Ingaba intliziyo yakho nayo inengxaki? Masifunde ngeGiant Cell Myocarditis!

Ngaba ngamanye amaxesha ukhe uzive ngathi intliziyo yakho iyabetha, ibetha ngamandla, okanye kukho into engaqhelekanga esifubeni sakho? Ezi zizinto ngamanye amaxesha esingazinaki kangako, kodwa zinokuba ziimpawu zezinye izifo zentliziyo ezingaqhelekanga. Namhlanje siza kuthetha ngesifo sentliziyo esingaqhelekanga, kodwa esinokuba sibi kakhulu. Igama laso yiGiant Cell Myocarditis, okanye ngesiNgesi `(Giant Cell Myocarditis)`.

Yintoni iGiant Cell Myocarditis? Masiyiqonde ngokulula.

Ngamafutshane, iGiant Cell Myocarditis luhlobo olungaqhelekanga lokudumba kwemisipha yentliziyo . Ukudumba luhlobo lokudumba. Okwenzekayo kwesi sifo kukuba ezinye 'zeeseli zokudumba' zomzimba wethu ziyahlangana zenze uhlobo lweseli enkulu ebizwa ngokuba yi'Giant Cells'. Ezi seli zinkulu, njengeentshaba, zihlasela izihlunu zentliziyo yakho kwaye zibangele amanxeba.

Cinga ngayo, intliziyo yethu ifana nempompo yamanzi. Yiyo epompa igazi emzimbeni wonke. Ngoko ke, xa ezi seli zinkulu zonakalisa izihlunu zentliziyo, intliziyo ayikwazi ukusebenza kakuhle. Oko kuthetha ukuba:

• Kunzima ukupompa igazi .
• Xa intliziyo ibetha, ayizizo zonke iindawo zayo ezifinyela ngaxeshanye .
• Imiqondiso yombane elawula ukubetha kwentliziyo iyaphazamiseka , kwaye loo miqondiso ayihambi kakuhle entliziyweni.

Ngenxa yokuba le meko inokuba mandundu ngokukhawuleza, abantu abanesi sifo badla ngokunyanzeleka ukuba bafakelwe intliziyo .

Yintoni umahluko phakathi kweMyocarditis kunye neGiant Cell Myocarditis?

I-Myocarditis ikwakukuvuvukala kwemisipha yentliziyo. Nangona kunjalo, i-giant cell myocarditis luhlobo olungaqhelekanga nolukhethekileyo lwe-myocarditis. Njengezinye iintlobo ze-myocarditis, inokubangela ukungaqheleki kwe-heart rhythm, okanye i-arrhythmias.

Usulelo lwentsholongwane ludla ngokuba yimbangela ephambili ye-myocarditis. Nangona kunjalo, abaphandi basazama ukufumanisa ukuba kutheni le myocarditis yeseli enkulu (GCM) isenzeka.

Ngubani ochaphazeleka kakhulu yile meko? Ixhaphake kangakanani?

I-Giant cell myocarditis (GCM) idla ngokuvela kubantu abancinci nabakwiminyaka ephakathi abasempilweni . Nangona kunjalo, inokwenzeka nakubantu bayo nayiphi na iminyaka, nokuba sisiphi na isini.

Ngokuphathelele ukuba oku kuxhaphake kangakanani, kunqabile kakhulu. Oogqirha bafumanisa esi sifo kubantu abangaphantsi komnye kubantu abayi-100,000 ngonyaka. Oko kuthetha ukuba sixelwe kubantu abamalunga ne-0.13 kubantu abayi-100,000 .

Zithini iimpawu? Sizibona njani?

