Ingaba intliziyo yakho ibetha ngokukhawuleza ngequbuliso? Masifunde ngale (Junctional Tachycardia)!

Ngaba wena okanye umntu osapho lwakho, ingakumbi umntwana omncinci, wakha waziva ukubetha kwentliziyo ngequbuliso, okungaqhelekanga? Okanye woyika kancinci xa ugqirha ekuxelela igama elithi `(Junctional Tachycardia)`? Ungakhathazeki. Le yimeko engaqhelekanga, kodwa wakuba uyiqonde ngokulula, uya kuziva ukhululekile. Makhe sithethe ngayo ngokweenkcukacha namhlanje.

Yintoni i-`(Junctional Tachycardia)`? Ngamafutshane nje...

Ngamafutshane, `(Junctional Tachycardia)` yimeko apho isingqisho sentliziyo yethu, oko kukuthi, indlela esibetha ngayo intliziyo yethu, sahlukile kancinci, kwaye senzeka ngokukhawuleza. Ukuchaneka, okwenzekayo apha kukuba ukubetha kwentliziyo akuqali kwindawo elungileyo, kodwa kuqala kwindawo eyahlukileyo kwaye kuqale ukubaleka ngokukhawuleza.

Khawuthelekelele, intliziyo yethu inenkqubo yombane. Yile nto inika intliziyo isignali yokubetha ngexesha elifanelekileyo. Ngokwesiqhelo, esi signali siqala kwindawo encinci ebizwa ngokuba yi-`(Sinoatrial node)` phezulu kwentliziyo. Kufana neswitshi ephambili endlwini yethu. Ukusuka apho, umyalezo wombane uhamba kuyo yonke intliziyo kwaye ubangele ukuba izihlunu zentliziyo zinciphe kwaye zibethe. Oku sikubiza ngokuba yi-`(Normal Sinus Rhythm)`.

Nangona kunjalo, ngamanye amaxesha ukuba kukho into eyenzekayo kule `(i-Sinoatrial node)`, ayinakusebenza kakuhle. Njengomdlali weqonga obambeleyo kumdlalo xa umdlali oyintloko egula, enye indawo entliziyweni, oko kukuthi, i-`(i-Atrioventricular node)` efumaneka phakathi kwamagumbi aphezulu nasezantsi entliziyo (oku kunokubizwa ngokuba yi-"junction" yentliziyo), ithatha uxanduva lokuqalisa ukubetha kwentliziyo. Ngale ndlela, intliziyo ebetha ngokukhawuleza eqala kwindawo yokudibana kwentliziyo ibizwa ngokuba yi-`(Junctional Tachycardia)`.

Ngokwesiqhelo, xa siphumle, intliziyo yethu ibetha phakathi kwezihlandlo ezingama-60 ukuya kwezili-100 ngomzuzu. Nangona kunjalo, kumntu one-"Junctional Tachycardia", intliziyo ibetha ngaphezu kwezihlandlo ezili-100 ngomzuzu, ngamanye amaxesha ikhawuleza kakhulu.

Ziziphi iintlobo eziphambili ze-`(Junctional Tachycardia)`?

Oku kungaqhelekanga kwesingqisho sentliziyo kunokwenzeka ngeendlela ezimbini eziphambili.

1. I-Primary okanye i-Congenital (i-Junctional Tachycardia)

Olu lolona hlobo lunqabileyo. Abanye abantwana banokuba nale meko xa bezalwa. Ukuba oku kuyenzeka, amagumbi asezantsi ('ama-ventricles') entliziyo yomntwana anokubetha ngesantya esiphezulu kakhulu, malunga namaxesha angama-200 ukuya kuma-250 ngomzuzu. Le yimeko enzulu kakhulu.

