Ingaba intliziyo yakho ayifumani igazi elaneleyo? Masifunde nge-"Ischemic Cardiomyopathy", ebangela ukuba izihlunu zentliziyo zibe buthathaka!

Intliziyo yethu ifana nomatshini omangalisayo osebenza ngokungayekiyo, akunjalo? Kodwa kwenzeka ntoni ukuba le ntliziyo ayifumani igazi elaneleyo, oko kukuthi, ioksijini nesondlo esifunekayo? Emva koko izihlunu zentliziyo ziqala ukuba buthathaka kwaye zikhule kancinci kancinci. Leyo yimeko embi kakhulu, kodwa enye ekufuneka sithethe ngayo kwaye siyiqaphele ibizwa ngokuba yi -`(Ischemic Cardiomyopathy)` . Makhe sithethe ngale nto ngokweenkcukacha namhlanje, kulungile?

Yintoni i-`(Ischemic Cardiomyopathy)`? Ngamafutshane...

Ngamafutshane, `(Ischemic Cardiomyopathy)` ithetha ukuba izihlunu zentliziyo entliziyweni yakho azifumani igazi elaneleyo, nto leyo ebangela ukuba zibe buthathaka kwaye zingakwazi ukupompa igazi ngokufanelekileyo. Oogqirha bakwabiza oku ngokuthi `(ischemia)`, nto leyo ethetha ukuncipha kokunikezelwa kwegazi.

Khawucinge nje, bekuya kwenzeka ntoni ukuba injini yamanzi ibingasebenza ngaphandle kwamanzi? Kunjalo. Xa imithambo ethwala igazi entliziyweni, oko kukuthi, imithambo yentliziyo , ivalekile, okanye xa kusenzeka uhlaselo lwentliziyo, ukuhamba kwegazi entliziyweni kuyancitshiswa ngale ndlela.

Oku kubangela ukuba i-ventricle yasekhohlo , igumbi eliphambili lokumpompa kwicala lasekhohlo lentliziyo, ibe buthathaka kwaye ikhule kancinci kancinci. Intliziyo ke ayikwazi ukupompa igazi ngokufanelekileyo kuwo wonke umzimba. Olu lolunye lwezona ntlobo zixhaphakileyo zesifo sentliziyo esibizwa ngokuba yiDilated Cardiomyopathy kwaye sesona sizathu siphambili sokusilela kwentliziyo ye-systolic ehlabathini. Le meko yenzeka kuma-60 ekhulwini ezigulana.

Ngaba nawe unazo ezi mpawu?

Umntu one-`(Ischemic Cardiomyopathy)` unokufumana iimpawu ezifana nezi. Kodwa khumbula, abanye abantu banokuba nale meko ngaphandle kweempawu.

• Ngaba uziva uphelelwa ngumoya? Ngaba uziva unesizungu xa uhamba kancinci okanye unyuka izitebhisi ezimbalwa?
• Ingaba imilenze namaqatha akho avuvukile (edema)? Ngokungathi agcwele amanzi.
• Ngaba uziva udiniwe ngokukhawuleza nasemva kokuba wenze umsebenzi omncinci? Ngaba uziva udiniwe kangangokuba awukwazi nokugqiba imisebenzi yakho yemihla ngemihla?
• Ngaba uziva iintlungu esifubeni, ukuqina, okanye uxinzelelo? Oku kubizwa ngokuba yi-`(Angina)`. Kodwa olu ayilophawu oluchaphazela wonke umntu.
• Ngaba umzimba wakho uziva unzima kwaye unzima, ngokungathi uzele ngamanzi? Oku kunokwenzeka xa amanzi eqokelelana emiphungeni yakho.
• Ngaba uziva ngathi intliziyo yakho ibetha ngendlela engaqhelekanga, ngathi kukho into eshukumayo esifubeni sakho, okanye ibetha ngokukhawuleza kakhulu? Oku sikubiza ngokuba yi-"arrhythmia" okanye i-irregular heart rhythm.
• Ngaba uziva unesizungu , amehlo akho ajika abe luhlaza okwesibhakabhaka, okanye uziva utyhafile?
• Ngamanye amaxesha usenokufa isiqaqa .

Ukuba unenye okanye ngaphezulu kwezi mpawu, kungcono ukuba ubonane nogqirha kwaye ufumane ingcebiso.

