Ese umunyungugu w'umutima wawe urimo kuva amaraso make? Reka twige ibijyanye no gusubiramo umunyungugu wa Mitral!

Ese rimwe na rimwe uhura n'ingorane mu buryo butunguranye zo guhumeka? Cyangwa wumva ikintu kidasanzwe, kiremereye mu gituza? Ese rimwe na rimwe wumva unaniwe ndetse no nyuma yo gukora utundi duto? Impamvu imwe ishobora kuba ikibazo cy'umuryango muto mu mutima wawe, ni ukuvuga valve. Uyu munsi tugiye kuvuga kuri Mitral Valve Regurgitation, ari na yo ndwara. Ntugahangayike, reka tubisobanukirwe mu buryo bworoshye.

Iyi valve yo mu mutima ni iki? Ni iki kibaho iyo idakora neza?

Mu magambo make, valve ya mitral ni urugi ruri hagati y’icyumba cyo hejuru (atrium y’ibumoso) n’icyumba cyo hasi (ventricle y’ibumoso) ku ruhande rw’ibumoso rw’umutima wawe. Tekereza nk’urugi ruri mu nzu yawe. Uru rugi rugomba gufungura no gufunga neza, bigatuma amaraso ava mu cyumba cyo hejuru ajya mu cyumba cyo hasi. Hanyuma, uru rugi rugomba gufungwa neza kugira ngo amaraso ava mu cyumba cyo hasi yoherezwe mu bindi bice by’umubiri wawe. Bitabaye ibyo, amaraso azatangira kuva mu cyumba cyo hejuru.

Ariko rimwe na rimwe uru rugi ntirufunga neza. Nk’uko inzugi zo mu mazu yacu rimwe na rimwe zidafunga neza, bigasiga umwanya muto. Ibi bishobora guterwa n’ikibazo cy’urugi ubwarwo, ni ukuvuga ingirangingo y’ingufu. Cyangwa bishobora guterwa n’ikibazo cy’inkuta zikikije urugi, ni ukuvuga icyumba cy’ibumoso cy’umutima. Ariko, iyo uru rugi rudafunga neza, amaraso amwe asubira inyuma, ni ukuvuga mu cyumba cyo hejuru. Ibi ni byo twita mitral valve regurgitation cyangwa ``Mitral Regurgitation - MR''.

Tekereza nk'amazi yo kuvoma. Iyo robine idafunze neza, amazi azavamo, sibyo? Uko ni ko bimeze kuri iyi.

Iyo uku gusohoka kw'amaraso ari guto, bivuze ko umwanya uri mu muryango ari muto cyane, bishobora kuba atari ikibazo gikomeye. Umutima wawe ushobora kubyihanganira, bityo ushobora kutagira itandukaniro na rimwe wumva. Ariko, niba uku gusohoka kw'amaraso ari gunini, bivuze ko urugi rufunguye cyane, umutima wawe wumva ufite umutwaro mwinshi. Kubera ko umutima ugomba gukora cyane kuruta uko bisanzwe kugira ngo upime amaraso ukeneye kugira ngo utere imbere. Uko igihe kigenda gihita, umutima ntuba ugishoboye kwihanganira ibi, kandi ushobora kugira ibimenyetso n'izindi ngorane.

Iyi ngingo kandi yitwa:

• Kudakora neza kwa valve ya Mitral (`(Kudakora neza kwa valve ya Mitral)`)
• Kutabasha gukoresha neza valve ya Mitral
• Valve ya mitral iva (`(valve ya mitral iva)`)

Mu by’ukuri, indwara ya mitral valve prolapse ni yo ndwara ikunze kugaragara cyane mu bihugu nka Leta Zunze Ubumwe za Amerika. Ikunze kugaragara cyane mu bantu bakuze, cyane cyane abarengeje imyaka 65.

Ese hari ubwoko bw'aho valve ya mitral iva?

Yego, hari ubwoko bubiri ahanini:

1. Gusubira mu myanya y'imbere mu gitral (`(Gusubira mu myanya y'imbere mu gitral)`): Muri iki gihe, ikibazo kiri kuri valve ubwayo. Iterwa no kwangirika kw'imiterere y'igice kimwe cyangwa byinshi bya valve bigatuma idafunga neza. Urugero, udupapuro tw'imashini dushobora guhinduka cyane ntitwikingwe neza, cyangwa se tukaba twabyimbye ntitwikingwe neza.

