Ingaba intliziyo yakho iqala ukubetha ngokukhawuleza ngequbuliso? Masithethe nge-PSVT (Paroxysmal Supraventricular Tachycardia)!

Ngaba wakha wahlangabezana nokunyuka okungalindelekanga kwesantya sentliziyo yakho, ukubetheka esifubeni sakho, uze emva koko ube nomzuzu omfutshane wesimo esiqhelekileyo? Usenokuba ucinge ukuba oku yinto eqhelekileyo, okanye into eyenzekayo xa usoyika kancinci. Nangona kunjalo, ngamanye amaxesha akunjalo. Namhlanje siza kuthetha ngemeko ebizwa ngokuba yi-'Paroxysmal Supraventricular Tachycardia' okanye i-'PSVT', ebangela utshintsho olukhawulezileyo kwisantya sentliziyo. Ungakhathazeki, siza kuthetha ngale nto ngendlela elula onokuyiqonda.

Yintoni i-PSVT?

Ngamafutshane, i-'PSVT' kukungahambelani kakuhle kwesingqisho sentliziyo yethu, oko kukuthi, indlela esibetha ngayo intliziyo yethu ('arrhythmia'). Kule meko, intliziyo iqala ukubetha ngokukhawuleza kakhulu. Emva koko, ngequbuliso, isantya sentliziyo siyehla siye kwisantya sayo esiqhelekileyo kwakhona. Ezi ntliziyo zibetha ngokukhawuleza ngequbuliso 'zii-paroxysms'. Le meko ibangelwa ngumsebenzi ongaqhelekanga wombane oqala kumagumbi amabini aphezulu entliziyo, abizwa ngokuba yi-'atria'. Sibiza amagumbi amabini asezantsi entliziyo, abizwa ngokuba yi-'ventricles'. La magumbi mane asebenza kunye ukupompa igazi emzimbeni wethu wonke.

Ngoko ke, i-'PSVT' ibangelwa ngumsebenzi ongaqhelekanga wombane kwezi atria, nto leyo ebangela ukuba zinciphe ngokukhawuleza nangokuqhubekayo. Kodwa into ebalulekileyo kukuba i-'PSVT' ayisoloko isisifo esifuna unyango okanye esisongela ubomi. Ngamanye amaxesha inokunyangeka ngaphandle konyango. Ukuba kuyimfuneko, oogqirha baya kucebisa amayeza, unyango oluthile lwentliziyo, kwaye kunqabile kakhulu, i-'pacemaker'. Ukuba uziva into engaqhelekanga ngendlela intliziyo yakho ebetha ngayo, ngokuqinisekileyo kungcono ukubona ugqirha uze uyihlole.

Intliziyo yethu isebenza njani ngokuqhelekileyo?

Ngaphambi kokuba siqonde ukuba yintoni i-PSVT, makhe sijonge indlela intliziyo yethu esebenza ngayo ngokuqhelekileyo. Kwintliziyo ephilileyo, ukubetha kwentliziyo kuqala kwiqhekeza elincinci lezicubu kwi-atria. Siyibiza ngokuba yi-sinoatrial node (i-SA node). Le yinto esebenza njenge-pacemaker yendalo yentliziyo.

Le `SA node` ithumela imiqondiso yombane ebangela ukuba i-atria inciphe ize ipompe igazi. Ezi miqondiso emva koko ziya kwi-ventricles ngenye inqwaba encinci yeeseli ezibizwa ngokuba yi-`atrioventricular node` (AV node). Le `AV node` ithumela imiqondiso yombane kwi-ventricles ukuze inciphe. Le yindlela intliziyo yethu ebetha ngayo ngocwangco.

Ngaba kukho iintlobo zePSVT?

Ewe, kukho ezinye iimeko ezininzi phantsi kodidi olubanzi lwe-'PSVT'. Ezi zinokubangelwa bubukho bonxibelelwano lombane olungaphezulu kwesinye oluvela kumagumbi aphezulu entliziyo ukuya kumagumbi asezantsi, nokuba ngokuthe ngqo okanye nge-'AV node'. Oku kubangela ukuba intliziyo ibethe ngokukhawuleza ('tachycardia'). Ngamanye amaxesha, olu xinzelelo lwentliziyo lukhawuleza lunokuqala 'kwingqwalasela ecaphukisayo' kumagumbi aphezulu entliziyo.