Kutheni oku kusenzeka? Zithini izizathu?

Oku kunokubangelwa yimeko enciphisa ukuhamba kwegazi ukuya kwimisipha yentliziyo kwaye yonakalise. Izizathu eziphambili zezi:

• Isifo semithambo yentliziyo:Le yeyona nto iphambili neyona ixhaphakileyo . Le meko ibangelwa kukuqokelelwa kwamafutha ngaphakathi kwimithambo yegazi ehambisa igazi entliziyweni.
• Uhlaselo lwentliziyo: Xa kuvela uhlaselo lwentliziyo, igazi eliya kwinxalenye yentliziyo liyanqanyulwa ngokupheleleyo, nto leyo ebangela ukuba izicubu ezikuloo nxalenye zife.
• I-Coronary Vasculitis: Imeko yokuvuvukala eyenzeka kwimithambo yegazi yentliziyo.
• Ukuqhaqhwa kwemithambo yentliziyo: Ukukrazuka kodonga lomthambo entliziyweni.
• Isifo seMithambo yeCoronary: Iingxaki kwimithambo yegazi emincinci kakhulu yentliziyo.
• I-Fibromuscular Dysplasia: Ukukhula okungaqhelekanga kweendonga zemithambo yegazi.
• `(I-Prinzmetal Angina)`: Iintlungu zesifuba ezibangelwa kukucutheka ngequbuliso kwemithambo yentliziyo.

Ngubani onokuba nethuba elikhulu lokuphuhlisa oku? (Izinto ezibangela umngcipheko)

Abanye abantu banamathuba amaninzi okufumana le meko (Ischemic Cardiomyopathy). Oko kuthetha ukuba kukho izinto ezininzi ezinobungozi. Jonga ukuba ezi zinto ziyasebenza na kuwe:

• Imbali yentsapho yesifo sentliziyo: Ukuba abazali bakho okanye abantakwenu banesifo sentliziyo, nawe usengozini enkulu.
• Uxinzelelo lwegazi oluphezulu: Uxinzelelo lwegazi oluphezulu luyimbangela enkulu yomngcipheko.
• Ukusetyenziswa kweemveliso zecuba: Ukusebenzisa izinto ezifana neecuba kunye ne-bidis.
• Isifo seswekile: Abantu abanesifo seswekile nabo basengozini enkulu.
• I-cholesterol ephezulu: Amanqanaba aphezulu e-cholesterol embi egazini .
• Isalathisi soBunzima boMzimba (BMI) ngaphezulu kwama-30: Ngamafutshane, ukutyeba kakhulu yimeko ephezulu kakhulu kunobude bakho.
• Ekubeni ndikhe ndahlaselwa yintliziyo ngaphambili.
• Ukungazilolongi kakuhle: Oku kuthetha ukungazilolongi kakuhle.

Ukuba unenye okanye ngaphezulu kwezi zinto ziyingozi, kubaluleke kakhulu ukuzilawula.

Zeziphi ezinye iingxaki ezinokubangela oku?

Ukuba i-Ischemic Cardiomyopathy ayinyangwa kakuhle, inokukhokelela kwezinye iingxaki zempilo ezinzulu. Ezi ziquka:

• Isingqisho sentliziyo esingaqhelekanga
• Ukusilela kwentliziyo okubangelwa kukungafumani igazi ngokufanelekileyo (intliziyo ayikwazi ukupompa igazi ngokufanelekileyo, nto leyo ebangela ukuba ulwelo luqokeleleke emzimbeni)
• Ukudumba kweMiphunga
• Ukuhlaziywa kweValve yeMitral
• Amahlwili egazi (ukuba la aya engqondweni, anokubangela izifo ezifana nestroke)
• Ukubanjwa kwe-cardiac
• Ukufa Ngesiquphe Kwentliziyo

Nangona ezi ngxaki zisenokubonakala ziyingozi, zinokuthintelwa kakhulu ukuba esi sifo sichongiwe kwangethuba kwaye sinyangwa ngokufanelekileyo.

