Hetiang hian i thinlung a lo danglam tawh em? Hypertrophic Cardiomyopathy (HCM) chungchang hi han sawi ila!

Lung natna, thinlung ruh a thim mai mai, a buaithlak deuh tih i hre tawh em? A chang chuan i nei tih pawh i hre lo mai thei, a chhan chu mi thenkhatin symptom an neih loh vang a ni. Mahse, thinlung a nghawng avangin fimkhur a pawimawh. Vawiin hian he natna hi doctor-te zingah hypertrophic cardiomyopathy, a nih loh leh `HCM' an tih chungchang kan sawi dawn a ni. Lungngai suh, awlsam takin, i hriatthiam theih dan tur angin kan sawi dawn a ni.

HCM chu eng nge a nih kan en hmasa ang u?

A awlsam zawngin, hypertrophic cardiomyopathy (HCM) hi natna khirh tak a ni a, i thinlung ruhte a nghawng a ni. Thil pawimawh tlemte avanga lo awm thei a ni:

• Heart muscle thickening: A bik takin heart chamber hnuai lam, ventricles kan tih te hian bang thicked an nei a.
• Left ventricular stiffness: Thinlung veilam (left ventricle) a main chamber chu a nghet a, a elastic lo deuh a, rubber ang maiin a nghet lo.
• Mitral valve inthlak danglam: Thinlung chhunga valve pawimawh tak mitral valve hnathawh dan a inthlak danglam thei.
• Cellular changes: Heart muscle cell-ah hian thil danglam thenkhat a awm thin (cellular changes).

Heng thilte hian thinlung hnathawh danah harsatna engemaw zat a thlen thei a ni.

He HCM dinhmun hian engtin nge i taksa a nghawng?

Okay, tunah chuan heng inthlak danglamna hian taksaah eng nge a tih tak tak tih hi han en ila.

Myocardium a thim nasa hle

Hei hi HCM-a symptom hmuh tur ber a ni. A tam zawkah chuan he thickening hi thinlung veilam leh dinglam inthenna wall-ah a thleng thin a, chu chu `(septum) an ti a ni.` Ngaihtuah teh, he thinlung pindan hnuai lam `(ventricles)` inkar he septum hi a thim chuan veilam ventricle atanga thisen kal dan chu a tikhawlo thei a, chu chu aorta, thisen kalna kawngpui ber, taksa pum puia thisen phurtu a ni. Hei hi `(outflow tract obstruction)` kan ti a. Tichuan thinlung hian he blockage hi thisen pump chhuak turin nasa zawkin a thawk a ngai a ni. Thisen kal dan tikhawlotu HCM chi chu `(Hypertrophic Obstructive Cardiomyopathy - HOCM)` an ti a.

A châng chuan thinlung hmun dang, apex, right ventricle emaw, left ventricle pumpui emaw chu a thim thei a ni. Hetiang hunah hian thisen kal dan a tikhawlo lo. Mahse, ventricle-in thisen a tuar theih zat chu a tlahniam a ni. Hei hi Hypertrophic Nonobstructive Cardiomyopathy an ti a.

Left Ventricular tih khauh tak a ni

Heart muscle a thim chuan chu cell-a inthlak danglamna chuan left ventricle chu a ti hahdam tha lo va, thisenin a khat ta a ni. Chuti a nih chuan eng nge thleng? Chamber chhungah thisen a tlem avangin taksa peng dang leh thau dangte hnenah oxygen tamna thisen a thawn tlem zawk a ni. He hardening hian thinlung chhunga pressure a tipung bawk a, symptoms i nei thei bawk:

• A rilru a na
• Thâwk a tawi
• Luak chhuak emaw, muhil emaw
• I thinlung a na hle tih hriatna (palpitations) .

Mitral Valve a inthlak danglam thin

Sawi tawh ang khan left ventricular outflow tract a block chuan heart chhunga mitral valve chu a thawk tha lo thei a ni. Hei hian thisen kalna a tikhawlo thei a, left ventricle-a pressure a tisang thei bawk.

Hetianga blockage awm chhan hi mitral valve hian septum thickened a rawn tawk a ni. Chutiang a nih chuan mitral valve chu a khar tha lo va, thisen chu left atrium-ah a leak leh thei a ni.

Cellular inthlak danglamna

Microscope hmanga ngun taka i en chuan HCM vei mi thinlung ruh cell te hi line dik takah an inrem lo va, a buaithlak deuhin an inrem zawk a ni. He natna hian thinlung hnuai lam chamber kal tlanga electrical signal a tidanglam thei a, chu chuan thinlung rhythm danglam tak, ventricular arrhythmia an tih chu a thlen thei a ni. Hei hi a hlauhawm thei hle.