Amanye amagama aqhelekileyo ezi ntlobo ze-tachycardia ngala:

• ``I-Atrioventricular nodal re-entrant tachycardia (AVNRT)''
• "I-Orthodromic reciprocating tachycardia (ORT)"
• "I-tachycardia ephikisanayo ne-antidromic reciprocating"
• `I-Atrial tachycardia`
• `Ukuphaphazela kwe-Atrial`

Nangona oku kungabonakala ngathi kungokwesayensi, kubalulekile ukuba oogqirha baqonde kakuhle imeko yakho baze banike unyango olufanelekileyo.

Kuqheleke kangakanani oku?

Izifo zesingqisho sentliziyo (arrhythmias) zixhaphake kakhulu. Izigidi zabantu eSri Lanka nakwihlabathi liphela zinengxaki ethile yesingqisho sentliziyo.

I-Supraventricular tachycardias (SVT) zezona ntlobo zixhaphakileyo zesifo sentliziyo, ingakumbi kubantwana abancinci nakwiintsana. Zikwaxhaphake kakhulu kubantwana abanesifo sentliziyo sokuzalwa.

Kutheni le PSVT isenzeka? Zithini izizathu?

I-PSVT (ekwabizwa ngokuba yi-re-entry tachycardia) sisifo sentliziyo esingaqhelekanga esenzeka kwi-atria. Sivela xa kukho umsebenzi ongaqhelekanga wombane kwi-atria. Oku kuthetha ukuba indawo enovakalelo olukhulu kwi-atria okanye i-short circuit kwiindlela zombane zentliziyo ibangela ukuba imiqondiso yombane iqale ukuhamba ngesangqa. Kulapho i-atria iqala ukufinyela ngokukhawuleza nangokuqhubekayo.

Ezi zimpawu zombane ezingaqhelekanga zinokwenzeka ukuba kukho indlela eyongezelelweyo yombane (`indlela eyongezelelweyo`) phakathi kwe-atria kunye ne-ventricles, nokuba ngokuthe ngqo okanye nge-`AV node`. Umzekelo, abantu abanesimo esibizwa ngokuba yi-`Wolff-Parkinson-White syndrome` banale ndlela eyongezelelweyo ezintliziyweni zabo. Emva koko, ukuba iimpawu zombane zihamba ngale ndlela eyongezelelweyo ngokukhawuleza kunokuba beziya kuhamba nge-`AV node` eqhelekileyo, intliziyo iqala ukubetha ngokukhawuleza kakhulu.

Njengezinye iingxaki zesingqisho sentliziyo (arrhythmias), i-PSVT inokuba yimfuza. Oku kuthetha ukuba ukuba umntu kusapho lwakho unayo, unokuba nayo. Ukongeza, kukho ezinye izizathu ezininzi ezinokubangela le meko. Makhe sijonge ukuba zeziphi:

• Ngokukhula: Kuba intliziyo iyatshintsha ngokuhamba kweminyaka.
• I-anemia: Xa umzimba ungafumani ioksijini eyaneleyo.
• Ukuphelelwa ngamanzi emzimbeni kunye nokudinwa kakhulu: Oku kunokubangela uxinzelelo entliziyweni.
• Iziselo nokutya okune-caffeine: Izinto ezifana neti, ikofu, itshokolethi, kunye nezinye iziselo ezinika amandla.
• Ukutya okuthile: Abanye abantu banokuba nentliziyo ebuhlungu emva kokutya ukutya okunamafutha amaninzi, iswekile, okanye iicarbohydrate. Umzekelo, ungaziva isifuba sakho sibetha emva kokutya okunzima okanye emva kwepati.
• Amanye amayeza: Umzekelo, i-pseudoephedrine, efumaneka kwezinye izithinteli zokuxinana kweempumlo.
• Ukusela utywala ngokugqithisileyo.
• Ukuba ukhe wahlaselwa yintliziyo ngaphambili okanye wenzakala ngenxa yotyando lwentliziyo.
• Isifo sentliziyo: ingakumbi isifo semithambo yegazi yentliziyo (CAD).
• Uxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu).
• Uxinzelelo olukhulu kunye noxinzelelo: Uxinzelelo olubangelwa zizinto ezifana novavanyo oluzayo, iingxaki zomsebenzi, okanye iingxaki zosapho.
• Utshintsho lweehomoni: Ngexesha lokuya exesheni kwabasetyhini, okanye ngexesha lokukhulelwa. Enyanisweni, ukubetha kwentliziyo kuxhaphake kakhulu ngexesha lokukhulelwa.
• Ukutyeba kakhulu (ukutyeba kakhulu) kunye nokutyeba kakhulu.
• Ukutshaya nokusetyenziswa kweemveliso zecuba.
• Iingxaki zesakhiwo sentliziyo: Umzekelo, isifo sevalvu yentliziyo.
• Iingxaki ze-thyroid: ingakumbi i-'Hyperthyroidism' (i-thyroid gland esebenza kakhulu).

