Ingaba intliziyo yakho ibuthathaka? Masifunde ngeSystolic Heart Failure.

Ngaba ngamanye amaxesha uziva uphelelwa ngumphefumlo? Ngaba uziva udiniwe nasemva kokuba wenze umsebenzi omncinci? Okanye imilenze yakho iyadumba? Ezi zinokuba ziimpawu zokuba intliziyo yakho ibuthathaka kancinci. Namhlanje, siza kuthetha ngesi sifo sentliziyo, 'Systolic Heart Failure'. Nangona oku kunzulu kancinci, yimeko enokulawulwa ukuba iqatshelwe kwangethuba kwaye inyangwe ngokufanelekileyo.

Yintoni iSystolic Heart Failure?

Ngamafutshane, intliziyo yakho ineegumbi ezine eziphambili. Igumbi elisezantsi ngasekhohlo, elibizwa ngokuba yi-ventricle yasekhohlo, limpompa igazi elineoksijini emzimbeni wonke. Lisebenza njengepompo yamanzi. Ngoku, kule meko ebizwa ngokuba yi-systolic heart failure, i-ventricle yasekhohlo iba buthathaka. Oko kuthetha ukuba ayikwazi ukupompa igazi ngokufanelekileyo nangendlela efanelekileyo.

Kwenzeka ntoni ke? Khawuthelekelele ukuba i-water motor ayinamandla ngokwaneleyo, amanzi awayi kuhamba kakuhle. Ngokufanayo, xa intliziyo ingapompi igazi ngokufanelekileyo, ulwelo lunokuqokelelwa emiphungeni. Kulapho ke izinto ezinje ngobunzima bokuphefumla nokudinwa ziqala khona. Amanye amalungu omzimba, ingakumbi imilenze, amaqatha, kunye nesisu, nazo zinokudumba . Oku kungenxa yokuba ulwelo emzimbeni alujikelezi kakuhle.

Ngoko ke yintoni le Ejection Fraction?

Ngoku masithethe ngokuba yintoni i-Ejection Fraction (EF) . Oku kubizwa ngokuba yi -'Ejection Fraction' ngesiSinhala. Nangona eli ligama lezonyango, kulula ukuliqonda. Ngamafutshane, eli lipesenti yegazi elingakanani eliphampa i-ventricle yakho yasekhohlo emzimbeni xa ibetha kube kanye.

Intliziyo ephilileyo nesebenza kakuhle kufuneka ibe nexabiso le-EF eliphakathi kwama-55% nama-70% . Oku kuthetha ukuba ngaphezulu kwesiqingatha segazi elingena kwi-ventricle yasekhohlo yentliziyo likhutshwa ngokukhawuleza. Nangona kunjalo, ukuba eli xabiso le-EF liwela ngaphantsi kwama-40% , lisenokuba luphawu lokusilela kwentliziyo ye-systolic. Oku kuthetha ukuba amandla okupompa kwentliziyo anciphile. Yiyo loo nto le meko ngamanye amaxesha ibizwa ngokuba yi -'Heart Failure with Reduced Ejection Fraction' (HFrEF) .

Ngubani onokuba nethuba elikhulu lokufumana le meko?

Ukusilela kwentliziyo ye-Systolic kunokuchaphazela nabani na, kodwa umngcipheko uyanda ngokuhamba kweminyaka. Kukwaqheleke kakhulu nakubantu abanezinye iingxaki zentliziyo, ezifana nokuhlaselwa yintliziyo ngaphambili okanye uxinzelelo lwegazi oluphezulu.

Yintoni ebangela ukusilela kwentliziyo ye-systolic (HFrEF)?

Ukungaphumeleli kwentliziyo ye-Systolic kudla ngokuvela xa i-ventricle yasekhohlo yentliziyo yonakaliswe sisifo esithile. Cinga ngale ndlela: izihlunu zentliziyo zifana nebhanti yerabha. Ziyanwebeka kwaye zifinyeze. Kodwa ukuba zonakele, azikwazi ukwenza loo msebenzi ngokufanelekileyo.

