Rutivi rweruboshwe rwemoyo wako rwakanetawo here? (Kukundikana kwemoyo Kudivi Reruboshwe) - Ngatikurukurei nezvazvo!

Dzimwe nguva unonzwa kushaya mweya here? Kana kuti unonzwa kushaya mweya here paunofamba, uchikotama, kana kuita basa? Unofanira kugara pasi husiku nekuti unonzwa kudzipwa paunorara? Une kuzvimba mumakumbo ako nemakumbo here? Izvi dzimwe nguva zvinogona kuva zviratidzo zverutivi rweruboshwe rwemoyo rusina simba. Nhasi, ngatitaurei nezvechirwere ichi chinonzi `(Left-Sided Heart Failure)` nenzira iri nyore yaunogona kunzwisisa. Usatya, zvakakosha kuziva izvi.

Chii chinonzi Kukundikana kweMwoyo Kudivi Rekuruboshwe?

Zvichitaurwa zviri nyore, izvi zvinoreva kuti rutivi rweruboshwe rwemwoyo wedu harukwanise kuita basa raro, iro riri rekupomba ropa mumuviri wese, nemazvo. Funga nezvazvo sepombi yemvura. Kana isiri kushanda nemazvo, mvura haizoendi mutangi. Ndizvo zvazviri. Kune mhando mbiri huru dzeizvi:

1. Kukundikana kwemoyo: Apa ndipo apo imba huru yekupomba iri kuruboshwe rwemoyo, inonzi left ventricle, inogumira uye inoshaya simba rekupomba ropa mumuviri wese. Izvi zvinoreva kuti huwandu hweropa rinopombwa nemoyo (chikamu chekubuda kweropa) hunoderera. Sezvinongoita kana simba remota risina kukwana, kumanikidzwa kunopomba mvura kunoderera.

2. Kukundikana kwemoyo kweDiastolic: Izvi zvakasiyana. Kunyangwe ventricle yekuruboshwe yakasimba, hairegi zvakanaka uye haitambanudzike zvakanyanya sezvainofanira kuita kuti izare neropa. Izvi zvinoreva kuti imba yemoyo inooma. Zvakafanana nekuedza kuzadza bharumu rakaomarara, risingachinjiki nemvura, uye rinoomerwa nekuzadza neropa. Muchiitiko ichi, huwandu hweropa hunopombwa nemoyo (ejection fraction) hungave hwakajairika.

Wava kunzwisisa musiyano uripo pakati pemhando mbiri idzi here?

Mativi ekuruboshwe nerudyi emwoyo wedu anoshanda sei?

Mwoyo wedu inhengo inoshamisa zvechokwadi. Unoshanda sepombi ine simba, unoshanda usingamiri. Une mativi maviri makuru, divi rekuruboshwe nedivi rerudyi. Rutivi rumwe nerumwe runoita basa rakasiyana.

• Rutivi rweruboshwe: Rutivi urwu ndirwo rwunonyanya kutaurwa munyaya yedu. Rutivi rweruboshwe rwemoyo runogamuchira ropa rakachena rine oxygen kubva mumapapu. Ropa iri rinozoparadzirwa mumuviri wese, kubva kuuropi kusvika kutsoka, kusvika kunhengo dzese, tsandanyama, uye nyama. Okisijeni iyi inopa chikamu chega chega chemuviri wedu simba nehupenyu hwachinoda kuti chiite basa racho.

• Rutivi rwerudyi: Rutivi rwerudyi runounganidza ropa rakashandiswa mumuviri, kureva ropa rakarasikirwa neokisijeni uye rakaunganidza kabhoni dhayokisaidhi, roridzosera kumapapu kuti richeneswe. Mumapapu ndimo matinoburitsa kabhoni dhayokisaidhi towedzera okisijeni itsva muropa.

Nenzira iyi, mativi maviri aya anoshanda pamwe chete kuchengetedza kutenderera kweropa mumuviri wedu kwakakodzera.

Chii chinoita kuti rutivi rwekuruboshwe rwemoyo rushaye simba?

