Ingaba ivalvu yentliziyo yakho ivaliwe? Masithethe nge-(Aortic Stenosis)!

Ngaba ngamanye amaxesha uziva iintlungu esifubeni, ukuphefumla kancinci, okanye isiyezi? Okanye ngaba ngequbuliso uziva ubuthathaka okanye unesiyezi? Ezi zinto zinokubangelwa kukuncitshiswa kwenye yeevalvu ezibalulekileyo entliziyweni yakho, ivalvu ye-aorta. Oogqirha babiza le meko ngokuthi yi-Aorta Stenosis. Xa oku kusenzeka, kuba nzima ukuba intliziyo ipompe igazi liye kuwo wonke umzimba. Umzimba awufumani ioksijini eyaneleyo. Le asinto onokuyilinda, kuba ingonakalisa intliziyo, ibangele iingxaki zempilo ezinzulu, kwaye ngamanye amaxesha ide ibe yingozi kubomi.

Ngoko ke yintoni le `(Aortic Stenosis)`?

Ngamafutshane, intliziyo yethu ifana nendlu encinci, inamagumbi amane. Phakathi kwala magumbi, apho igazi liphuma khona entliziyweni, kukho iindawo ezifana neengcango. Sizibiza ngokuba ziivalvu zentliziyo. Enye yezi valve zine ibizwa ngokuba yiAortic Valve. Eli lisango lokugqibela apho igazi lidlula khona lisuka entliziyweni liye kumzimba wonke. Njengomgcini wesango, eli sango livumela igazi ukuba lihambe kwicala elinye kwaye lithintele ukuba libuyele entliziyweni. Le Aortic Valve ineeflaps ezintathu ezincinci (amaphetshana). Ukuba ezi flaps azivuleki kakuhle kwaye zivaleke okanye zinciphe, imeko ebizwa ngokuba yiAortic Stenosis iyenzeka.

Cinga ngayo njengombhobho wamanzi obhajwa embindini uze ube nobunzima bokukhupha amanzi. Kuqhelekile ukuba noloyiko xa usiva ngengxaki ngale ndlela yokungena. Kodwa ngoku kukho iindlela ezininzi eziphambili zokunyanga le meko , ngoko akukho mfuneko yokukhathazeka.

Ixhaphake kangakanani le meko (i-Aortic Stenosis)?

Le meko ibizwa ngokuba yi-`(Aortic Stenosis)` ixhaphake kakhulu kubantu abaneminyaka engaphezu kwama-65 ubudala. Kodwa okubuhlungu kukuba, abantu abaninzi abazi ukuba banale meko de iimpawu zibe nzima. Ngamanye amaxesha ifunyanwa ngexesha lovavanyo olwenziweyo lwenye imeko. Ezinye izifo zinokubangela le meko kubantu abaneminyaka ephakathi, abaneminyaka engama-40-50 ubudala. Kunqabile kakhulu, le `(Aortic Valve Stenosis)` inokwenzeka nakubantwana abancinci njenge-`Congenital condition``.

Zithini iimpawu zoku?

Ayinguye wonke umntu one-Aortic Stenosis oza kuba neempawu ngoko nangoko. Abanye abantu basenokungaziboni izinto kangangeminyaka. Kodwa xa imeko inzima kakhulu, iimpawu ezifana nezi zinokuvela:

• Ukudinwa kakhulu: Usenokuziva udiniwe kangangokuba awukwazi nokwenza imisebenzi yakho yesiqhelo.
• Ukubetha kwentliziyo: Usenokuva intliziyo yakho ibetha, okanye ungaziva ibetha ngokukhawuleza, okanye isifuba sakho singaziva ngathi siyabetha. Oku sikubiza ngokuba yi-"Palpitations".
• Ukudumba kwemilenze namaqatha: Iindawo ezisezantsi zemilenze kunye nezijikeleze amaqatha zinokudumba.
• Intlungu yesifuba: Oku kubizwa ngokuba yi-`(Angina)`. Ingavakala ngathi kukucinezelwa, ukuqina, okanye ubunzima esifubeni. Ngamanye amaxesha le ntlungu ingafikelela entanyeni, emhlathini, engalweni yasekhohlo, okanye nasecaleni lesisu.
• Ubunzima bokuphefumla: Usenokuba nobunzima bokuphefumla, ingakumbi xa udiniwe kancinci, okanye kwanaxa uphumle.
• Ukudinwa, ukutyhafa: Usenokuziva utyhafa, amehlo akho asenokujika abe luhlaza okwesibhakabhaka, kwaye usenokude utyhafe.

