Ese imitsi y'umutima wawe "irasinziriye" cyangwa "irahagaze"? (Myocardium ihora mu gihe cy'ububabare n'umutima uhora uhagaze) Reka tubigeho!

Ese wigeze wumva ibice by'umutima "bisinziriye"? Cyangwa "bigwa" mu buryo butunguranye? Nubwo ibi bishobora kumvikana nk'amagambo adasanzwe, mu by'ukuri izi ni indwara ebyiri zigira ingaruka ku mitima yacu. Ntugahangayike, tuzazivugaho mu buryo bworoshye kandi bworoshye kumva. Tuzareba ibyo ari byo, impamvu bibaho, uburyo bwo kubimenya, ndetse niba bishobora gukira.

"Gusinzira" imitsi y'umutima ni iki? (Myocardium igenda yihuta)

Mu magambo make, iyo igice cy'imitsi y'umutima wawe (tuyita `(Myocardium)`) kibuze amaraso gutembera, buhoro buhoro kigabanya imikorere yacyo amaherezo kigahagarara. Ni nko kujya gusinzira kuko kinaniwe. Ibi ni byo twita `(Myocardium ihora mu gihe cy'ubushyuhe)` cyangwa "imitsi y'umutima isinziriye." Ibi bishobora kubaho mu mezi menshi, ndetse n'imyaka.

Tekereza, iyo ibimera bimwe na bimwe mu busitani bwawe bibuze amazi, birazingira bigasa n'aho birimo kuruma, si byo se? Uko ni ko bimeze kuri iyi. Imitsi y'umutima ikenera cyane cyane aside irike kugira ngo ikore (ni ukuvuga kugira ngo igabanuke). Ariko iyo amaraso abuze, iyi mitsi itangira gukoresha isukari (ni ukuvuga ubwoko bw'isukari) kugira ngo ikomeze kubaho. Ariko, nta ngufu ihagije ifite zo kohereza amaraso mu mutima muri iki gihe. Rero, iyi mitsi "isinziriye" ntabwo ifasha umutima gutera amaraso.

Iyo imitsi y'umutima "igwa" cyangwa "igiye muri koma" bivuze iki? (Stunned Myocardium)

Iyi ndwara itandukanye gato n'iyo twavuze mbere. Ishobora kubaho vuba cyane, mu minota mike cyangwa amasaha make. Iyo amaraso agera ku mitsi y'umutima agabanutse cyangwa agahagarara mu buryo butunguranye, imitsi irahagarara gukora, nk'aho "yafashe" cyangwa "yacitse intege." Ibi byitwa `(Stunned Myocardium)`.

Ikintu gitangaje ni uko, rimwe na rimwe nubwo abaganga bavura iyo mitsi ifunganye (urugero, bashyiramo stent, bagabanya umutsi ufunganye bakoresheje ibara ry'umuhondo, cyangwa bagashonga amaraso afunganye) kugira ngo amaraso yongere gutembera, ibi bice by'imitsi "yafashe" ntibihita bisubira uko byari bisanzwe. Bishobora gufata iminsi, cyangwa ibyumweru, kugira ngo iyo mitsi yongere ikore neza.

Ni gute izi ndwara zitandukanye n'indwara y'umutima?

Iki ni ikibazo cy'ingenzi cyane. Indwara y'umutima ni yo ndwara ikomeye cyane y'imitsi itera umutima guhagarara. Ibi bibaho iyo umwe cyangwa myinshi mu mitsi itanga amaraso mu mutima ifunzwe burundu n'ibintu birimo ibinure byitwa plaque, bigatuma uturemangingo tw'imitsi y'umutima dupfa. Uturemangingo tw'imitsi y'umutima twapfuye dusimburwa n'uturemangingo tw'inkovu. Iyi nkovu ntishobora gufasha umutima gukompa neza. Ibi bishobora gutera umutima guhagarara nabi.

