Isifo Sokufa Esibangelwa Yi-Arrhythmic Death Syndrome (SAD)

Ngaba wakha weva ngomntu owayesemncinci kwaye esempilweni owasweleka ngequbuliso? Ngaba wakha wazibuza ukuba oko kungenzeka njani? Ngamanye amaxesha kusenokuba ngenxa yemeko esiza kuthetha ngayo namhlanje ebizwa ngokuba yiSudden Arrhythmic Death Syndrome (SADS) . Le yinto enzulu kakhulu, kodwa kubalulekile ukuyiqaphela.

Yintoni i-Sudden Cardiac Death Syndrome (SADS)?

Ngamafutshane, le yimeko yentliziyo. Uninzi lwexesha, yinto oyizuz’ ilifa , oko kuthetha ukuba inokudluliselwa kwizizukulwana ngezizukulwana. Okwenzekayo koku kukuba kukho ingxaki ngenkqubo yombane entliziyweni yakho. Cinga ngayo, intliziyo yethu isebenza njengejenereyitha encinci. Ziimpawu zombane ezenza intliziyo ibethe ngokufanelekileyo. Ngoko ke, xa kukho ingxaki ngale nkqubo, isingqisho sentliziyo siba yinto engaqhelekanga . Ukuba oku akuphathwa ngokufanelekileyo, unokufuna ukujongana nokufa ngequbuliso. Yiyo loo nto kuyingozi.

Ziziphi iintlobo eziphambili ze-SADS?

Kukho iintlobo ezahlukeneyo ze-SADS. Nganye kuzo inomahluko omncinci. Makhe sijonge ezinye zeentlobo eziphambili:

• Isifo seBrugada: Le yimeko apho amagumbi asezantsi entliziyo, abizwa ngokuba yi-atria, aphuhlisa ukubetha kwentliziyo okukhawulezayo nokungaqhelekanga (i-polymorphic ventricular tachycardia).
• I-Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT): Le yimeko apho iiseli zentliziyo zibetha ngokukhawuleza nangokungaqhelekanga. Le meko inokwenzeka ingakumbi ngexesha lokuzilolonga okanye uxinzelelo lwengqondo.
• I-Long QT syndrome (LQTS): Kulapho izihlunu zentliziyo yakho zithatha ixesha elide ukulungiselela isigqi esilandelayo, oko kukuthi, ukuphinda zitshaje (ziphinde zitshaje okanye zitshaje). Kufana nebhetri ethatha ixesha elide ukutshaja. Ukuba ujonga i-EKG, umahluko phakathi kwamaza e-Q kunye ne-T ubizwa ngokuba yi-QT interval. Xa eli xesha lide kakhulu, iiseli zentliziyo zinokuqala ukubetha ngokukhawuleza kakhulu (ventricular tachycardia) okanye ngokungacwangciswanga (ventricular fibrillation).
• I-Short QT syndrome (SQTS): Oku kuchasene ne-long QT. Kuthetha ukuba iiseli zentliziyo zithatha ixesha elincinci kakhulu ukulungiselela ukubetha okulandelayo. Oku kunokubangela ukuba amagumbi aphezulu entliziyo (i-atrial fibrillation) abethe ngokungacwangciswanga, okanye amagumbi asezantsi (ventricular tachycardia) abethe ngokukhawuleza, okanye angcangcazele ngokungacwangciswanga (ventricular fibrillation).
• I-Timothy syndrome: Le yimeko engaqhelekanga kakhulu. Ikwaluhlobo lwe-long QT syndrome.
• Isifo sikaWolff-Parkinson-White (WPW):Kulapho kwenziwa khona indlela eyongezelelweyo nengaqhelekanga yokuba imiqondiso yombane ihambe phakathi kwamagumbi aphezulu (i-atria) kunye namagumbi asezantsi (i-mitra). Oku kongezwa kwindlela eqhelekileyo, enokubangela ukuba intliziyo ibethe ngokukhawuleza kakhulu (i-tachycardia).

Zixhaphake kangakanani ezi meko zeSADS?

