Yintoni i-Eisenmenger Syndrome? Singathetha ngayo ngokweenkcukacha?

Ngaba wakha weva ukuba ezinye iziphene zentliziyo ezizalwa nazo zinokubangela iingxaki ezinkulu kamva ebomini? Esinye sezi ngxaki zinzima yi-Eisenmenger syndrome. Eli gama lisenokuba litsha kuwe, kodwa kubalulekile ukwazi ngalo, ingakumbi ukuba umntu kusapho lwakho unesifo sentliziyo esizalwa naso. Makhe sithethe ngale nto ngokweenkcukacha, kuba ukubonwa kwangethuba kunye nokwazi ngale meko kubaluleke kakhulu.

Yintoni kanye kanye i-Eisenmenger Syndrome?

Ngamafutshane, i-Eisenmenger Syndrome yimeko eyenzeka xa igazi elininzi lihamba ngemithambo yegazi (imithambo yegazi) ethwala igazi lisuka entliziyweni yakho liye emiphungeni yakho. Cinga ngayo njengamanzi ahamba ngempompo ngokukhawuleza kakhulu. Oku kubangela uxinzelelo lwegazi oluphezulu kwimithambo yegazi yemiphunga yakho nakwicala lasekunene lentliziyo yakho, imeko ebizwa ngokuba yiPulmonary Hypertension . Kufana nokuzama ukutyhala amanzi amaninzi kumbhobho omncinci, nto leyo edala uxinzelelo olukhulu ngaphakathi kumbhobho.

Ukongeza, igazi liqala ukuhamba ngendlela engafanelekanga phakathi kwamacala asekhohlo nasekunene entliziyo (`ukushukuma kwegazi`). Oku kuthetha ukuba ngenxa yonxibelelwano olungaqhelekanga (njengomngxuma okhoyo ekuzalweni), igazi elivela kwicala lasekhohlo lentliziyo (elityebileyo ngeoksijini) lihamba liye kwicala lasekunene (ioksijini ephantsi). Ekuhambeni kwexesha, le meko inokuguqulwa, oko kuthetha ukuba igazi elineoksijini encinci lihamba ukusuka kwicala lasekunene ukuya ekhohlo.

Le meko, ebizwa ngokuba yi-Eisenmenger syndrome, idla ngokuvela xa isiphene esinye okanye ezingaphezulu zentliziyo ezizalwa nazo zinganyangwa okanye zingafunyaniswanga . Ukuba le meko iqhubeka ixesha elide, inokubangela umonakalo osisigxina emiphungeni kunye nezinye iingxaki ezisongela ubomi. Yiyo loo nto le yimeko efuna ingqalelo esondeleyo.

Ngubani onokuba nethuba elikhulu lokufumana le meko?

I-Eisenmenger syndrome yimeko edla ngokuvela kubantwana nakubantu abadala abancinci abazalwa bene-Ventricular Septal Defect (VSD), umngxuma eludongeni phakathi kwamagumbi amabini asezantsi okupompa entliziyo (ii-ventricles zasekhohlo nezasekunene).

Kwakhona, i-Eisenmenger syndrome inokwenzeka xa ezinye iziphene zentliziyo zokuzalwa zinganyangwanga kakuhle. Nazi imizekelo embalwa:

• Isiphene somjelo we-Atrioventricular
• I-Atrial septal defect
• Isifo sentliziyo esibizwa ngokuba yi-cyanotic (apho umzimba ujika ube luhlaza okwesibhakabhaka)
• I-patent ductus arteriosus (umthambo wegazi omele uvaleke emva kokuzalwa)
• I-Tetralogy of Fallot (indibaniselwano yeziphene ezine zentliziyo)
• Truncus arteriosus `(Truncus arteriosus)`

Enye into kukuba, i-Down syndrome.Abantwana abane-Down syndrome nabo banomngcipheko omkhulu wokuba nesifo sentliziyo esizalwa naso. Ngenxa yoko, basenokuba sengozini enkulu yokuba ne-Eisenmenger syndrome. Enyanisweni, izibalo zibonisa ukuba phakathi kwama-25% nama-50% abantu abadala abane-Eisenmenger syndrome nabo bane-Down syndrome.

Ixhaphake kangakanani i-Eisenmenger syndrome?

Ngethamsanqa, i-Eisenmenger syndrome yimeko engaqhelekanga kakhulu . Ichaphazela phakathi kwe-1% kunye ne-6% yabantu abadala abazelwe benesiphene sentliziyo. Nangona kunjalo, nangona ingaqhelekanga, kubalulekile ukuyiqonda ngenxa yobunzulu bayo.

Yintoni ebangela i-Eisenmenger syndrome?