Ariko, indwara zombi ""Inyoka y'umutima ihora mu gihe cy'ububabare"" na ""Inyoka y'umutima ihora ikora neza"" ni iz'igihe gito. Ikibaho hano ni uko imitsi y'umutima idakora neza, ariko uturemangingo twayo tuba tukiri bazima.Iyo amaraso n'umwuka wa ogisijeni bigarutse, ibi bice by'imitsi "bisinziriye" cyangwa "byafashe" bishobora kongera gukora. Icyo ni cyo kintu cy'ingenzi cyane!

Ni izihe mpamvu zitera ``Indwara ya 'Hibernating Myocardium''?

Iyi ndwara igaragara cyane cyane ku bantu bafite indwara ikomeye y’imitsi ijyana amaraso mu mutima. Muri iyi ndwara, ibinure byinshi (twita "plaque") byiyongera mu mitsi ijyana amaraso mu mutima, bigatuma ifungana. Iyo imitsi ibaye mito cyane, imitsi y’umutima ntibona ogisijeni n’intungamubiri bihagije kugira ngo ikomeze kubaho kandi ifashe umutima gupompa amaraso. Bityo, imitsi "irasinzira" kugira ngo izigame ingufu kugira ngo ikomeze gukora imirimo yayo y’ibanze y’uturemangingo.

Ni izihe mpamvu zitera 'Stunned Myocardium'?

Gutungurana kw'imitsi y'umutima, bizwi kandi nka "gufata" imitsi y'umutima, bishobora no kubaho mu gihe cyo kuvura indwara y'imitsi ifata umutima. Nubwo kuvurwa bisubiza amaraso mu mubiri, bimwe mu bice by'imitsi y'umutima ntibihita bikira. Byongeye kandi, iyi ndwara ishobora kubaho kubera izindi mpamvu nyinshi:

• Indwara zo mu bwonko (ihindagurika ry’imikorere y’amashanyarazi mu bwonko).
• Stress Cardiomyopathy ni indwara igira ingaruka ku mutima bitewe n'stress.
• Indwara isa n'indwara yo mu bwonko.
• Kuva amaraso mu bwonko (Subarachnoid Hemorrhage).

Ni ibihe bimenyetso by'izi ndwara zombi?

Kubera ko muri izo ndwara zombi, igice kimwe cyangwa igice kinini cy'imitsi y'umutima ni cyo kigira ingaruka, ibimenyetso akenshi bisa n'ibigaragara ku gucika intege k'umutima. Muri byo harimo:

• Guhumeka bigoranye
• Kubabara mu gatuza
• Kubyimba amaguru

Niba ufite ibi bimenyetso, ni byiza kujya kwa muganga no kwisuzumisha.

Ni gute wasuzuma ``Myocardium ihora mu gihe cy'ububabare``?

Kugira ngo umenye neza iyi ndwara, hakenewe ibizamini byinshi bigoye. Ibi bizamini bishobora gufasha gutandukanya ibice by'imitsi y'umutima "bisinziriye" cyangwa "byafashe" ariko bishobora kongera kuzuka , n'ibice byapfuye kandi bifite inkovu kandi bidashobora kongera kuzuka .

Bimwe mu bipimo by'ingenzi abaganga bakoresha muri iki gikorwa ni ibi bikurikira:

• `Dobutamine Stress Echocardiogram`: Ibi bikubiyemo kuguha umuti (witwa `(Dobutamine)`) kugira ngo utere umutima wawe imbaraga nk'aho uri gukora imyitozo ngororamubiri. Umuganga w'indwara z'umutima azareba uko umutima wawe ukora iyo uri mu karuhuko n'uko ukora iyo ingano y'umuti yongerewe. Niba ubushobozi bw'imitsi y'umutima bwo gukora bwiyongera iyo uhawe umuti, bivuze ko ufite indwara yitwa `(Stunned Myocardium)` cyangwa `(Hibernating Myocardium)`. Iyo imitsi idakora ndetse na nyuma y'uko ingano y'umuti yongerewe, bivuze ko imitsi yapfuye kandi ifite inkovu.
• MRI y'umutima:Ibi bikoresha imbaraga za rukuruzi n'imirasire ya radiyo kugira ngo bigaragaze neza kandi birambuye imitsi y'umutima wawe. Mu kureba uko imitsi y'umutima imeze n'ubunini bwayo muri aya mashusho, abaganga bashobora kumenya neza ingingo ifite inkovu (yapfuye), ibisanzwe, n'ibidakora cyangwa "byafashe."
• Isuzuma rya PET (Cardiac Positron Emission Tomography): Iri suzuma rikoresha ibikoresho bifite imirasire ihagije hamwe na kamera yihariye. Rigaragaza ibice by'imitsi y'umutima wawe bikora neza n'ibice bifite inkovu cyangwa ingingo zapfuye.

