Ngaba wakha waziva ngathi untywiliselwa emanzini, isifuba sakho siqinile, iinyawo zakho zidumbile, izihlangu zakho zidumbile kangangokuba awukwazi nokuzinxiba? Waziva udiniwe kakhulu, awukwazi nokunyuka izinyuko... Musa ukuzithatha nje njengezibuhlungu zomzimba. Ezi zinokuba ziimpawu ezinzulu zokusilela kwentliziyo ngokukhawuleza . Le yingxamiseko yezonyango esongela ubomi. Ngoko ke, ungoyiki. Namhlanje, siza kuthetha ngayo yonke into ngendlela elula neqondakalayo.
Kulungile, yintoni le ngxaki yentliziyo ekhawulezileyo (Acute Heart Failure)?
Ngamafutshane, oku kubhekisa kwimeko apho intliziyo yethu ngequbuliso ingakwazi ukupompa inani legazi elinomoya-mpilo elifunekayo emzimbeni.
Khawuthelekelele ukuba umzimba wakho sisixeko esikhulu, kwaye intliziyo yakho yeyona ndawo iphambili yokumpompa amanzi enika loo mzi amanzi. Lo gama nje le ndawo yokumpompa isebenza kakuhle, yonke indlu nayo yonke indawo esixekweni ifumana amanzi. Kodwa, kwenzeka ntoni ukuba le ndawo yokumpompa ibuthathaka okanye yaphuka ngequbuliso? Isixeko silahlekelwa ngamanzi, akunjalo? Yiyo loo nto. Xa ipompo ibiza intliziyo yethu ibuthathaka ngequbuliso, amalungu abalulekileyo emzimbeni wethu njengengqondo, izintso, nesibindi awafumani ioksijini kunye nesondlo abasidingayo. Oku kubizwa ngokuba yi-Acute Heart Failure.
Le meko ayisenzeka ngobusuku obunye. Rhoqo, xa intliziyo kufuneka ithwale umthwalo owongezelelweyo ngokuhamba kwexesha, iqala ukutshintsha kancinci kancinci.
- Intliziyo ekhulisiweyo: Njengokuba izihlunu zomntu ophakamisa iintsimbi zikhula, xa kufuneka usebenze nzima kakhulu, izihlunu zentliziyo zinokuqina kwaye intliziyo inokukhula.
- Ukujikeleza kwegazi okunciphileyo: Njengoko intliziyo ibuthathaka, ubungakanani begazi eliyimpompayo buyancipha.
- Ukuncitshiswa kwemithambo yegazi: Njengoko umzimba uzama ukuziqhelanisa noku, nemithambo yegazi isenokuncitshiswa.
- Ukubetha kwentliziyo okukhawulezayo okanye okungahambelaniyo (i-Arrhythmia): Uxinzelelo entliziyweni lubangela ukuba ilahlekelwe sisigqi sayo esiqhelekileyo.
- Ukuqina kwemisipha yentliziyo: Imisipha yentliziyo inokuba lukhuni kwaye ingaguquguquki.
Olu tshintsho luncinci kakhulu ekuqaleni. Usenokungaziva zimpawu. Kodwa ngokuhamba kwexesha, olu tshintsho luyanda kwaye xa intliziyo ingasakwazi ukumelana nomthwalo, kwenzeka imeko engxamisekileyo ebizwa ngokuba yi-Acute Heart Failure.
Oku kudla ngokuba yeyona nto iphambili ebangela ukuba abantu abangaphezu kweminyaka engama-65 ubudala bangeniswe esibhedlele. Kodwa khumbula, oku kunokwenzeka nakubani na wanoma yimuphi ubudala.
Ngaba kukho iintlobo ezahlukeneyo zezi?
Ewe, kukho iintlobo ezimbini kuphela.
