Indwara y'urupfu itunguranye (SAD)

Ese wigeze wumva umuntu wari ukiri muto kandi ufite ubuzima bwiza yapfuye mu buryo butunguranye? Ese wigeze wibaza uko byagenda? Hari igihe bishobora guterwa n'indwara tugiye kuvugaho uyu munsi yitwa Sudden Arrhythmic Death Syndrome (SADS) . Iki ni ikintu gikomeye cyane, ariko ni ngombwa kucyitondera.

Indwara y'urupfu rw'umutima mu buryo butunguranye (SADS) ni iki?

Mu magambo make, iyi ni indwara y'umutima. Akenshi, ni ikintu uvukana , bivuze ko gishobora guhererekanywa kuva ku gisekuru kugeza ku kindi. Ikibaho muri ibi ni uko hari ikibazo ku buryo bw'amashanyarazi mu mutima wawe. Tekereza kuri ibi, umutima wacu ukora nk'icyuma gito gitanga umuriro. Ni ibimenyetso by'amashanyarazi bituma umutima utera neza. Rero, iyo hari ikibazo kuri ubu buryo, umuvuduko w'umutima uba udasanzwe . Iyo ibi bitavuwe neza, ushobora no guhura n'urupfu rutunguranye. Niyo mpamvu ari akaga.

Ni ubuhe bwoko bw'ingenzi bwa SADS?

Hari ubwoko butandukanye bwa SADS. Buri bumwe muri bwo bufite itandukaniro rito. Reka turebe bumwe mu bwoko bw'ingenzi:

• Indwara ya Brugada: Iyi ni indwara aho icyumba cyo hasi cy'umutima, cyitwa atria, gitera umutima utera cyane kandi utari umeze neza (polymorphic ventricular tachycardia).
• Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT): Iyi ni indwara aho uturemangingo tw'umutima dutera cyane kandi mu buryo butunguranye. Iyi ndwara ishobora kubaho cyane cyane mu gihe cy'imyitozo ngororamubiri cyangwa stress yo mu mutwe.
• Indwara ya Long QT (LQTS): Iki ni cyo gihe imitsi y'umutima wawe ifata igihe kirekire kugira ngo witegure gutera gukurikira, ni ukuvuga kongera kongera ingufu (gusubiramo ingufu cyangwa kongera ingufu). Ni nk'aho batiri ifata igihe kinini kugira ngo ishyurwe. Iyo urebye EKG, itandukaniro riri hagati y'imiraba ya Q na T ryitwa interval ya QT. Iyo iki gihe ari kirekire cyane, uturemangingo tw'umutima dushobora gutangira gutera vuba cyane (ventricular tachycardia) cyangwa mu buryo butari bwo (ventricular fibrillation).
• Syndrome y'igihe gito cya QT (SQTS): Ibi ni ibinyuranye na QT ndende. Bivuze ko uturemangingo tw'umutima bifata umwanya muto cyane wo kwitegura gutera gukurikira. Ibi bishobora gutuma icyumba cyo hejuru cy'umutima (atrial fibrillation) gitera ku buryo butunguranye, cyangwa icyumba cyo hasi (ventricular tachycardia) kigatera vuba, cyangwa kigatera ku buryo butunguranye (ventricular fibrillation).
• Indwara ya Timothy: Iyi ni indwara idasanzwe. Ni ubwoko bwa syndrome y'igihe kirekire ya QT.
• Indwara ya Wolff-Parkinson-White (WPW):Ibi ni igihe hakorwa inzira y'inyongera kandi idasanzwe kugira ngo ibimenyetso by'amashanyarazi bigende hagati y'ibyumba byo hejuru (atria) n'ibyumba byo hasi (mitra). Ibi byiyongera ku nzira isanzwe, ishobora gutuma umutima utera cyane (tachycardia).

Ibi bibazo bya SADS bikunze kugaragara gute?

