Ngaba unesithuba esincinci entliziyweni yakho? Masithethe nge-(Patent Foramen Ovale - PFO)!

Ngaba wakha weva ukuba intliziyo yakho, okanye mandithi, phakathi kwamagumbi amabini aphezulu entliziyo, inokuba nomngxuma omncinci onokuhlala emva kokuzalwa? Abantu abaninzi bayamangaliswa kukuva oku. Kodwa yinyani. Le meko ibizwa ngokuba yi-'Patent Foramen Ovale' okanye `(PFO)`. Ungakhathazeki, siza kuthetha ngayo ngokulula, ngendlela onokuyiqonda.

Yintoni i-PFO? Masiyiqonde ngokulula

Ngamafutshane, i-patent foramen ovale (PFO) ngumngxuma omncinci, ofana nesiciko phakathi kwamagumbi amabini aphezulu entliziyo yakho, i-atrium yasekunene kunye ne-atrium yasekhohlo. Khawuthelekelele ukuba xa sonke sisesibelekweni sikamama, lo mngxuma, obizwa ngokuba yi-foramen ovale, ukhona. Ubalulekile. Kodwa ngesiqhelo, uyavalwa emva kokuba sizelwe. I-PFO xa ingavalwa emva kokuzalwa. Igama elithi "patent" lithetha "ukuvula."

Uninzi lwexesha, abantu abane-PFO abanazo iimpawu kwaye abadingi unyango. Nangona kunjalo, kunqabile kakhulu ukuba iingxaki ezithile, ezifana ne-stroke, zinxulunyaniswe ne-PFO.

Kutheni le nto ibalulekile le foramen ovale? Kwenzeka ntoni ngexesha lobuntwana?

Usana olusesibelekweni, oluyimveku, alusebenzisi imiphunga yalo ukuze lufumane igazi elinomoya-mpilo omninzi. Endaweni yoko, eli gazi linomoya-mpilo omninzi livela kumama nge-placenta, ecaleni kwe-umbilical cord. Oku kwenziwa yi-foramen ovale, iqondisa igazi elinomoya-mpilo omninzi ukusuka kwi-umbilical cord ukusuka kwi-atrium yasekunene yomntwana ngqo kwi-atrium yasekhohlo.

Ukusuka apho, elo gazi liya kwicala lasekhohlo lentliziyo yomntwana, linika ioksijini engqondweni yomntwana nakwezinye izitho ezibalulekileyo. Le yindlela emangalisayo, akunjalo?

Emva kokuba umntwana ezelwe, xa eqala ukuphefumla yedwa, igazi liya emiphungeni ukuze lifumane ioksijini. Kulapho ke le "foramen ovale" idla ngokuvaleka khona. Emva koko igazi elinooksijini liya kwicala lasekhohlo lentliziyo, kwaye ukusuka apho liphampelwa emzimbeni wonke.

Ngubani onokuhlakulela i-PFO? Ixhaphake kangakanani?

Enyanisweni, i-PFO inokuchaphazela nabani na, nokuba yindoda okanye ngumfazi, uhlanga, okanye umbala. Nangona kunjalo, ixhaphake kakhulu kumaqela athile:

• Iintlobo ngeentlobo zezilwanyana, ingakumbi abo banesifo esithi "Decompression sickness - air embolism", imeko apho amaqamza omoya avala imithambo yegazi ngenxa yotshintsho kuxinzelelo.
• Phakathi kwabo babe nestroke apho kungekho sizathu sichanekileyo sifumanekayo (i-cryptogenic stroke).

Ehlabathini lonke, malunga nomntu omnye kwabane (25%) unokuba ne-PFO. Ukongeza, kufunyenwe ukuba phakathi kwama-30% nama-40% abantu abaye baba ne-stroke ngaphandle kwesizathu esicacileyo bane-PFO. Nangona kunjalo, oku akuthethi ukuba wonke umntu one-PFO uza kuba ne-stroke. Kubalulekile ukukhumbula oko.

Ngaba ukuba ne-PFO kuyawuchaphazela umzimba?

Xa une-'PFO', igazi elincinci liphuma kwi-atrium yasekunene liye kwi-atrium yasekhohlo ngaloo maqhekeza amancinci. Ngokwesiqhelo, oku akwenzeki kuba la maqhekeza avaliwe.

Uninzi lwexesha, i-PFO ayibangeli ngxaki. Nangona kunjalo, ngamanye amaxesha ihlwili legazi linokuhamba ukusuka kwicala lasekunene lentliziyo ukuya kwicala lasekhohlo lentliziyo ngokusebenzisa le PFO. Ukuba oko kuyenzeka, intliziyo inokupompa elo hlwili legazi liye kwamanye amalungu omzimba. Khawucinge nje, ukuba elo hlwili legazi liya ebuchotsheni, ukuhanjiswa kwegazi ebuchotsheni kunokuphazamiseka. Kulapho kwenzeka imeko ebizwa ngokuba yi-ischemic stroke. Kwakhona, eli hlwili legazi linokonakalisa amanye amalungu anjengezintso kunye nentliziyo.

