Ese umutima wawe uhita utera mu buryo butunguranye? Ese byaba ari indwara ya Brugada?

Ese wigeze utakaza ubwenge mu buryo butunguranye, ukumva urwaye isereri? Cyangwa ukumva umutima utera cyane, cyangwa ukumva bigoye guhumeka? Hari igihe ibi bishobora guterwa n'ikintu kidakomeye cyane. Ariko, mu bihe bidasanzwe, bishobora kuba ibimenyetso by'indwara y'umutima yitwa Brugada Syndrome. Reka tubiganireho gato uyu munsi, kuko ni ngombwa kubimenya.

Indwara ya Brugada ni iki?

Muri make, indwara ya Brugada Syndrome ni indwara itera imikorere idasanzwe y'amashanyarazi mu byumba byo hasi by'umutima wawe, yitwa ventricles. Ibi bishobora gutuma umutima wawe utakaza umuvuduko wawo mu buryo butunguranye . Ibi byitwa ventricular fibrillation cyangwa v-fib . Tekereza umutima wawe utera aho gukompa amaraso neza. Ibi bituma ubwonko bwawe budahabwa amaraso ahagije. Ni bwo utakaza ubwenge (syncope) .

Iyi ishobora kuba indwara iteje akaga, kuko iyi 'v-fib' ishobora no gutera urupfu rutunguranye rw'umutima . Akenshi, ibi bibaho iyo uri kuruhuka cyangwa usinziriye. Abashakashatsi bavuga ko indwara ya Brugada Syndrome ari yo itera hafi 4% by'impfu zitunguranye z'umutima ku isi.

Ariko iyi si indwara ikunze kugaragara cyane. Abantu bagera kuri batatu kugeza kuri bane mu bihumbi icumi bafite iyi ndwara.

Ni ibihe bimenyetso bigaragara?

Ibimenyetso bya Brugada Syndrome bishobora kugaragara ku myaka iyo ari yo yose. Ariko, akenshi bitangira ahagana ku myaka 40. Hari abantu bashobora kutagaragaza ibimenyetso na gato. Abantu barenga 70% bivugwa ko nta bimenyetso bafite. Ariko, iyo ibimenyetso bigaragaye, bishobora kuba birimo:

• Umutima utari umeze neza (`ventricular arrhythmia`) : Ibi bivuze ko umuvuduko w'umutima uhungabanye.
• Kudasobanukirwa: Gutakaza ubwenge mu buryo butunguranye no kugwa.
• Kuzungera : Kumva umeze nk'uzunguruka.
• Kugorwa no guhumeka .
• Umutima utera cyane : Kumva uhuha cyangwa uzunguruka mu gituza.
• Guhagarara k'umutima : Iki ni cyo kimenyetso cya mbere kigaragara. Hari abantu bashobora gupfa basinziriye bitewe n'iki kibazo.

Icy'ingenzi: Niba ukunze kugira kimwe cyangwa byinshi muri ibi bimenyetso, ni byiza kujya kwa muganga kugira ngo akugire inama.

Ni ibihe bintu bitera indwara ya Brugada?

Hari ibintu bimwe na bimwe bishobora gutuma ibimenyetso bya Brugada syndrome bigaragara mu buryo butunguranye cyangwa bikarushaho kwiyongera. Ibyo tubyita 'ibitera'.

• Umuriro : Ibi bimenyetso bishobora kubaho iyo umuntu urwaye indwara ya Brugada agize umuriro.Ni ingenzi cyane kugabanya umuriro vuba . Nubwo waba ufite imashini igabanya umuriro mu mubiri (ICD), ugomba kugabanya umuriro. Ibi bishobora gukorwa ukoresheje imiti igabanya umuriro iboneka muri farumasi.
• Kunanirwa gushyuha / Kubura amazi mu mubiri : Kubika amazi mu mubiri, kunanirwa bitewe n'ubushyuhe bwinshi.
• Imiti imwe n'imwe :
• Ibikoresho bifunga imiyoboro ya sodium.
• Litiyumu.
• Imiti igabanya ubukana bwa tricyclic.
• Inzoga : Kunywa inzoga nyinshi.
• Ibiyobyabwenge : Gukoresha ibiyobyabwenge nka kokayine na marijuana.

