Ngaba ngamanye amaxesha uziva uxinene esifubeni sakho, njengokuthimla? Okanye ngaba ukufumanisa kunzima ukuphefumla xa uzibhokoxa kancinci? Ngamanye amaxesha oku kunokubangelwa ziingxaki zeevalvu ezikwintliziyo yethu, ezisebenza njengeengcango. Namhlanje siza kuthetha ngesifo esinxulumene neAortic Valve, enye yezona "ngcango" zibalulekileyo entliziyweni. Oku sikubiza ngokuba yi-`(Aortic Valve Disease)`.
Yintoni kanye kanye le `(Isifo se-Aortic Valve)`?
Ngamafutshane, ivalvu ye-aortic ivumela igazi ukuba liphume kwigumbi eliphambili lokumpompa lentliziyo yakho (i-ventricle yasekhohlo) liye kumthambo wegazi omkhulu (i-aorta) othwala igazi liye kuwo wonke umzimba wakho. Isebenza njengomnyango ophambili wendlu. Cinga ngayo, lo mnyango kufuneka uvuleke kwaye uvalwe ngexesha elifanelekileyo.
- Xa ivula: Ngalo lonke ixesha intliziyo ibetha, le valve kufuneka ivuleke ngokupheleleyo, ivumele lonke igazi ukuba liphume entliziyweni, liye kwi-aorta. Kulapho ke kuphela apho elo gazi liza kubonelela umzimba wonke ngeoksijini kunye nezondlo.
- Xa uvala: Emva kokuba igazi liphumile, le valve kufuneka ivaleke kakuhle, ithintele igazi ukuba lingabuyeli entliziyweni.
Ukuba enye okanye zombini ezi zinto azisebenzi kakuhle, sithetha ngemeko ebizwa ngokuba yi-`(Aortic Valve Disease)`.
Kukho iintlobo ezimbini eziphambili zale nto, akunjalo?
Ewe, kukho iintlobo ezimbini eziphambili ze-`(Isifo se-Aortic Valve)`. 1.
`(I-Aortic Stenosis)` - Ukuncitshiswa kwevalvu: Oku kuxa ucango lwentliziyo, oko kukuthi, ivalvu ye-aortic, luba mxinwa kwaye lungakwazi ukuvula kakuhle. Khawuthelekelele ukuba ucango luvuleka kancinci. Emva koko akukho ndawo yaneleyo yokuba igazi liphume entliziyweni. Intliziyo kufuneka isebenze nzima ukutyhala igazi kulo mnyango umxinwa. 2.
`(Ukuvuselelwa kwe-Aortic)` - Ukuvuza kwevalvu: Oku kuxa ucango lungavali kakuhle. Ukuba ucango aluvali kakuhle, elinye igazi eliphumileyo liphinda lingene entliziyweni. Kanye xa impompo yamanzi ingavalwa kakuhle, amanzi ayavuza.
Eyona nto ibalulekileyo kukuba, nokuba unenye yezi meko okanye zombini, usenokungazi nokuba unesifo okwethutyana. Oku kungenxa yokuba iimpawu zihlala zibonakala kuphela emva kokuba isifo sihambe kancinci. Ngoko ke kubalulekile ukukwazi oku.
Ngubani onokuba nethuba elikhulu lokufumana esi sifo?
Nangona nabani na enokuba nale meko ibizwa ngokuba yi-"Aortic Valve Disease," abanye abantu basengozini enkulu. Nazi:
- Abantu abangaphezu kweminyaka engama-60 ubudala: Njengoko ukhula, utshintsho kwiivalvu lunokwenzeka.
- Abantu abazalwa benomahluko omncinci kwiivalvu zentliziyo: Umzekelo, kukho imeko ebizwa ngokuba yi-" Bicuspid Aortic Valve ". Ngokwesiqhelo, ivalvu ye-aortic ineencwadana ezintathu. Kodwa aba bantu baneencwadana ezimbini.
