Kurova kwemoyo wako kwava kusashanda zvakanaka here? Ngatidzidzei nezve Ventricular Dyssynchrony nenzira iri nyore!

Dzimwe nguva unonzwa kushaya mweya, kuneta nguva dzese, kana kuzvimba makumbo here? Izvi zvinogona dzimwe nguva kuva zviratidzo zvedambudziko remoyo wako. Nhasi tichataura nezvechirwere chinokanganisa mashandiro emoyo, asi pamwe hatina kunzwa zvakawanda nezvazvo. Ndiyo ventricular dyssynchrony , kana sekudanwa kwazvinoitwa navanachiremba, ``(Ventricular Dyssynchrony)``. Kunyangwe zita racho ringanzwika serakaoma zvishoma, ngatitsanangure zviri nyore.

Chii chinonzi Ventricular Dyssynchrony?

Zvichitaurwa zviri nyore, ventricular arrhythmia inguva apo imwe kana kupfuura emakamuri epasi emwoyo wako, anonzi maventricles , anorova zvisina kuenzana uye pasina kubatana. Fungidzira kuti pane kunonoka kudiki kweinenge mamirisekonzi makumi mana pakati pezvikamu zvakasiyana zvemasero emwoyo wako zvinotanga kukotama, kana pakati pesero rimwe rinotanga kukotama kana tichienzanisa nerimwe. Izvozvo zvinogona kunzi arrhythmia.

Mwoyo wedu unoshanda zvakanaka chete kana tsandanyama dziri mumakamuri awo dzichikotamira panguva imwe chete uye nenzira imwe chete. Kazhinji, zviratidzo zvemagetsi zvinofamba nepakati pemoyo nenzira yakarongeka. Kana makamuri maviri makuru emoyo akagamuchira chiratidzo chekukotamira, tsandanyama dziri mumakamuri iwayo dzinofanira kukotamira kusvika pamwero wakafanana uye panguva imwe chete. Kunyanya, ventricle yako yekuruboshwe, imba huru yekupomba yemoyo, inofanira kukotamira nenzira yakarongeka. Zvakafanana nekusunda kubva kumativi ese kuenda pakati.

Zvisinei, kana chiratidzo ichi chikasasvika kumasero ese emwoyo panguva imwe chete, tsandanyama hadzigone kukwenya panguva imwe chete. Ndizvo zvatinodaidza kuti dyssynchrony .

Kusashanda zvakanaka kwemasero kunogona kukanganisa muviri wako nenzira dzinotevera:

• Zvinoderedza kushanda zvakanaka kwemoyo wako.
• Mavharuvhu anowanzo batsira ropa kufamba nenzira imwe chete anogona kukonzera kuti ropa rifambe richidzokera shure (richienda nenzira isiriyo).
• Huwandu hweropa rinogona kupombwa nemoyo wako (Cardiac Output) hunoderera.

Ndeapi marudzi e arrhythmias yemwoyo?

Kune mhando dzinoverengeka dzeasynchrony yemasero:

• Atrioventricular Dyssynchrony: Apa ndipo apo makamuri epamusoro (atria) nemakamuri epasi (ventricles) emwoyo wako anogumira pasina kubatana.
• Kusashanda zvakanaka kwemukati memoyo: Muizvi, maventricle ako ekuruboshwe nekururudyi (makamuri epasi) anogumira panguva dzakasiyana.
• Intraventricular Dyssynchrony: Muizvi, tsandanyama dziri muzvikamu zvakasiyana zvesero rimwe chete dzinogumira panguva dzakasiyana. Funga nezvazvo semadziro ekamuri anogumira panguva dzakasiyana, pane kusundidzirwa mukati panguva imwe chete.

Ndiani anonyanya kukanganiswa neasynchrony yemasero?

Chirwere ichi chinowanzoonekwa kune vanhu vane zvirwere zvinotevera:

• Vanhu vane chirwere chemwoyo.
• Bhuroko reBazi reKuruboshwe (LBBB).
• Chivharo cheBazi reKurudyi cheBundle (RBBB).
• Chirwere chetsandanyama dzemwoyo `(Cardiomyopathy)`.
• Kukwira kweropa.
• Zvimwe zvirwere zvemoyo.

