Kodi mtima wanu ndi wofooka? Tiyeni tiphunzire za kulephera kwa mtima kwa Systolic.

Kodi nthawi zina mumamva kusowa mpweya? Kodi mumamva kutopa ngakhale mutagwira ntchito pang'ono? Kapena miyendo yanu imatupa? Izi zitha kukhala zizindikiro zosonyeza kuti mtima wanu ndi wofooka pang'ono. Lero, tikambirana za matenda a mtima awa, 'Systolic Heart Failure'. Ngakhale kuti izi ndi zovuta pang'ono, ndi vuto lomwe lingathetsedwe ngati litazindikirika msanga ndikuchiritsidwa bwino.

Kodi Kulephera kwa Mtima wa Systolic N'chiyani?

Mwachidule, mtima wanu uli ndi zipinda zinayi zazikulu. Chipinda chapansi kumanzere, chotchedwa ventricle yakumanzere, chimapopera magazi okhala ndi mpweya m'thupi lonse. Chimagwira ntchito ngati pampu yamadzi. Tsopano, mu mkhalidwe uwu wotchedwa systolic heart failure, ventricle yakumanzere imakhala yofooka. Izi zikutanthauza kuti singathe kupopera magazi moyenera komanso moyenera.

Kodi chimachitika ndi chiyani? Tangoganizirani ngati injini yamadzi siili yolimba mokwanira, madzi sadzayenda bwino. Mofananamo, pamene mtima supompa magazi bwino, madzi amatha kusonkhana m'mapapo. Pamenepo ndi pamene zinthu monga kupuma movutikira ndi kutopa zimachitika. Ziwalo zina za thupi, makamaka miyendo, akakolo, ndi mimba, zimathanso kutupa . Izi zili choncho chifukwa madzi m'thupi sakuyenda bwino.

Ndiye kodi gawo la Ejection Fraction limeneli ndi chiyani?

Tsopano tiyeni tikambirane za tanthauzo la Ejection Fraction (EF) . Izi zimatchedwa 'Ejection Fraction' mu Chisinhala. Ngakhale kuti ili ndi dzina lachipatala, n'zosavuta kumvetsa. Mwachidule, ili ndi kuchuluka kwa magazi omwe ventricle yanu yakumanzere imapopera m'thupi ikagunda kamodzi.

Mtima wathanzi komanso wogwira ntchito bwino uyenera kukhala ndi EF value pakati pa 55% ndi 70% . Izi zikutanthauza kuti magazi opitilira theka omwe amalowa mu ventricle yakumanzere ya mtima amatulutsidwa kamodzi kokha. Komabe, ngati EF value iyi itsika pansi pa 40% , ikhoza kukhala chizindikiro cha kulephera kwa mtima kwa systolic. Izi zikutanthauza kuti mphamvu ya mtima yopompa yachepa. Ichi ndichifukwa chake vutoli nthawi zina limatchedwa 'Heart Failure with Reduced Ejection Fraction' (HFrEF) .

Ndani amene ali ndi mwayi waukulu wopeza vutoli?

Kulephera kwa mtima kwa systolic kungakhudze aliyense, koma chiopsezochi chimawonjezeka ndi ukalamba. Chimachitikanso kwambiri kwa anthu omwe ali ndi matenda ena a mtima, monga matenda a mtima kapena kuthamanga kwa magazi.

Kodi n’chiyani chimayambitsa kulephera kwa mtima kwa systolic (HFrEF)?

Kulephera kwa mtima kwa systolic nthawi zambiri kumachitika pamene ventricle yakumanzere ya mtima yawonongeka ndi matenda ena. Taganizirani izi motere: minofu ya mtima ili ngati lamba. Imatambasuka ndi kupindika. Koma ngati yawonongeka, singathe kugwira ntchitoyo bwino.