Ezi azixhaphakanga kangako, kodwa azikho kwaphela. Umzekelo, i -long QT syndrome (LQTS) ekhankanyiweyo ngaphambili kuqikelelwa ukuba ichaphazela malunga ne-1 kwi-2,000 yeentsana ezisandul’ ukuzalwa. I-Brugada syndrome ayixhaphakanga kangako, ichaphazela ngaphantsi kwe-1% yabemi. Imeko ebizwa ngokuba yi -CPVT ichaphazela malunga ne-1 kwi-1000.

Kodwa, ngokubanzi, malunga nabantu abangama-200,000 bafa ngenxa yokuma kwentliziyo ngesiquphe (i-SCA) minyaka le eMelika kuphela. Kukwabikwa nokuba malunga nabantwana abangama-4,000 kunye nabantu abadala abaselula bafa ngenxa yezi meko ze-SADS minyaka le. Ngoko ke, loo nto ayiyonto incinci, akunjalo?

Zithini iimpawu ze-SADS?

Nangona kukho iintlobo ezahlukeneyo ze-SADS, kukho iimpawu eziqhelekileyo. Nangona kunjalo, abanye abantu basenokungabi nazo kwaphela iimpawu.

Iimpawu eziqhelekileyo:

• Ukuquleka okanye ukuxhuzula kusenokwenzeka ngexesha lokuzilolonga, okanye xa uchwayitile kakhulu okanye usoyika.
• Intlungu yesifuba inokubakho ngexesha lokuzilolonga.
• Usenokuphelelwa ngumphefumlo xa usenza umthambo.

Ngoku makhe sijonge iimpawu ezahlukeneyo ezinxulumene nohlobo ngalunye lwe-SADS.

Iimpawu zeBrugada syndrome

Nangona uninzi lwabantu lungenazo iimpawu, abanye banokufumana ezi mpawu zilandelayo:

• Ukubanjwa kwentliziyo kunokwenzeka, ingakumbi xa ulele.
• Ukuquleka.
• Ukuxhuzula.
• Indlela yokuphefumla engaqhelekanga.

Iimpawu ze-catecholaminergic polymorphic ventricular tachycardia (CPVT)

Kusenokungabikho zimpawu de kube kuvele isifo sentliziyo, kodwa abanye abantu banokuziva betyhafile ngexesha lokuzilolonga.

Iimpawu zeLong QT Syndrome (LQTS)

Malunga nesiqingatha sabantu abane-LQTS abanazo iimpawu. Kodwa abanye abantu:

• I-arrhythmia ethile ebizwa ngokuba yiTorsades de Pointes inokubangela ukuhlaselwa yintliziyo.
• Ukuquleka.
• Ukuxhuzula.

Iimpawu ze-Short QT Syndrome (SQTS)

Malunga nama-40% abantu abanale meko abanazo iimpawu. Kodwa abanye:

• Ukubetha kwentliziyo .
• Ukuquleka.
• Ukuhlaselwa yintliziyo.

Iimpawu zesifo sikaTimothy

Iimpawu ezinokubonwa apha zezi:

• Ukuquleka.
• Ukuhlaselwa yintliziyo.
• Ngamanye amaxesha kukho iminwe eneentambo kunye/okanye iinzwane.
• Imiba yophuhliso.

Iimpawu ze-Wolff-Parkinson-White syndrome (WPW)

Iimpawu ze-WPW ziquka:

• Ukubetha kwentliziyo.
• Ukuziva unesizunguzi (ubudenge).
• Ubunzima bokuphefumla.
• Ukuquleka.
• Ukuxhuzula.

Kubalulekile: Ukuba wena okanye umntu omaziyo unenye okanye ngaphezulu kwezi mpawu, ngokuqinisekileyo kuya kufuneka ufune ingcebiso kagqirha.

Zithini izizathu zeSADS?

Amaxesha amaninzi, xa umntu oselula esifa ngequbuliso, kwaye ulwakhiwo lwentliziyo yakhe lubonakala luqhelekile xa ehlolwa, oogqirha bacinga ukuba wayene-arrhythmia engafunyaniswanga, ukubetha kwentliziyo okungahambelaniyo. Iimeko ze-SADS ezibangela ezi arrhythmia, esithethe ngazo ngaphambili, zihlala zidluliselwa kumzali ukuya emntwaneni . Oko kukuthi, zivela kwi-genes. Amathuba okuba ezi meko zidluliselwe ebantwaneni anokwahluka ngokuxhomekeke kwi-gene echaphazelekayo kunye nenxalenye yentliziyo echaphazelekileyo.

