Ngaba wakha waziva uphelelwa ngumoya, intlungu encinci esifubeni sakho, okanye intlungu encinci esifubeni sakho xa uhamba umgama omfutshane okanye unyuka izinyuko? Okanye ngaba ngamanye amaxesha uziva ngathi intliziyo yakho ibetha ngokukhawuleza ngaphandle kwesizathu? Nangona sicinga ukuba ezi zizinto eziqhelekileyo, ngamanye amaxesha ezi zinokuba ziimpawu ezincinci esizifumanayo entliziyweni yethu. Namhlanje siza kuthetha ngesimo esinjalo esinxulumene nentliziyo, abantu abaninzi abangasaziyo, kodwa kubaluleke kakhulu ukwazi ngaso. Oko yiHypertrophic Cardiomyopathy, okanye (HCM) ngamafutshane.
Ngamafutshane, yintoni i-Hypertrophic Cardiomyopathy (HCM)?
Eli gama lisenokuvakala liyinkimbinkimbi kancinci. Makhe sikuchazele lona. Igama elithi "hypertrophic" lithetha "okukhulu kunokuqhelekileyo." "I-Cardiomyopathy" liqela leemeko ezichaphazela izihlunu zentliziyo, okanye izihlunu zentliziyo. Xa uzidibanisa zombini, i-Hypertrophic Cardiomyopathy (HCM) ithetha ukuba izihlunu zentliziyo yakho (izihlunu zentliziyo) ziba zikhulu kuneziqhelekileyo .
Khawucinge ukuba iindonga zendlu yakho ziya ziqina. Oko kuthetha ukuba kukho indawo encinci ngaphakathi endlwini, akunjalo? Kwenzeka into efanayo entliziyweni. Njengoko izihlunu zentliziyo zikhula, akukho ndawo ingako yokuba igazi lizalise intliziyo. Oku kwenza kube nzima ngentliziyo ukupompa inani legazi elifunekayo emzimbeni.
Nangona oku kuqina kunokwenzeka nakweyiphi na indawo yentliziyo, kudla ngokuchaphazela udonga oluphakathi kwentliziyo. Ngokwezonyango, oku kubizwa ngokuba yi-septum. Xa olu donga luqina, lunokuthintela ukuhamba kwegazi ukusuka kwigumbi eliphambili lokumpompa lentliziyo, i-ventricle yasekhohlo, ukuya kwi-aorta, umthambo wegazi oyintloko othwala igazi emzimbeni.
Le meko ihlala ubomi bonke. Inokuba mandundu kancinci ngokuhamba kwexesha. Kodwa eyona nto ilungileyo kukuba ukuba ifunyaniswe kwangethuba kwaye inyangwa ngokufanelekileyo, iingxaki zinokuthintelwa kakhulu .
Kukho iintlobo ezimbini eziphambili zeHCM:
Le meko inokwahlulwahlulwa ibe ziindidi ezimbini eziphambili, kuxhomekeke ekubeni kukho na ukuphazamiseka kokuhamba kwegazi okanye akunjalo.
| Uhlobo lwe-HCM | Icacisiwe ngokulula |
|---|---|
| I-HCM ethintelayo | Nantsi udonga oluphakathi lwentliziyo (septum)Ukutyeba kuvala indlela ekhupha igazi kwi- ventricle yasekhohlo. Malunga nesibini kwisithathu sezigulane ze-HCM zinalolu hlobo. |
| I-HCM Engathinteliyo (i-HCM Engathinteliyo) | Apha, izihlunu zentliziyo ziyaqina kwezinye iindawo (umzekelo, inxalenye esezantsi yentliziyo). Nangona kunjalo, oku kuqina akuthinteli ngokuthe ngqo ukuhamba kwegazi. |
Zeziphi iimpawu umntu oneHCM anokuziva?
Le yeyona nto ibalulekileyo. Abanye abantu banokuphila iminyaka bengenazo iimpawu. Kodwa abanye basenokuba neempawu ezithile. Kubaluleke kakhulu ukuba nawe ube nombono ngezi mpawu.
- Intlungu yesifuba: Ukuqina okanye intlungu esifubeni, ingakumbi ngexesha lokuzilolonga okanye lokuzilolonga.
