Rutivi rwerudyi rwemwoyo wako rwakaneta here? Ngatidzidzei nezvechirwere ichi chine njodzi cheARVD (Arrhythmogenic Right Ventricular Dysplasia)?

O, dzimwe nguva unonzwa sekuti chipfuva chako chiri kurova kamwe kamwe, unonzwa sekuti une dambudziko rekufema, kana kuti unongonzwa sekuti uri kurwara nemoyo? Pamwe wakanzwa kuti dzimwe nguva kunyange mutambi wechidiki ane hutano anogona kurwara nemoyo kamwe kamwe. Ndizvo zvatichataura nezvazvo nhasi, asi chirwere chemwoyo chisinganyanyi kuzivikanwa, chisingawanzoitiki. Ichi chinonzi ``Arrhythmogenic Right Ventricular Dysplasia``, kana kuti muchidimbu.

Chii chinonzi ARVD (Arrhythmogenic Right Ventricular Dysplasia)? Ngatizvinzwisise zviri nyore!

Zvichitaurwa zviri nyore, ARVD chirwere chinokanganisa tsandanyama dzemwoyo, rudzi rwe 'cardiomyopathy'. Mwoyo wedu une makamuri mana. Chinoitika apa ndechekuti tsandanyama iri mukamuri rezasi kurudyi kwemoyo wako, 'ventricle yekurudyi', inokura panzvimbo pemafuta nenyama ine fibrous. Funga nezvazvo sekunge tsandanyama dzine hutano dzakabviswa dzotsiviwa nechimwe chinhu chakaita semafuta.

Chii chinoitika kana izvi zvikaitika? Mhuno yekurudyi inotatamuka zvishoma nezvishoma, inova diki, uye haigone kudzika zvakanaka. Izvi zvinoreva kuti kugona kwayo kupomba ropa kuenda kumoyo kunoderera.

Chinonyanya kukosha ndechekuti nyama itsva ine mafuta kana kuti fibrous inokanganisa mashandiro emagetsi emwoyo. Ndosaka vanhu vazhinji vane ARVD vachitanga kurova kwemoyo zvisina kurongeka (arrhythmias). Izvi zvinogona kuva nengozi zvikuru, sezvo zvichiwedzera njodzi yekumira kwemwoyo kamwe kamwe kana kufa.

ARVD iyi inonziwo `Arrhythmogenic Right Ventricular Cardiomyopathy` (ARVC). Dzimwe nguva inogonawo kukanganisa divi reruboshwe, saka inonziwo `Arrhythmogenic Cardiomyopathy` (ACM).

Matanho eARVD ndeapi?

Kana uine ARVD, inogona kupfuura nematanho akasiyana-siyana nekufamba kwenguva.

1. Danho rakavanzika: Munguva iyi, ungasava nezviratidzo. Zvisinei, unogona kunzwa kurova kwemoyo kusina kurongeka paunenge uchirovedza muviri. Zvinoshamisa kuti mimwe miedzo inoitwa panguva iyi inogona kuratidza kuti hapana chakaipa.

2. Danho remagetsi: Padanho iri, une mukana wekuti ventricle arrhythmias iite. Une mukana mukuru wekufa kamwe kamwe nemoyo. ECG inogona kuona matambudziko aya emoyo.

3. Danho rechimiro: Padanho iri, njodzi yekurohwa kwemoyo zvisina kujairika (ventricular rhythms) uye kufa kamwe kamwe kwemoyo kwakanyanya. Kuongororwa kwemifananidzo, senge scans, kunogona kuratidza zvakajeka shanduko mumagadzirirwo emwoyo wako.

Ndiani anonyanya kubatwa nechirwere ichi cheARVD?

Vanachiremba vanowanzoona dambudziko iri pakati pevechidiki.Kureva, pakati pevechidiki kana vechidiki. ARVD yakaonekwawo sechikonzero cherufu rwemwoyo rwakangoerekana rwaitika mune vamwe vatambi vechidiki. Dzimwe ongororo dzinoratidza kuti chirwere ichi chinowanzoitika muvarume .

