Kodi mbali yakumanja ya mtima wanu ndi yofooka? Tiyeni tiphunzire za ARVD yoopsa iyi (Arrhythmogenic Right Ventricular Dysplasia)?

Kodi nthawi zina mumamva ngati chifuwa chanu chikugunda mwadzidzidzi, mumamva ngati mukuvutika kupuma, kapena mumangomva ngati mukudwala matenda a mtima? Mwina mwamvapo kuti nthawi zina ngakhale wothamanga wachinyamata wathanzi amatha kudwala matenda a mtima mwadzidzidzi. Ndicho chimene tikambirane lero, koma ndi matenda a mtima osadziwika bwino, omwe ndi osowa kwambiri. Izi zimatchedwa ``Arrhythmogenic Right Ventricular Dysplasia``, kapena mwachidule ARVD.

Kodi ARVD (Arrhythmogenic Right Ventricular Dysplasia) ndi chiyani? Tiyeni timvetse mosavuta!

Mwachidule, ARVD ndi matenda omwe amakhudza minofu ya mtima, mtundu wa 'cardiomyopathy'. Mtima wathu uli ndi zipinda zinayi. Chomwe chimachitika pamenepa ndi chakuti minofu yomwe ili m'chipinda chapansi kumanja kwa mtima wanu, 'ventricle yakumanja', imakula m'malo mwa mafuta ndi minofu ya ulusi. Taganizirani ngati minofu yathanzi yachotsedwa ndipo yasinthidwa ndi chinthu chonga mafuta.

Kodi chimachitika n’chiyani izi zikachitika? Ventricular yakumanja imatambasuka pang’onopang’ono, imakhala yopyapyala, ndipo singathe kugwira bwino ntchito. Zimenezi zikutanthauza kuti mphamvu yake yopopera magazi kupita kumtima imafooka.

Chofunika kwambiri n’chakuti minofu yatsopano yamafuta kapena ya ulusi imasokoneza zizindikiro zamagetsi za mtima. Ndicho chifukwa chake anthu ambiri omwe ali ndi ARVD amakhala ndi kugunda kwa mtima kosasinthasintha (arrhythmias). Izi zitha kukhala zoopsa kwambiri, chifukwa zimawonjezera chiopsezo cha kulephera kwa mtima kapena kufa mwadzidzidzi.

ARVD iyi imatchedwanso `Arrhythmogenic Right Ventricular Cardiomyopathy` (ARVC). Nthawi zina imathanso kukhudza mbali yakumanzere, motero imatchedwanso `Arrhythmogenic Cardiomyopathy` (ACM).

Kodi magawo a ARVD ndi ati?

Ngati muli ndi matenda a ARVD, amatha kudutsa m'magawo angapo pakapita nthawi.

1. Gawo lobisika: Pa gawoli, mwina simungakhale ndi zizindikiro zilizonse. Komabe, mungamve kugunda kwa mtima kosakhazikika mukamachita masewera olimbitsa thupi. Chodabwitsa n'chakuti, mayeso ena omwe amachitika pa gawoli angasonyeze kuti palibe cholakwika chilichonse.

2. Gawo lamagetsi: Pa gawoli, mumakhala ndi mwayi waukulu wopeza matenda a ventricular arrhythmias. Mulinso pachiwopsezo chachikulu cha imfa yadzidzidzi ya mtima. ECG imatha kuzindikira mavuto a mtima awa.

3. Gawo la kapangidwe ka mtima: Pa gawoli, chiopsezo cha kayimbidwe ka mtima kosazolowereka (kayimbidwe ka mtima) ndi imfa yadzidzidzi ya mtima chimakhala chachikulu kwambiri. Mayeso ojambulira zithunzi, monga ma scan, amatha kusonyeza bwino kusintha kwa kapangidwe ka mtima wanu.

Ndani amene akukhudzidwa kwambiri ndi ARVD iyi?

Madokotala nthawi zambiri amaona vutoli pakati pa achinyamata.Ndiko kuti, pakati pa achinyamata kapena achinyamata. Matenda a ARVD apezekanso ngati chifukwa cha imfa yadzidzidzi ya mtima mwa achinyamata ena othamanga. Kafukufuku wina akusonyeza kuti vutoli ndi lofala pang'ono mwa amuna .