Nazi ezinye zezizathu eziphambili ezinokuchaphazela oku:

• Isifo semithambo yentliziyo: Le yeyona nto ixhaphakileyo. Imithambo yegazi ehambisa igazi entliziyweni (imithambo yegazi yentliziyo) iyancitshiswa okanye ivalwe ngamanqatha, nto leyo ethintela izihlunu zentliziyo ekufumaneni ioksijini kunye nezondlo ezifunekayo. Oku kubangela ukuba izihlunu zibe buthathaka.
• Uxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu): Xa uxinzelelo lwegazi luphezulu ixesha elide, intliziyo kufuneka isebenze nzima ukupompa igazi. Kufana nokupompa amanzi kwimithambo evalekileyo. Ekuhambeni kwexesha, oku kunokubangela ukuba izihlunu zentliziyo zikhule kwaye ekugqibeleni zibe buthathaka.
• Ukuhlaselwa yintliziyo kwangaphambili: Ukuhlaselwa yintliziyo kuxa igazi lihamba liye kwinxalenye yentliziyo, nto leyo ebangela ukuba iiseli zemisipha zife. Indawo efileyo emva koko iba namanxeba, nto leyo enciphisa amandla entliziyo okupompa.
• Isifo seswekile: Isifo seswekile singonakalisa imithambo yegazi kwaye sichaphazele ngqo izihlunu zentliziyo.
• Isingqisho Sentliziyo Esingaqhelekanga: Xa ukubetha kwentliziyo kungahambelani, intliziyo ayikwazi ukupompa igazi ngokufanelekileyo.
• Isifo seValve yentliziyo: Xa iivalve ezisentliziyweni zingasebenzi kakuhle, igazi linokugeleza ngasemva okanye phambili, nto leyo enokubangela uxinzelelo olongezelelekileyo entliziyweni.
• I-Myocarditis: Ukudumba kwemisipha yentliziyo. Oku kunokubangelwa zizinto ezifana nosulelo lwentsholongwane.

Lo monakalo unokubangela amanxeba kwimisipha yentliziyo, ukwanda, okanye ukuqina kweeventricle. Zonke ezi zinto zenza buthathaka iventricle yasekhohlo kwaye zinciphise i-EF. Iindaba ezimnandi zezokuba kwiimeko ezininzi, ukuba unobangela oyintloko unyangwa ngokufanelekileyo, ukusebenza kwentliziyo kunokuphuculwa kancinci.

Zithini iimpawu zale meko?

Kaloku, wazi njani ukuba unokuba nale ngxaki? Nazi ezinye iimpawu ekufuneka uzilumkele:

• Ukuphefumla kancinci (Dyspnea): Usenokuba nobunzima bokuphefumla, ingakumbi xa uzilolonga, ukhwela izinyuko, okanye ulele ebhedini. Ukuba kufuneka ulale unemiqamelo emibini okanye emithathu ebusuku, oko kukwaluphawu.
• Ukudinwa rhoqo kunye nobuthathaka: Ukuba uziva udiniwe kakhulu nasemva kokwenza imisebenzi ebekulula ngaphambili.
• Ukudumba emilenzeni, emaqatheni nasezinyaweni: Oku kudumba kunokubakho ngenxa yokugcina ulwelo. Ngamanye amaxesha isisu sinokudumba.
• Ukubetha kwentliziyo ngokukhawuleza okanye ngokungangqalanga: Ukuba uziva utshintsho kwindlela intliziyo yakho ebetha ngayo.
• Ukukhohlela okanye ukuphefumla okungapheliyo: Ukukhohlela okuhamba ngokukodwa ne-mucus emhlophe.
• Ukuncipha kwamandla okwenza umthambo.
• Isicaphucaphu okanye ukungabi namdla wokutya.
• Iintlungu zesifuba: Oku kusenokubangelwa sisifo esifana nesifo semithambo yegazi emithanjeni yegazi.
• Isiyezi.

Ukuba unenye okanye ngaphezulu kwezi mpawu, nceda ungazityesheli uze ubonane nogqirha. Okukhona uziqaphela kwangethuba, kokukhona kulula ukuzinyanga.