1. Ukusilela Kwentliziyo Okungahlawulwanga Kakhulu (ADHF): Oku kwenzeka ukuba sele unesifo sentliziyo (umzekelo, isifo semithambo yegazi emithanjeni yegazi, uxinzelelo lwegazi oluphezulu). Eli ligama elinikwa lona xa intliziyo yakho ibibuthathaka ixesha elide, kwaye ngesizathu esithile (njengokungasebenzisi amayeza, ukutya ityuwa eninzi), imeko iba mandundu ngequbuliso.
2.Ukusilela Kwentliziyo Okubukhali: Kwimeko enjalo, awuzange ube nesifo sentliziyo ngaphambili. Nangona kunjalo, esinye isifo sempilo, esifana nesifo seswekile, besisoloko silimaza intliziyo yakho ixesha elide ungaqondanga, kwaye esi sifo sinokuvela ngequbuliso.
Zithini iimpawu zoku? Ungazibona njani ngokukhawuleza?
Ukuba unenye okanye ngaphezulu kwezi mpawu, yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) esibhedlele ngoko nangoko, ngaphandle kokulibazisa. Esi asisosifo esinokugcinwa ekhaya.
Ezi mpawu zinokuqondwa ngokucacileyo kwitheyibhile engezantsi.
| Uphawu | Indlela oziva ngayo |
|---|---|
| Ubunzima obukhulu bokuphefumla (i-Dyspnea) | Olu lolona phawu luphambili nolunzima . Lunokuvakala ngathi uyafuthaniseka, isifuba sakho siqinile, kwaye uyatshona. Oku kuba kubi ngakumbi xa ulele ebhedini kwaye uzive ungcono kancinci xa uhleli. |
| Ukudumba kwemilenze, amaqatha, neenyawo (i-Edema) | Xa intliziyo ingakwazi ukupompa igazi ngokufanelekileyo, ulwelo luyaqokelelana kwiindawo ezisezantsi zomzimba. Xa uzicinezela ngomnwe wakho, zivakala zibetha ngamandla. Ngamanye amaxesha, isisu sinokudumba. |
| Ukudinwa nokudinwa okugqithisileyo | Ndiziva ndidiniwe kakhulu nokuba andenzanga nto okanye ndithule nje. Ndiziva ndibuthathaka kakhulu ukuba ndingavuka ebhedini. |
| Ukubetha kwentliziyo okukhawulezayo okanye okungahambelaniyo (i-Arrhythmia) | Uziva ngathi uyasiva isifuba sakho sibetha, okanye ukuba isingqisho sentliziyo yakho sitshintshile. |
| Intlungu yesifuba okanye ukuxinana | Kungavakala ngathi kukho umthwalo onzima ocinezela isifuba sakho, ngathi isifuba sakho siyacinezelwa. |
| Ukukhwehlela okungapheliyo | Ngenxa yolwelo oluzalisa imiphunga, ukukhwehlela okune-mucus emhlophe okanye epinki kunokubakho. |
| Ukulahlekelwa yingqondo | Ukudinwa kunye nokulahlekelwa zingqondo kunokwenzeka ngenxa yokuncipha komthamo wegazi elifikelela engqondweni. |
Khumbula! Ezi mpawu zinokuvela ngequbuliso. Ukuba uzibona, musa ukuhlala ekhaya. Yonke imizuzwana yobomi bakho ixabisekile.
Kutheni oku kusenzeka? Zithini izizathu?
Nantoni na ebangela uxinzelelo okanye uxinzelelo olungaphezulu entliziyweni inokubangela oku. Nazi ezinye zezizathu eziphambili:
- Isifo semithambo yentliziyo: Ukuvaleka kwemithambo yegazi ehambisa igazi entliziyweni ngenxa yokufakwa kwe-cholesterol.
- Uxinzelelo lwegazi oluphezulu: Uxinzelelo lwegazi oluphezulu olungalawulwayo lubangela ukuba intliziyo isebenze nzima ngokuhamba kwexesha.
- Isifo seValve yentliziyo: Xa iivalve ezisentliziyweni zingavali okanye zingavuli kakuhle, igazi liqala ukuhamba libuyela umva.