Khumbula, ukuba nje unale mpawu akuthethi ukuba une-Aortic Stenosis. Kodwa ukuba uyaqhubeka unazo, ngokuqinisekileyo kuya kufuneka ubone ugqirha . Umboneleli wakho wezempilo angakuthumela kwingcali yentliziyo.

Esi sifo singaba yingozi ngokukhawuleza kangakanani?

Oku kwahlukile kumntu wonke. Kwabanye abantu, le `(Aortic Valve Stenosis)` iba mandundu kancinci, ngokuhamba kweminyaka. Kwabanye, inokuba mandundu ngokukhawuleza, kwanakwiinyanga ezimbalwa. Into ebalulekileyo kukuba, ukuba uyalibazisa ukufumana unyango, usenokungakwazi ukulungisa umonakalo osentliziyweni yakho. Ukuba une`(Aortic Stenosis)` enzima, kukho umngcipheko wokufa ngequbuliso kwentliziyo. Yiyo loo nto ugqirha wakho eza kukuxelela ukuba ungalibaziseki unyango ukuba uneempawu.

Kutheni le nto `(Aortic Stenosis)` isenzeka? Zithini izizathu?

Kukho izizathu ezintathu eziphambili zokuba abantu abadala babe ne-Aortic Stenosis:

1. Ukuwohloka okunxulumene nobudala: Le yeyona nto ixhaphakileyo. Ekuhambeni kwexesha, njenge-limescale kwimibhobho yamanzi, i-calcium inokuqokelelana kwi-aortic valve yentliziyo yakho. Oku kubangela ukuba i-valve iqine kwaye ivaleke, nto leyo ethintela ukuba ivuleke kwaye ivaleke ngokufanelekileyo. Oku kwenzeka rhoqo emva kweminyaka engama-65.

2. Umonakalo obangelwa zizifo: Ukuba ezinye izifo ezibangelwa ziintsholongwane azinyangwa kakuhle, iintsholongwane zingangena egazini zize ziye kwiivalvu zentliziyo. Inkqubo yethu yokuzikhusela komzimba ingonakalisa ezi valve. Umzekelo, ukuba isifo somqala (Strep throat) okanye iScarlet fever asinyangwa kakuhle, isifo esibizwa ngokuba yiRheumatic Fever sinokukhula kwaye sonakalise iivalvu zentliziyo. Lo monakalo ungathatha iminyaka, ngamanye amaxesha amashumi eminyaka, ukuba ubonakale. Oku kudla ngokuchaphazela abantu abangaphezu kweminyaka engama-50 ubudala.

3. Ezinye izifo ezizuzwe njengelifa okanye ezingapheliyo: Izifo ezingaqhelekanga ezifana `(Isifo sikaPaget sethambo)` (isifo esinxulumene namathambo), ukusilela kwezintso (`Ukusilela kwezintso`) kunye `(I-Familial hypercholesterolemia)` (imeko ye-cholesterol ephezulu ezuzwe njengelifa) nazo zinokubangela `(I-Aortic Valve Stenosis). Kwakhona, le ngozi iphezulu kubantu abanezifo zokuzikhusela komzimba ezifana `(Lupus)` kunye `(I-Rheumatoid arthritis)`.

Ngaba zikho ezinye izinto ezibangela oku?

Ewe, kukho ezinye izinto ezininzi ezonyusa umngcipheko wokukhula kwe-`(Aortic Valve Stenosis):`

• Ukuba yindoda.
• Ukuba uneminyaka engaphezu kwama-65 ubudala.
• Ukwanda kwamanqanaba e-cholesterol egazini (i-Hyperlipidemia).
• Ukuba noxinzelelo lwegazi oluphezulu.
• Ukusetyenziswa kweemveliso zecuba (ezifana neecuba, ii-beedis).

