Ese umutima wawe warahindutse gutya? Reka tuvuge kuri Hypertrophic Cardiomyopathy (HCM)!

Ese wigeze wumva indwara y'umutima aho imitsi y'umutima irushaho gukomera, bikaba bigoye? Hari igihe ushobora no kutamenya ko uyifite, kuko hari abantu badafite ibimenyetso. Ariko ni ngombwa kuyimenya kuko igira ingaruka ku mutima. Uyu munsi tugiye kuvuga kuri iyi ndwara yitwa hypertrophic cardiomyopathy, cyangwa 'HCM' mu baganga. Ntugahangayike, tuzayivugaho mu buryo bworoshye, mu buryo ushobora gusobanukirwa.

Reka tubanze turebe icyo HCM ari cyo?

Muri make, indwara ya hypertrophic cardiomyopathy (HCM) ni indwara ikomeye ifata imitsi y'umutima wawe. Ishobora guterwa n'ibintu bike by'ingenzi:

• Ubwinshi bw'imitsi y'umutima: Cyane cyane ibyumba byo hasi by'umutima, twita ventricles, bifite inkuta zikomeye.
• Gukomera kw'imitsi y'ibumoso: Icyumba kinini kiri ibumoso bw'umutima (ventricle y'ibumoso) kirakomera, kigabanuka cyane, nk'umupira.
• Impinduka mu mikorere ya valvu ya mitral: Impinduka mu mikorere ya valvu ya mitral, valvu y'ingenzi mu mutima, zishobora kubaho.
• Impinduka mu turemangingo: Hari ibintu bimwe na bimwe bidasanzwe bibaho mu turemangingo tw'imitsi y'umutima (impinduka mu turemangingo).

Ibi bintu bishobora gutera ibibazo bimwe na bimwe mu mikorere y'umutima.

Ni gute iyi ndwara ya HCM igira ingaruka ku mubiri wawe?

Noneho reka turebe icyo izi mpinduka zigira ku mubiri.

Kubyimba kwa myocardium

Iki ni cyo kimenyetso cy'ingenzi kigaragara muri HCM. Akenshi, uku gukurura biba mu rukuta rutandukanya impande z'ibumoso n'iz'iburyo z'umutima, rwitwa `(septum).` Tekereza, iyo iyi septum iri hagati y'ibyumba byo hasi by'umutima `(ventricles)` ibyimbye, ishobora kuziba uburyo amaraso atembera ava muri ventral y'ibumoso ajya muri aorta, umuyoboro w'amaraso munini utwara amaraso mu mubiri wose. Ibi tubyita `(outflow tract obstruction)`. Hanyuma umutima ugomba gukora cyane kugira ngo unyuze muri uku gukurura amaraso. Ubwoko bwa HCM buziba uburyo amaraso atembera bwitwa `(Hypertrophic Obstructive Cardiomyopathy - HOCM)`.

Hari igihe ibindi bice by'umutima, nko mu gasongero, mu mugongo w'iburyo, cyangwa mu mugongo wose w'ibumoso, bishobora kubyimba. Muri ibi bihe, amaraso ntahagarara. Ariko, ingano y'amaraso mu mugongo ishobora kwihanganira iragabanuka. Ibi byitwa Hypertrophic Nonobstructive Cardiomyopathy.

Gukomera kw'imitsi yo mu bwonko ibumoso

Iyo imitsi y'umutima ikuze, impinduka muri utwo turemangingo zituma ventricle y'ibumoso idatuza neza kandi yuzura amaraso. Bigenda bite rero? Kubera ko amaraso ari make mu cyumba, amaraso make akungahaye kuri ogisijeni yoherezwa mu zindi ngingo n'imitsi mu mubiri. Uku gukomera kongera umuvuduko w'amaraso mu mutima, kandi ushobora kugira ibimenyetso nk'ibi:

• Kubabara mu gatuza
• Guhumeka nabi
• Kuzungera cyangwa gucika intege
• Kumva umutima wawe urimo gutera cyane (gutera cyane)

Impinduka mu mikorere ya Mitral Valve

Nkuko byavuzwe mbere, iyo inzira yo gusohora amaraso mu mutima y'ibumoso ifunze, valve ya mitral mu mutima ishobora kudakora neza. Ibi bishobora kubangamira gutembera kw'amaraso no kongera umuvuduko w'amaraso mu mutima w'ibumoso.

