Ngaba icala lasekhohlo lentliziyo yakho nalo libuthathaka? (Ukusilela kwentliziyo kwicala lasekhohlo) - Masithethe ngale nto!

Ngaba ngamanye amaxesha uziva uphelelwa ngumphefumlo? Okanye uziva uphelelwa ngumphefumlo xa uhamba, ugobile, okanye usenza umsebenzi othile? Ngaba kufuneka uhlale phantsi ebusuku kuba uziva ufuthanisekile xa ulala? Ngaba uvuvukele emilenzeni nasemaqatheni? Oku ngamanye amaxesha kunokuba ziimpawu zecala lasekhohlo elibuthathaka lentliziyo. Namhlanje, masithethe ngale meko ibizwa ngokuba yi -`(Left-Sided Heart Failure)` ngendlela elula onokuyiqonda. Ungoyiki, kubaluleke kakhulu ukuqaphela oku.

Yintoni i-Left-Side Heart Failure?

Ngamafutshane, oku kuthetha ukuba icala lasekhohlo lentliziyo yethu alikwazi ukwenza umsebenzi walo, okukupompa igazi emzimbeni wonke, ngokufanelekileyo. Cinga ngalo njengepompo yamanzi. Ukuba ayisebenzi kakuhle, amanzi akayi etankini. Yiyo loo nto kunjalo. Kukho iintlobo ezimbini eziphambili zale nto:

1. Ukusilela kwentliziyo yeSystolic: Oku kuxa igumbi eliphambili lokumpompa kwicala lasekhohlo lentliziyo, elibizwa ngokuba yi-ventricle yasekhohlo, lifinyela lize libe buthathaka ngokwaneleyo ukupompa igazi emzimbeni wonke. Oku kuthetha ukuba ubungakanani begazi elimpompa intliziyo (inxalenye yokukhupha igazi) buyancipha. Kanye njengokuba amandla emoto enganele, uxinzelelo olupompa amanzi luyancipha.

2. Ukusilela kwentliziyo okubangelwa yi-diastolic: Le yimeko eyahlukileyo. Nangona i-ventricle yasekhohlo inamandla, ayiphumli kakuhle kwaye ayoluli kangangoko kufanele ukuba izalise ngegazi. Oku kuthetha ukuba igumbi lentliziyo liyaqina. Kufana nokuzama ukugcwalisa ibhaluni eqinileyo nengaguqukiyo ngamanzi, kwaye kunzima ukugcwalisa ngegazi. Kwimeko enjalo, ubungakanani begazi eliphampa intliziyo (i-ejection fraction) bunokuba yinto eqhelekileyo.

Ngaba uyayiqonda umahluko phakathi kwezi ntlobo zimbini ngoku?

Asebenza njani amacala asekhohlo nasekunene entliziyo yethu?

Intliziyo yethu sisitho esimangalisayo ngokwenene. Isebenza njengempompo enamandla, isebenza ngokungayeki. Inamacala amabini aphambili, icala lasekhohlo necala lasekunene. Icala ngalinye lenza umsebenzi owahlukileyo.

• Icala lasekhohlo: Eli cala ngumlinganiswa oyintloko webali lethu. Icala lasekhohlo lentliziyo lifumana igazi elicocekileyo nelinomoya-mpilo elivela emiphungeni. Eli gazi lisasazwa kuwo wonke umzimba, ukusuka kwingqondo ukuya ezinyaweni, kuwo onke amalungu omzimba, izihlunu, kunye nezicubu zomzimba. Le oxygen inika lonke ilungu lomzimba wethu amandla kunye nobomi elibudingayo ukuze lenze umsebenzi walo.

• Icala lasekunene: Icala lasekunene liqokelela igazi elisetyenziswe emzimbeni, oko kukuthi, igazi elilahlekelwe yioksijini neliqokelele i-carbon dioxide, lize lilibuyisele emiphungeni ukuze licocwe. Kukwimiphunga apho sikhupha khona i-carbon dioxide size songeze ioksijini entsha egazini.

Ngale ndlela, la macala mabini asebenzisana ukugcina ukujikeleza kwegazi okufanelekileyo emizimbeni yethu.

Yintoni ebangela ukuba icala lasekhohlo lentliziyo libe buthathaka?