- IndaloAbantu abanesifo sentliziyo (`(Isifo sentliziyo esizalwa naso)`).
- Abantu abaye bafumana unyango lwemitha esifubeni: Unyango lwemitha esifubeni lunikwa iintlobo ezithile zomhlaza (umz., iHodgkin Lymphoma). Oku kunokuchaphazela iivalvu ngokuhamba kwexesha.
- Abantu abaneSifo seNtliziyo esiHlanganisiweyo: I-Rheumatic fever, eqala njengosulelo lomphimbo, inokonakalisa iivalvu zentliziyo.
Kumazwe afana neMelika neYurophu, oku kuthathwa njengesona sifo sixhaphakileyo nesiyingozi kwizifo zevalvu yentliziyo. Kuthiwa abantu aba-6 kwaba-10 abafa ngenxa yezifo zevalvu yentliziyo bafa ngenxa yoku. Oko kuthetha ukuba ukuba udibanisa zonke ezinye izifo zevalvu (mitral, pulmonary, tricuspid) kunye, inani labafayo lingaphezulu.
Zithini iimpawu zoku?
Njengoko besitshilo ngaphambili,
kusenokungabikho zimpawu kwaphela kwizigaba zokuqala. Nangona kunjalo, njengoko isifo siqhubeka, unokuqala ukuva izinto ezifana nezi:
- Intlungu yesifuba okanye ukuxinana: Kusenokuvakala ngathi kukho umntu ocinezela isifuba sakho.
- I-Syncope: Ukulahlekelwa yingqondo ngequbuliso.
- Ukubetha kwentliziyo: Usenokuziva ngathi intliziyo yakho ibetha ngokukhawuleza ngequbuliso, okanye unokuva isandi "esibetha ngamandla" esifubeni sakho.
- Ukuphelelwa ngamandla: Ubunzima bokuphefumla , ingakumbi xa usenza into ethile, usenza umthambo, ulele phantsi, okanye ulele ebusuku.
- Ukudumba kwemilenze namaqatha: Ukudumba kwemilenze engezantsi.
Kutheni oku kusenzeka? Zithini izizathu?
Kunokubakho izizathu ezahlukeneyo zokuba esi `(iSifo se-Aortic Valve)` siphuhliseke.
- Ivalvu iyaphela xa ikhula: Le yeyona sizathu siphambili. Njengokuba iindawo zomatshini ziphela xa zisetyenziswa.
- Isifo sentliziyo esibizwa ngokuba yiRheumatic Heart Disease: Njengoko bekutshiwo ngaphambili, irheumatic fever ibangela umonakalo kwiivalvu.
- Isifo sentliziyo esizalwa naso: Umzekelo, ukuba ne-bicuspid aortic valve.
- Uxinzelelo lwegazi oluphezulu : Ukuba noxinzelelo lwegazi oluphezulu kangangexesha elithile kunokuchaphazela neevalvu.
- Usulelo lweevalvu zentliziyo (endocarditis): Ukonakala kweevalvu ngenxa yosulelo lweebhaktheriya.
- Ukulimala esifubeni kunye neengozi.
- I-Thoracic Aortic Aneurysm: Ukudumba kwe-aorta.
- Ukuqhekeka kwe-Aorta: Ukukrazuka eludongeni lwe-aorta.
- Unyango lwemitha esifubeni (kwizinto ezinje ngomhlaza).
Zithini izinto ezibangela umngcipheko?
Kukho umngcipheko omkhulu wokufumana esi sifo ngezinto ezifana nezi:
- Ukuba uneminyaka engaphezu kwama-60 ubudala.
- Ukuba kukho ukuqina kunye ne-calcium deposits kwi-valve (i-Aortic Valve Sclerosis) (kule meko, i-valve ayikancitshiswa, kodwa inokuba luphawu lokuqala lwesifo).
- Ukuba unesiphene sevalvu yokuzalwa, ingakumbi i-`(Bicuspid Aortic Valve)`.
