Ngaba imiqondiso yombane yentliziyo yakho nayo ivaliwe? Masithethe ngeBifascicular Block!

Ngaba ngamanye amaxesha ngequbuliso unamehlo aluhlaza okwesibhakabhaka uze uzive unesizungu ? Okanye uzive ngathi intliziyo yakho ibetha ngokukhawuleza kakhulu okanye icotha kakhulu? Mhlawumbi umntu omaziyo ukhe wehlelwa yinto efana nale. Ngamanye amaxesha oku kunokubangelwa kukuphazamiseka okuncinci kwinkqubo yombane yentliziyo yethu, njengenkqubo yocingo endlwini. Namhlanje, siza kuthetha ngemeko ekhethekileyo apho isignali yombane ihamba kancinci okanye iphazamiseka malunga nesibini kwisithathu seendlela eziphambili kwinkqubo yocingo yombane yentliziyo - oko kubizwa ngokuba yi (Bifascicular Block) .

Yintoni le (iBloko yeBifascicular)? Masiyiqonde ngokulula?

Ngamafutshane, `(Bifascicular Block)` luhlobo lwe-heart block. Ukuze intliziyo yethu isebenze njengepompo, kufuneka ifumane imiqondiso yombane ngendlela ehlelekileyo. Le miqondiso yombane ihamba ngeendlela ezikhethekileyo entliziyweni. Sibiza le mizila ngokuthi ``bundle branches``. Kufana neengcingo endlwini efuna ukukhanyisa izibane.

Khawuthelekelele ukuba kukho iindlela ezintathu eziphambili entliziyweni yethu ezithwala le miyalezo yombane. Kwi-"Bifascicular Block"`, imiqondiso yombane ihamba kancinci kakhulu okanye iphazanyiswa kwezi ndlela zimbini kwezi zintathu. Igama elithi "Bi" lithetha "ezimbini". Igama elithi "Fascicle" libhekisa kumasebe eeseli zemisipha yentliziyo. Ngoko ke, xa kukho ukuvaleka kwezi ndlela zimbini, imiqondiso yombane ithunyelwa kade kancinci kwiindawo ezisezantsi zentliziyo ("ventricles"). Oku kunokutshintsha isigqi sentliziyo kunye nendlela epompa ngayo igazi.

Oogqirha bakubiza oku ngokuthi “ukuvinjwa kwentliziyo okungaphelelanga.” Le meko inokubangelwa sisifo sentliziyo sokuzalwa okanye ezinye iimeko zentliziyo. Ngamanye amaxesha, iimpawu zisenokuphela. Nangona kunjalo, imeko enzima yeBifascicular Block ebangela iimpawu inokufuna unyango.

Ziphi ezi fascicles ezintliziyweni zethu?

Uyazi ukuba intliziyo yethu ineegumbi ezine eziphambili. Iigumbi ezimbini eziphezulu zibizwa ngokuba yi-atria, kwaye iigumbi ezimbini ezisezantsi zibizwa ngokuba zii-ventricles. Ezi gumbi ziyafinyela kwaye zande ngendlela elawulwayo ukuze zipompe igazi emzimbeni wonke.

Ibhloko ye-bifascicular ichaphazela la magumbi asezantsi, okanye ii-ventricles.

• I-ventricle yasekunene: Le ikwicala lasekunene elisezantsi lentliziyo. Yiyo ethatha igazi ilithumele emiphungeni ukuze ifumane ioksijini. Le ventricle yasekunene inendlela enye yombane ephambili (i-fascicle) – oko kukuthiIsebe lephakheji lasekunene .
• I-ventricle yasekhohlo : Le ikwicala elisezantsi lasekhohlo lentliziyo. Lelona gumbi lokumpompa likhulu nelinamandla entliziyweni. Lithatha igazi elineoksijini kwaye liyipompe liye kuwo wonke umzimba nge- aorta . I-ventricle yasekhohlo ineendlela ezimbini eziphambili zombane: i-fascicle yasekhohlo yangaphambili kunye ne-fascicle yangasemva yasekhohlo . Zidibene, ezi zimbini zakha isebe le-bundle lasekhohlo. Ezi zahlulahlula zibe zizigidi zeefayibha ezincinci ezibizwa ngokuba zii-Purkinje fibers.