- Ukudinwa nokuquleka: Ukuziva unesizungu xa umi ngequbuliso okanye xa usenza umthambo, nto leyo ekhokelela ekulahlekelweni zingqondo.
- Ukuphefumla nzima: Ubunzima bokuphefumla, nokuba sele ugqibile umsebenzi omncinci okanye uhamba umgama omfutshane.
- Ukubetha kwentliziyo ngokukhawuleza: Imvakalelo yokuba intliziyo ibetha ngokukhawuleza kwaye isifuba sishukuma.
- Ukudumba (Edema): Ukudumba kwemithambo emilenzeni, emaqatheni, okanye entanyeni.
Into ebalulekileyo kukuba, usenokuba uneempawu ezininzi kwezi. Okanye usenokuba awunazo. Nangona kunjalo, ukuba unayo nayiphi na kwezi mpawu, kubalulekile ukubona ugqirha wakho ngokukhawuleza kwaye ufumane ingcebiso ngaphandle kokuzityeshela.
Kutheni le meko isenzeka?
Umbuzo abantu abaninzi abawubuzayo ngulo, "Kutheni oku kwenzeke kum?" Kukho izizathu ezibini eziphambili zeHCM.
1. Imbangela yemfuza: Malunga nabantu abathathu kwabahlanu abane-HCM banale meko ngenxa yotshintsho kwimfuza zabo. Ngamafutshane, sisifo sofuzo . Sibangelwa sisiphene kwimfuza ezilawula ukukhula kwemisipha yentliziyo. Sifuzwa ngendlela elawulwa yi-autosomal. Oku kuthetha ukuba ukuba umzali ngamnye une-gene enesiphene, kukho amathuba angama-50% okuba umntwana wakhe ayifumane. Nangona kunjalo, ubunzima besifo bunokwahluka nangaphakathi kusapho olunye. Abanye abantu banokuba ne-gene kodwa bangafumani sifo.
2. Akukho sizathu sifunyenweyo: Kwizigulane ezi-2 kwezi-5 ze-HCM, akukho sizathu sithile sifumanekayo. Oku kuthetha ukuba akukho mpembelelo yemfuza. Abaphandi basayifunda le nto.
Nangona le meko inokwenzeka nakweyiphi na iminyaka, idla ngokufunyaniswa imalunga neminyaka engama-40 ubudala.
Ziziphi iingxaki ezinokwenzeka ngenxa yeHCM?
Oku kusenokuvakala kusoyikisa, kodwa kubalulekile ukuba uqaphele. Ukuba akunyangwa, i-HCM inokukhokelela kwiingxaki. Kodwa khumbula, uninzi lwabantu abane-HCM alubi neengxaki ezinzulu.
| Ingxaki | Kwenzekani? |
|---|---|
| I-Atrial fibrillation (Afib) | Amagumbi aphezulu entliziyo abetha ngokungacwangciswanga nangokukhawuleza. Oku kunokubangela amahlwili egazi kunye neemeko ezifana nestroke. |
| Ukungaphumeleli kwentliziyo okubangelwa kukunganyamezelani | Imisipha yentliziyo etyebileyo ayikwazi ukupompa igazi ukuze ihlangabezane neemfuno zomzimba. |
| I-endocarditis esulelayo | Usulelo lweebhaktheriya kwingaphakathi okanye kwiivalvu zentliziyo. |
| Ukubetha kwentliziyo okungaqhelekanga (i-Ventricular arrhythmias) | Ukubetha kwentliziyo okungaqhelekanga okunokuba yingozi ebomini, okuvela kumagumbi asezantsi entliziyo. |
| Ukubanjwa kwentliziyo ngequbuliso | Le yingxaki engaqhelekanga kodwa enzima kakhulu enokwenzeka. |
Musa ukoyika ezi zinto. Ukuze uzikhusele kwezi zinto, kufuneka sihlolwe rhoqo ngugqirha. Ingakumbi ukuba umntu kusapho lwakho uneHCM, okanye ukuba umntu usweleke ngenxa yokuhlaselwa yintliziyo ngequbuliso, kubaluleke kakhulu ukuba uzihlole ngokwakho.
Oogqirha bayixilonga njani le sifo?