Khawucinge nje, bekuya kwenzeka ntoni ukuba besisebenzisa ipompo yamanzi endlwini yethu iminyaka emininzi ngaphandle kokulungiswa okanye ukubonelelwa? Kancinci kancinci, amalungu ayo aya kuguga, ukusebenza kwayo kuya kuncipha, kwaye ekugqibeleni iyeke ukusebenza, akunjalo? Yiyo loo nto ke intliziyo yethu. Ezinye izifo kunye nemikhwa yethu emibi inokonakalisa icala lasekhohlo lentliziyo ngokuhamba kwexesha, iyenze ibe buthathaka. Nazi ezinye zezizathu eziphambili:

• Isifo semithambo yegazi: Oku kwenzeka xa amafutha eqokelelana ngaphakathi kwimithambo yegazi (imithambo yegazi) ehambisa igazi entliziyweni. Oku kuthintela izihlunu zentliziyo ekufumaneni ioksijini kunye nezondlo ezifunekayo.
• Uhlaselo lwentliziyo: Uhlaselo lwentliziyo kukuphazamiseka ngequbuliso kokuhamba kwegazi entliziyweni. Oku kubangela ukuba inxalenye yentliziyo ife, nto leyo enciphisa amandla entliziyo okupompa.
• Uxinzelelo lwegazi oluphezulu (`Uxinzelelo lwegazi oluphezulu`) alulawulwa ixesha elide: Xa uxinzelelo luphezulu rhoqo, intliziyo kufuneka isebenze nzima ukupompa igazi. Ekuhambeni kwexesha, intliziyo iyadinwa kwaye ibe buthathaka.
• Iziphene zevalvu yentliziyo (`isifo sentliziyo seValvular`): Ukuba iivalvu entliziyweni azivali okanye azivuleki kakuhle, ukuhamba kwegazi kuyaphazamiseka kwaye intliziyo iziva ithwele umthwalo ongaphezulu.
• Izingqisho zentliziyo ezingaqhelekanga (i-Arrhythmia): Xa intliziyo ingashayi ngesingqisho esifanelekileyo, ukusebenza kwayo ngokumpompa kuyehla.
• Ezinye iimeko ezingaqhelekanga zonyango: Umzekelo, iimeko ezifana ne-`(Amyloidosis)` (ukubekwa kweproteni engaqhelekanga entliziyweni) okanye `(Sarcoidosis)` (ukwakheka kwamaqhuqhuva amancinci entliziyweni) zinokubangela ukuba izihlunu zentliziyo ziqine kwaye zibe buthathaka.

Kubalulekile: Esinye okanye ezingaphezulu kwezi zizathu zinokubangela ubuthathaka kwicala lasekhohlo lentliziyo.

Ukongeza koku, kukho nezinye izinto ezininzi ezibangela umngcipheko . Oku kuthetha ukuba abantu abanezi zinto banokuba nobuthathaka kwicala lasekhohlo lentliziyo:

• Ezinye iindlela zonyango lwe-chemotherapy zomhlaza zinokubangela iziphumo ebezingalindelekanga entliziyweni (i-cardiotoxicity).
• Isifo seswekile.
• Ukutyeba kakhulu.
• Ukuphelelwa ngamandla xa ulele.
• Njengoko sikhula, ukusebenza kwentliziyo yethu kunokuncipha kancinci ngokwemvelo.
• Ukutshaya nokuphefumla umsi wabanye abantu.
• Ukuqhubeka nokusebenzisa iziyobisi ezithile kunye neziselo ezinika amandla, eziyingozi entliziyweni.
• Kunqabile kakhulu, amanye amayeza asetyenziselwa ukunyanga ezinye iimeko (umz., izifo zokuzikhusela komzimba, ukungakwazi ukunikela ingqalelo/ukungasebenzi kakuhle emzimbeni (ADHD)) nawo anokuchaphazeleka.

Zithini iimpawu zale meko?

