Ese uruhande rw'iburyo rw'umutima wawe rufite intege nke? Reka twige kuri iyi ndwara iteje akaga ya ARVD (Arrhythmogenic Right Ventricular Dysplasia)?

Ese hari igihe wumva igituza cyawe gikubise mu buryo butunguranye, wumva ufite ikibazo cyo guhumeka, cyangwa wumva gusa urwaye indwara y'umutima? Ushobora kuba warumvise ko hari igihe n'umukinnyi ukiri muto kandi ufite ubuzima bwiza ashobora kugira indwara y'umutima mu buryo butunguranye. Ibyo nibyo tugiye kuvugaho uyu munsi, ariko ntabwo bizwi cyane, indwara y'umutima idasanzwe. Iyi yitwa ``Arrhythmogenic Right Ventricular Dysplasia``, cyangwa mu magambo ahinnye ARVD.

ARVD (Arrhythmogenic Right Ventricular Dysplasia) ni iki? Reka tubisobanukirwe mu buryo bworoshye!

Muri make, ARVD ni indwara ifata imitsi y'umutima, ubwoko bwa 'cardiomyopathy'. Umutima wacu ufite ibyumba bine. Ikibaho muri ibi ni uko imitsi yo mu cyumba cyo hasi ku ruhande rw'iburyo rw'umutima wawe, 'ventricle y'iburyo', ikura aho gukura ibinure n'imitsi ifite uturemangingo. Tekereza nk'aho imitsi myiza yakuweho igasimburwa n'ikintu kimeze nk'ibinure.

Bigenda bite iyo ibi bibaye? Iyo ventilateur y'iburyo irakura buhoro buhoro, irushaho kuba nto, kandi ntishobore kwifata neza. Ibyo bivuze ko ubushobozi bwayo bwo kohereza amaraso mu mutima bugabanuka.

Icy'ingenzi kurushaho, ibinure cyangwa udusimba dushya tw’imitsi bibangamira ibimenyetso by’amashanyarazi by’umutima. Niyo mpamvu abantu benshi barwaye ARVD bagira umutima utera utari mwiza (arrhythmias). Ibi bishobora kuba bibi cyane, kuko byongera ibyago byo guhagarara k’umutima cyangwa urupfu mu buryo butunguranye.

Iyi ARVD yitwa kandi `Arrhythmogenic Right Ventricular Cardiomyopathy` (ARVC). Hari igihe ishobora no kugira ingaruka ku ruhande rw'ibumoso, bityo yitwa `Arrhythmogenic Cardiomyopathy` (ACM).

Ni ibihe byiciro bya ARVD?

Iyo urwaye ARVD, ishobora kunyura mu byiciro bitandukanye uko igihe kigenda gihita.

1. Icyiciro cyihishe: Muri iki cyiciro, ushobora kuba udafite ibimenyetso. Ariko, ushobora kugira umutima utera nabi iyo ukora imyitozo ngororamubiri. Igitangaje ni uko ibizamini bimwe na bimwe byakozwe muri iki cyiciro bishobora kwerekana ko nta kibazo kirimo.

2. Icyiciro cy'amashanyarazi: Muri iki cyiciro, uba ufite amahirwe menshi yo kurwara indwara zo mu mitsi. Ufite kandi ibyago byinshi byo gupfa mu buryo butunguranye. ECG ishobora kumenya ibyo bibazo by'umutima.

3. Icyiciro cy’imiterere y’umutima: Muri iki cyiciro, ibyago byo kurwara imitsi y’umutima idasanzwe (imitsi y’umutima) ndetse n’urupfu rutunguranye rw’umutima biba byinshi kurushaho. Ibipimo by’amashusho, nko gupima, bishobora kwerekana neza impinduka mu miterere y’umutima wawe.

Ni nde wibasirwa cyane n'iyi ndwara ya ARVD?

Abaganga babona iyi ndwara cyane cyane mu rubyiruko.Ni ukuvuga mu bangavu cyangwa mu rubyiruko. ARVD yanagaragaye ko ari yo mpamvu itera impfu zitunguranye z'umutima kuri bamwe mu bakinnyi bakiri bato. Ubushakashatsi bumwe bwerekana ko iyi ndwara ikunze kugaragara ku bagabo .