Xa usiya kugqirha, uza kulandela amanyathelo aliqela ukuze afumanise ukuba unaso na esi sifo.
- Imbali yezonyango: Okokuqala, uza kubuzwa ngeempawu zakho, nokuba kukho umntu kusapho lwakho onesifo sentliziyo, okanye ngaba kukho umntu osweleke ngequbuliso.
- Uvavanyo lomzimba: Ugqirha uza kumamela intliziyo yakho kunye nemiphunga esebenzisa i-stethoscope. Ukuba une-HCM ethintela ukuvuvukala, ngamanye amaxesha unokuva intliziyo ikhala.
- Uvavanyo olukhethekileyo:
- I-ECG (i-Electrocardiogram): Olu luvavanyo lokuqala olwenziweyo. Olu vavanyo lurekhoda umsebenzi wombane wentliziyo kwaye lunokubona iingxaki kubantu abaninzi abane-HCM.
- I-Echocardiogram (Echo): Olu lolona vavanyo lubalulekileyo nolucacileyo lokufumanisa i-HCM. Lufana nokuskena komntwana. Lunokububona ngokucacileyo ubukhulu bemisipha yentliziyo, indlela esebenza ngayo intliziyo, kunye nendlela ehambisa ngayo igazi.
Ukongeza kwezi zilingo ziphambili, ugqirha unokucebisa ezinye iimvavanyo ukuba kuyimfuneko.
- Uvavanyo lwegazi
- Ukufakwa kwe-catheter kwintliziyo
- Iskeni ye-MRI yentliziyo
- Uvavanyo lwe-"Holter monitor" olujonga izinga lokubetha kwentliziyo iiyure ezingama-24 nangaphezulu
- Uvavanyo loxinzelelo lomzimba
- Uvavanyo lwemfuza
Ziziphi iindlela zonyango ze-HCM?
Wakuba ufunyenwe une-HCM, ugqirha wakho wentliziyo uza kugqiba isicwangciso sonyango esifanelekileyo kuwe. Injongo ephambili yonyango kukulawula iimpawu nokunciphisa umngcipheko weengxaki.
1. Utshintsho kwindlela yokuphila kunye nokubeka esweni
Ukuba awunazo iimpawu kwaye usemngciphekweni omncinci weengxaki, ugqirha wakho unokujonga imeko yakho ngokukuhlola rhoqo aze akucebise ukuba uphile ubomi obusempilweni.
- Ziphephe ngokupheleleyo ukutshaya.
- Ukutya ukutya okunempilo kwentliziyo (ukungabi netyuwa eninzi kunye neoyile encinci).
- Ukulala ngokwaneleyo.
- Ukuzibandakanya kumthambo othambileyo nophakathi njengoko uyalelwe ngugqirha (umthambo onamandla usenokungafaneleki).
- Ukugcina ubunzima obusempilweni.
- Ulawulo olufanelekileyo kwezinye iimeko zonyango ezifana noxinzelelo lwegazi oluphezulu kunye nesifo seswekile.
2. Amayeza
Amayeza ahlukeneyo asetyenziswa ukulawula iimpawu.
- Ii-Beta-blockers: Zinciphisa isantya sentliziyo kwaye zinciphise uxinzelelo entliziyweni.
- Izithinteli zeCalcium channel: Zikhulula izihlunu zentliziyo kwaye zincede ukuhamba kwegazi.
- Iziyobisi zomchamo:Isusa ulwelo olugqithisileyo emzimbeni kwaye inciphisa iimpawu ezifana nokuphefumla kancinci.
Kutshanje, kuye kwaveliswa iyeza elitsha elibizwa ngokuba yi-`(mavacamten)`. Eli liyeza lokuqala elijolise kwisizathu esiyintloko se-HCM.
