Kuthiwani uma befaka ikhamera encane enhliziyweni yakho bese beyibheka? Lokho ukuhlikihla inhliziyo!

Ingabe uvame ukuba nobuhlungu esifubeni? Noma ingabe udokotela wakho usola ukuthi unenkinga yenhliziyo? Namuhla sizokhuluma ngokuhlolwa okukhethekile okwenziwa ukuze sibone ukuthi kwenzekani ngaphakathi enhliziyweni yakho. Lokhu yilokho esikubiza ngokuthi `(Cardiac Catheterization)`. Igama lingase lizwakale njengento enkulu, kodwa ungesabi. Ake sixoxe ngalokhu kalula.

Kuyini i-Catheterization Yenhliziyo? Kalula nje...

Ake sithi ubufuna ukuhlola ukuthi imithambo yegazi engaphakathi kwenhliziyo yakho, amapayipi amancane athwala igazi enhliziyweni yakho, isebenza kahle yini nokuthi kukhona yini ukuvaleka endaweni ethile. Yilapho-ke kwenziwa khona lokhu kuhlolwa kwe-"Cardiac Catheterization".

Kalula nje, lokhu kuhilela ukudlulisa ipayipi elincane kakhulu, elincane (elibizwa nangokuthi ``catheter``) ngomthambo wegazi omkhulu ongalweni noma esithweni sakho senhliziyo. Kufana nokufaka ikhamera encane ngaphakathi. Uma ipayipi lingena enhliziyweni yakho, odokotela bangayibona ngokucacile imithambo yegazi eyinhloko enhliziyweni yakho, njenge-``coronary arteries`` (imithambo yegazi ehambisa igazi emisipheni yenhliziyo) noma ``pulmonary artery`` (umthambo othwala igazi lisuka enhliziyweni liye emaphashini). Lokhu kungabonisa kahle ukuthi kunenkinga ngesimo noma umsebenzi wenhliziyo.

Lokhu akusiwo ukuhlinzwa okukhulu. Lokho kusho ukuthi akukho ukusikwa okukhulu emzimbeni. Ngakho-ke isikhathi sokululama sifushane kakhulu kunokuhlinzwa. Kodwa-ke, ngezinye izikhathi ngemva kwalokhu kuhlolwa, kuye ngemiphumela, udokotela angase anqume ukuthi udinga ukuhlinzwa.

Lokhu kuhlolwa kwenziwa udokotela wezifo zenhliziyo othole ukuqeqeshwa okukhethekile kule ndawo kanye nethimba lakhe. Leli thimba lijoyinwe abanye odokotela, abahlengikazi kanye nochwepheshe.

Yiziphi izinhlobo ze-catheterization yenhliziyo?

Kunezinhlobo ezimbili zalokhu ikakhulukazi:

1. Ukufakwa kwe-catheter kwenhliziyo kwesobunxele: Lokhu kuhilela ukudlulisa ithubhu elincane (i-catheter) ngemithambo yegazi iye enhliziyweni. Le nqubo ikuvumela ukuthi ubone isimo samakamelo kanye nemithambo yegazi yenhliziyo ohlangothini lwesobunxele lwenhliziyo yakho, bese ulinganisa ingcindezi kulolo hlangothi.

2. Ukufakwa kwe-catheter yenhliziyo kwesokudla: Kulokhu, kufakwa ipayipi ngomthambo. Lokhu kusenza sikwazi ukubona amakamelo ohlangothini lwesokudla lwenhliziyo kanye nokucindezela kulolo hlangothi.

Kungani udokotela angancoma lokhu kuhlolwa kwe-catheterization yenhliziyo?

Kunezizathu eziningana zokuthi kungani udokotela angancoma lokhu kuhlolwa. Ake sibheke ukuthi ziyini:

• Uma uzwa ubuhlungu besifuba njalo noma ukushaya kwenhliziyo okungajwayelekile, thola imbangela.
• Thatha isampula yegazi noma ingxenye encane kakhulu yezicubu enhliziyweni bese uyihlola (`(biopsy)`).
• Qiniseka ukuthi akukho nkinga ngemithambo yakho yenhliziyo noma ama-valve enhliziyo.
• Hlola ukuthi imisipha yenhliziyo isebenza kahle yini bese uthola isifo semisipha yenhliziyo (cardiomyopathy).
• Hlola izinkinga ngemithambo yegazi eholela emaphashini akho (imithambo yegazi yamaphaphu) kanye nomfutho wegazi ophezulu (umfutho wegazi ophezulu wamaphaphu).
• Hlola ukuhamba kwegazi, amazinga omoya-mpilo, kanye nomfutho wegazi ezingxenyeni ezahlukene zenhliziyo.
• Thola ulwazi olungenakutholakala ngokunembile kwezinye izivivinyo.
• Nquma ukuthi yikuphi ukwelashwa okudingekayo ngokulandelayo. Isibonelo, uma umthambo wegazi uvalekile, lokhu kuzosiza ekunqumeni ukuthi uwuhlanze, ufake i-stent, noma wenze ukuhlinzwa okufana nokufakelwa kwemithambo yenhliziyo (i-CABG).
• Lokhu kuhlolwa kubalulekile nalapho uhlela ukufakelwa inhliziyo.

Isebenza kanjani i-catheterization yenhliziyo?

Ake ngikuchaze kancane lokhu. Ngemva kokuba udokotela efake lelo payipi elincane enhliziyweni, kufakwa uketshezi olukhethekile (olubizwa ngokuthi 'izinto eziphambene') ngalolo payipi enhliziyweni nasemithanjeni yegazi. Lolu ketshezi lwenza imithambo yegazi namagumbi enhliziyo kubonakale ngokucacile ezithombeni 'ze-X-ray'.

Njengoba lolu ketshezi luhamba enhliziyweni, luqoshwa ku-X-ray (ebizwa nangokuthi i-coronary angiogram). Kusukela kulezi zithombe zedijithali, udokotela angenza okulandelayo:

• Thola ngqo lapho umthambo wenhliziyo uvalekile noma uncishisiwe khona.
• Hlola ubukhulu nesimo samakamelo enhliziyo nemithambo yegazi.
• Hlola ukopha okungajwayelekile noma imihuzuko.

Ngezinye izikhathi, uma udinga ukufunda ulwazi olujulile, ezinye izivivinyo ezikhethekile zingenziwa ngesikhathi esifanayo nale "Cardiac Catheterization". Isibonelo:

• I-intravascular ultrasound (IVUS): Lokhu kungasetshenziswa ukubona ama-plaque kanye ne-calcium deposits ngaphakathi kwemithambo yegazi, kanye nokuhlola ukuthi i-stent ikhona yini.
• I-Fractional flow reserve (FFR): Lokhu kusetshenziselwa ukukala ingcindezi ezinhlangothini zombili zomthambo wegazi ovalekile bese kunqunywa ukuthi ukuvaleka kukhulu ngokwanele yini ukuthi kungelashwa.
• `(Optical coherence tomography - OCT)`: Lokhu kungathatha izithombe ezicacile kakhulu zangaphakathi kwemithambo yegazi.

Futhi, ngezinye izikhathi udokotela angenza ezinye izindlela zokwelapha ngenkathi enza lokhu "Catheterization Yenhliziyo". Lokhu akusikho ukuhlinzwa.

• I-Angioplasty: Ukwandisa imithambo yenhliziyo enciphile kanye nokuthuthukisa ukugeleza kwegazi enhliziyweni.
• `(Ukubekwa kwe-stent)`: Ukufaka idivayisi encane efana ne-mesh (`(Stent)`) emthanjeni ovulekile ukuze ungaphinde unciphe.
• I-Valvuloplasty: Ukuvula ivalvu yenhliziyo encishisiwe.
• `(Ukujikeleza)`: Ukwelashwa kokususa ama-calcium deposits emithanjeni yegazi.
• I-intravascular lithotripsy: Lokhu kuhilela ukusebenzisa ibhaluni elikhethekile namagagasi okucindezela ukuze kuhlukaniswe i-calcium.
• `(Ukususwa kwenhliziyo)`:Ukwelashwa kokulungisa isigqi senhliziyo esingajwayelekile.

Cabanga ukuthi kungaba usizo kangakanani ukube ungathola izinkinga enhliziyweni yakho ngokuhlolwa okukodwa, futhi ngezinye izikhathi uzelapha khona lapho? Yilokho okushiwo yilokhu.