2. I-Secondary okanye i-Postoperative (i-Junctional Tachycardia)

Olu lolona hlobo luxhaphakileyo. Lunokwenzeka, ingakumbi kubantwana abancinci abanengxaki yentliziyo emva kotyando ukuze lulungiswe. Umzekelo, ezinye iintsana ezityandwa ukuze kulungiswe imeko yentliziyo ebizwa ngokuba yiTetralogy of Fallot zinokuba nale meko. Lungenzeka phakathi kwe-5% kunye ne-11% yabantwana abatyandwayo.

Ngaba i-`(Junctional Tachycardia)` yi-`(SVT)`?

Ewe, `(Junctional Tachycardia)` luhlobo lwe `(SVT)`. `(SVT)` imele `(Supraventricular Tachycardia)`. Oko kukuthi, ukubetha kwentliziyo okukhawulezayo okuqala kumagumbi aphezulu entliziyo (ngaphezulu kwe `Ventricles`).

Ngubani ochaphazeleka kakhulu yile meko?

I-Junctional Tachycardia ayiqhelekanga kubantu abadala. Nangona kunjalo, ixhaphake kakhulu kwiintsana nabantwana abancinci. Njengoko bekutshiwo ngaphambili, inokwenzeka ngenxa yesizathu sokuzalwa (esingaqhelekanga kakhulu) okanye emva kotyando lwentliziyo.

Zithini iimpawu? Sizibona njani?

Ngamanye amaxesha le meko inokubakho ngaphandle kweempawu. Kodwa ukuba iimpawu ziyavela, zingabandakanya:

• Ukubetha kwentliziyo : Kusenokuvakala ngathi kukho umntu obaleka esifubeni sakho, okanye ngathi intliziyo yakho iyatsiba.
• Ukudinwa : Usenokuziva unesizungu kwaye ube nobunzima bokuma.
• Ukuquleka : Ungalahlekelwa zingqondo ngequbuliso uze uwe.
• Ukuziva udiniwe kakhulu : Usenokuziva udiniwe kangangokuba awukwazi kwenza nto.

Ukuba ezi mpawu zikhona, ingakumbi kumntwana omncinci, kubaluleke kakhulu ukufuna iingcebiso zonyango ngokukhawuleza.

Zithini izizathu ze-`(Junctional Tachycardia)`?

Kukho izizathu ezahlukeneyo ezinokuphazamisana ne-"Sinoatrial node" entliziyweni yethu ukuze ivelise imiqondiso yombane ngokufanelekileyo. Yiyo loo nto i-"Junctional Tachycardia" isenzeka.

Umzekelo, le meko inokwenzeka ngenxa yobuthi beziyobisi `(Digoxin)` (amagama eempawu `Cardoxin®` okanye `Digitek®`).

Nazi ezinye izizathu ezimbalwa:

• I-Myocarditis : Ukudumba kwemisipha yentliziyo.
• Uhlaselo lwentliziyo .
• Ukutshintshwa kwevalvu yentliziyo okanye olunye utyando lwentliziyo.
• Isifo sentliziyo esizalwa naso : Esi sisizathu esingaqhelekanga.
• Ukususwa kwe-catheter lunyango lolunye uphazamiseko lwentliziyo.
• Isifo seLyme .

Ungayiqaphela njani i-`(Junctional Tachycardia)`?

Uvavanyo oluphambili lokufumanisa le meko yi-`(Electrocardiogram - ECG)`. Le irekhoda umsebenzi wombane wentliziyo. Umntu one-`(Junctional Tachycardia)` uya kuba ne-`P wave`` engekho kwi-`ECG``. Le `P wave`` luphawu lokuba intliziyo iqala ukubetha kwi-`(Sinoatrial node).

Ukongeza kwi-ECG, ugqirha wakho uza kuthatha imbali yakho epheleleyo yezonyango. Angayalela nezinye iimvavanyo, ezifana novavanyo lwegazi kunye ne-echocardiogram, eyi-ultrasound yentliziyo.

Iphathwa njani?