Nubwo ibi bizamini bishobora gusa nkaho bigoye, ni ingenzi cyane kugira ngo usobanukirwe neza indwara yawe no guhitamo uburyo bwiza bwo kuvura.

Ese imitsi y'umutima ihora isinziriye ('Hibernating Myocardium') ishobora kuvurwa? Ni ubuhe buryo bwo kuvura?

Yego, iyi ni inkuru nziza cyane! Iyi ndwara ishobora gukira hakoreshejwe uburyo bwo kuyivura. Ikintu cy'ingenzi ni ukugarura amaraso mu gice cy'umutima cyagabanutseho amaraso. Hari uburyo bubiri bw'ingenzi bwo kuvura ibi:

• Angioplasty: Ibi bikubiyemo gukoresha umuyoboro muremure kandi muto (catheter) kugira ngo winjire mu miyoboro y'amaraso yazibye hanyuma ushyiremo agapira gato ku mpera y'umuyoboro kugira ngo ukureho plaque no kwagura umuyoboro. Hari igihe, igikoresho gisa n'umuyoboro (stent) gishobora gushyirwa mu muyoboro kugira ngo udafunga ukundi.
• Kubaga imitsi y'umutima (CABG): Ubu ni uburyo bwo kubaga busaba gufata umutsi w'amaraso muzima mu kindi gice cy'umubiri wawe (nk'ukuguru cyangwa igituza) ugashyiraho inzira nshya amaraso anyuramo, unyuze mu mitsi yazibye mu mutima wawe. Ni nko kubaka inzira yo kunyuramo iyo umuhanda ufunze.

Nyuma y’ubu buvuzi, ushobora no koherezwa muri gahunda ya "Cardiac Rehabilitation" kugira ngo igufashe gukira. Iyi ni gahunda y’imyitozo ngororamubiri igenzurwa n’abaganga igufasha kongera imbaraga n’ubuzima bwiza, no kugira ingeso nziza ku mutima.

Ni ubuhe buryo bwo kuvura indwara ya 'Stunned Myocardium'?

Uburyo bwo kuvura imitsi y'umutima yazibye bungana cyane n'uburyo busanzwe bwo kuvura indwara z'umutima n'indwara z'umutima. Imwe mu miti ikoreshwa cyane irimo:

• Asipirine
• Beta-blockers
• Statines (imiti igabanya cholesterol)
• Imiti igabanya umuvuduko w'amaraso (ACE inhibitors) cyangwa Angiotensin II receptor blockers (imiti igenzura umuvuduko w'amaraso kandi ikarinda umutima)

Muganga azasuzuma indwara yawe maze aguhe umuti ukubereye.

Wakwirinda ute ibi bihe?

Uburyo bwiza bwo kugabanya ibyago byo kurwara ibi bibazo ni ukwita ku mutima wawe neza. Ibyo bivuze:

• Gukurikiza indyo yuzuye:Indyo irimo amavuta make, isukari n'umunyu, hamwe n'imboga n'imbuto byinshi.
• Imyitozo ngororamubiri isanzwe: Ndetse n'ikintu cyoroshye nko kugenda n'amaguru iminota 30 ku munsi ni cyiza.
• Irinde kunywa itabi: Kunywa itabi ni bibi cyane ku mutima.
• Kugabanya ikoreshwa ry'inzoga.
• Kugumana ibiro byiza.
• Kugenzura imihangayiko.
• Niba ufite indwara nka diyabete, umuvuduko ukabije w'amaraso, cyangwa cholesterol nyinshi, zigenzure neza.
• Niba muganga wawe yaragundikiye, fata imiti nka statins kugira ngo ugabanye cholesterol cyangwa aspirine kugira ngo wirinde kubyimba kw'amaraso buri munsi.