2. Gusubira inyuma kw'imitsi mu gice cya kabiri : Ibi biterwa n'indi ndwara y'umutima ifata ibyumba by'umutima (atrium y'ibumoso cyangwa ventricle) bishyigikira umuyoboro w'amaraso. Urugero, indwara y'imitsi y'umutima (cardiomyopathy) ishobora gutuma umutima urushaho kwaguka no gucika intege. Izi mpinduka zishobora gutuma umuyoboro w'amaraso ugenda udafunga neza.

Uko byaba bimeze kose, bishobora kuba bikomeye mu buryo butunguranye (`(Acute)`), cyangwa bigatera imbere buhoro buhoro uko igihe kigenda (`(Chronic)`).

Ni ibihe bimenyetso bishobora kubaho iyo habayeho gutonyanga mu gice cy'imitsi (mitral valve)?

Iyo amazi asohotse ari make, ushobora kuba udafite ibimenyetso. Ariko iyo amazi asohotse abaye menshi agatangira kugira ingaruka ku mikorere y'umutima, ikimenyetso gikunze kugaragara ni ukubura umwuka (dyspnea) . Ushobora kumva udashobora kwinjiza umwuka uhagije mu bihaha byawe, cyangwa ukumva ubura umwuka iyo uhagaze gusa, uryamye, ugerageza gusinzira, cyangwa ndetse no gukora imirimo yoroshye.

Hashobora kandi kuba hari ibindi bimenyetso:

• Ububabare budasanzwe mu gituza.
• Inkorora.
• Kubyimba amaguru cyangwa ibirenge (`(Edema)`).
• Kumva unaniwe cyane (`(Umunaniro)`).
• Bisa n'aho ari ugucika intege, ariko mu by'ukuri ntibibaho (`(Presyncope)`).
• Kumva nk'aho umutima wawe utera uhinduka, nk'aho igituza cyawe kirimo gutera cyane (`(Umutima utera cyane)`).

Ibi bimenyetso bishobora kuza buhoro buhoro cyangwa bigatangira mu buryo butunguranye.

Ibi ni ibyihutirwa! Nubona ibi bimenyetso, jya kwa muganga vuba!

Niba umutima wawe ukora cyane, ushobora kugira ibimenyetso by'umutima unaniwe cyane. Ibi bishobora kugaragara mu buryo butunguranye, bityo rero itondere ibi bimenyetso:

• Guhumeka cyane.
• Ukumva urimo kubura umwuka.
• Kugorwa no guhumeka iyo uryamye.
• Kumva igituza gifunganye.
• Iyo icyuma gipima umuvuduko w'amaraso mu rugo kigaragaza ko urugero rwa ogisijeni mu maraso ruri hasi.

Gucika intege k'umutima ni ikibazo cyihutirwa cy'uburwayi aho umutima uhagarika gukora mu buryo butunguranye kandi bishobora gushyira ubuzima mu kaga. Kubwibyo, ni ngombwa gushaka ubuvuzi vuba.

Kuki iyi valve ya mitral idafunga neza? Impamvu ni izihe?

Nkuko twabiganiriyeho mbere, iki kibazo kibaho iyo valve ya mitral idafunze neza. Iyi valve ifite udupapuro tubiri (udupapuro). Irafungura kandi igafunga kugira ngo amaraso ava mu cyumba cyo hejuru ajye mu cyumba cyo hasi.

Iyo utu dupapuro cyangwa ibindi bice by'agapira byangiritse, cyangwa indwara zitandukanye zigatuma agapira kadafunga neza, amaraso make asubira inyuma buri gihe agapira gafunga.

Impamvu zibitera ziratandukanye bitewe n'ubwoko bwa MR ufite (iy'ibanze cyangwa iy'inyongera).