Ibi ntabwo bikunze kugaragara cyane, ariko nanone ntibibaho. Urugero, indwara ya QT syndrome (LQTS) yavuzwe haruguru ifatwa n’umwana umwe mu bana 2.000 bavutse. Indwara ya Brugada ntabwo ikunze kugaragara cyane, ifata munsi ya 1% by’abaturage. Indwara yitwa CPVT ifata umuntu umwe mu bantu ibihumbi icumi.

Ariko muri rusange, abantu bagera ku 200.000 bapfa bazize guhagarara k'umutima (SCA) buri mwaka muri Leta Zunze Ubumwe za Amerika honyine. Bivugwa kandi ko abana n'urubyiruko bagera ku 4.000 bapfa bazize izi ndwara za SADS buri mwaka. Ubwo rero, ibyo si ibintu bito, si byo se?

Ni ibihe bimenyetso bya SADS?

Nubwo hari ubwoko bwinshi butandukanye bwa SADS, hari ibimenyetso bimwe na bimwe bisanzwe. Ariko, hari abantu bashobora kutagaragaza ibimenyetso na gato.

Ibimenyetso bisanzwe:

• Gucika intege cyangwa gucika intege bishobora kubaho mu gihe cy'imyitozo ngororamubiri, cyangwa iyo unezerewe cyane cyangwa ufite ubwoba.
• Kubabara mu gituza bishobora kubaho mu gihe cy'imyitozo ngororamubiri.
• Ushobora kugira ikibazo cyo kubura umwuka mu gihe cy'imyitozo ngororamubiri.

Noneho reka turebe ibimenyetso bitandukanye bifitanye isano na buri bwoko bwa SADS.

Ibimenyetso bya syndrome ya Brugada

Nubwo abantu benshi badafite ibimenyetso, bamwe bashobora kugira ibi bikurikira:

• Guhagarara k'umutima bishobora kubaho, cyane cyane iyo umuntu asinziriye.
• Kunanirwa.
• Kubabara mu nda.
• Uburyo budasanzwe bwo guhumeka.

Ibimenyetso bya tachycardia y'umutima iterwa na catecholaminergic polymorphic ventricular (CPVT)

Nta bimenyetso bishobora kubaho kugeza igihe umutima urwaye, ariko hari abantu bashobora kumva bacitse intege mu gihe bakora imyitozo ngororamubiri.

Ibimenyetso bya Long QT Syndrome (LQTS)

Hafi kimwe cya kabiri cy'abantu barwaye LQTS nta bimenyetso bafite. Ariko hari abantu bamwe na bamwe:

• Indwara yo kuruhuka mu mutima yitwa Torsades de Pointes ishobora gutera indwara y'umutima.
• Kunanirwa.
• Kubabara mu nda.

Ibimenyetso bya Syndrome y'igihe gito ya QT (SQTS)

Abantu bagera kuri 40% bafite iyi ndwara nta bimenyetso bagira. Ariko abandi:

• Gutera ubwoba mu gifu .
• Kunanirwa.
• Indwara y'umutima.

Ibimenyetso bya syndrome ya Timothy

Ibintu bigaragara muri ibi ni ibi bikurikira:

• Kunanirwa.
• Indwara y'umutima.
• Hari igihe intoki cyangwa amano biba bifite urubuga.
• Ibibazo by'iterambere.

Ibimenyetso bya Wolff-Parkinson-White syndrome (WPW)

Ibimenyetso bya WPW birimo:

• Gutera ubwoba mu mutima.
• Kumva umeze nk'ufite umutwe ugororotse (soins de sécurité).
• Kugorwa no guhumeka.
• Kunanirwa.
• Kubabara mu nda.

Icy'ingenzi: Niba wowe cyangwa umuntu uzi afite kimwe muri ibi bimenyetso, ugomba gushaka inama kwa muganga.

Ni izihe mpamvu zitera SADS?