Kuthatha isikhathi esingakanani lokhu kuhlolwa kwe-catheterization yenhliziyo (i-Heart Cath)?

Ukuhlolwa kwe-catheter okuvamile kwenhliziyo, okubheka imithambo yakho yenhliziyo kuphela, kuthatha cishe imizuzu engama-30. Kodwa-ke, lesi sikhathi singahluka kuye ngenhloso yokuhlolwa.

Kodwa, uma uhlanganisa isikhathi sokulungiselela lokhu kanye nesikhathi sokululama ngemva kokuhlolwa, kuzodingeka uhlale esibhedlela usuku lonke. Kungathatha amahora amahlanu, ayisishiyagalolunye, noma ngaphezulu. Ngisho noma uphapheme ngesikhathi sokuhlolwa, kuzodingeka ubeke eceleni usuku lonke lwalokhu. Uma ngesizathu esithile odokotela benquma ukwenza inqubo efana ne-angioplasty, kungathatha isikhathi eside nakakhulu, mhlawumbe amahora amaningana.

Yini ongayilindela ngaphambi kokuhlolwa?

Ngaphambi kokusebenzisa i-`(Cardiac Catheterization)`, kufanele uqaphele lezi zinto:

• Kuzodingeka uyeke ukudla nokuphuza amahora ambalwa ngaphambi kokuhlolwa (ngokuvamile cishe amahora ayisithupha kuya kwayisishiyagalombili).
• Udokotela wakho angase akutshele ukuthi uyeke okwesikhashana ukuthatha imithi ethile noma ushintshe umthamo. Kufanele wenze kanjalo ngokufanele.
• Kufanele utshele udokotela wakho nganoma yikuphi ukungezwani komzimba onakho kanye nayo yonke imithi oyithathayo.

Ngemva kokufika esibhedlela:

• Kufanele ugqoke ingubo oyinikezwe yisibhedlela.
• Ipayipi elincane (elingena emthanjeni - IV) lizofakwa emthanjeni ongalweni yakho ukuze likunike umuthi kanye noketshezi.
• Kufanele ulale embhedeni okhethekile. Ngaphezu kwalo mbhede kunekhamera enkulu ye-X-ray kanye nezikrini eziningana ze-TV.
• Isikhumba silungiselelwa lapho kuzofakwa khona ipayipi elincane (i-catheter) (kungaba engalweni noma emphinjeni).
• Kubekwa ama-patches amaningana amancane, ayisicaba, anamathelayo (ama-electrode) esifubeni sakho. Lawa axhunywe kwi-monitor ye-electrocardiograph (EKG). Lokhu kuqapha ukushaya kwenhliziyo yakho kanye nesigqi.
• Uzonikezwa umuthi wokudambisa omnene ukuze uphumule, kodwa uzohlala uphapheme futhi uqaphile phakathi nokuhlolwa konke.
• Kunconywa ukuthi uqaphele izinto ezifana nokungezwani komzimba, isicanucanu, kanye nokungakhululeki esifubeni.

Kwenzekani ngesikhathi sokuhlolwa?

Ngesikhathi sokuhlinzwa kwenhliziyo, udokotela uzokwenza okulandelayo:

• Umuthi wokwenza izinzwa zibe buhlungu ufakwa ngaphansi kwesikhumba sakho ngenaliti encane.
• Isikhwama esincane sepulasitiki ('isikhwama sokwethula' - i-catheter idlula kulokhu) sifakwa emthanjeni wegazi engalweni yakho, entanyeni, noma embotsheni.
• I-catheter ifakwa nge-sheath bese iqondiswa enhliziyweni. (Ungase uzizwe ucindezelekile kancane lapho kufakwa i-sheath noma i-catheter, kodwa akufanele kube buhlungu.)
• Ukuze usize ekubekeni i-catheter kahle, ungase ucelwe ukuthi uphendule ikhanda lakho noma uphefumule ngokujulile bese uyibamba imizuzwana embalwa.
• Igumbi liyafiphala, futhi inani elincane loketshezi olukhethekile (izinto ezingafani) lifakwa nge-catheter emithanjeni yakho nasezindlini zenhliziyo. Phakathi nalesi sikhathi, ungase uzizwe umuzwa ofudumele emzimbeni wakho noma ebusweni imizuzwana embalwa .
• Usebenzisa ikhamera ye-X-ray, uketshezi luzodluliselwa emithanjeni yakho yemithambo kanye namagumbi enhliziyo ukuze uthwebule izithombe (uzocelwa ukuba ubambe umoya wakho ngenkathi kuthathwa i-X-ray).
• Ngesikhathi usamile, bazosusa i-catheter kanye ne-sheath.
• Izibani zivuliwe futhi.