- I-Cardiomyopathy: Ukubuthathaka, ukuqina, okanye ukwanda kwemisipha yentliziyo ngenxa yezizathu ezahlukeneyo.
- Ukubetha kwentliziyo ngendlela engaqhelekanga (Arrhythmia): Ukubetha kwentliziyo ngendlela engaqhelekanga okanye engaqhelekanga.
- I-Pulmonary Embolism: Le yimeko engxamisekileyo ebangela uxinzelelo oluphezulu ngesiquphe kwicala lasekunene lentliziyo.
- Isifo seswekile esingalawulekiyo: Isifo seswekile singonakalisa imithambo yegazi kunye nemithambo-luvo kwaye siyenze buthathaka intliziyo.
- Isifo sezintso: Xa izintso zingasebenzi kakuhle, amanzi netyuwa ziyaqokelelana emzimbeni, nto leyo ebangela uxinzelelo entliziyweni.
- Ingxaki Yokusebenzisa Utywala: Ukusela kakhulu ixesha elide konakalisa ngokuthe ngqo izihlunu zentliziyo.
- Usulelo olubangelwa ziintsholongwane: Ezinye iintsholongwane (umzekelo, intsholongwane enxulumene nesifo sentliziyo esibangelwa ziirheumatic) zinokosulela izihlunu zentliziyo kwaye zizenze buthathaka.
Ziziphi izinto ezibangela umngcipheko kule meko?
Nokuba unenye yezi meko zingasentla, kukho izinto ezithile ezinokubangela ukuba umntu aqalise ngequbuliso i-Acute Heart Failure. Ezi sizibiza ngokuba 'zii-triggers'.
- Ukungawasebenzisi kakuhle amayeza anikwe ngugqirha:Ukuba awuzithathi kakuhle amayeza akho oxinzelelo lwegazi oluphezulu, isifo seswekile, okanye isifo sentliziyo, esi sifo sinokungalawuleki size sibeke uxinzelelo olungakumbi entliziyweni yakho.
- Ukungalawuli utywala obusela ityuwa namanzi: Ukuba ugqirha wakho ukuxelela ukuba unciphise ityuwa kwaye unciphise utywala obusela amanzi, ngokuqinisekileyo kufuneka ubalandele. Ukutya ityuwa eninzi kubangela ukuba umzimba wakho ugcine amanzi. Intliziyo yakho ebuthathaka kufuneka isebenze nzima ukupompa la manzi agqithisileyo.
- Ukusetyenziswa kotywala neziyobisi: Ezi zinto ziyonakalisa ngqo intliziyo.
- Ezinye ii-painkillers (NSAIDs): Ukusetyenziswa rhoqo kwezinye ii-painkillers, ezifana ne-ibuprofen, ngaphandle kwengcebiso kagqirha nako akulunganga entliziyweni.
Ugqirha uyibona njani le nto?
Xa usiya kwiYunithi yoNyango oluNgxamisekileyo (i-ETU), oogqirha baya kukuxilonga ngokukhawuleza baze bazame ukufikelela kwisifo.
1. Bakubuza imibuzo emininzi: malunga neempawu zakho, ezinye izifo onazo, nokuba kukho nabani na kusapho lwakho onesifo sentliziyo, amayeza owaselayo, kunye nokuba uyatshaya na.
2. Uvavanyo lomzimba: Isifuba nemiphunga iphulaphulwa nge-stethoscope. Imilenze ijongwa ukuba ayinakudumba na kwaye imithambo entanyeni ijongwa. Uxinzelelo lwegazi luyalinganiswa.