Oogqirha bayifumana njani i-SADS?

Ukuba umntu oselula uneempawu ezichazwe apha ngasentla, kwaye ukuba umntu kusapho lwakhe uye wasweleka ngequbuliso ngendlela engachazekiyo ngaphambi kokuba afikelele kwiminyaka engama-40 ubudala, ugqirha unokurhanela ukuba une-SADS. Iindlela zokuxilonga ziyahluka ngokuxhomekeke kuhlobo lwe-SADS.

Iindlela zokuxilonga ezisetyenziswa kakhulu:

• I-Electrocardiogram (EKG): Oku kuvavanya ukusebenza kombane kwentliziyo.
• Uvavanyo lwe-genetic: Olu vavanyo lokujonga umahluko we-genetic onxulumene ne-SADS.
• Uvavanyo loxinzelelo lweTreadmill: Olu vavanyo luvavanya indlela intliziyo esabela ngayo xa isenza umthambo.
• Uvavanyo lweCatecholamine provocation: Kunikwa iyeza elikhethekileyo kwaye impendulo yentliziyo iyabonwa.
• Isixhobo sokubona ukubetha kwentliziyo iHolter: Sisixhobo esirekhoda ukubetha kwentliziyo rhoqo kangangeeyure ezingama-24.
• I-Echocardiogram: Olu luvavanyo lwe-ultrasound olujonga ulwakhiwo kunye nomsebenzi wentliziyo.
• I-ultrasound yosana olusesiswini: Oku kungenziwa ngelixa umntwana esesesibelekweni.
• Uvavanyo lokuxilonga i-catheterization yentliziyo: Uvavanyo apho kufakwa khona umbhobho omncinci entliziyweni.
• Uphononongo lwe-Electrophysiologic: Kolu phononongo, iingcingo ezincinci zidluliselwa entliziyweni ukuze zihlolisise inkqubo yombane yentliziyo nzulu.

Ziziphi iindlela zonyango ze-SADS?

Unyango luyahluka ngokuxhomekeke kuhlobo lwe-SADS, ngoko ke kubalulekile ukufumanisa ukuba loluphi uhlobo oluchanekileyo onalo.

Unyango lwe-Brugada syndrome

• I-ICD (i-ICD) efakelwa kwi-cardioverter defibrillator: Le yimatshini encinci efakwa phantsi kwesikhumba. Ukuba isantya sentliziyo siba sibi ngendlela eyingozi, ibangela ukubetheka kombane okuncinci ukubuyisela isantya sentliziyo.
• Amayeza afana neQuinidine .
• Kuphephe ukusebenzisa amayeza avala imijelo yesodium entliziyweni.

Unyango lweCatecholaminergic Polymorphic Ventricular Tachycardia (CPVT)

• Aba bantu banikwa uhlobo oluthile lwamayeza abizwa ngokuba yi -beta-blockers .
• Ukuba kuyimfuneko, i-ICD iya kufakelwa.

Unyango lwe-Long QT Syndrome (LQTS)

Oku kungenziwa ngezinto ezifana namayeza okanye utyando:

• Ii-Beta-blockers.
• I- ICD .
• Ukususwa kwemithambo-luvo yentliziyo ekhohlo: Olu lutyando olungenabungozi kangako olusika nolususa ezinye zemithambo-luvo ezizilawulayo eziya entliziyweni.
• Kuphephe ukusebenzisa amayeza athile andisa ixesha le-QT kwi-EKG yakho.

Unyango lwe-Short QT Syndrome (SQTS)

Kukho amayeza kunye nesixhobo sokwenza oku:

• I- ICD .
• I-Quinidine.

Unyango lwe-Timothy syndrome

Oku kusebenzisa amayeza kunye nesixhobo:

• Ii-Beta-blockers.
• I- ICD .
• Kuphephe ukusebenzisa amayeza andisa ixesha le-QT kwi-EKG yakho.

