Ebinywa by'omutima gwo "bisula" oba "bisibidde"? (Hibernating Myocardium ne Stunned Myocardium) Ka tuyige ku nsonga eno!

Wali owuliddeko ebitundu by'omutima nga bigenda "okwebaka"? Oba "okusibira" mu bwangu? Wadde nga bino biyinza okuwulikika ng’ebigambo ebyewuunyisa, mu butuufu bino embeera bbiri ez’obujjanjabi ezikosa emitima gyaffe. Tofaayo, tujja kubyogerako mu ngeri ennyangu era ennyangu okutegeera. Tujja kutunuulira kiki kye biri, lwaki bibaawo, engeri y’okubitegeera, n’okumanya oba bisobola okuwona.

Ebinywa by'omutima "hibernating" kye ki? (Omusuwa gw’omutima ogusula mu kiseera eky’obutiti) .

Mu ngeri ennyangu, ekitundu ky’ekinywa ky’omutima gwo (tukiyita `(Myocardium)`) bwe kiggyibwako omusaayi, kikendeeza mpolampola emirimu gyakyo era okukkakkana nga kiyimiridde. Kiringa okugenda okwebaka kubanga kikooye. Kino kye tuyita `(Hibernating Myocardium)` oba "ekinywa ky'omutima ekisula." Kino kiyinza okubaawo okumala emyezi, mpozzi n’emyaka.

Teebereza ebimera ebimu mu lusuku lwo bwe biggwaamu amazzi, byekulukuunya ne birabika ng’ebikala, nedda? Bwe kityo bwe kiri ku kino. Ekinywa ky’omutima okusinga kyetaaga asidi z’amasavu okukola (i.e. okukwatagana). Naye bwe waba tewabaawo musaayi gumala, ekinywa kino kitandika okukozesa glucose (i.e. ekika kya sukaali) okukuuma obutoffaali bwakyo nga bulamu. Wabula terina maanyi gamala kusindika musaayi ku mutima mu kiseera kino. Kale, ekinywa kino "ekyebaka" tekiyamba nkola ya mutima ey'okupampagira.

Ekinywa ky'omutima bwe "kyesittala" oba "kigenda mu kkoma" kitegeeza ki? (Ekitundu ky’omutima ekiwuniikiridde)

Embeera eno ya njawulo katono ku mbeera y’okusula eyayogeddwako emabegako. Kiyinza okubaawo amangu ddala, mu ddakiika ntono oba essaawa ntono. Singa omusaayi ogugenda mu kinywa ky'omutima gukendeera mu bwangu oba ne guyimirira, ekinywa ekyo kilekera awo okukola, nga kiringa "ekikwatiddwa" oba "ekisannyalala." Kino kiyitibwa `(Stunned Myocardium)`.

Ekyewuunyisa kiri nti, oluusi ne bwe baba abasawo bajjanjaba okuzibikira (okugeza, nga bayingiza stent, okugaziya omusuwa oguzibiddwa ne bbaatule, oba okusaanuusa omusaayi oguzimba) omusaayi okuddamu okukulukuta, ebitundu bino eby'ebinywa "ebikwatiddwa" tebidda mangu mu mbeera eya bulijjo. Kiyinza okutwala ennaku, oba wadde wiiki, ebinywa ebyo okuddamu okutandika okukonziba obulungi.

Embeera zino zaawukana zitya ku bulwadde bw’omutima?

Kino kibuuzo kikulu nnyo. Obulwadde bw’omutima bwe businga okutawaanya emisuwa gy’omutima. Kino kibaawo ng’omusuwa gumu oba okusingawo ogugaba omusaayi mu mutima guzibikira ddala ekintu eky’amasavu ekiyitibwa ‘plaque’ ekivaako obutoffaali bw’ebinywa by’omutima okufa. Obutoffaali bw’ebinywa by’omutima obufu bukyusibwamu ebitundu by’enkovu. Ekitundu kino eky’enkovu tekisobola kuyamba mutima kukuba bulungi. Kino kiyinza okuvaako omutima okulemererwa.