Zithini iimpawu zePSVT?

Iimpawu zePSVT zihlala ziqala ngequbuliso zize ziphele ngequbuliso. Zinokuba buthathaka kwabanye abantu, kwaye zibe buhlungu kwabanye. Usenokuziva olu kubetha kwentliziyo ngokukhawuleza emva kokuzilolonga nzima, emva kosuku olungalali kakuhle, okanye ngexesha loxinzelelo olukhulu.

Iimpawu eziphambili zezi:

• Isantya sentliziyo esikhawulezayo nesingaqhelekanga. Sidla ngokuba ngaphezulu kwe-100 beats ngomzuzu (BPM), kodwa ngamanye amaxesha siphakame sibe yi-250 BPM. Abantwana abancinci abane-PSVT banokuba nesantya sentliziyo esiphakamileyo nangakumbi.
• Ukuva imvakalelo yokubetheka, ukubetheka, okanye ukubetheka esifubeni, emqaleni, okanye entanyeni (`i-palpitations`). Abanye abantu bathi kuvakala ngathi "igubu libetha ngaphakathi esifubeni." Usenokuziva ukubetha ngamandla nokubetha ngokukhawuleza.
• Utshintsho olukhawulezileyo kwisantya sentliziyo. Intliziyo yakho inokubetha ngokukhawuleza kangangemizuzu embalwa okanye iiyure ezimbalwa, ize ngequbuliso iqale ukubetha ngokwesiqhelo kwakhona. (Isantya sentliziyo esiqhelekileyo kumntu omdala siphakathi kwe-60 kunye ne-100 beats ngomzuzu.)

Xa le meko ye-`PSVT` isenzeka, unokufumana ezinye iimpawu ezininzi:

• Ndiziva ndixhalabile kwaye ndinesiyezi.
• Intlungu yesifuba, ukungakhululeki, okanye ukuziva uxinezelekile esifubeni.
• Ubunzima bokuphefumla okanye ukuphefumla kancinci (ukuphelelwa ngamandla).
• Isiyezi kunye nentloko ekhaphukhaphu, amehlo aluhlaza okwesibhakabhaka.
• Ukulahlekelwa zingqondo (i-syncope) okanye ukuquleka.
• Ukudinwa okanye ukudinwa kakhulu.
• Isicaphucaphu.

Uyazi njani ukuba une-PSVT?

Xa usiya kugqirha, uza kuqala akubuze ngeempawu zakho aze amamele intliziyo yakho nge-stethoscope. Emva koko, baza kuyalela uvavanyo lwegazi. Olu vavanyo lwegazi lujonga ukusebenza kwe-thyroid yakho kunye nezinye iingxaki egazini lakho.

Okulandelayo, ugqirha wakho uza kwenza uvavanyo lwe-electrocardiogram (EKG okanye i-ECG). Olu luvavanyo olunokwenziwa eofisini kagqirha kwaye luthatha malunga nemizuzu eli-15. I-EKG irekhoda umsebenzi wombane wentliziyo yakho kunye nesantya sentliziyo yakho ngokusebenzisa iisensa ezibekwe eluswini lwakho. Ngamanye amaxesha, ukuba ufumana i-PSVT ngexesha lokuzilolonga okunzima, unokucelwa ukuba wenze uvavanyo loxinzelelo lokuzilolonga.

Ukuba i-EKG ayibonisi ukubetha kwentliziyo okungaqhelekanga, ugqirha wakho uya kukunika i-ambulatory monitor, eyaziwa ngokuba yi-Holter monitor okanye i-patch monitor, ukuze uyinxibe iintsuku ezimbalwa okanye inyanga. Esi sisixhobo esincinci onokusinxiba emzimbeni wakho. Sihlala sirekhoda izinga lentliziyo yakho kunye nokubetha kwentliziyo okungaqhelekanga (ukuba kukho).

