Ngaba ukubetha kwentliziyo yakho akuhambelani? Masifunde ngeVentricular Dyssynchrony ngendlela elula!

Ngaba ngamanye amaxesha uziva uphelelwa ngumphefumlo, udiniwe ngalo lonke ixesha, okanye unemilenze evuvukileyo? Ezi ngamanye amaxesha zinokuba ziimpawu zengxaki entliziyweni yakho. Namhlanje siza kuthetha ngemeko echaphazela ukusebenza kwentliziyo, kodwa mhlawumbi asikaziva kangako ngayo. Yiyo loo nto i-ventricular dyssynchrony , okanye njengoko oogqirha beyibiza, ``(Ventricular Dyssynchrony)``. Nangona igama lisenokuvakala liyinkimbinkimbi kancinci, masilichaze ngokulula.

Yintoni i-Ventricular Dyssynchrony?

Ngamafutshane, i-ventricular arrhythmia kuxa elinye okanye ngaphezulu kwamagumbi asezantsi entliziyo yakho, abizwa ngokuba zii-ventricles , ebetha ngokungalinganiyo kwaye ngaphandle kokulungelelaniswa. Khawuthelekelele ukuba kukho ukulibaziseka okuncinci malunga nee-millisecond ezingama-40 phakathi kwamalungu ahlukeneyo eeseli zentliziyo yakho aqala ukufinyela, okanye phakathi kweseli enye eqala ukufinyela ngokumalunga nenye. Oko kungathathwa njenge-arrhythmia.

Intliziyo yethu isebenza kakuhle kuphela xa izihlunu ezikwiigumbi zayo ziqina ngaxeshanye nangendlela efanayo. Ngokwesiqhelo, imiqondiso yombane ihamba entliziyweni ngendlela ehlelekileyo. Xa amagumbi amabini aphambili entliziyo efumana isibonakaliso sokuqina, izihlunu ezikuloo magumbi kufuneka ziqina ngomlinganiselo ofanayo nangaxeshanye. Ngokukodwa, i-ventricle yakho yasekhohlo, igumbi eliphambili lokumpompa lentliziyo, kufuneka liqina ngendlela ehambelanayo. Kufana nokutyhala ukusuka kumacala omabini ukuya embindini.

Nangona kunjalo, ukuba esi siginali asifikeleli kuzo zombini iiseli zentliziyo ngaxeshanye, izihlunu azikwazi ukufinyela ngaxeshanye. Yiloo nto siyibiza ngokuba yi -dysynchrony .

I-Cellular dyssynchrony inokuchaphazela umzimba wakho ngezi ndlela zilandelayo:

• Iyanciphisa ukusebenza kakuhle kwentliziyo yakho.
• Iivalvu ezidla ngokunceda igazi ukuba lihambe kwicala elinye kuphela zinokubangela ukuba igazi libuyele umva (kwicala elingalunganga).
• Ubungakanani begazi elinokupompa intliziyo yakho (Cardiac Output) buyancipha.

Ziziphi iintlobo ze-arrhythmias zentliziyo?

Kukho iintlobo ezininzi eziphambili ze-asynchrony yeseli:

• I-Atrioventricular Dyssynchrony: Oku kwenzeka xa amagumbi aphezulu (i-atria) kunye namagumbi asezantsi (ii-ventricles) entliziyo yakho zifinyela ngaphandle kokulungelelaniswa.
• I-Interventricular Dyssynchrony: Kule nto, ii-ventricles zakho zasekhohlo nezasekunene (amagumbi asezantsi) ziyafinyela ngamaxesha ahlukeneyo.
• I-Intraventricular Dyssynchrony: Kule nto, izihlunu kwiindawo ezahlukeneyo zeseli enye ziyafinyela ngamaxesha ahlukeneyo. Cinga ngayo njengodonga lwegumbi olufinyela ngamaxesha ahlukeneyo, endaweni yokutyhalelwa ngaphakathi ngaxeshanye.

Ngubani ochaphazeleka kakhulu kukungahambelani kweeseli?

Le meko idla ngokubonakala kubantu abanezi meko zilandelayo zonyango:

• Abantu abanesifo sentliziyo.
• Ibhulokhi yeSebe leBundle yasekhohlo (LBBB).
• Ibhulokhi yeSebe leBundle yasekunene (RBBB).
• Isifo semisipha yentliziyo `(Cardiomyopathy)`.
• Igazi elonyukayo.
• Ezinye izifo zentliziyo.

