Wakambonzwa sekunge uri kunyura mumvura here, chipfuva chako chakamanikana, tsoka dzako dzakazvimba, shangu dzako dzakazvimba zvekuti waisagona kutopfeka? Wainzwa kuneta zvakanyanya, waisagona kukwira masitepisi... Usazvitore sekurwadziwa kwemuviri. Izvi zvinogona kunge zviratidzo zvakakomba zvekushaya simba kwemoyo . Iyi idambudziko rehutano rinotyisidzira hupenyu. Saka, usavhunduke. Nhasi, tichataura nezvezvinhu zvese nenzira iri nyore uye inonzwisisika.
Zvakanaka, chii chinonzi kukundikana kwemoyo kamwe kamwe (Acute Heart Failure)?
Zvichitaurwa zviri nyore, izvi zvinoreva mamiriro ezvinhu apo mwoyo yedu inotadza kamwe kamwe kupomba huwandu hweropa rine oxygen yakawanda rinodiwa nemuviri.
Fungidzira kuti muviri wako iguta guru, uye moyo wako ndiwo nzvimbo huru yekupomba mvura inoendesa mvura kuguta iroro. Chero bedzi nzvimbo iyi yekupomba ichishanda zvakanaka, imba yega yega nenzvimbo dzese muguta dzinowana mvura. Asi, chii chinoitika kana nzvimbo iyi yekupomba ikangoerekana yapera simba kana kutyoka? Guta rikarasikirwa nemvura, handiti? Ndizvo zvazviri. Kana pombi yadana moyo wedu ikangoerekana yapera simba, nhengo dzakakosha mumuviri wedu dzakadai seuropi, itsvo, nechiropa hadziwani oxygen nekudya zvinodiwa. Izvi zvinonzi Acute Heart Failure.
Dambudziko iri hariitike kamwe kamwe. Kazhinji, kana mwoyo uchifanira kutakura mutoro wakawedzerwa nekufamba kwenguva, unotanga kuchinja zvishoma nezvishoma.
- Mwoyo wakakura: Kungofanana netsandanyama dzemunhu anosimudza zvinorema dzinokura, kana uchifanira kushanda nesimba, tsandanyama dzemwoyo dzinogona kukura uye moyo unogona kukura.
- Kufamba kweropa kushoma: Mwoyo painoshaya simba, huwandu hweropa raunopomba hunoderera.
- Kutetepa kwetsinga dzeropa: Muviri paunenge uchiedza kuchinjika neizvi, kunyange tsinga dzeropa dzinogona kutetepa.
- Kurova kwemoyo nekukurumidza kana kusina kurongeka (Arrhythmia): Kumanikidzwa kwemoyo kunoita kuti urasikirwe nerwiyo rwawo rwenguva dzose.
- Kuoma kwetsandanyama yemoyo: Tsandanyama yemoyo inogona kuoma uye kusachinjika.
Kuchinja uku kudiki pakutanga. Ungasanzwa zviratidzo. Asi nekufamba kwenguva, kuchinja uku kunowedzera uye kana moyo usingachakwanisi kutakura mutoro, panoitika emergency inonzi Acute Heart Failure.
Izvi zvinowanzova chikonzero chikuru chekuiswa muchipatara kune vanhu vane makore anopfuura 65. Asi yeuka, izvi zvinogona kuitika kune chero ani zvake wezera ripi zvaro.
Kune mhando dzakasiyana dzeizvi here?
Ehe, kune mhando mbiri chete.
1. Kukundikana Kwemwoyo Kwakakomba (ADHF): Izvi zvinoitika kana uine chirwere chemwoyo (semuenzaniso, chirwere chetsinga dzemwoyo, BP yakakwira). Iri ndiro zita rinopiwa kana moyo wako wave usina simba kwenguva yakareba, uye nekuda kwechimwe chikonzero (sekusatora mishonga, kudya munyu wakawandisa), mamiriro acho anongoerekana aipa.
2.De Novo Acute Heart Failure: Muchiitiko ichi, hauna kumbobvira warwara nemoyo. Zvisinei, chimwe chirwere, chakadai sechirwere cheshuga, chave chichikuvadza moyo wako kwenguva yakareba usingazvizivi, uye chirwere ichi chinogona kungoerekana chaitika.
Ndezvipi zviratidzo zveizvi? Ungazviziva sei nekukurumidza?
Kana uine chimwe chezviratidzo izvi kana kupfuura, enda kuchipatara kuEmergency Department (ETU) nekukasika, pasina kunonoka. Ichi hachisi chirwere chinogona kuchengetwa kumba.