Ukurikije uburyo ikunze kugaragara, ARVD ni indwara idakunze kugaragara. Bivugwa ko ifata umuntu umwe ku bantu 1.000 cyangwa umuntu umwe ku bantu 5.000. Ishobora kubaho nta muntu n'umwe mu muryango uyirwaye, ariko akenshi ikunze kugaragara mu miryango.

Ni ibihe bimenyetso bya ARVC? Reka tubimenye!

Ushobora kuba udafite ibimenyetso bya ARVD mu ntangiriro, ariko hari ibyago byo gupfa umutima utunguranye.

Ibimenyetso by'ingenzi bishobora kugaragara ni ibi bikurikira:

• Kudatera neza kw'imitsi yo mu mitsi: Ibi bishobora guteza akaga gakomeye. Mu bantu bagera kuri kimwe cya kabiri bafite iyi ndwara, ingaruka zishobora kuba mbi cyangwa zikaba zahitana abantu benshi. Indwara ikunze kugaragara cyane ni tachycardia yo mu mitsi yo mu mitsi, ibaho kuri 77% by'abantu bafite iyi ndwara.
• Supraventricular arrhythmias: Ikunze kugaragara ni indwara yitwa atrial fibrillation.
• Umutima utera cyane: Ibi bishobora kumva nk'aho hari ikintu kirimo gukubita mu gituza cyawe. Ibi biterwa n'umutima utera nabi.
• Kuzunguruka, kubabara umutwe cyangwa gucika intege: Ibi kandi biterwa no gutera k'umutima ku buryo budasanzwe.
• Kubabara mu gituza.
• Urupfu rw'umutima rutunguranye: Hari igihe iki gishobora kuba ikimenyetso cya mbere cya ARVD.
• Guhumeka nabi.
• Kubyimba amaguru, uturenge, ibirenge, cyangwa inda.
• Kunanirwa k'umutima.

Ibi bimenyetso akenshi bitangira hagati y'imyaka 20 na 50. Abaganga bakunze gusuzuma indwara ya ARVD bakiri bato (akenshi mbere y'imyaka 40).

Ni izihe mpamvu zitera ARVD?

Abantu bagera kuri 60% barwaye ARVD bafite ihinduka ry’uturemangingo. Abashakashatsi bavumbuye nibura uturemangingo 13 dutera iyi ndwara.

Izi ngirabuzimafatizo zidasanzwe zangiza poroteyine zifasha uturemangingo tw’imitsi y’umutima kwihuza no kuvugana hagati yatwo. Ibi bishobora gutuma uturemangingo tw’imitsi y’umutima two mu ventrikali y’iburyo dutandukana tugapfa. Ibi bishobora kugaragara cyane cyane mu bihe by’imihangayiko cyangwa imyitozo ngororamubiri.

Nibura 30% kugeza kuri 50% by'abarwayi ba ARVD bafite amateka yo mu muryango wabo.Bityo rero, ni ngombwa cyane ko abavandimwe bo mu cyiciro cya mbere n'icya kabiri (ababyeyi, abavandimwe, abana, abuzukuru, ba nyirarume, ba nyirasenge, ba mwishywa, ba mubyara) b'umuntu urwaye ARVD basuzumwa na muganga. Nubwo nta bimenyetso bigaragaza, bene wabo bakiri bato bagomba gushaka inama kwa muganga.

Abashakashatsi bavumbuye imiterere ibiri y'umurage mu miti igabanya ubukana bw'indwara z'imitsi itera SIDA (ARVDs):

1. `Autosomal dominant`: Umubyeyi umwe afite ihinduka ry’uturemangingo. Muri bene iyo miryango, abana bafite amahirwe ya 50% yo kurwara iyi ndwara. Ariko, ibimenyetso n'imyaka yo gutangira kwandura iyi ndwara bishobora gutandukana bitewe n'abagize umuryango. ARVD ikunze kugaragara cyane mu turere tumwe na tumwe, nko mu Butaliyani.

2. `Autosomal recessive` (ntibikunze kubaho cyane): Ababyeyi bombi bafite ihinduka ry'uturemangingo, ariko ntibagaragaza ibimenyetso. `Naxos disease` ni urugero rw'ibi. Itera ububyimba bw'uruhu rw'inyuma (`hyperkeratosis`) n'umusatsi munini, "umeze nk'ubwoya" (`umusatsi umeze nk'ubwoya`) ku biganza no ku birenge.

