Mwoyo wako hauna simba here? Ngatidzidzei nezveSystolic Heart Failure.

Dzimwe nguva unonzwa kushaya mweya here? Unonzwa kuneta here kunyangwe mushure mekuita basa diki? Kana kuti makumbo ako anozvimba here? Izvi zvinogona kuva zviratidzo zvekuti moyo wako hauna simba. Nhasi, tichataura nezvechirwere chemwoyo ichi, 'Systolic Heart Failure'. Kunyangwe ichi chiri chirwere chakakomba, chinogona kudzorwa kana chikaonekwa nekukurumidza uye chikarapwa nemazvo.

Chii chinonzi Systolic Heart Failure?

Zvichitaurwa zviri nyore, mwoyo wako une makamuri makuru mana. Kamuri repasi kuruboshwe, rinonzi ventricle yekuruboshwe, rinopomba ropa rine oxygen mumuviri wese. Rinoshanda sepombi yemvura. Zvino, mudambudziko iri rinonzi systolic heart failure, ventricle yekuruboshwe inoshaya simba. Izvi zvinoreva kuti haigone kupomba ropa nemazvo uye zvinobudirira.

Chii chinoitika ipapo? Fungidzira kana injini yemvura isina simba rakakwana, mvura haizofambi zvakanaka. Saizvozvowo, kana moyo usingapombi ropa zvakanaka, mvura inogona kuungana mumapapu. Ndipo panoitika zvinhu zvakaita sekuoma kufema uye kuneta . Dzimwe nhengo dzemuviri, kunyanya makumbo, zvitsitsinho, nedumbu, zvinogonawo kuzvimba . Izvi zvinokonzerwa nekuti mvura iri mumuviri haisi kutenderera zvakanaka.

Saka chii chinonzi Ejection Fraction iyi?

Zvino ngatitaurei nezvechinonzi Ejection Fraction (EF) . Izvi zvinonzi 'Ejection Fraction' muchiSinhala. Kunyangwe iri izwi rezvekurapa, zviri nyore kunzwisisa. Zvichitaurwa zviri nyore, iri ndiro huwandu hweropa rinopomba mumuviri wako kana ventricle yako yekuruboshwe.

Mwoyo une hutano hwakanaka uye unoshanda zvakanaka unofanirwa kuva neEF value iri pakati pe55% ne70% . Izvi zvinoreva kuti ropa rinopfuura hafu rinopinda mu ventricle yekuruboshwe yemoyo rinoburitswa kamwe chete. Zvisinei, kana EF value iyi iri pasi pe40% , inogona kunge iri chiratidzo chekukundikana kwemoyo. Izvi zvinoreva kuti kugona kwemoyo kupomba kwaderera. Ndosaka chirwere ichi dzimwe nguva chichinzi 'Heart Failure with Reduced Ejection Fraction' (HFrEF) .

Ndiani ane mukana mukuru wekuwana chirwere ichi?

Kukundikana kwemoyo kwesystolic kunogona kukanganisa chero munhu, asi njodzi yacho inowedzera nekukura. Izvi zvinowanzoitikawo kune vanhu vane mamwe matambudziko emwoyo, akadai sekurohwa nemoyo kare kana BP yakakwira.

Chii chinokonzera systolic heart failure (HFrEF)?

Kukundikana kwemoyo kwesystolic kunowanzoitika kana ventricle yekuruboshwe yemoyo ikakuvadzwa nechimwe chirwere. Funga nezvazvo nenzira iyi: tsandanyama yemoyo yakaita sebhandi rerubha. Inotambanuka uye inokotama. Asi kana ikakuvara, haigone kuita basa iroro nemazvo.

Heano zvimwe zvezvikonzero zvikuru zvinogona kukanganisa izvi:

• Chirwere chemwoyo: Ichi ndicho chikonzero chinowanzoitika. Mitsipa yeropa inoendesa ropa kumoyo (mitsipa yemoyo) inodzikira kana kuvharwa nemafuta akawanda, zvichiita kuti tsandanyama dzemwoyo dzisawane okisijeni nezvinovaka muviri zvainoda. Izvi zvinoita kuti tsandanyama dzishaye simba.
• Kukwira kweropa (Hypertension): Kana BP yakakwira kwenguva yakareba, mwoyo unofanirwa kushanda nesimba kuti upombe ropa. Zvakafanana nekupomba mvura mutsinga yakavharika. Nekufamba kwenguva, izvi zvinogona kukonzera kuti tsandanyama dzemwoyo dzikure uye pakupedzisira dzishaye simba.
• Kurwara kwemwoyo kwakapfuura: Kurwara kwemoyo kunoitika kana ropa richienda kuchikamu chemwoyo rikabviswa, zvichiita kuti masero emhasuru afe. ​​Nzvimbo yakafa inobva yava nemavanga, zvichiita kuti mwoyo usakwanise kupomba.
• Chirwere cheshuga: Chirwere cheshuga chinogonawo kukanganisa mitsipa yeropa uye kukanganisa zvakananga tsandanyama dzemwoyo.
• Mwoyo Usina Kunaka: Kana kurova kwemoyo kusina kurongeka, mwoyo haugone kupomba ropa zvakanaka.
• Chirwere cheVharuvhu yeMwoyo: Kana mavharuvhu ari mumoyo asingashande zvakanaka, ropa rinogona kuyerera richidzokera shure kana mberi, izvo zvinogona kuwedzera kuomesa moyo.
• Myocarditis: Kuzvimba kwetsandanyama yemwoyo. Izvi zvinogona kukonzerwa nezvinhu zvakaita sehutachiona.

Kukuvadzwa uku kunogona kukonzera mavanga emhasuru dzemwoyo, kukura, kana kuomarara kwemaventricle. Zvese izvi zvinoderedza simba reventricle yekuruboshwe uye zvinoderedza EF. Mashoko akanaka ndeekuti kazhinji, kana chikonzero chacho chikarapwa nemazvo, mashandiro emoyo anogona kuvandudzwa zvishoma.

Ndezvipi zviratidzo zvechirwere ichi?

Saka, unoziva sei kana uine dambudziko iri? Heano mamwe ezviratidzo zvekuchenjerera:

• Kushaya mweya (Dyspnea): Ungave uchinetseka nekufema, kunyanya paunenge uchirovedza muviri, uchikwira masitepisi, kana kutorara pamubhedha. Kana uchida kurara nemapiro maviri kana matatu husiku, izvozvowo chiratidzo.
• Kuneta uye kushaya simba nguva nenguva: Kana uchinzwa kuneta zvakanyanya kunyangwe mushure mekuita mabasa aimbova nyore.
• Kuzvimba mumakumbo, muzvitsitsinho, netsoka: Kuzvimba uku kunogona kuitika nekuda kwekusabata kwemvura mumuviri. Dzimwe nguva dumbu rinogonawo kuzvimba.
• Kurova kwemoyo nekukurumidza kana kusina kurongeka: Kana uchinzwa shanduko mukurova kwemoyo wako.
• Kukosora kana kufemera nguva dzose: Kukosora kunonyanya kuperekedzwa nemadzihwa machena.
• Kudzikira kwekugona kuita maekisesaizi.
• Kunzwa kuda kurutsa kana kushaya chido chekudya.
• Marwadzo epachipfuva: Izvi zvinogona kukonzerwa nechikonzero chakadai sechirwere chemwoyo.
• Dzungu.

Kana uine chimwe chezviratidzo izvi kana kupfuura, usazviregeredza woona chiremba. Kana ukangozviziva nekukurumidza, zvinova nyore kurapa.

Vanachiremba vanoona sei izvi?

Kana ukaenda kuna chiremba, anokuitira bvunzo dzakawanda kuti aone kana uine systolic heart failure. Chinhu chakakosha ndechekutsvaga chikonzero chacho kuitira kuti ugone kuchirapa zvakanaka.

Maitiro ekuyedza aya anowanzo sanganisira zvinotevera:

1. Kuongororwa kwemuviri:

• Chiremba achakubvunza nezvezviratidzo zvako (kuti zvave nenguva yakareba sei zviripo, kuti zvinonzwa sei, nezvimwewo).
• Vanobvunza nezvezvirwere zvawakamborwara nazvo kare, zvakaita sekuti pane here mumhuri mako ane chirwere chemwoyo.
• Stethoscope inoshandiswa kuteerera mwoyo nemapapu (kutarisa ruzha rusina kujairika uye mvura iri kubuda mumapapu).
• Kumanikidzwa kweropa rako kunoyerwa.
• Uchayerwa uremu (kuti zvionekwe kana wakangoerekana wawedzera uremu, nekuda kwekusawana mvura mumuviri).