Ni ingenzi cyane kumenya ibi bintu no kubyirinda uko bishoboka kose.

Impamvu ni izihe?

Impamvu nyayo ya Brugada Syndrome rimwe na rimwe ntizwi . Cyangwa ishobora kuba ari imiterere y'umubiri . Ntibiramenyekana neza imiterere y'umubiri itera iyi ndwara ku bantu bagera kuri 70%.

Ariko, hari abantu bafite impinduka 18 cyangwa zirenga za gene. Isanzwe muri izi ni impinduka muri gene yitwa SCN5A . Izi mpinduka zibangamira uburyo ibimenyetso by'amashanyarazi mu mutima bigenda.

Iyi ni indwara ishobora kuragwa n'umubyeyi umwe gusa . Ni ukuvuga ko umwana w'umuntu ufite imiterere y'uturemangingo ijyanye na syndrome ya Brugada afite amahirwe angana na 50% yo kuyirwara.

Ni nde ufite amahirwe menshi yo kurwara ibi? (Ibintu bishobora gutera ibyago)

Iyi ndwara ikunze kugaragara ku bagabo . Ikunze kugaragara ku bagabo inshuro zigera kuri 8 kugeza ku 10 kurusha abagore.

Nanone, niba hari umuntu wo mu muryango wawe wapfuye azize guhagarara k'umutima mu buryo butunguranye, cyangwa akaba yarafashwe na Brugada syndrome , byaba byiza nawe ugiye kwipimisha.

Ikindi kintu ni uko bivugwa ko iyi ndwara ikunze kugaragara cyane mu bantu bakomoka muri Aziya .

Ni gute umuganga asuzuma ibi? (Isuzuma)

Kugira ngo umuganga amenye niba ufite indwara ya Brugada, azakora ibi bikurikira:

• Uzahabwa ikizamini cy'umubiri .
• Amateka yawe y'ubuvuzi azasuzumwa.
• Amateka y'ubuzima bw'umuryango wawe (amateka y'umuryango w'umuntu) azabibazwa, cyane cyane niba hari umuntu wo mu muryango wawe wagize urupfu rw'umutima rutunguranye.
• Bazagusaba gukora ibizamini byinshi byihariye .

Ni ibihe bizamini bikorwa?

Hari ibizamini byinshi by'ingenzi bikoreshwa mu gusuzuma iyi ndwara:

• Gupima imiterere y'uturemangingo: Iki kizamini gishobora kumenya niba ufite ihinduka ry’uturemangingo runaka rijyanye na Brugada syndrome ukoresheje icyitegererezo cy’amacandwe yawe cyangwa amaraso yawe. Ni byiza kandi gukora iki kizamini kugira ngo urebe niba hari abandi bantu bo mu muryango wawe bafite iri hinduka ry’uturemangingo. Cyane cyane niba ufite mwene wanyu wa hafi (`umuvandimwe wo ku rwego rwa mbere`) ufite indwara ya Brugada syndrome, nk'ababyeyi bawe, abavandimwe bawe, cyangwa abana bawe, ugomba kwisuzumisha ibi .
• Electrocardiogram (EKG cyangwa ECG) : Iyi ikoreshwa mu kwandika imikorere y'amashanyarazi y'umutima wawe uko utera. Abaganga bashakisha imiterere runaka (icyitegererezo cya EKG cya Brugada syndrome type 1) kuri EKG. Hari igihe imiterere idakomeye yitwa type 2 cyangwa type 3 irashobora kugaragara, ariko ibyo byonyine ntibishobora kwemeza indwara. Ariko, bitewe n'ibintu byavuzwe haruguru (urugero: umuriro), iyi imiterere ya type 2 cyangwa type 3 ishobora guhinduka ikaba imiterere ya type 1. Hari igihe iyi imiterere idahita igaragara kuri EKG, bityo muganga ashobora gusubiramo EKG inshuro ebyiri cyangwa eshatu, ahindura imitsi. Hari igihe, EKG ikorwa nyuma yo kurya byuzuye.
• EKG hamwe n'imiti (ikizamini cy'ikibazo cy'imiti) : Mbere yo gufata EKG, muganga wawe ashobora kuguha umuti uzafasha EKG yawe kugaragara neza niba ufite indwara ya Brugada. Iki kizamini gikoreshwa kugira ngo harebwe niba EKG yawe ifite ubwoko bwa 2 cyangwa 3, ishobora guhinduka ubwoko bwa 1.

