Kodi kutupa kumeneku kumakhudza mtima wanu? Tiyeni tiphunzire za Cardiac Sarcoidosis!

Kodi nthawi zina mumangomva kutopa? Kapena mumamva kupweteka pachifuwa kapena kupuma movutikira? Mungaganize kuti izi ndi zinthu zachilendo. Komabe, izi ndi matenda osowa kwambiri omwe amakhudza mtima. Cardiac Sarcoidosis ndi matenda ena, omwe ndi ovuta pang'ono, koma ngati mwadziwitsidwa bwino, amatha kuthandizidwa. Lero, tikambirana za izi m'njira yosavuta yomwe mungamvetse.

Kodi Sarcoidosis ya Mtima N'chiyani?

Mwachidule, Sarcoidosis ndi matenda otupa omwe amapezeka m'thupi lathu. Pachifukwa ichi, maselo ang'onoang'ono otupa amasonkhana ndikupanga ziphuphu (granulomas) m'ziwalo zosiyanasiyana za thupi, makamaka m'malo monga mapapo, ma lymph nodes, khungu, ndi maso. Ziphuphu zimenezi zimatha kusokoneza magwiridwe antchito a ziwalozo.

Tsopano, ngati vuto la sarcoidosis ili likukhudza mtima, ndicho chimene timachitcha kuti cardiac sarcoidosis . Ichi ndi chinthu chomwe sichimachitika kawirikawiri ngakhale pakati pa odwala sarcoidosis. Komabe, mtima ukakhudzidwa motere, zipsera zimatha kupangika mu minofu ya mtima ndi m'njira zomwe zizindikiro zamagetsi zimadutsa mumtima. Taganizirani ngati chipsera pakhungu pambuyo pa kuvulala. Zipsera izi zingayambitse kugunda kwa mtima kosazolowereka komanso mavuto a kugunda kwa mtima.

Kodi vutoli ndi lofala bwanji?

Matenda a mtima (cardiac sarcoidosis) si matenda ofala kwambiri. Padziko lonse lapansi, madokotala nthawi zambiri amazindikira kuti anthu 2% mpaka 5% okha ndi omwe ali ndi matenda a mtima omwe ali m'malo ena m'thupi. Komabe, kafukufuku wina akusonyeza kuti m'maiko ngati United States, 20% mpaka 30% ya anthu omwe ali ndi matenda a mtima (sarcoidosis) akhoza kukhala ndi matendawa, koma sangawapeze.

Matendawa amapezeka kwambiri m'maiko ngati Japan, komwe anthu opitilira theka omwe ali ndi sarcoidosis alinso ndi matendawa mumtima mwawo. Komabe, sarcoidosis ya mtima ndi yosowa poyerekeza ndi sarcoidosis yomwe imakhudza ziwalo zina.

Chinthu china chofunika kudziwa ndi chakuti pafupifupi gawo limodzi mwa magawo atatu a anthu omwe ali ndi matenda a mtima sasonyeza zizindikiro za sarcoidosis kwina kulikonse m'thupi. Izi zikutanthauza kuti mtima wanu ukhoza kukhala chiwalo choyamba chomwe chakhudzidwa ndi matendawa.

Kodi zizindikiro za matendawa ndi ziti?

Zizindikiro za Cardiac Sarcoidosis zimatha kusiyana malinga ndi munthu. Anthu ena sangakhale ndi zizindikiro zilizonse. Komabe, pali zizindikiro zina zodziwika bwino:

• Kupweteka pachifuwa: Kungamveke ngati kufinya kapena kufinya.
• Kupuma movutikira:Mungamve ngati mukulephera kupuma, kaya mwatopa pang'ono kapena mukungopuma.
• Kukomoka kapena chizungulire: Mungataye mwadzidzidzi chidziwitso ndikugwa.
• Kutopa: Kumva kutopa nthawi zonse, zivute zitani.
• Kutsokomola: Pakhoza kukhala chifuwa chouma chosatha.
• Kutupa kwa miyendo yanu: Malo monga mbali ya akakolo angatupe.
• Kugunda kwa mtima kosazolowereka / Kugunda kwa mtima: Kugunda kwa mtima kungakwere mwadzidzidzi, kuchepa, kapena kumva ngati kuti sikunagwire bwino ntchito.

Ngati muli ndi chimodzi mwa zizindikiro izi kapena zingapo, musanyalanyaze. Ndi bwino kufunsa upangiri kwa dokotala.

