggalawo bulungi ate omusaayi ogumu guyinza okukulukuta okudda emabega.
• Omutima gutambula bulungi: Ebimu ku bitali bituufu mu kukuba kw’omutima biyinza okubaawo.

Ebizibu bino oluusi bisobola okubaawo ng’omwana akuze katono, ne mu buvubuka bwe. Eno y’ensonga lwaki okwekebejjebwa abasawo buli kiseera kikulu.

Embeera eno esobola okuziyizibwa?

Okuva bwe kiri nti ekituufu ekivaako ECD tekimanyiddwa, kizibu okwogera engeri y’okukiziyiza ddala. Wabula singa omuntu mu maka go abadde n’obulwadde bw’omutima obw’ekika kino (ECD) oba ensonga endala ez’obuzaale, kiyinza okuba ekirungi okubudaabudibwa ku buzaale nga tonnafuna lubuto.

Singa omwana wange alina ECD, kiki kye nsuubira?

Kino kye kibuuzo ekinene abazadde bangi kye balina. Amawulire amalungi gali nti oluvannyuma lw’okulongoosebwa okutereeza ECD, abalongo abasinga bagenda mu maaso ne babeera mu bulamu obwa bulijjo, obulungi. Wabula obulamu bw’omwana mu biseera eby’omu maaso businziira ku bintu ng’obuzibu bwa ECD ye, oba amawuggwe ge gaayonoonese, n’obulamu bwe okutwalira awamu.

Okusinziira ku bibalo, emikisa gy’okuwangaala mu mwaka ogusooka oluvannyuma lw’okulongoosebwa giri nga 80%. Emikisa gy’okuwangaala emyaka emirala 10 giri nga 75%, ate emikisa gy’okuwangaala okumala emyaka 20 giri nga 65%.

Ne bwe baba bamaze okulongoosebwa, abaana abamu bayinza okufuna ebizibu oluvannyuma. Ekizibu ekitera okubaawo kwe kuba nti mitral valve teggalawo bulungi omusaayi ne gukulukuta. Kino bwe kibaawo, bayinza okulongoosebwa okulala okukitereeza .

Embeera ya ECD ewangaala bbanga ki?

Kino kikulu nnyo. Endocardial cushion defect (ECD) si mbeera ejja kuwona ku bwayo. Obuzibu bujja kusigala okutuusa ng’omusawo alongoosa omutima alongoosezza okutereeza ekikyamu ekyo. Awatali kulongoosebwa, abalongo bangi tebajja kuwangaala okusukka emyaka 2 oba 3. Eno y’ensonga lwaki kyetaagisa okulongoosebwa mu budde.

Nlabirira ntya omwana wange?

Oluvannyuma lw’okuzuulibwa nti omwana wo alina ECD, era ne bwe yamala okulongoosebwa, omwana wo ajja kwetaaga okwekebejjebwa buli kiseera n’omusawo w’omutima . Okulonda kuno okw’okugoberera kuyinza okuba omulundi gumu oba ebiri mu mwaka. Okukeberebwa kuno kujja kugenda mu maaso mu buto bw’omwana wo n’okutuusa mu bukulu. Kino kisobozesa omusawo okulondoola embeera y’omwana wo, okulaba oba waliwo obuzibu bwonna ku patch oba valve, gamba ng’okukulukuta, n’okuyingira mu nsonga nga bukyali bwe kiba kyetaagisa.

Omwana wange mmutwale ddi ew’omusawo?

Omwana bw’aba alaga obubonero bwonna ku buno wammanga, laba omusawo mu bwangu:

• Okufuna obuzibu mu kussa
• Okukoowa nga tofubye nnyo oluvannyuma lw’okudduka n’okuzannya okumala akaseera
• Obutakula oba okugejja nga bwe kisuubirwa
• Okubeera n’olususu lwa bbululu

Bibuuzo ki bye nnina okubuuza omusawo wange?

Kikulu nnyo okugogola okubuusabuusa kwonna kw’oyinza okuba nakwo. Totya kubuuza musawo wo bibuuzo nga:

• "Doctor, omwana wange alina ekikyamu ekijjuvu oba ekitundu ku mutto gw'omutima?"
• "Enteekateeka ki ey'obujjanjabi omusawo gy'agamba ku mbeera y'omwana wange?"
• "Omusawo, okulongoosa kwa ECD kumeka kw'okoze bwe kuti?"
• "Bintu ki eby'enjawulo bye nneetaaga okulabirira oluvannyuma lw'okulongoosebwa?"

Ebintu ebikulu by'olina okujjukira (Take-Home Message)

Oyinza okuba nga tolootangako kulongoosebwa mwana wo omuto. Wabula okulongoosa y’engeri esinga obulungi era esinga okukola obulungi ey’okutereeza obuzibu mu mutto gw’omutima (ECD). Ekizibu kino tekijja kutereera ku bwakyo. N’olwekyo, bwe wabaawo ky’ototegedde, saba omusawo akunnyonnyola.

Ekisinga obukulu kwe kuba nti toli wekka. Abasawo, ba nurse, ne ttiimu yonna ey’ebyobulamu baliwo okukuyamba n’okukunyweza mu lugendo luno. Ne bw’omala okulongoosebwa, tosubwa malwaliro g’omwana wo era ogoberere ebiragiro by’omusawo nga bw’amulagidde. Mu ngeri eyo, ggwe n’omwana wo omuto mujja kusobola okuzuula ebizibu byonna ebiyinza okubaawo mu biseera eby’omu maaso ne mubigumira bulungi. Sigala nga oli mugumu!

` Endocardial Cushion Defect, AVSD, obulwadde bw’omutima, obulema mu kuzaalibwa, obulwadde bw’omutima mu baana, okulongoosa omutima, Down syndrome, obulwadde bw’omutima obuzaalibwa, obulwadde bw’omutima mu baana