Kodi mukuvutika kupuma chifukwa cha kupweteka pachifuwa? Izi zitha kukhala pericarditis!

Kodi munamvapo ululu waukulu pakati pa chifuwa chanu, zomwe zimapangitsa kuti zikhale zovuta kupuma? Izi zitha kuchitika ngakhale mutachira ku chimfine kapena chimfine. Anthu ambiri amaopa kuti uwu ndi matenda a mtima. Ndipotu, ukhoza kukhala kutupa kwa thumba lomwe lili pafupi ndi mtima. Lero, tikambirana mwatsatanetsatane za vutoli lotchedwa ``pericarditis.''

Kodi mukudziwa chomwe pericarditis ndi?

Mwachidule, `Pericarditis` ndi kutupa kapena kutupa kwa `pericardium`, thumba lopyapyala kwambiri, lokhala ndi zigawo ziwiri, lodzaza madzi lomwe limazungulira mtima wathu. Lili ngati kudula pakhungu lathu komwe kumapangitsa kuti malowo akhale ofiira komanso otupa. Ntchito yayikulu ya `pericardium` iyi ndikuteteza mtima ndikuupatsa mafuta ofunikira ukagunda. Chifukwa cha kutupa kumeneku, nthawi zina madzi owonjezera amatha kuwunjikana pakati pa zigawo za pericardium. Izi zimatchedwa `pericardial effusion`.

Matenda a mtima nthawi zambiri amabwera mwadzidzidzi. Komabe, nthawi zina amatha kwa milungu ingapo mpaka miyezi ingapo. Nthawi zambiri, matendawa amatha mkati mwa miyezi itatu, koma mwa anthu ena amatha kwa zaka zambiri.

Pali mitundu ingapo ya pericarditis, sichoncho?

Inde, pali mitundu yosiyanasiyana ya `Pericarditis`. Tiyeni tiwone mitundu ikuluikulu:

• Matenda a mtima otchedwa Acute Pericarditis: Uwu ndi mtundu wofala kwambiri. Kutupa kumeneku kumachitika mwadzidzidzi, ndipo zizindikiro zake zimayamba.
• Matenda a Pericarditis Osatha: Dzina lakuti kutupa komwe kumapitirira kwa miyezi itatu kapena kuposerapo pambuyo pa nthawi yoyamba ya matenda.
• Constrictive Pericarditis: Ili ndi vuto lalikulu kwambiri. Chomwe chimachitika apa ndi chakuti zigawo za pericardium zomwe zatupa pang'onopang'ono zimakhuthala, minofu ya zipsera imapangika, ndikumamatirana. Zimakhala ngati mtima ukukakamira. Izi zimasokoneza kwambiri magwiridwe antchito a mtima. Vutoli nthawi zambiri limachitika pambuyo pa nthawi yayitali ya `Acute Pericarditis`.
• Matenda a Pericarditis Opatsirana: Matendawa angayambitsidwe ndi matenda a mavairasi, mabakiteriya, bowa, kapena tizilombo toyambitsa matenda.
• Idiopathic Pericarditis: Nthawi zina chifukwa cha izi sichidziwika . Ndicho chifukwa chake chimatchedwa ichi.
• Matenda a mtima otchedwa Traumatic Pericarditis: Matendawa angachitike munthu akavulala pachifuwa, mwachitsanzo akavulala pagalimoto.
• Uremic Pericarditis: Izi zitha kuchitika mwa anthu omwe impso zawo sizikugwira ntchito bwino.
• Pericarditis Yoopsa:Vutoli likhozanso kuchitika chifukwa cha khansa yomwe imayamba kwina m'thupi.

Kodi pali kusiyana kotani pakati pa myocarditis ndi pericarditis?