Gusubira kwa valve ya mitral y’ibanze bishobora guterwa na:

• Kugabanuka kwa valve ya Mitral (MVP) : Iyi ni yo mpamvu ikunze kugaragara mu bihugu byateye imbere.
• Indwara y'umutima ya rubagimpande : Iyi ni yo ndwara ya mbere ku isi.
• Indwara z'imitsi ihuza igitsina (`(Indwara z'imitsi ihuza igitsina)`).
• Indwara y'umutima yavutse yitwa ``(Cleft mitral valve)``.
• Kwandura igice cy'imbere cy'umutima (endocarditis).
• Indwara z'umutima ziterwa no kuvurwa hakoreshejwe imirasire (`(Indwara z'umutima ziterwa n'imirasire)`).
• Ibikomere by'impanuka.

Gusubira kwa valve ya mitral mu buryo bwa kabiri bishobora guterwa na:

• Ischemic cardiomyopathy (iyi ni yo ikunze kugaragara cyane) iterwa no kuziba kw'imitsi ijyana amaraso ku mutima.
• Gutera umutima mu buryo butari bwo, umutima utera nabi.
• Indwara ya dilated cardiomyopathy (indwara y'imitsi y'umutima ituma umutima waguka nta mpamvu izwi)
• Indwara iterwa no kubyimba kw'imitsi y'umutima (`(Hypertrophic obstructive cardiomyopathy)`).

Ni izihe ngorane zishobora kubaho iyo iyi ndwara ibaye ikomeye?

Iyo itavuwe, prolapse ya mitral valve ishobora gushyira ubuzima mu kaga. Dore zimwe mu ngorane zishobora kubaho:

• Umutima wawe utangira gutera ku buryo budasanzwe (`(Atrial fibrillation)`), rimwe na rimwe bishobora gutera indwara yo mu bwonko.
• Umutima wawe ntushobora kohereza amaraso ahagije mu mubiri (`(Umutima unaniwe)`).
• Umuvuduko mu mitsi itwara amaraso ava mu mutima ajya mu bihaha uriyongera (`(Umuvuduko ukabije w'amaraso mu bihaha)`).
• Umutima ushobora guhagarika gukubita mu buryo butunguranye (`(Guhagarara k'umutima mu buryo butunguranye)`).

Ni gute umuganga asuzuma neza iyi ndwara?

Ikintu cya mbere muganga akora ni ukugusuzuma neza. Aho niho:

• Barakubaza ibimenyetso byawe n'izindi ndwara ufite.
• Bazasuzuma ibimenyetso by'ubuzima bwawe, nk'umuvuduko w'amaraso yawe n'umuvuduko w'umutima wawe.
• Basuzuma umubiri wabo niba nta kubyimba (edema).
• Imashini ikoresha stethoscope izagutega amatwi umutima n'ibihaha. Iyo wumvise ijwi ridasanzwe ry'umutima ("umutima uvuza umunwa"), bishobora kuba ikimenyetso cy'indwara y'imitsi.

Hanyuma muganga azategeka ko hakorwa ibizamini byinshi kugira ngo amenye byinshi.

Ni ibihe bipimo bikorwa kugira ngo hamenyekane iyi ndwara?

Abaganga bakunze gukora ikizamini cyitwa transthoracic echocardiogram (TTE) kugira ngo barebe aho umuvuduko w'amaraso uva mu gice cyawe cy'umutima utwikiriye. Iki ni ikizamini kidasaba ububabare kandi kidasaba kwibasira umubiri. Gishobora gusuzuma aho umuvuduko w'amaraso uva mu gice cyawe cy'umutima utwikiriye ndetse n'ibindi bibazo bijyanye n'imiterere cyangwa imikorere y'umutima wawe. Niba muganga wawe ashaka kureba neza umuvuduko w'amaraso utwikiriye umubiri wawe, ashobora no gukora ikizamini cyitwa transesophageal echocardiogram (TEE).

Muganga wawe ashobora gusaba ko hakorwa ibindi bipimo kugira ngo amenye uburemere bw'indwara yawe kandi agateganya uburyo bwo kuyivura. Ibi birimo:

• `(CT scan)` y'umutima (`(Cardiac CT scan - computed tomography scan)`).
• `(Echocardiogram)` ikorwa mu gihe cyo gukora imyitozo ngororamubiri (`(Imyitozo ngororamubiri ikoresha echocardiogram)`).
• Ikizamini cya MRI y'umutima (magnetic resonance imaging).
• Gupima umutima hakoreshejwe catheter, izwi kandi nka cardiac cath cyangwa coronary angiogram.