Zviratidzo izvi zvinogona kunzwisiswa zvakajeka kubva patafura iri pazasi.
| Chiratidzo | Manzwiro ako |
|---|---|
| Kuoma kukuru kwekufema (Dyspnea) | Ichi ndicho chiratidzo chikuru uye chakakomba . Chinogona kunzwa sekunge uri kudzipwa, chipfuva chako chakaoma, uye uri kunyura. Izvi zvinonyanya kuipa kana wakarara pamubhedha uye uchinzwa zviri nani kana wakagara. |
| Kuzvimba kwemakumbo, zvitsitsinho, netsoka (Edema) | Kana moyo usingakwanise kupomba ropa zvakanaka, mvura inoungana muzvikamu zvepasi zvemuviri. Paunodzvanya pairi nemunwe wako, inonzwa ichirova. Dzimwe nguva, dumbu rinogona kutozvimba. |
| Kuneta zvakanyanya uye kuneta | Kunzwa kuneta zvakanyanya kunyangwe pasina chauri kuita kana kungonyarara. Kunzwa kushaya simba zvekusagona kumuka pamubhedha. |
| Kurova kwemoyo nekukurumidza kana kusina kurongeka (Arrhythmia) | Kunzwa sekunge uri kunzwa chipfuva chako chichirova, kana kuti moyo wako wachinja. |
| Kurwadziwa kwechipfuva kana kuomarara | Zvinogona kunzwa sekunge mutoro unorema uri kudzvanywa pachipfuva chako, sekunge chipfuva chako chiri kudzvanywa. |
| Kukosora kunogara kwenguva refu | Nekuda kwemvura inozadza mapapu, kukosora kune hurwa huchena kana kuti hwepingi kunogona kuitika. |
| Kurasikirwa nepfungwa | Kunzwa dzungu uye kurasikirwa nepfungwa zvinogona kuitika nekuda kwekudzikira kwehuwandu hweropa rinosvika kuuropi. |
Yeuka! Zviratidzo izvi zvinogona kungoerekana zvaitika. Kana ukaona izvi, usagare kumba. Sekondi yega yega yehupenyu hwako inokosha.
Sei izvi zvichiitika? Ndezvipi zvikonzero?
Chero chinhu chipi zvacho chinoisa kumanikidzwa kwakanyanya kana kuomeswa kwemoyo chinogona kukonzera izvi. Heano mamwe ematambudziko makuru:
- Chirwere chemwoyo: Kuvharika kwetsinga dzinoendesa ropa kumoyo nekuda kwemafuta akawanda akawandisa muropa.
- Kukwira kweropa: Kukwira kweropa kusingadzoreki kunoita kuti mwoyo ushande nesimba nekufamba kwenguva.
- Chirwere cheVharuvhu yeMwoyo: Kana mavharuvhu ari mumoyo asingavharike kana kuvhurika zvakanaka, ropa rinotanga kuyerera richidzokera kumashure.
- Cardiomyopathy: Kupera simba, kukora, kana kukura kwetsandanyama yemwoyo nekuda kwezvikonzero zvakasiyana-siyana.
- Kusarongeka kwekurova kwemoyo (Arrhythmia): Kurova kwemoyo kusingawanzoitiki kana kusina kurongeka.
- Kuputika kwemapapu: Ichi chirwere chekukurumidzira chinokonzera kumanikidzwa kwakanyanya kurudyi kwemoyo.
- Chirwere cheshuga chisingadzoreki: Chirwere cheshuga chinogona kukuvadza mitsipa yeropa netsinga uye kunetesa mwoyo.
- Chirwere cheitsvo: Kana itsvo dzikasashanda zvakanaka, mvura nemunyu zvinoungana mumuviri, zvichiita kuti mwoyo uremerwe.
- Dambudziko rekushandisa doro: Kunwa doro zvakanyanya kwenguva refu kunokuvadza tsandanyama dzemwoyo zvakananga.
- Utachiona hwemavhairasi: Mamwe mavhairasi (semuenzaniso, hutachiona hunobatanidzwa nechirwere chemwoyo chinonzi rheumatic heart disease) anogona kukanganisa tsandanyama dzemwoyo nekudzipedza simba.
Ndezvipi zvinhu zvinokonzera njodzi zvinokonzera chirwere ichi?
Kunyangwe uine chimwe chezvirwere zvataurwa pamusoro apa, zvimwe zvinhu zvinogona kukonzera kamwe kamwe kutanga kweAcute Heart Failure. Tinozviti 'zvinokonzera'.
- Kusatora mishonga yakanyorerwa nachiremba nemazvo:Kana ukasatora mishonga yako yeBP, chirwere cheshuga, kana chirwere chemwoyo nemazvo, chirwere ichi chinogona kusadzoreka uye kuwedzera kumanikidzwa kwemoyo wako.