Ukuze uqonde ukuba kutheni oku kusenzeka, kufuneka ube nombono omncinci wendlela igazi elihamba ngayo ezintliziyweni zethu. Khawuthelekelele ukuba iintliziyo zethu zifana nendlu enamagumbi amane.

Ukujikeleza kwegazi entliziyweni ephilileyo kwenzeka ngolu hlobo lulandelayo:

1. I-atrium yasekunene: Igazi elisetyenzisiweyo nelingenaoksijini liza kuqala lize liqokelele apha. Eli gazi emva koko liphampulelwa kwi-ventricle yasekunene.

2. I-ventricle yasekunene: Kulapho igazi elingenaoksijini lithunyelwa khona emiphungeni ukuze lifumane ioksijini entsha.

3. I-atrium yasekhohlo: Igazi elicocekileyo elifakwe ioksijini emiphungeni libuyela entliziyweni apha. Eli gazi lithunyelwa kwi-ventricle yasekhohlo.

4. I-ventricle yasekhohlo: Le yipompo ephambili yentliziyo. Kulapho igazi elineoksijini eninzi lisasazwa khona emzimbeni wonke.

Ngoku khawucinge ukuba kukho isiphene esakhiweyo entliziyweni, njengomngxuma eludongeni phakathi kwe-ventricles yasekunene neyasekhohlo (VSD). Kwenzeka ntoni emva koko? Igazi elinomoya-mpilo omninzi (kwicala lasekhohlo) kunye negazi elingenawo umoya-mpilo omninzi (kwicala lasekunene) ziqala ukudibana . Ngenxa yoko, igazi elininzi lihamba liye emiphungeni. Yiyo le nto ibangela uxinzelelo lwegazi oluphezulu lwemiphunga olukhankanyiweyo ngaphambili. Kwakhona, ubungakanani begazi elinomoya-mpilo omninzi ekufuneka liye kuwo wonke umzimba buyancipha. Le yingxaki esisiseko ye-Eisenmenger syndrome.

Zithini iimpawu ze-Eisenmenger syndrome?

Iimpawu ze-Eisenmenger syndrome zingahluka kumntu nomntu. Zixhomekeke kuhlobo lwesiphene sentliziyo kunye namalungu achaphazelekileyo. Amaxesha amaninzi, ezi mpawu azibonakali ngaxeshanye. Zidla ngokuqala ukubonakala ngexesha lokufikisa okanye ekuqaleni kokukhula kolutsha. Emva koko, iimpawu ziya zisiba mandundu kancinci kancinci.

Nazi ezinye zeempawu ezibonakala kakhulu:

• Intlungu yesifuba okanye ukuxinana (i-Angina)
• Ukubetha kwentliziyo okungaqhelekanga (i-Arrhythmias) - Oku kuthetha ukuba intliziyo ibetha ngeendlela ezahlukeneyo endaweni yokuba ibethe ngendlela enye.
• Ukwandiswa kweziphelo zeenzipho kunye nokugoba kwezipikili (Clubbing) - njengeziphelo zedrumstick.
• Ukukhohlela igazi.
• Ukutshintsha kombala wesikhumba okuluhlaza okwesibhakabhaka okanye okungwevu (iCyanosis) - Oku kubangelwa kukuncipha komthamo weoksijini egazini.
• Ukudinwa okanye ukuquleka.
• Ukudumba kwemilenze, amaqatha, iinyawo, okanye isisu (i-edema).
• Ukuziva ngathi intliziyo yakho ibetha ngokukhawuleza, uva isandi sesifuba sakho sibetha ngamandla (ukubetha kwentliziyo).
• Ukudinwa kakhulu kunye nokungabi namandla (Ukudinwa).
• Ukuphelelwa ngamandla - Ubunzima bokuphefumla nokuba uqhuba kancinci.

Ukuba unenye okanye ngaphezulu kwezi mpawu, kubaluleke kakhulu ukufuna ingcebiso kagqirha ngokukhawuleza.

Ziziphi iingxaki ezinokubakho ze-Eisenmenger syndrome?

Ngelishwa, i-Eisenmenger syndrome ayisosifo esihlala kwindawo enye. Ingakhokelela kwiingxaki ezahlukeneyo zempilo. Ezinye zazo zezi:

• Ukopha igazi engqondweni.
• Ithumba lobuchopho elibangelwa kusulelo.
• Ukungabikho kwegazi elaneleyo engqondweni (Ukungabikho kokwaneleyo kwemithambo yegazi kwimithambo yegazi).
• Igawuthi.
• Ukuhlaselwa yintliziyo.
• Ukumelwa yintliziyo.
• Usulelo lwentliziyo, umzekelo, i-endocarditis.
• Ukuqina kwegazi (i-Hyperviscosity syndrome).
• Ukungasebenzi kakuhle kwezintso.
• Iingxaki ngexesha lokukhulelwa (oku kuyingozi kakhulu).
• Istroke.
• Ukufa ngequbuliso.

