Kodi kugunda kwa mtima kwanu kwasokonekera? Tiyeni tiphunzire za Ventricular Dyssynchrony m'njira yosavuta!

Kodi nthawi zina mumamva kupuma movutikira, kutopa nthawi zonse, kapena kutupa miyendo? Izi nthawi zina zingakhale zizindikiro za vuto la mtima wanu. Lero tikambirana za vuto lomwe limakhudza magwiridwe antchito a mtima, koma mwina sitinamve zambiri za vutoli. Ndi vuto la ventricular dyssynchrony , kapena monga momwe madokotala amalitchulira, ``(Ventricular Dyssynchrony)``. Ngakhale dzinalo lingamveke lovuta pang'ono, tiyeni tilifotokoze mwachidule.

Kodi Ventricular Dyssynchrony ndi chiyani?

Mwachidule, ventricular arrhythmia ndi pamene chipinda chimodzi kapena zingapo zapansi pa mtima wanu, zotchedwa ventricles , zikugunda mosagwirizana komanso popanda kugwirizana. Tangoganizani kuti pali kuchedwa pang'ono kwa pafupifupi ma millisecond 40 pakati pa magawo osiyanasiyana a maselo a mtima wanu akuyamba kugwedezeka, kapena pakati pa selo limodzi likuyamba kugwedezeka poyerekeza ndi linzake. Zimenezo zingaganizidwe kuti ndi arrhythmia.

Mtima wathu umagwira ntchito bwino pokhapokha ngati minofu m'zipinda zake ikugwedezeka nthawi imodzi komanso mofanana. Kawirikawiri, zizindikiro zamagetsi zimadutsa mumtima mwadongosolo kwambiri. Zipinda ziwiri zazikulu za mtima zikalandira chizindikiro choti zizungulire, minofu m'zipinda zimenezo iyenera kugwedezeka mofanana komanso nthawi yomweyo. Makamaka, ventricle yanu yakumanzere, chipinda chachikulu chopopera mpweya cha mtima, iyenera kugwedezeka molumikizana bwino. Zili ngati kukankhira kuchokera mbali zonse ziwiri kupita pakati.

Komabe, ngati chizindikirochi sichifika ku maselo onse a mtima nthawi imodzi, minofu singathe kugwedezeka nthawi imodzi. Ndicho chimene timachitcha kuti dyssynchrony .

Kusokonezeka kwa ma cell kungakhudze thupi lanu m'njira zotsatirazi:

• Zimachepetsa kugwira ntchito bwino kwa mtima wanu.
• Ma valve omwe nthawi zambiri amathandiza kuti magazi aziyenda mbali imodzi yokha angayambitse magazi kubwerera m'mbuyo (njira yolakwika).
• Kuchuluka kwa magazi omwe mtima wanu ungathe kupompa (Cardiac Output) kumachepa.

Kodi mitundu ya arrhythmias ya mtima ndi iti?

Pali mitundu ikuluikulu ingapo ya asynchrony ya maselo:

• Kusakhazikika kwa mtima (atria): Apa ndi pamene zipinda zapamwamba (atria) ndi zipinda zapansi (ventricles) za mtima wanu zimachepa popanda kugwirizana.
• Kusasinthasintha kwa Pakati pa Venticular: Pachifukwa ichi, ma ventricle anu akumanzere ndi akumanja (zipinda zapansi) amafupika nthawi zosiyanasiyana.
• Kusinthasintha kwa Mitsempha ya M'kati mwa Selo: Mu izi, minofu m'magawo osiyanasiyana a selo lomwelo imachepa nthawi zosiyanasiyana. Taganizirani izi ngati makoma a chipinda chomwe chimachepa nthawi zosiyanasiyana, m'malo mokakamizidwa mkati nthawi imodzi.

Ndani amene amakhudzidwa kwambiri ndi kusalumikizana kwa maselo?

Vutoli limapezeka kwambiri mwa anthu omwe ali ndi matenda otsatirawa:

• Anthu omwe ali ndi vuto la mtima.
• Chipinda cha Nthambi cha Kumanzere (LBBB).
• Chipinda cha Nthambi cha Kumanja (RBBB).
• Matenda a minofu ya mtima `(Cardiomyopathy)`.
• Kuthamanga kwa magazi kwambiri.
• Matenda ena a mtima.