Zonsezi ndi matenda otupa a mtima, koma amapezeka m'malo awiri. Myocarditis ndi kutupa kwa minofu ya mtima. Pericarditis ndi kutupa kwa thumba lozungulira mtima, lotchedwa pericardium. Zonsezi nthawi zambiri zimayambitsidwa ndi kachilombo. Zonsezi zingayambitse kupweteka pachifuwa. Komabe, ndi pericarditis, kupweteka pachifuwa kuyenera kuchepetsedwa mukawerama patsogolo. Ndi myocarditis, mudzamva kutopa kwambiri komanso kufooka.

Ndani amene ali ndi mwayi waukulu wopeza Pericarditis?

Aliyense akhoza kudwala matenda a pericarditis. Komabe, amapezeka kwambiri mwa amuna azaka zapakati pa 16 ndi 65. Malinga ndi ziwerengero, vutoli limapezeka mwa anthu pafupifupi 28 mwa anthu 100,000 pachaka.

Kodi chimachitika ndi chiyani m'thupi pamene pericarditis imachitika?

Mukakhala ndi pericarditis, nembanemba yozungulira mtima wanu imakhala yofiira komanso yotupa. Zili ngati khungu lozungulira bala lomwe lili padzanja kapena mwendo wanu. Pericardium iyi ndi yofunika kwambiri. Imapaka mafuta pamtima, imateteza ku matenda ndi khansa, ndipo imathandiza kuti ikhale pamalo ake pachifuwa. Imaletsanso mtima kukula kwambiri magazi akachuluka. Izi zimathandiza mtima kugwira ntchito bwino.

Kodi zizindikiro za pericarditis ndi ziti? Kodi mumazindikira bwanji?

Chizindikiro chachikulu cha pericarditis ndi kupweteka pachifuwa. Ululu uwu ulinso ndi zizindikiro zingapo zapadera:

• Ululu woopsa komanso wobaya (izi zimachitika chifukwa mtima umakwinya pa pericardium yotupa).
• Ululu uwu ukhoza kuwonjezeka mukakosoza, kumeza, kupuma mozama, kapena kugona pansi.
• Komabe, mukakhala pansi ndikuwerama, muyenera kumva ululu ukuchepa. Ichi ndi chizindikiro chofunikira kwambiri.

Nthawi zina mungamve kufunika kowerama kapena kugwira chifuwa chanu kuti mupumule mosavuta.

Pali zizindikiro zina:

• Kupweteka kumbuyo, khosi, kapena phewa lamanzere.
• N'zovuta kupuma ukakhala kuti watsekeredwa.
• Chifuwa chouma.
• Kugunda kwa mtima ndi kumva mtima ukugunda mofulumira kapena mosagwirizana.
• Kumva nkhawa komanso kutopa nthawi zonse.
• Malungo.
• Pa milandu yoopsa, kutupa kwa miyendo, akakolo, ndi mapazi.

Ngati miyendo yanu, mapazi, ndi akakolo anu atupa, kapena mukuvutika kupuma ngakhale mukuchita zinthu zazing'ono, izi zitha kukhala chizindikiro cha matenda oopsa otchedwa Constrictive Pericarditis. Izi zimachitika pamene pericardium imakhuthala ndikuletsa mtima kukula bwino. Izi zimalepheretsa mtima kupopa magazi bwino. Izi zingayambitse mapapo, mimba, ndi miyendo kudzaza ndi magazi ndi kutupa, mofanana ndi zizindikiro za Congestive Heart Failure. Kusinthasintha kwa mtima kosazolowereka kungachitikenso.

Ngati muli ndi zizindikiro zilizonse za `Acute Pericarditis`, pitani kwa dokotala nthawi yomweyo. Ngati mukuganiza kuti zizindikiro zanu ndi zadzidzidzi, funani chithandizo kuchipatala chapafupi.

Kodi n’chifukwa chiyani matenda a pericarditis amapezeka? Kodi zimayambitsa chiyani?

Chodabwitsa n'chakuti, pa milandu pafupifupi 90 mwa 100, palibe chifukwa chenicheni chomwe chingapezeke cha "pericarditis." Izi zimatchedwa "idiopathic pericarditis."