Ponena za kuchuluka kwa matendawa, matenda a ARVD ndi matenda osowa kwambiri. Nthawi zambiri amati amakhudza munthu m'modzi pa anthu 1,000 kapena munthu m'modzi pa anthu 5,000. Amatha kuchitika popanda aliyense m'banjamo kukhala nawo, koma nthawi zambiri amapezeka m'mabanja.

Kodi zizindikiro za ARVC ndi ziti? Tiyeni tidziwe!

Mwina simungakhale ndi zizindikiro zilizonse za ARVD pachiyambi, koma pali chiopsezo cha imfa yadzidzidzi ya mtima.

Zizindikiro zazikulu zomwe zingawonekere ndi izi:

• Kusakhazikika kwa mitsempha ya m'magazi: Izi zitha kukhala zoopsa kwambiri. Pafupifupi theka la anthu omwe ali ndi kusakhazikika kwa mitsempha ya m'magazi, zotsatira zake zimatha kukhala zakupha kapena pafupifupi kupha. Kusakhazikika kwa mitsempha ya m'magazi komwe kumachitika nthawi zambiri ndi tachycardia ya ventricular, yomwe imachitika mwa 77% ya anthu omwe ali ndi vutoli.
• Matenda a Supraventricular arrhythmias: Matenda ofala kwambiri ndi matenda otchedwa atrial fibrillation.
• Kugunda kwa mtima: Izi zingamveke ngati chinachake chikugunda mkati mwa chifuwa chanu. Izi zimachitika chifukwa cha kugunda kwa mtima kosazolowereka.
• Chizungulire, mutu wopepuka kapena kukomoka: Izi zimachitikanso chifukwa cha kugunda kwa mtima kosakhazikika.
• Kupweteka pachifuwa.
• Imfa yadzidzidzi ya mtima: Izi nthawi zina zimakhala chizindikiro choyamba cha matenda a ARVD.
• Kupuma movutikira.
• Kutupa kwa miyendo, akakolo, mapazi, kapena mimba.
• Kulephera kwa mtima.

Zizindikiro zimenezi nthawi zambiri zimayamba pakati pa zaka 20 ndi 50. Madokotala nthawi zambiri amazindikira matenda a ARVD ali aang'ono (nthawi zambiri asanakwanitse zaka 40).

Kodi ndi zinthu ziti zomwe zimayambitsa matenda a ARVD?

Pafupifupi 60% ya anthu omwe ali ndi matenda a ARVD ali ndi kusintha kwa majini. Ofufuza apeza majini osachepera 13 omwe amayambitsa matendawa.

Majini osazolowereka amenewa amawononga mapuloteni omwe amathandiza maselo a minofu ya mtima kulumikizana ndi kulankhulana. Izi zingayambitse maselo a minofu ya mtima omwe ali mu ventricle yakumanja kulekana ndi kufa. Izi zitha kuchitika kwambiri nthawi yamavuto kapena kuchita masewera olimbitsa thupi.

Osachepera 30% mpaka 50% ya odwala matenda a ARVD ali ndi mbiri ya m'banja lawo.Choncho, ndikofunikira kwambiri kuti achibale a munthu amene ali ndi matenda a ARVD (makolo, abale, ana, zidzukulu, amalume, azakhali, adzukulu aakazi, ndi adzukulu aakazi) a munthu amene ali ndi matenda a ARVD akapimidwe ndi dokotala. Ngakhale ngati palibe zizindikiro, achibale achinyamata ayenera kufunsa uphungu kwa dokotala.

Ofufuza apeza njira ziwiri za cholowa mu ma ARVD:

1. `Autosomal dominant`: Kholo limodzi lili ndi kusintha kwa majini. M'mabanja otere, ana ali ndi mwayi wa 50% wotengera matendawa. Komabe, zizindikiro ndi msinkhu wa matendawa zimatha kusiyana pakati pa abale. ARVD imapezeka kwambiri m'madera ena, monga Italy.

2. `Autosomal recessive` (si kawirikawiri): Makolo onse awiri ali ndi kusintha kwa majini, koma sasonyeza zizindikiro. `Naxos disease` ndi chitsanzo cha izi. Imayambitsa kukhuthala kwa khungu lakunja (`hyperkeratosis`) ndi tsitsi lokhuthala, "longa ubweya" (`tsitsi longa ubweya`) pa zikhatho ndi pansi.