Nazi zina mwa zifukwa zazikulu zomwe zingakhudze izi:

• Matenda a Mitsempha ya Mtima: Ichi ndi chomwe chimayambitsa kwambiri. Mitsempha yomwe imapereka magazi kumtima (mitsempha ya mtima) imachepa kapena kutsekedwa ndi mafuta ambiri, zomwe zimapangitsa kuti minofu ya mtima isalandire mpweya ndi michere yomwe imafunika. Izi zimapangitsa kuti minofuyo ifooke.
• Kuthamanga kwa magazi (Kuthamanga kwa magazi): Kuthamanga kwa magazi kukakwera kwa nthawi yayitali, mtima umayenera kugwira ntchito molimbika kuti upompe magazi. Zili ngati kupompa madzi mumtsempha wotsekeka. Pakapita nthawi, izi zingayambitse minofu ya mtima kukula kenako n’kufooka.
• Kuvulala kwa Mtima Kwapita: Matenda a mtima ndi pamene magazi amapita ku gawo lina la mtima, zomwe zimapangitsa kuti maselo a minofu afe. ​​Kenako malo akufa amakhala ndi zipsera, zomwe zimapangitsa kuti mtima usathe kupopa magazi.
• Matenda a shuga: Matenda a shuga amathanso kuwononga mitsempha yamagazi ndikukhudza mwachindunji minofu ya mtima.
• Mtima Wosasinthasintha: Pamene kugunda kwa mtima sikukuyenda bwino, mtima sungapope magazi bwino.
• Matenda a Valavu ya Mtima: Pamene mavavu a mumtima sakugwira ntchito bwino, magazi amatha kuyenda chammbuyo kapena chamtsogolo, zomwe zingapangitse mtima kupanikizika kwambiri.
• Myocarditis: Kutupa kwa minofu ya mtima. Izi zitha kuchitika chifukwa cha matenda monga mavairasi.

Kuwonongeka kumeneku kungayambitse zipsera pa minofu ya mtima, kukulirakulira, kapena kuuma kwa ma ventricle. Zonsezi zimafooketsa ventricle yakumanzere ndikuchepetsa EF. Nkhani yabwino ndi yakuti nthawi zambiri, ngati chifukwa chake chithandizidwa bwino, ntchito ya mtima ikhoza kusinthidwa pang'ono.

Kodi zizindikiro za vutoli ndi ziti?

Chabwino, mungadziwe bwanji ngati muli ndi vutoli? Nazi zizindikiro zina zomwe muyenera kuzisamala nazo:

• Kupuma movutikira (Dyspnea): Mungakhale ndi vuto lopuma, makamaka mukamachita masewera olimbitsa thupi, kukwera masitepe, kapena kugona pabedi. Ngati mukufuna kugona ndi mapilo awiri kapena atatu usiku, chimenechonso ndi chizindikiro.
• Kutopa ndi kufooka pafupipafupi: Ngati mukumva kutopa kwambiri ngakhale mutachita ntchito zomwe kale zinali zosavuta.
• Kutupa kwa miyendo, akakolo, ndi mapazi: Kutupa kumeneku kungachitike chifukwa cha kusunga madzi m'thupi. Nthawi zina mimba imathanso kutupa.
• Kugunda kwa mtima mwachangu kapena kosasinthasintha: Ngati mukumva kusintha kwa momwe mtima wanu umagunda.
• Chifuwa chosalekeza kapena kupuma movutikira: Chifuwa chomwe chimatsagana ndi ntchofu yoyera.
• Kuchepa kwa luso lochita masewera olimbitsa thupi.
• Kusanza kapena kusowa chilakolako cha chakudya.
• Kupweteka pachifuwa: Izi zitha kukhala chifukwa cha matenda monga matenda a mitsempha ya mtima.
• Chizungulire.

Ngati muli ndi chimodzi mwa zizindikiro izi, chonde musanyalanyaze ndipo pitani kwa dokotala. Mukazindikira msanga, zimakhala zosavuta kuchiza.

Kodi madokotala amazindikira bwanji izi?