Nchifukwa chiyani sarcoidosis ya mtima imachitika?

Ndipotu, madokotala sanapezebe chifukwa chenicheni cha matendawa. Komabe, ofufuza amakhulupirira kuti majini a anthu ena komanso zinthu zina zomwe zimachitika m'chilengedwe zimatha kukhala ndi gawo. Izi zikutanthauza kuti matupi a anthu ena amatha kuchitapo kanthu pa chinthu china chomwe chili m'chilengedwe (monga bakiteriya, kachilombo, kapena fumbi) chomwe chimayambitsa vutoli. Komabe, izi zikadali mu gawo lofufuza.

Kodi matendawa amapezeka bwanji?

Ngati mukuganiza kuti muli ndi matenda a mtima otchedwa cardiac sarcoidosis, dokotala wanu ayamba kaye wakuyezani thupi. Kenako adzakufunsani za mbiri yanu yachipatala . Izi zikutanthauza zinthu monga matenda anu akale komanso ngati pali wina aliyense m'banja mwanu amene adakumanapo ndi matenda ofanana ndi anu.

Kuphatikiza apo, mayeso osiyanasiyana adzalamulidwa kuti aone ngati kugunda kwa mtima sikukuyenda bwino. Dokotala adzafufuza zizindikiro za sarcoidosis kwina kulikonse m'thupi lanu, komanso umboni wa zizindikiro zomwezo mumtima mwanu.

Kodi mayeso oyezetsa matenda ndi ati?

Pali mayeso angapo kuti adziwe matendawa molondola:

• Electrocardiogram (EKG/ECG): Iyi imalemba momwe magetsi a mtima wanu amagwirira ntchito ngati chitsanzo. Imatha kuzindikira zolakwika zilizonse mu kayendedwe ka mtima wanu.
• Echocardiogram: Izi zili ngati kujambula mtima. Zimagwiritsa ntchito mafunde a phokoso kuti zione mawonekedwe ndi kukula kwa mtima, momwe zipinda ndi ma valve a mtima akugwirira ntchito, ndi zina zambiri. Nthawi zina ma echo odutsa pachifuwa amachitidwa.
• Chowunikira cha Holter: Ichi ndi chipangizo chaching'ono chomwe mumavala kwa maola 24 mpaka 48. Chimathandiza kulemba nthawi zonse zomwe mtima wanu umachita pamene mukuchita ntchito zanu za tsiku ndi tsiku.
• Kujambula kwa Positron Emission Tomography (PET scan):Iyi ndi njira yapadera yofufuzira. Ndi yothandiza kwambiri pozindikira malo omwe ali ndi kutupa ndi zipsera mumtima.
• MRI ya Mtima (Cardiac Magnetic Resonance Imaging): Izi zimagwiritsa ntchito mphamvu zamaginito ndi mafunde a wailesi kuti zipange zithunzi zatsatanetsatane za mtima. Izi zingathandizenso kuwona bwino kuwonongeka ndi zipsera pa minofu ya mtima.

Sarcoidosis nthawi zambiri imapezeka m'zigawo zina za thupi potenga biopsy (chitsanzo chaching'ono cha minofu ndikuchiyang'ana pansi pa maikulosikopu). Komabe, izi sizofala kwambiri mumtima, chifukwa zimakhala zovuta kupeza chitsanzo kuchokera kudera lenileni la mtima komwe vutoli lili.

Mayeso awa ojambulira zithunzi amathandizanso madokotala kudziwa magawo a sarcoidosis ya mtima. Imatha kuyambira yofatsa mpaka yoopsa. Imatha kupita patsogolo m'magawo oyambirira, magawo opita patsogolo, komanso magawo ogwira ntchito, zomwe zimapangitsa kuti mtima uwonongeke komanso kuti mafupa agwire bwino ntchito.

Kodi mankhwala ake ndi otani?