- Kusadzora munyu nemvura: Kana chiremba wako akakuudza kuti uderedze munyu uye uderedze mvura yaunonwa, unofanira kuvatevedzera. Kudya munyu wakawandisa kunoita kuti muviri wako uchengetedze mvura. Mwoyo wako usina simba unofanira kushanda nesimba kuti ubvise mvura iyi yakawandisa.
- Kunwa doro nezvinodhaka: Izvi zvinokuvadza mwoyo zvakananga.
- Mimwe mishonga inoderedza marwadzo (NSAIDs): Kushandisa mishonga inoderedza marwadzo nguva dzose, yakadai seibuprofen, pasina kurairwa nachiremba hakuna kunakawo pamoyo.
Chiremba anoziva sei izvi?
Kana ukaenda kuEmergency Treatment Unit (ETU), vanachiremba vanokurumidza kukuongorora voedza kuwana chirwere chacho.
1. Vanokubvunza mibvunzo yakawanda: nezvezviratidzo zvako, zvimwe zvirwere zvaunazvo, kana paine munhu mumhuri mako ane chirwere chemwoyo, mishonga yaunotora, uye kana uchisvuta.
2. Kuongororwa kwemuviri: Chipfuva nemapapu zvinoteererwa ne stethoscope. Makumbo anoongororwa kuti haana kuzvimba here uye tsinga dziri mumutsipa dzinoongororwa. Kumanikidzwa kweropa kunoyerwa.
Zvadaro, bvunzo dzinoverengeka dzinoitwa kuti dzisimbise chirwere chacho.
| Bvunzo | Unotarisira chii kubva pazviri? |
|---|---|
| ECG (Electrocardiogram) | Inorekodha mashandiro emagetsi emwoyo. Inogona kuona zvinhu zvakaita sekurwadziwa kwemoyo uye kurova kwemoyo kusina kurongeka. |
| X-ray yechipfuva | Izvi zvinobatsira kuona kana moyo wakakura kana mapapu azere nemvura. |
| Echocardiogram (kuongorora kwemoyo) | Izvi zvakafanana nevhidhiyo yemoyo. Unogona kuona zvakajeka zvinhu zvakawanda zvakaita sekurova kwemoyo, kushanda zvakanaka kwekupomba ropa (Ejection Fraction), uye mashandiro emavharuvhu. |
| Kuongororwa kweRopa reBNP | Kana mwoyo wava nekushushikana, tsandanyama yemoyo inoburitsa hormone muropa. Nekuyera huwandu hwehormone iyi muropa, tinogona kuona kana chikonzero chekupererwa nemhepo chiri kutadza kushanda kwemoyo kana chimwewo chinhu. |
| Kumwe kuongororwa kweropa | Zvinhu zvakaita sekushanda kwenhengo dzakadai seitsvo, chiropa, uye thyroid gland, uye huwandu hwemunyu muropa, zvinoongororwa. |
Ndezvipi zvinorapwa izvi?
Kurapa kunogona kukamurwa muzvikamu zviviri: kurapwa kwekukurumidzira uye kurapwa kwenguva refu.
Kurapwa kwekukurumidzira
PaETU, chinangwa chekutanga chevanachiremba ndechekugadzirisa mamiriro ako ezvinhu.
- Kurapa Okisijeni: Okisijeni inopihwa kuburikidza nemasiki ekumeso kuderedza kuoma kwekufema uye kudzoreredza huwandu hweokisijeni muropa.
- Mishonga inobvisa mvura mumuviri - "mapiritsi emvura": Mishonga iyi inopihwa sejekiseni rekubatsira muviri kubvisa mvura yakawandisa mumuviri nekukurumidza kuburikidza neweti. Izvi zvinoderedza huwandu hwemvura mumapapu, zvichiita kuti zvive nyore kufema uye kuderedza kuzvimba.
- Mishonga yeVasodilator: Mishonga iyi inowedzera mitsipa yeropa, inoderedza kuramba kwemoyo pakupomba ropa, uye inoderedza kumanikidzwa kweropa pairi.
Kurapwa kwenguva refu uye manejimendi
Mushure mekukurumidzira, chirwere chakakonzera chirwere ichi chinofanira kurapwa.
- Mishonga: Uchafanira kuramba uchitora mishonga yakasiyana-siyana (semuenzaniso, beta-blockers, ACE inhibitors) inovandudza mashandiro emwoyo, inodzora BP, uye inodzivirira mwoyo.