Ukujonga ezi ngxaki, ungabona ukuba le meko inzima kangakanani, akunjalo? Yiyo loo nto kufuneka sinikele ingqalelo ekhethekileyo kule nto.

Ifunyanwa njani i-Eisenmenger syndrome?

Ugqirha uhlala ekhangela iimpawu ze-Eisenmenger syndrome ngexesha lokuhlolwa komzimba. Umzekelo, nokuba ulusu lwakho luluhlaza okwesibhakabhaka, nokuba iminwe yakho inxibe iingceba, nokuba uyaziva izandi ezingaqhelekanga xa umamele intliziyo yakho.

Emva koko, ugqirha unokuyalela olunye okanye ngaphezulu kwezi vavanyo zilandelayo ukuqinisekisa ukuxilongwa:

• Ukujonga inqanaba leoksijini egazini.
• Ukufakwa kwe-catheter kwintliziyo: Oku kuquka ukufaka umbhobho omncinci entliziyweni ukuze kulinganiswe uxinzelelo kwaye kujongwe ulwakhiwo lwayo.
• I-X-ray yesifuba.
• Ubalo lwegazi olupheleleyo (CBC).
• I-Echocardiogram (Echocardiogram - echo): Olu luvavanyo lwe-ultrasound lwentliziyo. Lunokujonga amagumbi entliziyo, iivalvu, kunye nendlela igazi elihamba ngayo.
• I-Electrocardiogram (EKG/ECG): Le nkqubo ivavanya ukusebenza kombane kwentliziyo.
• Uvavanyo lwe-MRI yentliziyo.
• Uvavanyo lomsebenzi wemiphunga.

Ugqirha unokusichonga ngokuchanekileyo isifo ngokusekelwe kulwazi olufunyenwe kwezi mvavanyo.

Inyangwa njani i-Eisenmenger syndrome?

Injongo ephambili yokunyanga i-Eisenmenger syndrome kukulawula iimpawu nokuthintela umonakalo ongakumbi entliziyweni okanye emiphungeni.

Ezi zilandelayo zingasetyenziswa njengonyango:

• Ii-antibiotics: Zithintela ukosuleleka ziintsholongwane entliziyweni nasemiphungeni.
• Izinto ezithintela ukugabha kwegazi: Zinciphisa ukwakheka kwamahlwili egazi kwimithambo yegazi.
• I-Diuretics (iipilisi zamanzi): Nciphisa ulwelo olongezelelweyo oluqokelelana emzimbeni.
• Ii-dual endothelin receptor antagonists: Ezi luhlobo olukhethekileyo lwamayeza olunikwa ukunciphisa uxinzelelo lwegazi oluphezulu emiphungeni.
• Izongezo zesinyithi: Nyanga i-anemia ebangelwa kukungabikho kwesinyithi.
• Ioksijini eyongezelelweyo: Yenza ukuphefumla kube lula kwaye yonyusa amanqanaba eoksijini egazini.

Into ebalulekileyo kukuba xa i-Eisenmenger syndrome iqalile, kudla ngokuba sekwephuzile ukulungisa isiphene sentliziyo esizalwe naso ngotyando, kuba ngelo xesha umonakalo emiphungeni sele wenziwe.

Nangona kunjalo, abanye abantu abaneempawu ezibi kakhulu kunye nomonakalo omkhulu wamalungu omzimba banokufuna ukufakelwa intliziyo okanye imiphunga. Kodwa loo nto ikwayinkqubo enzima kakhulu kwaye inobungozi.

Ngaba i-Eisenmenger syndrome ingathintelwa?

Ewe, indlela ekuphela kwayo yokuthintela i-Eisenmenger syndrome kukufumanisa iziphene zentliziyo zokuzalwa kwangethuba, kwasebuntwaneni, nokunyanga ngokufanelekileyo, kwaye ukuba kuyimfuneko, wenze utyando. Ukuba ezi ziphene zichongiwe kwaye zinyangwa ebuntwaneni, kukho ithuba elikhulu lokuthintela imeko enzima njenge-Eisenmenger syndrome.

Ingakanani iminyaka yokuphila yabantu abane-Eisenmenger syndrome?

