Mwoyo wako wachinja seizvi here? Ngatitaurei nezveHypertrophic Cardiomyopathy (HCM)!

Wakambonzwa nezvechirwere chemwoyo apo tsandanyama dzemwoyo dzinongokora, zvichinetsa zvishoma? Dzimwe nguva ungasatomboziva kuti unacho, nekuti vamwe vanhu havana zviratidzo. Asi zvakakosha kuziva nezvazvo nekuti zvinokanganisa moyo. Nhasi tichataura nezvechirwere ichi chinonzi hypertrophic cardiomyopathy, kana kuti `HCM' pakati pevanachiremba. Usazvidya moyo, tichataura nezvazvo zviri nyore, nenzira yaunogona kunzwisisa.

Ngatitangei taona kuti HCM chii?

Zvichitaurwa zviri nyore, hypertrophic cardiomyopathy (HCM) chirwere chakaoma chinokanganisa tsandanyama dzemwoyo wako. Chinogona kukonzerwa nezvinhu zvishoma zvikuru:

• Kukora kwetsandanyama yemwoyo: Kunyanya makamuri epasi emwoyo, atinodaidza kuti maventricle, ane madziro akakora.
• Kuomarara kwetsinga yeropa kuruboshwe: Kamuri guru riri kuruboshwe rwemoyo (tsinga yeropa kuruboshwe) rinoomarara, richiva risina kusimba, serabha.
• Kuchinja kwevharuvhu yeMitral: Kuchinja kwebasa revharuvhu yemitral, vharuvhu inokosha mumoyo, kunogona kuitika.
• Kuchinja kwemasero: Zvimwe zvinhu zvisina kunaka zvinoitika mumasero emhasuru dzemwoyo (kuchinja kwemasero).

Zvinhu izvi zvinogona kukonzera kukanganiswa kwekushanda kwemoyo.

Dambudziko iri reHCM rinokanganisa sei muviri wako?

Zvakanaka, ngationei kuti shanduko idzi dzinoita sei chaizvo kumuviri.

Kukora kwemwoyo

Ichi ndicho chiratidzo chikuru chinoonekwa muHCM. Kazhinji, kukora uku kunoitika mumadziro anoparadzanisa mativi ekuruboshwe nerudyi emwoyo, anonzi `(septum).` Fungidzira, kana septum iyi iri pakati pemakamuri epasi emwoyo `(ventricles)` yakora, inogona kuvharira nzira iyo ropa rinoyerera kubva kuruboshwe kuenda kuaorta, tsinga huru yeropa inotakura ropa mumuviri wese. Tinoidaidza kuti `(outflow tract obstruction)`. Ipapo moyo unofanirwa kushanda nesimba kuti upombe ropa kupfuura kuvharika uku. Rudzi rweHCM runovhara nzira iyo ropa rinoyerera nayo runonzi `(Hypertrophic Obstructive Cardiomyopathy - HOCM)`.

Dzimwe nguva zvimwe zvikamu zvemoyo, zvakaita semusoro, ventricle yekurudyi, kana ventricle yese yekuruboshwe, zvinogona kukobvu. Muzviitiko izvi, kufamba kweropa hakuvharirwi. Zvisinei, huwandu hweropa hunogona kubatwa neventricle hunoderera. Izvi zvinonzi Hypertrophic Nonobstructive Cardiomyopathy.

Kuomarara kweVentricular yekuruboshwe

Kana tsandanyama dzemwoyo dzakora, shanduko dziri mumasero iwayo dzinoita kuti ventricle yekuruboshwe isazorore zvakanaka yozadzwa neropa. Chii chinoitika ipapo? Nekuti ropa shoma mukamuri, ropa shoma rine oxygen rinotumirwa kune dzimwe nhengo netsandanyama mumuviri. Kuoma uku kunowedzerawo kumanikidzwa mukati memoyo, uye unogona kuona zviratidzo zvakaita se:

• Kurwadziwa kwechipfuva
• Kushaya mweya
• Dzungu kana kupera simba
• Kunzwa sekuti moyo wako uri kurova nekukurumidza (kurova kwemoyo)

Kuchinja kweMitral Valve

Sezvambotaurwa, kana nzira yekubuda kweropa mu ventricular yekuruboshwe ikavharika, vharuvhu yemitral iri mumoyo inogona kusashanda zvakanaka. Izvi zvinogona kuvharira kuyerera kweropa uye kuwedzera kumanikidzwa kweropa mu ventricle yekuruboshwe.

