Ingaba uneentlungu esifubeni kwaye kunzima ukuphefumla? Oku kusenokuba yi-pericarditis!

Ngaba wakha waziva intlungu ebukhali, ehlabayo esifubeni sakho, nto leyo eyenza kube nzima ukuphefumla? Oku kunokwenzeka nasemva kokuba uphilile kumkhuhlane okanye umkhuhlane. Abantu abaninzi bayoyika ukuba esi sisifo sentliziyo. Enyanisweni, sinokuba kukudumba kwesingxobo esijikeleze intliziyo. Namhlanje, siza kuthetha ngale meko ngokweenkcukacha ebizwa ngokuba yi-"pericarditis."

Ngaba uyazi ukuba yintoni i-pericarditis?

Ngamafutshane, i-'Pericarditis' kukudumba okanye ukudumba kwe-'pericardium', ingxowa encinci kakhulu, enamaleko amabini, egcwele ulwelo ejikeleze intliziyo yethu. Ifana nokusikeka eluswini lwethu okubangela ukuba indawo ibe bomvu kwaye idumbe. Umsebenzi ophambili wale 'pericardium' kukukhusela intliziyo kwaye uyinike ukuthambisa okufunekayo xa ibetha. Ngenxa yokudumba, ngamanye amaxesha ulwelo olongezelelweyo lunokuqokelelana phakathi kwale pericardium. Oku kubizwa ngokuba yi-'pericardial effusion'.

I-Pericarditis idla ngokuvela ngequbuliso. Nangona kunjalo, ngamanye amaxesha inokuhlala iiveki ukuya kwiinyanga. Ngokwesiqhelo, imeko iyaphela kwiinyanga ezintathu, kodwa kwabanye abantu, inokuhlala iminyaka.

Kukho iintlobo ezahlukeneyo ze-pericarditis, akunjalo?

Ewe, kukho iintlobo ezahlukeneyo ze-'Pericarditis'. Makhe sibone ukuba zeziphi iintlobo eziphambili:

• I-Acute Pericarditis: Olu lolona hlobo luxhaphakileyo. Olu kuvuvukala kwenzeka ngequbuliso, kunye neempawu.
• I-Chronic Pericarditis: Eli ligama elinikwa ukudumba okuhlala iinyanga ezintathu okanye ngaphezulu emva kwesiganeko sokuqala esibuhlungu.
• I-Constrictive Pericarditis: Le yimeko enzulu ngakumbi. Okwenzekayo apha kukuba iileya ze-pericardium ezivuvukileyo ziyaqina kancinci kancinci, izicubu ezibomvu ziyakheka, kwaye zinamathelane. Kufana nokuba intliziyo iyaxina. Oku kuphazamisa kakhulu ukusebenza kwentliziyo ngokuqhelekileyo. Le meko idla ngokuvela emva kwexesha elide le-'Acute Pericarditis'.
• I-Pericarditis Esulelayo: Le meko inokubangelwa lusulelo olubangelwa yintsholongwane, yibhaktiriya, yifungus, okanye yiparasite.
• I-Idiopathic Pericarditis: Ngamanye amaxesha unobangela woku awaziwa . Yiyo loo nto ibizwa ngolu hlobo.
• I-Traumatic Pericarditis: Le meko ingenzeka emva kokwenzakala esifubeni, umzekelo emva kwengozi yemoto.
• I-Uremic Pericarditis: Oku kunokwenzeka kubantu abanezintso ezingasebenzi kakuhle.
• I-Pericarditis enobungozi:Le meko inokwenzeka ngenxa yomhlaza okhula kwenye indawo emzimbeni.

Yintoni umahluko phakathi kweMyocarditis kunye nePericarditis?

Zombini ziimeko zokudumba kwentliziyo, kodwa zenzeka kwiindawo ezimbini. I-Myocarditis kukudumba kwemisipha yentliziyo. I-Pericarditis kukudumba kwesingxobo esijikeleze intliziyo, esibizwa ngokuba yi-pericardium. Zombini zihlala zibangelwa yintsholongwane. Zombini zinokubangela iintlungu zesifuba. Nangona kunjalo, nge-pericarditis, iintlungu zesifuba kufuneka zincitshiswe xa uthe tyaba phambili. Nge-myocarditis, uya kuziva udiniwe kwaye ubuthathaka ngakumbi.