Emva koko, kwenziwa iimvavanyo ezininzi ukuqinisekisa ukuxilongwa.
| Uvavanyo | Ulindele ntoni kuyo? |
|---|---|
| I-ECG (i-Electrocardiogram) | Irekhoda umsebenzi wombane wentliziyo. Iyakwazi ukubona izinto ezifana nokuhlaselwa yintliziyo kunye nokubetha kwentliziyo okungaqhelekanga. |
| I-X-reyi yesifuba | Oku kunceda ukujonga ukuba intliziyo ikhulu na okanye imiphunga izaliswe lulwelo. |
| I-Echocardiogram (ukuskena kwentliziyo) | Oku kufana nevidiyo yentliziyo. Ungazibona ngokucacileyo izinto ezininzi ezifana nendlela intliziyo ebetha ngayo, ukusebenza kakuhle kokupompa igazi (i-Ejection Fraction), kunye nomsebenzi weevalvu. |
| Uvavanyo lwegazi lwe-BNP | Xa intliziyo ixinezelekile, izihlunu zentliziyo zikhupha ihomoni egazini. Ngokulinganisa inqanaba lale homoni egazini, sinokufumanisa ukuba ingaba imbangela yokuphefumla kancinci kukusilela kwentliziyo okanye yinto enye. |
| Ezinye iimvavanyo zegazi | Izinto ezifana nomsebenzi wamalungu anjengezintso, isibindi, kunye ne-thyroid gland, kunye namanqanaba etyuwa egazini, ziyajongwa. |
Zithini iindlela zonyango zoku?
Unyango lunokwahlulwa lube ziinxalenye ezimbini: unyango olungxamisekileyo kunye nolawulo lwexesha elide.
Unyango olungxamisekileyo
Kwi-ETU, injongo yokuqala yoogqirha kukuzinzisa imeko yakho.
- Unyango lwe-oksijini: I-oksijini ifakwa ngemaski yobuso ukunciphisa ubunzima bokuphefumla nokubuyisela amanqanaba e-oksijini egazini.
- I-Diuretics - "iipilisi zamanzi": La mayeza anikwa njengeenaliti ukunceda umzimba ukhuphe ngokukhawuleza amanzi agqithisileyo emzimbeni ngomchamo. Oku kunciphisa ubungakanani bamanzi emiphungeni, okwenza kube lula ukuphefumla kwaye kunciphise ukudumba.
- IiVasodilators: La mayeza andisa imithambo yegazi, anciphisa ukumelana namandla entliziyo okupompa igazi, kwaye anciphisa uxinzelelo kuyo.
Unyango kunye nolawulo lwexesha elide
Emva kwengxakeko, isifo esibangele le ngxaki kufuneka sinyangwe.
- Amayeza: Kuya kufuneka uqhubeke usebenzisa amayeza ahlukeneyo (umz., ii-beta-blockers, ii-ACE inhibitors) eziphucula ukusebenza kwentliziyo, zilawula uxinzelelo lwegazi, kwaye zikhusela intliziyo.
- Utyando nezinye iindlela: Ngamanye amaxesha amayeza ewodwa anganelanga. Kwimeko enjalo, kusenokufuneka usebenzise izinto ezifana nezi:
- I-Angioplasty kunye ne-Stenting: Ukuvula umthambo wentliziyo ovalekileyo kunye nokufaka isixhobo esifana ne-mesh (stent) ukuthintela ukuba ungavaleki kwakhona.
- Utyando lwe-Bypass: Utyando lokudala indlela entsha yokuba igazi lijikeleze umthambo ovalekileyo.
- Ukulungiswa/Ukutshintshwa kweValve: Ukulungiswa kweevalve zentliziyo ezineengxaki okanye ukufakwa kwevalve yokwenziwa.
- Ukufakelwa kwesixhobo se-pacemaker okanye i-ICD: Ukuba ukubetha kwentliziyo akuhambelani kakuhle, ezi zixhobo zifakwa phantsi kwesikhumba sesifuba ukuze sibuyele esiqhelweni.
- Ukufakelwa kwentliziyo:Ukufakelwa intliziyo ephilileyo kumntu ofileyo engqondweni kwiimeko zentliziyo ezikwinqanaba lokugqibela ezingenakunyangeka ngalo naluphi na olunye unyango.