Ugqirha uyifumanisa njani le nto? (Ukuxilongwa)

Xa usiya kugqirha, uza kwenza izinto ezifana nezi ukuze afumanise ukuba unale meko:

• Buza ngembali yakho yezonyango: izinto ezifana nezifo zangaphambili kunye namayeza owaselayo.
• Ndiphulaphule ngenyameko iimpawu ozichazayo.
• Buza ngezifo ezikwintsapho yakho: ingakumbi isifo sentliziyo.
• Kuza kwenziwa uvavanyo lomzimba: ukumamela intliziyo, ukujonga imiphunga, nokukhangela ukudumba.
• Baza kukucela ukuba wenze uvavanyo olukhethekileyo.

Zithini ezi mvavanyo?

Ukuze kuchongwe ngokuchanekileyo esi sifo nokubona ubungakanani bomonakalo entliziyweni, kunokwenziwa ezi mvavanyo zilandelayo:

• Uvavanyo lweGazi: Jonga izinto ezifana nee-enzyme ezithile eziqokelelana egazini xa intliziyo yonakele, amanqanaba e-cholesterol, kunye namanqanaba eswekile.
• I-Electrocardiogram (EKG): Uvavanyo olurekhoda umsebenzi wombane wentliziyo. Oku kunokunceda ekufumaneni izinto ezifana nohlaselo lwentliziyo okanye ukubetha kwentliziyo okungaqhelekanga.
• I-X-ray yesifuba: Ukujonga izinto ezifana nentliziyo ekhulisiweyo kunye nolwelo olukwimiphunga.
• I-Transthoracic Echocardiogram (TTE): Oku kufana ne-ultrasound scan yentliziyo. Ingabonelela ngolwazi olubalulekileyo malunga namagumbi entliziyo, indlela esebenza ngayo iivalvu, kunye nokuba intliziyo ikhupha igazi elingakanani (i-ejection fraction).
• Uvavanyo loxinzelelo lomzimba: I-ECG yakho kunye noxinzelelo lwegazi zijongwa ngelixa uhamba kwi-treadmill okanye uqhuba ibhayisekile. Oku kulinganisa ukuba intliziyo yakho inokusebenza nzima kangakanani na kunye nokuba kukho naziphi na iingxaki ngokujikeleza kwegazi.
• I-Catheterization yentliziyo / i-Angiogram: Oku kuquka ukufaka umbhobho omncinci ngaphakathi kwesisu okanye ingalo, ukufaka idayi kwimithambo yentliziyo, kunye nokuthatha i-X-ray. Oku kuvumela ugqirha ukuba abone ngqo apho kuvaliwe khona kwimithambo.
• I-CT Scan okanye i-MRI Scan: Ezi zinceda ekufumaneni ulwazi oluthe kratya malunga nesakhiwo kunye nomsebenzi wentliziyo.
• Imifanekiso yeMithi yeNyukliya: Inceda ekuchongeni iindawo apho igazi liphuma khona kunye nomonakalo entliziyweni.
• I-Myocardial Biopsy: Kwiimeko ezingaqhelekanga, iqhekeza elincinci lentliziyo linokuthathwa lize lihlolwe phantsi kwemakroskopu. Oku kunokunceda ekufumaneni unobangela we-cardiomyopathy.

Ngoko ke, zeziphi iindlela zonyango zoku?

Oogqirha baneenjongo ezintathu eziphambili xa benyanga le meko (i-Ischemic Cardiomyopathy):

1. Unyango lwesifo semithambo yegazi.

2. Ukuphucula ukusebenza kwentliziyo.

3. Ukunciphisa iimpawu zokuhlaselwa yintliziyo.

Kukho iindlela ezininzi eziphambili zonyango zoku:

1. Amayeza

Ugqirha wakho angakunika elinye okanye ngaphezulu la mayeza:

• Ii-Beta-blockers: Zinciphisa isantya sentliziyo, zilawula uxinzelelo lwegazi, kwaye zinciphisa umthwalo womsebenzi entliziyweni.
• Ii-ACE inhibitors okanye ii-ARB: Ziyandisa imithambo yegazi, zehlise uxinzelelo lwegazi, kwaye zenze kube lula ukuba intliziyo ipompe igazi.
• `(ARNI)`: Olu lukwaluhlobo olutsha lweyeza eliphucula ukusebenza kwentliziyo.
• I-Diuretics (iipilisi zamanzi): Zinceda ekususeni amanzi agqithisileyo emzimbeni ngomchamo, zinciphisa ukudumba kunye nokuphefumla kancinci.
• `(Ii-Aldosterone Antagonists)`: Olu lukwaluhlobo lwe-diuretic olukhusela intliziyo.
• I-Antiarrhythmics: Lawula ukungahambelani kwesantya sentliziyo ukuba kuyenzeka.
• Ii-Anticoagulants: Zithintela ukujiya kwegazi.
• IiStatins: Yehlisa amanqanaba e-cholesterol egazini.