Ngubani onokuthi abe nePericarditis?

Nabani na unokuba nesifo sentliziyo esibizwa ngokuba yi-pericarditis. Nangona kunjalo, sixhaphake kakhulu kumadoda aphakathi kweminyaka eli-16 nengama-65 ubudala. Ngokwezibalo, esi sifo senzeka kubantu abamalunga nama-28 kwabayi-100,000 ngonyaka.

Kwenzeka ntoni emzimbeni xa kuvela i-pericarditis?

Xa une-pericarditis, inwebu ejikeleze intliziyo yakho iba bomvu kwaye idumbe. Kufana nolusu olujikeleze inxeba elingalweni okanye emlenzeni wakho elidumbileyo. Le pericardium ibaluleke kakhulu. Ithambisa intliziyo, iyikhusele kwiintsholongwane kunye nomhlaza, kwaye inceda ukuyigcina ikwindawo yayo esifubeni. Ikwathintela intliziyo ekubeni ibe nkulu kakhulu xa umthamo wegazi unyuka. Oku kunceda intliziyo isebenze kakuhle.

Zithini iimpawu ze-pericarditis? Uyibona njani?

Uphawu oluphambili lwe-pericarditis ziintlungu zesifuba. Le ntlungu ikwaneempawu ezithile:

• Intlungu ebukhali nehlabayo (oku kubangelwa kukukhuhla kwentliziyo kwi-pericardium evuvukileyo).
• Le ntlungu inokwanda xa ukhohlela, uginya, uphefumla nzulu, okanye ulala phantsi.
• Nangona kunjalo, xa uhlala phantsi uze ugobe phambili, kufuneka uzive iintlungu ziyancipha. Olu luphawu olubaluleke kakhulu.

Ngamanye amaxesha ungaziva ufuna ukugoba okanye ukubamba isifuba sakho ukuze kube lula ukuphefumla.

Kukho nezinye iimpawu:

• Intlungu emqolo, entanyeni, okanye egxalabeni lasekhohlo.
• Kunzima ukuphefumla xa ubambekile.
• Ukukhwehlela okomileyo.
• Ukubetha kwentliziyo kukuziva intliziyo ibetha ngokukhawuleza okanye ngokungacwangciswanga.
• Ndihlala ndiziva ndixhalabile kwaye ndidiniwe.
• Ifiva.
• Kwiimeko ezinzima, ukudumba kwemilenze, amaqatha, kunye neenyawo.

Ukuba imilenze yakho, iinyawo, namaqatha akho avuvukile, okanye unengxaki yokuphefumla nokuba wenza imisebenzi emincinci, oko kungaba luphawu lwemeko enzima ebizwa ngokuba yiConstrictive Pericarditis. Oku kuxa i-pericardium iqina kwaye ithintela intliziyo ukuba ikhule ngokufanelekileyo. Oku kuthintela intliziyo ekupompeni igazi ngokufanelekileyo. Oku kunokubangela ukuba imiphunga, isisu, kunye nemilenze zizaliswe ligazi kwaye zidumbe, ezifana neempawu zeCongestive Heart Failure. Izingqisho zentliziyo ezingaqhelekanga nazo zinokwenzeka.

Ukuba uneempawu ze-'Acute Pericarditis', bonana nogqirha wakho ngoko nangoko. Ukuba ucinga ukuba iimpawu zakho zingxamisekile, funa unyango kwisibhedlele esikufutshane.

Kutheni i-Pericarditis isenzeka? Zithini izizathu?

Okumangalisayo kukuba, kwiimeko ezingama-90 kwezili-100, akukho sizathu sicacileyo esifumanekayo sale "pericarditis." Oku kubizwa ngokuba yi "idiopathic pericarditis."