Wabula embeera zombi ``Hibernating Myocardium'' ne ``Stunned Myocardium'' za kaseera buseera. Ekibeerawo wano, ekinywa ky’omutima tekikola bulungi, naye obutoffaali bwagwo bukyali bulamu.Singa omusaayi ne oxygen biddamu, ebitundu bino eby'ebinywa "ebisula" oba "ebikwatiddwa" bisobola okuddamu okukola. Ekyo kye kintu ekisinga obukulu!

Biki ebivaako `Hibernating Myocardium`?

Embeera eno esinga kulabibwa mu bantu abalina obulwadde obw’amaanyi obw’emisuwa. Mu bulwadde buno, amasavu (kino tukiyita ``plaque'') gazimba munda mu misuwa egitwala omusaayi okutuuka ku mutima, ne gizibikira. Omusuwa bwe gufunda ennyo, ebinywa by’omutima tebifuna mukka gwa mukka gwa oxygen n’ebiriisa bimala okusigala nga mulamu n’okuyamba omutima okukuba omusaayi. Kale, ekinywa "kyebaka" okukuuma amaanyi okukuuma emirimu gyakyo emikulu egy'obutoffaali.

Biki ebivaako `Stunned Myocardium`?

Okuwunyiriza kw'emisuwa gy'omutima, era okumanyiddwa nga "okusibira" kw'ebinywa by'omutima, nakyo kisobola okubaawo mu kiseera ky'okujjanjaba obulwadde bw'emisuwa gy'omutima. Wadde ng’obujjanjabi buzzaawo omusaayi, ebitundu ebimu eby’ebinywa by’omutima tebitereera mangu. Okugatta ku ekyo, embeera eno eyinza okubaawo olw’ensonga endala eziwerako:

• Okukonziba (amasannyalaze agatali ga bulijjo mu bwongo).
• Stress Cardiomyopathy mbeera ekosa omutima olw’okunyigirizibwa.
• Embeera eringa eya stroke.
• Okuvaamu omusaayi mu bwongo (Subarachnoid Hemorrhage).

Bubonero ki obulaga embeera zino zombi?

Olw’okuba mu mbeera zombi, ekitundu oba ekisinga obungi ku binywa by’omutima bye bikosebwa, obubonero buno butera okufaananako n’obwo obulabibwa mu kulemererwa kw’omutima. Mulimu:

• Okukaluubirirwa okussa
• Obulumi mu kifuba
• Okuzimba amagulu

Bw’oba ​​olina obubonero buno, kirungi n’ogenda ew’omusawo n’ogenda okwekebejjebwa.

Oyinza otya okuzuula obulwadde bwa `Hibernating Myocardium`?

Okusobola okuzuula obulungi embeera eno, kyetaagisa okukeberebwa okuwerako okutali kwa maanyi. Ebigezo bino bisobola okuyamba okwawula wakati w'ebitundu by'ekinywa ky'omutima "ebisula" oba "ebikwatiddwa" naye nga bisobola okuzuukizibwa , n'ebitundu ebifudde n'enkovu era ebitasobola kuzuukizibwa .

Ebimu ku bigezo ebikulu abasawo bye bakozesa mu nsonga eno bye bino:

• `Dobutamine Stress Echocardiogram`: Kino kizingiramu okukuwa eddagala (eriyitibwa `(Dobutamine)`) okusitula omutima gwo nga gulinga gwe gukola dduyiro. Olwo omusawo w’omutima ajja kutunuulira engeri omutima gwo gye gukola nga guwummudde n’engeri gye gukola nga ddoozi y’eddagala eyongezeddwa. Singa obusobozi bw’ekinywa ky’omutima okukola bweyongera ng’eddagala liweereddwa, kitegeeza nti olina embeera eyitibwa `(Stunned Myocardium)` oba `(Hibernating Myocardium)`. Singa ekinywa tekikonziba ne bwe kiba nti ddoozi y’eddagala eyongezeddwa, kitegeeza nti ekinywa kifudde era kiriko enkovu.
• MRI y’omutima:Kino kikozesa magineeti ey’amaanyi n’amayengo ga leediyo okukola ebifaananyi ebitegeerekeka obulungi ennyo, ebikwata ku binywa by’omutima gwo. Nga batunuulira endabika n'obugumu bw'ekinywa ky'omutima mu bifaananyi bino, abasawo basobola okumanya ddala ebitundu ki ebirina enkovu (ebifudde), ebya bulijjo, n'ebyo "ebisula" oba "ebikwatiddwa."
• Cardiac Positron Emission Tomography (PET) scan: Kino kikozesa ekintu ekitali kya bulabe eky’ebintu ebikola amasannyalaze ne kkamera ey’enjawulo. Kiraga ebitundu by’ebinywa by’omutima gwo ebikola mu ngeri eya bulijjo n’ebitundu ki ebirina enkovu oba ebitundu ebifu.

