Ngaba ngequbuliso uziva unesizungu, isifuba sakho siyabetha ngamandla, amehlo akho aluhlaza okwesibhakabhaka, kwaye uzive ngathi uza kufa? Ngamanye amaxesha oku kunokuba luphawu lwesingqisho sentliziyo esiyingozi. Namhlanje sithetha ngenye imeko engaqhelekanga kodwa enokuba yingozi. Ibizwa ngokuba yiTorsades de Pointes (igama lesiFrentshi, elibizwa ngokuba yi "torsades de pointes"). Eli gama lisenokuvakala lingaqhelekanga, kodwa kubalulekile ukwazi ukuba lithetha ukuthini kwaye linokwenza ntoni.
Ukubeka nje, yintoni iTorsades de Pointes?
Olu lujikelezo lwentliziyo olukhawulezayo kakhulu, olungaqhelekanga, noluyingozi oluqala kumagumbi amabini asezantsi entliziyo yakho (ii-ventricles). Ukuchaneka, olu luhlobo olukhethekileyo lokubetha kwentliziyo ngokukhawuleza (i-Ventricular Tachycardia). Ngokwesiqhelo, ukubetha kwentliziyo yomntu ophilileyo kuphakathi kwe-60 kunye ne-100 beats ngomzuzu. Nangona kunjalo, xa le meko isenzeka, ukubetha kwentliziyo kunokunyuka ukuya kwi-150 ukuya kwi-300 beats ngomzuzu .
Oku kuyingozi kuba kukho ithuba lokufa ngesiquphe kwentliziyo ngaphandle kwesilumkiso .
Ukuba ujonga i-EKG yakho (i-electrocardiogram), kukho indlela ethile oogqirha abayibonayo kule meko. Yindlela yamaza ajikajikayo, njenge-coil. Igama lesiFrentshi elithi "Torsades de Pointes" lithetha "ukujika kwamanqaku." Igama layo livela kwindlela ejijekileyo ye-EKG.
Le meko idla ngokuvela xa kukho enye ingxaki kumsebenzi wombane wentliziyo. Ibizwa ngokuba yi-long QT interval. Ngamafutshane, i-QT interval lixesha elithathwayo ukuba amagumbi asezantsi entliziyo yakho abethe kube kanye uze ulungiselele ukubetha okulandelayo. Ukuba eli xesha lide ngokungaqhelekanga (long QT), ukubetha okongezelelweyo kunokwenzeka, okubangela iTorsades de Pointes.
Zithini iimpawu zale meko?
Into eyoyikisayo apha kukuba isiqingatha sabantu abanale meko asinazo iimpawu . Abo bafumana ezi mpawu banokuhlangabezana nezi zilandelayo. Kufuneka ulumke kakhulu ngezi zinto.
| Uphawu | Ingcaciso elula |
|---|---|
| Isiyezi | Kwenzeka xa intliziyo ingapompi igazi ngokufanelekileyo, nto leyo ebangela ukuncipha kokunikezelwa kwegazi engqondweni. |
| Ukubetha kwentliziyo | Uqala ukuziva intliziyo yakho ibetha ngokukhawuleza okanye ngendlela engaqhelekanga. |
| Ubukrelekrele | Ndivakalelwa kukuba ndiza kulahlekelwa zingqondo. |
| Ukuquleka | Ingabangelwa kukuphazamiseka okwethutyana kokunikezelwa kwegazi engqondweni. |
| Ukubanjwa kwe-cardiac | Le yimeko eyingozi kakhulu. Intliziyo iyayeka ukubetha ngequbuliso. |
Kutheni oku kusenzeka? Zithini izizathu?
Kukho iindidi ezimbini eziphambili zezizathu zoku.
1. Izizathu zokuzalwa: Abanye abantu bazalwa benesimo semfuza esibizwa ngokuba yi-'Long QT Syndrome'. Oku kuthetha ukuba banale meko kusapho lwabo. Aba bantu basengozini enkulu yokuhlaselwa yiTorsades de Pointes.