Nangona kunjalo, kukho ezinye izizathu ezininzi zokuba i-pericarditis inokwenzeka:

• Njengengxaki yosulelo lwentsholongwane (idla ngokuba yintsholongwane yesisu).
• Usulelo olubangelwa yintsholongwane, umzekelo, isifo sephepha.
• Usulelo lwefungus.
• Usulelo oluvela kwi-parasite.
• Ngenxa yezinye 'Izifo Ezichaphazela Umzimba', umzekelo 'Lupus', 'Rheumatoid Arthritis', 'Scleroderma'.
• Ukwenzakala esifubeni, njengasemva kwengozi yemoto.
• Ngenxa 'yokungasebenzi kakuhle kwezintso'.
• Ngenxa yomhlaza ofana ne-'Lymphoma'.
• Ngenxa yezifo zemfuza ezifana ne-'Familial Mediterranean Fever (FMF)'.
• Ngenxa yamayeza athile acinezela inkqubo yomzimba yokuzikhusela (oku kunqabile kakhulu).

Kwakhona, umngcipheko wokufumana i-Pericarditis uphezulu emva kwezi zinto zilandelayo:

• Emva 'kokuhlaselwa yintliziyo'.
• Emva kotyando lwentliziyo oluvulekileyo (Utyando lwentliziyo oluvulekileyo / i-Postpericardiotomy Syndrome).
• Emva konyango lwemitha.
• Emva konyango oluthile olufana ne-'Cardiac Catheterization' okanye i-'Radiofrequency Ablation (RFA)`.

Kwezi meko, i-pericarditis inokubangelwa yingxaki kwindlela umzimba osabela ngayo kutyando okanye kwimeko ethile. Ngamanye amaxesha, iimpawu ze-pericarditis zingathatha iiveki ezininzi ukuba zivele emva kotyando lwe-bypass. Thetha nogqirha wakho ngale nto.

Gqirha, uyifumanisa njani i-pericarditis?

Intlungu ebukhali esifubeni sakho ngasemva kweentloko zamagxa akho, ingakumbi xa ugoba phambili, kunye nentlungu esifubeni xa uphefumla zezona zinto zimbini zibalulekileyo ezibonisa ukuba unokuba ne-pericarditis. Oku kunokukunceda uqonde ukuba ayisosifo sentliziyo na. Ugqirha wakho uza kukubuza ngeempawu zakho, nokuba ubugula kutshanje, naziphi na izifo zangaphambili, naluphi na utyando olwenzekileyo, kunye nezinye iingxaki zempilo ezinokunyusa umngcipheko wakho wokuba ne-pericarditis.

Ugqirha uza kumamela intliziyo yakho. Xa iileya ezivuvukileyo ze-pericardium zixubana, uya kuva isandi esifana namagqabi amabini exubana, okanye iziqwenga ezibini zesikhumba esomileyo zixubana . Oku kubizwa ngokuba yi-"pericardial rub." Esi sandi sivakala kakuhle xa uthe tyaba phambili, ubambe umphefumlo wakho, uze uphefumle kancinci. Ngokuxhomekeke kubukhali bokudumba, unokuva "ukuqhekeka" emiphungeni. Oku kuthetha ukuba kukho ulwelo kwindawo ejikeleze imiphunga, okanye kukho ulwelo olongezelelweyo kwi-pericardium.

Zeziphi iimvavanyo ezenziwayo koku?

Oogqirha baza kwenza uvavanyo olwahlukeneyo ukujonga i-pericarditis, kunye neengxaki ezifana ne-pericardial effusion okanye i-constrictive pericarditis. Kusenokufuneka wenze enye okanye ezingaphezulu kwezi zilandelayo:

• I-X-reyi yesifuba: Jonga ubungakanani bentliziyo uze ubone ukuba kukho ulwelo emiphungeni.
• I-Electrocardiogram (ECG okanye EKG): Ijonga utshintsho kwisingqisho sentliziyo. Malunga nesiqingatha sabantu abane-pericarditis baya kuba notshintsho olubonakalayo kwi-ECG yabo. Abanye abantu basenokungabi nalo naluphi na utshintsho konke konke.
• I-Echocardiogram (Echo): Ukubona ukuba intliziyo isebenza kakuhle kangakanani na nokuba kukho ulwelo olujikeleze intliziyo (i-pericardial effusion). I-echo ingabonisa iimpawu ze-constrictive pericarditis, eyisingxobo esiqinileyo nesiqinileyo esijikeleze intliziyo.
• I-MRI yentliziyo: Ukujonga ulwelo olongezelelweyo, ukudumba, ukuqina, okanye ukurhawuzelela kwentliziyo kwi-pericardium . Into ekhethekileyo ebizwa ngokuba yi-'Gadolinium' ifakwa entliziyweni.
• I-CT Scan: Ukubona ukuba kukho i-calcium deposits, ulwelo, ukudumba, iithumba, okanye ezinye izifo kwi-pericardium. Oku kusebenzisa idayi equlethe 'i-Iodine'. Funda ngakumbi malunga nokudumba. Olu vavanyo lubaluleke kakhulu ukuba ufuna utyando lwe-'Constrictive Pericarditis'.
• Ukulungisa iCatheterization yentliziyo: Kujonga uxinzelelo olungaphakathi entliziyweni. Oku kunokuqinisekisa ukuba uneConstrictive Pericarditis.
• Uvavanyo lweGazi: Ukuqinisekisa ukuba awunasifo sentliziyo, ukubona ukuba intliziyo yakho isebenza kakuhle kangakanani, ukujonga ulwelo olukwi-pericardium, kunye nokunceda ekufumaneni unobangela we-pericarditis. Ukuba une-pericarditis, i-ESR (Erythrocyte Sedimentation Rate) kunye namanqanaba e-C-reactive protein (CRP) akho ahlala ephezulu kunesiqhelo. Ezinye iimvavanyo zinokwenziwa ukujonga izifo ezibangelwa kukuzikhusela komzimba ezifana ne-lupus kunye ne-rheumatoid arthritis.

Ziziphi iindlela zonyango lwe-pericarditis?

Kwiimeko ezininzi, amayeza odwa anele abantu abane-pericarditis, kuxhomekeke kwisizathu esirhanelwayo. Nangona kunjalo, ukuba ulwelo luqokelelene kwi-pericardium yakho, lunokufuneka lususwe. Ukuba une-pericarditis exineneyo, utyando lunokufuneka.

Amayeza ePericarditis

I-Acute pericarditis inyangwa ngamayeza eentlungu kunye nokudumba, njenge-ibuprofen okanye i-aspirin enedosi ephezulu. Ngokuxhomekeke kwisizathu se-pericarditis, unokufuna amayeza okubulala iintsholongwane okanye amayeza okulwa ne-fungus.

Ukuba uneempawu eziqatha kangangeeveki ezingaphezu kwesibini, okanye ukuba zibuya emva kokuba uphilile, ugqirha wakho angakunika amayeza okulwa nokuvuvukala abizwa ngokuba yiColchicine (Colcrys® okanye iGloperba®). IColchicine inokunceda ukulawula ukudumba kunye nokuthintela i-pericarditis ukuba ingabuyi kangangeeveki okanye iinyanga. Ukuba unesifo sezintso, ugqirha wakho angakunika ne-steroid ebizwa ngokuba yiPrednisone, enokwenza kube nzima ukuthatha i-ibuprofen kunye ne-colchicine.

Ukuba kufuneka uthathe iidosi eziphezulu ze-`Ibuprofen`, ugqirha wakho uya kukunika neminye imithi yokunciphisa ukungakhululeki kwamathumbu. Ukuba uthatha iidosi eziphezulu ze-`NSAIDs (Nonsteroidal Anti-inflammatory Drugs)`, kuya kufuneka wenze uvavanyo lwe-`Follow-up` rhoqo ukujonga utshintsho ekusebenzeni kwezintso nakwisibindi.