Ngaba kukho isizathu esithile sokuba i-PFO iphuhliseke?

Abaphandi abakafumani ngqo ukuba yintoni ebangela i-PFO. Oko kukuthi, akukacaci nokuba yimfuza, indalo, okanye enye into.

Zithini iimpawu ze-PFO? Jonga ukuba nawe unazo ezi

Abantu abaninzi abane-PFO ababonisi zimpawu. Yiyo loo nto. Nangona kunjalo, ngamanye amaxesha unokubona izinto ezinje:

• Istroke.
• Uhlaselo lwe-Ischemic oluThutyana (TIA) okanye i-mini-stroke . Oku kunokubangela ubunzima bokushukumisa ilungu, kwaye kunokuchaphazela amalungu abalulekileyo anjengengqondo, amathumbu amancinci, amathumbu amakhulu (ikholoni), okanye izintso.

Ukongeza, iimeko ezingaqhelekanga ziquka:

• Imyocardial infarction.
• Ukwehla kwamanqanaba eoksijini egazini (iHypoxemia).
• I-Platypnea-orthodeoxia syndrome (PO syndrome): Le yimeko apho inqanaba leoksijini egazini liyehla ngobunzima bokuphefumla ngelixa uhleli uthe nkqo.

Ufumanisa njani ukuba une-PFO? Zithini iimvavanyo?

Ugqirha wakho uza kuqala akubuze ngeempawu zakho aze enze uvavanyo lomzimba. Ukuba kurhanelwa ukuba une-PFO, banokucebisa uvavanyo olufana nolu:

• I-Transthoracic echocardiogram : I-echocardiogram (okanye i-echo) luvavanyo olusebenzisa amaza esandi ukuvelisa imifanekiso yamagumbi entliziyo. Uvavanyo lwenziwa ngokubeka isixhobo phezu kwesifuba.
• I-Transesophageal echocardiogram (TEE) : Kolu vavanyo, ugqirha wakho ufaka ityhubhu encinci enekhamera kwi-esophagus yakho. Oku kunokuvelisa umfanekiso ocacileyo we-PFO kune-echo eqhelekileyo.
• I-ultrasound ye-Transcranial Doppler (TCD) : I-ultrasound ye-TCD isebenzisa amaza esandi ukujonga ukuhamba kwegazi ukuya nangaphakathi kwengqondo yakho. Inokukunceda nokubona imivimbo ebangelwa kukuqhekeka kwegazi.

Kunye nezi mvavanyo, ugqirha wakho unokucebisa ukuba kwenziwe uvavanyo lwe-"bubble test". Oku kuquka ukufaka isisombululo se-saline emthanjeni wakho. Ukuba la maqamza ahamba ngomngxuma aye kwicala lasekhohlo lentliziyo yakho ngaphandle kokucoca imiphunga, anokuchonga ukuba ngaba unokuba ne-"PFO."

Ngaba kukho unyango lwe-PFO? Ngaba wonke umntu uyalufuna?

Uninzi lwabantu abane-PFO abaludingi unyango. Nangona kunjalo, ukuba unembali yestroke okanye amahlwili egazi, okanye usemngciphekweni omkhulu wokuwafumana, ugqirha wakho unokucebisa unyango. Iindlela zonyango ze-PFO ziquka:

• Amayeza athintela ukujiya kwegazi : Umzekelo, i-aspirin okanye i-warfarin.
• Ukufakwa kweCatheter : Kule nkqubo, ingcali yentliziyo engenelelayo isebenzisa ityhubhu ende nebhityileyo (i-catheter) ukuvala ivalvu. Le catheter idluliselwa ngomthambo omkhulu osesinqeni iye entliziyweni kwaye kusetyenziswa isixhobo esikhethekileyo (isixhobo sokuvala) ukuvala ivalvu. Izifundo zifumanise ukuba le nkqubo ye-catheter isebenza ngcono kunotyando ekunyangeni ii-PFOs kubantu abangaphantsi kweminyaka engama-60 ubudala.
• Utyando lwentliziyo : Ugqirha wenza utyando aze athunge i-flap ivaliwe. Oku kungenziwa ukuba indlela ye-catheter ayiphumelelanga. Oku kungenziwa ngotyando lwentliziyo evulekileyo okanye ngokusikwa okuncinci esifubeni okubizwa ngokuba yi-minimally invasive robotically assisted patent foramen ovale repair.

Uphando lwakutshanje lubonise ukuba kubantu abane-PFO abaye baba ne-stroke engachazwanga, ukuvala i-PFO kunokunceda ukuthintela i-stroke kwixesha elizayo. Kungcono ukuthetha nogqirha wakho malunga nonyango olufanelekileyo kuwe.

Ngaba unyango lunokubangela iziphumo ebezingalindelekanga?