Funga nezvaSekuru Somapala vekumusha kwedu. Vakanga vachirwara ne `(Heart Failure)` kwenguva yakati. Munguva pfupi yapfuura, vanga vachinetseka kufema uye vachinyanya kuneta. Chiremba paakavaongorora, vakati vane chirwere ichi chinonzi `(Ventricular Dyssynchrony)` mumoyo mavo, ndosaka zviratidzo zvavo zvawedzera kuipa.

Dambudziko iri rakajairika zvakadii?

Vanhu vanosvika chikamu chimwe muzvitatu vane imwe mhando yekushaya simba kwemoyo vanogona kusangana nerudzi urwu rwekusawirirana kwemasero. Vanhu vakuru vanosvika 2% munyika dzakabudirira vanotambura nekushaya simba kwemoyo. Uyewo, pakati pe6% ne10% yevanhu vane makore anopfuura 65 vane kushaya simba kwemoyo. Saka, chirwere ichi chimwe chinhu chinoonekwawo maererano nazvo.

Zviratidzo zvacho ndezvipi?

Kusashanda zvakanaka kwemasero kunogona kuwedzera zviratidzo zvekushaya simba kwemoyo, kana kutokonzera zviratidzo zvakasiyana. Izvi ndizvo zvikuru:

• Kuoma kufema (kunyanya kana wakaneta).
• Kunzwa kuneta zvakanyanya (kunyangwe kwenguva pfupi).
• Kukosora (zvichida kunoramba kuripo).
• Kuzvimba (edema) mumuviri (kunyanya munzvimbo dzakadai semakumbo netsoka).

Ndezvipi zvikonzero zvekusawirirana kwemaseru?

Matambudziko akasiyana-siyana emwoyo anogona kukonzera izvi. Mamwe acho ndeaya:

• Kusashanda zvakanaka kweVhini.
• Mavanga anokonzerwa nechirwere chemwoyo.
• Kunonoka kwekufambisa magetsi, kunosanganisira mamiriro akaita seLeft Bundle Branch Block neRight Bundle Branch Block.
• Tsandanyama dzemwoyo dzine chirwere.
• Kusafamba zvakanaka kweropa kuenda kutsandanyama yemwoyo (Ischemia).

Ndedzipi bvunzo dzinoitwa kuti chirwere ichi chionekwe?

Chiremba wako achatanga akubvunza nezvezviratidzo zvako uye oita bvunzo yemuviri kuti aongorore mashandiro emoyo wako. Dzimwe nguva , kuteerera moyo wako uchishandisa stethoscope kunogonawo kukupa pfungwa yeasynchrony iyi.

Bvunzo huru inoshandiswa kuongorora matambudziko ane chekuita nemagetsi emoyo ielectrocardiogram (ECG) . Inogona kuona mamiriro akaita seRight Bundle Branch Block neLeft Bundle Branch Block, izvo zvinoita kuti mwoyo urove zvisina kurongeka. Kana mamiriro aya akawanikwa paECG, chiremba achakutumira kuti uongororwe zvimwe.

Vanachiremba vanowanzo shandisa echocardiogram kuona kusagadzikana kwemoyo . Izvi zvinovabatsira kuona kuti makamuri emwoyo, mavharuvhu, uye tsandanyama dziri kudhonzana sei.

Mimwe miedzo inogona kuitwawo:

• Kuongororwa kwePositron Emission Tomography (PET).
• Kuongororwa kweMultigated Acquisition (MUGA).
• Kufungidzira Magineti Emoyo (MRI).
• Kuongororwa kwekombiyuta (CT) (Computerized Tomography).
• Kuongororwa kweSingle Photon Emission Computed Tomography (SPECT).

Kusawirirana kwemasero kunorapwa sei?

Vanachiremba vanogona kurapa chirwere chiri kukonzera kusawirirana kwemasero ako.