Ziziphi iingxaki ezinokubakho ngenxa yale `(Aortic Stenosis)`?

Xa une-`(Aortic Stenosis)`, intliziyo kufuneka isebenze nzima kakhulu ukutyhala igazi kuloo mngxuma umxinwa. Kufana nokuzama ukuvula ucango oluxinzelelweyo. Xa intliziyo isebenza nzima ngale ndlela, inokuba buthathaka ngokuhamba kwexesha. Kungenxa yesi sizathu:

• Ukuhlaselwa yintliziyo
• Ukusilela kwentliziyo ( ukungakwazi kwentliziyo ukupompa igazi elaneleyo emzimbeni)
• Ukufa kwentliziyo ngequbuliso
• Uxinzelelo lwegazi oluphezulu lwemiphunga
• Ukopha kakhulu
• Usulelo lwengaphakathi lentliziyo (`i-Infective endocarditis`)

Iingxaki ezinzulu zinokwenzeka.

Oogqirha bayibona njani le nto?

Ukuba ukrokrela ukuba une-Aortic Stenosis, ugqirha wentliziyo uza kukuxilonga. Esi simo sidla ngokuchongwa ngokusekelwe kwiimpawu zakho (ukuba zikhona) kunye novavanyo olunye okanye ngaphezulu kwezi zilandelayo:

• Uvavanyo lomzimba: Ugqirha uza kujonga imilenze yakho namaqatha akho ukuba akavuvukalanga na, aze amamele intliziyo yakho nge-stethoscope. Ukuba une-aortic stenosis, ukurhawuzelela kwentliziyo luphawu oluqhelekileyo.
• Uvavanyo lwe-ECG (`i-Electrocardiogram - i-ECG okanye i-EKG`): Olu vavanyo lulinganisa umsebenzi wombane wentliziyo.
• I-X-reyi yesifuba, i-Angiography, okanye i-Cardiac CT scan: Zonke ezi zinto zisebenzisa i-X-reyi okanye ezinye iindlela zokujonga ngaphakathi emzimbeni, ingakumbi intliziyo nemiphunga.
• I-Echocardiogram: Olu lolona vavanyo luphambili olusetyenziselwa ukuxilonga i-aortic stenosis. Lusebenzisa amaza e-ultrasound ukubona ngokucacileyo indlela ezisebenza ngayo iivalvu zentliziyo, nokuba zivaliwe na, kunye nendlela igazi elihamba ngayo.
• Uvavanyo loxinzelelo lomthambo: Lulinganisa izinto ezifana nendlela intliziyo yakho esebenza ngayo kunye notshintsho kwi-ECG yakho ngelixa ubaleka kwi-treadmill okanye uqhuba ibhayisekile.
• Ukufakwa kwe-catheter kwintliziyo: Kule nkqubo, ugqirha ufaka ityhubhu encinci, ebhityileyo (i-catheter) emthanjeni osengalweni okanye emlenzeni wakho aze ayifake entliziyweni yakho ukuze alinganise uxinzelelo kwiivalvu zakho aze abone ukuba ziqine kangakanani.
• I-MRI yeNtliziyo (iMagnetic Resonance Imaging): I-magnetic field enamandla ingasetyenziselwa ukuthatha imifanekiso eneenkcukacha ezininzi zentliziyo.

Emva kwezi mvavanyo, ugqirha wakho uza kuhlela imeko yakho ngokusekelwe kwiimpawu zakho kunye nokuba i-aortic valve yakho inciphile kangakanani. Ngokwesiqhelo kukho amanqanaba amane: A, B, C, kunye no-D, apho u-D iyeyona inzima kakhulu.

Ziziphi iindlela zonyango ze-`(Aortic Stenosis)`?