Mukapita kwa dokotala, adzakuyesani mayeso angapo kuti adziwe ngati muli ndi vuto la mtima la systolic. Chofunika kwambiri ndikupeza chomwe chimayambitsa vutoli kuti muchiritse bwino.

Njira yoyeserayi nthawi zambiri imakhala ndi izi:

1. Kuyezetsa thupi:

• Dokotala adzakufunsani za zizindikiro zanu (nthawi yomwe zakhalapo, momwe zimamvera).
• Amafunsa za matenda anu akale, monga ngati pali aliyense m'banja mwanu amene ali ndi matenda a mtima.
• Stethoscope imagwiritsidwa ntchito kumvetsera mtima ndi mapapo (kuyang'ana mawu osazolowereka ndi madzi m'mapapo).
• Kuthamanga kwa magazi anu kumayesedwa.
• Mudzayesedwa (kuti muwone ngati mwawonjezera kulemera mwadzidzidzi, chifukwa cha kusunga madzi m'thupi).

2. Kuyezetsa magazi (Kuyezetsa magazi):

• Mayeso a magazi awa amatha kuwona ngati ziwalo zina (monga impso ndi chiwindi) zakhudzidwa ndi kufooka kumeneku mumtima.
• Kawirikawiri, zinthu monga `Albumin` (mtundu wa puloteni), `Creatinine` (muyeso wa ntchito ya impso), ndi sodium ndi potaziyamu (ma electrolyte) zimayesedwa.
• Pali mayeso apadera a magazi otchedwa BNP (B-type Natriuretic Peptide). Mtima ukakhala ndi nkhawa, kuchuluka kwa BNP m'magazi kumawonjezeka. Izi zimathandiza kwambiri pozindikira kulephera kwa mtima.

3. Kuyesa kujambula mtima:

• Mayeso amenewa amatha kuwona zinthu zambiri, monga mawonekedwe ndi kukula kwa mtima, makulidwe a makoma a maselo, ngati ma valve akugwira ntchito bwino, komanso ngati pakhala kuwonongeka chifukwa cha matenda a mtima omwe adachitika kale.
• X-ray ya pachifuwa: Kuona ngati mtima wakula kapena ngati madzi asonkhana m'mapapo.
• `Echocardiogram (Echo)`: Iyi ndi mayeso ofunikira kwambiri. Ili ngati ultrasound scan ya mtima. Imatha kuyeza molondola EF value. Imatha kuwona bwino momwe zipinda ndi ma valve a mtima amagwirira ntchito.
• Electrocardiogram (EKG/ECG): Kuyeza komwe kumalemba momwe magetsi a mtima amagwirira ntchito. Kumatha kuzindikira zinthu monga kayimbidwe ndi liwiro la kugunda kwa mtima, komanso zizindikiro za matenda a mtima omwe adachitikapo kale.
• Nthawi zina, mayeso ena apadera monga `Cardiac MRI`, `Cardiac CT scan`, `Cardiac Catheterization` (Angiogram), `Exercise Stress Test` kapena `Nuclear Exercise Stress Test`, `Multigated Acquisition Scan` (MUGA)` angachitikenso.

Kodi izi zimachiritsidwa bwanji?

Chabwino, tsopano tiyeni tiwone momwe tingachiritsire vuto la kulephera kwa mtima kwa systolic. Pali zolinga zazikulu zingapo za chithandizo:

• Kuchepetsa zizindikiro (monga kupuma movutikira, kutupa).
• Kuletsa kapena kulamulira mtima kuti usafooke kwambiri.
• Kukweza moyo wabwino.
• Kuthandiza kutalikitsa moyo.

Njira zochiritsira zitha kugawidwa m'magulu akuluakulu angapo:

1. Kusintha kwa moyo

Izi ndi zofunika kwambiri. Sikokwanira kungomwa mankhwala, muyeneranso kuchita zinthu izi kumbali yanu.