Iphathwa njani i-PSVT?

Ngokuxhomekeke kwimpilo yakho iyonke kunye neempawu zakho, usenokungadingi naluphi na unyango. Ukuba unesingqisho sentliziyo esingaqhelekanga (i-`arrhythmia`), uya kuthunyelwa ku-`cardiologist`. Usenokucebisa oku kulandelayo:

• Ziphephe utywala kunye ne-caffeine (iti, ikofu, iziselo ezibandayo). Kwakhona, yeka ukusebenzisa amayeza athile aqulethe i-pseudoephedrine, njenge-decongestants.
• Lala kakuhle uphumle.
• Sela amanzi amaninzi ukuze ugcine amanzi aneleyo emzimbeni.
• Fumana uncedo lokunciphisa uxinzelelo kunye nexhala, kwaye wenze umthambo wokuphumla.
• Ukuba utyebile kakhulu (utyebile kakhulu), yehlisa ubunzima kwaye ugcine ubunzima obusempilweni.
• Ukuba uyatshaya, yeka ngokupheleleyo.

Kwakhona, xa ufumana le meko ye-'PSVT', ungabuza ugqirha wakho ngeendlela ezithile zokuthoba isantya sentliziyo yakho okwethutyana. Ezi zibizwa ngokuba yi-'Vagal maneuvers'. Imizekelo:

• Ukutshiza ngamanzi abandayo ebusweni bakho ngaxeshanye.
• Ukukhwehlela ngendlela ekhethekileyo.
• Vala amehlo akho uze ucinezele kancinci kwiinkophe zakho.

Kubalulekile: Ungaze uzame ezi 'ndlela zokusebenzisa isitho sangasese somfazi' wedwa, ngaphandle koqeqesho olufanelekileyo. Ngokuqinisekileyo kufuneka udibane nogqirha wakho kwaye wenze kanye njengoko ekuxelela.

• Enye indlela efana nale yi-'Valsalva maneuver'. Kule ndlela, uphefumlela ngaphakathi, ucinezele impumlo yakho, uyibambe ngokungathi uzele, uze uyikhuphe ngokukhawuleza, ngokungathi ufutha ibhaluni. Oku kunokunciphisa isantya sentliziyo yakho kancinci.

Ukuba izinga lentliziyo yakho litshintsha rhoqo, ukuba libangela ukungakhululeki, okanye ukuba unezinye iingxaki zentliziyo, ugqirha wakho unokucebisa unyango. Olu nyango luquka:

• `Ukususwa kweCatheter`:Oku kuquka ukwenza umonakalo omncinci kwinxalenye yethishu yentliziyo ethumela imiqondiso yombane engaqhelekanga. Olu lunyango olubandakanya ukufaka ityhubhu encinci (i-catheter) ngomthambo, ngaphandle kokwenza umngxuma omkhulu.
• `Ukuphululwa kwe-Carotid sinus`: Kule nto, ugqirha ufaka uxinzelelo oluncinci kwindawo ethile entanyeni yakho ukuze anciphise isantya sentliziyo yakho. Oku kufanele kwenziwe ngugqirha kuphela, kwaye akufanele ukwenze ekhaya.
• Izixhobo: Ngamanye amaxesha isixhobo esifana ne-`Implantable Cardioverter Defibrillator (ICD), `subcutaneous ICD` okanye `permanent pacemaker` sinokucetyiswa ukuba sifakwe entliziyweni.
• I-Electrical cardioversion: Kule nto, intliziyo inikwa umbane okhuselekileyo (ukubetha kwamandla), ukuyeka isigqi esingahambelaniyo nokuvumela intliziyo ukuba ibethe ngendlela eqhelekileyo.
• Amayeza: Kukho amayeza anokubuyisela isigqi sentliziyo kwaye athintele ukungalungelelani kwesingqisho sentliziyo.

Ungayinciphisa njani ingozi ye-PSVT?