Yintoni iHeart Block kunye neBundle Branch Block?

Ukuvaleka kwentliziyo kwenzeka xa kukho ingxaki kwinkqubo yokuhambisa umbane yentliziyo. Oku kubangela ukulibaziseka kokudluliselwa kwemiqondiso yombane phakathi kwamagumbi entliziyo. Ngenxa yoko, amagumbi entliziyo ayancipha ngaphandle kwesigqi. Oku kuchaphazela ukuhamba kwegazi entliziyweni, ukubetha kwentliziyo, kunye nesantya sentliziyo.

`(Ibhloko yeNtliziyo)` kunye `(Ibhloko yeAtrioventricular / Ibhloko yeAV)` zimeko efanayo. `(Ibhloko yeSebe leBundle)` luhlobo lwe `(Ibhloko yeNtliziyo).` Kwenzeka xa kukho ukuvaleka kwelinye lamasebe e-bundle esithethe ngawo.

Isebenza njani inkqubo yombane ezintliziyweni zethu? Iyamangalisa, akunjalo?

Khawuthelekelele ngaphakathi entliziyweni kukho inkqubo yocingo entsonkothileyo kakhulu, kodwa ecwangcisiweyo kakhulu. Nantsi indlela olu phawu lombane oluhamba ngayo:

1. Isignali iqala kwindawo ekhethekileyo kwi-atrium ephezulu yentliziyo ebizwa ngokuba yi-SA node. Le yi-pacemaker yendalo yentliziyo.

2. Olu phawu luhamba nge-atria luze lufike kwenye indawo ekhethekileyo ebizwa ngokuba yi-AV node.

3. Emva kwe-AV node, isignali ingena kwindlela ebizwa ngokuba yi-bundle of His.

4. Ukusuka apho, yahlulahlula ibe lisebe le-bundle lasekunene kunye nesebe le-bundle lasekhohlo, ize ekugqibeleni iye kwi-fibres ezincinci ezibizwa ngokuba yi-``Purkinje fibers`` kwiiseli ze-``ventricles``.

5. Xa esi siginali sifunyenwe, ii-ventricles ziyafinyela zize zipompe igazi. Emva koko inkqubo iqala kwakhona kwasekuqaleni.

Konke oku kwenzeka ngemizuzwana embalwa, ngokumangalisayo, akunjalo?

Ngaba kukho iintlobo zeebhloko zentliziyo?

Ewe, oogqirha bahlula ezi blocks zentliziyo (ii-AV blocks) ngokobunzima bazo:

• Ibloko yenqanaba lokuqala: Oku kukulibaziseka okuncinci kwimiqondiso yombane esuka kwi-atria ukuya kwi-ventricles. Nangona kunjalo, olu hlobo lwebloko alunakwenzeka kangako ukuba lubangele iimpawu kwaye aludingi unyango.
• Ukuvimba kwenqanaba lesibini: Kulapho ezinye iimpawu zombane, kodwa kungekhona zonke, zivaliwe khona ukuba zingafikeleli kwiiseli. Oku kunokubangela isantya sentliziyo esicothayo ( bradycardia ) okanye ukubetha kwentliziyo okungahambelaniyo (arrhythmia). Ukuba oku kubi kakhulu okanye kubangela iimpawu eziphazamisayo, unyango lunokufuneka.
• Ibhloko yenqanaba lesithathu: Oku kukwabizwa ngokuba yi-"complete heart block." Apha, akukho nxibelelwano phakathi kokusebenza kwe-atria kunye ne-ventricles. Oku kuthetha ukuba amagumbi aphezulu asebenza njengoko kufanele, kwaye amagumbi asezantsi asebenza njengoko kufanele. Kule meko, kufuneka kufakwe i-pacemaker. Ukuba "ibhloko ye-bifascicular" iba nzima, le meko inokukhula.