Cinga ngoMalume uSomapala wasezilalini zethu. Ebesoloko ephethwe yi-`(Heart Failure)` kangangexesha elithile. Kutshanje, ebenengxaki yokuphefumla kwaye edinwa ngakumbi nangakumbi. Xa ugqirha emhlola, wathi naye une-`(Ventricular Dyssynchrony)` entliziyweni yakhe, yiyo loo nto iimpawu zakhe ziye zaba mandundu.

Ixhaphake kangakanani le meko?

Malunga nesinye kwisithathu sabantu abanohlobo oluthile lokusilela kwentliziyo banokuhlangabezana nolu hlobo lokungasebenzi kakuhle kweeseli. Malunga ne-2% yabantu abadala kumazwe aphuhlileyo banengxaki yokusilela kwentliziyo. Kwakhona, phakathi kwe-6% kunye ne-10% yabantu abangaphezu kweminyaka engama-65 ubudala banesifo sentliziyo. Ngoko ke, le meko ikwayinto ebonwayo ngokunxulumene noko.

Zithini iimpawu?

I-Cellular dyssynchrony ingenza iimpawu zokusilela kwentliziyo zibe mandundu, okanye ibangele iimpawu ezikhethekileyo. Nazi ezona ziphambili:

• Ubunzima bokuphefumla (ingakumbi xa udiniwe).
• Ndiziva ndidiniwe kakhulu (nokuba kungomzuzwana nje).
• Ukukhwehlela (mhlawumbi okungapheliyo).
• Ukudumba (i-edema) emzimbeni (ingakumbi kwiindawo ezifana nemilenze namaqatha).

Zithini izizathu zokungahambelani kweeseli?

Iingxaki ezahlukeneyo zentliziyo zinokubangela oku. Ezinye zazo zezi:

• Ukungasebenzi kakuhle kwemithambo yegazi.
• Izicwili ezibangelwa kukuhlaselwa yintliziyo.
• Ukulibaziseka kokuHanjiswa koMbane, okubandakanya iimeko ezifana neBloko yeSebe leLeft Bundle kunye neBloko yeSebe leRight Bundle.
• Imisipha yentliziyo enesifo.
• Ukungahambi kakuhle kwegazi ukuya kwimisipha yentliziyo (i-Ischemia).

Zeziphi iimvavanyo ezenziwayo ukuze kufunyaniswe esi sifo?

Ugqirha wakho uza kuqala akubuze ngeempawu zakho aze enze uvavanyo lomzimba ukuze ahlole ukusebenza kwentliziyo yakho. Ngamanye amaxesha , ukumamela intliziyo yakho nge-stethoscope kunokukunika umbono wolu hlobo lwe-asynchrony.

Uvavanyo oluphambili olusetyenziselwa ukuxilonga iingxaki kwinkqubo yokuhambisa umbane yentliziyo yi -electrocardiogram (ECG) . Ingaxibona iimeko ezifana neRight Bundle Branch Block kunye neLeft Bundle Branch Block, ezibangela ukuba intliziyo ibethe ngendlela engahambelaniyo. Ukuba ezi meko zifunyenwe kwi-ECG, ugqirha uza kukuthumela kwiimvavanyo ezongezelelweyo.

Oogqirha badla ngokusebenzisa i-echocardiogram ukuze babone ukuba i-cardiac arrhythmias iqhubeka njani. Oku kubavumela ukuba babone ukuba amagumbi entliziyo, iivalvu kunye nemisipha ziyancipha njani.

Ezinye iimvavanyo zingenziwa:

• Iskeni sePositron Emission Tomography (PET).
• Iskeni seMultigated Acquisition (MUGA).
• Umzobo weNtlalo yeMagnetic yeNtliziyo (i-MRI).
• Iskeni yeTomography eKhompyutha (CT).
• Iskeni se-Single Photon Emission Computed Tomography (SPECT).

Iphathwa njani i-cell asynchrony?

Ababoneleli ngeenkonzo zonyango banokunyanga imeko yezempilo ebangela ukuba iiseli zakho zingahambelani.