Ndingaphila njani nale meko?
Inyaniso kukuba, esi sisifo esibi kakhulu. Umntu okhe waba naso usengozini enkulu yokuba naso kwakhona. Ezinye izifundo zibonise ukuba inani elikhulu labantu abanaso esi sifo bayafa kungekapheli nonyaka.
Kodwa, ungakhathazeki. Akunjalo kubo bonke abantu. Indlela yakho yekamva iya kuxhomekeka kwizinto ezimbalwa:
- Isifo esibangela oku kunye nobunzima baso.
- Indlela okhawuleze ngayo ukufumana unyango.
- Impilo yakho iyonke kunye nendlela umzimba wakho osabela ngayo kunyango.
- Eyona nto ibalulekileyo: ukuzinikela kwakho kwindlela yokuphila enempilo nentliziyo.
Ukuba uzimisele kwaye ulandela imiyalelo kagqirha wakho ngokuchanekileyo, ungayilawula kakuhle le meko kwaye uphile ubomi obude.
Ndingenza ntoni emva kokuphuma esibhedlele?
Ukubuyela ekhaya uvela esibhedlele akuthethi ukuba kuphelile. Enyanisweni, ubomi bakho obutsha, obunempilo yentliziyo buqala apho.
- Sela amayeza akho ngexesha: Musa ukulibazisa idosi enye.
- Zilinganisele rhoqo kusasa: Zilinganisele ngaxeshanye, ungenanto okanye unxibe impahla elula, uze uyibhale phantsi encwadini. Ukunyuka ngesiquphe kwe-1-2 kg ngosuku okanye ezimbini kunokuthetha ukuba ugcina amanzi. Ukuba oku kuyenzeka, yazisa ugqirha wakho ngoko nangoko.
- Lawula ityuwa: Yeka ngokupheleleyo ukongeza ityuwa ekutyeni kwakho nokutya ukutya okunetyuwa eninzi, njengeepickles, intlanzi eyomisiweyo, iisosi kunye neesoseji.
- Amanzi kunye nolwelo: Musa ukudlula ubungakanani bolwelo (kuquka amanzi, iti, ubisi, kunye nesuphu) ugqirha wakho ucebisa ukuba ulusele ngosuku.
- Yeka ukutshaya notywala ngokupheleleyo.
- Ukuzilolonga okulula: Ziqhelise kancinci njengokuhamba njengoko ugqirha wakho ekucebisile.
- Yiya kwiikliniki ngemihla emiselweyo: Qiniseka ukuba uya kugqirha ngeentsuku akunika zona ukuba umbone.
Umyalezo Wokuya Ekhaya
- Ukusilela kwentliziyo okukhawulezileyo yingxaki yezonyango . Ukuba ufumana iimpawu, musa ukuhlala ekhaya.
- Ukuphefumla okungapheliyo, ukudumba kwemilenze, ukuqina kwesifuba, kunye nokudinwa kakhulu zezona mpawu ziphambili. Ukuba ezi mpawu zikhona, yiya kwiSebe lezeMpilo eNgxamisekileyo (ETU) esibhedlele ngoko nangoko.
- Isizathu esiphambili soku zezinye iimeko zonyango ezibeka uxinzelelo entliziyweni, ezifana noxinzelelo lwegazi oluphezulu kunye nesifo semithambo yegazi emithanjeni yegazi.
- Xa unyango olungxamisekileyo lubonelelwa esibhedlele kwaye imeko izinzile, oku kufuneka kulawulwe ixesha elide ngokusebenzisa amayeza kunye notshintsho kwindlela yokuphila.
- Ubomi bakho busezandleni zakho. Ngokulandela imiyalelo kagqirha (ukuthatha amayeza, ukulawula ityuwa namanzi okusebenzisayo, kunye nokuphepha ukutshaya) ngokuchanekileyo, ungaphila ubomi obusempilweni.
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