Akenshi, iyo umuntu ukiri muto apfuye mu buryo butunguranye, kandi imiterere y'umutima we isa n'isanzwe iyo bamusuzumye, abaganga bakeka ko yagize arrhythmia itaramenyekana, umutima utera nabi. Indwara za SADS zitera iyi arrhythmia, twavuze mbere, akenshi zihererekanywa ku babyeyi ku mwana . Ni ukuvuga ko zituruka ku ngirabuzimafatizo. Amahirwe yo kuba izi ndwara zandurira abana ashobora gutandukana bitewe na gene igaragaramo n'igice cy'umutima cyafashwe.

Abaganga babona bate SADS?

Iyo umuntu ukiri muto afite ibimenyetso byavuzwe haruguru, kandi niba hari umuntu wo mu muryango we wagize urupfu rutunguranye rutazwi mbere y'imyaka 40, muganga ashobora gukeka ko ari we wagize SADS. Uburyo bwo kuyisuzuma buratandukanye bitewe n'ubwoko bwa SADS.

Uburyo bwo gusuzuma indwara bukoreshwa cyane cyane:

• Electrocardiogram (EKG): Iyi electrocardiogram ipima imikorere y'amashanyarazi y'umutima.
• Gupima imiterere y'uturemangingo: Ibi bizamini byo gupima ihindagurika ry'uturemangingo rijyanye na SADS.
• Ikizamini cyo guhangayika mu gice cyo hejuru: Iki kizasuzuma uko umutima witabira imyitozo ngororamubiri.
• Ikizamini cyo gushyushya indwara cya Catecholamine: Hatangwa umuti wihariye kandi umutima ubyitwaramo neza.
• Holter monitor: Igikoresho gihora gifata amajwi y'umutima mu gihe cy'amasaha agera kuri 24.
• Echocardiogram: Iyi ni scan ya ultrasound ireba imiterere n'imikorere y'umutima.
• Ultrasound y'umwana uri mu nda: Ibi bishobora gukorwa umwana akiri mu nda.
• Ikizamini cyo gusuzuma indwara y'umutima: Ikizamini aho umuntu yinjiza umuyoboro muto mu mutima.
• Inyigo ya Electrophysiologiya: Muri ubu bushakashatsi, insinga nto zinjira mu mutima kugira ngo zisuzume imikorere y'amashanyarazi y'umutima mu buryo bwimbitse.

Ni ubuhe buryo bwo kuvura SADS?

Uburyo bwo kuvura buratandukanye bitewe n'ubwoko bwa SADS, bityo rero ni ngombwa kumenya neza ubwoko bw'indwara ufite.

Uburyo bwo kuvura indwara ya Brugada

• Imashini ntoya ikoreshwa mu gutera umutima mu mubiri (ICD): Iyi ni imashini nto ishyirwa munsi y'uruhu. Iyo umutima utera nabi cyane, itera amashanyarazi make kugira ngo yongere gutera umutima mu mubiri.
• Ibiyobyabwenge nka Quinidine .
• Irinde gukoresha imiti ifunga imiyoboro ya sodium mu mutima.

Uburyo bwo kuvura indwara ya Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT)

• Aba bantu bahabwa ubwoko bw'umuti witwa beta-blockers .
• Nibiba ngombwa, ICD izaterwa.

Uburyo bwo kuvura indwara ya Long QT Syndrome (LQTS)

Ibi bishobora gukorwa hakoreshejwe imiti cyangwa kubagwa:

• Beta-blockers.
• ICD .
• Gupima umutima ukoresheje uruhu rw'ibumoso: Ubu ni uburyo bwo kubaga bugabanya kandi bugakuraho imwe mu mitsi ijya mu mutima.
• Irinde gukoresha imiti imwe n'imwe yongera igihe cya QT kuri EKG yawe.

Uburyo bwo kuvura indwara ya "short QT syndrome" (SQTS)

Hari umuti n'igikoresho cyabyo:

• ICD .
• Quinidine.

Uburyo bwo kuvura indwara ya Timothy

Ibi kandi bikoresha imiti n'igikoresho:

• Beta-blockers.
• ICD .
• Irinde gukoresha imiti yongera igihe cya QT kuri EKG yawe.