Nkhani yabwino ndi yakuti pali mankhwala a matenda a mtima otchedwa cardiac sarcoidosis. Dokotala wanu adzasankha chithandizo choyenera kwambiri pa vuto lanu. Nazi zina mwa mankhwala omwe amagwiritsidwa ntchito kwambiri:

• Mankhwala a Corticosteroid: Izi zimagwira ntchito pochepetsa kutupa m'thupi. Prednisolone ndi mankhwala omwe amaperekedwa nthawi zambiri m'gululi.
• Mankhwala ena oletsa chitetezo chamthupi: Nthawi zina, ngati mankhwala a corticosteroid okha sakwanira, kapena ngati zotsatira zake zili zoopsa kwambiri, mankhwala ena angaperekedwe kuti achepetse chitetezo chamthupi kuti chisagwire ntchito mopitirira muyeso.
• Mankhwala oletsa kupweteka kwa mtima: Ngati kugunda kwa mtima sikukuyenda bwino, pali mankhwala apadera owongolera.
• Chothandizira kupuma: Ngati mtima ukugunda mofulumira kwambiri, kachipangizo kakang'ono aka kamayikidwa mumtima kuti kakhalebe ndi mphamvu nthawi zonse.
• Chotsukira mtima chotchedwa Implantable Cardioverter Defibrillator (ICD): Chipangizochi chimayikidwa pamene pali chiopsezo cha arrhythmias yoopsa yomwe ingawononge moyo. Nthawi ngati zimenezi, chimapangitsa mtima kugwedezeka pang'ono kuti ubwererenso ku rhythm yabwinobwino.
• Kuchotsa catheter: Iyi ndi njira yochiritsiranso kugunda kwa mtima kosakhazikika. Malo omwe ali mumtima omwe amayambitsa zizindikiro zamagetsi zosakhazikika amapezeka ndikuwonongeka pogwiritsa ntchito catheter.

Kawirikawiri, ngati matendawa afika poipa kwambiri moti angayambitse kulephera kwa mtima , kuikidwa mtima wina kungafunike.

Kodi mankhwala ndi mankhwala omwe amagwiritsidwa ntchito kwambiri ndi ati?

Madokotala nthawi zambiri amayamba ndi mlingo waukulu wa corticosteroid wotchedwa prednisone (mayina a makampani ndi Sterapred® kapena Rayos®). Izi zimatengedwa kwa miyezi ingapo. Kenako mlingo umachepetsedwa pang'onopang'ono. Ngati matendawa apezeka ndi kuchiritsidwa msanga, mankhwalawa amatha kuwongolera kwambiri zizindikiro.

Kodi pali zotsatirapo zilizonse za mankhwalawa?

Mankhwala a corticosteroid monga Prednisone angayambitse zotsatirapo zina akagwiritsidwa ntchito kwa nthawi yayitali. Ichi ndichifukwa chake dokotala wanu amakuyang'anirani nthawi zonse. Zotsatirapo zoyipa kwambiri ndi izi:

• Kufooka kwa mafupa: Kufooka kwa mafupa.
• Matenda: Chiwopsezo cha matenda chikhoza kukwera pamene chitetezo cha mthupi chikuchepa.
• Kuthamanga kwa magazi kwambiri.
• Kukwera kwa shuga m'magazi.
• Kusintha kwa maganizo.
• Kusowa tulo.

Ngakhale kuti chithandizo cha catheter ablation chimayamba bwino, anthu ena, makamaka omwe ali ndi ventricular tachycardia (kugunda kwa mtima mofulumira komwe kumayambira m'zipinda zapansi pa mtima), amatha kubwereranso mpaka 86% ya milandu.

Chiwopsezo cha matenda a mtima otchedwa cardiac sarcoidosis chimabweranso pambuyo poika mtima wina ndi chochepera 10%.

Kodi Cardiac Sarcoidosis ndi vuto lalikulu?

Izi zimasiyana malinga ndi matenda anu. Zotsatira zabwino zimapezeka ngati matendawa apezeka msanga ndipo chithandizo chikuyamba msanga. Ngati chithandizo chachedwa, vutoli likhoza kukhala lalikulu kwambiri.

Ngati muli ndi matenda monga kuthamanga kwa magazi m'mapapo ( kupanikizika kwakukulu m'mitsempha yomwe imanyamula magazi kupita ku mapapo) kapena ventricular aneurysm (kufooka kwa khoma la chipinda chimodzi chapansi cha mtima chomwe chimatupa ngati baluni), zizindikiro sizingakhale zabwino.

Kodi mungakhale ndi matendawa kwa nthawi yayitali bwanji?

Ngati chithandizo chayamba msanga, anthu ambiri amakhala bwino.

Kafukufuku wapeza kuti pakati pa 83% ndi 93% ya anthu omwe ali ndi matenda a mtima (cardiac sarcoidosis) amakhalabe ndi moyo patatha zaka 10.