Fungidzira, chii chingaitika dai takashandisa pombi yemvura mumba medu kwemakore tisina kugadzirisa kana kuigadzirisa? Zvishoma nezvishoma, zvikamu zvayo zvinopera, kushanda kwayo kunoderedza, uye inogona kumira kushanda, handiti? Ndizvo zvazviri nemoyo yedu. Zvimwe zvirwere netsika dzedu dzakaipa zvinogona kukuvadza rutivi rwekuruboshwe rwemoyo nekufamba kwenguva, zvichiita kuti ushaye simba. Heano mamwe ezvikonzero zvikuru:

• Chirwere chetsinga dzeropa: Izvi zvinoitika kana mafuta aunganidzwa mutsinga dzeropa (coronary arteries) dzinoendesa ropa kumoyo. Izvi zvinodzivirira tsandanyama dzemoyo kuti dzisawane okisijeni nezvinovaka muviri zvainoda.
• Kurwara nemoyo: Kurwara nemoyo kunokanganisa kuyerera kweropa kunoenda kumoyo kamwe kamwe. Izvi zvinoita kuti chikamu chemoyo chife, zvichiita kuti mwoyo usakwanise kupomba ropa.
• Kukwira kweropa (`BP yakakwira`) hakudzoreki kwenguva yakareba: Kana kukwira kweropa kwakakwira nguva dzose, mwoyo unofanirwa kushanda nesimba kuti upombe ropa. Nekufamba kwenguva, moyo unoneta uye unoshaya simba.
• Kukanganisika kwemavharuvhu emwoyo (`Valvular heart disease`): Kana mavharuvhu ari mumoyo akasavhara kana kuvhurika zvakanaka, kufamba kweropa kunokanganiswa uye mwoyo unonzwa mutoro wakawedzerwa.
• Kurira kwemwoyo kusina kujairika (Arrhythmia): Kana mwoyo usingarove zvakanaka, kushanda kwawo pakupomba kunoderera.
• Zvimwe zvirwere zvisingawanzoitiki: Semuenzaniso, zvirwere zvakaita se `(Amyloidosis)` (kuiswa kwepuroteni isina kujairika mumoyo) kana `(Sarcoidosis)` (kuumbwa kwemapundu madiki mumoyo) zvinogonawo kukonzera kuti tsandanyama dzemwoyo dziome uye dzisashande zvakanaka.

Zvakakosha: Chimwe chezvikonzero izvi kana kupfuura zvinogona kukonzera kusasimba kuruboshwe rwemoyo.

Pamusoro peizvi, kune zvimwe zvinhu zvakawanda zvinokonzera njodzi . Izvi zvinoreva kuti vanhu vane zvinhu izvi vane mukana wekushaya simba kuruboshwe rwemoyo:

• Mimwe mishonga yekurapa kenza inogona kukonzera migumisiro yakaipa pamoyo (cardiotoxicity).
• Chirwere cheshuga.
• Kufuta zvakanyanya.
• Kutadza kufema zvakanaka pakurara.
• Sezvatinokura, mashandiro emwoyo yedu anogona kudzikira zvishoma.
• Kusvuta uye kufema utsi hwevamwe vanhu.
• Kuramba uchishandisa mimwe mishonga nezvinwiwa zvinopa simba, izvo zvinokuvadza mwoyo.
• Kashoma, mimwe mishonga inoshandiswa kurapa mamwe matambudziko (semuenzaniso, zvirwere zve autoimmune, attention-deficit/hyperactivity disorder (ADHD)) inogonawo kukanganiswa.

Ndezvipi zviratidzo zvechirwere ichi?

