Usizo lwenhliziyo yakho: Kuyini i-cardiology yokungenelela?

Wake wezwa ngegama elithi "Interventional Cardiology"? Mhlawumbe udokotela wakho ukhulumile ngalo, noma mhlawumbe uyalihlola ngoba unenkinga yenhliziyo. Nokho, lo mkhakha wezokwelapha obaluleke kakhulu. Ake sixoxe ngakho kafushane, akunjalo?

Kuyini i-Interventional Cardiology? Kulula kakhulu!

Kalula nje, i-interventional cardiology inqubo ekhethekile esebenzisa ithubhu elincane kakhulu , eliguquguqukayo elibizwa ngokuthi ``i-catheter``` ukuxilonga nokwelapha izifo zenhliziyo nezemithambo yegazi . Cabanga ngayo njenge-cannula encane esiyisebenzisayo lapho sifaka usawoti engalweni yethu, kodwa le ``catheter`` iyithubhu elicolekile nakakhulu. Lokhu kufakwa ngomunye wemithambo yegazi yakho. Ngakho-ke, asikho isidingo sokwenza ukusika okukhulu esikhumbeni nokwenza ukuhlinzwa. Lena inzuzo enkulu yale ndlela.

Odokotela kulo mkhakha (sibabiza ngokuthi odokotela benhliziyo abangenelelayo) basiza abantu abanesifo semithambo yegazi kanye nesenhliziyo. Baphinde belaphe izinsana, izingane ezincane, kanye nabantu abadala abanezinkinga zenhliziyo, njengezinkinga ze-valve yenhliziyo noma isifo senhliziyo esizalwa naso, njengezinkinga ze-septal.

Uyini umehluko phakathi kwe-Interventional Cardiology kanye ne-Cardiothoracic Surgery?

Nakuba kokubili lokhu kuhlobene nenhliziyo, kunomehluko omncane.

Udokotela wenhliziyo ohlinzayo wenza ukwelashwa "okuncane okungenayo i-"Minimally Invasive", engikushilo ekuqaleni, esebenzisa ""(i-Catheter)"", ngaphandle kokusikwa okukhulu, ngembobo encane. Okusho ukuthi, abenzi "" ukuhlinzwa kwenhliziyo okuvulekile" ", okuhilela ukwenza ukusika okukhulu phakathi kwesifuba ("Sternotomy").

Kodwa-ke, udokotela ohlinza inhliziyo ngumuntu ohlinza izitho ezisesifubeni, njengenhliziyo, amaphaphu, kanye nomphimbo. Benza ukuhlinzwa kwenhliziyo okuvulekile. Ngezinye izikhathi basebenzisa nezimbobo eziningi ezincane esikhundleni sokumbozwa okukodwa okukhulu.

Into ebaluleke kakhulu ukuthi, ezimweni eziningi, bobabili laba ochwepheshe basebenzisane ukuze banqume ukuthi iyiphi indlela yokwelapha efaneleka kakhulu kuwe.

Yini eyenziwa yi-cardiologist engenelela ngqo?

Laba odokotela bangochwepheshe ekusebenziseni leyo "(i-catheter)" ukuxilonga nokwelapha izifo zenhliziyo nemithambo yegazi. Ezinye izindlela zisetshenziswa ukuthola ukuthi siyini ngempela lesi sifo, kanti ezinye zisetshenziswa ukwelapha lesi sifo.

Yiziphi izivivinyo eziyalelwa udokotela wezifo zenhliziyo ongenelelayo?

Kule nsimu ikakhulukaziIhlola ukuthi ukujikeleza kwegazi emzimbeni wakho kusebenza kahle yini. Ibheka izinkinga eziphazamisa ukugeleza kwegazi bese izama ukuzixazulula. Isibonelo, ihlola ukugeleza kwegazi kanye nomfutho emithanjeni yegazi enikeza igazi enhliziyweni yakho ("i-Coronary Arteries") kanye nangaphakathi kwamagumbi enhliziyo.

Ezinye zezivivinyo ezenziwe ngalokhu yilezi:

• Ukuhlolwa kwe-CT kwemithambo yegazi yenhliziyo (i-computed tomography (CT) yemithambo ye-Coronary).
• I-echocardiogram (i-intracardiac echocardiogram).
• I-MRI yenhliziyo.
• I-X-ray yesifuba .

Iyini Inqubo Yokwelapha Inhliziyo Ephakathi?

Lena indlela yokwelapha inhliziyo kusetshenziswa i-`(Catheter)` kuphela, ngaphandle kokusika isikhumba noma ukwenza ukuhlinzwa. Isibonelo, uma kufakwa esikhundleni se-valve yenhliziyo noma kulungiswa i-valve yenhliziyo kusetshenziswa i-`(Catheter)`, kuyindlela yokwelapha inhliziyo engenelelayo.

Yikuphi ukwelashwa okwenziwa yi-cardiologist engenelelayo?

Kunezindlela eziningi zokwelapha ezenziwa yilaba odokotela. Kungenzeka ukuthi uke wezwa ngezinye zazo.