2. Kuongororwa kweropa (Kushanda kweropa):

• Kuongororwa kweropa uku kunogona kutarisa kana dzimwe nhengo dzemuviri (dzakadai seitsvo nechiropa) dzakakanganiswa nekushaya simba uku mumoyo.
• Kazhinji, zvinhu zvakaita se'Albumin' (rudzi rweprotein), 'Creatinine' (chimwe chinhu chinotaura nezvekushanda kweitsvo), uye sodium nepotassium (electrolytes) zvinoyerwa.
• Kune bvunzo yeropa inonzi BNP (B-type Natriuretic Peptide). Kana mwoyo wava nekushushikana, huwandu hweBNP iyi muropa hunowedzera. Izvi zvinobatsira zvikuru pakuongorora kutadza kushanda kwemoyo.

3. Kuongororwa kwemifananidzo yemoyo:

• Kuongororwa uku kunogona kuongorora zvinhu zvakawanda, zvakaita sechimiro nehukuru hwemwoyo, ukobvu hwemadziro emasero, kana mavharuvhu ari kushanda nemazvo, uye kana pakambova nekukuvadzwa kubva pakurwara kwemoyo.
• X-ray yechipfuva: Kuona kana moyo wakakura kana kuti mvura yakaungana mumapapu.
• `Echocardiogram (Echo)`: Iyi ndiyo bvunzo inonyanya kukosha. Yakafanana neultrasound scan yemoyo. Inogona kuyera EF value nemazvo. Inogona kuona zvakajeka mashandiro emakamuri nemavharuvhu emoyo.
• Electrocardiogram (EKG/ECG): Muedzo unonyora mashandiro emagetsi emwoyo. Unokwanisa kuona zvinhu zvakaita semutinhimira nekumhanya kwekurova kwemoyo, uye zviratidzo zvekurohwa kwemoyo kwakamboitika.
• Dzimwe nguva, mimwe miedzo yakagadzirwa nehunyanzvi yakaita se `Cardiac MRI`, `Cardiac CT scan`, `Cardiac Catheterization` (Angiogram), `Exercise Stress Test` kana `Nuclear Exercise Stress Test`, `Multigated Acquisition Scan` (MUGA)` inogonawo kuitwa.

Izvi zvinorapwa sei?

Zvakanaka, ngatitarisei kuti tingarapa sei chirwere ichi chemwoyo chinonzi systolic heart failure. Pane zvinangwa zvikuru zvekurapa:

• Kuderedza zviratidzo (zvakadai sekufema zvishoma, kuzvimba).
• Kumisa kana kudzora moyo kuti usanyanya kuneta.
• Kuvandudza hupenyu.
• Kubatsira kuwedzera hupenyu.

Nzira dzekurapa dzinogona kukamurwa muzvikamu zvikuru zvakasiyana:

1. Kuchinja kwemararamiro

Izvi zvakakosha zvikuru. Hazvina kukwana kungotora mushonga chete, unofanirawo kuita zvinhu izvi uri parutivi rwako.

• Deredza munyu: Munyu (sodium) unoita kuti muviri uchengetedze mvura yakawandisa. Izvi zvinowedzera kuzvimba uye zvinoomesa mwoyo. Deredza munyu sezvakarairwa nachiremba wako. Kazhinji, hazvikurudzirwi kudya sodium inodarika 1500-2000 milligrams pazuva.
• Kuderedza mvura: Vamwe vanhu vanoudzwawo kuti vaderedze huwandu hwemvura yavanonwa pazuva. Ichi chinhu chaunofanira kukurukura nachiremba wako wosarudza.
• Ramba uine huremu hwakanaka: Kana wakafuta, edza kudzikisa huremu. Zvakanaka kuzviyera zuva nezuva. Kana ukawedzera huremu kamwe kamwe (kirogiramu imwe kana maviri pazuva), zvinogona kuva chiratidzo chekuti mvura haichanyungudike. Kana izvi zvikaitika, udza chiremba wako .
• Dzivisa kusvuta: Kusvuta kunokuvadza mwoyo netsinga dzeropa zvikuru.
• Deredza kana kurega doro: Doro rinogonawo kuderedza tsandanyama dzemwoyo.
• Kurovedza muviri nguva dzose: Taura nachiremba wako nezve maekisesaizi akakunakira. Tanga zvishoma nezvishoma wowedzera zvishoma nezvishoma maekisesaizi ako. Kufamba kurovedza muviri kwakanaka. Zvingava zvakanaka kana ukakwanisa kutora chikamu muchirongwa chekurapa mwoyo.
• Deredza kushushikana, zorora zvakanaka, uye wana nguva yakakwana yekurara.
• Idya chikafu chine hutano: idya miriwo, michero, chikafu chine fibrous, uye chikafu chine mafuta mashoma.