Komabe, palinso zifukwa zina zomwe pericarditis ingachitike:

• Monga vuto la matenda opatsirana ndi kachilombo (nthawi zambiri kachilombo ka m'mimba).
• Matenda a bakiteriya, mwachitsanzo, chifuwa chachikulu.
• Matenda a bowa.
• Matenda ochokera ku tizilombo toyambitsa matenda.
• Chifukwa cha 'Matenda ena a Autoimmune', mwachitsanzo 'Lupus', 'Rheumatoid Arthritis', 'Scleroderma'.
• Kuvulala pachifuwa, monga pambuyo pa ngozi ya galimoto.
• Chifukwa cha 'Kulephera kwa Impso'.
• Chifukwa cha khansa monga `Lymphoma`.
• Chifukwa cha matenda a majini monga `Familial Mediterranean Fever (FMF)`.
• Chifukwa cha mankhwala ena omwe amaletsa chitetezo chamthupi (izi zimachitika kawirikawiri).

Komanso, chiopsezo chotenga pericarditis chimakhala chachikulu pambuyo pa izi:

• Pambuyo pa 'Nthenda ya Mtima'.
• Pambuyo pa opaleshoni ya mtima (Open Heart Surgery / Postpericardiotomy Syndrome).
• Pambuyo pa chithandizo cha radiation.
• Pambuyo pa chithandizo china monga `Cardiac Catheterization` kapena `Radiofrequency Ablation (RFA)`.

Pazochitikazi, pericarditis ingayambitsidwe ndi vuto la momwe thupi limayankhira opaleshoni kapena vutolo. Nthawi zina, zizindikiro za pericarditis zimatha kutenga milungu ingapo kuti ziwonekere mutachita opaleshoni ya bypass. Lankhulani ndi dokotala wanu za izi.

Dokotala, kodi mumazindikira bwanji pericarditis?

Kupweteka kwambiri pachifuwa panu ndi kumbuyo kwa mapewa anu, makamaka mukawerama patsogolo, ndi kupweteka pachifuwa mukapuma ndi zizindikiro ziwiri zazikulu zomwe zikusonyeza kuti mungakhale ndi pericarditis. Izi zingakuthandizeni kudziwa ngati si matenda a mtima. Dokotala wanu adzakufunsani za zizindikiro zanu, ngati mwadwala posachedwapa, matenda aliwonse omwe mudachitapo kale, opaleshoni iliyonse yomwe mudachitapo, ndi mavuto ena azaumoyo omwe angakuwonjezereni chiopsezo chanu chokhala ndi pericarditis.

Dokotala adzamvetsera mtima wanu. Pamene zigawo zotupa za pericardium zikukhutchumuka pamodzi, mudzamva phokoso ngati masamba awiri akukhutchumuka pamodzi, kapena zidutswa ziwiri za chikopa chouma zikukhutchumuka pamodzi . Izi zimatchedwa "pericardial rub." Phokosoli limamveka bwino mukawerama patsogolo, kugwira mpweya wanu, kenako n’kupuma pang’onopang’ono. Kutengera ndi kuopsa kwa kutupa, mungamvenso "kung’ambika" m’mapapo. Izi zikutanthauza kuti pali madzi m’malo ozungulira mapapo, kapena pali madzi owonjezera m’pericardium.

Ndi mayeso ati omwe akuchitidwa pa izi?

Madokotala adzachita mayeso osiyanasiyana kuti aone ngati pali vuto la pericarditis, komanso mavuto monga pericardial effusion kapena constrictive pericarditis. Mungafunike kuchita chimodzi kapena zingapo mwa izi:

• X-ray ya pachifuwa: Yang'anani kukula kwa mtima ndikuwona ngati pali madzi m'mapapo.
• Electrocardiogram (ECG kapena EKG): Kufufuza kusintha kwa kagwiridwe ka mtima. Pafupifupi theka la anthu omwe ali ndi vuto la pericarditis adzakhala ndi kusintha koonekera pa ECG yawo. Anthu ena sangakhale ndi kusintha kulikonse.
• Echocardiogram (Echo): Kuwona momwe mtima ukugwira ntchito bwino komanso ngati pali madzi ozungulira mtima (pericardial effusion). Echo ikhoza kusonyeza zizindikiro za constrictive pericarditis, yomwe ndi thumba lolimba komanso lokhuthala lozungulira mtima.
• Kujambula MRI ya Mtima: Kuyang'ana ngati pali madzi ochulukirapo, kutupa, kukhuthala, kapena kugunda kwa mtima mu pericardium . Mankhwala apadera otchedwa `Gadolinium` amalowetsedwa mumtima.
• Kujambula kwa CT: Kuti muwone ngati pali calcium, madzi, kutupa, zotupa, kapena matenda ena mu pericardium. Izi zimagwiritsa ntchito utoto wokhala ndi `Iodine`. Dziwani zambiri za kutupa. Kuyeza kumeneku ndikofunikira kwambiri ngati mukufuna opaleshoni ya `Constrictive Pericarditis`.
• Kutsegula mtima (Catheterization): Kumayesa kuthamanga kwa magazi mkati mwa mtima. Izi zitha kutsimikizira ngati muli ndi Constrictive Pericarditis.
• Kuyezetsa Magazi: Kuonetsetsa kuti simukudwala matenda a mtima, kuona momwe mtima wanu ukugwira ntchito bwino, kuyang'ana madzi omwe ali mu pericardium, ndikuthandizira kupeza chomwe chimayambitsa pericarditis. Ngati muli ndi pericarditis, ESR (Erythrocyte Sedimentation Rate) ndi ultra-sensitive C-reactive protein (CRP) yanu nthawi zambiri imakhala yokwera kuposa yachibadwa. Mayeso ena angachitikenso kuti aone matenda a autoimmune monga lupus ndi rheumatoid arthritis.

Kodi mankhwala a pericarditis ndi ati?

Nthawi zambiri, kwa anthu omwe ali ndi vuto la pericarditis, mankhwala okha ndi okwanira, kutengera chomwe chikukayikiridwa. Komabe, ngati madzi asonkhana mu pericardium yanu, angafunike kuchotsedwa. Ngati muli ndi pericarditis yotsekeka, opaleshoni ingafunike.

Mankhwala a Pericarditis

Matenda a mtima otchedwa acute pericarditis amachiritsidwa ndi mankhwala opweteka komanso otupa, monga ibuprofen kapena aspirin wambiri. Kutengera ndi chomwe chimayambitsa pericarditis, mungafunike mankhwala opha tizilombo toyambitsa matenda kapena opha tizilombo toyambitsa matenda.

Ngati muli ndi zizindikiro zoopsa kwa milungu yoposa iwiri, kapena ngati zabweranso mutachira, dokotala wanu angakulembeninso mankhwala oletsa kutupa otchedwa Colchicine (Colcrys® kapena Gloperba®). Colchicine ingathandize kuchepetsa kutupa ndikuletsa pericarditis kuti isabwererenso kwa milungu kapena miyezi. Ngati muli ndi matenda a impso, dokotala wanu angakulembeninso mankhwala otchedwa Prednisone, omwe angapangitse kuti zikhale zovuta kumwa ibuprofen ndi colchicine.

Ngati mukuyenera kumwa `Ibuprofen` wambiri, dokotala wanu adzakupatsaninso mankhwala ena kuti muchepetse kusasangalala kwa m'mimba. Ngati mukumwa `NSAIDs` zambiri (Nonsteroidal Anti-inflammatory Drugs)`, muyenera kuyesedwa nthawi zonse kuti muwone ngati impso ndi chiwindi zasintha.