Kazhinji, kurapa kwemwoyo (CRT) (inonziwo CRT kana kuti biventricular pacemaker) kunogona kubatsira moyo kupomba zviri nani nekudzora kurira kwemativi ese emwoyo. Zvisinei, kurapwa uku kunongovandudza zviratidzo mu50% kusvika 70% yevanhu vanowana kurapwa uku. Vanhu vane asynchrony yakanyanya vanowanzobudirira.

Matambudziko ekurapwa kweCRT

Matambudziko anotevera anogona kuitika kana uchiisa `CRT` (bi-polar pacemaker) (aya haawanzoitiki, asi zvakanaka kuziva nezvawo):

• Pneumothorax.
• Kuungana kweropa pakati pemadziro echipfuva nemapapu (Hemothorax).
• Kuboorwa kwemoyo.
• Kukurudzirwa kwetsandanyama dzisiri dzemoyo.
• Vatungamiriri vepacemaker vachibuda panzvimbo yavo.

Ndichakurumidza sei kunzwa zviri nani mushure mekurapwa?

Kurapa neCRT kunoderedza kusawirirana kwemasero nekukasika. Vamwe vanhu vanotanga kunzwa zviri nani mukati memavhiki mashoma mushure mekuisirwa mudziyo. Kunewo mabhenefiti enguva refu:

• Kuvandudza huwandu hweropa rinopombwa nemoyo wako (Cardiac Output).
• Kuderedza kubuda kweropa kubva pavharuvhu yemitral.
• Kuvandudza hupenyu hwako.
• Nharaunda yaunogona kufamba nayo mumaminitsi matanhatu inowedzera.

Mushonga upi unoshandiswa?

Pazvirwere zvinokonzera atrial fibrillation, zvakaita sekushaya simba kwemoyo, cardiomyopathy, kana BP yakakwira, chiremba anogona kunyora mishonga yakaita se:

• MaInhibitors eAngiotensin-Converting Enzyme (ACE).
• MaAngiotensin II Receptor Blockers (ARBs).
• Beta-Blockers.
• Zvinodhaka zvinoderedza mvura (diuretics).

Kunyange zvazvo mishonga iyi ichigona kuvandudza mashandiro emwoyo wako kusvika pamwero wakati, haigone kuchinja zvachose kusawirirana kunokonzerwa nekusashanda zvakanaka kwemagetsi. Ndosaka kurapwa kwakadai seCRT kuchidikanwa.

Ungaderedza sei njodzi yekusawirirana kwemaseru?

Chinhu chakanakisa chaungaita kuchengetedza moyo wako zvakanaka. Kana ukadaro, uchakwanisa kudzivirira mamwe ematambudziko anokonzera kusawirirana kwemasero.

Dzimwe nzira dzekudzivirira moyo wako:

• Idya chikafu chine mafuta mashoma (deredza mafuta akakangwa nezvikafu zvisina mafuta).
• Edza kurovedza muviri kwemaminitsi makumi matatu mazuva ese (kunyangwe kufamba zvakanaka).
• Kuchengetedza huremu hwakanaka kwauri.
• Kutora mushonga sezvakarairwa nachiremba.

Chii chinoitika kana ndikaita kuti masero asawirirane?

Kushaya simba kwemoyo (LVD) kweLeft Ventricular Dyssynchrony (LVD) hakurapwe, uye mhedzisiro yacho haina kunaka. Vanhu vane LVD vari panjodzi huru yezviitiko zvemwoyo kupfuura avo vasina chirwere ichi. Unogona kuva nedysynchrony mu (kana kuti ese ari maviri) emaventricles ako, asi ventricle yako yekuruboshwe ndiyo inonyanya kupomba ropa rine oxygen mumuviri wako wese. Iri ibasa rakakosha zvikuru.

Kurapa kunonzi `CRT` (dual-cell pacemaker) kunogona kubatsira vanhu vane chirwere chemwoyo kuderedza kugara muchipatara uye kurarama kwenguva yakareba.

Yeuka, chikonzero chikuru chekusawirirana kwemazwi chinokanganisawo mhedzisiro yacho. Mamiriro evamwe vanhu anogona kunge akaipa kupfuura evamwe.