Ukuba une-'Chronic' okanye 'Recurrent' Pericarditis, kunokufuneka uthathe 'NSAIDs' okanye 'Colchicine' iminyaka eliqela, nokuba usempilweni. 'Iipilisi zamanzi' ("iipilisi zamanzi") zihlala zinceda ukususa ulwelo olongezelelekileyo oluqokelelana ngenxa ye-'Constrictive Pericarditis'. Ukuba unengxaki ye-heart rhythm, ugqirha wakho uya kuthetha nawe malunga nonyango lwaloo nto.

Ugqirha wakho angathetha nawe malunga nokunyanga imeko yakho ngee-steroids okanye amanye amayeza, anjenge-`Azathioprine (Azasan® okanye i-Imuran®)`, `IV Human Immunoglobulins`, okanye `Anakinra` okanye `Rilonacept`.

Ukuba i-pericarditis yakho ibangelwa lusulelo, ugqirha wakho uya kukunika amayeza athile okunyanga olo sulelo. Ukuba lubangelwa lumhlaza, unyango olungcono kukunyanga umhlaza.

Utyando kunye neenkqubo ze-pericarditis

Xa ulwelo luqokelelana phakathi kweengqimba ze-pericardium, lubangela imeko ebizwa ngokuba yi-'Pericardial Effusion.' Ukuba olu lwelo luqokelelana ngokukhawuleza, lunokubangela i-'Cardiac Tamponade', imeko enzima ebeka uxinzelelo entliziyweni kwaye iphazamise ukusebenza kwayo. I-'Cardiac Tamponade' yingxamiseko yezonyango esongela ubomi efuna unyango olukhawulezileyo.

Oku kuqokelelana ngequbuliso kolwelo phakathi kweengqimba zentliziyo kunokuthintela intliziyo ukuba isebenze kakuhle kwaye kubangele ukwehla koxinzelelo lwegazi. Oku kusongela ubomi, ngoko ke ugqirha kufuneka asuse ulwelo ngoko nangoko.

Ukuba unolwelo kwi-pericardial effusion yakho, olubangela uxinzelelo entliziyweni yakho, kunokufuneka wenze inkqubo ebizwa ngokuba yi-pericardiocentesis. Oku kubandakanya ugqirha esebenzisa ityhubhu ende, encinci ebizwa ngokuba yi-catheter ukususa ulwelo olugqithisileyo. Le tyhubhu kunye nenaliti zikhokelwa kwi-pericardial sac kusetyenziswa i-echocardiogram okanye i-CT scan.

Ukuba ulwelo alunakukhutshelwa ngenaliti, ugqirha uya kwenza inkqubo encinci yotyando ebizwa ngokuba yi-"pericardial window." Oku kuquka ukwenza umngxuma omncinci esifubeni nokwenza umngxuma kwi-pericardium ukuze kususwe ulwelo.

Ukuba une-constrictive pericarditis, inxalenye ye-heart sac yakho inokufuneka isuswe. Olu tyando lubizwa ngokuba yi-pericardiectomy. Lwenziwa kubantu abanezicwili kwi-heart sac. Aluqhelekanga ukwenziwa kubantu abanokuvuvukala okusebenzayo kunye nentlungu yesifuba ngenxa ye-pericarditis.

Utyando alusoloko lusetyenziswa njengonyango kubantu abane-pericarditis ephindaphindayo, njengoko ukudumba kunokwenza kube nzima ukuchacha emva kotyando. Nangona kunjalo, ugqirha wakho unokuxoxa nawe ngale nto ukuba ezinye iindlela zonyango azisebenzanga.

Kuthatha ixesha elingakanani ukuchacha emva konyango?

Ufanele uphendule kunyango kwisithuba seveki, kodwa kuya kufuneka uthathe amayeza kangangeeveki ezimbini. Ukuchacha emva kotyando kuthatha ixesha elide. Kungathatha iiveki okanye iinyanga ukuchacha ngokupheleleyo kwi-pericarditis. Kubaluleke kakhulu ukufumana ukuphumla okwaneleyo ngelo xesha.

Ngaba ukuphinda kwe-pericarditis kungancitshiswa?