Oogqirha bayibona njani le nto?

Xa usiya kugqirha, uza kwenza uvavanyo oluninzi ukuze abone ukuba unesifo sentliziyo esibizwa ngokuba yi-systolic heart failure. Eyona nto ibalulekileyo kukufumanisa ukuba yintoni imbangela ukuze ukwazi ukuyinyanga ngendlela eyiyo.

Le nkqubo yovavanyo idla ngokuquka oku kulandelayo:

1. Uvavanyo lomzimba:

• Ugqirha uza kukubuza ngeempawu zakho (ukuba zikho ixesha elingakanani, zivakalelwa njani, njl.njl.).
• Bakubuza ngezifo zakho zangaphambili, njengokuthi ngaba kukho umntu kusapho lwakho onesifo sentliziyo.
• I-stethoscope isetyenziselwa ukumamela intliziyo nemiphunga (ukujonga izandi ezingaqhelekanga kunye nolwelo olukwimiphunga).
• Uxinzelelo lwakho lwegazi luyalinganiswa.
• Uza kulinganiswa (ukuze kubonwe ukuba ngaba utyebile ngequbuliso, ngenxa yokugcinwa kolwelo emzimbeni).

2. Uvavanyo lwegazi (Umsebenzi wegazi):

• Olu vavanyo lwegazi lunokujonga ukuba ezinye izitho zomzimba (ezifana nezintso nesibindi) zichaphazelekile na bubuthathaka obusentliziyweni.
• Ngokwesiqhelo, izinto ezifana ne-'Albumin' (uhlobo lweproteni), i-'Creatinine' (into echaza ukusebenza kwezintso), kunye ne-sodium kunye ne-potassium (ii-electrolytes) ziyalinganiswa.
• Kukho uvavanyo lwegazi olukhethekileyo olubizwa ngokuba yi-BNP (B-type Natriuretic Peptide). Xa intliziyo ixinezelekile, inqanaba lale BNP egazini liyakhula. Oku kunceda kakhulu ekuxilongeni ukusilela kwentliziyo.

3. Uvavanyo lwemifanekiso yentliziyo:

• Olu vavanyo lunokujonga izinto ezininzi, ezinje ngokuma nobukhulu bentliziyo, ukuba iindonga zeeseli zinobukhulu obungakanani, ukuba iivalvu zisebenza kakuhle na, nokuba kukho umonakalo obangelwe kukuhlaselwa yintliziyo ngaphambili.
• I-X-reyi yesifuba: Ukujonga ukuba intliziyo ikhulu na okanye ukuba ulwelo luqokelelene na emiphungeni.
• `I-Echocardiogram (Echo)`: Olu lolona vavanyo lubalulekileyo. Lufana ne-ultrasound scan yentliziyo. Lunokulinganisa ngokuchanekileyo ixabiso le-EF. Lunokubona ngokucacileyo ukusebenza kwamagumbi entliziyo kunye neevalvu.
• I-Electrocardiogram (EKG/ECG): Uvavanyo olurekhoda umsebenzi wombane wentliziyo. Lunokubona izinto ezifana nesingqi kunye nesantya sokubetha kwentliziyo, kunye neempawu zohlaselo lwentliziyo lwangaphambili.
• Ngamanye amaxesha, ezinye iimvavanyo ezikhethekileyo ezifana ne-'Cardiac MRI', 'Cardiac CT scan', 'Cardiac Catheterization' (i-Angiogram), 'uVavanyo loXinzelelo loMthambo' okanye 'uVavanyo loXinzelelo loMthambo weNyukliya', 'iMultigated Acquisition Scan' (i-MUGA)` nazo zinokwenziwa.

Iphathwa njani le nto?

Kulungile, ngoku makhe sijonge indlela yokunyanga le meko yokusilela kwentliziyo ye-systolic. Kukho iinjongo eziphambili zonyango:

• Ukunciphisa iimpawu (ezifana nokuphefumla kancinci, ukudumba).
• Ukuthintela okanye ukulawula intliziyo ekubeni buthathaka ngakumbi.
• Ukuphucula umgangatho wobomi.
• Ukunceda ukwandisa ubomi.