Unyango luxhomekeke kwisizathu semeko kunye neempawu zakho. Ukuba isigqi esingaqhelekanga siqale emva kotyando lwentliziyo, ugqirha wakho unokuthi:

• Ukulungisa ukungalingani kwee-electrolytes emzimbeni.
• Jonga ukuba unayo na ifiva, uze uyinyange ukuba ikhona.
• Ukunika amayeza okunciphisa isantya sentliziyo.

Kukho ezinye iindlela zonyango:

• Amayeza okuthoba isantya sentliziyo okanye ukuyibuyisela kwisantya esiqhelekileyo, anjenge-`(Amiodarone)` (amagama eempawu ze-`Cordarone®` okanye `Pacerone®`), anokunikwa.
• Iindlela zonyango ezibizwa ngokuba yi-`(Catheter ablation)` okanye `(Cryoablation)` nazo zezi. Kule meko, kufakwa i-catheter kwindawo yentliziyo ebangela imiqondiso yombane engahambelaniyo kwaye itshabalalise loo ndawo. `(Cryoablation)` yindlela esebenzisa ukubanda kakhulu.
• Isantya se-atrial esiqhutywa yi-Overdrive: Umzamo wokubuyisela isigqi sentliziyo kwisimo esiqhelekileyo kusetyenziswa isixhobo sangaphandle, esifana ne-pacemaker.

Ngaba kukho naziphi na iingxaki kunyango?

Emva konyango lwe-`(Catheter ablation)`, ngamanye amaxesha esi sigqi singaqhelekanga sinokubuya. Kwakhona, nge-`(Catheter ablation)` kubantu abadala, kukho umngcipheko we-`(Atrioventricular block)` (oko kukuthi, ukuvaleka komqhubi olandelayo othwala isignali yombane emva kwe-`(Sinoatrial node)`). Ngenxa yokuba lo mngcipheko uphantsi, oogqirha ngamanye amaxesha basebenzisa indlela ye-`(Cryoablation)`. Ukuba unyango lwe-`(Ablation)` aluphumeleli emva kwezihlandlo ezibini, unokufuna ukuba ufake i-`(Pacemaker)` (isixhobo esincinci esilawula ukubetha kwentliziyo).

Kuthatha ixesha elingakanani ukuchacha kwezi ndlela zonyango?

Ngokwesiqhelo, emva kokususwa kwe-catheter, ungaya ekhaya uqalise imisebenzi yakho yesiqhelo ngoko nangoko. Nangona kunjalo, kunokufuneka ulinde iintsuku ezimbalwa ngaphambi kokuba wenze nayiphi na imisebenzi enzima. Ugqirha wakho uza kukunika imiyalelo ethile malunga noku.

Ngaba umngcipheko we-`(Junctional Tachycardia)` ungancitshiswa?

Oogqirha banokunciphisa umngcipheko wokuba neJunctional Tachycardia ngokunika amayeza athile ngaphambi okanye ngexesha lotyando. Umzekelo:

• `(I-Magnesium)`
• `(Propranolol)` (amagama eebhrendi `Inderal®XL` okanye `InnoPran®XL`)
• `(Dexmedetomidine)` (Ngamanye amaxesha le isetyenziswa ngexesha lotyando lwentliziyo kubantwana abancinci)

Yintoni enokulindelwa ngumntu one-`(Junctional Tachycardia)`?

Xa unobangela wesi sigqi esingaqhelekanga ufunyenwe kwaye wanyangwa, iimpawu ziya kuba ngcono kancinci kancinci. Nangona kunjalo, kuya kufuneka uhlale esibhedlele de imeko yakho ye-"Junctional Tachycardia" iphucuke.

Isiphumo (`Imbono`) sale meko siyahluka kuhlobo ngalunye.