Nangona ungenakukuthintela isiganeko se-'Acute Pericarditis', ungayinciphisa ingozi yokuba iphindaphindeke ngokufumana unyango olukhawulezileyo kwaye ulandele unyango ngokuchanekileyo. Kwakhona, landela imiyalelo kagqirha wakho malunga nexesha lokuqalisa umthambo. Ukuzilolonga ngamandla ngexesha le-'Pericarditis' esebenzayo kunokuyenza imeko ibe mandundu.

Yintoni omele uyikhumbule xa uphila ne-pericarditis?

Wakuba uphilile kwi-pericarditis, kufuneka ukwazi ukubuyela kwimisebenzi yakho yesiqhelo ngaphandle kokukhathazeka. Nangona kunjalo, ungaqhubeki nokuzilolonga okunzima de ugqirha wakho akunike ithuba. Ugqirha wakho uza kukuxelela okungakumbi ngale nto.

I-pericarditis ihlala ixesha elingakanani?

• I-Acute Pericarditis ihlala phakathi kweeveki ezine ukuya kwezintandathu.
• I-'Incessant Pericarditis' (eqhubekayo) ihlala ixesha elide kunoko, kodwa ingaphantsi kweenyanga ezintathu.
• I-Chronic Pericarditis ibisoloko ikho kangangeenyanga ezingaphezu kwezintathu.
• Phakathi kwe-15% kunye ne-30% yabantu abane-pericarditis banokufumana iziqendu eziphindaphindayo kwiminyaka edlulileyo.

Ukuba banyangiwe, abantu abane-'Acute Pericarditis' banethuba eliphezulu lokuchacha. Uninzi lwabantu luyachacha ngokupheleleyo. Ukuba unesifo esincinci, sinokuphela ngokuphumla. Nangona kunjalo, ukuba asinyangwa, abanye abantu banokuba ne-'Chronic Pericarditis'.

Eyona nto ibalulekileyo kukuthatha amayeza njengoko ugqirha ewayalele kwaye ubone ugqirha ngemihla ebekiweyo.

Ufanele uye nini kugqirha?

Ukuba uneempawu ze-'Constrictive Pericarditis', bona ugqirha ngokukhawuleza. Ezi mpawu ziquka:

• Ubunzima bokuphefumla.
• Ukudumba kwemilenze neenyawo.
• Ukugcinwa kwamanzi emzimbeni.
• Ukubetha kwentliziyo.
• Ukudumba okukhulu kwesisu.

Nangona iintlungu zesifuba ziluphawu oluqhelekileyo lwe-pericarditis, zinokuba luphawu lokuhlaselwa yintliziyo. Ngoko ke, ukuba ufumana iintlungu zesifuba, zisenokuba luhlaselo lwentliziyo, ngoko ke yiya kwigumbi longxamiseko ngokukhawuleza.

Okokugqibela, ezinye izinto ezibalulekileyo

Ndiyathemba ukuba ngoku uyiqonda ngcono le meko ibizwa ngokuba yi-'Pericarditis'. Khumbula,Ukuba unentlungu esifubeni, ingakumbi xa ugoba phambili naxa uphefumla, kunye neempawu ezifana nomkhuhlane nokudinwa, isenokuba yi-pericarditis. Ukuba oku kuyenzeka, kungcono ukufuna ingcebiso kagqirha ngaphandle kokukhathazeka.

Ukuba ufumana unyango kwangethuba, ungaphila ubomi obupheleleyo. Ukuba ulandela unyango ngokufanelekileyo, kunokunceda ekuthinteleni ukuba imeko ingaphindi ibuyele esiqhelweni. Kungoko ke, kubaluleke kakhulu ukusebenzisa amayeza achazwe ngugqirha wakho ngokuchanekileyo kwaye uye rhoqo kutyelelo lokulandelela. Qaphela iimpawu ze-pericarditis, ukuze ukuba iphinda ivele, ufumane unyango ngokukhawuleza. Ndikunqwenelela impilo entle!

I- Pericarditis, i-pericarditis, iintlungu zesifuba, ukuphefumla okufutshane, isifo sentliziyo, uhlaselo lwentliziyo, i-Colchicine