ARVD ishobora guterwa n'izindi mpamvu:

• Utumenyero tw’umutima dusanzwe mu mutsi w’iburyo.
• `Myocarditis` iterwa na virusi cyangwa indwara yo kubyimba kw'imitsi y'umutima.
• Impamvu ntiziramenyekana.

Ni gute indwara ya ARVD (Arrhythmogenic Right Ventricular Dysplasia) ipimwa?

Muganga wawe ashobora gusuzuma ARVD akurikije amateka y'ubuzima bwawe, isuzuma ry'umubiri wawe, n'ibizamini bitandukanye.

Muganga wawe ashobora gusuzuma indwara ya ARVD iyo ufite ibibazo byinshi muri ibi bikurikira:

• Imikorere idahwitse ya ventricle y'iburyo.
• Kuba hari ibinure cyangwa fibro-binure mu mitsi y'umutima (`myocardium`) y'umutima w'iburyo.
• Raporo idasanzwe ya `ECG/EKG` (Electrocardiogram)
• Imiterere y'umutima idahwitse (arrhythmias): Urugero, tachycardia yo hejuru y'umutima, tachycardia yo mu mitsi, cyangwa fibrillation yo mu mitsi, cyane cyane mu gihe cy'imyitozo ngororamubiri.
• Amateka y'umuryango ya ARVD.

Bitewe n'ingano y'ibi bintu ufite, muganga wawe ashobora kuguha isuzuma ry'indwara "zidahinduka", "zidahinduka", cyangwa "zishoboka." Hari igihe, ariko si buri gihe, muganga wawe ashobora no kukwohereza mu isuzuma ry'uturemangingo .

Ni ibihe bipimo bikoreshwa mu gusuzuma ARVD?

• Electrocardiogram (ECG/EKG): Ikizamini kireba imikorere y'amashanyarazi y'umutima.
• Echocardiogram ya Transthoracic: Ibi ni nk'isuzuma ry'umutima rya ultrasound. Rishobora kureba ibyumba by'umutima, valves, n'ubushobozi bwo gupompa.
• `Holter monitor`: Iyi ni nk'imashini nto ya `ECG` wambara amasaha 24 kugeza kuri 48. Ifata amajwi y'umutima wawe umunsi wose.
• Angiogramu y'umutima w'iburyo: Iyi ntabwo ikoreshwa gake cyane.
• `Gupima amashanyarazi`:Ikizamini cyihariye cyo gusuzuma ibibazo by'amashanyarazi y'umutima.
• Ishusho ya MRI y'umutima: Ibi bishobora gutanga amashusho arambuye y'umutima. Ibi ni ingenzi cyane mu kumenya ibintu nk'ibinure biri mu muvuduko w'iburyo muri ARVD.
• `Isuzuma ry’umutima (CT):` Ubu ni ubundi buryo bwo kubona amashusho y’umutima.
• `Biopsy` (gufata icyitegererezo cy'ingingo): Ibi nabyo bikorwa gake cyane. Agace gato k'ingingo gakurwa mu mutima kagasuzumwa.

Ni ubuhe buryo bwo kuvura ARVD?

Kugeza ubu nta muti uhari wa ARVD. Ariko, muganga wawe azagerageza gukora ibi bikurikira:

• Genzura uburyo umutima wawe utera nabi (`ventricular arrhythmias`).
• Irinde kubyimba kw'amaraso.
• Genzura ikibazo cy'umutima wawe.

Uburyo bwo kuvura ARVD ni ubu:

• Imiti igabanya ubukana bw'umutima: Irinda gutera k'umutima mu buryo butunguranye igihe kirekire cyangwa urupfu rutunguranye. Ubu ni bwo buryo bwo kuvura bukunze gukoreshwa n'abaganga. Ushobora guhabwa imiti nka sotalol cyangwa amiodarone.
• Imiti y'umuvuduko w'amaraso: Imiti nka diuretics (ikura amazi menshi mu mubiri) cyangwa beta-blockers (igabanya umutwaro w'umutima).
• Umuti ugabanya amaraso: Imiti nka warfarin itangwa kugira ngo idatera amaraso kuzura.
• Gukuraho catheter ikoresha radiofrequency: Ni uburyo bwo kuvura indwara zikunze kugaragara mu mutima zidakurikije imiti. Ibi bikubiyemo kwangiza agace gato k'umutima gatera umutima utera ...
• Imashini itera umutima mu buryo bworoshye (ICD): Agakoresho gato gashyirwa mu mutima w'abantu bashobora gupfa mu buryo butunguranye. Iyo gasanze umutima urimo gutera nabi, kazagatahura maze kagatera umutima guhungabana kugira ngo gakosorwe.
• Gutera umutima: Ibi bikorwa iyo ubundi buryo bwose bwo kuvura bwananiranye. Ijanisha rito ry'abantu bafite iyi ndwara, hagati ya 2% na 4%, ni bo bakeneye umutima mushya.

Wibuke ko ushobora gukenera imiti irenze imwe kuri iyi ndwara mu buzima bwawe bwose.

Ese hari ingorane cyangwa ingaruka mbi z'ubuvuzi?

Yego, hari ibintu bimwe na bimwe ugomba kwitondera mu bijyanye n'ubuvuzi bumwe na bumwe.

• Niba ufata warfarin, uzakenera gupimwa amaraso buri gihe . Muganga wawe azakenera kugenzura neza ko ufata dose ikwiye. Dose yawe ishobora guhindurwa hashingiwe ku bisubizo by'ibizamini.
• Nubwo uburyo bwo kuvura hakoreshejwe catheter bwagize ingaruka nziza ku bantu benshi, kuko indwara ikomeza kwiyongera uko igihe kigenda gihita, abantu bagera kuri 60% bashobora kongera kugira ikibazo cyo kutumvikana kw'imitsi y'umutima wabo.
• Insinga ziri mu gikoresho cya ICD zishobora kugenda cyangwa ntizikore neza, bityo ugomba gukomeza kuzigenzura.

Ni gute niyitaho? Ni izihe mpinduka mu mibereho zikenewe?

Ni ingenzi cyane kugira impinduka mu mibereho yawe kugira ngo worohereze umutima wawe.

• Gabanya kunywa inzoga.
• Hagarika burundu gukoresha ibikomoka ku itabi.
• Kurya indyo yuzuye (ibinure bike, imbuto n'imboga nyinshi)
• Gabanya ibiryo n'ibinyobwa birimo kafeyine (nk'ikawa, icyayi, shokora).
• Komeza kugira ibiro byiza by'umubiri.
• Gabanya imyitozo ngororamubiri igoye.

Icy'ingenzi kurushaho: Buri gihe banza ubaze muganga wawe mbere yo gutangira gukora siporo. Siporo zo guhatana ntizisabwa. Siporo zo mu rwego rwo hasi zishobora kuba nziza.

Vugana na muganga wawe buri gihe mu gihe cyose cy'ubuvuzi bwawe. Bazamenya neza ko uhabwa imiti ikwiye. Nanone, ugiye mu nama zo gukurikirana indwara buri gihe, ushobora kubona impinduka iyo ari yo yose mu buzima bwawe hakiri kare.

Ese ibyago bishobora kugabanuka?

Yego, ku rugero runaka. Niba hari umuntu wo mu muryango wawe ufite ARVD, kwipimisha vuba bishoboka ni bwo buryo bwiza bwo kugabanya ibyago byo kwandura. Ibipimo byoroshye kandi bitababaza bishobora kukwereka niba ufite ibyago byo kugira umutima uhindagurika mu buryo budasanzwe. Niba umeze utyo, muganga wawe ashobora kugufasha gutegura gahunda y'ubuvuzi ikubereye.

Imyaka yo kubaho umuntu afite ARVD ni iyihe?

Imyaka yo kubaho ya ARVD iratandukana bitewe n'igihe yasuzumwe. Ikintu cyiza cyo gukora ni ugusuzuma indwara hakiri kare kandi ugahabwa ubuvuzi kugira ngo wirinde gutera umutima mu buryo budasanzwe. Iyi ndwara irushaho kwiyongera uko igihe kigenda gihita.

Iyo ARVD itavuwe, ventricle yawe y'iburyo ishobora kunanirwa. Hanyuma ventricle yawe y'ibumoso nayo ishobora kunanirwa. Ibi bishobora gutera indwara nka 'umutima unanirwa' na 'atrial fibrillation'. Abashakashatsi bemeza ko ibintu biba bibi kurushaho iyo ARVD igize ingaruka ku ventricle zombi.