Abantu abane-Eisenmenger syndrome banokuba nexesha elifutshane lokuphila kunoluntu ngokubanzi. Oku kungenxa yeengxaki ezihambisana nale meko. Nangona kunjalo, abanye abantu baphila bade babe phakathi kweminyaka. Ubude bexesha abanokuphila ngalo buxhomekeke kwizinto ezifana nobunzima beempawu zabo, uhlobo lwesiphene sentliziyo abazalwa naso, kunye nendlela abasabela ngayo kunyango. Ke ngoko, kubalulekile ukulandela icebiso likagqirha wakho kwaye ukhathalele impilo yakho.

Ukuba ndine-Eisenmenger syndrome, ndingakhulelwa?

Lo ngumbuzo obaluleke kakhulu. Ukukhulelwa kuyingozi kakhulu kumntu one-Eisenmenger syndrome. Kungakhokelela kwiingozi ezinkulu ezifana nokusilela kwentliziyo, ukuqhekeka kwegazi, kunye nokufa ngequbuliso. Ukuba unale meko kwaye ucinga ngokukhulelwa, ngokuqinisekileyo kuya kufuneka ubone ingcali kwiimeko zentliziyo zabantu abadala (`(ingcali kwiimeko zentliziyo zabantu abadala)`) ukuze baxoxe ngale mingcipheko. Nguye onokukunika icebiso elihle.

Ndingazinyamekela njani xa ndine-Eisenmenger syndrome?

Ukuba une-Eisenmenger syndrome, zininzi izinto onokuzenza ukunciphisa umngcipheko weengxaki. Ukulandela la manyathelo kuya kunceda ukuphucula ubomi bakho kunye nomgangatho wobomi.

Izinto zokwenza:

• Yitya ukutya okulawulwa yi-sodium: Ukutya ityuwa eninzi kunokubangela ukugcinwa kolwelo kwaye konyuse uxinzelelo lwegazi.
• Fumana imigonyo efanelekileyo: Zikhusele kwiintsholongwane ezifana ne-pneumonia kunye ne-influenza.
• Sela amanzi amaninzi kwaye ungavumeli umzimba wakho uphelelwe ngamanzi emzimbeni (`(Hlala unamanzi emzimbeni)`) : Kodwa kuphela ngomlinganiselo ocetyiswe ngugqirha wakho.
• Landela onke amayeza kunye nezinye iindlela zonyango ezichazwe ngugqirha wakho wentliziyo ngokuchanekileyo. Ungaphoswa yidosi enye.
• Sela amayeza okubulala iintsholongwane ngaphambi kokuba unyangwe okanye utyando lwamazinyo: Oku kunokunceda ekuthinteleni usulelo lwentliziyo. Buza ugqirha wakho ngale nto.

Izinto ekungamele zenziwe:

• Kuphephe ukuya kwiindawo eziphakamileyo kakhulu ngaphezu kolwandle (`(Ukuphakama okuphezulu)`): Ubunzima bokuphefumla bunokwanda ngenxa yokunqongophala kweoksijini kwiindawo eziphakamileyo.
• Kuphephe ukusebenzisa ii-sauna, amagumbi anomphunga, okanye iibhafu ezishushu: Ezi zinokubangela ukwehla ngequbuliso koxinzelelo lwegazi.
• Kuphephe ukutshaya okanye ukusebenzisa iimveliso zecuba ngokupheleleyo.
• Kuphephe ukwenza umthambo onzima: Yenza umthambo olula kuphela kwinqanaba elivunyiweyo ngugqirha wakho.

Umyalezo Wokuya Ekhaya

I-Eisenmenger syndrome yimeko apho kukho uxinzelelo lwegazi oluphezulu kwimithambo yegazi yemiphunga nakwicala lasekunene lentliziyo. Idla ngokubangelwa ziziphene zentliziyo ezizalwa nazo ezinganyangwanga. Iimpawu zihlala ziqala ukubonakala ebusheni okanye ebutsheni. Iimpawu ziquka ulusu oluluhlaza okwesibhakabhaka (i-cyanosis), ukuphefumla okunzima ngexesha lokuzilolonga, kunye nokubetha kwentliziyo okungaqhelekanga.

Unyango lwale meko lujolise kakhulu ekunciphiseni iimpawu nokunciphisa umonakalo entliziyweni nasemiphungeni. Kudala kakhulu ukuba le meko inganyangeki ngotyando. Ke ngoko, kungcono ukuxilonga nokunyanga iziphene zentliziyo zokuzalwa nazo kwangethuba.

Ukuba uneminye imibuzo malunga noku, ungoyiki ukuthetha nogqirha wakho. Baza kukunceda.

I- Eisenmenger syndrome, isifo sentliziyo, uxinzelelo lwegazi oluphezulu lwemiphunga, i-cyanosis, iziphene zentliziyo zokuzalwa, ubunzima bokuphefumla, impilo yentliziyo