2. Mishonga (mhando dzemishonga)

Kune mishonga yakawanda inoshanda iripo yekurapa systolic heart failure. Mishonga iyi inogona kuvandudza EF yako, zviratidzo, uye mashandiro emoyo wese. Chiremba wako anogona kukupa imwe kana kupfuura yemishonga iyi pamwe chete.

• Beta-blockers: Izvi zvinovandudza mashandiro emwoyo nekudzikamisa kurova kwemoyo, zvichideredza huwandu hwebasa rinofanira kuitwa nemoyo. Zvinogona kubatsira kudzora BP, kuderedza njodzi yekurwara nemoyo, uye kudzora kurova kwemoyo kusina kurongeka.
• Angiotensin-Converting Enzyme (ACE) inhibitors: Izvi zvinodzora BP, zvinokudza mitsipa yeropa, uye zvinovhara mahormone ekushushikana mumuviri, zvichivandudza mashandiro emoyo nekufamba kwenguva.
• Angiotensin-II Receptor Blockers (ARBs): Izvi zvinopihwa kuvanhu vane migumisiro yakaipa yakaita sekukosora kubva kuACE inhibitors. Zvinoshanda zvakafanana neACE inhibitors.
• Angiotensin Receptor-Neprilysin Inhibitors (ARNIs): Iyi mishonga mitsva uye inoshanda zvikuru. Iyi inoderedzawo mahormone ekushushikana, inovhura mitsipa yeropa, uye inovandudza mashandiro emoyo.
• Mishonga Inodzivirira Kushushikana yeAldosterone (Mineralocorticoid Receptor Antagonists - MRAs): Iyi mishonga inoderedza mahormone ekushushikana uye inobatsira itsvo kubvisa mvura yakawandisa nemunyu mumuviri. Unofanira kungwarira huwandu hwepotassium mumuviri wako paunenge uchitora mishonga iyi.
• Mishonga inobvisa mvura mumuviri (mapiritsi emvura): Iyi mishonga inokurumidza kuderedza zviratidzo (kunyanya kuzvimba nekufema zvishoma) nekubvisa mvura yakawandisa nemunyu kubva muitsvo. Kana mvura yadzikira, zvinova nyore kuti mwoyo upombe ropa.
• Mishonga inodzivirira chirwere cheshuga inonzi SGLT-2: Iyi mishonga pakutanga yaishandiswa pakurapa chirwere cheshuga. Asi gare gare zvakazoonekwa kuti inobatsirawo varwere vane chirwere chemwoyo vasina chirwere cheshuga. Inoburitsa mvura yakawandisa pamwe chete neshuga muweti.

Chinhu chinonyanya kukosha kutora mushonga waunonyorerwa nachiremba wako panguva chaiyo uye muchiyero chawakanyorerwa. Usamborega kutora mushonga kana kuchinja chiyero chako wega.

3. Midziyo nekuvhiyiwa

Vamwe varwere vangasakwanisa kudzora mamiriro avo ezvinhu nekushandisa mishonga nekuchinja mararamiro avo chete. Vangangoda zvinhu zvakaita se:

• ICD (Implantable Cardioverter-Defibrillator): Mudziyo mudiki unoona kurova kwemoyo kusina kurongeka (arrhythmia) uye unoburitsa kuvhunduka kudiki kwemagetsi kumoyo kuti udzorere rhythm yakajairika. Izvi zvinoiswa pasi peganda rechipfuva.
• CRT (Cardiac Resynchronization Therapy) / Biventricular Pacemaker: Mudziyo uyu unobatsira kugadzirisa kusawirirana pakati pemakamuri ekuruboshwe nerudyi emwoyo. Izvi zvinovandudzawo kugona kwemoyo kupomba.
• Kubatanidza Mitsipa yeCoronary Artery Bypass (CABG) kana Angioplasty ine stenting: Rapai mitsipa yecoronary kana yakavharika.
• Kugadziriswa kwemavharuvhu emwoyo kana kuvhiyiwa kwekutsiva.
• Kuisirwa moyo kana LVAD (Chishandiso Chekubatsira Ventricular Chekuruboshwe): Aya ndiwo marapirwo anowanzo fungwa nezvawo kune varwere vanorwara zvakanyanya.

Njodzi yechirwere ichi ingaderedzwa sei?

"Kudzivirira kuri nani pane kurapa," vanodaro. Saka, pane zvinhu zvaunogona kuita kudzivirira kana kuderedza njodzi yekukundikana kwemoyo. Tsika dzakanaka dzehutano ndidzo dzinokosha.