Iimpawu zokuqala ze-giant cell myocarditis (GCM) zingabandakanya:

• Ukubetha kwentliziyo (ukuziva ngathi intliziyo yakho ibetha ngokukhawuleza okanye isifuba sakho siyabetha ngamandla)
• Iintlungu zesifuba
• Ubunzima bokuphefumlaokanye Ukuphefumla kancinci
• Amaqatha avuvukileyo
• Ukudinwa kakhulu

Ezi mpawu zihlala ziqala ngokukhawuleza kakhulu . Kamva, iingxaki zesingqisho sentliziyo zinokuvela. Abantu abangaphezu kwesiqingatha abanale sifo bafumana iingxaki zesingqisho sentliziyo eziyingozi (`Ventricular arrhythmias`), eziqala kwigumbi lentliziyo . Ezi zinokubangela ukuba intliziyo ime ngequbuliso.

Kwakhona, isantya sentliziyo singakhawuleza kakhulu okanye sicothe kakhulu. Usenokuziva unesizungu okanye utyhafile . Abanye abantu banokuba nesifo esibi esibizwa ngokuba yi-"cardiogenic shock," apho intliziyo ingakwaziyo ukupompa igazi ngokufanelekileyo.

Kutheni oku kusenzeka? Zithini izizathu?

Abaphandi abakayazi kakuhle into ebangela i- giant cell myocarditis (GCM). Bajonga izinto ezahlukeneyo. Umzekelo, bajonga ukuba ingaba izifo ezithile, ukungasebenzi kakuhle kwenkqubo yakho yokuzikhusela, okanye into ethile kwi-genes yakho inokukwenza ube sengozini enkulu yokuhlaselwa sesi sifo.

Enye into kukuba malunga nama-20% abantu abafumana esi sifo bafunyenwe beneengxaki zokuzikhusela komzimba . Izifo ezizikhusela emzimbeni zenzeka xa inkqubo yokuzikhusela yomzimba wethu, oko kukuthi, inkqubo yokuzikhusela komzimba, ihlasela iiseli zomzimba wethu. Ngoko ke, olu hlobo lwezifo lunokuba yimbangela okanye umngcipheko wokuphuhlisa i-GCM.

Ungayixilonga njani ngokuchanekileyo le sifo?

Ukuqinisekisa ukufunyaniswa kwe-giant cell myocarditis (GCM), ugqirha wakho kuya kufuneka athathe isampuli encinci yemisipha yentliziyo yakho . Oku kubizwa ngokuba yi-heart biopsy. Isampuli ithunyelwa kwilebhu kwaye ihlolwe yingcali yezifo zentliziyo.

Kubalulekile ukuba isampulu ihlolwe yingcali efana nale kuba iziphumo ze-biopsy ye-giant cell myocarditis zinokufana nezezinye izifo ezibangela ukudumba kwemisipha yentliziyo, njenge-cardiac sarcoidosis. Ke ngoko, ukuxilongwa ngokuchanekileyo kubalulekile kwisicwangciso sonyango.

Olu vavanyo lwe-`(Biopsy)` luyingozi, kodwa yindlela ekuphela kwayo yokwazi ngokuqinisekileyo ukuba unalo na esi sifo. Ezinye zeengxaki ezinokubakho ngemisipha yentliziyo `(Biopsy)` zezi:

• Ukuphuma kolwelo kwi-pericardial effusion (ukuqokelelana kolwelo kwi-membrane ejikeleze intliziyo)
• I-tamponade yentliziyo
• Ukugqobhoka kodonga lwegumbi lentliziyo (udonga lwe-ventricular)

Xa ethatha le sampulu, ugqirha ufaka umbhobho omncinci kakhulu, obizwa ngokuba yi-catheter, entliziyweni yakho ngomthambo omkhulu wegazi entanyeni okanye emathunjini akho. Le catheter ikhokelwa entliziyweni kusetyenziswa isixhobo esikhethekileyo (`Imaging`). Emva koko, isixhobo esikhethekileyo ngaphakathi kwi-catheter sithatha iqhekeza elincinci lemisipha yentliziyo.

Ngamanye amaxesha kufuneka ngaphezulu kwe-`(Biopsy)` enye. Oku kungenxa yokuba i-`(GCM)` isenokungazichaphazeli zonke iindawo zentliziyo ngendlela efanayo. Ukwenza into efana ne-`(MRI)` scan yentliziyo kuya kunceda ugqirha ukuba agqibe ngokuchanekileyo apho aza kuyithatha khona i-`(Biopsy)`.