Ekuqaleni, xa icala lasekhohlo lentliziyo liqala ukuba buthathaka, usenokungaziboni iimpawu ezinkulu. Usenokucinga , "Owu, ngumkhuhlane nje" okanye " Yinto eyenzekayo xa ukhula." Kodwa njengoko ukusebenza kwentliziyo yakho kusiba mandundu, usenokuqala ukuqaphela izinto ezinje:

• Ukukhohlela okungapheliyo: Ufanele ukhathazeke xa ukhohlela, ingakumbi ebusuku okanye xa ulele.
• Ukuqhawukelwa ngumphefumlo:
• Xa ndihamba kancinci, ndinyuka izitebhisi ezimbalwa, ndize ndigobe, ndiba yintloko ebuhlungu.
• Xa ndivuka ebusuku, ndiziva ngathi ndiphefumla nzima, ngokungathi isifuba sam siyaxina.
• Kunzima ukulala xa ulele phantsi, kwaye kulula ukuphefumla xa uhleli phezulu. (Oku kungenxa yokuba ulwelo oluninzi luqokelelana emiphungeni xa ulele phantsi).
• Ukunyuka kobunzima ngequbuliso: Ungonyuka ikhilogram enye okanye ezimbini kwiintsuku ezimbalwa. Oku akukokuba kukhulu, kodwa kukugcina ulwelo emzimbeni.
• Ukudumba (ukudumba): Ukudumba kwamaqatha, imilenze, kwaye ngamanye amaxesha isisu. Oku kubangelwa kukugcinwa kolwelo emzimbeni.

Ekuhambeni kwexesha, njengoko intliziyo isebenza nzima ukwenza umsebenzi wayo, iingxaki ezifana nezi:

• Umothuko wentliziyo: Le yimeko engxamisekileyo. Intliziyo ayikwazi ukupompa igazi elaneleyo, nto leyo ebangela ukunqongophala kwegazi eliya kumalungu abalulekileyo omzimba.
• Intliziyo ekhulisiweyo: Xa intliziyo isebenza nzima kakhulu, izihlunu zayo ziyaqina kwaye intliziyo iba nkulu.
• Ukuphazamiseka kwentliziyo (`Arrhythmia`): Isingqisho sentliziyo sisenokuba singaqhelekanga.

Ukuba unayo nayiphi na kwezi mpawu, nceda ubone ugqirha.

Ugqirha uyibona njani le nto?

Xa usiya kugqirha, baqala bakubuze imibuzo emininzi. Zithini iimpawu zakho, unexesha elingakanani unazo, ngaba kukho nabani na kusapho lwakho onesifo sentliziyo, ngawaphi amayeza owasebenzisayo, njalo njalo. Emva koko bayakuhlola. Bamamela intliziyo yakho, bahlole imiphunga yakho, baze bajonge ukudumba.

Ukongeza, ezi mvavanyo zilandelayo (uvavanyo lwelebhu kunye nezifundo zomfanekiso) zingenziwa ukuqinisekisa imeko echanekileyo kunye nokufumana unobangela:

• Uvavanyo lwegazi (`Uvavanyo lwelebhu`):
• Uvavanyo lwegazi lwe-BNP (B-type natriuretic peptide): Olu luvavanyo olukhethekileyo lwe-biomarker. Xa uxinzelelo olukwiigumbi zentliziyo lusanda, le hormone ikhutshwa egazini. Amanqanaba ayo anokunika umbono wokuba intliziyo ibuthathaka na.
• `Iphaneli ye-Metabolic`: Oku kujonga ukusebenza kwezintso nesibindi, kunye namanqanaba eetyuwa egazini, njenge-sodium kunye ne-potassium. Ezi zibalulekile kwisifo sentliziyo.

• Izifundo zomfanekiso:
• I-Electrocardiogram (ECG/EKG): Le irekhoda umsebenzi wombane wentliziyo. Ingabona izinto ezifana nokuhlaselwa yintliziyo okanye ingxaki yesingqisho sentliziyo.
• I-Echocardiogram (ECHO): Oku kufana ne-ultrasound scan yentliziyo. Ingabona ngokucacileyo izinto ezininzi, njengobukhulu bamagumbi entliziyo, ubukhulu beendonga, umsebenzi weevalvu, kunye nendlela intliziyo epompa ngayo igazi (i-ejection fraction).
• I-angiography ye-coronary:Uvavanyo olukhethekileyo lwe-``(X-ray)``` ukuze kubonwe ukuba kukho ukuvaleka kwemithambo yegazi yentliziyo ehambisa igazi entliziyweni.
• I-Cardiac MRI (Cardiac Magnetic Resonance Imaging): Oku kungathatha imifanekiso ecacileyo neneenkcukacha zentliziyo. Kunokunceda ekuchongeni izinto ezifana nemeko yemisipha yentliziyo kunye neendawo ezonakeleyo.