Ngaba kukho iintlobo ezahlukeneyo zeBifascicular Block?

Ewe, kukho iipateni ezahlukeneyo ze-`(Bifascicular Block)`. Ezona zixhaphakileyo zezi:

• Ibhloko yesebe ephethe i-bundle yasekunene kunye nebhloko ye-fascicular yangaphambili yasekhohlo.
• Kwakhona, kunokubakho ibhloko yesebe enesixa sasekunene kunye nebhloko ye-fascicular engasemva ekhohlo.
• Ngamanye amaxesha, isebe le-bundle lasekhohlo linokuvalwa ngokupheleleyo (oko kuthetha ukuba zombini i-fascicles yangaphambili neyangasemva zasekhohlo zivaliwe, kodwa isebe le-bundle lasekunene alinakonakala).

Ixhaphake kangakanani le meko?

I-Bifascicular Block ifumaneka kubantu abamalunga ne-1.5% abafumana i- ECG . Oko akuthethi ukuba ayiqhelekanga kangako.

Kutheni le nto (iBifascicular Block) yenzeka? Zithini izizathu?

I-Bifascicular Block idla ngokubangelwa sisifo sentliziyo esizalwa naso. Oku kuthetha ukuba umntu uzalwa enotshintsho oluthile kwisakhiwo sentliziyo. Ngamanye amaxesha, iimpawu zesi sifo sentliziyo esizalwa naso zinokuvela kamva, mhlawumbi ebuntwaneni okanye kwiminyaka ephakathi. Umngcipheko wokuba ne-heart block uyanda ngokuhamba kweminyaka .

Amaxesha amaninzi, le meko inokubangelwa lutshintsho lwemfuza (ukuguqulwa kwemfuza) oludluliselwa kusapho ukuya kusapho. Oku kubizwa ngokuba yi-progressive familial heart block. Olu tshintsho lwemfuza lunokubangela i-scar tissue (fibrosis) okanye i-calcium deposits (calcification) entliziyweni. Olu tshintsho lunokubangela ne-heart block.

Ukongeza, i-``Bifascicular Block`` inokubangelwa kukonakala kwentliziyo. Lo monakalo ungaba:

• Ngenxa yokuhlaselwa yintliziyo (i-myocardial infarction).
• Ngenxa yezinye izifo zentliziyo .
• Ngenxa yesifo sevalvu yentliziyo .
• Ngenxa yamanqanaba aphezulu e-potassium egazini (hyperkalemia).

Zithini iimpawu zeBifascicular Block? Ngaba nawe unazo ezi?

Ukuvaleka kwentliziyo okungaphelelanga (kwinqanaba lokuqala okanye lesibini) kusenokungabangeli zimpawu. Nangona kunjalo, xa kuvela iimpawu, uphawu oluphambili abantu abaninzi abalufumanayo kukuquleka (i-syncope). Oku kwenzeka xa isantya sentliziyo sicotha kakhulu (i-bradycardia) okanye sicotha kakhulu (i-arrhythmia) kuba igazi lingampompi kakuhle emzimbeni.

Ngamanye amaxesha, i-`(Bifascicular Block)` inokunyuka iye kwi-block epheleleyo (inqanaba lesithathu). Kwimeko enjalo, iimpawu zinokwenzeka kakhulu. Kubaluleke kakhulu ukufuna ingcebiso yezonyango ngokukhawuleza ukuba unempawu enye okanye ezingaphezulu kwezi zilandelayo:

• Intlungu yesifuba okanye ukuxinana (i-angina).
• Isiyezi.
• Ukuhlala uziva udiniwe kakhulu.
• Ukuva intliziyo ibetha ngendlela engaqhelekanga (ukubetha kwentliziyo).
• Isicaphucaphu.
• Ukuqhawukelwa ngumphefumlo.