• I-Primary okanye i-Congenital (i-Junctional Tachycardia)Le meko inzima ukuyinyanga. Ingakhokelela nakwiimeko ezinzima ezifana `(Ukusilela kwentliziyo)` (ukusilela kwentliziyo), `(Ukuvimba kwentliziyo ngokupheleleyo)` (ukuvaleka ngokupheleleyo kwemiqondiso yombane yentliziyo), kunye `(Ukubetha kwe-Ventricular)` (ukubetha okungalawulekiyo kwamagumbi asezantsi entliziyo). Ukuba ayinyangwa, kukho ithuba lokufa eliyi-9%. Nangona kunjalo, ukuba olu rhythm luqala emva kweenyanga ezintandathu zokuqala zobomi, isiphumo siba ngcono kakhulu.
• I-Secondary okanye i-Postoperative Junctional Tachycardia idla ngokuvela kwiintsuku ezimbini ukuya kwezintathu emva kotyando, kodwa idla ngokuphela kwiveki. Inokubangela uxinzelelo lwegazi oluphantsi, isiyezi, kunye nokulahlekelwa zingqondo.

Ndifanele ndimbone nini ugqirha?

Kuya kufuneka ubone ugqirha wakho ukuze akubonise ixesha lokulandela emva kweeveki ezimbini emva kokuba ubuyile esibhedlele. Kuya kufuneka uqhubeke nokufumana unyango lwemeko ebangele i-junctional tachycardia.

Ndingaya nini kwigumbi likaxakeka (ER)?

Ukuba ukhe wakhutshwa i-catheter, funa ingcebiso kagqirha ngokukhawuleza ukuba ufumanisa naziphi na ezi mpawu zilandelayo kwindawo yokufaka i-catheter (ngesiqhelo i-groin):

• Ukuba idumba ngequbuliso.
• Ukuba ukopha akupheli nokuba sele kucinezelwe kwaye kubanjwe.

Ndingayibuza yiphi imibuzo ugqirha wam?

Xa ufumanisa ukuba wena okanye umntwana wakho unale meko, kuyinto eqhelekileyo ukuba nemibuzo emininzi. Musa ukoyika ukubuza ugqirha wakho ngezi zinto:

• Luhlobo luni lwe-Junctional Tachycardia olunalo umntwana/mna?
• Yeyiphi indlela engcono yonyango lwengxaki yam?
• Ingaba kukho ithuba lokuba nabanye abantwana bam nabo baza kuba nale meko?

Ukuba umntwana wakho une-Junctional Tachycardia, buza ugqirha wakho ngeempawu uze uziqonde. Emva koko, ukuba into efana nale iphinda yenzeke, unokuyibona ngokukhawuleza. Musa ukoyika ukubuza imibuzo malunga nonyango umntwana wakho alufumanayo kunye neengozi ezibandakanyekileyo. Ukuzazi zonke ezi zinto kuya kukunceda wenze izigqibo ezilungileyo zempilo-ntle yomntwana wakho.

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Musa ukoyika xa usiva igama elithi `(Junctional Tachycardia)`. Le yingxaki ngesingqisho sentliziyo, kodwa:

• Oku kunokuchongwa. Oku kunokuchongwa ngovavanyo olufana ne-`ECG`.
• Kukho unyango. Ngokuxhomekeke kwisizathu, ingalawulwa ngamayeza okanye iindlela ezifana ne-``(Ablation)``.
• Uhlobo oluvelayo, ingakumbi emva kotyando, ludla ngokuba lolwexeshana. Luza kuphola kwiintsuku ezimbalwa.
• Thetha ngokukhululekileyo nogqirha wakho. Thetha nogqirha wakho ngayo yonke imibuzo yakho kunye noloyiko lwakho kwaye uzive ukhululekile.

Eyona nto ibalulekileyo kukukhumbula ukuba awuwedwa. Oogqirha kunye nabasebenzi bezempilo bahlala bekulungele ukukunceda.

Ndikunqwenelela impilo entle wena nosapho lwakho!

Ukubetha kwentliziyo , Isifo sentliziyo, i-Tachycardia, Isifo sentliziyo sabantwana, i-ECG, utyando lwentliziyo, i-Junctional Tachycardia