Unyango lwe-Wolff-Parkinson-White syndrome (WPW)

Amayeza anokunceda ukuthintela iimpawu ze-WPW. Kukwakho nenkqubo ebizwa ngokuba yi-ablation therapy . Oku kutshabalalisa indlela yombane engaphezulu. Oku ngamanye amaxesha kunokunyanga ngokupheleleyo i-WPW. Oogqirha bakwanika amayeza abizwa ngokuba yi -antiarrhythmics ukunciphisa umngcipheko we-strong yentliziyo engaqhelekanga.

Ngaba kukho naziphi na iziphumo ebezingalindelekanga kwezi ndlela zonyango?

Ewe, ezinye iindlela zonyango zinokuba nemiphumo emibi emincinci.

• Abanye abantu banokuba nobunzima bokunyamezela ii-beta-blockers ezimiselwe ngugqirha wabo.
• Emva koko utyando lwentliziyo olusekhohlo olubangela ukudumba kwentliziyo :
• Ukubila okungaqhelekanga.
• Izandla ezomileyo.
• Utshintsho kubushushu okanye kumbala kwezinye iindawo zobuso.
• Kodwa olu tyando lunokuphucula kakhulu umgangatho wobomi.
• Ngenxa yokuba isixhobo se-ICD senza umatshini wombane ukubuyisela isigqi sentliziyo, kunokuba yinto engathandekiyo. Kwakhona:
• Usulelo lunokwenzeka.
• Isixhobo sisenokungasebenzi kakuhle.

Ndingawunciphisa njani umngcipheko wam? Ngaba i-SADS ingathintelwa?

Ukuba kukho umntu kusapho lwakho one-SADS, amanye amalungu osapho kufuneka enze i-CPR.Ukuba uyazi indlela yokukwenza oku, kwaye ukuba une -Automatic External Defibrillator (AED) ekhaya, kunokuba yintuthuzelo enkulu kumntu one-SADS. Kuba kuhle ukwazi ukuba kukho umntu oza kunceda xa kukho imeko engxamisekileyo.

Nangona i-SADS ingenakuthintelwa ngokupheleleyo, ukuba kukho umntu kusapho lwakho ofunyaniswe enale meko, kubalulekile ukuba uvavanywe ukuze kubonwe ukuba unayo na i-genetic mutation. Ungathetha nogqirha wakho ukuze kugqitywe ukuba ngubani omele avavanywe. Nje ukuba umntu afunyaniswe enale meko, amanyathelo anokuthathwa ukumkhusela, nokuba ngamayeza okanye olunye unyango.

Ikamva limphathele ntoni umntu one-SADS?

Kuxhomekeke kakhulu kuhlobo lwe-SADS onalo, ukuba ifunyaniswa kwangoko kangakanani, kwaye unyango luqalwa ngokukhawuleza kangakanani. Yimeko yobomi bonke , kwaye ngamanye amaxesha inokubulala .

Nangona kunjalo, abantu abane- Wolff-Parkinson-White syndrome (WPW) banembono engcono kakhulu kuba unyango lwe-ablation lungayilungisa le ngxaki. Abantu abanyangwa kwi-long QT syndrome (LQTS) banomngcipheko omncinci wokufa ngequbuliso. Nangona kunjalo, abantu abaninzi abanokungenelwa kwi-left ventricular ablation abanayo. Akukho phando luncinci kakhulu malunga neemeko ezifana ne- short QT syndrome (SQTS) , kuba zimbalwa kuphela izigulana (malunga nama-200) ezinale meko.

Ngoko ke, uphando olongezelelweyo luyadingeka ukuze kufunyanwe unyango olufanelekileyo kubo bonke abane-SADS.

Ukufakelwa i-ICD kunokuthintela ukufa kwentliziyo ngesiquphe kuba kunyanga izingqisho zentliziyo ezingaqhelekanga. Nangona kunganyanga esi sifo, yindlela esebenzayo yokunciphisa umngcipheko wokufa ngenxa yezi meko.

Ukuba une-SADS, uzinyamekela njani?