Matenda a ARVD amathanso kuchitika chifukwa cha zifukwa zina:

• Matenda obadwa nawo a ventricle yakumanja.
• Matenda a mtima otchedwa `myocarditis` (kutupa kwa minofu ya mtima).
• Zifukwa sizinapezekebe.

Kodi matenda a Arrhythmogenic Right Ventricular Dysplasia (ARVD) amawapeza bwanji?

Dokotala wanu akhoza kupeza matenda a ARVD kutengera mbiri yanu yachipatala, mayeso anu, ndi mayeso osiyanasiyana.

Dokotala wanu angakupatseni mankhwala a ARVD ngati muli ndi mavuto angapo otsatirawa:

• Kusagwira bwino ntchito kwa ventricle yakumanja.
• Kupezeka kwa minofu yamafuta kapena fibro-fatty mu minofu ya mtima (`myocardium`) ya ventricle yakumanja.
• Lipoti la `ECG/EKG` (Electrocardiogram) losazolowereka.
• Kusakhazikika kwa kamvekedwe ka mtima (arrhythmias): Mwachitsanzo, supraventricular tachycardia, ventricular tachycardia, kapena ventricular fibrillation, makamaka panthawi yochita masewera olimbitsa thupi.
• Mbiri ya banja la odwala matenda a ARVD.

Kutengera ndi kuchuluka kwa zinthu zomwe muli nazo, dokotala wanu angakupatseni matenda a "definite," "borderline," kapena "zotheka." Nthawi zina, koma osati nthawi zonse, dokotala wanu angakutumizireninso kuti mukayesedwe majini .

Kodi ndi mayeso ati omwe amagwiritsidwa ntchito pozindikira matenda a ARVD?

• Electrocardiogram (ECG/EKG): Kuyeza komwe kumayang'ana momwe magetsi a mtima amagwirira ntchito.
• Transthoracic echocardiogram: Mofanana ndi ultrasound ya mtima, imatha kuwona zipinda za mtima, ma valve, ndi mphamvu ya kupompa.
• `Chowunikira cha Holter`: Ichi chili ngati makina ang'onoang'ono a `ECG` omwe mumavala kwa maola 24 mpaka 48. Chimalemba kugunda kwa mtima wanu tsiku lonse.
• Angiogram ya ventricle yakumanja: Izi sizigwiritsidwa ntchito kawirikawiri.
• `Kuyesa kwa electrophysiology`:Mayeso apadera owunikira mavuto amagetsi a mtima.
• Kujambula zithunzi za mtima (MRI): Izi zimatha kupanga zithunzi zatsatanetsatane za mtima. Izi ndizofunikira kwambiri pozindikira zinthu monga mafuta omwe ali mu ventricle yakumanja mu ARVD.
• `Cardiac computed tomography (CT):` Iyi ndi njira ina yopezera zithunzi za mtima.
• `Biopsy` (kutenga chitsanzo cha minofu): Izi zimachitikanso kawirikawiri. Kachidutswa kakang'ono ka minofu kamatengedwa kuchokera mumtima ndikuwunikidwa.

Kodi mankhwala a ARVD ndi otani?

Pakadali pano palibe mankhwala a ARVD. Komabe, dokotala wanu adzayesa kuchita izi:

• Lamulirani kusakhazikika kwa kayendedwe ka mtima wanu (`ventricular arrhythmias`).
• Pewani magazi kuundana.
• Konzani vuto lanu la mtima.

Mankhwala a ARVD ndi awa:

• Mankhwala oletsa kupweteka kwa mtima: Amaletsa kugunda kwa mtima kosakhazikika kwa nthawi yayitali komanso/kapena imfa yadzidzidzi. Uwu ndi mankhwala omwe madokotala amagwiritsa ntchito kwambiri. Mutha kupatsidwa mankhwala monga sotalol kapena amiodarone.
• Mankhwala ochepetsa kuthamanga kwa magazi: Mankhwala monga diuretics (omwe amachotsa madzi ochulukirapo m'thupi) kapena beta-blockers (omwe amachepetsa ntchito ya mtima).
• Mankhwala oletsa magazi kuundana (ochepetsa magazi kuundana): Mankhwala monga warfarin amaperekedwa kuti magazi asaundane.
• Kuchotsa catheter ya radiofrequency: Chithandizo cha kusayenda bwino kwa kugunda kwa mtima komwe sikulamulidwa ndi mankhwala. Izi zimaphatikizapo kuwononga gawo laling'ono la mtima lomwe limayambitsa kugunda kwa mtima kosasinthasintha.
• Chosinthira mtima (ICD): Kachipangizo kakang'ono kamene kamaikidwa mumtima mwa anthu omwe ali pachiwopsezo cha imfa yadzidzidzi. Ngati kazindikira kugunda kwa mtima koopsa, kamazindikira ndipo kamachititsa kuti mtima ugwedezeke ndi magetsi kuti akonze.
• Kusamutsa mtima: Izi zimachitika pamene njira zina zonse zochiritsira zalephera. Anthu ochepa okha omwe ali ndi matendawa, pafupifupi 2% mpaka 4%, ndi omwe amafunikira mtima watsopano.

Kumbukirani, mungafunike mankhwala opitilira limodzi a matendawa pa moyo wanu wonse.

Kodi pali zovuta zilizonse kapena zotsatirapo zina za chithandizochi?

Inde, pali zinthu zina zomwe muyenera kusamala nazo ndi mankhwala ena.

• Ngati mukumwa warfarin, muyenera kuyesedwa magazi nthawi zonse . Dokotala wanu ayenera kuonetsetsa kuti mukupeza mlingo woyenera. Mlingo wanu ukhoza kusinthidwa kutengera zotsatira za mayeso.
• Ngakhale kuti chithandizo cha catheter ablation poyamba chimagwira ntchito bwino kwa anthu ambiri, popeza matendawa amakula pakapita nthawi, pafupifupi 60% ya anthu amatha kukumana ndi vuto la kugunda kwa mtima wawo.
• Mawaya omwe ali mu chipangizo cha ICD amatha kuyendayenda kapena kusagwira ntchito bwino, kotero muyenera kuwayang'ana nthawi zonse .

Kodi ndimadzisamalira bwanji? Ndi kusintha kotani kwa moyo komwe kumafunika?

Ndikofunikira kwambiri kusintha moyo wanu kuti mtima wanu ukhale womasuka.

• Chepetsani kumwa mowa.
• Siyani kugwiritsa ntchito fodya kwathunthu.
• Idyani zakudya zopatsa thanzi (mafuta ochepa, zipatso ndi ndiwo zamasamba zambiri)
• Chepetsani zakudya ndi zakumwa zomwe zili ndi caffeine (monga khofi, tiyi, chokoleti).
• Sungani kulemera koyenera kwa thupi.
• Chepetsani kuchita zinthu zolimbitsa thupi kwambiri.

Chofunika kwambiri: Nthawi zonse funsani dokotala wanu musanayambe kuchita masewera olimbitsa thupi. Masewera ampikisano sakuvomerezeka. Masewera olimbitsa thupi ochepa akhoza kukhala abwino.

Lankhulani ndi dokotala wanu nthawi zonse panthawi yonse ya chithandizo chanu. Adzaonetsetsa kuti mukupeza mlingo woyenera wa mankhwala. Komanso, popita kukaonana ndi dokotala nthawi zonse, mutha kuwona kusintha kulikonse pa thanzi lanu msanga.

Kodi chiopsezochi chingachepe?

Inde, mpaka pamlingo winawake. Ngati wina m'banja mwanu ali ndi matenda a ARVD, kuyezetsa magazi mwachangu ndiyo njira yabwino kwambiri yochepetsera chiopsezo chanu. Mayeso osavuta komanso osapweteka angakuuzeni ngati muli pachiwopsezo cha kugunda kwa mtima kosazolowereka. Ngati muli pachiwopsezo, dokotala wanu angakuthandizeni kupanga dongosolo la chithandizo lomwe lili loyenera kwa inu.

Kodi moyo wa munthu amene ali ndi ARVD ndi wotani?

Nthawi yoti munthu akhale ndi matenda a ARVD imasiyana malinga ndi nthawi yomwe wapezeka ndi matendawa. Chinthu chabwino kwambiri kuchita ndikupeza matendawa msanga ndikupeza chithandizo kuti apewe kugunda kwa mtima kosakhazikika. Matendawa amakula pakapita nthawi.