• Chepetsani kumwa mchere: Mchere (sodium) umapangitsa thupi kusunga madzi ochulukirapo. Izi zimawonjezera kutupa ndipo zimapangitsa mtima kuvutika kwambiri. Chepetsani kumwa mchere monga momwe dokotala wanu wanenera. Nthawi zambiri, sikoyenera kudya mamiligalamu opitilira 1500-2000 a sodium patsiku.
• Kuchepetsa madzi: Anthu ena amauzidwanso kuti achepetse kuchuluka kwa madzi omwe amamwa patsiku. Izi ndi zomwe muyenera kukambirana ndi dokotala wanu ndikusankha.
• Khalani ndi kulemera kwabwino: Ngati muli onenepa kwambiri, yesani kuchepetsa thupi. Ndi bwino kudzilemera tsiku lililonse. Ngati mulemera mwadzidzidzi (kilo imodzi kapena ziwiri patsiku), izi zitha kukhala chizindikiro cha kusunga madzi m'thupi. Ngati izi zitachitika, uzani dokotala wanu .
• Pewani kusuta: Kusuta fodya kumawononga kwambiri mtima ndi mitsempha yamagazi.
• Chepetsani kapena siyani kumwa mowa: Mowa ungafooketsenso minofu ya mtima.
• Kuchita masewera olimbitsa thupi nthawi zonse: Lankhulani ndi dokotala wanu za masewera olimbitsa thupi omwe ali oyenera kwa inu. Yambani pang'ono pang'onopang'ono ndipo pang'onopang'ono onjezerani zochita zanu. Kuyenda ndi masewera olimbitsa thupi abwino. Zingakhale bwino ngati mungatenge nawo mbali mu pulogalamu yothandiza anthu kuchira matenda a mtima.
• Chepetsani nkhawa, pumulani bwino, ndipo gonani mokwanira.
• Idyani zakudya zabwino: idyani ndiwo zamasamba, zipatso, zakudya zokhala ndi ulusi, ndi zakudya zopanda mafuta ambiri.

2. Mankhwala (mitundu ya mankhwala)

Pali mankhwala ambiri othandiza omwe alipo pochiza kulephera kwa mtima kwa systolic. Mankhwalawa amatha kukonza EF yanu, zizindikiro, komanso magwiridwe antchito a mtima wonse. Dokotala wanu angakupatseni mankhwala amodzi kapena angapo pamodzi.

• Ma Beta-blockers: Izi zimathandiza kuti mtima ugwire bwino ntchito mwa kuchepetsa kugunda kwa mtima, kuchepetsa ntchito yomwe mtima uyenera kugwira. Zingathandize kuwongolera kuthamanga kwa magazi, kuchepetsa chiopsezo cha matenda a mtima, komanso kuwongolera kugunda kwa mtima kosakhazikika.
• Mankhwala oletsa Angiotensin-Converting Enzyme (ACE): Mankhwalawa amayang'anira kuthamanga kwa magazi, amakulitsa mitsempha yamagazi, ndikuletsa mahomoni opsinjika m'thupi, zomwe zimapangitsa kuti mtima uzigwira ntchito bwino pakapita nthawi.
• Angiotensin-II Receptor Blockers (ARBs): Izi zimaperekedwa kwa anthu omwe ali ndi mavuto monga chifuwa chochokera ku ACE inhibitors. Zimagwira ntchito mofanana ndi ACE inhibitors.
• Mankhwala Oletsa Kupanikizika a Angiotensin-Neprilysin (ARNIs): Mankhwalawa ndi atsopano komanso ogwira mtima kwambiri. Mankhwalawa amachepetsanso mahomoni opsinjika maganizo, amatsegula mitsempha yamagazi, komanso amathandiza kuti mtima uzigwira ntchito bwino.
• Mankhwala Oletsa Kupanikizika a Aldosterone (Mineralocorticoid Receptor Antagonists - MRAs): Mankhwalawa amachepetsa mahomoni opsinjika maganizo ndipo amathandiza impso kuchotsa madzi ndi mchere wochuluka m'thupi. Muyenera kusamala ndi kuchuluka kwa potaziyamu m'thupi lanu mukamamwa mankhwalawa.
• Mankhwala ochepetsa mphamvu ya madzi m'thupi (mapiritsi a madzi): Mankhwalawa amachepetsa msanga zizindikiro (makamaka kutupa ndi kupuma movutikira) mwa kuchotsa madzi ochulukirapo ndi mchere m'impso. Madzi akachepa, zimakhala zosavuta kuti mtima upompe magazi.
• Mankhwala oletsa matenda a shuga otchedwa SGLT-2: Awa poyamba anali mtundu wa mankhwala a matenda a shuga. Koma pambuyo pake zinapezeka kuti ndi abwino kwambiri kwa odwala matenda a mtima omwe alibe matenda a shuga. Amatulutsa madzi ochulukirapo pamodzi ndi shuga mu mkodzo.