Chikonzero chekuvharika uku ivharuvhu remitral rinopinda mu septum yakakora. Kana izvi zvikaitika, vharuvhu remitral harivharike zvakanaka uye ropa rinogona kudonhera mu atrium yekuruboshwe.

Kuchinja Kwemasero

Kana ukanyatsotarisa uchishandisa maikorosikopu, masero emhasuru dzemwoyo dzemunhu ane HCM haana kurongeka mumutsara wakatwasuka, asi nenzira isina kurongeka. Dambudziko iri rinogona kukonzera shanduko mumasaini emagetsi anofamba nemumakamuri epasi emwoyo, zvichikonzera kurova kwemoyo kusingawanzoitiki kunonzi ventricular arrhythmia. Izvi zvinogona kuva nengozi.

Chirwere ichi chinonzi HCM chakajairika zvakadii?

Zvinofungidzirwa kuti vanhu vanosvika mamiriyoni 1.5 muUnited States chete, kana kuti munhu mumwe chete pavanhu 500, vane HCM. Izvi zvakajairika kupfuura chirwere chakaita se "(Multiple Sclerosis)". Saka, hazvisi zvisingawanzoitiki.

HCM inowanzo tanga pazera ripi?

Kazhinji, chirwere ichi chemwoyo chinowanikwa muvechidiki, vane makore angangoita gumi nemasere kana makumi maviri. Zvisinei, chinogona kutanga chero pazera ripi zvaro.

Kana ndine HCM, pane njodzi here yekubata pamuviri?

Ungangoda rubatsiro rwakakosha rwechiremba, senge echocardiography yenguva dzose. Zvisinei, ungangove uine pamuviri pakanaka uye kusununguka zvakanaka. Zvisinei, zvakakosha kukurukura izvi nachiremba wako usati wabata pamuviri uye kukurukura nezvengozi dziripo. Chiremba wako achakuudzawo kuti ndeipi mishonga yeHCM yaunogona kuramba uchitora panguva yekuzvitakura. Ungangodawo kuiswa pacemaker kana implantable cardioverter defibrillator (ICD) kana zvichidikanwa panguva yekuzvitakura.

Chii chinokonzera HCM?

Kune zvinhu zvakawanda zvinogona kukonzera HCM:

• Majini: Ichi ndicho chikonzero chikuru. HCM chirwere chinogona kutorwa kubva kuvabereki kuenda kuvana. Izvi zvinoreva kuti pane chikanganiso mumajini anodzora hunhu hwetsandanyama yemwoyo. Kune marudzi akasiyana-siyana emajini anokonzera HCM. Kunyangwe paine chikanganiso chemajini, havasi vese mumhuri vachawana chirwere ichi nenzira imwechete. Vamwe vanhu vanogona kunge vaine jini reHCM asi havambofi vakawana chirwere ichi.
• Kukwira kweropa: Kukwira kweropa kwagara kuripo kwenguva yakareba kunogonawo kuva chikonzero cheizvi.
• Kukwegura: Pane mukana wekuti chirwere ichi chiitike sezvaunokura.
• Dzimwe nguva chikonzero hachizivikanwe:Dzimwe nguva, hapana chikonzero chaicho chinogona kuwanikwa cheHCM.

Ndezvipi zviratidzo zvingaonekwa nemunhu ane HCM?

Vamwe vanhu vane HCM vanogona kusangana nezviratidzo zvakasiyana-siyana, nepo vamwe vangave vasina zviratidzo zvachose. Zviratidzo zvinonyanya kuzivikanwa ndeizvi:

• Kurwadziwa pachipfuva: Izvi zvinowanzoitika panguva yekurovedza muviri kana kurovedza muviri, asi dzimwe nguva zvinogona kuitika wakamira kana mushure mekudya.
• Kushaya mweya uye kuneta: Zviratidzo izvi, kunyanya kana wakaneta, zvinowanzoonekwa muvanhu vakuru. Izvi zvinokonzerwa nekumanikidzwa kwakanyanya muatrium yekuruboshwe nemapapu.
• Kufenda kana kufenda (syncope): Izvi zvinogona kukonzerwa nekusagadzikana kwemoyo (arrhythmias) kana kupindura kwetsinga dzeropa zvisina kujairika panguva yekurovedza muviri. Dzimwe nguva, hapana chikonzero chingawanikwe.
• Kurova kwemoyo nehasha: Izvi zvinogona kukonzerwa nekusagadzikana kwemoyo, zvakaita seatrial fibrillation (atrial flutter) kana ventricular tachycardia (ventricular tachycardia). Vanhu vanosvika 25% vane HCM vane atrial fibrillation. Izvi zvinowedzera njodzi yekugwamba kweropa uye kutadza kushanda kwemoyo.
• Kuzvimba kwetsinga dzemuviri wepazasi kana mutsipa.

Ndezvipi zvimwe zvinetso zvehutano zvinogona kusanganiswa neHCM?

Vanhu vazhinji vane HCM vanorarama hupenyu hwakajairika uye havana matambudziko makuru ehutano. Vamwe havatombofaniri kutora mishonga. Zvisinei, kunyangwe usina zviratidzo, chiremba wako anogona kukukurudzira kuti usaite maekisesaizi anorema.

Zvisinei, vamwe vanhu vane HCM vanogona kuva nezvirwere zvemwoyo zvinopfupisa hupenyu hwavo kana kuderedza kunaka kwehupenyu hwavo. Zvikuru ndeizvi:

Kusungwa Kwemwoyo Nekukurumidza Uye Rufu Rwemwoyo Nekukurumidza

Kumira kwemwoyo kamwe kamwe kunokonzerwa nekurasikirwa nekushanda kwemoyo nekukurumidza (semuenzaniso, Ventricular Tachycardia). Muchiitiko ichi, kurapwa kwekukurumidzira, kwakadai seCPR uye defibrillation, kunodiwa nekukurumidza kana zviratidzo zvatanga. Kana kurapwa uku kukasaitwa nemazvo, kufa kwemwoyo kamwe kamwe kunogona kuitika.

Vanhu vazhinji vane HCM vane mukana mudiki wekufa kamwe kamwe nemwoyo. Zvisinei, HCM ndiyo inonyanya kukonzera kufa kamwe kamwe nemwoyo muvanhu vari pasi pemakore makumi matatu nemashanu. Ungave wakanzwa kuti HCM yakabatanidzwawo nekufa kamwe kamwe kwevamwe vatambi vechidiki vane hunyanzvi.

Kukundikana kweMwoyo

Kungoti une `(Heart Failure)` hazvirevi kuti moyo wako "wakundikana" uye warega kushanda. Zvinoreva kuti moyo wako hausi kupomba ropa nemazvo uye nemazvo. Zviratidzo zve `(Heart Failure)` zvinosanganisira:

• Kushaya mweya.
• Kunzwa kuneta kana uchiita basa (kuneta).
• Kuzvimba kwezvitsitsinho, makumbo, uye dumbu.
• Kuda kuita weti husiku uchizorora.
• Dzungu, kuvhiringidzika, kuoma kuisa pfungwa pane chimwe chinhu, kupera simba.
• Kunzwa sekuti moyo wako uri kurova nekukurumidza (kurova kwemoyo).
• Kukosora kwakaoma, kunorwadza.
• Kunzwa kuguta, kuzvimba, kushaya chido chekudya, kana kurwadziwa mudumbu.

Nzira yekuongorora HCM? (Kuongororwa)

HCM inoongororwa zvichibva pane zvinotevera:

• Nhoroondo yezvekurapa: Chiremba wako achakubvunza nezvezviratidzo zvako uye kana paine mumwe munhu mumhuri mako akamborwarawo nezvirwere zvakafanana.
• Kuongororwa kwemuviri: Chiremba achateerera mwoyo wako nemapapu. Vanhu vane HOCM vanogona kunzwa ruzha rwemwoyo rusina kujairika (heart murmur).
• Miedzo: Echocardiogram (echo) ndiyo nzira huru inoshandiswa kuongorora HCM. Izvi zvinogona kubatsira kuona kana madziro emwoyo akakora.