Uburyo bwo kuvura indwara ya Wolff-Parkinson-White syndrome (WPW)

Imiti ishobora gufasha gukumira ibimenyetso bya WPW. Hariho kandi uburyo bwitwa ablation therapy . Ibi byangiza inzira y'amashanyarazi idasanzwe. Ibi rimwe na rimwe bishobora gukiza burundu WPW. Abaganga banatanga imiti yitwa antiarrhythmics kugira ngo bagabanye ibyago byo kurwara indwara zidasanzwe z'umutima.

Ese hari ingaruka mbi kuri ubu buryo bwo kuvura?

Yego, bumwe mu buryo bwo kuvura bushobora kugira ingaruka mbi nto.

• Hari abantu bashobora kugorwa no kwihanganira imiti ya beta-blockers bagenewe na muganga wabo.
• Nyuma y’aho kubagwa ibumoso bw’umutima utera indwara y’umutima :
• Kubira ibyuya bidasanzwe.
• Amaboko yumye.
• Impinduka mu bushyuhe cyangwa ibara mu bice bimwe na bimwe by'isura.
• Ariko ubu buryo bwo kubaga bushobora kuzamura cyane ubuzima.
• Kubera ko igikoresho cya ICD gitanga amashanyarazi kugira ngo gisubize umutima mu buryo bukwiye, gishobora kugorana gato. Nanone:
• Kwandura bishobora kubaho.
• Igikoresho gishobora kudakora neza.

Nigute nagabanya ibyago byanjye? Ese SADS ishobora kwirindwa?

Niba hari umuntu wo mu muryango wawe ufite SADS, abandi bagize umuryango bagomba gukora CPR.Niba uzi uburyo bwo kubikora, kandi niba ufite Automatic External Defibrillator (AED) mu rugo, bishobora kuba ihumure rikomeye ku muntu urwaye SADS. Kuko ni byiza kumenya ko hari umuntu uhari wo kugufasha mu gihe cy’impanuka.

Nubwo SADS idashobora kwirindwa burundu, niba hari umuntu wo mu muryango wawe usanzwe ayirwaye, ni ngombwa kwipimisha kugira ngo urebe niba afite na gene mutation. Ushobora kuvugana na muganga wawe kugira ngo ufate umwanzuro ku bagomba gupimwa. Iyo umuntu amaze gupimwa, hashobora gufatwa ingamba zo kumurinda, haba hakoreshejwe imiti cyangwa ubundi buryo bwo kuvura.

Ejo hazaza hafite iki ku muntu urwaye SADS?

Biterwa cyane n'ubwoko bwa SADS ufite, uburyo ipimwa hakiri kare, n'uburyo ubuvuzi butangira vuba. Ni indwara y'ubuzima bwose , kandi rimwe na rimwe ishobora kwica .

Ariko, abantu barwaye indwara ya Wolff-Parkinson-White syndrome (WPW) bafite icyizere cyiza cyane kuko ubuvuzi bwo gukuramo amaraso bushobora gukosora ikibazo. Abantu barwaye indwara ya long QT syndrome (LQTS) bafite ibyago bike cyane byo gupfa gitunguranye. Ariko, abantu benshi bashobora kungukirwa no gukuramo amaraso mu mitsi y'ibumoso ntabwo babyungukiramo. Hari ubushakashatsi buke cyane ku ndwara nka syndrome ngufi ya QT (SQTS) , kuko hari abarwayi bake gusa (hafi 200) bafite iyi ndwara.

Kubwibyo, hakenewe ubushakashatsi bwimbitse kugira ngo haboneke uburyo bwiza bwo kuvura abantu bose bafite SADS.

Gutera ICD bishobora gukumira urupfu rutunguranye rw'umutima kuko bivura imitsi idasanzwe y'umutima. Nubwo bidakiza iyo ndwara, ni uburyo bwiza bwo kugabanya ibyago byo gupfa bitewe n'izi ndwara.

Niba ufite SADS, wiyitaho ute?