3. Iinkqubo ezikhethekileyo kunye notyando
Kukho unyango olukhethekileyo lweemeko ezingenakulawulwa ngamayeza, ingakumbi i-HCM ethintelayo, kunye nokuthintela iingxaki.
| Indlela yonyango | Yintoni eyenziwayo |
|---|---|
| I-Septal myectomy | Olu lutyando lwentliziyo evulekileyo. Kule nkqubo, ugqirha ususa icandelo elincinci lodonga lwentliziyo oluqinileyo (septum) , oluthintela ukuhamba kwegazi. |
| Ukususwa kwe-septal yotywala | Oku kwenziwa kwizigulana ezingakwaziyo utyando. Kusetyenziswa i-catheter, kufakwa utywala obuncinci kumthambo omncinci ohambisa igazi kwizihlunu zentliziyo ezityebileyo. Oku kutshabalalisa izicubu ezityebileyo kwaye kwenze ukuba zinciphe. |
| Isixhobo se-ICD (Implantable Cardioverter Defibrillator) | Oku kusetyenziswa kwizigulana ezisengozini yokuma kwentliziyo ngequbuliso. Isixhobo esincinci esifakwe phantsi kolusu. Sifana nesikhuselo somntu sentliziyo. Kwakuba nje ukubetha kwentliziyo okungahambelaniyo okunokuba yingozi ebomini, esi sixhobo senza umbane wokothuka ukubuyisela intliziyo kwimeko yesiqhelo. |
Yintoni onokuyilindela xa uhlala neHCM?
Akukho mfuneko yokoyika ukuxelelwa ukuba uneHCM. Uninzi lwabantu lunokuphila ubomi obuqhelekileyo ngonyango olufanelekileyo nolawulo. Nangona izinga lokufa kwesi sifo laliphezulu ngaphambili, namhlanje, ngenxa yonyango oluphambili, loo mngcipheko wehle waya kwinqanaba eliphantsi kakhulu le-0.5%.
Eyona nto ibalulekileyo kuwe kukuhlala unxibelelana rhoqo nogqirha wakho wentliziyo. Yiya kuhlolwa rhoqo, usele amayeza akho, kwaye ugcine indlela ophila ngayo njengoko ecebisa.
Kodwa kukho into enye ekufuneka uyiqaphele. I-HCM engafunyaniswanga yeyona nto iphambili ebangela ukufa ngesiquphe kwentliziyo kubadlali abangaphantsi kweminyaka engama-35 ubudala. Yiyo loo nto kubaluleke kakhulu ukuba uhlolwe ngaphambi kokuba uqale ukudlala imidlalo ukuba unembali yosapho.
Ngaba esi sifo singathintelwa?
Ekubeni i-HCM idla ngokubangelwa zizinto zemfuza, akukho ndlela yokuthintela ukuba ingenzeki. Kodwa eyona nto ingcono esinokuyenza kukuthintela iingxaki . Eyona ndlela ingcono yokwenza oko kukwenza uvavanyo lokuhlola ukuze kufunyanwe isifo kwangethuba.
Ukuba kukho umntu kusapho lwakho (umama, utata, abantakwenu, abantwana) one-HCM, ngokuqinisekileyo ufanele uhlolwe.
Okokuqala, uza kwenziwa i-ECG kunye ne-Echocardiogram. Nokuba ezo vavanyo ziqhelekile, kuyacetyiswa ukuba zihlolwe rhoqo emva kweminyaka emi-3 ude ube neminyaka engama-30 uze emva koko rhoqo emva kweminyaka emi-5.
Umyalezo Wokuya Ekhaya
- I-HCM yimeko apho izihlunu zentliziyo ziba nkulu kunesiqhelo, nto leyo eyenza kube nzima ukuba intliziyo ipompe igazi.
- Esi sisifo esidla ngokuba yimfuza eyenzeka kwiintsapho . Ukuba kukho umntu kusapho lwakho onaso, kubalulekile ukuba uvavanywe.
- Abantu abaninzi basenokungabi nazo naziphi na iimpawu . Ukuba ufumana iimpawu ezifana nobunzima bokuphefumla, iintlungu zesifuba, okanye ukuquleka, funa ingcebiso kagqirha ngokukhawuleza.
- Uvavanyo oluphambili lokufumanisa isifo yi- Echocardiogram (Echo) .
- Ngonyango olufanelekileyo, amayeza, kunye notshintsho kwindlela yokuphila , uninzi lwabantu abaneHCM banokuphila ubomi obuqhelekileyo nobusempilweni . Akukho mfuneko yokoyika, okufuneka ukwenze kukwazi kwaye ulawule ngendlela efanelekileyo.
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