La mayeza anceda ukuphucula ukusebenza kwentliziyo, ukulawula iimpawu, ukuthintela iingxaki, ukuthintela isifo semithambo yegazi yentliziyo ukuba singabi mandundu, kwaye kuncitshiswe umngcipheko wokuhlaselwa sisifo sentliziyo kwixesha elizayo. Ugqirha wakho uya kumisela uhlobo kunye nomlinganiselo wamayeza afanelekileyo kuwe. Njengoko esitsho, kubaluleke kakhulu ukuthatha amayeza akho ngexesha.

2. Utshintsho kwindlela yokuphila

Ukongeza kumayeza, utshintsho oluthile kwindlela yakho yokuphila yemihla ngemihla lunokunceda kakhulu ekulawuleni esi sifo:

• Nciphisa ubungakanani betyuwa obongeza ekutyeni kwakho: Zama ukutya phakathi kwe-2,000 kunye ne-3,000 milligrams yetyuwa ngosuku (oko kungaphantsi kwetispuni enye).
• Ukuzilolonga: Thetha nogqirha wakho uze ubuze ukuba zeziphi izithambo ezifanelekileyo kuwe kwaye kufuneka uzenze ixesha elingakanani.
• Ziphephe ngokupheleleyo iimveliso zecuba: Ukuba uyatshaya, yeka.
• Yitya ukutya okunesondlo: Yitya imifuno emininzi, iziqhamo, iimbotyi, iintlanzi, kunye nokutya okunefayibha eninzi. Nciphisa ioyile, iswekile, kunye nomgubo. Kuthiwa iMediterranean Diet ilungile kakhulu kwizigulane ezinjalo.

3. Izixhobo Ezifakelwayo

Abanye abantu kufuneka bafakelwe izixhobo ezikhethekileyo phantsi kolusu ukuze intliziyo yabo isebenze kakuhle.

• Unyango Lokuvuselela Intliziyo (i-CRT): Olu lukwabizwa ngokuba yi-biventricular pacing, olu lunceda amagumbi entliziyo ukuba asebenze kunye ngempumelelo.
• Ii-ICD ezifakelwayo zeCardioverter Defibrillators: Esi sixhobo sinokubona iingxaki eziyingozi zesingqisho sentliziyo kwaye sinike umothuko omncinci wombane ukubuyisela isingqisho sentliziyo esiqhelekileyo. Oku kunceda kakhulu ekuthinteleni ukufa kwentliziyo ngequbuliso.

Ngamanye amaxesha kunokwenzeka ukufaka isixhobo esibizwa ngokuba yi-`(CRT-D)` esidibanisa zombini ezi zixhobo.

4. Iinkqubo zokungenelela kunye notyando

Ukuba amayeza kunye notshintsho kwindlela yokuphila alwanelanga, oogqirha banokucebisa iinkqubo okanye utyando olufana nolu:

• I-Angioplasty kunye nokubekwa kwe-stent: Umthambo wentliziyo ovalekileyo uvuthelwa ngento efana nebhaluni, kwaye kubekwa i-mesh encinci (stent) endaweni yayo ukuthintela ukuba ingavaleki kwakhona.
• Utyando lweCoronary Artery Bypass (CABG): Umthambo omtsha wegazi wenziwa ngokudlula umthambo ovalekileyo kusetyenziswa iqhekeza lomthambo othathwe kwenye indawo yomzimba.
• Ukulungiswa okanye Ukwakhiwa Kabutsha Kwe-Left Ventricle: Le nkqubo ilungisa kancinci imo kunye nobukhulu be-ventricle yasekhohlo ebuthathaka nekhulisiweyo.
• Utyando Lokunciphisa Umthamo Wemithambo Yasekhohlo .
• Izixhobo zoNcedo lweMithambo yasekhohlo (LVAD): Umatshini omncinci onceda intliziyo ipompe igazi. Oku kusetyenziswa okwethutyana kubantu abalinde ukufakelwa intliziyo, kwaye kwezinye iimeko ngokusisigxina.
• Ukufakelwa Intliziyo: Njengendlela yokugqibela, ukuba akukho nyango lusebenzayo, intliziyo ephilileyo evela kumntu oswelekileyo iyafakelwa kwenye indawo.
• Kukwakho neendlela zotyando kwezinye izifo zentliziyo.