Zeziphi iingxaki ezinokubangela oku?

I-Heart block iphazamisa amandla entliziyo okupompa igazi emzimbeni. I-"Bifascicular Block" (i-incomplete block) ngamanye amaxesha inokunyuka iye kwi-third-degree (epheleleyo). Xa oku kusenzeka, iingxaki ezifana nezi:

• Ukubetha kwentliziyo okungaqhelekanga (i-Arrhythmia).
• Ukuhlaselwa yintliziyo.
• Ukumelwa yintliziyo.
• Ukufa kwentliziyo ngequbuliso / ukuvaleka kwentliziyo ngequbuliso.

Ungakhathazeki! Asinguye wonke umntu oza kujongana nezi ngxaki. Ingcebiso nonyango olufanelekileyo lwezonyango lunokunciphisa kakhulu le ngozi.

Ungayixilonga njani ngokuchanekileyo iBloko yeBifascicular?

Uvavanyo oluphambili lokufumanisa i-Bifascicular Block yi -ECG. Oku kukwabizwa ngokuba yi-EKG. Oku kulinganisa umsebenzi wombane wentliziyo yakho. Luvavanyo olulula kakhulu, olungenantlungu. Luthatha malunga nemizuzu eli-15.

Ugqirha uza kubeka izitikha ezincinci (ezibizwa ngokuba zii-electrode) esifubeni sakho, ezingalweni, nasemilenzeni. Iingcingo eziqhagamshelwe kwezi electrode ziqhagamshelwe kumatshini we-ECG. Lo matshini urekhoda umsebenzi wombane wentliziyo yakho njengegrafu. Ezi electrode azithumeli mbane emzimbeni wakho. Endaweni yoko, zilinganisa kuphela umsebenzi wombane emzimbeni wakho. Ngokujonga le grafu, ugqirha unokwazi ukubona ukuba kukho utshintsho okanye ukuvaleka kwipateni yesignali yombane yentliziyo.

Ingaba kukho unyango? Yintoni enokwenziwa?

Ukuba une-`(Bifascicular Block)` kwaye awunazo naziphi na iimpawu, usenokungadingi unyango. Nangona kunjalo, ugqirha wakho uza kuyijonga impilo yentliziyo yakho ngokusondeleyo. Banokwenza uvavanyo lwe-`(ECG)` rhoqo ukuze babone ukuba imeko iya isiba mandundu na kwaye ikhula ibe yi-third-degree (epheleleyo) heart block. Ukuba oko kuyenzeka, kufuneka unyango.

Kodwa ukuba unesifo sentliziyo esingaqhelekanga (i-arrhythmia) okanye iimpawu ezifana nokuquleka (i-syncope), ugqirha wakho unokucebisa utyando lokufakelwa i- pacemaker . Kukho iintlobo ezimbini ze-pacemaker:

• Ii-pacemakers: Ezi zithumela imiqondiso yombane kumagumbi entliziyo ukuze zihlale zibetha ngesingqi, njengokunika intliziyo uncedo olongezelelekileyo.
• Ii-ICDs ezifakelwa kwi-Cardioverter Defibrillators (ICDs): Ezi zisebenza njenge-pacemaker. Ukongeza, i-ICD inokubona ukubetha kwentliziyo okungaqhelekanga kwaye iyilungise ngokubangela ukubetha kombane okuncinci entliziyweni. Ingayiqalisa kwakhona intliziyo kwiimeko zokuma kwentliziyo ngequbuliso.

Ezi zixhobo zifakelwa yingcali yentliziyo (i-electrophysiologist).

Ngaba kukho iindlela zokuthintela i-Bifascicular Block?

Inyaniso kukuba, zininzi izinto ezinokubangela ukungasebenzi kakuhle kwentliziyo esingenakukwazi ukuzilawula, njengesifo sentliziyo esizalwa naso okanye ukwaluphala.