Kune mimwe miedzo:

• Kuongororwa kweropa.
• Kuongororwa kwemoyo (ECG).
• X-ray yechipfuva.
• Bvunzo rekusimbisa muviri.
• Kuisa catheter mumoyo.
• Kufungidzira kwemagnetic resonance (MRI).

Ndezvipi zvirongwa zvekurapa HCM?

Chiremba wako achasarudza kuti ndeipi nzira yekurapa yakakunakira zvichienderana nezvinhu zvinotevera:

• Pane here kuvharika kwenzira iyo ropa rinobuda mumoyo (kuderera kwenzira yekubuda)?
• Moyo wako unoshanda sei?
• Zviratidzo zvako.
• Zera rako uye kuti unoshanda zvakadini.
• Une kurova kwemoyo kusingajairiki here (arrhythmias)?

Chinangwa chikuru chekurapa ndechekuderedza kana kudzivirira zviratidzo uye kuderedza njodzi yematambudziko akadai sekushaya simba kwemoyo uye kufa kamwe kamwe kwemoyo.

Zvinotevera zvinogona kuitwa sekurapa:

• Ziva njodzi uye ramba uchienda kuna chiremba.
• Kuchinja mararamiro.
• Mishonga.
• Maitiro ekurapa akasarudzika.

Maitiro ekuongorora HCM?

Sezvo HCM iri chirwere chinogona kupfuudzwa kubva kuchizvarwa kuenda kune chimwe, kana mumwe wevabereki vako, vanun'una, kana vana (kureva hama yepamusoro) aine chirwere ichi, zvakakosha kuti aongororwe.

Danho rekutanga nderekuti mwoyo wako uongororwe neElectrocardiogram (ECG) uye Echocardiogram (echo). Kana bvunzo idzi dzichiratidza zviratidzo zveHCM, uchafanirwa kuona chiremba ane ruzivo nezvechirwere ichi (cardiologist).

Dzimwe nguva, kunyangwe kana uine nhoroondo yemhuri yeHCM, mhinduro dzako dzinogona kunge dzakajairika. Kana zvakadaro, vanachiremba vanokurudzira kuti upinzwe echo neECG makore matatu ega ega kusvika wava nemakore makumi matatu, uye wozopinda makore mashanu ega ega.

Ndiani ari panjodzi huru yekufa nemwoyo kamwe kamwe nekuda kweHCM?

Vanhu vazhinji vane HCM vane mukana mudiki wekufa kamwe kamwe nemwoyo. Zvisinei, vanhu vashoma vane HCM vane mukana wakawedzerwa wekufa nechirwere ichi. Zvakakosha kuziva kana uine chirwere ichi. Chiremba wako anogona kukuudza zvaungaita kuti uderedze njodzi yako.

Vanhu vari panjodzi huru yekufa nemwoyo kamwe kamwe nekuda kweHCM ndevanotevera:

• Vanhu vane nhoroondo yemhuri yekufa nechirwere chemwoyo kamwe kamwe.
• Vanhu vakambova ne syncope kakawanda vachiri vadiki.
• Vanhu vane BP isingawanzoitiki kana vachiita maekisesaizi.
• Vanhu vakambova nenhoroondo yekurova kwemoyo nekukurumidza zvisina kujairika (arrhythmia).
• Avo vane zviratidzo zvakakomba uye kushanda kwemoyo kusina kunaka.

Taura nachiremba wako nezvenjodzi yako pachako. Kana uine zvinhu zviviri kana kupfuura zvinokonzera kufa kamwe kamwe, chiremba wako anogona kukurudzira mishonga inoderedza kusagadzikana kwemoyo (mishonga inodzora mafambiro emwoyo asina kujairika) kana kuti mushonga unopinzwa mu cardioverter defibrillator (ICD) kuderedza njodzi yako.

Ndeipi mishonga inoshandiswa kurapa HCM?

Vanachiremba vanokupa mishonga yakasiyana-siyana yekudzora zviratidzo zvako uye kudzivirira mamwe matambudziko. Mishonga yakaita se "Beta blockers" uye "calcium channel blockers" inozorodza tsandanyama dzemwoyo, ichibatsira kuti uzadze ropa uye ipombe ropa zvinobudirira. Mimwe mishonga inogona kudzora kurova kwemoyo wako kana kuderedza njodzi yekurohwa kwemoyo zvisina kujairika (arrhythmias).