Chiŵerengero cha moyo pambuyo pa kusamutsidwa mtima ndi 80% kapena kuposerapo pa chaka chimodzi ndi zisanu.

Kumbukirani, ngakhale ziwerengerozi zikusonyeza matenda ambiri, vuto lanu lingasiyane. Choncho lankhulani ndi dokotala wanu kuti mumvetse bwino za vuto lanu.

Kodi Cardiac Sarcoidosis ingakhale yoopsa?

Inde, matenda a mtima otchedwa cardiac sarcoidosis amatha kupha anthu ena. Chiwopsezo cha imfa n'chokwera, makamaka ngati ventricle yakumanzere ya mtima wanu siikupopa magazi moyenera.

Imfa yadzidzidzi ya mtima nthawi zambiri imayamba chifukwa cha ventricular arrhythmias (kugunda kwa mtima kosasinthasintha m'zipinda zapansi pa mtima). Ngati muli pachiwopsezo, dokotala wanu angakulangizeni kuti muyike chipangizo cha ICD.

Kodi ndiyenera kudzisamalira bwanji?

Popeza vutoli likhoza kuipiraipira pakapita nthawi yochepa, ndikofunikira kumwa mankhwala monga momwe dokotala wanu wanenera. Mungafunike kumwa mankhwala monga Prednisone kwa chaka chimodzi. Ngati mukukumana ndi zotsatirapo zilizonse kuchokera ku mankhwalawa, uzani dokotala wanu. Koma musasiye kumwa mankhwalawo popanda upangiri wa dokotala.

Ndiyenera kupita kwa dokotala liti?

Mudzafunika kuyesedwanso zithunzi pafupifupi mwezi umodzi kapena miyezi isanu ndi umodzi mutayamba kumwa mankhwala a steroid (monga prednisone). Izi zimathandiza dokotala wanu kudziwa momwe mankhwalawo akugwirira ntchito komanso mlingo womwe uyenera kuperekedwa mtsogolo.

Ngakhale mutasiya kumwa mankhwala a steroid kapena kuchepetsa mlingo, muyenera kupitiriza kukaonana ndi dokotala wanu kwa zaka zosachepera zitatu. Izi zili choncho chifukwa chakuti matenda a mtima otchedwa cardiac sarcoidosis amatha kubwereranso. Pafupifupi 40% ya anthu adzabwereranso matendawa mwanjira imeneyi.

Kodi ndiyenera kupita liti ku Emergency Treatment Unit (ETU) ?

Ngati mwadzidzidzi mukukumana ndi zizindikiro izi , pitani kuchipatala chapafupi nthawi yomweyo kapena imbani 1990:

• Kupweteka pachifuwa ndi kupuma movutikira
• Kugunda kwa mtima kosalekeza
• Chizungulire ndi/kapena kukomoka

Izi zitha kukhala zizindikiro za vuto loopsa la mtima.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala?

Musaiwale kufunsa mafunso awa mukapita kwa dokotala:

• Kodi ndingathe kuwongolera vutoli ndi mankhwala okha?
• Kodi maganizo anga ndi otani, makamaka poganizira momwe zinthu zilili panopa?
• Kodi ventricle yanga yakumanzere ikugwira ntchito bwino bwanji?
• Ndiyenera kumwa mankhwalawo kwa nthawi yayitali bwanji?
• Ndi kusintha kotani kwa moyo komwe ndingapange?

Pomaliza, zinthu zoti muzikumbukira (Uthenga Wopita Nawo Kunyumba)

Cardiac Sarcoidosis ndi mawu owopsa pang'ono, koma ndikofunikira kwambiri kuwadziwa.

Zotsatira zabwino kwambiri zitha kupezeka ngati matendawa atapezeka msanga ndipo chithandizo chimayamba msanga.

Choncho, ngati muli ndi zizindikiro izi, musazinyalanyaze ndipo funsani upangiri kwa dokotala. Imwani mankhwala omwe dokotala wanu wakupatsani nthawi yake. Lankhulani ndi dokotala wanu za zotsatirapo zake. Pitani kukayezetsa kuchipatala nthawi yake. Ngati muchita izi bwino, mutha kukhala bwino ndi vutoli. Simuli nokha, ndipo madokotala alipo kuti akuthandizeni.

Matenda a mtima , sarcoidosis, kutupa kwa mtima, kupuma movutikira, kupweteka pachifuwa, kugunda kwa mtima kosakhazikika, corticosteroids