Taganizirani za Amalume Somapala ochokera kumudzi kwathu. Anali akuvutika ndi `(Heart Failure)` kwa nthawi ndithu. Posachedwapa, wakhala akuvutika kupuma komanso kutopa kwambiri. Dokotala atamufufuza, anati nayenso ali ndi vuto lotchedwa `(Ventricular Dyssynchrony)` mumtima mwake, ndichifukwa chake zizindikiro zake zikuipiraipira.

Kodi vutoli ndi lofala bwanji?

Pafupifupi gawo limodzi mwa magawo atatu a anthu omwe ali ndi vuto la mtima angakumane ndi vuto la mtundu uwu wa maselo osagwira ntchito. Pafupifupi 2% ya akuluakulu m'maiko otukuka amavutika ndi vuto la mtima. Komanso, pakati pa 6% ndi 10% ya anthu azaka zopitilira 65 ali ndi vuto la mtima. Chifukwa chake, vutoli ndi chinthu chomwe chimawonekeranso chifukwa cha izi.

Kodi zizindikiro zake ndi ziti?

Kulephera kwa ma cell kungayambitse zizindikiro za kulephera kwa mtima, kapena kuyambitsa zizindikiro zomwe zimakhala zosiyana ndi izi. Izi ndi zazikulu:

• Kuvuta kupuma (makamaka mukatopa).
• Kumva kutopa kwambiri (ngakhale kwa kanthawi kochepa).
• Chifuwa (mwina chimapitirira).
• Kutupa (edema) m'thupi (makamaka m'malo monga miyendo ndi akakolo).

Kodi zifukwa za kusalumikizana kwa maselo ndi ziti?

Mavuto osiyanasiyana a mtima angayambitse izi. Ena mwa iwo ndi awa:

• Kulephera kwa Ventricular.
• Zilonda zomwe zimayambitsidwa ndi matenda a mtima.
• Kuchedwa kwa Kuyendetsa Magetsi, komwe kumaphatikizapo zinthu monga Left Bundle Branch Block ndi Right Bundle Branch Block.
• Minofu ya mtima yodwala.
• Kusayenda bwino kwa magazi kupita ku minofu ya mtima (Ischemia).

Ndi mayeso ati omwe amachitidwa kuti adziwe vutoli?

Dokotala wanu adzakufunsani kaye za zizindikiro zanu ndikukuyesani kuti muwone momwe mtima wanu umagwirira ntchito. Nthawi zina , kumvetsera mtima wanu pogwiritsa ntchito stethoscope kungakupatseninso lingaliro la kusiyana kumeneku.

Chiyeso chachikulu chomwe chimagwiritsidwa ntchito pozindikira mavuto omwe ali ndi dongosolo lamagetsi la mtima ndi electrocardiogram (ECG) . Chimatha kuzindikira matenda monga Right Bundle Branch Block ndi Left Bundle Branch Block, zomwe zimapangitsa kuti mtima usagwire bwino ntchito. Ngati matenda awa apezeka pa ECG, dokotala adzakutumizani kuti mukayesedwenso.

Madokotala nthawi zambiri amagwiritsa ntchito echocardiogram kuti azindikire matenda a mtima omwe amabwera chifukwa cha kusakhazikika kwa mtima. Izi zimawathandiza kuona momwe zipinda za mtima, ma valve, ndi minofu zikuchepa.

Mayeso ena atha kuchitidwanso:

• Kujambula kwa Positron Emission Tomography (PET).
• Kujambula kwa Multigated Acquisition (MUGA).
• Chithunzi cha Magnetic Resonance cha Mtima (MRI).
• Kujambula kwa Computerized Tomography (CT).
• Kujambula kwa Single Photon Emission Computed Tomography (SPECT).

Kodi asynchrony ya maselo imachiritsidwa bwanji?

Ogwira ntchito zachipatala angachiritse vuto lomwe likuyambitsa kusalingana kwa maselo anu.