Ngati muli ndi vuto la `Chronic` kapena `Recurrent` Pericarditis, mungafunike kumwa `NSAIDs` kapena `Colchicine` kwa zaka zingapo, ngakhale mutakhala ndi thanzi labwino. ``Diuretics`` ("mapiritsi amadzi") nthawi zambiri amathandiza kuchotsa madzi owonjezera omwe amaunjikana chifukwa cha ``Constrictive Pericarditis``. Ngati muli ndi vuto la mtima, dokotala wanu adzakulankhulani za chithandizo cha zimenezo.

Dokotala wanu angakuuzeninso za kuchiza vuto lanu ndi ma steroid kapena mankhwala ena, monga `Azathioprine (Azasan® kapena Imuran®)`, `IV Human Immunoglobulins`, kapena `Anakinra` kapena `Rilonacept`.

Ngati pericarditis yanu yayamba chifukwa cha matenda, dokotala wanu adzakupatsani mankhwala enaake ochizira matendawa. Ngati yayamba chifukwa cha khansa, chithandizo chabwino kwambiri ndi kuchiza khansa.

Opaleshoni ndi njira zochizira pericarditis

Madzi akamaunjikana pakati pa zigawo za pericardium, amayambitsa vuto lotchedwa `Pericardial Effusion`. Ngati madziwa akuunjikana mwachangu, angayambitse `Cardiac Tamponade`, vuto lalikulu lomwe limaika mtima pansi ndikusokoneza ntchito yake. `Cardiac Tamponade` ndi vuto lachipatala lomwe limayambitsa ngozi ndipo limafuna chithandizo chachangu.

Kusonkhana kwa madzi mwadzidzidzi pakati pa zigawo za mtima kungalepheretse mtima kugwira ntchito bwino ndikupangitsa kuti kuthamanga kwa magazi kuchepe. Izi zikuika moyo pachiswe, choncho dokotala ayenera kuchotsa madziwo nthawi yomweyo.

Ngati muli ndi madzi m'kati mwa mtima wanu, zomwe zikukupangitsani kupanikizika, mungafunike kuchita opaleshoni yotchedwa pericardiocentesis. Izi zikutanthauza kuti dokotalayo akugwiritsa ntchito chubu chachitali, chopyapyala chotchedwa catheter kuti achotse madzi ochulukirapo. Chubuchi ndi singano iyi zimalowetsedwa mu thumba la mtima pogwiritsa ntchito echocardiogram kapena CT scan.

Ngati madziwo sangachotsedwe ndi singano, dokotalayo adzachita opaleshoni yaying'ono yotchedwa ``pericardial window.'' Izi zimaphatikizapo kudula pang'ono pachifuwa ndi kuboola dzenje mu pericardium kuti achotse madziwo.

Ngati muli ndi vuto la pericarditis yotsekeka, gawo la thumba lanu la mtima lingafunike kuchotsedwa. Opaleshoni iyi imatchedwa pericardiectomy. Imachitika kwa anthu omwe ali ndi zipsera mu thumba la mtima. Nthawi zambiri siimachitika kwa anthu omwe ali ndi kutupa komanso kupweteka pachifuwa chifukwa cha pericarditis.

Opaleshoni nthawi zambiri siigwiritsidwa ntchito ngati chithandizo cha anthu omwe ali ndi vuto la pericarditis yobwerezabwereza, chifukwa kutupa kungapangitse kuti zikhale zovuta kuchira pambuyo pa opaleshoni. Komabe, dokotala wanu angakambirane nanu izi ngati njira zina zothandizira sizinagwire ntchito.

Kodi zimatenga nthawi yayitali bwanji kuti munthu achire pambuyo pa chithandizo?

Muyenera kuyankha chithandizo mkati mwa sabata imodzi, koma muyenera kumwa mankhwala kwa pafupifupi milungu iwiri. Kuchira pambuyo pa opaleshoni kumatenga nthawi yayitali. Zingatenge milungu kapena miyezi kuti muchiritse matenda a pericarditis. Ndikofunikira kwambiri kupuma mokwanira panthawiyi.

Kodi kubwereranso kwa pericarditis kungachepe?