Panyaya yekuti chirwere ichi chakajairika sei, ARVD chirwere chisingawanzoitiki. Chinowanzo taurwa kuti chinobata munhu mumwe chete pavanhu chiuru kana mumwe pavanhu chishanu. Chinogona kuitika pasina munhu mumhuri ane chirwere ichi, asi chinowanzo itika mumhuri.

Ndezvipi zviratidzo zveARVC? Ngatizivei!

Ungasava nezviratidzo zveARVD pakutanga, asi pane njodzi yekufa kamwe kamwe kwemwoyo.

Zviratidzo zvikuru zvinogona kuonekwa ndezvi:

• Kusagadzikana kwetsinga dzemutsinga: Izvi zvinogona kuva nengozi zvikuru. Muvanhu vanenge hafu vane kusagadzikana kwetsinga idzi, mhedzisiro yacho inogona kuva yerufu kana kuti inenge yerufu. Kusagadzikana kwetsinga kunowanzoitika i ventricular tachycardia, iyo inoitika mu77% yevanhu vane chirwere ichi.
• Supraventricular arrhythmias: Chinonyanya kutaurwa ndechekuti atrial fibrillation ndiyo inonyanya kuitika.
• Kurova kwemoyo: Izvi zvinogona kunzwa sekunge pane chiri kurova mukati mechipfuva chako. Izvi zvinokonzerwa nekurova kwemoyo kusina kujairika.
• Dzungu, musoro wakachenuruka kana kufenda: Izvi zvinokonzerwawo nekurova kwemoyo kusina kurongeka.
• Kurwadziwa kwechipfuva.
• Kufa kamwe kamwe kwemwoyo: Izvi zvinogona dzimwe nguva kuva chiratidzo chekutanga cheARVD.
• Kushaya mweya.
• Kuzvimba kwemakumbo, zvitsitsinho, tsoka, kana dumbu.
• Kukundikana kwemoyo.

Zviratidzo izvi zvinowanzotanga pakati pemakore makumi maviri nemakumi mashanu. Vanachiremba vanowanzo ongorora ARVD vachiri vadiki (kazhinji vasati vasvika makore makumi mana).

Ndezvipi zvikonzero zveARVD?

Vanhu vanosvika 60% vane ARVD vane majini akasiyana. Vaongorori vakaona majini anosvika gumi nematatu anokonzera chirwere ichi.

Majini aya asingawanzoitiki anokuvadza mapuroteni anobatsira masero emhasuru dzemwoyo kubatana nekutaurirana. Izvi zvinogona kukonzera kuti masero emhasuru dzemwoyo ari mu ventricle yekurudyi aparadzane ofa. Izvi zvinogona kuitika zvakanyanya panguva yekushushikana kana kushanda nesimba.

Vanenge 30% kusvika 50% yevarwere vane ARVD vane nhoroondo yemhuri yavo.Saka, zvakakosha kuti hama dzemunhu ane ARVD dziongororwe nachiremba nehama dzemuchipatara (vabereki, vanun'una, vana, vazukuru, vanasekuru, vanatete, vazukuru, vazukuru). Kunyangwe pasina zviratidzo, hama dzechidiki dzinofanira kutsvaga rubatsiro rwechiremba.

Vaongorori vakawana nzira mbiri dzekugara nhaka muARVDs:

1. `Autosomal dominant`: Mubereki mumwe chete ane gene mutation. Mumhuri dzakadaro, vana vane mukana we50% wekugara nhaka chirwere ichi. Zvisinei, zviratidzo nezera rekutanga kwechirwere zvinogona kusiyana pakati pemhuri. ARVD inowanikwa zvakanyanya munzvimbo dzakasiyana, dzakadai seItari.

2. `Autosomal recessive` (hazviwanzoitika): Vabereki vese vane gene mutation, asi havaratidzi zviratidzo. `Naxos disease` muenzaniso weizvi. Inokonzera kukobvu kweganda rekunze (`hyperkeratosis`) uye bvudzi gobvu, "rakafanana nemvere" (`vhudzi rakafanana nemvere`) pazvanza nepasi.