- Kuvhiyiwa nedzimwe nzira: Dzimwe nguva mishonga chete ingasakwana. Kana zvakadaro, ungafanira kushandisa zvinhu zvakaita se:
- Angioplasty uye Stenting: Kuvhura tsinga yemoyo yakavharika uye kuisa mudziyo wakaita semesh (stent) kudzivirira kuti isavhare zvakare.
- Kuvhiya kweBypass: Kuvhiya kugadzira nzira itsva yekuti ropa riyerere richitenderedza tsinga yakavharika.
- Kugadzirisa/Kutsiva Mavharuvhu: Kugadzirisa mavharuvhu emwoyo akakanganisika kana kuiswa kwevharuvhu yekugadzira.
- Kuisirwa kwemuchina wepacemaker kana ICD: Kana kurova kwemoyo kusina kurongeka, michina iyi inoisirwa pasi peganda rechipfuva kuti chidzoke pakare.
- Kuisirwa Mwoyo:Kuisirwa moyo wakagwinya kubva kumunhu akafa muuropi, asi chirwere chemwoyo chiri padanho rekupedzisira chisingarapike nerumwe rudzi rwekurapa.
Ndingararama sei nemamiriro ezvinhu aya?
Kutaura chokwadi, chirwere ichi chakakomba zvikuru. Munhu akambova nechirwere ichi ane mukana mukuru wekuwana chirwere ichi zvakare. Dzimwe ongororo dzakaratidza kuti vanhu vakawanda vane chirwere ichi vanofa mukati megore.
Asi, musazvidya mwoyo. Hazvina kufanana kune wese munhu. Nzira yenyu yeramangwana ichasarudzwa nezvinhu zvishoma:
- Chirwere chakakonzera izvi uye kuoma kwazvo.
- Kukurumidza kwawakaita kurapwa.
- Hutano hwako hwese uye maitiro emuviri wako pakurapwa.
- Chinonyanya kukosha: kuzvipira kwako kumararamiro ane hutano hwemwoyo.
Kana wakazvipira uye ukatevera mirairo yachiremba wako nemazvo, unogona kurarama zvakanaka nechirwere ichi uye kurarama hupenyu hurefu.
Ndinofanira kuitei mushure mekubuda muchipatara?
Kudzokera kumba kubva kuchipatara hazvirevi kuti zvapera. Kutaura zvazviri, hupenyu hwako hutsva, hune hutano hwemwoyo hunotangira ipapo.
- Inwa mushonga wako nenguva: Usapotsa mushonga mumwe chete.
- Zviyere mangwanani ega ega: Zviyere panguva imwe chete, usina kupfeka kana kupfeka mbatya dzakareruka, wozvinyora mubhuku. Kuwedzera uremu kamwe kamwe kwe 1-2 kg muzuva rimwe chete kana maviri kunogona kureva kuti uri kuchengeta mvura. Kana izvi zvikaitika, zivisa chiremba wako nekukasika.
- Dzora munyu: Rega zvachose kuwedzera munyu muchikafu chako uye kudya chikafu chine munyu wakawanda, zvakaita semagaka, hove dzakaomeswa, masosi, uye masoseji.
- Mvura nezvinwiwa: Usapfuure huwandu hwezvinwiwa (kusanganisira mvura, tii, mukaka, uye muto) izvo chiremba wako anokurudzira kunwa pazuva.
- Rega kusvuta nedoro zvachose.
- Kurovedza muviri zvishoma: Ita maekisesaizi mashoma akadai sekufamba-famba sezvakakurudzirwa nachiremba wako.
- Endai kumakiriniki nenguva dzakatarwa: Iva nechokwadi chekuenda kuna chiremba pamazuva aanokupai kuti muone.
Mharidzo Yekuenda Nayo Kumba
- Kukundikana kwemoyo zvakanyanya idambudziko rehutano . Kana ukaona zviratidzo, usagare kumba.
- Kufema zvishoma, kuzvimba kwemakumbo, kuomarara kwechipfuva, uye kuneta zvakanyanya ndizvo zviratidzo zvikuru. Kana izvi zvikaitika, enda kuchipatara cheEmergency Department (ETU) nekukasika.
- Chikonzero chikuru cheizvi imamwe matambudziko anoisa kumanikidzwa kwemoyo, akadai seBP yakakwira uye chirwere chemwoyo.
- Kana kurapwa kwekukurumidzira kwaitwa muchipatara uye mamiriro acho agadzikana, izvi zvinofanirwa kugadziriswa kwenguva refu kuburikidza nemishonga uye shanduko dzemararamiro.
- Hupenyu hwako huri mumaoko ako. Nekutevera mirairo yachiremba (kutora mishonga, kudzora munyu nemvura yaunonwa, uye kurega kusvuta) chaizvo, unogona kurarama hupenyu hune hutano.
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