- Ukuba ukhe waba nomkhuhlane wamathambo ngaphambili.
- Ukuba ukhe waba nosulelo lwevalvu yentliziyo (endocarditis).
- Ukuba uneengxaki ezithile zempilo ezifihlakeleyo (umzekelo, iMarfan Syndrome, iEhlers-Danlos Syndrome, iLupus).
Ngaba kukho amanqanaba esi sifo?
Ewe, esi sifo siqhubeka kancinci kancinci. Oogqirha basebenzisa amanqanaba amane ukuchaza ubukhali baso:
- Inqanaba A (Emngciphekweni / Inqanaba A): Ivalvu yakho ye-aorta isebenza kakuhle ngeli xesha, kodwa ubuncinane unento enye enokubangela esi sifo.
- Inqanaba B (Eliqhubekayo): Eli liSifo seValve ye-Aortic esincinci ukuya kwesesiphakathi. Kukho utshintsho oluncinci ekusebenzeni kwevalvu, kodwa awunazo iimpawu okwangoku.
- Inqanaba C (Asymptomatic Severe / Inqanaba C): Olu luhlobo olubi lweSifo se-Aortic Valve. Usenokungabi nazimpawu ngelixa usenza imisebenzi yakho yesiqhelo. Nangona kunjalo, unokufumana iimpawu ngexesha lovavanyo loxinzelelo lomthambo.
- C1: Intliziyo isenako ukupompa igazi elaneleyo emzimbeni.
- C2: Intliziyo ayinakukwazi ukupompa igazi elingako (Inxalenye Yokukhupha Imithambo Yasekhohlo - `(Inxalenye Yokukhupha Imithambo Yasekhohlo)` ingaphantsi kwama-50%.
- Inqanaba D (Iimpawu Ezinzima): Unesifo esibi se-aortic valve esibangela iimpawu kubomi bakho bemihla ngemihla. Ekuqaleni, iimpawu zinokuvela kuphela ngexesha lokuzilolonga, kodwa kamva, iimpawu zinokuvela nokuba awuzilolongi.
Zeziphi iingxaki ezinokubangela oku?
Esi sisifo esinzulu, kwaye ukuba asinyangwa ngokufanelekileyo, sinokukhokelela kwiingxaki ezinkulu.
Eyona ngxaki ixhaphakileyo neyingozi kukusilela kwentliziyo . Oku kuthetha ukuba intliziyo yakho ayikwazi ukupompa igazi elaneleyo emzimbeni wakho. Oku kunokukhokelela ekulahlekelweni kokusebenza komzimba wonke. Ezinye iingxaki ziquka:
- Ukubetha kwentliziyo okungaqhelekanga (`(Arrhythmia)`).
- Ukuhlaselwa yintliziyo.
- Ukubanjwa Kwentliziyo Ngequbuliso (`(Ukubanjwa Kwentliziyo Ngequbuliso)`).
- Istroke (`(Istroke)`).
Uyibona njani le nto? Zeziphi iimvavanyo ezisetyenziswa ngoogqirha?
Oogqirha bayasixilonga esi sifo ngokukuxilonga nokwenza ezinye iimvavanyo ezikhethekileyo. Ngexesha lovavanyo, ugqirha uya kwenza oku kulandelayo:
- Bakubuza ngeemeko zakho zempilo, njengokuthi kukho umntu onesifo sentliziyo kusapho lwakho na.
- Iimpawu zakho ezibalulekileyo (uxinzelelo lwegazi, izinga lokubetha kwentliziyo, njl.njl.) ziyajongwa.
- Intliziyo iphulaphulwa nge-stethoscope (`(Auscultation)`). Ukuba uva isandi sentliziyo esingaqhelekanga (esibizwa ngokuba yi-`(Murmur)`), isenokuba luphawu lwe-`(Aortic Valve Disease)`.