Iindlela zonyango zingahlulwahlulwa zibe ziindidi ezininzi eziphambili:

1. Utshintsho kwindlela yokuphila

Ezi zibaluleke kakhulu. Akwanelanga ukusela amayeza nje kuphela, kufuneka nawe wenze ezi zinto ecaleni kwakho.

• Nciphisa umlinganiselo wetyuwa: Ityuwa (isodium) ibangela ukuba umzimba ugcine ulwelo olugqithisileyo. Oku kwandisa ukudumba kwaye kubeka uxinzelelo olungakumbi entliziyweni. Nciphisa umlinganiselo wetyuwa njengoko ugqirha wakho ekuyalele. Ngokubanzi, akukhuthazwa ukuba utye ngaphezu kwe-1500-2000 milligrams yesodium ngosuku.
• Ukunciphisa ulwelo: Abanye abantu baxelelwa ukuba banciphise umlinganiselo wamanzi abawaselayo ngosuku. Le yinto ekufuneka uyixoxe nogqirha wakho uze wenze isigqibo.
• Gcina ubunzima obusempilweni: Ukuba utyebile kakhulu, zama ukunciphisa umzimba. Kungumbono olungileyo ukuzilinganisa yonke imihla. Ukuba ufumana ubunzima ngequbuliso (ikhilogram enye okanye ezimbini ngosuku), oko kusenokuba luphawu lokugcinwa kolwelo emzimbeni. Ukuba oku kuyenzeka, xelela ugqirha wakho .
• Kuphephe ukutshaya: Ukutshaya kuyingozi kakhulu entliziyweni nakwimithambo yegazi.
• Nciphisa okanye uyeke utywala: Utywala bunokwenza buthathaka izihlunu zentliziyo.
• Ukuzilolonga rhoqo: Thetha nogqirha wakho malunga nokuba zeziphi imithambo efanelekileyo kuwe. Qala kancinci kancinci uze wandise kancinci kancinci umsebenzi wakho. Ukuhamba ngumthambo olungileyo. Kungangcono ukuba ungabandakanyeka kwinkqubo yokuvuselela intliziyo.
• Nciphisa uxinzelelo, phumla kakuhle, kwaye ulale ngokwaneleyo.
• Yitya ukutya okunempilo: yitya imifuno, iziqhamo, ukutya okune-fiber, kunye nokutya okunamafutha aphantsi.

2. Amayeza (iintlobo zamayeza)

Kukho amayeza amaninzi asebenzayo okunyanga ukusilela kwentliziyo ye-systolic. La mayeza anokuphucula i-EF yakho, iimpawu, kunye nokusebenza kwentliziyo iyonke. Ugqirha wakho unokukunika elinye okanye ngaphezulu la mayeza kunye.

• Ii-Beta-blockers: Ezi ziphucula ukusebenza kwentliziyo ngokunciphisa isantya sentliziyo, zinciphise umsebenzi ekufuneka wenziwe yintliziyo. Zinokunceda ekulawuleni uxinzelelo lwegazi, zinciphise umngcipheko wokuhlaselwa sisifo sentliziyo, kwaye zilawule ukubetha kwentliziyo okungaqhelekanga.
• Izithinteli ze-Angiotensin-Converting Enzyme (ACE): Ezi zilawula uxinzelelo lwegazi, zandisa imithambo yegazi, kwaye zithintele iihomoni zoxinzelelo emzimbeni, ziphucula ukusebenza kwentliziyo ngokuhamba kwexesha.
• Ii-Angiotensin-II Receptor Blockers (ARBs): Ezi zinikwa abantu abaneziphumo ebezingalindelekanga ezifana nokukhwehlela okuvela kwii-ACE inhibitors. Zisebenza ngendlela efanayo nee-ACE inhibitors.
• I-Angiotensin Receptor-Neprilysin Inhibitors (ARNIs): Olu luhlobo olutsha nolusebenzayo kakhulu lwamayeza. Akwanciphisa iihomoni zoxinzelelo, avule imithambo yegazi, kwaye aphucula ukusebenza kwentliziyo.
• Ii-Aldosterone Antagonists (iiMineralocorticoid Receptor Antagonists - ii-MRA): Ezi zinciphisa ii-hormones zoxinzelelo kwaye zinceda izintso zisuse ulwelo olugqithisileyo kunye netyuwa emzimbeni. Kufuneka uqaphele amanqanaba akho e-potassium xa usebenzisa la mayeza.
• I-Diuretics (iipilisi zamanzi): Ezi zikhawuleza zithomalalise iimpawu (ingakumbi ukudumba kunye nokuphefumla kancinci) ngokususa ulwelo olugqithisileyo kunye netyuwa kwizintso. Xa ulwelo lunciphile, kulula ukuba intliziyo ipompe igazi.
• Izithinteli ze-SGLT-2: Ezi ekuqaleni luhlobo lwamayeza esifo seswekile. Kodwa kamva kwafunyaniswa ukuba zilungile kakhulu nakwizigulana ezineengxaki zentliziyo ezingenaso isifo seswekile. Zikhupha ulwelo olugqithisileyo kunye neswekile emchameni.