Ungaudzwa kuti usatore mimwe mishonga, semuenzaniso nitrates (inoderedza BP) kana digoxin (inowedzera simba rekurwadziwa kwemoyo).

Dzimwe nguva ungangoda kutora mishonga inorwisa mabhakitiriya uye kutora matanho ekudzivirira kuti uderedze njodzi yehutachiona hunogona kukonzera njodzi kuhupenyu hunonzi bacterial endocarditis.

Ndeapi maitiro chaiwo ekurapa anoshandiswa kurapa HCM?

Kune nzira dzakasiyana siyana dzekurapa Hypertrophic Obstructive Cardiomyopathy (HOCM), chirwere chinokonzera kuvharika kweropa:

Kuvhiyiwa kweMyectomy yeSeptal

Uku kuvhiyiwa. Pakuvhiyiwa kwe septal myectomy, chiremba anobvisa chikamu chidiki chemadziro ako e septal akakora. Izvi zvinoita kuti nzira yekubuda iwedzere kubva kuruboshwe kuenda ku aorta. Vanachiremba vanofunga nezvekuvhiyiwa uku chete kana mushonga usingabatsire. Izvi zvinowanzogadzirisa dambudziko re mitral valve.

Kubviswa kweEthanol

Izvi zvinonziwo `(septal ablation)`. Nzira iyi inoshandiswa kune vanhu vasingakwanisi kuvhiyiwa `(septal myectomy)` kwambotaurwa. Muizvi, chiremba anowana tsinga diki yemoyo inoendesa ropa kuchikamu chepamusoro cheseptum yako. Ipapo anoisa catheter yebharumu mutsinga iyoyo oiputira. Tevere, anobaya `(contrast agent)` kuti awane nzvimbo chaiyo yemadziro eseptal akakora ari kudzivirira kufamba kweropa.

Kana nzvimbo yacho yaonekwa, chiremba anobaya doro shoma shoma kuburikidza necatheter. Doro iri rinouraya masero, uye mumwedzi mishoma inotevera septum inodzokera pahukuru hwayo hwenguva dzose. Izvi zvinoita kuti nzira yeropa ifambe zvakanaka.

Chinobvisa Kuora Kwemwoyo Chinoiswa Mukati (ICD)

Muchina wekudzikisa kurova kwemoyo (ICD) unogona kubatsira vanhu vane arrhythmias inotyisidzira hupenyu kana kufa kamwe kamwe kwemoyo. ICD mudziyo mudiki unoiswa pasi peganda rako. Wakabatana nemoyo wako newaya. ICD inoramba ichitarisa kurova kwemoyo wako. Kana ikaona kurova kwemoyo kunokurumidza, kusingawanzoitiki, inopa kurohwa kwemoyo kudiki asi kune simba, zvichiita kuti urove zvakajairika zvakare. Chiremba wako achakuudza kana ICD yakakunakira.

Kutarisira Kukundikana Kwemwoyo

Kune nzira dzakasiyana siyana dzekugadzirisa kutadza kwemoyo, kubva pakuchinja mararamiro kusvika kumishonga inoderedza zviratidzo uye inobatsira tsandanyama dzemwoyo kushanda nemazvo.

Ndingavandudza sei hupenyu hwangu neHCM?

Ungave uine zviratidzo kana kuti kwete, ungave wakamboonekwa uine HCM, kana kuti mumwe munhu mumhuri mako ane chirwere ichi, pane zvinhu zvakawanda zvaunogona kuita kuti hutano hwemwoyo wako hurambe hwakanaka:

• Deredza mvura nemunyu (sodium): Kana uine zviratidzo zvekusashanda zvakanaka kwemoyo, ungangoda kuderedza kudya kwako mvura nemunyu. Bvunza chiremba wako kuti akupe gwara rakananga nezvekudya kwako, kusanganisira doro necaffeine.
• Maekisesaizi nekungwarira: Chiremba wako achakutaurira nezvemaekisesaizi akakunakira. Vanhu vazhinji vane HCM vanogona kuita mabasa ekurovedza muviri asingakwikwidzi. Vanachiremba havakurudziri kusimudza zvinorema kana mitambo yekurovedza muviri zvakanyanya.
• Ona chiremba wako nguva dzose: Kana uine HCM, unofanira kuona chiremba wemwoyo wako nguva nenguva kuti akuongorore.
• Deredza njodzi yako yekutapukirwa: Kana uine HCM, chiremba wako achakupa zano rekuti utore matanho ekuderedza njodzi yako yekutapukirwa nehutachiona hunonzi infective endocarditis.