Hetiang dinhmun hi engtiang chiahin nge HCM tia koh a nih?

United States-ah ringawt pawh mi maktaduai 1.5 vel, a nih loh leh mi 500 zinga pakhat velin HCM an vei nia chhut a ni. Hei hi ``(Multiple Sclerosis)'' ang natna aiin a tam zawk. Chuvangin, chutiang chuan a tlem lo.

Kum engzat nge HCM hi a lo awm tlangpui?

A tam zawkah chuan he lung natna hi thalai, kum sawm leh pariat emaw kum sawmhnih emaw vel an ni. Mahse, kum eng pawhah a intan thei.

HCM ka neih chuan naupai theihna a awm em?

Damdawi lam enkawlna bik i mamawh mai thei, chu chu regular echocardiography ang chi hi a ni. Mahse, naupai hrisel tak leh nau neih dan pangngai i neih a rinawm ber. Mahse, naupai hmaa doctor nen sawiho a, a hlauhawm dan sawiho a pawimawh. I doctor chuan naupai laiin HCM damdawi engte nge i ei chhunzawm theih tih a hrilh bawk ang che. Naupai laiin a tul chuan pacemaker emaw implantable cardioverter defibrillator (ICD) emaw dah a ngai thei bawk.

Eng thilin nge HCM hi a thlen?

HCM thlen thei thil engemaw zat a awm a:

• Genetics: Hei hi a chhan ber a ni. HCM hi nu leh pa atanga fate rochun theih natna a ni. Chumi awmzia chu thinlung ruh (heart muscle) ziarang thununtu gene-ah hian chhiatna a awm tihna a ni. HCM thlentu gene chi hrang hrang a awm a. Genetic defect a awm a nih pawhin chhungkuaa mi zawng zawngin he natna hi an nei vek dawn lo. Mi thenkhat chuan HCM gene nei mahse natna hi an nei ngai lo.
• Thisen sang: Hun rei tak atanga lo awm tawh thisen sang pawh hi a thlentu a ni thei bawk.
• Tar: Kum upat deuh deuh hian he natna hi a lo awm thei a ni.
• A chhan hriat loh case-te:A châng chuan HCM hi a chhan chiang tak hmuh theih a ni lo.

HCM vei mi pakhatin eng symptom nge a neih theih ang?

HCM vei thenkhat chuan symptom hrang hrang an nei thei a, thenkhat erawh chuan symptom an nei lo thei bawk. A lan chhuah dan tlangpui chu:

• Chhung natna: Hei hi exercise emaw, thawhrimna emaw laiin a thleng tlangpui a, mahse a chang chuan ding mai mai emaw, ei zawh hnu emaw pawhin a thleng thei.
• Thâwk hah leh hah: Heng symptoms te hi, a bik takin i chau lai hian puitling kum upa zawkah a awm fo thin. Hei hi left atrium leh lung-a pressure sang vang a ni.
• Fainting emaw fainting (syncope): Hei hi exercise laiin thisen kalna kawng dik lo (arrhythmias) emaw, thisen kalna kawng dik lo emaw avanga lo awm thei a ni. A châng chuan, a chhan engmah hmuh theih a ni lo.
• Palpitations: Hei hi thinlung rhythm dik lo vang a ni thei a , chu chu atrial fibrillation (atrial flutter) emaw ventricular tachycardia (ventricular tachycardia) emaw a ni thei. HCM vei zinga 25% vel chuan atrial fibrillation an nei a. Hei hian thisen zam leh heart failure a tipung a ni.
• Taksa hnuai lam emaw, kawr hnuai lam emawa thisen kalna (veins) a hring chhuak.

HCM nen hian hriselna lama harsatna dang eng nge inzawm theih?

HCM vei tam tak chu nun pangngaiin an khawsa a, hriselna lama harsatna lian tham an nei lo. Thenkhat chuan damdawi ei pawh a ngai lo. Mahse, symptom i nei lo a nih pawhin i doctor chuan exercise hahthlak tak tak ti lo turin a fuih thei che a ni.