Ngakhale simungathe kupewa matenda a `Acute Pericarditis`, mutha kuchepetsa chiopsezo choti abwererenso mwa kulandira chithandizo mwachangu ndikutsatira chithandizocho ndendende. Komanso, tsatirani malangizo a dokotala wanu okhudza nthawi yoti muyambirenso kuchita masewera olimbitsa thupi. Kuchita masewera olimbitsa thupi mwamphamvu panthawi ya `Pericarditis` kungapangitse vutoli kukhala loipa kwambiri.

Kodi muyenera kukumbukira chiyani mukakhala ndi pericarditis?

Mukachira matenda a pericarditis, muyenera kubwerera ku zochita zanu zachizolowezi popanda nkhawa. Komabe, musayambenso kuchita masewera olimbitsa thupi mpaka dokotala wanu atakupatsani chithandizo. Dokotala wanu adzakuuzani zambiri za izi.

Kodi pericarditis imatenga nthawi yayitali bwanji?

• Matenda a mtima otchedwa acute pericarditis amatha pakati pa milungu inayi ndi isanu ndi umodzi.
• `Pericarditis yosatha` (yopitirira) imatenga nthawi yayitali kuposa pamenepo, koma yosakwana miyezi itatu.
• Matenda a Pericarditis osatha akhalapo kwa miyezi yoposa itatu.
• Pakati pa 15% ndi 30% ya anthu omwe ali ndi pericarditis amatha kukhala ndi zochitika zobwerezabwereza pakapita zaka.

Ngati munthu ali ndi vuto la `Acute Pericarditis` akalandira chithandizo, amakhala ndi mwayi waukulu wochira. Anthu ambiri amachira kwathunthu. Ngati muli ndi vuto lochepa, limatha kutha ndi kupuma. Komabe, ngati silinalandire chithandizo, anthu ena amatha kudwala `Chronic Pericarditis`.

Chofunika kwambiri ndikumwa mankhwala monga momwe dokotala wanenera komanso kuonana ndi dokotala pa masiku omwe akonzedwa.

Kodi muyenera kupita kwa dokotala liti?

Ngati muli ndi zizindikiro za `Constrictive Pericarditis`, pitani kwa dokotala nthawi yomweyo. Zizindikiro izi zikuphatikizapo:

• Kuvuta kupuma.
• Kutupa kwa miyendo ndi mapazi.
• Kusunga madzi m'thupi.
• Kugunda kwa mtima.
• Kutupa kwambiri m'mimba.

Ngakhale kupweteka pachifuwa ndi chizindikiro chofala cha pericarditis, kungakhalenso chizindikiro cha matenda a mtima. Chifukwa chake, ngati mukumva kupweteka pachifuwa, kungakhale matenda a mtima, choncho pitani kuchipatala mwamsanga.

Pomaliza, zinthu zina zofunika

Ndikukhulupirira kuti tsopano mwamvetsa bwino za vuto ili lotchedwa `Pericarditis`. Kumbukirani,Ngati muli ndi kupweteka pachifuwa, makamaka mukawerama patsogolo komanso mukapuma, limodzi ndi zizindikiro monga kutentha thupi ndi kutopa, izi zitha kukhala pericarditis. Ngati izi zitachitika, ndi bwino kufunafuna upangiri wa dokotala popanda mantha.

Ngati mwalandira chithandizo msanga, nthawi zambiri mumatha kuchira mokwanira. Ngati mutsatira chithandizocho moyenera, zingathandizenso kupewa kuti vutoli lisabwererenso. Chifukwa chake, ndikofunikira kwambiri kugwiritsa ntchito mankhwala omwe dokotala wanu wakupatsani molondola komanso kupita kukaonana ndi dokotala nthawi zonse. Dziwani zizindikiro za pericarditis, kuti ngati zitachitikanso, mutha kulandira chithandizo mwachangu. Ndikukufunirani kuchira kwathanzi!

Pericarditis , pericarditis, kupweteka pachifuwa, kupuma movutikira, matenda a mtima, matenda a mtima, Colchicine