Ungaderedza sei njodzi yekubatwa neInfective Endocarditis?

Vanhu vane HCM vane mukana mukuru wekuwana hutachiona hwebhakitiriya hunonzi ``bacterial endocarditis`` kana ``infective endocarditis``.

Chirwere cheBacterial endocarditis chirwere chinotapukira mumavharuvhu emwoyo wako kana mukati memwoyo wako (endocardium). Chinoitika kana utachiona (kunyanya mabhakitiriya, asi dzimwe nguva fungus nedzimwe tupukanana) hukapinda muropa rako huchirwisa mukati memwoyo wako kana mumavharuvhu. Izvi zvinogona kukonzera kuti mavharuvhu akobvu, aboore, kana kuti aite mavanga. Izvi zvinowanzokonzera kuti vharuvhu yemwoyo ibude. Kana ikasarapwa zvakanaka, inogona kuuraya.

Unogona kutora matanho aya kuderedza njodzi iyi:

• Chengetedza mazino ako nematadza zvakanaka: Enda kuna chiremba wemazino mwedzi mitanhatu yega yega, geza mazino ako zuva nezuva, geza neshinda, uye tarisa kuti mushonga wemazino wako unokwana zvakanaka.
• Ona chiremba kana uine zviratidzo zvehutachiona:
• Fivha inodarika madhigirii 100 Fahrenheit, kudikitira, kana kutonhorwa.
• Mapundu paganda.
• Marwadzo, kupfava, kutsvuka, kana kuzvimba.
• Ronda kana kuti kucheka kusingapore, kana ronda rakatsvuka, rinopisa, uye rinobuda urwa.
• Huro inorwadza, pahuro painooma, kana kurwadziwa pakumedza.
• Kubuda kwemusana, kuzara kwemhino, musoro, kana kurwadziwa pamusoro pematama.
• Kukosora kwakaoma kana kuti kunorwadza kunotora mazuva anopfuura maviri.
• Mavara machena mumuromo kana parurimi.
• Kusvotwa, kurutsa, kana manyoka.

Usanonoka kutsvaga kurapwa. Dzihwa nefuruu hazvikonzeri endocarditis. Zvisinei, mamwe hutachiona hune zviratidzo zvakafanana hunogona kukonzera endocarditis. Saka, chengeteka uye ona chiremba wako.

• Tora mishonga inorwisa mabhakitiriya usati watanga kurapwa nemazino. Taura nachiremba wako nezvemhando yemishonga inorwisa mabhakitiriya yaunofanira kutora, huwandu hwayo, uye mhando dzemishonga yaunofanira kuishandisa.
• Chengeta kadhi rekuziva chirwere chemwoyo chebhakitiriya rinowanikwa kubva kuAmerican Heart Association.

Chekupedzisira, izvi ndizvo zvaunofanira kutaura (Mharidzo Yekuenda Kumba)

Vanhu vazhinji vane HCM vanorarama hupenyu hwakajairika uye hunofadza. Kune nzira dzakasiyana-siyana dzekurapa dziripo kune avo vane zviratidzo kana vari panjodzi yekuva nematambudziko akakomba. Kufanotaura kwako kunoenderana nekuti tsandanyama dzemwoyo wako dziri kushanda sei, zviratidzo zvako, uye kuti unopindura uye unotevera sei chirongwa chako chekurapa.

Bvunza chiremba wako nezvenjodzi dzako uye zvaunogona kuita kuti uvandudze hupenyu hwako uye kudzivirira hutachiona. Kana ukaonekwa uine HCM uye ukava nezviratidzo kana kuti ukafungidzira kuti une hutachiona, enda kuna chiremba wako nekukasika. Yeuka, unogona kurarama hupenyu hwakanaka nechirwere ichi!

'Hypertrophic cardiomyopathy, HCM, chirwere chemwoyo, kukura kwemoyo, kurwadziwa kwechipfuva, kupererwa nemweya, kufa kamwe kamwe kwemoyo