ARVD inogonawo kukonzerwa nezvimwe zvikonzero:

• Kusagadzikana kwemuviri we ventricle yekurudyi.
• `Myocarditis` yehutachiona kana kuzvimba (kuzvimba kwetsandanyama yemwoyo).
• Zvikonzero hazvisati zvawanikwa.

ARVD (Arrhythmogenic Right Ventricular Dysplasia) inoonekwa sei?

Chiremba wako anogona kuongorora chirwere cheARVD zvichibva pane nhoroondo yako yehutano, kuongororwa kwemuviri, uye bvunzo dzakasiyana-siyana.

Chiremba wako anogona kuona kuti une ARVD kana uine musanganiswa wematambudziko anotevera:

• Kusashanda zvakanaka kwe ventricle yekurudyi.
• Kuvapo kwenyama ine mafuta kana kuti fibro-fatty mutsandanyama yemwoyo (`myocardium`) ye right ventricle.
• Mushumo we `ECG/EKG` (Electrocardiogram) usingawanzoitiki.
• Kusarongeka kwerhythm yemoyo (arrhythmias): Semuenzaniso, supraventricular tachycardia, ventricular tachycardia, kana ventricular fibrillation, kunyanya panguva yekurovedza muviri.
• Nhoroondo yemhuri yeARVD.

Zvichienderana nekuti une zvinhu zvingani izvi, chiremba wako anogona kukuudza kuti une chirwere che "definite," "borderline," kana "zvinogoneka." Mune zvimwe zviitiko, asi kwete nguva dzose, chiremba wako anogonawo kukutumira kunoongororwa majini .

Ndezvipi zviedzo zvinoshandiswa kuongorora ARVD?

• Electrocardiogram (ECG/EKG): Muedzo unotarisa mashandiro emagetsi emwoyo.
• Transthoracic echocardiogram: Izvi zvakafanana neultrasound yemoyo. Inogona kutarisa makamuri emoyo, mavharuvhu, uye kugona kupomba.
• `Holter monitor`: Izvi zvakafanana nemuchina mudiki we`ECG` waunopfeka kwemaawa makumi maviri nemana kusvika makumi mana nemasere. Unonyora kurova kwemoyo wako mukati mezuva.
• Angiogram ye ventricular yekurudyi: Izvi hazviwanzo shandiswa.
• `Kuongororwa kweElectrophysiology`:Kuongororwa kwakakosha kwekutarisa matambudziko nemagetsi emoyo.
• Kufungidzira kwemoyo nemagnetic resonance imaging (MRI): Izvi zvinogona kuburitsa mifananidzo yakadzama yemoyo. Izvi zvakakosha zvikuru pakuona zvinhu zvakaita semafuta ari mu right ventricle muARVD.
• `Cardiac computed tomography (CT):` Iyi imwe nzira yekuwana mifananidzo yemoyo.
• `Biopsy` (kutora sampuro yenyama): Izvi hazviwanzoitiki. Kanyama kadiki kanotorwa kubva pamoyo koongororwa.

Ndeipi mishonga yeARVD?

Parizvino hapana mushonga weARVD. Zvisinei, chiremba wako achaedza kuita zvinotevera:

• Dzora kusarongeka kwemutinhimira wemoyo wako (`ventricular arrhythmias`).
• Dzivirira kuumbwa kweropa.
• Gadzirisa kutadza kwemoyo wako.

Mishonga yeARVD ndeiyi:

• Mishonga inoderedza kurova kwemoyo: Inodzivirira kurova kwemoyo kusingawanzoitiki kwenguva refu uye/kana kufa kamwe kamwe. Uku ndiko kurapwa kunonyanya kushandiswa navanachiremba. Unogona kunyorerwa mishonga yakaita sesotalol kana amiodarone.
• Mishonga yeBP: Mishonga yakaita sediuretics (inobvisa mvura yakawandisa mumuviri) kana beta-blockers (inoderedza basa remwoyo).
• Mushonga unorwisa ropa kuti riome: Mishonga yakaita sewarfarin inopiwa kudzivirira kuumbwa kweropa.
• Kubviswa kwecatheter neRadiofrequency: Kurapa kusagadzikana kwemoyo kunowanzoitika kusingadzoreki nemishonga. Izvi zvinosanganisira kuparadza nzvimbo diki yemoyo iri kukonzera kurova kwemoyo kusingadzoreki.
• Muchina wekudzikisa mwoyo (ICD): Muchina mudiki unoiswa mumoyo yevanhu vari panjodzi yekufa kamwe kamwe. Kana ukaona kurova kwemoyo kune njodzi, unouona wobva waita kuti mwoyo urove nemagetsi kuti ugadziriswe.
• Kuisirwa moyo: Izvi zvinoitwa kana mimwe mishonga yese yakundikana. Chikamu chidiki chete chevanhu vane chirwere ichi, vanenge 2% kusvika 4%, ndivo vanoda moyo mutsva.

Yeuka, ungangoda kurapwa kwechirwere ichi kanopfuura kamwe chete muhupenyu hwako hwese.

Pane matambudziko kana migumisiro yekurapwa here?

Ehe, pane zvimwe zvinhu zvekungwarira pakurapa.

• Kana uchitora warfarin, unofanira kuongororwa ropa nguva nenguva . Chiremba wako anofanira kuve nechokwadi chekuti uri kuwana mushonga wakakodzera. Mushonga wako unogona kugadziriswa zvichienderana nezvawanikwa pabvunzo.
• Kunyangwe kurapwa kwekubvisa catheter pakutanga kuchibudirira kune vanhu vazhinji, sezvo chirwere ichi chichiwedzera nekufamba kwenguva, vanhu vanosvika 60% vanogona kudzokorora kusagadzikana kwemoyo wavo.
• Waya dziri muICD device dzinogona kufamba-famba kana kusashanda zvakanaka, saka unofanira kuramba uchidziongorora.

Ndinozvitarisira sei? Ndedzipi shanduko dzemararamiro dzinodiwa?

Zvakakosha zvikuru kuchinja mararamiro ako kuti mwoyo wako ufare.

• Deredza kunwa doro.
• Rega kushandisa zvigadzirwa zvefodya zvachose.
• Idya chikafu chine hutano (mafuta mashoma, michero nemiriwo yakawanda)
• Deredza kudya zvinwiwa zvine caffeine (senge kofi, tii, chokoreti).
• Ramba uine huremu hwakakodzera hwemuviri.
• Deredza mabasa emuviri anorema.

Chinonyanya kukosha: Gara uchibvunza chiremba wako usati watanga kurovedza muviri. Mitambo yemakwikwi haikurudzirwi. Mitambo isina simba rakawanda inogona kunge yakanaka.

Taura nachiremba wako nguva dzose panguva yekurapwa kwako. Vachave nechokwadi chekuti uri kuwana mushonga wakakodzera. Zvakare, nekuenda kunoonana nachiremba nguva nenguva, unogona kuona chero shanduko dziri kuitika pahutano hwako nekukurumidza.

Njodzi yacho inogona kuderedzwa here?

Ehe, kusvika pamwero wakati. Kana mumwe munhu mumhuri yako aine ARVD, kuongororwa nekukurumidza ndiyo nzira yakanakisisa yekuderedza njodzi yako. Kuongororwa kuri nyore, kusingarwadzi kunogona kukuudza kana uri panjodzi yekurova kwemoyo zvisina kujairika. Kana zvakadaro, chiremba wako anogona kukubatsira kugadzira hurongwa hwekurapa hwakakunakira.

Ndeipi nguva yekurarama neARVD?

Nguva yekurarama yeARVD inosiyana zvichienderana nekuti yaonekwa riini. Chinhu chakanakisa chekuita ndechekuongorora chirwere ichi nekukurumidza uye kuwana kurapwa kudzivirira kurova kwemoyo kusina kurongeka. Chirwere ichi chinotowedzera nekufamba kwenguva.

Kana ARVD ikasarapwa, ventricle yako yekurudyi inogona kutadza kushanda. Zvadaro ventricle yako yekuruboshwe inogona kutadza kushandawo. Izvi zvinogona kukonzera matambudziko akadai se 'heart failure' uye 'atrial fibrillation'. Vaongorori vanotenda kuti mamiriro acho ezvinhu anotoipa kana ARVD ikakanganisa ventricle dzese dziri mbiri.