Ariko, iyo uvuwe, ushobora kubona ubufasha ukeneye kugira ngo ugabanye umuvuduko ku mutima wawe no kwirinda indwara z’umutima ziteye ubwoba. Ubushakashatsi bumwe bwerekana ko hari abantu bafatwa n’iyi ndwara nyuma y’imyaka 65. Bivugwa kandi ko hafi umuntu umwe kuri batanu barwaye ARVC atangira kugaragaza ibimenyetso nyuma y’imyaka 50. Kubwibyo, birashoboka kubaho igihe kirekire ukoresheje ARVC.

Muri iki gihe, ikoranabuhanga rigezweho ryo gufata amashusho nka CT na MRI rituma umuntu ashobora gusuzuma no kuvurwa hakiri kare, bityo icyizere cy'igihe kirekire ku bantu barwaye ARVD ni cyiza.

Ariko, urupfu rutunguranye rushobora kubaho ku bantu batapimwe cyangwa batahawe ubuvuzi bukenewe. Bivugwa ko ARVD ari yo itera 11% by'impfu zitunguranye z'umutima ku bantu bari munsi y'imyaka 35 na 22% by'impfu zitunguranye z'umutima ku bakinnyi.

Ni ryari nkwiye kujya kwa muganga? Ni ryari nkwiye kujya mu cyumba cy’ubutabazi bw’ibanze?

Niba ufite ARVD, uzakenera gukomeza kwisuzumisha kwa muganga mu buzima bwawe bwose.Muganga wawe azakenera kwisuzumisha buri gihe kugira ngo amenye neza ko wahawe ubuvuzi bukwiye. Niba ufite ICD, izakenera kwisuzumisha buri gihe .

Ni iki cyakorwa mu gihe cy'ubutabazi bwihutirwa?

Niba umuntu aguye mu buryo butunguranye ntasubize telefoni zawe, hamagara ako kanya 1990 (serivisi y’imbangukiragutabara yo muri Sri Lanka). Hanyuma, niba bishoboka, tangira CPR (gusubiza umutima mu maraso), cyangwa nibura CPR ikorwa n’intoki gusa.

Niba ufite ibyago byo guhagarara umutima mu buryo butunguranye, ni byiza ko abo mu rugo bari kumwe nawe bahabwa amahugurwa ya CPR.

Ni ibihe bibazo ngomba kubaza muganga wanjye?

• Ese nshobora gukora siporo cyangwa kwitabira siporo? Niba ari byo, ni iyihe siporo?
• Ni ubuhe buryo bwo kuvura bubereye kuri njye?
• Ese nkeneye ICD muri iki gihe?

Kubera ko indwara ya ARVD ishobora kugorana kuyisuzuma mbere yuko ibimenyetso bigaragara, ni ngombwa kumenya amateka y'umuryango wawe. Niba uri mu kaga bitewe n'amateka y'iyi ndwara mu muryango wawe, muganga wawe ashobora kugupima.

Ubutumwa bwo kujyana mu rugo

Noneho rero ubu usobanukiwe neza icyo twavuze uyu munsi, ARVD. Nubwo bidakunze kubaho, bishobora kuba indwara ikomeye y'umutima. Akenshi iterwa n'ibintu bigize imiterere y'umubiri . Kubwibyo, niba hari umuntu wo mu muryango wawe ufite iyi ndwara, ni ngombwa cyane gupimisha abandi.

Iyo usuzumye indwara hakiri kare, ugahabwa ubuvuzi bukwiye, kandi ugahindura imibereho yawe, ushobora kubaho neza n'iyi ndwara. Komeza kuvugana na muganga wawe kandi ukurikize inama ze. Nanone, kumenya neza ko abakunzi bawe bazi `CPR` bishobora kugufasha kurokora ubuzima bwawe mu gihe cy'impanuka. Ntutinye, kumenya ni byo bigutera imbaraga nyinshi!

ARVD , Arrhythmogenic Right Ventricular Dysplasia, indwara z'umutima, indwara z'umutima, indwara z'umutima, urupfu rutunguranye rw'umutima, indwara z'uturemangingo, indwara z'umutima