Nthawi zambiri, chithandizo cha cardiac resynchronization therapy (CRT) (chomwe chimatchedwanso CRT kapena biventricular pacemaker) chingathandize mtima kupopa bwino polamulira kamvekedwe ka mbali zonse ziwiri za mtima. Komabe, chithandizochi chimangowonjezera zizindikiro mwa anthu 50% mpaka 70% omwe amalandira chithandizochi. Anthu omwe ali ndi vuto la asynchrony kwambiri amakhala ndi mwayi wopambana.

Mavuto a chithandizo cha CRT

Mavuto otsatirawa angachitike mukayika `CRT` (chopangira mpweya wa bipolar) (izi sizichitika kawirikawiri, koma ndi bwino kuzidziwa):

• Pneumothorax.
• Kusonkhana kwa magazi pakati pa khoma la chifuwa ndi mapapo (Hemothorax).
• Kuboola mtima.
• Kulimbikitsa minofu ina kupatula mtima.
• Ma pacemaker otsogolera akuchoka pamalo pake.

Kodi ndidzamva bwino msanga bwanji nditalandira chithandizo?

Chithandizo cha CRT chimachepetsa kusalumikizana kwa maselo nthawi yomweyo. Anthu ena amayamba kumva bwino pakatha milungu ingapo kuchokera pamene chipangizocho chaikidwa. Palinso ubwino wa nthawi yayitali:

• Kukweza kuchuluka kwa magazi omwe mtima wanu umapopa (Cardiac Output).
• Kuchepetsa kutuluka kwa magazi kuchokera ku valavu ya mitral.
• Kukonza moyo wanu.
• Mtunda womwe mungayendemo mu mphindi zisanu ndi chimodzi umawonjezeka.

Ndi mankhwala ati omwe amagwiritsidwa ntchito?

Pa matenda omwe amayambitsa matenda a mtima, monga kulephera kwa mtima, matenda a mtima, kapena kuthamanga kwa magazi, dokotala angapereke mankhwala monga:

• Zoletsa za Angiotensin-Converting Enzyme (ACE).
• Ma ARB (Angiotensin II Receptor Blockers).
• Beta-Blockers.
• Mankhwala ochepetsa mphamvu ya okodzetsa (diuretics).

Ngakhale kuti mankhwala awa angathandize kuti mtima wanu ugwire bwino ntchito, sangasinthe kotheratu vuto la kusagwira ntchito bwino kwa magetsi chifukwa cha zinthu zina zomwe zimachitika chifukwa cha kusokonekera kwa kayendedwe ka magetsi. Ichi ndichifukwa chake chithandizo monga CRT chikufunika.

Kodi mungachepetse bwanji chiopsezo cha kusalumikizana kwa maselo?

Chinthu chabwino kwambiri chomwe mungachite ndikusamalira mtima wanu bwino. Ngati mutero, mudzatha kupewa matenda ena omwe amayambitsa kusalingana kwa maselo.

Njira zina zotetezera mtima wanu:

• Idyani zakudya zokhala ndi mafuta ochepa (kuchepetsa mafuta ndi zakudya zokazinga).
• Chitani masewera olimbitsa thupi kwa mphindi zosachepera 30 masiku ambiri (ngakhale kuyenda ndikwabwino).
• Kusunga kulemera koyenera kwa inu.
• Kumwa mankhwala monga momwe dokotala wanenera.

Kodi chimachitika ndi chiyani ngati ndili ndi asynchrony ya maselo?

Matenda a Kumanzere kwa Ventricular Dyssynchrony (LVD) sachiritsidwa, ndipo zotsatira zake si zabwino kwenikweni. Anthu omwe ali ndi LVD ali pachiwopsezo chachikulu cha matenda a mtima kuposa omwe alibe vutoli. Mutha kukhala ndi matenda a dyssynchrony m'ma ventricles anu onse (kapena onse awiri), koma ventricle yanu yakumanzere ndiyo gawo lalikulu lomwe limapopera magazi okhala ndi mpweya wambiri m'thupi lanu lonse. Imeneyi ndi ntchito yofunika kwambiri.

Chithandizo chotchedwa `CRT` (dual-cell pacemaker) chingathandize anthu omwe ali ndi vuto la mtima kuchepetsa nthawi yomwe amakhala kuchipatala ndikukhala ndi moyo wautali.

Kumbukirani, chomwe chimayambitsa kusalumikizana kwa zinthu kumakhudzanso zotsatira zake. Matenda a anthu ena akhoza kukhala oipa kuposa ena.