Zeziphi ezinye iimvavanyo ozenzayo?

Ukuqinisekisa ukuba awunaso esinye isifo sentliziyo, ugqirha wakho unokuyalela ezinye iimvavanyo. Ezinye zezi ziquka:

• I-Electrocardiogram (EKG)
• I-Echocardiogram
• Ukufakwa kwe-catheter kwintliziyo

Zithini iindlela zonyango?

Ugqirha wakho angakunika amayeza ahlukeneyo okunyanga le meko. La mayeza aquka:

• Inganciphisa ukudumba .
• Inceda ekuthinteleni ukwenzeka kwezingqisho zentliziyo ezingaqhelekanga okanye ukungasebenzi kakuhle kwentliziyo.
• Usenokunikwa ixesha elingakumbi de kufuneke ukufakelwa intliziyo.
• Inceda ekwandiseni ubomi .

Ezinye iindlela zonyango lwe-giant cell myocarditis (GCM) zinceda ukulawula ukusilela kwentliziyo kunye nesantya sentliziyo esingaqhelekanga. Ezi ndlela zonyango zingabandakanya:

• Amayeza
• Ukususwa kwe-catheter
• Isixhobo sokunceda abantu balale ngesantya sentliziyo
• Isixhobo sokunciphisa ukubetha kwentliziyo esifakelwayo (i-ICD) sisixhobo esifakelwa emzimbeni ukulawula nokuphazamisa isantya sentliziyo.
• Ukufakelwa kwentliziyo

Ngelixa ulinde ukufakelwa intliziyo, ungadinga isixhobo sokuncedisa i-ventricular yasekhohlo (LVAD). Ukuba ufuna ukufakelwa intliziyo, kuya kufuneka wenze uvavanyo kunye nonyango esibhedlele esinezibonelelo zaloo nto.

Luhlobo luni lwamayeza asetyenziswayo?

Unyango lwe-giant cell myocarditis (GCM) luquka amayeza alawula inkqubo yakho yomzimba yokuzikhusela (i-immunosuppressants). Oko kukuthi, amayeza anciphisa amajoni omzimba. Ezinye zezi ziquka:

• I-Cyclosporine (umz. iGengraf®, iNeoral®)
• Ii-corticosteroids ezifana ne-prednisone (umz. iSterapred®, iRayos®)
• IAzathioprine (umz. Imuran®, Azasan®)

Kubaluleke kakhulu ukuqala la mayeza ngokukhawuleza. Ngaphandle kwala mayeza, ukufakelwa intliziyo kungafuneka kwiinyanga ezintathu emva kokuba iimpawu ziqalile, okanye imeko ingabulala. Nangona kunjalo, abantu abasebenzisa amayeza alawula inkqubo yomzimba yokuzikhusela badla ngokuphila malunga neenyanga ezili-12.

Ngaba kukho naziphi na iziphumo ebezingalindelekanga zonyango?

Iziphumo ebezingalindelekanga zinokwahluka ngokuxhomekeke kuhlobo lwamayeza owasebenzisayo. Ezinye zeziphumo ebezingalindelekanga eziqhelekileyo ziquka:

• Intlungu okanye ubuthathaka bemisipha
• Intloko ebuhlungu
• Iswekile ephezulu egazini
• Urhudo
• Ukungalali

Ukuba uziva into efana nale, ungalibali ukuxelela ugqirha wakho.

Buza kuba njani ubomi ngesi sifo?

Ukuba une-giant cell myocarditis (GCM), ingakhokelela ekuhlulekeni kwentliziyo okanye ekuvalekeni kwentliziyo . Xa ezi meko ziba nzima (ngesiqhelo kwiinyanga ezintlanu), ungadinga ukufakelwa intliziyo, ukuba uyafaneleka. Abantu abaninzi baphelelwa ziimpawu emva kokufumana intliziyo entsha, kodwa kuya kufuneka bathathe amayeza amaninzi amatsha ukuxhasa intliziyo entsha.