Pakutanga, kana rutivi rwekuruboshwe rwemoyo rukatanga kupera simba, ungasaona zviratidzo zvikuru. Ungafunga kuti , "Aa, ingori dzihwa" kana kuti " Chinhu chinoitika kana wakura." Asi mashandiro emoyo wako paanowedzera kuipa, ungatanga kuona zvinhu zvakaita se:

• Kukosora kunoramba kuripo: Unofanira kunetseka kana uchikosora, kunyanya husiku kana wakarara pasi.
• Kushaya mweya:
• Pandinofamba zvishoma, ndokwira masitepisi mashoma, ndokotama, ndinonzwa musoro.
• Pandinomuka husiku, ndinonzwa sekunge ndiri kutadza kufema, sekunge chipfuva changu chiri kuvharika.
• Zvakaoma kurara kana wakarara pasi, uye zvinoita sezviri nyore kufema kana wakagara. (Izvi zvinokonzerwa nekuti mvura yakawanda inoungana mumapapu kana wakarara pasi).
• Kuwedzera uremu kamwe kamwe: Unogona kuwedzera kilo imwe kana maviri mumazuva mashoma. Izvi hazvisi kuwedzera kukura, asi kuti zvinochengetedza mvura mumuviri.
• Kuzvimba (edema): Kuzvimba kwezvitsitsinho, makumbo, uye dzimwe nguva dumbu. Izvi zvinokonzerwawo nekuchengetwa kwemvura mumuviri.

Nekufamba kwenguva, sezvo mwoyo uchishanda nesimba kuti uite basa rawo, matambudziko akadai se:

• Kuvhunduka kwemwoyo: Izvi zvinoitika nekukurumidza. Mwoyo haugone kupomba ropa rakakwana, zvichikonzera kushaikwa kweropa rinoenda kunhengo dzinokosha dzemuviri.
• Mwoyo wakakura: Kana mwoyo ukashanda nesimba, tsandanyama dzawo dzinokora uye mwoyo unowedzera kukura.
• Kusarongeka kwekurova kwemoyo (`Arrhythmia`): Kutenderera kwemoyo kunogona kusarongeka.

Kana uine chimwe chezviratidzo izvi, ndapota ona chiremba.

Chiremba anoona sei izvi?

Paunoenda kuna chiremba, vanotanga vakubvunza mibvunzo yakawanda. Ndezvipi zviratidzo zvako, wava nenguva yakareba sei uchizvibata, pane mumwe munhu mumhuri mako ane chirwere chemwoyo, mishonga yaunotora, nezvimwewo. Zvadaro vanokuongorora. Vanoteerera mwoyo wako, vanoongorora mapapu ako, uye vanotsvaga kuzvimba.

Pamusoro pezvo, bvunzo dzinotevera (bvunzo dzemurabhoritari nezvidzidzo zvemifananidzo) dzinogona kuitwa kuti pave nechokwadi chekuti chirwere chacho ndechechokwadi uye kuti pave nechikonzero chacho:

• Kuongororwa kweropa (`Kuongororwa kwerabhoritari`):
• Kuongororwa kweropa kweBNP (B-type natriuretic peptide): Iyi i biomarker yakakosha. Kana kumanikidzwa mumakamuri emwoyo kukawedzera, hormone iyi inoburitswa muropa. Mazinga ayo anogona kupa pfungwa yekuti mwoyo hauna simba here.
• `Metabolic panel`: Izvi zvinoongorora mashandiro eitsvo nechiropa, pamwe nehuwandu hwemunyu muropa, senge sodium nepotassium. Izvi zvakakosha muzvirwere zvemwoyo.

• Zvidzidzo zvemifananidzo:
• Electrocardiogram (ECG/EKG): Iyi electrocardiogram inoongorora mashandiro emagetsi emwoyo. Inogona kuona zvinhu zvakaita sechirwere chemwoyo kana dambudziko remwoyo.
• Echocardiogram (ECHO): Izvi zvakafanana neultrasound scan yemoyo. Inogona kuona zvinhu zvakawanda zvakajeka, zvakaita sehukuru hwemakamuri emwoyo, ukobvu hwemadziro, mashandiro emavharuvhu, uye mapombi anoita mwoyo ropa (ejection fraction).
• Angiography yemoyo:Kuongororwa kwakakosha kwe "X-ray" kuti uone kana paine kuvharika kwetsinga dzemwoyo dzinopa ropa kumoyo.
• Cardiac MRI (Cardiac Magnetic Resonance Imaging): Izvi zvinogona kutora mifananidzo yakajeka uye yakadzama yemoyo. Zvinogona kubatsira kuona zvinhu zvakaita semamiriro emhasuru yemwoyo nenzvimbo dzakakuvara.