- Kwenziwa i-ECG (i-electrocardiogram). Oku kujonga ukusebenza kombane kwentliziyo.
Ukongeza,
i-`(Echocardiogram)` (Echocardiogram) lolona vavanyo luphambili nolungcono lokuxilonga `(Isifo seValve ye-Aortic)`. Oku kusebenzisa amaza esandi aqhelekileyo (`(Ultrasound)`) ukuthatha imifanekiso ephilayo yentliziyo kunye neevalvu. Oku kungabonisa yonke into ukususela ekubeni ivalvu iyavuleka kwaye ivala ngokufanelekileyo na ukuya ekubeni igazi lihamba ngasemva na. Ezinye iimvavanyo onokuba nazo:
- Ukufakwa kweCatheterization yentliziyo (`(Ukufakwa kweCatheterization yentliziyo)`).
- I-CT scan yentliziyo.
- I-X-ray yesifuba.
- I-angiogram yentliziyo (`(I-Angiogram yentliziyo)`).
- Uvavanyo loxinzelelo lokuzivocavoca (`(Uvavanyo loxinzelelo lokuzivocavoca)`).
- I-MRI yentliziyo.
Luthini unyango?
Unyango luxhomekeke kwizinto ezahlukeneyo, kuquka uhlobo lweSifo se-Aortic Valve onaso (i-stenosis, i-regurgitation, okanye zombini), ukuba siqhubele phambili
kangakanani (inqanaba), kunye nobunzima beempawu zakho. Ugqirha wakho uya kuvavanya imeko yakho aze akucebise isicwangciso sonyango esifanelekileyo kuwe. Iindlela zonyango zingabandakanya:
- Amayeza: Amayeza awanakunyanga ngokupheleleyo ingxaki yakho yevalvu. Kodwa anokunceda ukulawula iimpawu, ukunciphisa uxinzelelo entliziyweni yakho, kunye nokunciphisa umngcipheko weengxaki. Ugqirha unokukunika amayeza okuthintela ukubetha kwentliziyo okungaqhelekanga, ukunciphisa uxinzelelo lwegazi, ukulawula i-cholesterol, okanye ukunyanga ukungasebenzi kakuhle kwentliziyo.
- I-Valvuloplasty: Le yinkqubo encinci engadingi kuvulwa okukhulu. Ityhubhu encinci ifakwa emlenzeni okanye engalweni yakho, kwaye ibhaluni ekupheleni isetyenziselwa ukwandisa ivalvu yakho ye-aortic enciphileyo. Ukuba une-aortic stenosis, oku kunokuphucula ukuhamba kwegazi kwivalvu. Nangona kunjalo, oku kudla ngokuba sisisombululo sexeshana.
- Utyando lweValve yeNtliziyo: Kule nkqubo, ugqirha uza kulungisa ivalve yakho ye-aortic okanye ayitshintshe ngentsha. Ivalve entsha inokuba yivalve yethishu okanye ivalve yentliziyo eyenziwe ngento efana nentsimbi. Ngamanye amaxesha, oogqirha benza utyando lwevalve kunye ne-coronary artery bypass grafting (CABG) okanye olunye utyando lwentliziyo.
- Ukutshintshwa kweValve ye-Aortic yeTranscatheter (TAVR): I-TAVR yindlela entsha, engenabungozi kangako kunotyando lwentliziyo oluqhelekileyo. Endaweni yokwenza umngxuma omkhulu esifubeni, kufakwa ityhubhu encinci ngemithambo yegazi emlenzeni ukuze kufakwe ivalve entsha ye-aortic entliziyweni, kwaye ivalve endala iqiniswe ngaphakathi.
- Inkqubo kaRoss: Le yinkqubo efuna ivalvu entsha ye-aortic, ingakumbi kubantu abangaphantsi kweminyaka engama-60 ubudala. Ugqirha utshintsha ivalvu yakho ye-aortic ngevalvu yakho ye-pulmonary (ivalvu ethwala igazi ukusuka entliziyweni ukuya emiphungeni), aze atshintshe ivalvu ye-pulmonary esusiweyo ngevalvu ye-pulmonary yomnikelo. Le yinkqubo enzima ngakumbi.