Mahse, HCM vei thenkhat chuan thinlung lam natna an nei thei a, chu chuan an dam chhung a ti tawi emaw, an nunphung a ti hniam emaw a ni. A bulpui berte chu:

Sudden Cardiac Arrest leh Sudden Cardiac Death a awm bawk

Sudden cardiac arrest chu heart rate hlauhawm tak (e.g., Ventricular Tachycardia) avanga heart function hloh nghal a ni. Chutiang a nih chuan emergency treatment, CPR leh defibrillation te chu a lan chhuah tan veleh a ngai a ni. He enkawlna hi a dik loh chuan cardiac death nghal a awm thei a ni.

HCM vei tam zawk hi chu sudden cardiac death risk an nei tlem hle. Mahse, HCM hi kum 35 hnuai lam cardiac thihna thlentu lian ber a ni a, HCM hi professional athletes naupang thenkhat thih thut nen pawh a inzawm tih i hre tawh mai thei.

Lung lam chak lohna

`(Heart Failure)` i neih vang mai mai chuan i thinlung chu a "fail" a, hna a thawk tawh lo tihna a ni lo. I thinlung hian thisen a pump tha lo leh tha lo tihna mai a ni. `(Heart Failure)` natna lan chhuah dan chu:

• Thâwk a tawi.
• Active laiin chau tih hriat (fatigue).
• Ke ruh, ke leh pum a hring.
• Chawlh laiin zan lama zun a ngai.
• Luak chhuak, buai, ngaihtuahna seng harsa, muthilh.
• I thinlung a na hle tih hriatna (palpitations).
• A vawt, hacking cough a ni.
• Chaw ei, pum na, chaw ei chak lohna emaw, pum na emaw.

HCM hi engtin nge kan hriat theih ang? (Diagnosis) tih a ni.

HCM hi a hnuaia mi ang hian a hriat theih a ni:

• Medical history: I doctor chuan i symptoms te leh i chhungkuaah hetiang natna hi an nei tawh em tih te a zawt ang che.
• Physical exam: Doctor in i thinlung leh lung lam a ngaithla ang. HOCM vei te hian thinlung ri danglam tak (heart murmur) an hre thei.
• Test: Echocardiogram (echo) hi HCM hriat theihna atana hman ber a ni. Hei hian thinlung bangte chu a thim em tih hriat nan a pui thei a ni.

Test dang pawh a awm a:

• Thisen test a ni.
• Electrocardiogram (ECG) hmanga tih a ni.
• Chest X-ray neih a ni.
• Exercise stress echo test neih a ni.
• Cardiac catheter hmanga tih a ni.
• Magnetic resonance imaging (MRI) hmanga enfiah a ni.

HCM enkawlna tur engte nge ni?

I doctor chuan a hnuaia thilte hi a zirin eng damdawi nge i tana tha tur tih a rel ang:

• Thisen thinlung atanga a chhuah danah blockage a awm em (outflow tract narrowing)?
• Engtin nge i thinlung hian hna a thawh?
• I symptoms te chu.
• I kum leh i active zia.
• Lungphung pangngai lo (arrhythmias) i nei em?

Enkawlna tum ber chu natna lan chhuah dan tihtlem emaw ven emaw a ni a, lungphu chak lohna leh rilru lam thih thut ang chi harsatna awm thei tihziaawm a ni.

Enkawlna atan a hnuaia mite hi tih theih a ni:

• Risk awm thei te hriatchhuah la, doctor pan chhunzawm rawh .
• Nunphung a inthlak danglam thin.
• Damdawi chi hrang hrang.
• Damdawi lam thil tih dan bik (specialized medical procedures) a ni.

HCM hi engtin nge kan screen ang?

HCM hi thlah khat atanga thlah danga inkaichhawn theih a nih avangin i nu leh pa emaw, i unau emaw, i fate (i.e., first-degree relative) zinga pakhatin natna a neih chuan test neih a pawimawh hle.

A hmasa ber atan chuan i thinlung hi Electrocardiogram (ECG) leh Echocardiogram (echo) hmanga enfiah tir a ni. Heng test-ah hian HCM chhinchhiahna a awm chuan he natna vei doctor (cardiologist) i pan a ngai ang.

A châng chuan chhungkaw history-a HCM nei tawh mah la, i test result chu a pangngai mai thei. Chutiang a nih chuan doctor-te chuan kum 30 i tlin thlengin kum thum danah echo leh ECG neih thin tur a ni a, chutah chuan kum nga danah tih thin tur a ni.

HCM vangin tute nge sudden cardiac death hlauhawm zawk?

HCM vei tam zawk hi chu sudden cardiac death risk an nei tlem hle. Mahse, HCM vei mi tlemte chuan an hlauhawmna a sang hle. Hetiang dinhmun hi i nei em tih hriat a pawimawh. I doctor chuan i risk tihtlem nan eng nge i tih theih tih a hrilh thei che a ni.