Impamvu y’uku kuziba ni valve ya mitral ikubita kuri septum yabyimbye. Iyo ibi bibaye, valve ya mitral ntifunga neza kandi amaraso ashobora gusubira mu atrium y’ibumoso.

Impinduka mu ma selile

Iyo urebye neza ukoresheje mikorosikopi, uturemangingo tw’imitsi y’umutima w’umuntu urwaye HCM ntabwo dutondetse neza, ahubwo tuba dufite imiterere idasobanutse neza. Iyi ndwara ishobora gutera impinduka mu bimenyetso by’amashanyarazi binyura mu byumba byo hasi by’umutima, bigatera umutima utari mwiza witwa ventricular arrhythmia. Ibi bishobora guteza akaga.

Iyi ndwara yitwa HCM ikunze kugaragara gute?

Bivugwa ko abantu bagera kuri miliyoni 1.5 muri Leta Zunze Ubumwe za Amerika gusa, cyangwa umuntu umwe muri buri bantu 500, bafite HCM. Ibi bikunze kugaragara kurusha indwara nka ``(Multiple Sclerosis)``. Rero, ntabwo ari gake cyane.

Ubusanzwe HCM ikura ku kigero kingana iki?

Akenshi, iyi ndwara y'umutima igaragara mu rubyiruko, rufite imyaka iri hagati ya cumi n'umunani cyangwa makumyabiri. Ariko, ishobora gutangira ku myaka iyo ari yo yose.

Ese niba mfite HCM, hari ibyago byo gutwita?

Ushobora gukenera ubuvuzi bwihariye, nko gupima umutima buri gihe. Ariko, birashoboka cyane ko utwite neza kandi ukabyara neza. Ariko, ni ngombwa kubiganiraho na muganga wawe mbere yuko utwita no kuganira ku ngaruka zishobora kubaho. Muganga wawe azakubwira kandi imiti ya HCM ushobora gukomeza gufata mu gihe utwite. Ushobora kandi gukenera gushyirwaho pacemaker cyangwa implantable cardioverter defibrillator (ICD) nibiba ngombwa mu gihe utwite.

Ni iki gitera HCM?

Hari ibintu byinshi bishobora gutera HCM:

• Genetike: Iyi ni yo mpamvu nyamukuru. HCM ni indwara ishobora kuragwa n'ababyeyi kugeza ku bana. Ibi bivuze ko hari inenge mu ngirabuzimafatizo zigenzura imiterere y'imitsi y'umutima. Hari ubwoko bwinshi bw'uturemangingo dutera HCM. Nubwo haba hari inenge mu ngirabuzimafatizo, si buri wese mu muryango uzarwara iyi ndwara mu buryo bumwe. Hari abantu bashobora kugira ngirabuzimafatizo ya HCM ariko ntibagire iyo ndwara.
• Umuvuduko ukabije w'amaraso: Umuvuduko ukabije w'amaraso umaze igihe kinini uhari na wo ushobora kuba impamvu y'ibi.
• Gusaza: Hari amahirwe ko iyi ndwara ishobora kubaho uko ugenda usaza.
• Hari aho impamvu itazwi:Hari igihe nta mpamvu yihariye iboneka itera HCM.

Ni ibihe bimenyetso umuntu urwaye HCM ashobora kugira?

Bamwe mu bantu barwaye HCM bashobora kugira ibimenyetso bitandukanye, mu gihe abandi bashobora kutagira ibimenyetso na gato. Ibimenyetso bikunze kugaragara ni ibi bikurikira:

• Kubabara mu gituza: Ibi bikunze kubaho mu gihe cy'imyitozo ngororamubiri cyangwa imyitozo ngororamubiri, ariko rimwe na rimwe bishobora kubaho uhagaze cyangwa umaze kurya.
• Guhumeka nabi no kunanirwa: Ibi bimenyetso, cyane cyane iyo unaniwe, bikunze kugaragara ku bantu bakuru. Ibi biterwa no kwiyongera k'umuvuduko mu gice cy'ibumoso cy'imbere no mu bihaha.
• Gucika intege cyangwa gucika intege (syncope): Ibi bishobora guterwa n'imitsi y'umutima idasanzwe (arrhythmias) cyangwa uburyo imitsi y'amaraso ikora budasanzwe mu gihe cy'imyitozo ngororamubiri. Hari igihe nta mpamvu iboneka.
• Guhagarara mu gifu: Ibi bishobora guterwa n'imikorere idasanzwe y'umutima, nko kugabanuka kw'umutima mu gifu (atrial fibrillation) cyangwa tachycardia y'umutima mu gifu (ventricular tachycardia). Abantu bagera kuri 25% barwaye HCM bagira atrial fibrillation. Ibi byongera ibyago byo kubyimba kw'amaraso no kunanirwa k'umutima.
• Kubyimba imitsi yo hasi cyangwa mu ijosi.

Ni izihe ngorane zindi z'ubuzima zishobora guterwa na HCM?

Abantu benshi barwaye HCM babaho ubuzima busanzwe kandi nta bibazo bikomeye by'ubuzima bafite. Bamwe ntibakenera no gufata imiti. Ariko, nubwo udafite ibimenyetso, muganga wawe ashobora kukugira inama yo kudakora imyitozo ngororamubiri igoye.

Ariko, bamwe mu bantu barwaye HCM bashobora kurwara indwara z'umutima zigabanya igihe cyo kubaho cyangwa zikagabanya ubuzima bwabo. Iby'ingenzi ni ibi bikurikira:

Gufatwa n'umutima mu buryo butunguranye n'urupfu rw'umutima mu buryo butunguranye

Guhagarara k'umutima mu buryo butunguranye ni ugutakaza imikorere y'umutima mu buryo butunguranye bitewe n'umuvuduko w'umutima wihuta cyane (urugero: Ventricular Tachycardia). Muri iki gihe, ubuvuzi bwihutirwa, nka CPR na defibrillation, bukenewe vuba ibimenyetso bitangiye. Iyo ubu buryo budatanzwe neza, umutima ushobora gupfa mu buryo butunguranye.

Abantu benshi barwaye HCM bafite ibyago bike byo gupfa mu buryo butunguranye. Ariko, HCM ni yo mpamvu ikomeye itera impfu zitunguranye mu bantu bari munsi y'imyaka 35. Ushobora kuba warumvise ko HCM yanagaragaye ko ifitanye isano n'impfu zitunguranye za bamwe mu bakinnyi bakiri bato babigize umwuga.

Umutima unanirwa

Kuba ufite `(Umutima unaniwe)` ntibivuze ko umutima wawe "wananiwe" kandi uhagaritse gukora. Bisobanura gusa ko umutima wawe udatera amaraso neza kandi neza. Ibimenyetso bya `(Umutima unaniwe)` birimo:

• Guhumeka nabi.
• Kumva unaniwe iyo uri gukora (umunaniro).
• Kubyimba utubuto, amaguru n'inda.
• Gukenera kunyara nijoro mu gihe uruhuka.
• Kuzunguza, urujijo, kugorwa no kwita ku bintu, gucika intege.
• Kumva umutima wawe urimo gutera cyane (gutera cyane).
• Inkorora yumye kandi ishyushye.
• Kumva uhaze, ubyimbye, utakaje ubushake bwo kurya, cyangwa ubabara mu gifu.

Ni gute wasuzuma HCM? (Isuzuma)

HCM ipimwa hashingiwe ku bikurikira:

• Amateka y'ubuvuzi: Muganga wawe azakubaza ibimenyetso byawe n'uko hari umuntu wo mu muryango wawe wigeze kugira indwara nk'izo.
• Isuzuma ry'umubiri: Muganga azatega amatwi umutima wawe n'ibihaha. Abantu barwaye HOCM bashobora kumva ijwi ridasanzwe ry'umutima (umutima uvuza umuborogo).
• Ibizamini: Echocardiogram (echo) ni cyo kizamini nyamukuru gikoreshwa mu gusuzuma HCM. Ibi bishobora gufasha kureba niba inkuta z'umutima zaruzuye.

Hari ibindi bizamini:

• Gupima amaraso.
• Isuzuma ry'umutima (ECG).
• X-ray yo mu gituza.
• Ikizamini cyo gupima stress mu myitozo ngororamubiri.
• Gushyiramo katheta ku mutima.
• Ishusho ya resonance ya magnetic (MRI).