Ukuba une-`(Aortic Stenosis)` kodwa ungenazo iimpawu, oko kuthetha ukuba imeko ayinzima kangako, ugqirha wakho uya kukuxelela ukuba uze kuhlolwa rhoqo kwaye wenze uvavanyo lwe-`(Echocardiogram)`. Kodwa ukuba ufumanisa iimpawu, kuya kufuneka unyango. Kukho iindlela ezininzi zonyango eziphambili:

• Amayeza: Ukuba imeko ayinzima kakhulu, oogqirha banokunika amayeza okulawula iimpawu. Ezi zinokubandakanya amayeza okunciphisa igazi, amayeza okukhupha umchamo, kunye namayeza okuphazamiseka kwentliziyo, uxinzelelo lwegazi oluphezulu, kunye nokusilela kwentliziyo. Kodwa khumbula, amayeza alawula kuphela iimpawu; awanakukuthintela ukuba ivalvu ingabi mandundu.
• Ukulungiswa kweevalvu: Oku kungenziwa ngotyando okanye ngenkqubo ebizwa ngokuba yi-balloon valvuloplasty.
• Ukulungiswa kotyando (`utyando lwe-Aortic valve`): Ugqirha wenza i-incision esifubeni sakho aze aye ngqo kwi-valve yentliziyo, akhulule ukuvaleka, aze ayilungise.
• I-valvuloplasty yebhaluni: Kule nkqubo, ibhaluni enetyhubhu encinci (i-catheter) efakwe entliziyweni iyafuthwa ngaphakathi kwevalvu encitshisiweyo, nto leyo eyandisa ivalvu. Oku kunokunciphisa iimpawu okwethutyana. Ihlala isenziwa kubantu abangakwaziyo ukwenza utyando lokutshintshwa kwevalvu, okanye njengoncedo lwexeshana ngaphambi kotyando.
• Ukutshintshwa kwevalvu: Ukuba ivalvu yonakele kakhulu ukuba ingalungiswa, kuya kufuneka itshintshwe. Kukho iindlela ezahlukeneyo zokwenza oku:
• Utyando lokutshintshwa kwevalvu ye-aorta: Ivalvu eyonakeleyo iyasuswa ize ithathelwe indawo yivalvu entsha. Le valve intsha inokuba ngumntu onikelayo (ngesiqhelo umntu onikelayo), ivalvu ye-bioprosthetic (ngesiqhelo inkomo okanye ihagu), okanye ivalvu yomatshini eyenziwe ngesinyithi.
• Inkqubo kaRoss: Olu lutyando olukhethekileyo. Kule meko, ivalvu yakho yepulmonary iyathathwa ize ityalwe kwindawo apho yayikhona ivalvu ye-aortic. Emva koko, ivalvu evela kumntu onikelayo ifakwa kwindawo apho yayikhona ivalvu yepulmonary.
• Ukutshintshwa kweValve ye-Aortic yeTranscatheter (i-TAVR okanye i-TAVI): Le yindlela entsha nephucukileyo. Lutyando olukhulu, oko kuthetha ukuba ivalvu inokutshintshwa ngaphandle kokuvula isifuba. Ityhubhu encinci (i-catheter) ifakwa ngomthambo omkhulu emlenzeni okanye engalweni, kwaye ivalvu egobileyo idluliselwa kuyo iye entliziyweni, apho ifakwa khona ngaphakathi kwevalvu ye-aortic evalekileyo. Oku kudla ngokwenziwa kubantu abadala abangakwaziyo ukunyamezela utyando olukhulu.

Kuthatha ixesha elingakanani ukuchacha emva kolu nyango?

Oku kuyahluka ngokuxhomekeke kwindlela yonyango esetyenzisiweyo.

• Ukuba utyando:Kuthatha ixesha ukuba uphile. Ngokuqhelekileyo kufuneka uhlale esibhedlele iintsuku ezimbalwa. Nokuba sele ubuyele ekhaya, kungathatha iiveki ezimbalwa, mhlawumbi inyanga okanye ezimbini, ngaphambi kokuba uphile ngokupheleleyo kwaye uqalise imisebenzi yakho yesiqhelo.
• Ukuba ukhe wasebenzisa iinkqubo ezifana neBalloon valvuloplasty okanye iTAVR: Ezi nkqubo zifuna ixesha elifutshane kakhulu lokuchacha. Ngamanye amaxesha ungaya ekhaya ngaloo mini okanye ngosuku olulandelayo emva kwenkqubo. Ungabuyela kubomi bakho obuqhelekileyo kwiintsuku ezimbalwa.