HCM vanga cardiac thihna hlauhawm zawkte chu:

• Chhungkaw history-a cardiac death rang tak nei te.
• An tleirawl laia vawi tam tak syncope vei tawhte.
• Exercise an tih hian thisen sang (abnormal blood pressure response) nei te.
• Tun hmaa thinlung thawk chak lo (arrhythmia) nei tawhte.
• Symptom na tak nei leh thinlung hnathawh that lohna nei te.

I doctor nen i personal risk chungchang sawipui rawh. Thih thut theihna tur risk factor pahnih emaw a aia tam emaw i neih chuan i doctor chuan i hlauhawmna tihziaawmna turin antiarrhythmic damdawi (thinlung rhythm pangngai lo control thei damdawi) emaw, implantable cardioverter defibrillator (ICD) emaw a rawt thei ang.

HCM enkawl nan hian eng damdawi nge hman thin?

Doctor-te chuan i natna lan chhuah dan control nan leh harsatna dang i neih loh nan damdawi chi hrang hrang an pe thin. Damdawi ``Beta blockers`` leh ``calcium channel blockers`` te hian thinlung ruh a ti hahdam a, thisen a khat a, thisen a pump tha zawk bawk. Damdawi dangte hian i heart rate a control thei a, heart rhythm pangngai lo (arrhythmias) awm theihna a ti tlem thei bawk.

Damdawi thenkhat, entirnan nitrates (thisen sang tihhniamtu) emaw digoxin (thinlung inzawmna chakna tipungtu) emaw ei lo turin an hrilh thei che a ni.

A châng chuan antibiotics ei a ngai mai thei a, fimkhur dan dang pawh i tih a ngai thei a, chu chuan nunna atana hlauhawm natna bacterial endocarditis an tih chu a tihziaawm thei a ni.

HCM enkawlna atan hian eng damdawi lam kalphung bik nge hman?

Thisen kal dan tikhawtlai thei Hypertrophic Obstructive Cardiomyopathy (HOCM) enkawl dan chi hrang hrang a awm a:

Septal Myectomy tih a ni

Hei hi surgical procedure a ni. Septal myectomy-ah chuan surgeon chuan i septal wall thicked tawh chu a la chhuak thin. Hei hian left ventricle atanga aorta thlenga outflow tract a tizau a ni. Damdawi in a puih loh chuan doctor-te chuan he surgery hi an ngaihtuah chauh a ni. Hei hian mitral valve buaina chu a chinfel sak fo thin.

Ethanol hmanga tihbo a ni

Hei hi `(septal ablation)` an ti bawk. Hetiang tih dan hi a hmaa kan sawi tawh `(septal myectomy)` surgery nei thei lote tan hman a ni. Hetah hian doctor chuan i septum chunglam thisen petu coronary artery te tak te a hmu a. Tichuan chu artery-ah chuan balloon catheter a dah a, a inflate ta a ni. A dawtah chuan thisen kalna tikhawlotu septal wall thickened awmna hmun dik tak zawng turin dye `(contrast agent)` a inject a.

Chu hmun chu hmuh a nih veleh doctor chuan catheter hmangin zu thianghlim tlemte chauh a inject a. Zu hian cell te chu a that a, thla engemaw zat hnuah chuan septum chu a size pangngaiah a tlahniam leh ta a ni. Hei hian thisen kalna kawng a tizau a ni.

Cardioverter Defibrillator (ICD) hmanga dah theih a ni.

Implantable cardioverter defibrillator (ICD) hian nunna atana hlauhawm arrhythmias emaw, cardiac thih thut emaw nei te chu a pui thei a ni. ICD hi hmanraw te tak te, i vun hnuaia dah a ni. I thinlung nen wire hmanga inzawm a ni. ICD hian i thinlung rhythm chu a enfiah chhunzawm zel a. Heartbeat chak tak, pangngai lo tak a hriat chuan thinlungah electric shock te tak te mahse chak tak a pe a, chu chuan a normal takin a ti leh ta a ni. I doctor chuan ICD hi i tan a tha em tih a hrilh ang che.

Lung lam chak lohna enkawl dan

Heart failure hi enkawl dan kawng hrang hrang a awm a, nunphung tihdanglam atanga a natna lanchhuahna tihziaawmna leh heart muscle hnathawh thatna tura puitu damdawi thlengin a awm.

HCM hmang hian engtin nge ka nunphung ka tihsan theih ang?