• Ukufakwa kwe-catheter enhliziyweni: Ukuhlolwa kwenhliziyo ngokufaka i-catheter kuyo.
• I-Angiogram (`Angiogram` - `Peripheral` noma `Coronary`): Kufakwa uketshezi olukhethekile emithanjeni yegazi bese kuthathwa ama-X-ray ukuze kutholakale ukuthi kukuphi lapho kuvinjiwe khona.
• I-Angioplasty: Ukuvula kabusha umthambo wegazi ovinjiwe ngokuwufutha ngedivayisi encane efana nebhaluni.
• Ukususwa kwe-Coronary Atherectomy: Ukususwa kwama-fatty deposits (i-plaque) emithanjeni yegazi .
• Ukulinganiswa Kokugeleza Kwengxenye (i-FFR): Ukulinganiswa kokuthi kungakanani ukugeleza kwegazi okuvinjiwe ngenxa yokuvaleka komthambo wegazi.
• I-Intravascular Ultrasound (IVUS): Inqubo lapho kufakwa khona idivayisi encane ye-ultrasound emthanjeni wegazi.
• I-Optical Coherence Tomography (OCT): Indlela esebenzisa ukukhanya ukubona ingaphakathi lemithambo yegazi ngokucacile.
• Ukubekwa kwe-Stent: Ipayipi elincane eline-mesh elifakwa emthanjeni wegazi ovalekile ovulwe yi-angioplasty ukuze ungavaleki futhi. Lokhu kuvame ukwenziwa ngensimbi.
• Ukufakwa Nokulungiswa Kwevalvu Yenhliziyo: Lokhu manje kungenziwa nge-catheter.
• Ukuvalwa kwe-Atrial Appendage kwesobunxele.
• Ukuvala imbobo odongeni phakathi kwe-atria (`Atrial Septal Defect Closure`).
• Utshwala Septal Ablation.
• Ukuvalwa kwe-Patent Foramen Ovale.
• Ukususwa Kwezinso: Ukwelashwa okuqondiswe ezinsweni ukuze kuncishiswe umfutho wegazi ophezulu.
• I-Thrombolysis: Ukuncibilikisa amahlule egazi.

Yiluphi ukwelashwa okuvamile okwenziwa odokotela benhliziyo abangenelelayo?

Inqubo evame kakhulu eyenziwa yilaba odokotela i -angioplasty kanye nokufakwa kwe-stent emithanjeni yegazi yenhliziyo. Lokhu kuhilela ukusebenzisa i-catheter ukuthola ukuvaleka kwemithambo yegazi enhliziyweni. Bese kuthi, ngethuluzi elincane njengebhaluni, ukuvaleka (okungukuthi, i-plaque eyakhiwe yi-cholesterol deposits) kucindezelwe odongeni lwemithambo yegazi, kudala indlela yokugeleza kwegazi. Bese kuthi, uma kudingeka, kufakwe ipayipi le-mesh elibizwa ngokuthi i-stent lapho ukuvimbela indlela ukuthi ingavaleki futhi. Lokhu kuyindlela yokwelapha esindisa impilo yomuntu oye waba nokuhlaselwa yinhliziyo.

Yiziphi izifo nezimo eziphathwa yi-cardiology yokungenelela?

Le ndlela ingelapha izifo eziningana ezithinta inhliziyo nemithambo yegazi. Nazi izibonelo ezimbalwa:

• Isifo Se-Valve Yenhliziyo
• I-atherosclerosis
• Isifo senhliziyo
• Isifo se-Carotid Artery (lesi yisifo esiyinhloko semithambo yegazi entanyeni)
• Isifo Semithambo Yenhliziyo
• I-Hypertrophic Cardiomyopathy (ukuqina kwemisipha yenhliziyo)
• I-Coronary Artery Fistula (Ukuxhumana okungajwayelekile phakathi komthambo wegazi enhliziyweni nomunye umthambo wegazi noma ingxenye yenhliziyo)
• Isifo Semithambo Yegazi Engaphazamisi (ukuvaleka kwemithambo yegazi emalungeni)
• Isifo Semithambo Engamahlalakhona (Imithambo)
• I-Aortic Valve Stenosis
• Izifo zokujiya kwegazi (`Isifo se-Thromboembolic`)
• I-Aneurysm
• Izimbobo odongeni phakathi kwe-atria (`Atrial Septal Defect`)
• Izimbobo odongeni phakathi kwama-ventricle (`Ventricular Septal Defect`)

Ingabe ngidinga i-referral ukuze ngibone udokotela wenhliziyo ongenelelayo?

Yebo, uzodinga ukudluliselwa komunye udokotela ukuze ubone udokotela wenhliziyo ongenelelayo. Lokhu kungenxa yokuthi laba ochwepheshe baqeqeshwe ukwenza ukuhlolwa noma ukwelashwa okudingayo.

Basebenza kuphi laba odokotela benhliziyo abangenelelayo?

Odokotela benhliziyo abasebenza ngokungenelela basebenza ezibhedlela, ezikhungweni zezokwelapha ezizimele, kanye nasezikoleni zezokwelapha. Abanye bahlanganyela ocwaningweni nasekufundiseni abafundi bezokwelapha ngenkathi behlinzeka ngokwelashwa.