2. Izizathu zamva: Le yeyona ixhaphakileyo. 'Ixesha le-QT' linokwandiswa ngokusebenzisa amayeza athile kunye nokwehla kwamanqanaba e-electrolytes emzimbeni. Oku kwandisa umngcipheko we-Torsades de Pointes.
Amayeza onyusa umngcipheko:
- Amanye amayeza alawula isingqisho sentliziyo (i-Antiarrhythmics)
- Amanye amayeza okubulala iintsholongwane
- Amanye amayeza okuhlanza (i-Antiemetics)
- Izinto ezilwa nokungunda
- Ii-antipsychotics ngamayeza asetyenziselwa ukunyanga izifo ezithile zengqondo.
- Amanye amayeza omhlaza
Kubalulekile: Ukuba usebenzisa olu hlobo lwamayeza, ungoyiki. Asinguye wonke umntu oza kuba nale meko. Kodwa kubaluleke kakhulu ukuthetha nogqirha wakho ngale nto kwaye uqaphele iingozi.
Zithini izinto ezibangela oku?
Abanye abantu banamathuba amaninzi okufumana le meko. Ezi zinto zinobungozi zezi:
- Ukuba nesifo esibizwa ngokuba yi-'Long QT Syndrome'.
- Ukuba nezinye izifo zentliziyo.
- Ukuba ngumfazi (abafazi basengozini enkulu)
- Ukuba uneminyaka engaphezu kwama -65 ubudala.
- I-thyroid engasebenzi kakuhle.
- Ekubeni ehlaselwe sistroke.
- Ukusetyenziswa kwe-diuretics.
- Isantya sentliziyo esicothayo (iBradycardia).
- Amanqanaba aphantsi e- calcium, i-magnesium, okanye i-potassium emzimbeni.
- Urhudo olugqithisileyo okanye ukuhlanza.
Ngaba umngcipheko ungancitshiswa?
Ewe, ngokuqinisekileyo ungakwenza. Zimbalwa izinto onokuzenza:
- Ukuba kukho umntu kusapho lwakho one-'Long QT Syndrome', yiya kuvavanya. Ukuba unayo, bonana nogqirha wentliziyo ngaphambi kokuba uqalise inkqubo yokuzilolonga.
- Lumka ngamayeza owasebenzisayo: Ukuba usebenzisa amayeza anokwandisa ixesha eliphakathi kwe-'QT', buza ugqirha wakho ukuba ungawasebenzisa na amanye amayeza endaweni yawo. Xa uqala amayeza amatsha, cela ugqirha wakho ukuba aqinisekise ukuba awayi kubangela iingxaki ngamayeza owasebenzisayo ngoku.
- Cinga ngesondlo: Ukuba ugqirha wakho uyacebisa, yongeza amanqanaba akho e-calcium, i-magnesium, kunye ne-potassium.
- Sela amayeza akho ngexesha: Ukuze uthintele ukuba le meko ingaphindi ivele, sebenzisa amayeza njengoko ugqirha wakho ekuyalele.
- Sela amanzi amaninzi: Gcina amanzi netyuwa zisesilinganisweni esifanelekileyo emzimbeni.
- Yazi izinga lentliziyo yakho: Funda ukuba lithini izinga lentliziyo eliqhelekileyo kunye nendlela yokulilinganisa.
- Ukuba unikwe isixhobo sokujonga intliziyo: Ukuba ugqirha wakho ukunike isixhobo sokujonga intliziyo ukuba usinxibe ekhaya, qiniseka ukuba usinxibe.
Yenziwa njani le nto yokuxilonga?
Eyona ndlela iphambili yokufumanisa oku kukusebenzisa uvavanyo lwe -`EKG` (i-Electrocardiogram) . Oogqirha banokukubona oku ngokujonga ipateni eyahlukileyo `ejijekileyo` kunye nesithuba eside `se-QT` esibonwa kwi-`EKG`.
Ukongeza, ezi mvavanyo zinokwenziwa:
- Uvavanyo lwegazi: Jonga amanqanaba ee-electrolytes emzimbeni, njenge-magnesium kunye ne-potassium.
- I-Echocardiogram: Iskeni yokujonga ulwakhiwo kunye nomsebenzi wentliziyo.