Bitewe n'ibisubizo bya EKG, ibindi bizamini bishobora gukorwa:

• Gupima Electrophysiology (EP) : Ibi bikubiyemo gushyira umuyoboro muto (catheter) mu mutsi munini uri mu kaguru kawe (femoral vein) mu mutima wawe kugira ngo upime imikorere y'amashanyarazi mu mutima wawe. Ibi bishobora gukorwa niba indwara itamenyekanye neza nyuma y'ibindi bizamini.
• Ibizamini byo muri laboratwari: Ibizamini by'amaraso bikorwa kugira ngo harebwe urugero rw'ibinyabutabire nka potasiyumu, kalisiyumu, na manyeziyumu mu maraso, no kugira ngo harebwe izindi mpamvu zishobora gutera imivuduko idahwitse y'umutima.

Uburyo bwo kuvura? (Ubuvuzi)

Intego nyamukuru yo kuvura indwara ya Brugada ni ukwirinda ko habaho indwara zo mu mitsi no kuzigenzura vuba mu gihe zibayeho.

Ushobora kwivuriza muri ubu buryo:

• Imiti nka Isoproterenol .
• Imiti nka quinidine .
• Agakoresho gato gashyirwa mu mutima (Implantable Cardioverter Defibrillator - ICD): Niba warigeze kugira indwara y'umutima (tachycardia), gucika intege, cyangwa guhagarara k'umutima, ushobora gushyirwamo ICD. Iki gikoresho gipima umutima urimo gutera ubwoba kandi kigatera umutima guhungabana gato kugira ngo ugaruke mu buryo busanzwe.
• Gutera amaraso mu mutima ( mu bihe bimwe na bimwe): Ibi bikubiyemo kumenya no gusenya ibice byo mu mutima bitera ibimenyetso bidasanzwe by'amashanyarazi.

Nubwo udafite ibimenyetso, muganga wawe ashobora gufata icyemezo cyo gushyiramo ICD hashingiwe ku mateka y'umuryango wawe n'ibisubizo by'ibizamini. Hari abaganga bashobora gufata icyemezo cyo kugusuzuma buri gihe bakakuvura gusa iyo ugaragaje ibimenyetso. Ariko, abandi baganga bashobora kutemeranya n'ubu buryo, kuko ikimenyetso cya mbere gishobora kuba urupfu rw'umutima rutunguranye.

Ese hari ingorane ziri mu kuvura?

ICD si ibikoresho 100% bidashobora kwirindwa. Hari igihe ibintu nk'ibi bishobora kubaho:

• Ushobora gutanga ihungabana mu gihe kitari cyo .
• Hashobora kuba hari ikibazo muri imwe mu nsinga ziri muri iyo mashini.
• Indwara ishobora kubaho hafi y'imashini.

Bityo rero, nyuma yo guterwa ICD, ni ngombwa cyane kujya kwipimisha neza nk'uko muganga abisaba.

Bifata igihe kingana iki kugira ngo umuntu akire?

Nyuma yo gushyirwamo ICD, ushobora gukora ibikorwa byawe bisanzwe mu minsi mike. Ariko, uzakenera guhagarika gutwara imodoka mu gihe cy'icyumweru kimwe. Ushobora gukora akazi gakomeye buri munsi, ariko ntukagakore kugeza aho unaniwe. Ntugaterure ibyuma cyangwa ngo ukore imyitozo ngororamubiri igoye kugeza igihe muganga wawe agutegetse.

Ese ibi bishobora kwirindwa? (Kwirinda)

Iyo uvukanye indwara ya Brugada Syndrome ku babyeyi bawe, ntabwo ishobora guhinduka. Ariko, niba uzi ko hari umuntu wo mu muryango wawe ufite indwara ya Brugada Syndrome, wowe n'abavandimwe bawe mushobora gupimwa imiterere y'umubiri kugira ngo barebe niba uyifite.