Nangona kunjalo, unokuhlala uthatha amanyathelo okugcina nokukhusela impilo yentliziyo yakho. La manyathelo aquka:

• Ukuba uyatshaya, cela uncedo lokuyeka. Kuphephe nokuba ngumsi otshayiweyo ngumntu otshayayo.
• Yitya ukutya okunempilo kwentliziyo kwaye uziqhelise ukwenza umthambo imihla ngemihla.
• Nciphisa ukusetyenziswa kotywala.
• Lawula iimeko ezibangela ingozi kwintliziyo ezifana noxinzelelo lwegazi oluphezulu, isifo seswekile, kunye ne-cholesterol ephezulu.
• Fumana iindlela eziphilileyo zokulawula uxinzelelo.
• Zama ukugcina ubunzima obusempilweni.

Nangona ezi zinto zisenokungathinteli ngokupheleleyo uphuhliso lwe-`(Bifascicular Block), ngokuqinisekileyo ziya kukunceda ukugcina impilo yentliziyo yakho ikwimeko entle.

Ngaba singaphila nale meko? Injani imbono yethu?

Uninzi lwabantu abaneBifascicular Block abaludingi unyango. Nokuba kufuneka unyango, iimpawu zihlala ziphela emva kokufakwa kwepacemaker.

Ngonyango olufanelekileyo, umngcipheko wokuba le meko iqhubekele ekubeni yi-heart block epheleleyo uphantsi kakhulu. Enyanisweni, umonakalo onokubangelwa kukubetha kwentliziyo okungalawulekiyo (arrhythmia) mkhulu kunomonakalo obangelwa kukubetha kwentliziyo. Ke ngoko, kubalulekile ukufuna ingcebiso kagqirha ngexesha elifanelekileyo kwaye ufumane unyango ukuba kuyimfuneko.

Ndifanele ndibonane nogqirha nini?

Ukuba unenye okanye ngaphezulu kwezi mpawu zilandelayo, bona ugqirha ngokukhawuleza:

• Ndiziva ndidiniwe kakhulu.
• Ukubetha kwentliziyo okungaqhelekanga.
• Intlungu ebuhlungu esifubeni.
• Ubunzima bokuphefumla.
• Iimpawu zokuhlaselwa yintliziyo (umz., iintlungu eziqatha embindini wesifuba eziphuma engalweni).
• Ukucaphuka ngaphandle kwesizathu.

Yeyiphi imibuzo ebalulekileyo ekufuneka uyibuze ugqirha?

Xa usiya kugqirha, ungabuza le mibuzo:

• Kutheni ndifumene le `(Bifascicular Block)`?
• Ndingenza ntoni ukunciphisa umngcipheko wokuba nesifo sentliziyo okanye esinye isifo sentliziyo?
• Ngaba ndifuna i-pacemaker okanye i-ICD?
• Zithini iingozi zokufakelwa i-pacemaker okanye i-ICD?
• Ngaba kufuneka ndixhalabele iingxaki? Zithini iimpawu?

Ukubuza le mibuzo kuya kukunceda uqonde ngcono imeko yakho kwaye ucacelwe kakuhle ngento omawuyenze ngokulandelayo.

Okokugqibela, izinto ekufuneka uzikhumbule

Ibhloko ye-bifascicular kukuvalwa kweendlela ezimbini kwezithathu eziphambili ezithwala imiqondiso yombane entliziyweni. Oku kunokutshintsha isigqi sentliziyo kunye nendlela empompa ngayo igazi. Abanye abantu basenokungabi nazimpawu, ngelixa abanye banokubona iimpawu ezifana nokuquleka.

Eyona nto ibalulekileyo kukungabi naxhala ngale nto, kodwa kukufuna ingcebiso efanelekileyo yezonyango. Oku kunokubonwa ngovavanyo olulula olufana ne-ECG. Ukuba kuyimfuneko, le meko inokulawulwa ngempumelelo ngonyango olufana ne-pacemaker. Nyamekela intliziyo yakho, phila ubomi obusempilweni, kwaye ungahlala usempilweni!