Ngaba ikho indlela yokuthintela uphuhliso lwale `(Aortic Stenosis)`?

I-Aortic Stenosis inokuthintelwa ngenxa yezizathu ezithile. Ngokukodwa, kubaluleke kakhulu ukunyanga usulelo lweentsholongwane ngokukhawuleza nangendlela efanelekileyo. Umzekelo, ukuba une-strep throat infection, kufuneka uthathe amayeza okubulala iintsholongwane njengoko ugqirha wakho emyalele. Akuyonto ilungileyo ukuyeka ukuwasebenzisa kuba nje intlungu iphelile. Ukwenza njalo kunokuthintela umkhuhlane we-rheumatic ukuba ungaphuhli kwaye wonakalise iivalvu zentliziyo.

Nangona kunjalo, kudla ngokuba nzima ukuthintela i-"Aortic Valve Stenosis", enokubangelwa kukwaluphala, izifo ezidluliselwa kwilifa, okanye ezinye izifo ezingapheliyo. Nangona kunjalo, ukulandela indlela yokuphila enempilo yentliziyo (ukutya okunempilo, ukuzilolonga, kunye nokuphepha ukutshaya) kunokunceda ukulawula ukonakala kwesi sifo.

Ukuba ndine-`(Aortic Stenosis)`, ndimele ndilindele ntoni?

Ikamva lemeko yakho ye-Aortic Stenosis, oko kukuthi, indlela oza kuphila ngayo, lixhomekeke kakhulu ekubeni ufumana unyango ngokukhawuleza nangokufanelekileyo kangakanani.

• Ukuba ayinyangwa: I-Aortic Stenosis, ingakumbi ukuba inzima kakhulu, inokuba yingozi ebomini. Uninzi lwabantu aluphili iminyaka engaphezu kwemibini ngaphandle konyango.
• Unyango Olulibazisekileyo: Ukuba unyango lulibazisekile, iziphumo ziyaxubana. Kuxhomekeke ekubeni ingaba kukho umonakalo osisigxina entliziyweni. Okukhona kukho umonakalo omkhulu, kokukhona imeko iya kuba mandundu. Uza kuphila kancinci kancinci, kodwa kunzima ukulindela ukuba uphile ngokupheleleyo.
• Ukuba unyangwa ngokukhawuleza okanye ngokukhawuleza: Ukuba unyangwa ngokukhawuleza nangendlela efanelekileyo, ikamva le-`(Aortic Stenosis)` lihle kakhulu. Kuya kufuneka uye kuhlolwa rhoqo phantsi kweliso likagqirha ubomi bakho bonke, kodwa kungenjalo ungaqhubeka phantse nayo yonke imisebenzi yakho yesiqhelo kwaye uphile ubomi obuhle.

Ndingazinyamekela njani?

• Ukuba i-aortic stenosis yakho incinci kwaye awunazo iimpawu, okufuneka ukwenze kukwenza i-echocardiogram rhoqo kwaye ubone ugqirha wakho.
• Ukuba une-Aortic Valve Stenosis ephakathi, kunokufuneka ujonge iimpawu zakho, wenze ii-echocardiograms rhoqo, unciphise imisebenzi yakho (njengoko kuyalelwe ngugqirha wakho), kwaye uthabathe amayeza athile.
• Ukuba une-aortic valve stenosis enzima, kuya kufuneka uqhubeke ubona ugqirha wakho nokuba sele ulungisiwe okanye utshintshiwe. Amanye amayeza anokufuneka uwathathe ubomi bakho bonke.
• Kuzo zonke iinqanaba, ugqirha wakho uza kukuxelela ukuba utye ukutya okunetyuwa encinci namafutha amaninzi, kwaye wenze umthambo rhoqo. Kodwa kufuneka ubuze ugqirha wakho ukuba loluphi uhlobo lomthambo olulungele wena.

Ndifanele ndimbone nini ugqirha wam?