Eyona nto ibalulekileyo kukuthatha amayeza achazwe ngugqirha wakho ngqo, ngexesha lawo nakwidosi echazwe ngugqirha wakho. Ungaze uyeke ukuwathatha amayeza okanye utshintshe idosi ngokwakho.

3. Izixhobo kunye notyando

Ezinye izigulana zisenokungakwazi ukulawula imeko yazo ngamayeza kunye nokutshintsha indlela eziphila ngayo zodwa. Zisenokufuna izinto ezifana nezi:

• I-ICD (Implantable Cardioverter-Defibrillator): Isixhobo esincinci esibona ukubetha kwentliziyo okungaqhelekanga okuyingozi (i-arrhythmia) kwaye sinike umothuko omncinci wombane entliziyweni ukuze kubuyiselwe isigqi esiqhelekileyo. Esi sifakwe phantsi kwesikhumba sesifuba.
• I-CRT (Unyango Lokuvumelanisa Intliziyo) / I-Biventricular Pacemaker: Esi sixhobo sinceda ukulungisa ukungalingani phakathi kwamagumbi asekhohlo nasekunene entliziyo. Oku kuphucula nokukwazi kwentliziyo ukupompa.
• I-Coronary Artery Bypass Grafting (CABG) okanye i-Angioplasty ene-stenting: Nyanga imithambo yentliziyo ukuba ivalekile.
• Ukulungiswa kwevalvu yentliziyo okanye utyando lokutshintsha.
• Ukufakelwa kwentliziyo okanye i-LVAD (Isixhobo soNcedo lweNtsholongwane yasekhohlo): Ezi zezona ndlela zonyango ziqwalaselwa kakhulu kwizigulana ezigula kakhulu.

Ingancitshiswa njani ingozi yale meko?

Bathi, “Ukuthintela kungcono kunokunyanga.” Ngoko ke, kukho izinto onokuzenza ukuthintela okanye ukunciphisa umngcipheko wokuhlaselwa sisifo sentliziyo esibizwa ngokuba yi-systolic heart failure. Imikhwa emihle yempilo yeyona nto ibalulekileyo.

• Yitya ukutya okunesondlo nokulinganiselayo (ityuwa encinci, ioyile encinci, imifuno neziqhamo ezininzi).
• Zilolonge rhoqo.
• Gcina ubunzima bakho busempilweni.
• Kuphephe ukutshaya ngokupheleleyo.
• Nciphisa ukusetyenziswa kotywala.
• Ukuba uneengxaki zempilo ezifana noxinzelelo lwegazi oluphezulu, isifo seswekile, okanye i-cholesterol, zilawule kakuhle. Landela imiyalelo kagqirha wakho ngononophelo.
• Nciphisa uxinzelelo kwaye ulale ngokwaneleyo.

Zithini izinto onokuzilindela xa uphila nale meko?