Nanone, niba wifuza kubyara umwana, ushobora guhura n'umujyanama mu by'imiterere y'umubiri ukaganira na we ku byago byo kubyara abana bawe.

Ni iki wakwitega mu gihe ubana n'indwara ya Brugada?

Nta muti uhari wa Brugada Syndrome. Ariko, kuvura bishobora kugabanya cyane ibyago byo gupfa mu buryo butunguranye k'umutima.

Abantu barwaye indwara ya Brugada bafite ibimenyetso ariko ntibahabwe ubuvuzi bafite ibyago byinshi byo gupfa mu mutima bitunguranye. Ibi byago biri hasi cyane ku bantu badafite ibimenyetso kandi bafite EKG isanzwe.

Niyitaho nte? (Kwiyitaho)

Iyo umuganga akubwiye ko ufite indwara ya Brugada, icy'ingenzi ni ukwirinda ibintu byinshi bishobora gutuma umuntu ahungabana uko bishoboka kose.

• Irinde umuriro. Niba ugize umuriro, gabanya vuba.
• Irinde imiti imwe n'imwe n'ibindi bintu . Baza muganga wawe urutonde rw'imiti igutera ubwivumbure.
• Irinde inzoga n'ibiyobyabwenge bikabije burundu .
• Nywa amazi menshi kugira ngo wirinde umwuma .
• Witondere igihe ukora imirimo ivunanye .

Ni ryari ugomba kujya kwa muganga? / Ese ugomba kujya mu cyumba cy’ubutabazi bw’ibanze?

Niba ufite indwara ya Brugada, ugomba kujya kwa muganga nibura rimwe mu mwaka kugira ngo agupime . Niba ufite ICD, ugomba kuyisuzumisha nibura kabiri mu mwaka . Niba wumva ikintu kidasanzwe, bwira muganga wawe .

Ibyihutirwa! Niba ufite ikibazo cy'umutima, ntuzashobora kwifasha. Kubwibyo, uzakenera umuntu wo kugufasha. Niba ufite ibyago byo guhagarara k'umutima, bwira umuryango wawe kwiga CPR (Cardiopulmonary Resuscitation) , hanyuma uhamagare 1990 (serivisi y'imbangukiragutabara yo muri Sri Lanka) cyangwa nimero y'ubutabazi iri hafi yawe. Menyesha kandi aho ukorera ibijyanye n'iyi ngaruka.

Ibibazo by'ingenzi ugomba kubaza muganga wawe

Iyo ugiye kwa muganga, ntukibagirwe kubaza ibibazo nk'ibi:

• Ese ngomba kugira ICD?
• Ni gute ICD igomba kubungabungwa?
• Ese wambwira itsinda rishinzwe ubufasha aho abandi bantu bafite iyi ndwara bashobora guhurira?
• Ni iyihe miti ngomba kwirinda? Mwampa urutonde?
• Ese abandi bo mu muryango wanjye bagomba gupimwa ibi?

Ubutumwa bwo kujyana mu rugo

Ni ibisanzwe kumva uremerewe cyane iyo umenye ko ufite ikibazo gishobora gutera indwara y'umutima itunguranye. Ariko, kumenya ko uri mu kaga biguha amahirwe yo gufata ingamba zo kugabanya iyo ngaruka . Muganga wawe azagushakira uburyo bwiza bwo kuvura.

Niba bishoboka, byaba byiza cyane mu rugo rwawe no ku ishuri ry'umwana wawe mufite AED (Automatic External Defibrillator) . Saba kandi abaturanyi bawe n'abo mukorana kwiga CPR. Ibi bintu bishobora kugufasha kurokora ubuzima. Buri gihe kurikiza amabwiriza ya muganga wawe, ujye wisuzumisha buri gihe, kandi wirinde ibintu bishobora gushyira ubuzima mu kaga .

Indwara ya Brugada , indwara z'umutima zitera kugabanuka k'umutima, indwara z'umutima zitunguranye, indwara zikomoka ku ngirabuzimafatizo, EKG, ICD, indwara z'umutima