Ni ubuhe buryo bwo kuvura HCM?

Muganga wawe azaguhitiramo uburyo bwo kuvura bukubereye ashingiye ku bintu bikurikira:

• Ese hari ikibazo cyo kuziba kw'amaraso mu mutima (inzira isohoka igabanuka)?
• Umutima wawe ukora ute?
• Ibimenyetso byawe.
• Imyaka yawe n'uburyo ukora cyane.
• Ese ufite imivuduko idasanzwe y'umutima (arrhythmias)?

Intego nyamukuru y'ubuvuzi ni ukugabanya cyangwa gukumira ibimenyetso no kugabanya ibyago byo kurwara indwara nko kunanirwa k'umutima no gupfa umutima utunguranye.

Ibi bikurikira bishobora gukorwa nk'ubuvuzi:

• Menya ingaruka zishobora kubaho hanyuma ukomeze kubonana na muganga.
• Impinduka mu mibereho.
• Imiti.
• Uburyo bwihariye bwo kuvura.

Ni gute wasuzuma HCM?

Kubera ko HCM ari indwara ishobora guhererekanywa kuva ku gisekuru kugera ku kindi, niba umwe mu babyeyi bawe, abavandimwe bawe, cyangwa abana bawe (ni ukuvuga umuvandimwe wawe wo ku rwego rwa mbere) afite iyi ndwara, ni ngombwa kwipimisha.

Intambwe ya mbere ni ugusuzuma umutima wawe ukoresheje Electrocardiogram (ECG) na Echocardiogram (echo). Niba ibi bizamini bigaragaza ibimenyetso bya HCM, uzakenera kubonana na muganga w’inzobere muri iyi ndwara (inzobere mu by’umutima).

Hari igihe, nubwo waba ufite amateka y’umuryango wawe ya HCM, ibisubizo by’ibizamini byawe bishobora kuba bisanzwe. Niba ari uko bimeze, abaganga bakugira inama yo kujya upima indwara ya ECG buri myaka itatu kugeza ufite imyaka 30, hanyuma buri myaka itanu.

Ni nde uri mu kaga gakomeye ko gupfa umutima bitunguranye bitewe na HCM?

Abantu benshi barwaye HCM bafite ibyago bike byo gupfa mu buryo butunguranye. Ariko, umubare muto w'abantu barwaye HCM bafite ibyago byinshi. Ni ngombwa kumenya niba ufite iyi ndwara. Muganga wawe ashobora kukubwira icyo wakora kugira ngo ugabanye ibyago byawe.

Abantu bafite ibyago byinshi byo gupfa umutima bitunguranye bitewe na HCM ni:

• Abantu bafite amateka y'urupfu rw'umutima rutunguranye mu muryango wabo.
• Abantu bagiye bagira ikibazo cyo kwiheba inshuro nyinshi mu buto bwabo.
• Abantu bafite umuvuduko w'amaraso udasanzwe mu gihe bakora imyitozo ngororamubiri.
• Abantu bafite amateka yo gutera kw'umutima vuba cyane (arrhythmia).
• Abafite ibimenyetso bikomeye n'imikorere mibi y'umutima.

Vugana na muganga wawe ku byakubangamira. Niba ufite ibintu bibiri cyangwa byinshi bishobora gutera urupfu rutunguranye, muganga wawe ashobora kukugira inama yo gukoresha imiti igabanya ubukana bw'umutima (imiti igenzura imivuduko idasanzwe y'umutima) cyangwa imiti igabanya ubukana bw'umutima (ICD) kugira ngo ugabanye ibyago byo kurwara.

Ni iyihe miti ikoreshwa mu kuvura HCM?

Abaganga baguha imiti itandukanye kugira ngo bagenzure ibimenyetso byawe kandi wirinde izindi ngorane. Imiti nka ``Beta blockers`` na ``calcium channel blockers`` iruhura imitsi y'umutima, ikawufasha kuzuza amaraso no kohereza amaraso neza. Indi miti ishobora kugenzura umuvuduko w'umutima wawe cyangwa ikagabanya ibyago byo kugira umutima utari mwiza (arrhythmias).