Kodi ndimadzisamalira bwanji?

• Ngati dokotala wanu wakupatsani mankhwala, onetsetsani kuti mwamwa monga momwe mwalangizidwira . Imwani mankhwalawo monga mwalangizidwira mpaka dokotala wanu atakuuzani kuti musiye.
• Ngati muli ndi choyezera mtima cha biventricular pacemaker, kumbukirani kupita kuzipatala pa masiku omwe akonzedwa . Apa ndi pomwe dokotala wanu angayang'ane ngati choyezera mtima chanu chikugwira ntchito bwino. Zipatala zina zili ndi zipatala zapadera zotchedwa CRT clinics. Kumeneko, akatswiri a mtima ndi akatswiri a mtima amagwira ntchito limodzi kuti atsimikizire kuti mukupindula kwambiri ndi choyezera mtima chanu.

Ndiyenera kupita liti kwa dokotala wanga?

• Ngati simukumva bwino ndi mankhwala omwe mwapatsidwa.
• Ngati pali vuto ndi biventricular pacemaker yanu.

Zikatero, pitani kwa dokotala nthawi yomweyo.

Kodi ndiyenera kupita ku Dipatimenti Yothandiza Anthu Odwala Pangozi (ETU) liti?

Ngati mukukumana ndi zizindikiro izi , funsani upangiri wa dokotala nthawi yomweyo:

• Kupweteka pachifuwa kapena kusasangalala.
• Vertigo (kumva ngati ukuzungulira).
• Kuvuta kwambiri kupuma.
• Kupweteka m'mimba, nseru.
• Kupweteka kwa msana, khosi, kapena nsagwada.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala wanga?

Musaiwale kufunsa mafunso awa mukapita kwa dokotala wanu:

• N’chifukwa chiyani ndinapanga asynchrony ya maselo?
• Kodi ndine woyenera kulandira chithandizo cha `CRT`?
• Kodi pali magulu othandizira omwe amathandiza anthu omwe ali ndi matenda a mtima?

Ndizachibadwa kukhala ndi nkhawa pang'ono mukazindikira kuti mtima wanu sukugwira ntchito bwino. Koma musadandaule. Dokotala wanu akhoza kupeza chomwe chimayambitsa kusakhazikika kwa mtima wanu ndikusankha chithandizo chabwino kwambiri kwa inu. Tsatirani malangizo omwe ali pa botolo la mankhwala molondola. Kumwa mankhwala anu nthawi yomweyo tsiku lililonse kudzakuthandizani kukumbukira kumwa. Lembani masiku anu okumana nawo pa kalendala kapena ikani chikumbutso pafoni yanu. Izi zikuthandizani kupewa kuwaphonya.

Chidule ndi Uthenga Wopita Nawo Kunyumba

Chabwino, ndikukhulupirira kuti tsopano mwamvetsa bwino za ``Ventricular Dyssynchrony'' yomwe tidakambirana lero.

Mwachidule, iyi ndi vuto lomwe zipinda zapansi (maselo) a mtima zimagundana mosagwirizana, mosagwirizana. Izi zitha kuchepetsa kugwira ntchito kwa mtima, komanso zingayambitse zizindikiro monga kupuma movutikira komanso kutopa.

• Mayeso monga `(ECG)` ndi `(Echocardiogram)` amathandiza kuzindikira vutoli.
• Monga chithandizo, kuwonjezera pa kuchiza matenda oyamba, chithandizo cha pacemaker chotchedwa ``Cardiac Resynchronization Therapy (CRT)`` ndi chofunikira kwambiri.
• Kusamalira mtima wanu ndi kutsatira moyo wathanzi kumathandiza kwambiri kupewa mavuto otere.
• Ngati muli ndi zizindikiro izi, musazengereze kufunafuna upangiri kwa dokotala. Matendawa akapezeka msanga ndikuchiritsidwa, zotsatira zake zimakhala zabwino.

Kumbukirani, mtima wanu ndi chinthu chamtengo wapatali kwambiri chomwe muli nacho. Ndi udindo wanu kuuteteza.

Matenda a mtima, ventricular dyssynchrony, ventricular tachycardia, matenda a mtima, CRT, pacemaker