Yini ongayilindela ngemva kokufakwa kwe-catheter yenhliziyo?

Ngemva kokuhlolwa okuqediwe, udokotela ususa i-catheter kanye ne-sheath.

Uma i-catheter ifakiwe esandleni sakho:

• Kufakwa ibhandishi lapho kufakwe khona ipayipi.
• Kufanele ugcine ingalo yakho iqondile okungenani ihora elilodwa (kodwa ungahamba).
• Uzoqashwa amahora ambalwa ukuze kubonakale ukuthi kukhona yini izimpawu noma imiphumela emibi.
• Bazokunikeza imiyalelo yokuthi ungazinakekela kanjani izandla zakho uma usuya ekhaya.
• Uma uzizwa sengathi uyopha (umanzi, ufudumele), uma iminwe yakho ingenamizwa, noma uma uzwa into engavamile, kufanele utshele udokotela wakho.

Uma i-catheter ifakiwe nge-groin yakho:

• Indawo yokufaka iqinisiwe, ngezinye izikhathi nge-suture noma "i-plug" (lokhu kunciphisa ukuphuma kwegazi).
• Bakutshela ukuthi ulale embhedeni imilenze yakho iqonde amahora amabili kuya kwayisithupha ukuze umise ukuphuma kwegazi (kulokhu kungancishiswa uma ufaka "ipulaki"). Bakutshela nokuthi ungaphakamisi ikhanda lakho ngaphezu kwemicamelo emibili.
• Ukuze kuvikelwe ekuthelelekeni, kufakwa ibhandishi elihlanzekile phezu kwendawo yembobo futhi lihlolwe njalo.
• Uma uzizwa uphuma igazi (umanzi, ufudumele), uma izinzwane zakho zingasasebenzi, noma uma uzwa into engavamile, mtshele.

Ukuvuselelwa ngemva kokuhlinzwa kwenhliziyo

Nakekela lezi zinto ngesikhathi sokululama kwakho:

• Udinga ukuphuza amanzi amaningi ukuze ukhiphe uketshezi olukhethekile (izinto ezihlukile).
• Udokotela uzokutshela ukuthi uzoya ekhaya ngalolo suku noma uzolala esibhedlela ubusuku bonke (noma ngabe yikuphi, uzobhekwa amahora ambalwa ngemva kokuhlolwa).
• Khuluma nodokotela wakho ngendlela yokunakekela inxeba.
• Udinga umuntu ozokuhambisa ngemoto ukuya ekhaya (uma ikhaya lakho liqhele ngamahora angaphezu kwamabili, hlala ehhotela bese uhamba ngezinyawo imizuzu emihlanu kuya kweyishumi njalo ngehora).

Ngokuvamile ungashayela amahora angama-24 ngemuva kokuphuma esibhedlela. Kuye ngokuthi i-catheter ifakwe kuphi, kufanele ugweme imisebenzi enzima (njengezemidlalo noma ukuphakamisa izinto ezisindayo) izinsuku ezimbili kuya kwezinhlanu. Udokotela wakho uzokutshela ukuthi ungabuyela nini emsebenzini.

Uma usekhaya, akukuhle ukucwilisa inxeba emanzini isonto lonke.Lokho kusho ukuthi akufanele ubhukude noma ungene ebhavini. Kodwa ungageza ngemva kwamahora angu-24 uhlolwe.

Ziyini izingozi zalolu vivinyo?

Njengazo zonke izivivinyo zezokwelapha, kunezingozi ezincane ezihilelekile, kodwa lezi azivamile kakhulu.