Ushobora kubwirwa kutanywa imiti imwe n'imwe, urugero nka nitrate (igabanya umuvuduko w'amaraso) cyangwa digoxin (yongerera imbaraga umutima utera cyane).

Hari igihe ushobora gukenera gufata imiti igabanya ubukana bw'indwara ziterwa n'udukoko (antibiotiques) no gufata ingamba zo kwirinda kugira ngo ugabanye ibyago byo kwandura indwara ishobora gushyira ubuzima mu kaga yitwa bacterial endocarditis.

Ni ubuhe buryo bwihariye bwo kuvura bukoreshwa mu kuvura HCM?

Hari uburyo butandukanye bwo kuvura indwara ya Hypertrophic Obstructive Cardiomyopathy (HOCM), indwara ituma amaraso adatembera neza:

Kuva mu kwezi kwa Nzeri kwa Myectomy

Ubu ni uburyo bwo kubaga. Mu kubaga septal myectomy, umuganga akuramo igice gito cy'urukuta rwawe rw'inyuma rwuzuye. Ibi byongera inzira yo gusohoka iva mu muyoboro w'ibumoso ijya mu muyoboro w'amaraso. Abaganga basuzuma ubu buryo gusa iyo imiti idafashije. Ibi akenshi bikemura ikibazo cya mitral valve.

Kugabanya Ethanol

Ibi kandi byitwa `(septal ablation)`. Ubu buryo bukoreshwa ku bantu badashobora kubagwa `(septal myectomy)` twavuze mbere. Muri ibi, muganga abona umutsi muto w'umutima utanga amaraso mu gice cyo hejuru cya septum yawe. Hanyuma ashyiramo catheter y'ibara ry'umuhondo muri uwo mutsi maze akawushyiramo umwuka. Hanyuma, atera irangi `(contrast agent)` kugira ngo amenye neza aho urukuta rw'iseptum rwagutse ruri kubuza amaraso gutembera.

Iyo aho hantu habonetse, muganga atera inshinge nke cyane z’inzoga nziza binyuze muri catheter. Inzoga yica uturemangingo, kandi mu mezi make ari imbere septum iragabanuka ikongera ku bunini bwayo busanzwe. Ibi bigabanya inzira amaraso atemberamo.

Imashini igabanya ububabare bw'umutima (ICD)

Imashini itera umutima mu buryo bwihuse (ICD) ishobora gufasha abantu bafite indwara zo kutagira umutima cyangwa urupfu rutunguranye rw'umutima. ICD ni igikoresho gito gishyirwa munsi y'uruhu rwawe. Gihuzwa n'umutima wawe hakoreshejwe insinga. ICD ihora igenzura imivuduko y'umutima wawe. Iyo ibonye umutima wawe utera vuba kandi udasanzwe, itera umutima guhungabana guto ariko gukomeye, bigatuma wongera gutera neza. Muganga wawe azakubwira niba ICD ikubereye.

Kurwanya indwara y'umutima

Hari uburyo butandukanye bwo guhangana n'indwara y'umutima, kuva ku guhindura imibereho kugeza ku miti igabanya ibimenyetso no gufasha imitsi y'umutima gukora neza.

Ni gute nakongera ubuzima bwanjye hamwe na HCM?

Waba ufite ibimenyetso cyangwa udafite, waba waranduye HCM, cyangwa niba hari umuntu wo mu muryango wawe uyirwaye, hari ibintu byinshi wakora kugira ngo umutima wawe ukomeze kugira ubuzima bwiza:

• Gabanya ibinyobwa n'umunyu (sodium): Niba ufite ibimenyetso by'indwara y'umutima, ushobora kugabanya ibinyobwa n'umunyu urya. Baza muganga wawe amabwiriza yihariye yerekeye imirire yawe, harimo inzoga na kafeyine.
• Imyitozo ngororamubiri witonze: Muganga wawe azakubwira imyitozo ikubereye. Abantu benshi barwaye HCM bashobora gukora imyitozo ngororamubiri idasaba amarushanwa. Abaganga ntibakugira inama yo guterura ibintu biremereye cyangwa siporo ikomeye.
• Jyana na muganga wawe buri gihe: Niba ufite HCM, ugomba kujya kureba muganga w'indwara z'umutima buri gihe kugira ngo akurikirane uko umerewe.
• Gabanya ibyago byo kwandura: Niba ufite HCM, muganga wawe azakugira inama yo gufata ingamba zo kugabanya ibyago byo kwandura indwara yitwa "infectious endocarditis".