Ngaba unyango lunokubangela iziphumo ebezingalindelekanga?

Njengakwezinye iindlela zonyango, ezi ndlela zonyango zinokubangela iziphumo ebezingalindelekanga. Nangona kunjalo, ayinguye wonke umntu ozifumanayo, kwaye ubunzima bungahluka kumntu nomntu.

• Ukusuka kumayeza: isiyezi , isisu esibuhlungu, ukudinwa, ukukhwehlela okomileyo, intloko ebuhlungu, uxinzelelo lwegazi oluphantsi, ukulahleka kweenwele, ukopha (ngenxa yokunciphisa igazi), njl.
• Kwizixhobo ezifakelweyo: ukopha, usulelo, ukungasebenzi kakuhle kwesixhobo, i-pulmonary embolism, i-cardiac tamponade.
• Ukususela kwiinkqubo notyando: iintlungu zesifuba, ukopha, usulelo, ukuhlaselwa yintliziyo, amahlwili egazi, ukungalungelelani kwesantya sentliziyo, isifo sohlangothi, ukwaliwa kokufakelwa kwentliziyo.

Ungakhathazeki ngale nto. Ugqirha wakho uza kuthetha nawe ngayo yonke le nto ngaphambi kokuba aqalise naluphi na unyango. Ukuba ufumana naziphi na iziphumo ebezingalindelekanga, zikhona nezinye iindlela zonyango zazo.

Kuza kuthatha ixesha elingakanani ukuphiliswa?

Kwiyeza, kungathatha iiveki ezininzi ukuze lisebenze ngokupheleleyo. Kwezinye iindlela zonyango, ixesha lokuchacha linokuba lusuku olunye, ukuya kwiiveki ezimbalwa, okanye kwaneenyanga. Kuxhomekeke kuhlobo lonyango kunye nempilo yakho iyonke.

Asinakuyiphepha na le sifo? (Ukuthintela)

Ewe, kunokwenzeka kakhulu! Isizathu esiphambili se-`(Ischemic Cardiomyopathy)` sisifo semithambo yegazi yentliziyo, ngoko ke ukuba uyasithintela, ungasiphepha nesi sifo.

Ungayinciphisa njani ingozi?

Ukuze uphephe isifo semithambo yegazi yentliziyo kunye nemeko enokubangelwa siso (iCardiomyopathy), yenza ezi zinto zilandelayo:

• Ziphephe ngokupheleleyo iimveliso zecuba.
• Zilolonge ubuncinane iintsuku ezi-5 ngeveki, ubuncinane imizuzu engama-30 ngosuku.
• Fumana ubuthongo obufunekayo emzimbeni wakho.
• Gcina ubunzima bakho bufanelekile ngokweenqanaba lakho lobude.
• Lawula uxinzelelo lobomi bemihla ngemihla.
• Ukuba unezifo ezifana nesifo seswekile, i-cholesterol ephezulu, okanye uxinzelelo lwegazi oluphezulu, zilawule kakuhle. Sela amayeza owanikwe ngugqirha wakho.
• Yitya ukutya okunempilo. Yitya imifuno, iziqhamo kunye nemifuno engakumbi.
• Ukuba usela utywala, nciphisa.

Liyintoni ikamva lomntu one-`(Ischemic Cardiomyopathy)`?

Ngokuxhomekeke kwimeko yakho, umonakalo entliziyweni yakho unokuba mncinci okanye ube mkhulu. Amayeza anokuphucula ukusebenza kwentliziyo yakho aze anciphise iimpawu. Kodwa ukuba awanelanga, ugqirha wakho unokucebisa ezinye iindlela okanye izixhobo.

Ngaba le meko inganyangeka ngokupheleleyo?

Ukuba ukuhamba kwegazi entliziyweni kunciphile okwethutyana nje, umonakalo unokuguqulwa. Nangona kunjalo, ukuba izihlunu zentliziyo azifumani igazi neoksijini ixesha elide, njengaxa kuhlaselo lwentliziyo, umonakalo usenokungaguqulwa.