Kwiimeko ezininzi, unyango lwe-cardiac resynchronization therapy (CRT) (olukwabizwa ngokuba yi-CRT okanye i-biventricular pacemaker) lunokunceda intliziyo ipompe ngcono ngokulawula isigqi samacala omabini entliziyo. Nangona kunjalo, olu nyango luphucula kuphela iimpawu kubantu abangama-50% ukuya kuma-70% abafumana olu nyango. Abantu abane-asynchrony enzima banamathuba amaninzi okuphumelela.

Iingxaki zonyango lwe-CRT

Ezi ngxaki zilandelayo zinokwenzeka xa kufakelwa i-`CRT` (i-bi-polar pacemaker) (ezi azixhaphakanga, kodwa kulungile ukuziqaphela):

• I-Pneumothorax.
• Ukuqokelelwa kwegazi phakathi kodonga lwesifuba nomphunga (iHemothorax).
• Ukuhlatywa kwentliziyo.
• Ukuvuselelwa kwemisipha ngaphandle kwentliziyo.
• Iipacemaker zikhokela zisuka endaweni yazo.

Ndiza kuziva ngcono ngokukhawuleza kangakanani emva konyango?

Unyango lwe-CRT luyanciphisa ukungahambelani kweeseli phantse ngoko nangoko. Abanye abantu baqala ukuziva bebhetele kwiiveki ezimbalwa emva kokufakelwa isixhobo. Kukwakho neenzuzo zexesha elide:

• Ukuphucula ubungakanani begazi elimpontshwa yintliziyo yakho (Cardiac Output).
• Ukunciphisa ukuvuza kwegazi okuphuma kwivalvu ye-mitral.
• Ukuphucula umgangatho wobomi bakho.
• Umgama onokuwuhamba ngemizuzu emithandathu uyakhula.

Liliphi iyeza elisetyenziswayo?

Kwiimeko ezibangela i-atrial fibrillation, ezinje ngokusilela kwentliziyo, i-cardiomyopathy, okanye uxinzelelo lwegazi oluphezulu, ugqirha angakunika amayeza anjengala:

• Izithinteli ze-Angiotensin-Converting Enzyme (ACE).
• Ii-Angiotensin II Receptor Blockers (ii-ARB).
• Ii-Beta-Blockers.
• Ii-diuretics (i-diuretics).

Nangona la mayeza anokuphucula ukusebenza kwentliziyo yakho ukuya kwinqanaba elithile, awanakukuguqula ngokupheleleyo ukungahambelani okubangelwa kukungasebenzi kakuhle kombane. Yiyo loo nto kufuneka unyango olufana neCRT.

Ungayinciphisa njani ingozi yokungasebenzi kakuhle kweeseli?

Eyona nto ingcono onokuyenza kukunyamekela intliziyo yakho kakuhle. Ukuba wenza njalo, uya kukwazi ukuthintela ezinye zeemeko ezibangela ukungahambelani kweeseli.

Ezinye iindlela zokukhusela intliziyo yakho:

• Yitya ukutya okunamafutha aphantsi (nciphisa ioyile nokutya okuqhotsiweyo).
• Zilolonge ubuncinane imizuzu engama-30 phantse yonke imihla (nokuba ukuhamba ngeenyawo kulungile).
• Ukugcina ubunzima bakho busempilweni.
• Ukusela amayeza kanye njengoko ugqirha emyalele.

Kuza kwenzeka ntoni ukuba ndine-cell asynchrony?

I-Left Ventricular Dyssynchrony (LVD) ayinyangwa, kwaye isiphumo asibi sihle kangako. Abantu abane-LVD basengozini enkulu yeziganeko zentliziyo kunabo bangenayo le meko. Unokuba ne-dysynchrony nakweyiphi na (okanye zombini) kwi-ventricles yakho, kodwa i-ventricle yakho yasekhohlo yeyona nto iphambili ehambisa igazi elineoksijini emzimbeni wakho wonke. Lo ngumsebenzi obaluleke kakhulu.

Unyango olubizwa ngokuba yi-'CRT' (i-dual-cell pacemaker) lunokunceda abantu abanesifo sentliziyo ukunciphisa ukuhlala esibhedlele baze baphile ixesha elide.

Khumbula, unobangela oyintloko we-asynchrony uchaphazela nesiphumo. Imeko yabanye abantu isenokuba mbi kakhulu kuneyabanye.