Chofunika kwambiri ndikumwa mankhwala omwe dokotala wanu wakupatsani ndendende, panthawi yake komanso mu mlingo womwe mwapatsidwa. Musasiye kumwa mankhwalawo kapena kusintha mlingo nokha.

3. Zipangizo ndi opaleshoni

Odwala ena sangathe kuwongolera vuto lawo ndi mankhwala ndi kusintha moyo wawo okha. Angafunike zinthu monga:

• ICD (Implantable Cardioverter-Defibrillator): Chipangizo chaching'ono chomwe chimazindikira kugunda kwa mtima kosakhazikika (arrhythmia) ndikubweretsa kugwedezeka pang'ono kwamagetsi kumtima kuti abwezeretse kugunda kwa mtima kwabwinobwino. Izi zimayikidwa pansi pa khungu la chifuwa.
• CRT (Cardiac Resynchronization Therapy) / Biventricular Pacemaker: Chipangizochi chimathandiza kukonza kusalingana pakati pa zipinda zakumanzere ndi zakumanja za mtima. Izi zimathandizanso kuti mtima uzitha kupopa magazi.
• Kulumikiza Mitsempha ya Mtima (CABG) kapena Angioplasty yokhala ndi stenting: Chitani mitsempha ya mtima ngati yatsekeka.
• Kukonza ma valavu a mtima kapena opaleshoni yosintha.
• Kuika mtima kapena LVAD (Chida Chothandizira Kumanzere kwa Ventricular): Izi ndi njira zomwe nthawi zambiri zimaganiziridwa kwa odwala omwe ali ndi vuto lalikulu.

Kodi chiopsezo cha vutoli chingachepe bwanji?

"Kupewa kuli bwino kuposa kuchiza," akutero iwo. Chifukwa chake, pali zinthu zomwe mungachite kuti mupewe kapena kuchepetsa chiopsezo cha kulephera kwa mtima kwa systolic. Zizolowezi zabwino pa thanzi ndiye chinsinsi.

• Idyani zakudya zopatsa thanzi komanso zopatsa thanzi (mchere wochepa, mafuta ochepa, ndiwo zamasamba ndi zipatso zambiri).
• Kuchita masewera olimbitsa thupi nthawi zonse.
• Khalani ndi kulemera koyenera.
• Pewani kusuta fodya kotheratu.
• Chepetsani kumwa mowa.
• Ngati muli ndi matenda monga kuthamanga kwa magazi, matenda a shuga, kapena cholesterol, samalani bwino. Tsatirani malangizo a dokotala wanu mosamala.
• Chepetsani kupsinjika maganizo ndipo gonani mokwanira.

Kodi ndi ziyembekezo zotani zomwe mungakhale nazo pamene mukukhala ndi vutoli?

Kulephera kwa mtima kwa systolic ndi vuto losatha, la nthawi yayitali, komanso loopsa. Silingathe kuchiritsidwa kwathunthu. Komabe, ndi chithandizo choyenera komanso kusintha kwa moyo, zizindikiro zimatha kuthetsedwa ndipo moyo wabwino ukhoza kukhalapo.