Ngaba zikho iindlela zokuphepha oku?
Isifo se-Aortic Valve asisoloko silula ukusithintela. Sidla ngokubangelwa kukwaluphala, isifo sentliziyo esizalwa naso, okanye iimeko zonyango ezihlala ixesha elide ezinzima ukuzilawula. Nangona kunjalo, ungenza oku kulandelayo ukunciphisa umngcipheko wakho kwaye ugcine iivalvu zentliziyo yakho zisempilweni kangangoko kunokwenzeka:
- Ziphephe ngokupheleleyo iimveliso zecuba kunye neziyobisi zokuzonwabisa. Ezi ziyingozi kakhulu entliziyweni.
- Zilolonge ubuncinane imizuzu engama-30 phantse yonke imihla evekini. Nokuba yinto elula njengokuhamba okanye ukukhwela ibhayisekile ilungile.
- Xa ugula, ingakumbi ukuba unentsholongwane efana ne-strep throat, bonana nogqirha ngoko nangoko. Ukuba ayinyangwa, le ntsholongwane ingajika ibe yi-rheumatic fever kwaye yonakalise iivalvu zentliziyo.
- Sela amayeza owanikwe ngugqirha wakho (umz., amayeza oxinzelelo lwegazi oluphezulu okanye i-cholesterol) ngokuchanekileyo nangexesha.
- Ukuba unesifo sevalvu, bona ugqirha wakho rhoqo ukuze ahlolwe ukuze anyangwe ngokukhawuleza. Okukhona sifunyanwa kwangoko, kokukhona unyango luphumelela ngakumbi.
Yintoni ekufuneka uyazi xa uphila nale meko?
Wakuba ufunyenwe une-Aortic Valve Disease, indlela eza kukuchaphazela ngayo ixhomekeke kwizinto ezininzi. Ezi ziquka ukuba ufunyenwe nini, ukuba isifo sihambe
kangakanani , kunye nempilo yakho iyonke. Kubalulekile ukuthetha ngokukhululekileyo nogqirha wakho malunga nekamva lakho. Banokukunika umbono ocacileyo wendlela oza kusabela ngayo kunyango kunye nento onokuyilindela. Ugqirha wakho uza kukunika iingcebiso malunga notshintsho lwendlela yokuphila kunye nendlela onokuzinyamekela ngayo imihla ngemihla. Landela le miyalelo ngononophelo, kwaye ubuze nayiphi na imibuzo onayo. Ugqirha wakho unokucebisa izinto ezinje:
- Yamkela ukutya okunempilo kwentliziyo (njengokutya kwaseMedithera): Yitya imifuno, iziqhamo, iimbotyi, iintlanzi, kunye nokutya okutyebileyo kwi-fiber. Nciphisa ityuwa, iswekile, kunye neoyile.
- Ukuzilolonga: Nangona kunjalo, kuxhomekeke ekubeni isifo sakho se-Aortic Valve sinzima kangakanani na, usenokuba nemida yokuzilolonga. Kubalulekile ukubuza ugqirha wakho ukuba yintoni kanye kanye omawuyenze nengafanele uyenze.
- Yeka ngokupheleleyo ukutshaya okanye ukusebenzisa ezinye iimveliso zecuba.
- Ukuthintela usulelo lwe-valve yentliziyo (endocarditis), kubalulekile ukuba unakekele amazinyo akho neentsini kakuhle: Ukuxubha amazinyo akho imihla ngemihla kunye nokubona ugqirha wamazinyo rhoqo kubalulekile.
Ndifanele ndimbone nini ugqirha?
Ugqirha wakho uza kukuxelela ukuba kufuneka uye kugqirha wakho kangaphi.