Ngati ARVD sichithandizidwa, ventricle yanu yakumanja ikhoza kulephera. Kenako ventricle yanu yakumanzere ikhozanso kulephera. Izi zingayambitse matenda monga `kulephera kwa mtima` ndi `atrial fibrillation`. Ofufuza amakhulupirira kuti vutoli limakhala loipa kwambiri ngati ARVD ingakhudze ventricle zonse ziwiri.

Koma, mukalandira chithandizo, mutha kupeza thandizo lomwe mukufuna kuti muchepetse kupsinjika kwa mtima wanu ndikupewa matenda oopsa a mtima. Kafukufuku wina akusonyeza kuti anthu ena amapezeka ndi matendawa atakwanitsa zaka 65. Akutinso munthu m'modzi mwa anthu asanu omwe ali ndi ARVC amayamba zizindikiro atakwanitsa zaka 50. Chifukwa chake, n'zotheka kukhala ndi moyo wautali ndi ARVC.

Masiku ano, ukadaulo wapamwamba wojambulira zithunzi monga CT ndi MRI umalola kuzindikira ndi kulandira chithandizo msanga, kotero chiyembekezo chamtsogolo cha anthu omwe ali ndi ARVD ndi chabwino.

Komabe, imfa yadzidzidzi ingachitike kwa anthu omwe sanapezeke ndi matendawa kapena omwe sanalandire chithandizo chofunikira. ARVD akuti ndi yomwe imayambitsa 11% ya imfa zadzidzidzi za mtima mwa anthu osakwana zaka 35 ndi 22% ya imfa zadzidzidzi za mtima mwa othamanga.

Kodi ndiyenera kupita liti kwa dokotala? Kodi ndiyenera kupita liti ku chipinda chodzidzimutsa?

Ngati muli ndi matenda a ARVD, muyenera kupitiliza kukaonana ndi dokotala moyo wanu wonse.Dokotala wanu ayenera kufufuzidwa nthawi zonse kuti atsimikizire kuti mukulandira chithandizo choyenera. Ngati muli ndi ICD, iyenera kufufuzidwa nthawi zonse .

Chochita pakakhala ngozi?

Ngati wina wagwa mwadzidzidzi ndipo sakuyankhani mafoni anu, imbani nthawi yomweyo 1990 (ntchito ya ambulansi yadzidzidzi ku Sri Lanka). Kenako, ngati n'kotheka, yambani CPR (cardiopulmonary resuscitation), kapena CPR yochitidwa ndi manja okha.

Ngati muli pachiwopsezo cha kulephera kwa mtima mwadzidzidzi, ndi bwino kukhala ndi anthu omwe ali kunyumba kwanu akuphunzitsidwa za CPR.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala wanga?

• Kodi ndingathe kuchita masewera olimbitsa thupi kapena kutenga nawo mbali pa masewera? Ngati ndi choncho, ndi masewera amtundu wanji?
• Ndi chithandizo chiti chomwe chili chabwino kwa ine?
• Kodi ndikufunika ICD panthawiyi?

Popeza matenda a ARVD amatha kukhala ovuta kuwazindikira zizindikiro zisanawonekere, ndikofunikira kudziwa mbiri ya banja lanu. Ngati muli pachiwopsezo chifukwa cha mbiri ya banja lanu ya matendawa, dokotala wanu akhoza kukuyesani.

Uthenga Wopita Nawo Kunyumba

Chabwino, tsopano mwamvetsa bwino zomwe takambirana lero, ARVD. Ngakhale kuti sizichitika kawirikawiri, zimatha kukhala matenda oopsa a mtima. Nthawi zambiri amayamba chifukwa cha majini . Chifukwa chake, ngati wina m'banja mwanu ali ndi vutoli, ndikofunikira kwambiri kukayezetsa ena.

Mukazindikira matendawa msanga, kupeza chithandizo choyenera, ndikusintha moyo wanu, mutha kukhala bwino ndi matendawa. Lumikizanani ndi dokotala wanu ndikutsatira malangizo awo. Komanso, kuonetsetsa kuti okondedwa anu akudziwa za `CPR` kungakuthandizeni kupulumutsa moyo wanu pakagwa ngozi. Musachite mantha, kuzindikira ndiye mphamvu yayikulu!

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