Zotsatira zake zimadalira zinthu zingapo:

• Matenda a mtima ndi oopsa bwanji.
• Thanzi lanu lonse komanso ngati muli ndi matenda ena (monga matenda a impso, matenda a shuga).
• Momwe mumachitira mukalandira chithandizo.
• Kodi chifukwa chachikulu cha izi n'chiyani?

Choncho, ndikofunikira kwambiri kuti musachite mantha kapena kukhumudwa, koma kutsatira malangizo a dokotala molondola ndikusintha moyo wanu. Gwirani ntchito limodzi ndi gulu lanu lachipatala.

Kodi muyenera kufunafuna chithandizo chamankhwala nthawi yomweyo liti?

Ngati mukukumana ndi zizindikiro izi, muyenera kupeza thandizo lachipatala nthawi yomweyo, kutanthauza kuti :

• Kupweteka pachifuwa mwadzidzidzi komanso koopsa.
• Kupuma movutikira komanso movutikira kwambiri.
• Kufooka kapena kufooka kwakukulu.
• Kupweteka pachifuwa, chizungulire, kapena kupuma movutikira chifukwa cha kugunda kwa mtima mofulumira kapena kosakhazikika.
• Kutupa mwadzidzidzi kwa miyendo kapena kunenepa.

Ndi mafunso ati omwe mungafunse dokotala?

Mukapita kwa dokotala wanu, mutha kufunsa mafunso ngati awa kuti mumvetse bwino vuto lanu:

• Kodi chifukwa chenicheni cha kulephera kwa mtima wanga wa systolic ndi chiyani?
• Kodi mtengo wanga wa ejection fraction (EF) ndi wotani? Kodi umatanthauza chiyani?
• Kodi vutoli lakhudza ziwalo zanga zina (monga impso, chiwindi)?
• Ndi mankhwala ati omwe ndi oyenera kwa ine? Kodi ubwino ndi kuipa kwake ndi kotani?
• Kodi ndi zinthu ziti zofunika kwambiri zomwe ndiyenera kusintha pa moyo wanga?
• Ndi chakudya ndi zakumwa zamtundu wanji zomwe ndiyenera kudya ndipo ndiyenera kupewa chiyani?
• Ndi masewera olimbitsa thupi ati omwe ndingachite? Ndiyenera kuchita nthawi yayitali bwanji?
• Kodi sindiyenera kuchita chiyani?
• Kodi zotsatirapo zake zingakhale zotani? Kodi ndiyenera kuchita chiyani ngati zitachitika?
• Kodi ndiyenera kubwera kangati kudzayezetsa? Kodi mayeso anga a EF adzayezedwenso liti?
• Kodi ndiyenera kuchita chiyani pakagwa ngozi?

Zinthu zofunika kwambiri zomwe tiyenera kukumbukira

Kulephera kwa mtima kwa systolic ndi vuto lalikulu, la nthawi yayitali lomwe ventricle yakumanzere ya mtima singathe kupopa magazi bwino. Ngati muli ndi zizindikiro izi, chonde onani dokotala. Zikadziwika msanga, zimakhala zosavuta kuchiza ndipo zotsatira zake zimakhala zabwino.

Mwa kuchiza chomwe chimayambitsa vutoli, kumwa mankhwala omwe dokotala wanu wakupatsani, komanso kukhala ndi makhalidwe abwino a moyo, mutha kuthandiza kuwongolera zizindikiro zanu ndikukhala ndi moyo wathanzi, wokangalika, komanso wautali. Musachite mantha, khalani olimba mtima! Simuli nokha, madokotala anu, abale anu, ndi anzanu onse alipo kuti akuthandizeni.

Matenda a mtima , kulephera kwa mtima kwa systolic, gawo lotulutsa magazi, kufooka kwa mtima, kupuma movutikira, kutupa kwa miyendo, zizindikiro za mtima