- Isixhobo sokuGcina Intliziyo: Sisixhobo esisetyenziswa iintsuku ezininzi kwaye sihlala sijonga isigqi sentliziyo.
Iphathwa njani?
Unyango luxhomekeke kwisizathu sengxaki. Umntu one-Long QT Syndrome yokuzalwa uza kufuna unyango olude kunomntu one-drug imbangela.
| Uhlobo lonyango | Inkcazo |
|---|---|
| Amayeza | |
| Ukuyeka amayeza abangela ingxaki | Into yokuqala kukuba ugqirha ayeke amayeza acinga ukuba abangela oku. |
| I-Magnesium kunye/okanye i-potassium | Ukuba amanqanaba ezi tyuwa emzimbeni aphantsi, zifakwa ngemithambo ukuze zibuyiselwe kwimeko yesiqhelo. |
| Ii-Beta-blockers | Inikwa ukulawula izinga lokubetha kwentliziyo kunye nabo bane-'Long QT Syndrome'. |
| Ezinye iindlela kunye nezixhobo (Iinkqubo) | |
| Isixhobo sokuncedisa ukubetha kwentliziyo | Kwabo banentliziyo ebetha kancinci kakhulu, kufakelwa isixhobo esincinci ukuze sihlale sisebenza kakuhle. |
| I-ICD (I-Implantable Cardioverter Defibrillator) | Esi sisixhobo esifakwe emzimbeni. Xa sibona isigqi sentliziyo esiyingozi, ngokuzenzekelayo senza uqhushumbo lombane ukubuyisela intliziyo esiqhelweni. |
| Intliziyo yoMbane/Ukuguqulwa kweMizimba | Kwimeko engxamisekileyo, ukubetheka ngombane esifubeni ukuze kubuyiselwe isigqi sentliziyo esiqhelekileyo. |
Ndifanele ndimbone nini ugqirha?
Ukuba ufumana iimpawu ezifana nokubetha kwentliziyo ngokukhawuleza, iintlungu zesifuba, isiyezi, amehlo aluhlaza okwesibhakabhaka, okanye ukuphelelwa zingqondo, yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) esibhedlele ngoko nangoko. Le yimeko engxamisekileyo.
Ukuba kufuneka uhlale esibhedlele ngenxa yeTorsades de Pointes, ngokuqinisekileyo kuya kufuneka uye ekhaya ukuze uhlolwe emva kweeveki ezimbini. Ekubeni le yimeko enomngcipheko wokufa ngequbuliso, kubalulekile ukuba uhlale phantsi kweliso likagqirha wentliziyo rhoqo.
Ungabuza ugqirha wakho le mibuzo:
- Ngaba ndizalwa ndine-Long QT Syndrome, okanye ibangelwa ngamayeza?
- Ngawaphi amathuba okuba le meko ingenzeka nakwabanye abantu kusapho lwam?
- Ngaba likho elinye iyeza endingalithatha endaweni yelo libangele le ngozi?
Ngonyango, le meko inokulawulwa kwaye ungaphila ubomi obuhle. Nangona kunjalo, ukuba ayinyangwa, ingabulala. Kungoko ke, kubaluleke kakhulu ukulandela imiyalelo kagqirha wakho ngokuchanekileyo kwaye uye kwiikliniki ngemihla ebekiweyo.
Umyalezo Wokuya Ekhaya
- I-Torsades de Pointes sisingqisho sentliziyo esikhawulezayo nesisongela ubomi.
- Oku kunokubangelwa yimeko yemfuza (`iLong QT Syndrome`) okanye kukungafumani amayeza athile kunye nokungabikho kwetyuwa emzimbeni.
- Ukuba uneempawu ezifana nentlungu yesifuba ngequbuliso, isiyezi, okanye ukulahlekelwa zingqondo, yingxamiseko leyo. Yiya kwi -ETU (iYunithi yoNyango oluNgxamisekileyo) ngoko nangoko.
- Ungaze uyeke ukuthatha amayeza akho okanye utshintshe umthamo ngaphandle kwengcebiso kagqirha wakho.
- Ukuba le meko ifunyenwe, unyango oluqhelekileyo kunye nokulandelelana phantsi kogqirha wentliziyo kubalulekile.
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