Kusenokungabi lula ukuyithintela ngokupheleleyo i-PSVT. Nangona kunjalo, ungayinciphisa ingozi yakho ngokulandela indlela yokuphila esempilweni nokuhlala usempilweni. Nazi ezinye izinto onokuzenza ukunciphisa ingozi yakho:

• Landela ukutya okunempilo kwentliziyo ( ukutya okuneoyile encinci, ityuwa encinci, neswekile encinci, kwaye utye imifuno emininzi, iziqhamo kunye nemifuno eluhlaza).
• Ukuba unezinto (`izinto ezibangela`) ozaziyo ukuba zibangela le meko ye-`PSVT`, ziphephe.
• Zilolonge kakuhle, hlala usempilweni, kwaye uzame ukugcina umzimba wakho usempilweni.
• Ukuba utyebile kakhulu, yehlisa umzimba, thetha nogqirha wakho, kwaye ugcine ubunzima bakho busempilweni.
• Ukuba une-high blood pressure (uxinzelelo lwegazi), yilawule.
• Gcina amanqanaba e-cholesterol asempilweni.
• Ukuba uyatshaya, yeka ngokupheleleyo.
• Ukuba wena okanye umntwana wakho unesifo sentliziyo esongeza umngcipheko we-PSVT, thetha nogqirha wakho ngaso. Uza kukunika iingcebiso ezithile malunga nendlela yokuhlala usempilweni kwaye unciphise umngcipheko wesifo sentliziyo.

Kwenzeka ntoni kumntu one-PSVT? Ikamva linjani?

Imbono yomntu one-PSVT ixhomekeke kwizinto ezininzi, kuquka ubudala bakho kunye nempilo yakho iyonke. Unokunceda ekulawuleni iimpawu zakho ngokwenza utshintsho kwindlela ophila ngayo kunye nokutya.

Ekuhambeni kwexesha, i-PSVT inokwenza buthathaka izihlunu zentliziyo. Kwiimeko ezinzima, i-PSVT inokubangela ukulahlekelwa zingqondo kwanokuma kwentliziyo ngequbuliso. Ke ngoko, ukuba une-PSVT, kubaluleke kakhulu ukubona ugqirha wakho rhoqo ukuze ajonge impilo yentliziyo yakho.

Iindaba ezimnandi zezokuba kwiimeko ezininzi, i-PSVT inokunyangeka ngokupheleleyo ngonyango olubizwa ngokuba yi-catheter ablation.

Ndingambona nini ugqirha malunga ne-PSVT?

Ukuba unenkxalabo malunga nesantya sentliziyo yakho, okanye ukuba uneempawu zentliziyo engahambelaniyo (i-arrhythmia), qiniseka ukuba uthetha nogqirha. Ukuba ufunyenwe une-PSVT, kubaluleke kakhulu ukubona ugqirha wakho wentliziyo rhoqo.

Ukuba ezi zinto ziyenzeka, funa ingcebiso kagqirha ngoko nangoko:

• Ukuba ngequbuliso uzive udiniwe kakhulu ngaphandle kwesizathu esicacileyo.
• Ukuba uziva utyhafile okanye ulahlekelwe zingqondo.
• Ukuba ufumana iintlungu esifubeni, ubunzima bokuphefumla, okanye ukuphefumla okunzima.

Okokugqibela, yintoni ekufuneka uyikhumbule (Umyalezo Wokuya Ekhaya)

I-Paroxysmal Supraventricular Tachycardia (PSVT) inokuba yoyikeka xa isenzeka. Nangona kunjalo, ayisoloko isongela ubomi okanye isongela ubomi. Nangona kunjalo, ukuba uneengxaki okanye imibuzo malunga nesantya sentliziyo yakho, kungcono ukubona ugqirha ukuze ahlolwe ngokupheleleyo ukuqinisekisa ukuba akukho ngxaki inzulu yempilo.

Nangona i-PSVT ingasoloko ifuna unyango, kukho unyango olufumanekayo ukuba uyalufuna. Ngokuhlala usebenza, ukunciphisa izinto ezifana ne-caffeine kunye notywala, ukulandela indlela yokuphila enempilo, kunye nokubona ugqirha wakho wentliziyo ngexesha, unokunciphisa umngcipheko weengxaki ezivela kwi-PSVT. Ngoko ke, nyamekela intliziyo yakho, kuba ligazi lakho lobomi!

Ukubetha kwentliziyo ngokukhawuleza, ukubetha kwentliziyo ngokukhawuleza, i-PSVT, i-Paroxysmal Supraventricular Tachycardia, i-arrhythmia, isifo sentliziyo, iintlungu zesifuba, i-tachycardia