Ngaba i-giant cell myocarditis ingathintelwa?

Nangona abantu banokuphila ixesha elide bene-giant cell myocarditis (GCM) kunangaphambili, isesisifo esibulalayo ngaphandle kokufakelwa intliziyo . Kwiminyaka emininzi yoo-1900, abantu abane-GCM baphila ixesha elingaphantsi kweenyanga ezintathu. Kodwa namhlanje, ukuba esi sifo sichongiwe kwangethuba kwaye sinyangwa ngamayeza alawula amajoni omzimba, ama-90% abantu abane-GCM baphila ubuncinane unyaka. La mayeza anokukunika iinyanga okanye iminyaka de ufune ukufakelwa intliziyo.

Ithini ingxelo yokubikezela ukuba esi sifo siza kuqala?

Emva kokufakelwa intliziyo, malunga nama-71% abantu abane-giant cell myocarditis (GCM) baphila iminyaka emihlanu (82% kolunye uphando) . Kwiminyaka elishumi emva kokufakelwa intliziyo, izinga lokusinda limalunga nama-68%.

Nangona kunjalo, iiseli ezinkulu zinokuphinda zivele phakathi kwe-10% kunye ne-50% yabantu abafumana intliziyo entsha. Oku kunokwenzeka naphi na ukususela kwiiveki ezimbalwa ukuya kwiminyaka elithoba emva kokufakelwa. Ukuba oku kuyenzeka, kuya kufuneka uthathe ii-steroids kangangeenyanga eziliqela.

Ndingazinyamekela njani?

Ukuba une-giant cell myocarditis (GCM), kufuneka uphephe imidlalo yokhuphiswano ubuncinane iinyanga ezintathu ukuya kwezintandathu . Nje ukuba i-GCM yakho izinzile, buza ugqirha wakho ukuba kukhuselekile na ukubuyela kancinci kancinci ekuzilolongeni.

Udinga nini ukubona ugqirha?

Ukuba ufumana iziphumo ebezingalindelekanga ezibi kakhulu ngenxa yamayeza akho, okanye ukuba iimpawu zakho zibonakala zisiba mandundu, bona ugqirha wakho ngoko nangoko . Kubalulekile nokubona ugqirha wakho rhoqo ukuze ujonge imeko yakho.

Kufuneka uye nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Ukuba ufumana iintlungu eziqatha esifubeni okanye ubunzima bokuphefumla, fowunela u-911 okanye uye kwigumbi likaxakeka ngokukhawuleza. Oku kubaluleke kakhulu, njengoko ezi zinokuba ziimpawu zesimo esibi.

Ndingayibuza yiphi imibuzo ugqirha?

Ungalibali ukubuza le mibuzo xa ubona ugqirha wakho:

• Kufuneka ndize kangaphi kwixesha lokulandela?
• Ngaba ikho iqela lenkxaso abantu abanesifo abanokuthi bajoyine?
• Ucinga ukuba ndiza kuyidinga intliziyo efakelweyo?

Okokugqibela, eyona nto ibalulekileyo ekufuneka uyikhumbule

Ngoko ke, ngoku mhlawumbi uyaqonda ukuba iGiant Cell Myocarditis sisifo sentliziyo esingaqhelekanga, kodwa esibi kakhulu. Eyona nto ibalulekileyo kukubona iimpawu kwangethuba, ufune ingcebiso kugqirha, kwaye uqale unyango olufanelekileyo. Ungakhathazeki, kuba kukho unyango lwesi sifo ngoku, kwaye ixesha lokuphila linokwandiswa. Ke ngoko, ukuba uziva into engaqhelekanga ngentliziyo yakho, ungayityesheli kwaye ubone ugqirha. Nyamekela intliziyo yakho!

I- Giant Cell Myocarditis, i-Giant Cell Myocarditis, Isifo sentliziyo, ukufakelwa kwentliziyo, ii-Giant Cells, iingxaki zesingqisho sentliziyo, inkqubo yomzimba yokuzikhusela, uhlaselo lwentliziyo, isifo sentliziyo