Ni ubuhe buryo bwo kuvura kuvogera kwa valve ya mitral?

Nta buryo bwo kuvura bungana buhari. Abaganga bazagukorera ubuvuzi bujyanye n'ibyo ukeneye. Bazasuzuma ibi bikurikira:

• Ubwoko bw'isubira ry'imitsi (iry'ibanze cyangwa iry'inyongera).
• Ubukana bw'indwara yawe. Ishobora gusobanurwa nk'icyiciro A, B, C, D. D ni cyo cyiciro gikomeye cyane.
• Ingaruka z'ingorane zikomoka ku kubagwa.

Muganga wawe azagusobanurira uburyo bwo kuvura, harimo ibyiza n'ibibi byabwo. Menya neza ko ubaza ibibazo niba hari icyo udasobanukiwe. Muri ubwo buryo, ushobora gufata icyemezo usobanukiwe.

Kugarura imitsi mu mitsi ni yo mpamvu ya kabiri ikunze kugaragara mu kubaga imitsi y'umutima mu bihugu by'Iburengerazuba bw'Isi (iya mbere ni stenosis y'imitsi y'umutima).

Hari uburyo butandukanye bwo kuvura:

Gusana valve ya Mitral (`(Gusana valve ya Mitral)`)

Amahitamo kuri ibi:

• Kubagwa umutima ufunguye.
• Kubaga umutima hakoreshejwe uduce duto (`(Kubagwa umutima mu buryo budakunze kugaragara)`).
• Gusana Mitral transcatheter impande zose (TEER): Muri ubu buryo, muganga akoresha umuyoboro muremure kandi woroshye (catheter) kugira ngo ashyireho agace gato k'agapfunyika ku dupapuro twa valve yawe. Aka gapfunyika gafasha udupapuro gufunga neza.

Gusimbuza valve ya Mitral (`(gusimbuza valve ya Mitral)`)

Amahitamo kuri ibi:

• Uzahabwa uburyo bwo kubaga umutima ufunguye (`(kubaga umutima ufunguye)`) hanyuma hashyirwemo valve nshya ya mitral. Iyi valve ishobora kuba ikozwe mu cyuma (`(mekanike)`) cyangwa ikozwe mu nyamaswa (`(bioprosthetic)`).
• Gusimbuza valve ya mitral ya Transcatheter (TMVR) ni uburyo bworoshye cyane.

Uburyo bwo kuvura indwara y'umutima

Ibi bishobora kuba bikubiyemo:

• Imiti nka diuretics .
• Gutera icyuma gifasha ventricular y'ibumoso (LVAD).
• Ubuvuzi bw'indwara zibabaza.

Uburyo bwo kuvura indwara ya fibrillation y'umutima

Ibi bishobora kuba bikubiyemo:

• Imiti.
• Uburyo bwo gukora.
• Kubagwa.

Ubuzima bwanjye buzaba bumeze bute nindamuka ngize iyi ndwara?

Hari ibintu byinshi bigira ingaruka ku kuntu ubuzima bwawe buzaba bumeze. Urugero:

• imyaka yawe.
• Ese ufite ibimenyetso kandi ubukana bwabyo ni ubuhe?
• Uburemere bw'aho amazi yavuye.
• Ese valve yawe ishobora gusanwa?
• Ingano y'ibyangiritse ku mutima wawe.

Kubera ko ibi bintu byose bigira ingaruka ku buzima bwawe, imimerere yawe ishobora kuba itandukanye n'iy'abandi. Muganga wawe ni we muntu mwiza wo kumenya neza uko indwara yawe izagenda. Azi wowe ubwawe, amateka yawe y'ubuvuzi, n'uburyo bwo kugufasha.

Uku gusohoka kwa valve ya mitral kwiyongera vuba gute?

Kuri bamwe, ibi bigenda buhoro buhoro. Ku bandi, bishobora kugenda vuba. Muganga wawe azakubwira uko indwara yawe imeze, inshuro ugomba kujya kwa muganga kugira ngo agusuzume, n'uburyo iyi ndwara ishobora kugira ingaruka ku buzima bwawe.