Wadde ng’okukebera kuno kuyinza okulabika ng’okuzibu katono, kikulu nnyo okutegeera embeera yo entuufu n’okulonda obujjanjabi obusinga okukukwatako.

`Hibernating Myocardium` (ekinywa ky'omutima ekyebaka) kisobola okuwona? Obujjanjabi bwe buruwa?

Yee, gano ge mawulire agasinga obulungi! Embeera eno esobola okuwona n’obujjanjabi. Ekikulu okukola kwe kuzzaawo omusaayi okutambula obulungi mu kitundu ky’ekinywa ky’omutima ekikendedde ku kutambula kw’omusaayi. Waliwo obujjanjabi obukulu bubiri ku kino:

• Angioplasty: Kino kizingiramu okukozesa ekyuma ekiwanvu ekigonvu (catheter) okugenda mu musuwa oguzibiddwa n’ofuuwa akapiira akatono ku nkomerero ya ttanka okuggyamu obuwuka obuyitibwa ‘plaque’ n’okugaziya omusuwa. Oluusi, ekyuma ekiringa akatimba (stent) kiyinza okuteekebwa munda mu kibya okusobola okukikuuma obutaddamu kuggalawo.
• Coronary Artery Bypass Surgery (CABG): Eno nkola ya kulongoosa erimu okuggya omusuwa omulamu okuva mu kitundu ekirala eky’omubiri gwo (nga okugulu oba ekifuba) n’okola ekkubo eppya omusaayi we guyitamu, n’oyita ku musuwa oguzibiddwa mu mutima gwo. Kiringa okuzimba bypass ng’oluguudo luzibiddwa.

Oluvannyuma lw'obujjanjabi buno, oyinza n'okusindikibwa mu nteekateeka ya ``Cardiac Rehabilitation'' okuyamba mu kudda engulu kwo. Eno nteekateeka ya dduyiro erabirirwa abasawo ekuyamba okwongera amaanyi n’okubeera omulamu obulungi, n’okukulaakulanya emize egiyamba omutima.

Bujjanjabi ki obwa `Stunned Myocardium`?

Obujjanjabi bw’ekinywa ky’omutima ekizibiddwa okusinga bwe bumu n’obujjanjabi obwa bulijjo obw’obulwadde bw’omutima n’okulemererwa kw’omutima. Ezimu ku ddagala erisinga okukozesebwa mulimu:

• Aspirin eddagala eriweweeza ku bulwadde
• Ebiziyiza ebiziyiza (Beta-blockers).
• Statins (eddagala erikendeeza ku kolesterol) .
• Ebiziyiza ACE oba Angiotensin II receptor blockers (eddagala erifuga puleesa n’okukuuma omutima) .

Omusawo ajja kukebera embeera yo era akuwandiikire eddagala erisinga okukusaanira.

Oyinza otya okwekuuma embeera zino?

Engeri esinga okukendeeza ku bulabe bw’embeera zino kwe kulabirira obulungi omutima gwo. Ekyo kitegeeza nti:

• Okugoberera endya ennungi:Endya erimu amafuta amatono, ssukaali n’omunnyo, ate nga erimu enva endiirwa n’ebibala bingi.
• Dduyiro buli kiseera: N’ekintu eky’angu ng’okutambula okumala eddakiika 30 olunaku kirungi.
• Weewale okunywa sigala: Okunywa sigala kibi nnyo eri omutima.
• Okussa ekkomo ku kunywa omwenge.
• Okukuuma obuzito obulungi.
• Okufuga situleesi.
• Bw’oba ​​olina endwadde nga sukaali, puleesa, oba kolesterol omungi, zifuge bulungi.
• Omusawo bw’aba akulagidde, mira eddagala nga Statin okukendeeza ku kolesterol oba aspirin okuziyiza omusaayi okuzimba buli lunaku.