• Ukusabela kokungezwani komzimba.
• Isigqi senhliziyo esingajwayelekile.
• Umfutho wegazi ophansi.
• Ukopha noma ukutheleleka endaweni yokufaka i-catheter.
• Ukuwa kwamaphaphu (i-pneumothorax).
• Ubuhlungu besifuba obuqhubekayo.
• Ukwehluleka kwezinso.
• Ukuqongelela koketshezi oluzungeze inhliziyo (`(i-cardiac tamponade)`).
• Amahlule egazi, ukuhlaselwa yinhliziyo, isifo sohlangothi noma ukufa (lokhu akuvamile kakhulu ).
• Ukudinga ukuhlinzwa okuphuthumayo, isibonelo ukuhlinzwa kwe-coronary artery bypass graft (CABG).

Uma ukhuluma nodokotela wakho, qiniseka ukuthi uyaziqonda zonke lezi zingozi. Futhi, buza ukuthi kungani ucelwa ukuba wenze lokhu kuhlolwa. Nakuba lokhu kungeyona inqubo yokuhlinzwa, kungase kubonakale kuyinqubo engathi sína. Kodwa-ke, khumbula ukuthi izinkinga ezivela kule nqubo azivamile.

Iyini imiphumela? Kusho ukuthini u-Eva?

Ngemva kokuhlinzwa kwenhliziyo, udokotela wakho uzoba nolwazi oluningi olubalulekile oluzokusiza ukunquma indlela yakho elandelayo yokwelashwa. Imiphumela ingahluka kuye ngesizathu sokuhlolwa.

Udokotela angenza lokhu:

• Thola inkinga, njengokuvaleka kwenye yemithambo yakho yenhliziyo, bese uyiphatha khona lapho.
• Thola isimo sezokwelapha esidinga ukuhlinzwa.
• Isampula yemisipha yenhliziyo yakho ithunyelwa elabhorethri ukuze ihlolwe "i-biopsy".
• Thola ulwazi oludingayo ukuze uhlele ukwelashwa.
• Qiniseka ukuthi inhliziyo yakho isebenza kahle ngemva kokwelashwa kwangaphambilini.

Imiphumela izokwaziwa nini?

Udokotela wakho angase akhulume nawe ngemiphumela ngokushesha, kodwa njengoba kuthatha isikhathi ukuthi into efana nesampula yezicubu ihlaziywe elabhorethri, kungathatha izinsuku ezimbalwa ukuthola imiphumela.

Uma imiphumela ingajwayelekile, yini oyenzayo ngokulandelayo?

Uma udokotela ethola noma yiziphi izinkinga ngesikhathi sokuhlinzwa kwenhliziyo, uzohlela ukuhlolwa okwengeziwe noma ukwelashwa. Ngolwazi olutholiwe, angase alungiselele nokuhlinzwa.

Kufanele ngimshayele nini udokotela?

Uma uhlangabezana nanoma yiziphi zalezi zimpawu ngemva kokufakwa kwe-catheter yenhliziyo, shayela udokotela wakho ngokushesha:

• Uma uthola umkhuhlane .
• Uma uzizwa unesiyezi .
• Uma kukhona ubuhlungu, ukuvuvukala, ukopha, noma ubomvu endaweni lapho kufakwe khona i-catheter.
• Uma unezinhlungu esifubeni .
• Uma unenkinga yokuphefumula .
• Uma ukushaya kwenhliziyo yakho kuzwakala kungajwayelekile .

Uma uzizwa sengathi unesifo senhliziyo noma isifo sohlangothi, funa usizo lwezokwelapha ngokushesha.

Okokugcina, okufanele ukukhumbule (Umyalezo Wokuya Ekhaya)

Kungaba yinto esabekayo ukucabanga ukuthi othile ubheka ngaphakathi kwenhliziyo yakho. Kodwa khumbula, lokhu `(i-Cardiac Catheterization)` akusikho ukuhlinzwa, futhi unethimba lezokwelapha elinekhono lokukunakekela. Ulwazi olutholakala kulolu vivinyo lubaluleke kakhulu kodokotela abakhetha ukwelashwa okufanele kakhulu kuwe. Ngakho-ke, lolu vivinyo luyisinyathelo esisodwa nje ohambweni oluya ekululameni kwakho. Ungesabi ukubuza udokotela wakho noma yimiphi imibuzo noma ukungabaza onakho. Kubaluleke kakhulu ukucacisa okusengqondweni yakho.

Ukufakwa kwe - catheter kwenhliziyo, isifo senhliziyo, i-angiogram, i-stent, ukuhlolwa kwenhliziyo, ukwelashwa kwenhliziyo, impilo yenhliziyo