Abanye abantu banokufumana iingxaki ngenxa yonyango lwe-PFO. Ezi ngxaki ziyahluka ngokuxhomekeke kwindlela yonyango:

Izinto ezinokwenzeka ngamayeza

Xa usebenzisa amayeza afana ne-Aspirin okanye i-Warfarin, oku kulandelayo kunokwenzeka:

• Ukopha.
• Ukopha igazi engqondweni (Intracranial hemorrhage).

Yintoni enokwenzeka ngexesha lonyango lwe-catheter?

Iingxaki eziqhelekileyo zokufakwa kwe-catheter:

• Amahlwili egazi.
• Ukonakala kwemithambo yegazi.
• Isixhobo sokuvala sikhululekile.
• Usulelo lwentliziyo okanye `i-endocarditis`.
• I-`PFO` ayivali kakuhle.
• `Ukugabha kwegazi emiphungeni (i-Pulmonary embolism)`.

Iingxaki ezingaqhelekanga:

• Ukubetheka komoya.
• Ukuphazamiseka kwentliziyo (i-Arrhythmia).
• `I-Atrial fibrillation (Afib)`.
• I-tamponade yentliziyo (ukwakheka kolwelo olujikeleze intliziyo).

Izinto ezinokwenzeka ngotyando

Utyando lokuvala i-PFO lunokubangela iingxaki ezifana nezi:

• `I-Atrial fibrillation (Afib)`.
• Ukopha.
• Iintsholongwane.
• Istroke.

Ngaba ikho indlela yokunciphisa umngcipheko wokwakheka kwe-PFO?

Akukho nto unokuyenza ukunciphisa umngcipheko wokuba ne-PFO. Asinto esinokuyilawula. Nangona kunjalo, ukuba une-stroke engachazwanga (i-cryptogenic stroke), kubalulekile ukuba uvavanyelwe le meko. Emva koko, ukuba kuyimfuneko, ungafumana unyango ngokukhawuleza.

Injani imeko yempilo yomntu one-PFO? Ngaba yinto ekufuneka ixhalatyelwe?

Kwiimeko ezininzi, isigqubuthelo somntwana one-PFO sivaleka ngokupheleleyo kwiminyaka emithathu yokuqala yobomi bakhe. Abantu abaninzi abane-PFO baphila ubomi obupheleleyo nobusempilweni ngaphandle kweengxaki xa sele bekhulile. Ngoko ke musa ukukhathazeka ngayo ngokungeyomfuneko .

Ukuba ndine-PFO, ndingayinyamekela njani impilo yam?

Ungayigcina intliziyo yakho isempilweni kwaye unciphise umngcipheko wakho westroke ngokulandela la manyathelo:

• Kuphephe ukusebenzisa utywala okanye ezinye iziyobisi.
• Yitya ukutya okunempilo okunentliziyo.
• Lawula uxinzelelo lwegazi oluphezulu (iHypertension) okanye amanqanaba aphezulu e-cholesterol.
• Gcina ubunzima bakho busempilweni.
• Yeka ukutshaya nokusebenzisa iimveliso zecuba.
• Fumana unyango olufanelekileyo kwezinye iimeko zempilo ezikwandisa umngcipheko wakho westroke, njenge-atrial fibrillation (Afib).

Kwakhona, ukungahlali kwindawo efanayo ixesha elide kunokunciphisa umngcipheko wokuqhekeka kwegazi.

Ngawaphi amaxesha afanelekileyo okubonana nogqirha?

Ukuba uneempawu zestroke , bona ugqirha ngoko nangoko okanye utsalele umnxeba ku-911 (okanye inombolo yakho yongxamiseko yasekuhlaleni). Ezi mpawu zingabandakanya:

• Ubunzima bokuthetha okanye ukuqonda.
• Ukuba nesiyezi okanye ukulahleka kokulinganisela.
• Ubungqindilili okanye ubuthathaka ebusweni, engalweni, okanye emlenzeni.
• Ubunzima bokubona kwelinye okanye omabini amehlo.
• Intloko ebuhlungu kakhulu ngequbuliso.

Umyalezo Wokuya Ekhaya

I-patent foramen ovale (PFO) ngumngxuma omncinci entliziyweni phakathi kwamagumbi asekunene nasekhohlo entliziyo. Ichaphazela umntu omnye kwabane (25%) . Uninzi lwexesha, i-PFO ayibangeli zimpawu kwaye ayifuni nyango. Nangona kunjalo, ngamanye amaxesha inokuba luphawu lwestroke okanye i-mini-stroke. Ukuba unembali yestroke okanye amahlwili egazi, ugqirha wakho unokucebisa unyango. Iindlela zonyango ziquka amayeza, i-catheterization, kunye notyando. Into ebalulekileyo kukuba uninzi lwabantu abane-PFO banokuphila ubomi obupheleleyo nobusempilweni. Ukuba uneengxaki, ungathandabuzi ukuthetha nogqirha wakho.

"I-PFO, i-patent foramen ovale, umngxuma entliziyweni, isifo sohlangothi, ihlwili legazi, isifo sentliziyo, i-foramen ovale