• Niba muganga wawe yakwandikiye imiti, fata neza uko wabitegetswe, nta munsi n'umwe ubura. Ni ko bigenda no ku mwana urwaye SADS. Agomba guhabwa imiti ku gihe, kandi si byiza gusimbuza doze imwe.
• Buri gihe banza ubaze muganga wawe cyangwa umufarumasiye mbere yo gutangira umuti mushya. Imiti myinshi, harimo imiti isanzwe irwanya indwara zandura n'imiti igabanya isesemi, ishobora kugira ingaruka ku miti y'umutima wawe. Ishobora kandi kugira ingaruka ku gihe cya QT, ibyo bikaba byongera ibyago byo gupfa gitunguranye ku muntu ufite indwara ya QT y'igihe kirekire.
• Sobanukirwa uburyo ICD yawe (cyangwa iy'umwana wawe) ikora. Nanone, jya uyisuzumisha buri gihe kwa muganga wawe. Uburyo bumwe bwo kwa muganga n'ibikoresho bya elegitoroniki bya buri munsi bishobora kubangamira imikorere ya ICD yawe. Rero, menya icyo ugomba kwirinda.
• Niba umwana wawe afite SADS, baza muganga niba ashobora gukina siporo ijyanye n'uburwayi bwe.

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

Niba ufite SADS, kwisuzumisha buri gihe ni ingenzi cyane. Ibi ni ukugira ngo umenye neza ko ufata imiti ikwiye. Niba umwana wawe afite SADS, urugero rw'imiti rushobora kuba ngombwa ko rwongerwa uko agenda akura kandi akabyibuha. Niyo mpamvu ari ingenzi cyane ko abana bajya bisuzumisha buri gihe. Niba ufite ICD, jya kwa muganga nibura kabiri mu mwaka.

Mu gihe cy'impanuka:

• Niba hari umuntu ufite ikibazo cy'umutima , hamagara 911 (cyangwa nimero y'ubutabazi bw'ibanze yo mu gihugu cyawe) ako kanya hanyuma ukore CPR.
• Niba ubonye kimwe muri ibi bimenyetso, jya mu cyumba cy’ubutabazi bw’ibanze cyangwa uhamagare 911 ako kanya:
• Niba wumva ufite intege nke, uzungera, cyangwa ufite umutima uhagaze nabi.
• Niba ubabara mu gituza gitunguranye cyangwa ukumva bigoye guhumeka.

Ni ibihe bibazo by'ingenzi ugomba kubaza muganga wawe?

Niba wowe cyangwa umuntu wo mu muryango wawe afite ikibazo cya SADS, ni ngombwa cyane kubaza muganga wawe ibi bibazo:

• Ni ubuhe bwoko bwa SADS mfite?
• Ni ubuhe buryo bwo kuvura wangiriye inama ku ndwara yanjye?
• Ese wamfasha kumenya abo mu muryango wanjye bakeneye gupimwa ibi?
• Ese nkeneye defibrillator?
• Ese hari imiti nkwiye kwirinda iyo ndwaye?

Amaherezo, ibuka ibi bintu!

Nubwo SADS ari indwara ikomeye, kuyimenya no gufata ingamba zikwiye bishobora kukurinda wowe n'abo ukunda. Kumenya indwara yawe bishobora kugufasha gusobanukirwa amahitamo yawe. Korana na muganga wawe kugira ngo uhitemo uburyo bwiza bwo kuvura wowe cyangwa uwo ukunda. Kwisuzumisha buri gihe, cyane cyane niba ufite ICD, ni ingenzi. Kugira AED mu rugo no kumenya neza ko buri wese azi uko ikoreshwa no gukora CPR bishobora kugufasha wowe n'umuryango wawe. Ntugatinye, kumenya ni bwo buryo bwiza bwo kwirinda.

` Indwara y'urupfu rutunguranye rw'umutima, SADS, indwara z'umutima, umutima utera nabi, indwara zikomoka ku ngirabuzimafatizo, urupfu rutunguranye, amashanyarazi y'umutima