Ese hari uburyo bwo kwirinda iyi ndwara?

Ushobora kutazigera ubasha kwirinda ibi buri gihe. Ariko, ushobora gukorana na muganga wawe kugira ngo ugabanye ibyago byo kurwara indwara zitandukanye z'umutima. Muganga wawe azasuzuma amateka y'ubuzima bwawe n'ibintu bishobora gutera ibyago kandi aguhe inama zikubereye. Muri rusange, ushobora gukora ibi bikurikira:

• Kureka burundu gukoresha ibikomoka ku itabi (nk'itabi, beedis).
• Gukora imyitozo ngororamubiri buri gihe.
• Kurya ibiryo bitanga ubuzima bwiza ku mutima.
• Komeza kugira ibiro bizima kuri wewe.
• Jya kwa muganga nibura rimwe mu mwaka kugira ngo agusuzume kandi umenye ikibazo cyose vuba.
• Niba ukunze kugira ububabare mu muhogo hamwe n'umuriro, cyangwa niba warigeze kugira umuriro wa rubagimpande mu bihe byashize, gana muganga.

Nitwara nte?

Ni byiza kugenzura umuvuduko w'amaraso yawe no kurya imbuto n'imboga nyinshi .

Kwitabira gahunda yo kuvura indwara z'umutima (`(Cardiac rehab)`) nyuma yo kubagwa imitsi y'umutima bishobora kugufasha kongera gutangira gukora imyitozo ngororamubiri.

Niba ufite agakoresho gashya ko gushushanya, uzakenera gufata imiti nyuma yaho. Uzakenera gufata imiti igabanya amaraso (anticoagulants) ubuzima bwawe bwose kugira ngo wirinde kubyimba kw'amaraso. Uzakenera kandi gufata imiti igabanya amaraso kugira ngo wirinde indwara ya endocarditis (kwandura igice cy'umutima) mbere yo kubagwa amenyo no gupimwa bimwe na bimwe byo mu myanya yo hejuru y'ubuhumekero.

Ni ryari nkwiye kujya kwa muganga? Ni ibihe bibazo nkwiye kubaza?

Muganga wawe azakubwira inshuro ugomba kujya kwa muganga wawe kugira ngo agusuzumishe. Uko indwara yawe irushaho kuba mbi, niko uzakenera kujya kwa muganga wawe kenshi no gukorerwa ibizamini byo gufata amashusho (nk'ibipimo byo gupima). Ni ngombwa kubahiriza gahunda zawe zose.Hanyuma muganga ashobora gukurikirana ikibazo cyawe no kukugira inama yo kuvura mu gihe gikwiye.

Dore ibibazo bimwe na bimwe ushobora kubaza muganga wawe kugira ngo amenye byinshi ku bijyanye n'uburwayi bwawe:

• Uburyo valve yanjye ya mitral ivamo bungana iki?
• Ni ubuhe buryo bwo kuvura wangira inama?
• Ni izihe nyungu n'ibibi by'ubuvuzi?
• Ni izihe mpinduka mu mibereho ngomba kugira?
• Ni kangahe ngomba kujya kwa muganga cyangwa gukorerwa ibizamini byo gufata amashusho?
• Ubuzima bwanjye bw'ejo hazaza buzaba bumeze bute?

Ikintu cyo gutekerezaho

Ni ibisanzwe kumva uremerewe cyane iyo wumvise ko urwaye indwara y'umutima. Ariko uko ugenda umenya byinshi ku ndwara yawe no kubona ubuvuzi, uzongera gutera imbere vuba.

Gucika kw'imitsi ya Mitral bigira ingaruka ku bantu bose mu buryo butandukanye, bityo muganga wawe azaguhuza n'ibyo ukeneye. Ntutindiganye gusangiza muganga wawe ibibazo byawe n'impungenge zawe. Azagufasha gusobanukirwa byinshi ku mikorere y'umutima wawe. Azagusaba kandi uburyo bwo kuvura no guhindura imibereho yawe bizagufasha kugira ubuzima bwiza no kubaho ubuzima bwiza bushoboka.

` Vali ya Mitral, indwara y'umutima, kubura umwuka, indwara y'umutima, kubagwa umutima, echocardiogram, gusubirana kwa vali ya mitral