Ngokusekelwe kulwazi olufunyenwe kwezi mvavanyo, ugqirha uya kugqiba ukuba loluphi uhlobo lwesimo onaso kunye nonyango olufanelekileyo kuso.

Inyangwa njani? Ngawaphi amayeza afumanekayo?

Iindaba ezimnandi zezokuba kukho iindlela ezahlukeneyo zonyango lokusilela kwentliziyo kwicala lasekhohlo. Unyango olufanelekileyo kuwe luya kuxhomekeka ekubeni unayo na "ukusilela kwentliziyo yeSystolic" okanye "ukusilela kwentliziyo yeDiastolic", kunye nobunzima bemeko.

Amayeza adla ngokuba lolona nyango luphambili. La mayeza anceda ukuphucula ukusebenza kwentliziyo, ukunciphisa iimpawu, kunye nokwandisa ubomi. Nazi ezinye zezona mayeza zisetyenziswa kakhulu:

• Ii-ACE inhibitors (ii-angiotensin-converting enzyme inhibitors), ii-Angiotensin II receptor blockers (ii-ARB), ii-Angiotensin-receptor neprilysin inhibitors (ii-ARNI): Ezi ndidi zamayeza zisebenza ngokukhulula imithambo yegazi, ukunciphisa uxinzelelo lwegazi, kunye nokunceda intliziyo ukuba itshintshe.
• Ii-Aldosterone antagonists: Ezi zilawula ii-hormone ezinxulumene noxinzelelo kwaye zithintela iimpawu ukuba zingabi mbi. Zikwanceda ekunciphiseni ukudumba ngokunciphisa ukugcinwa kwamanzi (i-diuretic ethambileyo).
• Ii-Beta blockers: La mayeza anciphisa isantya sentliziyo aze anciphise umthwalo womsebenzi entliziyweni, oko kukuthi, ubungakanani bomsebenzi ekufuneka wenziwe.
• I-Digoxin: Eli yeza linceda abanye abantu, ingakumbi abo baneengxaki ezithile zesingqisho sentliziyo, ukuba bazive bebhetele kwaye balawule izinga lentliziyo yabo.
• I-Diuretics: Ezi zisebenza ngokukhupha ulwelo olugqithisileyo emzimbeni ngomchamo, nto leyo enokunciphisa iimpawu ezifana nokuphefumla kancinci kunye nokudumba.
• Izithinteli zeSodium-glucose transport protein 2 (SGLT2): Olu hlobo lutsha lwamayeza luluncedo kakhulu kubantu abanesifo seswekile nabangenaso isifo sentliziyo. Zikwanceda ekunciphiseni ulwelo olugqithisileyo emzimbeni kwaye zikhusela intliziyo.

Khumbula: Kubalulekile ukuthatha la mayeza njengoko ugqirha wakho ewamisele, ngedosi echanekileyo, nangexesha elifanelekileyo. Ungaze uyeke ukuwathatha la mayeza okanye utshintshe idosi ngaphandle kwengcebiso kagqirha wakho.

Ngaba abanye abantu kufuneka banyangwe ngendlela ekhethekileyo (`iinkqubo`)?

Ewe, kwezinye iimeko, ukuba iimpawu azinakulawulwa ngamayeza kuphela, okanye ukuba uvavanyo lubonisa ukuba imeko yentliziyo iya isiba mandundu, ugqirha unokucebisa iinkqubo ezikhethekileyo okanye utyando. Nazi ezinye zazo:

• Unyango lokuvuselela intliziyo (CRT): Oku kuquka ukufaka isixhobo esincinci (njenge-pacemaker) phantsi kolusu esizisa ukuvuselelwa kombane ukunceda amagumbi asekhohlo nasekunene entliziyo ukuba anciphe ngaxeshanye. Oku kukwabizwa ngokuba yi-biventricular pacemaker. Oku kwenza isenzo sokumpompa kwentliziyo sisebenze ngakumbi.
• I-Electrical cardioversion: Unyango oluzisa umothuko wombane esifubeni ukubuyisela isigqi sentliziyo esiqhelekileyo xa intliziyo ingalingani.
• I-ICD (i-ICD) efakelwayo: Esi sisixhobo esifakwa phantsi kwesikhumba. Sibona ukungalingani kwesantya sentliziyo kwaye sithumela ngokuzenzekelayo imiqondiso yombane ukuze siyibuyisele kwimeko yesiqhelo.
• Isixhobo sokuncedisa i-ventricular yasekhohlo (LVAD): Le yimpompo efakwa ngotyando entliziyweni ukunceda intliziyo ipompe igazi. Isetyenziselwa abantu abanesifo sentliziyo esinzima abalinde ukufakelwa intliziyo.
• Ukufakelwa intliziyo: Kwizigulana ezineentliziyo ezibuthathaka kakhulu ezingaphumelelanga kuzo zonke ezinye iindlela zonyango, ukufakelwa intliziyo ephilileyo kumntu oswelekileyo yindlela yokugqibela.

Singenza ntoni ukuze siphephe le meko? (Ukuthintela)

Kukho intetho ethi "Ukuthintela kungcono kunonyango." Oko kuyasebenza nalapha. Ukulandela indlela yokuphila enempilo yentliziyo kunokunciphisa kakhulu umngcipheko wokusilela kwentliziyo kwicala lasekhohlo. Ukuba sele unayo le meko, imikhwa emihle inokunceda ukuthintela iingxaki zexesha elizayo kunye nokulawula imeko.

Nazi ezinye izinto onokuzenza:

• Gcina uxinzelelo lwakho lwegazi, amanqanaba e-cholesterol, kunye nesifo seswekile phantsi kolawulo ukuba unazo. Sela amayeza achazwe ngugqirha wakho.
• Zilolonge rhoqo. Yenza umthambo olula njengokuhamba ubuncinane imizuzu engama-30 ngosuku.
• Zinike ixesha lokulala kamnandi ebusuku . Udinga ukulala iiyure ezisi-7-8 ngosuku.
• Gcina ubunzima bomzimba busempilweni. Ukutyeba kakhulu ngumthwalo omkhulu entliziyweni.
• Yitya ukutya okunempilo. Yitya iziqhamo, imifuno, iimbotyi, kunye nokutya okutyebileyo kwi-fiber. Nciphisa ityuwa, iswekile, kunye neoyile.
• Nciphisa uxinzelelo. Yenza izinto ezifana neyoga, ukucamngca, umthambo wokuphefumla ('iindlela zokuphumla'). Zibandakanye nomsebenzi owuthandayo.
• Ukuba uyatshaya, yeka ngoko nangoko. Hlala kude neendawo apho abanye abantu batshaya khona ('umsi otshaywe ngomnye umntu').
• Nciphisa okanye uyeke ngokupheleleyo ukusebenzisa utywala .

Buza kuba njani ubomi ukuba icala lasekhohlo lentliziyo libuthathaka? Zithini iingxaki ezinokubakho?

Ukuba ulandela imiyalelo kagqirha wakho ngokuchanekileyo, usebenzise amayeza akho ngokuchanekileyo, kwaye uye kwiindawo zokulandelela ngexesha, ungazigcina impilo yakho isempilweni. Uninzi lwabantu lunokuphila ubomi obuqhelekileyo.

Nangona kunjalo, ukuba le meko ayilawulwa kakuhle, ezinye iingxaki zinokubakho. Nazi ezinye zazo:

• Ukungahambi kakuhle kwesingqisho sentliziyo (`Arrhythmias`): Umzekelo, ``ventricular tachycardia`` (ukubetha kwentliziyo okukhawulezayo), ``atrial fibrillation / Afib`` (ukubetha kwentliziyo okungaqhelekanga kwe-atrium).
• I-apnea yokulala (i-apnea yokungalali kakuhle kunye ne-central sleep).
• Iingxaki zeevalvu zentliziyo (`isifo sevalvu yentliziyo`), njengokuvuza kwegazi ngasemva ngeevalvu.
• Isifo sesibindi: Xa intliziyo ingapompi igazi ngokufanelekileyo, isibindi naso sinokuchaphazeleka.
• Ukungasebenzi kakuhle kwentliziyo kwicala lasekunene: Xa icala lasekhohlo lentliziyo libuthathaka, kunokuchaphazela necala lasekunene.
• Ubuthathaka kunye nobuthathaka bemisipha.
• I-anemia.
• Isifo sezintso: Xa intliziyo ibuthathaka, umlinganiselo wegazi eliya kwizintso uyancipha, nto leyo enokuchaphazela ukusebenza kwazo.
• Uxinzelelo okanye ixhala: Ukuphila nesigulo esihlala ixesha elide kunokuba nemiphumo yengqondo.

Yintoni ekufuneka siyitshintshe xa siphila nale meko?

Xa uphila nokungasebenzi kakuhle kwe-ventricular yasekhohlo, kukho utshintsho olubalulekileyo kwindlela ophila ngayo onokulwenza ukunceda ukulawula imeko yakho, ukunciphisa iimpawu, nokwenza ubomi bube lula.

• Yiba nomdla womzimba ngakumbi kunangaphambili: Zibandakanye kwimithambo efanelekileyo kuwe, njengoko ugqirha wakho ekucebisile.
• Jonga uxinzelelo lwakho lwegazi yonke imihla: Lubhale phantsi njengoko ugqirha wakho ekuxelela.
• Qhubeka usela amayeza akho okusilela kwentliziyo njengoko uyalelwe: ungaphoswa lusuku olunye.
• Bona ugqirha wakho ngexesha kwaye uye kwiikliniki: Oku kuya kunceda ugqirha ukuba ajonge imeko yakho aze enze naluphi na utshintsho olufunekayo.
• Nciphisa ityuwa ekutyeni kwakho: Ityuwa inokunyusa ukugcinwa kwamanzi emzimbeni, nto leyo ekhokelela ekudumbeni nasekuphefumuleni nzima.
• Zilinganisele rhoqo kusasa: ngaxeshanye, ngendlela efanayo (umz., emva kokusebenzisa indlu yangasese, ngaphambi kokuba unxibe). Ukuba unyukelwa yikhilogram enye okanye ezimbini ngosuku okanye ezimbini, oko kusenokuba kukugcina amanzi. Ukuba oko kuyenzeka, xelela ugqirha wakho.
• Sela kuphela ubungakanani bolwelo (njengamanzi, iti, isuphu) obunikiweyo ngosuku: Abanye abantu kufuneka balawule indlela abatya ngayo ulwelo.

Okokugqibela, yintoni ekufuneka uyikhumbule (Umyalezo Wokuya Ekhaya)

Ngamafutshane, i-Left-Side Heart Failure yimeko apho amandla entliziyo okupompa igazi ehla khona, kwaye yinto ekufuneka ixhalatyelwe. Oku kuxhaphake kakhulu kubantu abaneengxaki zentliziyo ezifana noxinzelelo lwegazi oluphezulu, isifo semithambo yegazi, kunye nokungaphumeleli kwentliziyo.

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Nangona kunjalo, akukho sizathu sokoyika. Ukuba uzibona iimpawu zale meko kwangethuba, uyinyange ngokufanelekileyo ngokweengcebiso zonyango, sebenzisa amayeza amiselweyo, kwaye ulandele indlela yokuphila enempilo yentliziyo, ungaphila kamnandi kwaye ukhululekile nale meko.

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Ngoko ke, ukuba uneempawu ezikhankanyiweyo kweli nqaku, eyona nto ingcono onokuyenza kukubona ugqirha ofanelekileyo ngokukhawuleza uze ufumane ingcebiso ngaphandle kokuyityeshela. Okukhona isifo sifunyanwa ngokukhawuleza, kokukhona unyango luya kuphumelela. Ndikunqwenelela impilo entle!

Ukusilela kwentliziyo , Ukusilela kwentliziyo kwicala lasekhohlo, Ukuphelelwa ngumphefumlo, Ukudumba, Isifo sentliziyo, Uhlaselo lwentliziyo, Uxinzelelo lwegazi oluphezulu