Zvichibva paruzivo rwakawanikwa kubva mukuongororwa uku, chiremba ndiye achasarudza rudzi rwechirwere chaunacho uye kuti ndeipi nzira yakanakisisa yekurapa chirwere chacho.

Inorapwa sei? Ndeipi mishonga iripo?

Mashoko akanaka ndeekuti kune nzira dzakasiyana-siyana dzekurapa kutadza kwemoyo kweruboshwe. Kurapa kwakakodzera iwe kunoenderana nekuti une "Systolic heart failure" yambotaurwa kana kuti "Diastolic heart failure", pamwe nekuoma kwechirwere chacho.

Mishonga ndiyo inowanzo shandiswa pakurapa. Mishonga iyi inobatsira kuvandudza mashandiro emwoyo, kuderedza zviratidzo, uye kuwedzera hupenyu hwemunhu. Heano mimwe yemishonga inonyanya kushandiswa:

• Mishonga yeACE inhibitors (angiotensin-converting enzyme inhibitors), Angiotensin II receptor blockers (ARBs), Angiotensin-receptor neprilysin inhibitors (ARNIs): Mishonga iyi inoshanda nekuzorodza mitsipa yeropa, kuderedza BP, uye kubatsira moyo kuti ugadzirise.
• Aldosterone antagonists: Izvi zvinodzora mahormone ane chekuita nekushushikana uye zvinodzivirira zviratidzo kuti zvisawedzere kuipa. Zvinobatsirawo kuderedza kuzvimba nekuderedza kuchengetwa kwemvura mumuviri (mushonga wekubvisa mvura mumuviri).
• Beta blockers: Mishonga iyi inoderedza kurova kwemoyo uye inoderedza basa remoyo, kureva kuti, huwandu hwebasa raunofanira kuita.
• Digoxin: Mushonga uyu unobatsira vamwe vanhu, kunyanya avo vane mamwe matambudziko emwoyo, kunzwa zviri nani uye kudzora kurova kwemoyo wavo.
• Mishonga inobvisa mvura mumuviri: Iyi inoshanda nekubvisa mvura yakawandisa mumuviri kuburikidza neweti, izvo zvinogona kuderedza zviratidzo zvakaita sekushaya mweya uye kuzvimba.
• Mishonga inodzivirira sodium-glucose transport protein 2 (SGLT2): Iyi mishonga mitsva inobatsira zvikuru kune vanhu vane chirwere cheshuga nevasina chirwere chemwoyo. Inobatsirawo kuderedza mvura yakawandisa mumuviri uye inodzivirira mwoyo.

Rangarira: Zvakakosha kutora mishonga iyi sezvakarairwa nachiremba wako, muchiyero chakakodzera, uye panguva chaiyo. Usamborega kutora mushonga kana kushandura chiyero pasina kurairwa nachiremba wako.

Vamwe vanhu vanofanira kurapwa zvakasiyana here ('maitiro')?

Ehe, mune dzimwe nguva, kana zviratidzo zvisingagone kudzorwa nemishonga chete, kana bvunzo dzichiratidza kuti mamiriro emwoyo ari kuipa, chiremba anogona kukurudzira nzira dzakasiyana kana kuvhiyiwa. Heano mamwe acho:

• Kurapa kwemwoyo (CRT): Izvi zvinosanganisira kuisa mudziyo mudiki (wakaita sepacemaker) pasi peganda unopa simba remagetsi kuti ubatsire makamuri ekuruboshwe neekurudyi emwoyo kupwanyika panguva imwe chete. Izvi zvinonziwo biventricular pacemaker. Izvi zvinoita kuti kushanda kwemoyo pakupomba kushande zviri nani.
• Kurapa kwemagetsi nemwoyo: Kurapa kunopa kurohwa nemagetsi pachipfuva kuti mwoyo udzorere kushanda zvakanaka kana mwoyo usina kumira zvakanaka.
• Muchina wekudzikisa tsinga dzemwoyo (ICD): Uyu mudziyo unoiswa pasi peganda. Unoona kusagadzikana kwemoyo uye unotumira masaini emagetsi kuti udzorere kumamiriro awo ezvinhu.
• Mudziyo wekubatsira ventricle yekuruboshwe (LVAD): Uyu muchina unoiswa mukati memoyo nevanovhiyiwa kuti ubatsire moyo kupomba ropa. Unoshandiswa kune vanhu vane chirwere chemwoyo chakakomba vari kumirira kuisirwa moyo.
• Kuisirwa Moyo: Kune varwere vane mwoyo isina simba zvakanyanya vakakundikana kurapwa kwese, kuisirwa moyo une hutano kubva kumupi akafa ndiyo nzira yekupedzisira.

Chii chatingaita kuti tidzivise mamiriro ezvinhu aya? (Kudzivirira)

Pane chirevo chinoti "Kudzivirira kuri nani pane kurapa." Izvi zvinoshandawo pano. Kutevedzera mararamiro ane hutano hwemoyo kunogona kuderedza zvikuru njodzi yekukundikana kwemoyo kuruboshwe. Kana uchitova nechirwere ichi, tsika dzakanaka dzinogona kubatsira kudzivirira matambudziko emangwana uye kugadzirisa chirwere chacho.

Heano zvimwe zvinhu zvaunogona kuita:

• Chengetedza BP yako, cholesterol yako, uye chirwere cheshuga zviri pasi pesimba rako kana uchizvidya. Inwa mishonga yawakanyorerwa nachiremba.
• Rovedza muviri nguva dzose. Ita maekisesaizi ari nyore sekufamba kwemaminitsi makumi matatu pazuva.
• Wana nguva yekurara zvakanaka husiku . Unoda maawa manomwe kusvika masere ekurara pazuva.
• Ramba uine huremu hwakanaka mumuviri. Kufuta mutoro mukuru pamoyo.
• Idya chikafu chine hutano. Idya michero yakawanda, miriwo, nyemba, uye chikafu chine fiber yakawanda. Deredza munyu, shuga, nemafuta.
• Deredza kushushikana. Ita zvinhu zvakaita seyoga, kufungisisa, maekisesaizi ekufema ('maitiro ekuzorora'). Ita chimwe chinhu chaunofarira.
• Kana uchisvuta, rega ipapo ipapo. Gara kure nenzvimbo dzinosvuta vamwe ('utsi hwevamwe').
• Deredza kana kurega zvachose kushandisa doro .

Hupenyu huchava hwakaita sei kana rutivi rworuboshwe rwemoyo rukashaya simba? Ndezvipi zvinetso zvinogona kuitika?

Kana ukatevera mirairo yachiremba wako nemazvo, ukashandisa mishonga yako nemazvo, uye ukaenda kunoonana nachiremba nenguva, unogona kuchengetedza hutano hwako zvakanaka. Vanhu vazhinji vanogona kurarama hupenyu hwakajairika.

Zvisinei, kana chirwere ichi chisina kudzorwa zvakanaka, mamwe matambudziko anogona kuitika. Heano mamwe acho:

• Kusarongeka kwemutinhimira wemoyo (`Arrhythmias`): Semuenzaniso, ``ventricular tachycardia`` (kurova kwemoyo nekukurumidza), ``atrial fibrillation / Afib`` (kurova kwemoyo kusina kurongeka kweatrium).
• Kumbomira kufema nepaburi retsono (kumbomira kufema nepaburi retsono).
• Matambudziko evharuvhu yemoyo (`chirwere chevharuvhu yemoyo`), akadai seropa riri kubuda richidzokera kumashure richipfuura nemuvharuvhu.
• Chirwere chechiropa: Kana moyo usingapombi ropa zvakanaka, chiropa chinogonawo kukanganiswa.
• Kukundikana kwemoyo kurudyi: Kana divi rekuruboshwe remoyo rikashaya simba, zvinogonawo kukanganisa divi rekurudyi.
• Kusasimba uye kushaya simba kwetsandanyama.
• Kushaya ropa.
• Chirwere cheitsvo: Kana mwoyo ukaneta, huwandu hweropa rinoyerera richienda kuitsvo hunoderera, izvo zvinogona kukanganisa mashandiro adzo.
• Kuora Mwoyo kana Kunetseka: Kurarama nechirwere chenguva refu kunogonawo kukanganisa pfungwa.

Chii chatinofanira kuchinja patinenge tichirarama nemamiriro ezvinhu aya?

Kana uchirarama nedambudziko re ventricular yekuruboshwe, pane zvimwe zvinhu zvakakosha zvaunogona kuchinja muhupenyu hwako kuti ubatsire kugadzirisa dambudziko rako, kuderedza zviratidzo, uye kuita kuti hupenyu huve nyore.

• Iva nemuviri wakasimba kupfuura kare: Ita maekisesaizi akakodzera iwe, sezvakakurudzirwa nachiremba wako.
• Tarisa BP yako zuva nezuva: Nyora pasi sezvaunoudzwa nachiremba wako.
• Ramba uchitora mushonga wekushaya simba kwemoyo wako sezvawakarairwa: usapotsa zuva rimwe chete.
• Ona chiremba wako nenguva uye enda kumakiriniki: Izvi zvichabatsira chiremba kutarisa mamiriro ako uye kuita chero shanduko dzinodiwa.
• Deredza munyu mukudya kwako: Munyu unogona kuwedzera kuchengetwa kwemvura mumuviri, zvichikonzera kuzvimba uye kuoma kufema.
• Zviyere mangwanani ega ega: panguva imwe chete, nenzira imwecheteyo (semuenzaniso, mushure mekushandisa chimbuzi, usati wapfeka). Kana ukawedzera kilo imwe kana mbiri muzuva rimwe chete kana maviri, zvinogona kukonzera kuchengetwa kwemvura. Kana izvozvo zvikaitika, udza chiremba wako.
• Inwa mvura chete (yakadai semvura, tii, soup) yawakanyorerwa pazuva: Vamwe vanhu vanofanira kudzora kunwa kwavo mvura.

Pakupedzisira, zvekurangarira (Mharidzo Yekuenda Kumba)

Zvichitaurwa zviri nyore, Kukundikana kwemoyo Kunobatana Neruboshwe chirwere chinoita kuti mwoyo usakwanise kupomba ropa, uye chinhu chinofanira kufungwa nezvacho. Izvi zvinonyanya kuitika kuvanhu vane zvirwere zvemwoyo zvakaita seBP, chirwere chemwoyo, uye kutadza kushanda kwemoyo.

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Zvisinei, hapana chikonzero chekuvhunduka. Kana ukaona zviratidzo zvechirwere ichi nekukurumidza, ukarirapa zvakanaka zvichienderana nemazano echiremba, ukashandisa mishonga yawakanyorerwa, uye ukatevera mararamiro ane hutano hwemoyo, unogona kurarama zvakanaka uye zvakanaka nechirwere ichi.

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Saka, kana uine chimwe chezviratidzo zvataurwa munyaya ino, chinhu chakanakisa chaunogona kuzviitira ndechekuona chiremba ane hunyanzvi nekukasika wotsvaga mazano usingaregeredzi. Kana chirwere chikaonekwa nekukurumidza, mukana wekuti kurapwa kwacho kubudirire. Tinokushuvira hutano hwakanaka!

Kukundikana kwemoyo , Kukundikana kwemoyo Kudivi Rekuruboshwe, Kushaya mweya, Kuzvimba, Chirwere chemoyo, Kurwara kwemoyo, Kukwira kweropa