Osobola n’okukozesa ebyuma ebibalirira akabi okuva mu bibiina nga American College of Cardiology oba European Society of Cardiology okuzuula akabi kwo n’obwetaavu bwo obw’obujjanjabi. Wabula bw’oba ​​olina dda obulwadde bw’omutima, kirungi okwogera n’omusawo wo ku bulabe bw’olina. Mu mbeera zino , obujjanjabi obulung’amya obulagirizi bulagiddwa nti bukendeeza nnyo ku bulabe bw’okulwala omutima, okulemererwa kw’omutima, n’okufa.

Prognosis eri etya?

Obulamu bw'omuntu alina embeera eno mu biseera eby'omu maaso (kino tukiyita ``okuteebereza``) kisinziira ku nsonga eziwerako. Okugeza nga:

• Obusobozi bw’omutima obw’okupampagira bwe bukendedde.
• Oba okozesa eddagala lyennyini omusawo lye yakulagidde.
• Oba osaanira okulongoosebwa `(Angioplasty)`/`(Stent)` oba `(CABG)`.

Abantu abalina obulwadde bw’emisuwa gy’omutima balina akabi ak’okulwala ebizibu by’omutima obulamu bwabwe bwonna mu biseera eby’omu maaso. Singa emisuwa gyo egy'omutima giddamu okuzibikira, ebinywa by'omutima byo bisobola okuddamu "okusula mu kiseera ky'obutiti".

Ekikulu: Hibernating Myocardium ebaawo ng’omusaayi mu binywa by’omutima guziyiziddwa okumala ebbanga eddene olw’okuzibikira ennyo omusuwa gw’omutima mu bantu abalina obulwadde bw’emisuwa. Stunned Myocardium ebaawo ng’omusaayi gukendedde mu bwangu. Singa omusaayi guddamu okutambula, ebinywa by’omutima gwo birina okusobola okuddamu okukwatagana mu bbanga ttono. Embeera zino zombi zijjanjabibwa. Kikulu nnyo okulabirira obulungi omutima gwo okutangira embeera zino obutaddamu.

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

Okay, kale ka tufunze ebintu by'olina okujjukira okuva mu bye twogeddeko:

• Hibernating Myocardium ne Stunned Myocardium mbeera bbiri ezibeerawo olw’okukendeera kw’omusaayi okugenda mu binywa by’omutima.
• Mu mbeera zino zombi, ekinywa ky’omutima tekifa, naye tekikola bulungi. Kino kyawukana ku bulwadde bw’omutima.
• Embeera zino zombi zitera okuwona! Kikulu okuzzaawo entambula y’omusaayi era bwe kiba kyetaagisa okunoonya obujjanjabi.
• Bw’oba ​​olina obubonero ng’okukaluubirirwa okussa, okulumwa mu kifuba, oba okuzimba mu magulu, funa amagezi g’abasawo nga tomala biseera.
• Obulabe bw‟embeera zino busobola okukendeezebwa nga tugoberera obulamu obulungi n‟okuddukanya embeera z‟obujjanjabi eziriwo (nga ssukaali ne puleesa).
• Bw’oba ​​olina obulwadde bw’omutima, kikulu nnyo okugoberera ddala ebiragiro by’omusawo n’okukeberebwa buli kiseera.

Omutima gwo kye kintu kyo ekisinga okuba eky’omuwendo. Kale kifaayo. Nsuubira nti amawulire gano ga mugaso gy'oli!

` Obulwadde bw’omutima, hibernating myocardium, stun myocardium, okulwala omutima, obulwadde bw’emisuwa gy’omutima, angioplasty, okulongoosa bypass