Asi, nekurapwa, unogona kuwana rubatsiro rwaunoda kuderedza kushushikana pamoyo wako uye kudzivirira kurwiswa kwemwoyo kune njodzi. Dzimwe ongororo dzinoratidza kuti vamwe vanhu vanoonekwa vaine chirwere ichi mushure memakore 65. Zvinofungidzirwawo kuti munhu mumwe chete pavanhu vashanu vane ARVC anotanga zviratidzo mushure memakore 50. Nokudaro, zvinokwanisika kurarama hupenyu hurefu neARVC.

Mazuva ano, matekinoroji epamusoro ekuona mifananidzo akadai seCT neMRI anobvumira kuongororwa nekukurumidza uye kurapwa, saka tarisiro yenguva refu yevanhu vane ARVD yakanaka.

Zvisinei, rufu rwechimbichimbi runogona kuitika kune avo vasina kuongororwa kana kuti vasina kurapwa kwakakodzera. ARVD inonzi ndiyo inokonzera 11% yerufu rwechimbichimbi rwemwoyo muvanhu vari pasi pemakore makumi matatu nemashanu uye 22% yerufu rwechimbichimbi rwemwoyo muvatambi.

Ndinofanira kuona chiremba riini? Ndinofanira kuenda kuchipatara riini?

Kana uine ARVD, uchafanirwa kuramba uchiongororwa nachiremba muhupenyu hwako hwese.Chiremba wako anofanira kugara achikutarisa kuti ave nechokwadi chekuti uri kuwana kurapwa kwakakodzera. Kana uine ICD, inofanira kugara ichiongororwa.

Chii chekuita kana paine emergency?

Kana mumwe munhu akangoerekana adonha orega kupindura nhare dzako, fonera 1990 (Sri Lanka's emergency ambulance service). Zvadaro, kana zvichibvira, tanga CPR (cardiopulmonary resuscitation), kana kuti CPR inongoitwa nemaoko chete.

Kana uri panjodzi yekumira kwemwoyo kamwe kamwe, zvakanaka kuti vari kumba vadzidze CPR.

Mibvunzo ipi yandinofanira kubvunza chiremba wangu?

• Ndinogona here kurovedza muviri kana kutora chikamu mumitambo? Kana zvakadaro, mitambo yerudzii?
• Ndeipi nzira yekurapa yakandinakira?
• Ndinoda ICD panguva ino here?

Nekuti ARVD inogona kuoma kuona zviratidzo zvisati zvaonekwa, zvakakosha kuziva nhoroondo yemhuri yako. Kana uri panjodzi nekuda kwenhoroondo yemhuri yechirwere ichi, chiremba wako anogona kukuyedza.

Mharidzo Yekuenda Nayo Kumba

Zvakanaka, saka ikozvino wava kunzwisisa zviri nani zvatataura nezvazvo nhasi, ARVD. Kunyangwe zvisingawanzoitiki, zvinogona kunge zviri chirwere chemwoyo chakakomba. Chinowanzo kukonzerwa nezvinhu zvemajini . Saka, kana mumwe munhu mumhuri yako aine chirwere ichi, zvakakosha kuti vamwe vaongororwe.

Nekuongorora chirwere ichi nekukurumidza sezvinobvira, kuwana kurapwa kwakakodzera, uye kuchinja mararamiro anodiwa, unogona kurarama zvakanaka nechirwere ichi. Ramba uchitaurirana nachiremba wako uye tevera mazano avo. Uyewo, kuve nechokwadi chekuti vadikanwi vako vanoziva nezve 'CPR' kunogona kubatsira kuponesa hupenyu hwako munguva yenjodzi. Usatya, kuziva ndicho chinhu chikuru!

ARVD , Arrhythmogenic Right Ventricular Dysplasia, chirwere chemwoyo, kurwara kwemoyo, cardiomyopathy, kufa kamwe kamwe kwemwoyo, chirwere chemajini, kurwara kwemoyo