Ni gute wagabanya ibyago byo kurwara indwara ya Endocarditis yandura?

Abantu barwaye HCM bashobora kurwara indwara ya bagiteri yitwa ``bacterial endocarditis`` cyangwa ``infectious endocarditis``.

Indwara ya bagiteri iterwa n'indwara y'umutima (bacterial endocarditis) ni indwara iterwa n'imitsi y'umutima cyangwa igice cy'umutima (endocardium). Ibaho iyo mikorobe (cyane cyane bagiteri, ariko rimwe na rimwe fungi n'utundi dukoko) zinjiye mu maraso yawe zigatera igice cy'umutima cyangwa igice cy'umutima. Ibi bishobora gutuma imitsi y'umutima ikomera, igatobora, cyangwa igatera inkovu. Ibi akenshi bitera imitsi y'umutima kuva amaraso. Iyo idavuwe neza, ishobora kwica.

Ushobora gufata izi ntambwe kugira ngo ugabanye iyi ngaruka:

• Wite ku menyo yawe n'ishinya yawe neza: Jyana na muganga w'amenyo buri mezi atandatu, woze amenyo yawe buri munsi, oza amenyo, kandi urebe neza ko amenyo yawe ajyanye neza.
• Shaka muganga niba ufite ibimenyetso by'ubwandu:
• Umuriro urenze dogere 100 z'ubushyuhe, kubira ibyuya, cyangwa gukonja.
• Uduheri ku ruhu.
• Ububabare, ububabare, gutukura, cyangwa kubyimba.
• Igikomere cyangwa igikomere kidakira, cyangwa igikomere gitukura, gishyushye, kandi gisohora amabyi.
• Kubabara mu muhogo, gufungana mu muhogo, cyangwa kubabara iyo uri kumira.
• Kuva mu mazuru, kuziba izuru, kuribwa umutwe, cyangwa kubabara mu matama yo hejuru.
• Inkorora yumye cyangwa ifuro imara iminsi irenga ibiri.
• Uduheri tw'umweru mu kanwa cyangwa ku rurimi.
• Isesemi, kuruka, cyangwa impiswi.

Ntutinde gushaka ubuvuzi. Ibicurane n'ibicurane bisanzwe ntabwo bitera indwara y'umutima. Ariko, izindi ndwara zifite ibimenyetso bisa nazo zishobora gutera indwara y'umutima. Rero, gira umutekano urebe muganga wawe.

• Fata imiti yica udukoko mbere yo gukoresha imiti imwe n'imwe yo kwa muganga no mu menyo. Vugana na muganga wawe ku bwoko bwa miti yica udukoko ugomba gufata, ingano, n'ubwoko bw'imiti ugomba gufata.
• Bika ikarita iranga indwara ya bagiteri iterwa n'indwara ya bacterial endocarditis iboneka mu Ishyirahamwe ry'Abanyamerika ryita ku ndwara y'umutima.

Hanyuma, ibi nibyo ugomba kuvuga (Ubutumwa bwo kujyana mu rugo)

Abantu benshi barwaye HCM babaho ubuzima busanzwe kandi bushimishije. Hari uburyo butandukanye bwo kuvura abafite ibimenyetso cyangwa bashobora kugira ibibazo bikomeye. Isuzuma ry'uko indwara ihagaze riterwa n'uburyo imitsi y'umutima wawe ikora, ibimenyetso byawe, n'uburyo witabira kandi ugakurikiza gahunda yawe yo kuvura.

Baza muganga wawe ibyago byawe n'icyo wakora kugira ngo urusheho kugira ubuzima bwiza kandi wirinde kwandura. Niba usanzwe ufite HCM kandi ukagira ibimenyetso cyangwa ukeka ko ufite ubwandu, hita ubonana na muganga wawe. Wibuke ko ushobora kubaho ubuzima bwiza ufite iyi ndwara!

"Hypertrophic cardiomyopathy, HCM, indwara z'umutima, kwaguka k'umutima, kubabara mu gituza, kubura umwuka, urupfu rutunguranye rw'umutima