Ndingazinyamekela njani?

• Ukuba ugqirha wakho ukunike amayeza, qiniseka ukuba uwathatha kanye njengoko kuyalelwe . Thatha amayeza njengoko kuyalelwe de ugqirha wakho akuxelele ukuba uyeke.
• Ukuba une-biventricular pacemaker, khumbula ukuya kwiikliniki ngemihla emiselweyo . Ezi ziindawo apho ugqirha wakho anokujonga khona ukuba i-pacemaker yakho isebenza kakuhle na. Ezinye izibhedlele zinekliniki ezikhethekileyo ezibizwa ngokuba zii-CRT clinics. Apho, iingcali zentliziyo kunye neengcali zentliziyo ziyasebenzisana ukuqinisekisa ukuba ufumana okuninzi kwi-pacemaker yakho.

Ndifanele ndimbone nini ugqirha wam?

• Ukuba awuziva bhetele ngamayeza anikiweyo.
• Ukuba kukho ingxaki nge-biventricular pacemaker yakho.

Kwiimeko ezinjalo, bonana nogqirha ngokukhawuleza.

Ndingaya nini kwiSebe leeNgxamiseko (i-ETU) ?

Ukuba ufumana naziphi na kwezi mpawu , funa ingcebiso kagqirha ngoko nangoko:

• Intlungu yesifuba okanye ukungakhululeki.
• I-Vertigo (ukuziva ngathi uyajikeleza).
• Ubunzima obukhulu bokuphefumla.
• Intlungu yesisu, isicaphucaphu.
• Intlungu yomqolo, intamo, okanye umhlathi.

Ndingayibuza yiphi imibuzo ugqirha wam?

Ungalibali ukubuza le mibuzo xa ubona ugqirha wakho:

• Kutheni ndiphuhlise i-cell asynchrony?
• Ngaba ndifanelekile kunyango lwe-'CRT'?
• Ngaba kukho amaqela enkxaso anceda abantu abanesifo sentliziyo?

Kuqhelekile ukuba nexhala kancinci xa ufumanisa ukuba intliziyo yakho ayisebenzi kakuhle. Kodwa ungakhathazeki. Ugqirha wakho angayifumana imbangela ye-arrhythmia yakho aze akhethe unyango olulungele wena. Landela imiyalelo ekwibhotile yeyeza ngokuchanekileyo. Ukusela amayeza akho ngexesha elifanayo yonke imihla kuya kukunceda ukhumbule ukuwasela. Phawula imihla yakho yokuqeshwa kwikhalenda okanye usete isikhumbuzo kwifowuni yakho. Oku kuya kukunceda uphephe ukuwaphosa.

Isishwankathelo kunye nomyalezo oya nawo ekhaya

Kulungile, ngoko ke ndiyathemba ukuba ngoku uyiqonda ngcono i-"Ventricular Dyssynchrony" esithethe ngayo namhlanje.

Ngamafutshane, le yimeko apho amagumbi asezantsi (iiseli) zentliziyo zibetha ngokungalinganiyo, zingahambelani. Oku kunokunciphisa ukusebenza kakuhle kwentliziyo, kwaye kunokubangela iimpawu ezifana nokuphefumla kancinci kunye nokudinwa.

• Uvavanyo olufana ne-`(ECG)` kunye ne-`(Echocardiogram)` lunceda ekuxilongeni le meko.
• Njengonyango, ukongeza ekunyangeni isifo esisisiseko, unyango lwe-pacemaker olubizwa ngokuba yi-"Cardiac Resynchronization Therapy (CRT)" nalo lubaluleke kakhulu.
• Ukunyamekela intliziyo yakho nokulandela indlela yokuphila esempilweni kuyanceda kakhulu ekuthinteleni ezo meko.
• Ukuba unale mpawu, ungathandabuzi ukufuna ingcebiso kugqirha. Okukhona isifo sifunyanwa ngokukhawuleza kwaye sinyangwa, kokukhona iziphumo ziya kuba ngcono.

Khumbula, intliziyo yakho yeyona nto ixabisekileyo kuwe. Luxanduva lwakho ukuyikhusela.

Isifo sentliziyo, i-ventricular dyssynchrony, i-ventricular tachycardia, uhlaselo lwentliziyo, i-CRT, i-pacemaker