Nokuba ugqibe ekubeni ungalufuni unyango okanye awukalufumani unyango, kufuneka uthethe nogqirha wakho ngoko nangoko ukuba kukho nayiphi na kwezi zilandelayo:

• Nokuba kuvela uphawu olutsha lwe-`(Aortic Stenosis)`, okanye ukuba iimpawu ezikhoyo ziya zisiba mandundu ngequbuliso.
• Ukuba iimpawu zakho ziqala ukuphazamisa ubomi bakho bemihla ngemihla.

Ndingaya nini kwigumbi likaxakeka (ER)?

Emva kokuqalisa amayeza amatsha, yiya kwigumbi likaxakeka ukuba kukho nayiphi na kwezi zilandelayo:

• Ukuba ufumana isiphumo esingalindelekanga nesinzima esivela kwiyeza (ugqirha wakho uya kukuxelela ukuba zeziphi iziphumo ezingafunekiyo unyango olukhawulezileyo).
• Ukuba uphelelwa lithemba okanye ulahlekelwa bubuthongo nangasiphi na isizathu, kulungile.
• Ukuba uthatha amayeza okunciphisa igazi uze uwe, usengozini enkulu yokopha ngaphakathi - ingakumbi emva kokuwa okanye ukwenzakala kwenye indawo.

Nokuba emva kotyando okanye inkqubo ye-catheter, yiya kwigumbi likaxakeka ukuba kukho nayiphi na kwezi zilandelayo:

• Ukuba inxeba lakho libomvu, lidumbile, okanye lishushu xa ulichukumisa, ezi ziimpawu zosulelo olufuna unyango olukhawulezileyo.
• Ukuba uneempawu eziqatha ze-Aortic Stenosis, ezinje ngobunzima bokuphefumla, iintlungu zesifuba, ukubetha kwentliziyo ngokukhawuleza, okanye ukuquleka.
• Ukuba uthatha amayeza okunciphisa igazi uze uwe, kungenxa yesizathu esifanayo nesichazwe apha ngasentla.

Ndingayibuza yiphi imibuzo ugqirha wam?

Xa usiya kugqirha, ungathandabuzi ukubuza imibuzo efana nale:

• Gqirha, ucinga ukuba iimpawu zam ziya kuba zimbi ngakumbi?
• Ngaba kuya kufuneka nditshintshe ivalvu?
• Loluphi uhlobo lwevalvu olungcono ukuba ndilutshintshe?
• Liliphi ixesha elifanelekileyo lokuba ndenze utyando?
• Ziziphi iindlela zonyango zamva nje zokunyanga oku?

Umyalezo Wokuya Ekhaya

Kulungile, ngoku uyiqonda ngcono imeko esithethe ngayo ebizwa ngokuba yi-`(Aortic Stenosis)`. Ewe, kuyoyikisa kakhulu ukuba nenxalenye yentliziyo yakho, oko kukuthi, isango elibaluleke kakhulu, elingasebenzi kakuhle. Nangona kunjalo, eyona nto ibalulekileyo kukungaphakuzeli kwaye ufune ingcebiso yezonyango ngaphandle kokulibazisa.

Ukuba unayo nayiphi na kwezi mpawu, okanye ukuba kukho umntu kusapho lwakho onesifo sentliziyo, qiniseka ukuba ubona ugqirha aze ahlolwe intliziyo yakho.

Nangona `(Aortic Stenosis)` iyimeko enzima, amayeza aqhubele phambili kakhulu kule mihla. Ngotyando kunye nonyango olutsha olusekelwe kwi-catheter olufana ne`(TAVR)` esithethe ngalo, amandla okusinyanga akakaze abe ngcono. Ngoko ke ungoyiki. Ukuba uyibona kwangethuba isifo kwaye ufumane unyango olufanelekileyo, ungaphila ubomi obusempilweni nobonwabisayo kwakhona. Nyamekela intliziyo yakho, kulungile?

I- Aortic Stenosis, Ivalvu Yentliziyo, Isifo Sentliziyo, Intlungu Yesifuba, Ubunzima Bokuphefumla, Utyando Lwentliziyo, I-TAVR