• Idya chikafu chine hutano uye chakaringana (munyu mushoma, mafuta mashoma, miriwo nemichero zvakawanda).
• Rovedza muviri nguva dzose.
• Ramba uine huremu hwakanaka.
• Dzivisa kusvuta zvachose.
• Deredza kunwa doro.
• Kana uine zvirwere zvakaita seBP, chirwere cheshuga, kana cholesterol, zvidzore zvakanaka. Tevedzera mirairo yachiremba wako nokungwarira.
• Deredza kushushikana uye wana nguva yakakwana yekurara.

Ndezvipi zvaunotarisira paunenge uchirarama nemamiriro ezvinhu aya?

Kukundikana kwemoyo kwesystolic chirwere chisingaperi, chinogara kwenguva refu, uye chakakomba. Chingasanyatsorapika. Zvisinei, nekurapwa kwakakodzera uye shanduko dzemararamiro, zviratidzo zvinogona kudzorwa uye hupenyu hwakanaka hunogona kuraramwa.

Mhedzisiro yacho inoenderana nezvinhu zvakati wandei:

• Chirwere chemwoyo chakakomba sei.
• Hutano hwako hwese uye kana uine zvimwe zvirwere (zvakaita sechirwere cheitsvo, chirwere cheshuga).
• Maitiro aunoita kana warapwa.
• Chikonzero chikuru cheizvi chii?

Saka, zvakakosha kuti usatye kana kushatirwa, asi kuti utevedzere mirairo yachiremba nemazvo uye uchinje mararamiro ako. Shanda pamwe chete nechikwata chako chekurapa.

Unofanira kutsvaga rubatsiro rwechiremba nekukasika rini?

Kana ukaona chimwe chezviratidzo izvi, unofanira kutsvaga rubatsiro rwechiremba nekukasika, zvichireva kuti nekukurumidza sezvinobvira :

• Kurwadziwa kwechipfuva kamwe kamwe uye kwakanyanya.
• Kutadza kufema kamwe kamwe uye zvakaoma.
• Kufenda kana kushaya simba kwakanyanya.
• Marwadzo echipfuva, dzungu, kana kushaya mweya nekukasira kana kurova kwemoyo kusina kurongeka.
• Kuzvimba kwemakumbo kamwe kamwe kana kuwedzera uremu.

Mibvunzo ipi yaungabvunza chiremba?

Kana ukaona chiremba wako, unogona kubvunza mibvunzo yakaita seiyi kuti unzwisise zviri nani mamiriro ako ezvinhu:

• Chii chinonyanya kukonzera systolic heart failure yangu?
• Chii chinonzi ejection fraction (EF)? Zvinorevei?
• Dambudziko iri rakanganisa here dzimwe nhengo dzangu (dzakaita seitsvo, chiropa)?
• Ndezvipi zvakanakira nezvakaipa? Ndezvipi zvakanakira nezvakaipa?
• Ndezvipi zvinhu zvinonyanya kukosha zvandinofanira kuchinja muhupenyu hwangu?
• Ndinofanira kudya rudzii rwechikafu nechinwiwa uye ndinofanira kudzivisa chii?
• Ndeapi maekisesaizi andingaite? Ndinofanira kuaita kwenguva yakareba sei?
• Chii chandisingafaniri kuita?
• Ndezvipi zvingakonzera migumisiro yemushonga uyu? Ndingaitei kana zvikaitika?
• Ndinofanira kuuya kuzoongororwa kangani? Chiiko changu cheEF chichaongororwazve?
• Chii chandinofanira kuita kana paine emergency?

Zvinhu zvinonyanya kukosha zvatinofanira kurangarira

Kukundikana kwemoyo kwesystolic chirwere chakakomba, chinotora nguva refu apo ventricle yekuruboshwe yemoyo haigone kupomba ropa nemazvo. Kana uine chimwe chezviratidzo izvi, ndapota ona chiremba. Kana zvikaonekwa nekukurumidza, zviri nyore kurapa uye mhedzisiro yacho iri nani.

Nekurapa chikonzero chacho, kutora mishonga yawakanyorerwa nachiremba wako, uye kuva netsika dzakanaka dzemararamiro, unogona kubatsira kudzora zviratidzo zvako uye kurarama hupenyu hune hutano, hunoshanda, uye hurefu. Usatya, ramba wakasimba! Hausi wega, vanachiremba vako, mhuri, neshamwari dzako varipo kuti vakubatsire.

Kurwara nemoyo , kushaya simba kwemoyo, chikamu chekubuda kweropa, kushaya simba kwemoyo, kushaya mweya, kuzvimba kwemakumbo, zviratidzo zvemoyo