• Ukuba ugqirha wakho ukunike amayeza, thatha kanye njengoko uyalelwe, ungaphoswa lusuku olunye. Kunjalo nakumntwana one-SADS. Kufuneka anikwe amayeza akhe ngexesha, kwaye ayingombono ulungileyo ukutsiba idosi enye.
• Soloko ubuza ugqirha wakho okanye ikhemisti ngaphambi kokuba uqalise amayeza amatsha. Amayeza amaninzi, kuquka amayeza aqhelekileyo okubulala iintsholongwane kunye namayeza okulwa nesicaphucaphu, anokusebenzisana namayeza akho entliziyo. Angachaphazela nexesha le-QT, nto leyo enyusa umngcipheko wokufa ngequbuliso kumntu onesifo se-QT eside.
• Qonda indlela esebenza ngayo i-ICD yakho (okanye yomntwana wakho). Kwakhona, yihlole rhoqo ngugqirha wakho. Ezinye iinkqubo zonyango kunye nezixhobo ze-elektroniki zemihla ngemihla zinokuphazamisana nokusebenza kwe-ICD yakho. Ngoko ke, yazi ukuba yintoni omawuyiphephe.
• Ukuba umntwana wakho une-SADS, buza ugqirha ukuba angakwazi na ukudlala imidlalo enxulumene nemeko yakhe.

Ufanele uye nini kugqirha? Ufanele uye nini kwigumbi longxamiseko?

Ukuba une-SADS, ukuvavanywa rhoqo kubaluleke kakhulu. Oku kukuqinisekisa ukuba uthatha amayeza afanelekileyo. Ukuba umntwana wakho une-SADS, umthamo wamayeza unokufuneka unyuswe njengoko ekhula kwaye etyeba. Yiyo loo nto kubaluleke kakhulu ukuba abantwana bahlolwe rhoqo. Ukuba une-ICD, bona ugqirha wakho ubuncinane kabini ngonyaka.

Kwimeko yongxamiseko:

• Ukuba umntu unesifo sokuma kwentliziyo , fowunela u-911 (okanye inombolo yongxamiseko yelizwe lakho) ngoko nangoko uze wenze i-CPR.
• Ukuba ufumana naziphi na kwezi mpawu, yiya kwigumbi likaxakeka okanye utsalele umnxeba ku-911 ngoko nangoko:
• Ukuba uziva utyhafile, unesiyezi, okanye ubetha ngamandla.
• Ukuba ufumana iintlungu esifubeni ngequbuliso okanye ubunzima bokuphefumla.

Yeyiphi imibuzo ebalulekileyo omele uyibuze ugqirha wakho?

Ukuba wena okanye umntu kusapho lwakho une-SADS, kubaluleke kakhulu ukubuza ugqirha wakho le mibuzo:

• Luhlobo luni lwe-SADS endinalo?
• Luluphi unyango olucebisayo kwimeko yam ethile?
• Ungandinceda ndifumanise ukuba ngubani kusapho lwam ekufuneka avavanywe oku?
• Ngaba ndifuna i-defibrillator?
• Ngaba kukho amayeza endifanele ndiwaphephe kwimeko yam?

Okokugqibela, khumbula ezi zinto!

Nangona i-SADS yimeko enzima, ukuyiqonda nokuthatha amanyathelo afanelekileyo kunokukukhusela wena kunye nabantu obathandayo. Ukuyiqonda into oyifumanisileyo kunokukunceda uqonde iindlela onokukhetha kuzo. Sebenzisana nogqirha wakho ukuze ugqibe ukuba loluphi unyango olulungele wena okanye umntu omthandayo. Ukuhlolwa rhoqo, ingakumbi ukuba une-ICD, kubalulekile. Ukuba ne-AED ekhaya nokuqinisekisa ukuba wonke umntu uyazi indlela yokuyisebenzisa nokwenza i-CPR kunokukunceda wena nosapho lwakho. Musa ukoyika, ukuqonda yeyona ndlela ilungileyo yokuzikhusela.

Isifo Sokufa Esikhawulezileyo se-Arrhythmic, i-SADS, isifo sentliziyo, ukubetha kwentliziyo okungaqhelekanga, izifo zemfuza, ukufa ngequbuliso, inkqubo yombane yentliziyo