Imbonakalo

Impilo yakho yexesha elizayo ixhomekeke kwizinto ezininzi:

• Ingakanani igazi elinokupompa i-ventricle yakho yasekhohlo ngexesha (i-ejection fraction).
• Ubunzima besifo sakho semithambo yegazi yentliziyo.
• Ngaba wakha wahlaselwa yintliziyo ngaphambili?

Kodwa khumbula, unyango lunokuyiphucula kakhulu imeko yakho, ngoko ke ungalahli ithemba.

Ndingazinyamekela njani? (Ukuzinyamekela)

Zininzi izinto onokuzenza ukuze uphucule impilo yakho:

• Zama ukugcina ubunzima obusempilweni.
• Nciphisa ukusetyenziswa kotywala.
• Lala kakuhle ubusuku ngabunye.
• Zilolonge rhoqo (ngokwengcebiso kagqirha).
• Yitya ukutya okunempilo okunentliziyo. Ukutya okunamafutha aphantsi kunye netyuwa encinci.
• Ziphephe ngokupheleleyo iimveliso zecuba.
• Lawula uxinezeleko lwakho.

Ndifanele ndimbone nini ugqirha?

Ukuba unale meko, kuya kufuneka ubone ugqirha wakho amaxesha amaninzi ngonyaka ukuze ajonge imeko yakho. Ngexesha lotyelelo lwakho, ugqirha wakho angakujonga oku kulandelayo:

• Ingaba iyeza oliselayo lisebenza kakuhle?
• Ukuba unesixhobo esifakiweyo, ngaba sisebenza kakuhle?
• Uchacha njani emva kotyando okanye utyando?

Ngexesha lokudibana nogqirha, ukuba ufumana nayiphi na kwezi zilandelayo, xelela ugqirha wakho ngoko nangoko:

• Ukuba iimpawu zakho ziya zisiba mandundu.
• Ukuba uqalisa ukuba neempawu ezintsha obungenazo ngaphambili.
• Ukuba uvakalelwa kukuba isixhobo sakho asisebenzi kakuhle.
• Ukuba uneziphumo ebezingalindelekanga ezivela kumayeza owasebenzisayo.

Ufanele uye nini esibhedlele ngoko nangoko? (ETU)

Ukuba ufumana ezi mpawu, kuya kufuneka uye kwigumbi likaxakeka ngoko nangoko :

• Ukuba ngequbuliso ufumana ubunzima bokuphefumla.
• Ukuba unentlungu eqatha esifubeni.
• Ukuba ulahlekelwa zingqondo uze uwe.

Yeyiphi imibuzo omele uyibuze ugqirha?

Kuqhelekile ukuba uzive usoyika kwaye ukhathazekile xa ufumanisa ukuba une-`(Ischemic Cardiomyopathy)`. Kodwa kubaluleke kakhulu ukuthetha nogqirha wakho ukuze ufumane ukuqonda okucacileyo ngemeko yakho. Ungabuza imibuzo efana nale:

• Ingakanani ingozi eyenzekileyo entliziyweni yam?
• Yeyiphi indlela yonyango engcono kum?
• Ngaba kukho amaqela enkxaso anokundinceda?
• Ndingakulumkela njani ukutya nokusela?
• Zeziphi imithambo endinokuyenza nendingenakuyenza?

Ungoyiki ukubuza ugqirha ngayo nantoni na ongayiqondiyo. Uza kukunceda.

Okokugqibela, izinto ekufuneka uzikhumbule...

I-Ischemic Cardiomyopathy yimeko enzima, kodwa inokulawulwa. Ukufunyaniswa kwangoko kunye nonyango olufanelekileyo zezona zinto zibalulekileyo. Utshintsho olulula kwindlela ophila ngayo lunokwenza umahluko omkhulu. Landela imiyalelo kagqirha wakho, uthathe amayeza akho ngexesha, kwaye uye kuhlolwa. Awuwedwa, kwaye kukho oogqirha kunye nabantu obathandayo abanokukunceda. Ngoko ke jongana nale meko ngenkalipho.

I- Ischemic Cardiomyopathy, Ischemic Cardiomyopathy, isifo sentliziyo, isifo semithambo yegazi emithanjeni yegazi, uhlaselo lwentliziyo, ubuthathaka bemisipha yentliziyo, iimpawu zohlaselo lwentliziyo