Ushobora kandi gukoresha ibyuma bipima ibyago bituruka mu miryango nka Koleji y’Abanyamerika y’Ubumenyi bw’Imitima cyangwa Umuryango w’Uburayi w’Ubumenyi bw’Imitima kugira ngo umenye ibyago byawe bwite n’ibyo ukeneye mu kwivuza. Ariko, niba usanzwe ufite indwara y’umutima, ni byiza kuvugana na muganga wawe ku byago byawe. Muri ibi bihe , uburyo bwo kuvura bushingiye ku mabwiriza bwagaragaye ko bugabanya cyane ibyago byo kurwara indwara z’umutima, gucika intege k’umutima, ndetse no gupfa.

Ni iki giteganyijwe?

Ubuzima bw'umuntu ufite iyi ndwara mu gihe kizaza (tubyita "prognosis") buterwa n'ibintu byinshi. Urugero:

• Uburyo ubushobozi bw'umutima bwo gutera amagufwa bwagabanutse.
• Niba ukoresha umuti nyawo wanditswe na muganga.
• Niba ukwiriye kubagwa `(Angioplasty)`/`(Stent)` cyangwa `(CABG)`.

Abantu barwaye indwara y'imitsi ifata umutima bafite ibyago byo kurwara indwara z'umutima mu gihe kizaza. Iyo imitsi ifata umutima yongera kuziba, imitsi y'umutima ishobora kongera "gusinzira".

Icy'ingenzi: Myocardium ihora mu gihe cy'ubukonje iba iyo amaraso atembera mu mitsi y'umutima igihe kirekire bitewe n'uko imitsi y'umutima ifunganye cyane ku bantu bafite indwara y'imitsi y'umutima. Myocardium itunguranye iba iyo amaraso atembera mu buryo butunguranye. Iyo amaraso agarutse, imitsi y'umutima wawe igomba kongera guhagarara mu gihe gito. Izi ndwara zombi ziravurwa. Ni ngombwa kwita ku mutima wawe neza kugira ngo wirinde ko izi ndwara zisubira.

Ibintu by'ingenzi ugomba kwibuka (Ubutumwa bwo kujyana mu rugo)

Noneho reka tuvuge muri make ibintu ugomba kwibuka mu byo twavuze:

• Myocardium ihora mu gihe cy'ubushyuhe n'indwara ya Stunned Myocardium ni indwara ebyiri ziterwa no kugabanuka kw'amaraso ajya mu mitsi y'umutima.
• Muri izi ndwara zombi, imitsi y'umutima ntipfa, ariko ntikora neza. Ibi bitandukanye n'indwara y'umutima.
• Izi ndwara zombi akenshi zishobora gukira! Ni ngombwa kugarura amaraso mu mubiri, kandi nibiba ngombwa, hamagara muganga.
• Niba ufite ibimenyetso nko kugorwa no guhumeka, kubabara mu gatuza, cyangwa kubyimba amaguru, shaka inama kwa muganga udapfushije igihe.
• Ingaruka z'izi ndwara zishobora kugabanuka ukurikije imibereho myiza no gucunga indwara zisanzweho (nk'indwara ya diyabete n'umuvuduko ukabije w'amaraso).
• Niba ufite indwara y'umutima, ni ngombwa cyane gukurikiza amabwiriza ya muganga wawe neza no kwipimisha buri gihe.

Umutima wawe ni wo mutungo wawe w'agaciro kanini. Rero wirinde. Ndizera ko aya makuru azagufasha!

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