Symptoms i nei emaw nei lo emaw, HCM i vei tih hmuhchhuah i nih pawhin, i chhungte zinga mi pakhatin a nei a nih pawhin, i thinlung hriselna a tha ber tura i tih theih tur thil engemaw zat a awm a:

• Fluid leh salt (sodium) tihtlem: Lung chak lohna symptom i neih chuan i fluid in leh salt intake kha tihtlem a ngai mai thei. I doctor hnenah i ei leh in chungchangah kaihhruaina chiang tak zawt la, zu leh caffeine te pawh a tel.
• Fimkhur takin exercise la rawh: I doctor chuan eng exercise nge i tana tha tur tih a sawipui ang che. HCM vei tam tak chuan noncompetitive aerobic activity an ti thei a. Doctor-te chuan heavy lifting emaw high-intensity sports emaw hi an rawt lo.
• Doctor hmu fo rawh: HCM i neih chuan i dinhmun enfiah turin i cardiologist i pan fo tur a ni.
• I hri kai theihna tihtlem: HCM i neih chuan i doctor chuan ``infective endocarditis'' tih hming pu natna i vei theihna tur tihtlem nan hma la turin a fuih ang che.

Engtin nge Infective Endocarditis vei theihna tur i tihziaawm theih ang?

HCM vei te hian bacteria infection ``bacterial endocarditis`` emaw ``infective endocarditis`` emaw an nei tam zawk.

Bacterial endocarditis chu i thinlung valve emaw, i thinlung lining (endocardium) emaw a infection a ni. I thisenah hrik (a bik takin bacteria, mahse a chang chuan fungi leh microorganism dang) te chu i thisenah an lut a, i thinlung lining emaw, valve emaw an beih hian a thleng thin. Hei hian valve te chu a ti thim thei a, a perforated thei a, a scarred thei bawk. Hei hian heart valve leak a thlen fo thin. Enkawl that loh chuan thihna a thlen thei a ni.

He hlauhawmna tihtlem nan hian hengte hi i ti thei ang:

• I ha leh i hate uluk taka enkawl: Thla ruk danah ha enkawltu hmu la, nitin ha sil la, floss la, i toothpaste chu a in fit tha em tih enfiah bawk ang che.
• Infection symptoms i neih chuan doctor pan rawh:
• 100 degree Fahrenheit aia sang khawsik, thawk hah, emaw, khawsik emaw.
• Vun a hring chhuak.
• Natna, natna, sen, emaw, hring emaw.
• Hliam emaw, hliam emaw, a dam lo emaw, hliam sen, lum leh tui chhuak chhuak.
• Thlarau na, ril tightness, emaw ei laiin na.
• Sinus discharge, hnar congestion, lu na emaw, hmui chunglam ruh na emaw a awm.
• Ni hnih aia rei khuh (dry or phlegmy cough) a awm.
• Kawng emaw leiah emaw hmun dum a awm.
• Nausea, luak chhuak emaw, luak chhuak emaw.

Enkawlna zawng chu tikhawtlai suh. Common colds leh flu hian endocarditis a thlen lo. Mahse, infection dang, symptom inang nei chuan endocarditis a thlen thei a ni. Chuvangin, him takin awm la, i doctor hmu rawh.

• Damdawi leh ha lam thil thenkhat tih hmain preventive antibiotics ei hmasa phawt ang che. I doctor nen antibiotics i ei tur chi hrang hrang, a zat leh eng ang procedure nge i ei tur tih te sawipui rawh.
• American Heart Association atanga bacterial endocarditis hriat theihna card hmuh theih turin vawng reng ang che.

A tawp berah chuan hei hi i sawi tur a ni (Take-Home Message) .

HCM vei tam zawk hi chu nun pangngai, hlim takin an khawsa thin. Symptom nei emaw, harsatna lian tham nei thei tur emaw tan chuan enkawlna chi hrang hrang a awm a. I prognosis chu i heart muscle hnathawh that dan te, i symptoms te, leh i treatment plan i chhan dan leh i zawm that danah a innghat a ni.

I doctor hnenah i hlauhawmna leh i nunphung tihchangtlunna tur leh hri kai laka invenna atana i tih theih turte zawt rawh. HCM i vei tih hmuhchhuah a nih a, symptoms i neih emaw, infection i rinhlelh emaw chuan doctor pan nghal rawh. Hetiang dinhmun nen hian nun tha tak i hmang thei tih hre reng ang che!

`Hypertrophic cardiomyopathy, HCM, thinlung natna, thinlung lian, rilru na, thawk hah, cardiac thih thut