Ukusilela kwentliziyo ye-Systolic yimeko engapheliyo, ehlala ixesha elide, neyingozi. Isenokunganyangeki ngokupheleleyo. Nangona kunjalo, ngonyango olufanelekileyo kunye notshintsho kwindlela yokuphila, iimpawu zinokulawulwa kwaye ubomi obuhle bunokuphilwa.

Isiphumo sixhomekeke kwizinto ezininzi:

• Indlela esibi ngayo isifo sentliziyo.
• Impilo yakho iyonke kunye nokuba unazo naziphi na ezinye izifo (ezifana nesifo sezintso, isifo seswekile).
• Indlela osabela ngayo kunyango.
• Yintoni esona sizathu siphambili soku?

Kungoko ke, kubaluleke kakhulu ukuba ungoyiki okanye ucaphuke, kodwa ulandele imiyalelo kagqirha ngokuchanekileyo kwaye ulungise indlela ophila ngayo. Sebenzisana neqela lakho lezonyango.

Ufanele ufune nini unyango ngokukhawuleza?

Ukuba ufumana naziphi na kwezi mpawu, kufuneka ufune uncedo lwezonyango ngokukhawuleza, oko kuthetha ukuba ngokukhawuleza :

• Intlungu yesifuba ekhawulezileyo neqatha.
• Ubunzima bokuphefumla ngequbuliso nangokunzima.
• Ukutyhafa okanye ubuthathaka obukhulu.
• Intlungu esifubeni, isiyezi, okanye ukuphefumla okufutshane nokubetha kwentliziyo okukhawulezayo okanye okungahambelaniyo.
• Ukudumba ngequbuliso kwemilenze okanye ukunyuka kobunzima.

Yeyiphi imibuzo onokuyibuza ugqirha?

Xa ubona ugqirha wakho, ungabuza imibuzo efana nale ukuze uqonde ngcono imeko yakho:

• Yintoni kanye kanye imbangela yokusilela kwentliziyo yam ye-systolic?
• Ithini ixabiso le-ejection fraction yam (EF)? Ithetha ukuthini?
• Ingaba le meko ichaphazele amanye amalungu am omzimba (njengezintso, isibindi)?
• Ziziphi iindlela zonyango ezifanelekileyo kum? Zithini izinto ezilungileyo nezingalunganga?
• Zeziphi iinguqu ezibalulekileyo ekufuneka ndizenze kwindlela endiphila ngayo?
• Luhlobo luni lokutya nesiselo endifanele ndilutye kwaye yintoni endifanele ndiyiphephe?
• Zeziphi imithambo endinokuyenza? Ndingazenza ixesha elingakanani?
• Yintoni endingafanele ndiyenze?
• Zithini iziphumo ebezingalindelekanga ezinokubakho ngeli yeza? Ndingenza ntoni ukuba ziyavela?
• Ndifanele ndiye kangaphi ukuza kuhlolwa? Amanqaku am e-EF aza kuhlolwa nini kwakhona?
• Ndingenza ntoni xa kukho imeko engxamisekileyo?

Izinto ezibaluleke kakhulu ekufuneka sizikhumbule

Ukusilela kwentliziyo yeSystolic yimeko enzima, ehlala ixesha elide apho i-ventricle yasekhohlo yentliziyo ingakwazi ukupompa igazi ngokufanelekileyo. Ukuba unayo nayiphi na kwezi mpawu, nceda ubone ugqirha. Okukhona ibonwa kwangoko, kokukhona kulula ukuyinyanga kwaye iziphumo zingcono.

Ngokunyanga unobangela oyintloko, ukuthatha amayeza achazwe ngugqirha wakho, kunye nokuphuhlisa imikhwa emihle yokuphila, unokukunceda ukulawula iimpawu zakho kwaye uphile ubomi obusempilweni, obusebenzayo, nobuhlala ixesha elide. Ungoyiki, hlala uqinile! Awuwedwa, oogqirha bakho, usapho, kunye nabahlobo bakho bonke bakhona ukukunceda.

Uhlaselo lwentliziyo , ukusilela kwentliziyo ye-systolic, iqhekeza lokukhupha umoya, ubuthathaka bentliziyo, ukuphefumla okufutshane, ukudumba kwemilenze, iimpawu zentliziyo