Ngokuvamile, laba odokotela bavame ukuba semsebenzini wokwelapha isimo esiphuthumayo, isibonelo, umuntu oye waba nesifo senhliziyo.

Yikuphi ukuqeqeshwa okudingekayo ukuze uthole i-cardiology yokungenelela?

Ukusebenza kulo mkhakha kudinga iminyaka yokuqeqeshwa. Ngemva kwesikole sezokwelapha (iminyaka emi-4), labo abaphishekela lo msebenzi okhethekile baqeda iminyaka emithathu yokuqeqeshwa kokuhlala e-Internal Medicine, kulandelwe eminye iminyaka emithathu yokuqeqeshwa okukhethekile kwi-General Cardiology.

Ngemuva kwalokho, uzothola okungenani unyaka owodwa wokuqeqeshwa okukhethekile kwe-cardiology yokungenelela (`Ubudlelwano`) kumasu asetshenziswa ukusebenzisa ``i-Catheter``. Kulapho-ke kuphela lapho uzothola khona ``Isitifiketi`` ebhodini lezokwelapha.

Abanye odokotela benhliziyo abahlinzayo bangamalungu ezinhlangano ezifana ne-Society for Cardiovascular Angiography and Interventions (SCAI) noma banobulungu obukhethekile ("Fellow"). "Fellow" ngumuntu owenze izinqubo ezingaphezu kwe-1,000. Lokhu kusho ukuthi welashwa ngumuntu othole ukuqeqeshwa okuthuthukile kakhulu.

Yini ongayilindela ngesikhathi sokuqokwa kukadokotela wenhliziyo ongenelelayo?

Ngaphandle kokuthi kuyisimo esiphuthumayo, udokotela wenhliziyo ozongenela ukuhlinzwa uzokhuluma nawe ngezinkinga zenhliziyo yakho noma zemithambo yegazi. Bazokubuza ngezimpawu zakho nokuthi usunesikhathi esingakanani unazo. Kubalulekile ukuletha uhlu lwazo zonke izidakamizwa ozithathayo (ezinqunywe ngudokotela, ezithengiswa ngaphandle kwemithi kadokotela, amavithamini, ngisho nezithasiselo).

Udokotela uzolalela inhliziyo yakho. Uzobuza nokuthi usebenzisa imikhiqizo kagwayi noma uphuza utshwala. Uzobuza nokuthi kukhona yini emndenini wakho oke waba nesifo senhliziyo noma izinkinga zemithambo yegazi. Angase futhi enze izivivinyo ezilula lapho, njengokuhlola umfutho wegazi lakho.

Uma udinga ukuhlolwa kokuxilonga kanye/noma ukwelashwa, kuzodingeka uhlele i-aphoyintimenti ehlukile ngalolo suku. Udokotela wakho uzochaza ukwelashwa okungenelela abacabanga ukuthi kulungile kuwe, kanye nezinzuzo nezingozi. Bazokutshela nokuthi ungalungiselela kanjani ukwelashwa. Isibonelo, ungase ucelwe ukuthi ungadli noma ungaphuzi amahora ayisishiyagalombili ngaphambi kokuhlolwa noma ukwelashwa.

Kuvamile ukuzizwa ukhathazekile kancane uma utshelwa ukuthi uzohlinzwa inhliziyo. Kodwa khumbula, uma une-cardiology yokwelapha inhliziyo, unakekelwa uchwepheshe oqeqeshwe kahle. Bangaqoqa ulwazi abaludingayo ukuze bathole lesi simo bese beselapha ngaphandle kokwenza ukuhlinzwa kwenhliziyo okuvulekile.

Izinto ezibaluleke kakhulu okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Ngakho-ke, i-cardiology yokungenelela iyinsimu yezokwelapha ethuthuke kakhulu futhi enobungane kakhulu nesiguli.

• Akukho ukusikwa okukhulu: Inzuzo enkulu ukuthi izinkinga eziningi zenhliziyo nemithambo yegazi zingelashwa kusetshenziswa i-catheter encane kuphela, ngaphandle kokwenza noma yikuphi ukusikwa okukhulu.
• Ukululama okusheshayo: Njengoba kungekho ukuhlinzwa okukhulu okwenziwayo, ukuhlala esibhedlela kufushane, futhi ungalulama ngokushesha futhi ubuyele empilweni yakho evamile.
• Ubuchwepheshe: Lokhu kwelashwa kwenziwa odokotela abaqeqeshwe ngokukhethekile ngale njongo.
• Ungesabi: Uma unikezwe ukwelashwa okunjalo, khuluma nodokotela wakho ngakho ngokuphelele bese uthola imininingwane. Ukwazi ulwazi olufanele kuzokusiza ugweme ukwesaba okungadingekile.

Uma unezinkinga zenhliziyo, ungakhohlwa ukubona udokotela ukuze akunike iseluleko. Inhliziyo enempilo isho impilo enempilo!

Isifo senhliziyo, i-cardiology yokungenelela, i-catheter, i-angioplasty, i-stent, ukuhlinzwa kwenhliziyo, impilo yenhliziyo