Kubalulekile ukuba ugcine onke amadinga akho. Ugqirha wakho uza kwenza uvavanyo oluqhelekileyo, olufana ne-echocardiogram, ukujonga ukusebenza kwentliziyo yakho kunye nevalvu yakho. Olu vavanyo lunokunceda
ugqirha wakho ukuba acebise unyango olufanelekileyo kwaye anciphise umngcipheko weengxaki ezizayo.
Fowunela ugqirha wakho ngoko nangoko ukuba:- Ukuba iimpawu zakho (ezifana neentlungu zesifuba, ukuphefumla kancinci) ziya zisiba mandundu.
- Ukuba ubonakalisa iimpawu ezintsha.
- Ukuba uneziphumo ebezingalindelekanga ezivela kumayeza akho.
Ufanele uye nini kwigumbi likaxakeka?
Ukuba kwenzeka into efana nale kuwe
, yiya kwigumbi likaxakeka lesibhedlele esikufutshane ngoko nangoko, okanye utsalele umnxeba ku-1990:- Kulungile ukuba uyafa isiqaqa okanye ulahlekelwe zingqondo.
- Ukuba uyawa ngelixa usela amayeza okunciphisa igazi (umz. iWarfarin, iAspirin). La mayeza andisa umngcipheko wokopha ngaphakathi ukuba uyawa okanye wenzakele.
- Ukuba uneempawu zosulelo kwinxeba lakho (ububomvu, ukudumba, umkhuhlane, ububomvu obunuka kakubi) emva kotyando okanye inkqubo.
- Ukuba uneempawu zokuhlaselwa yintliziyo (`(Iimpawu zokuhlaselwa yintliziyo)`): iintlungu eziqatha esifubeni, ubunzima bokuphefumla, iintlungu eziphuma engalweni yasekhohlo, entanyeni, emhlathini, ukubila, isicaphucaphu, ukuhlanza.
- Ukuba ngequbuliso ufumana ubunzima obukhulu bokuphefumla.
- Iimpawu zestroke ziquka: ukungaziva okanye ubuthathaka kwelinye icala lomzimba, intetho engacacanga, ukugoba kwelinye icala lobuso, utshintsho olukhawulezileyo embonweni, kunye nentloko ebuhlungu kakhulu.
Ukufumanisa ukuba unesifo se-Aortic Valve kunokuba yinto eyoyikisayo neyoyikisayo. Yinto eqhelekileyo leyo. Kodwa iindaba ezimnandi zezokuba ngonyango oluphambili lwanamhlanje, ungazinciphisa kakhulu iimpawu zakho, unciphise umngcipheko weengxaki, kwaye uphile ubomi obusempilweni nobusebenzayo. Ukuba uziva uxhalabile okanye ukhathazekile ngekamva, ukuthetha nabanye abantu abanesifo se-valve yentliziyo kunye nokujoyina amaqela enkxaso kunokunceda. Buza ugqirha wakho ngayo.
Ngoko ke, zeziphi izinto ezibalulekileyo esifanele sizithathele ekhaya kweli bali?
Isifo se-Aortic Valve sisifo esichaphazela i-valve ebaluleke kakhulu entliziyweni yethu kwaye sinokuba sibi kakhulu. Kodwa
ungalibali ukuba ukuba siqatshelwe kwangethuba, silandelwe yingcebiso efanelekileyo yezonyango, kwaye sinyangwa ngokufanelekileyo, sinokulawulwa kakuhle. Ukuba uneempawu, ingakumbi iintlungu zesifuba, ukuphefumla kancinci, ukudinwa, okanye ukuquleka, musa ukuzityeshela ucinga ukuba "yinto eyahlukileyo."
Bona ugqirha ngoko nangoko kwaye ufumane ingcebiso. Khumbula, ukunyamekela intliziyo yakho lolona ncedo lukhulu onokulwenza kuwe! Intliziyo ephilileyo ithetha ubomi obusempilweni.
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