Ndinozvitarisira sei?

• Kana chiremba wako akakunyorera mushonga, iva nechokwadi chekuti wautora sezvakarairwa . Inwa mushonga sezvakarairwa kusvika chiremba wako akuudza kuti urege.
• Kana uine biventricular pacemaker, yeuka kuenda kumakiriniki pamazuva akarongwa . Apa ndipo panogona kuongororwa nachiremba wako kana pacemaker yako iri kushanda nemazvo. Zvimwe zvipatara zvine makiriniki akakosha anonzi maCRT clinics. Ikoko, vanachiremba vemwoyo nenyanzvi dzemwoyo vanoshanda pamwe chete kuti vave nechokwadi chekuti uri kushandisa zvakanyanya pacemaker yako.

Ndinofanira kuona chiremba wangu rini?

• Kana usiri kunzwa zviri nani nemishonga yawakanyorerwa.
• Kana paine dambudziko ne biventricular pacemaker yako.

Muzviitiko zvakadaro, enda kuna chiremba nekukasika.

Ndinofanira kuenda kuDhipatimendi reEmergency (ETU) riini?

Kana ukaona chimwe chezviratidzo izvi , tsvaga rubatsiro rwechiremba nekukasika:

• Kurwadziwa pachipfuva kana kusagadzikana.
• Vertigo (kunzwa sekunge uri kutenderera).
• Kunetseka zvakanyanya kufema.
• Kurwadziwa kwemudumbu, kuda kurutsa.
• Kurwadziwa kwemusana, mutsipa, kana shaya.

Mibvunzo ipi yandinofanira kubvunza chiremba wangu?

Usakanganwa kubvunza mibvunzo iyi kana waona chiremba wako:

• Sei ndakagadzira kusawirirana kwemasero?
• Ndakakodzera here kurapwa kwe 'CRT'?
• Pane mapoka ekutsigira anobatsira vanhu vane chirwere chemwoyo here?

Zvakajairika kuti unzwe kunetseka zvishoma paunoona kuti mwoyo wako hausi kushanda zvakanaka. Asi usazvidya mwoyo. Chiremba wako anogona kuwana chikonzero che arrhythmia yako uye osarudza mushonga wakanakira iwe. Tevedzera mirairo iri pabhodhoro remushonga nemazvo. Kutora mushonga wako panguva imwe chete zuva rega rega kuchakubatsira kurangarira kuutora. Maka mazuva ako ekusangana pakarenda kana kuisa chiyeuchidzo pafoni yako. Izvi zvichakubatsira kuti usapotsa mazuva acho.

Pfupiso uye Mharidzo Yekuenda Nayo Kumba

Zvakanaka, saka ndinovimba wava kunzwisisa zviri nani ``Ventricular Dyssynchrony'' yatataura nezvayo nhasi.

Zvichitaurwa zviri nyore, iyi inyaya yekuti makamuri epasi (masero) emwoyo anorova zvisina kuenzana, zvisingaenderane. Izvi zvinogona kuderedza kushanda kwemoyo, uye zvinogonawo kukonzera zviratidzo zvakaita sekushaya mweya uye kuneta.

• Miedzo yakaita se `(ECG)` uye `(Echocardiogram)` inobatsira kuona chirwere ichi.
• Sekurapa, pamusoro pekurapa chirwere chiripo, kurapwa kwepacemaker kunonzi ``Cardiac Resynchronization Therapy (CRT)`` kwakakoshawo zvikuru.
• Kuchengetedza moyo wako uye kutevedzera mararamiro ane hutano zvinobatsira zvikuru mukudzivirira matambudziko akadaro.
• Kana uine zviratidzo izvi, usazeza kutsvaga rubatsiro rwechiremba. Kana chirwere chikaonekwa nekukurumidza uye chikarapwa, mhedzisiro yacho inova nani.

Yeuka, moyo wako ndiwo chinhu chako chinokosha kupfuura zvose. Ibasa rako kuuchengetedza.

Chirwere chemwoyo , ventricular dyssynchrony, ventricular tachycardia, kurwiswa kwemoyo, CRT, pacemaker