Wake wazizwa sengathi ucwila emanzini, isifuba sakho siqinile, izinyawo zakho zivuvukele, izicathulo zakho zivuvukele kangangokuthi awukwazi ngisho nokuzigqoka? Wazizwa ukhathele kakhulu, awukwazi ngisho nokukhuphuka izitebhisi... Ungamane nje uzishaye indiva njengobuhlungu obungokomzimba. Lokhu kungaba izimpawu ezinkulu zokwehluleka kwenhliziyo okukhulu . Lesi yisimo esiphuthumayo sezokwelapha esisongela impilo. Ngakho-ke, ungesabi. Namuhla, sizoxoxa ngakho konke ngendlela elula neqondakalayo.
Kulungile, kuyini lokhu kwehluleka kwenhliziyo okungazelelwe (Ukwehluleka Kwenhliziyo Okukhulu)?
Kalula nje, lokhu kubhekisela esimweni lapho inhliziyo yethu ihluleka khona ukupompa inani legazi elinomoya-mpilo elidingwa umzimba.
Cabanga nje ukuthi umzimba wakho uyidolobha elikhulu, futhi inhliziyo yakho iyisiteshi esikhulu sokupompa amanzi esihlinzeka ngamanzi kulowo muzi. Uma nje lesi siteshi sokupompa sisebenza kahle, yonke indlu nayo yonke indawo edolobheni ithola amanzi. Kodwa, kwenzekani uma lesi siteshi sokupompa sibuthakathaka noma siphuka ngokuzumayo? Idolobha lilahlekelwa amanzi, akunjalo? Yilokho okwenzekayo. Lapho ipompo ibiza inhliziyo yethu ngokuzumayo iba buthaka, izitho ezibalulekile emzimbeni wethu njengobuchopho, izinso, nesibindi azitholi umoya-mpilo kanye nokudla okudingakalayo. Lokhu kubizwa ngokuthi i-Acute Heart Failure.
Lesi simo asikwenzeka ngobusuku obubodwa. Ngokuvamile, lapho inhliziyo kufanele ithwale umthwalo owengeziwe ngokuhamba kwesikhathi, iqala ukushintsha kancane kancane.
- Inhliziyo ekhulisiwe: Njengoba nje imisipha yomuntu ophakamisa izinsimbi iba mikhulu, uma kufanele usebenze kanzima kakhulu, imisipha yenhliziyo ingaba nkulu futhi inhliziyo ingaba nkulu.
- Ukuncipha kokujikeleza kwegazi: Njengoba inhliziyo iba buthaka, inani legazi eliyipompayo liyancipha.
- Ukuncipha kwemithambo yegazi: Njengoba umzimba uzama ukuzivumelanisa nalokhu, ngisho nemithambo yegazi ingase inciphe.
- Ukushaya kwenhliziyo okusheshayo noma okungajwayelekile (i-Arrhythmia): Ukucindezeleka enhliziyweni kubangela ukuthi ilahlekelwe yisigqi sayo esijwayelekile.
- Ukuqina kwemisipha yenhliziyo: Imisipha yenhliziyo ingaba lukhuni futhi ingaguquguquki.
Lezi zinguquko zincane kakhulu ekuqaleni. Ungase ungezwa zimpawu. Kodwa ngokuhamba kwesikhathi, lezi zinguquko ziyanda futhi lapho inhliziyo ingasakwazi ukuthwala umthwalo, kuvela isimo esiphuthumayo esibizwa ngokuthi i-Acute Heart Failure.
Lokhu ngokuvamile kuyimbangela ehamba phambili yokulaliswa esibhedlela kwabantu abangaphezu kweminyaka engu-65. Kodwa khumbula, lokhu kungenzeka kunoma ubani wanoma yimuphi ubudala.
Ingabe kunezinhlobo ezahlukene zalokhu?
Yebo, kunezinhlobo ezimbili ikakhulukazi.
1. Ukwehluleka Kwenhliziyo Okungaphelele (ADHF): Lokhu kwenzeka uma usuvele unesifo senhliziyo (isibonelo, isifo semithambo yenhliziyo, umfutho wegazi ophakeme). Leli igama elinikezwa lapho inhliziyo yakho ibilokhu ibuthakathaka isikhathi eside, futhi ngesizathu esithile (njengokungaphuzi imithi, ukudla usawoti omningi), isimo siba sibi ngokuzumayo.
2.Ukwehluleka Kwenhliziyo Okukhulu Kwe-De Novo: Kulesi simo, awukaze ube nesifo senhliziyo ngaphambilini. Kodwa-ke, esinye isimo sezokwelapha, njengesifo sikashukela, besilokhu silimaza inhliziyo yakho isikhathi eside ungaqapheli, futhi lesi simo singavela ngokuzumayo.
Ziyini izimpawu zalokhu? Ungakubona kanjani ngokushesha?
Uma unesinye noma ngaphezulu salezi zimpawu, iya eMnyangweni Wezimo Eziphuthumayo wesibhedlela (ETU) ngokushesha, ngaphandle kokulibala. Lesi akusona isifo esingagcinwa ekhaya.
Lezi zimpawu zingaqondakala kahle kusukela kuthebula elingezansi.
| Isibonakaliso | Indlela ozizwa ngayo |
|---|---|
| Ubunzima obukhulu bokuphefumula (i-Dyspnea) | Lesi yisibonakaliso esiyinhloko nesibucayi kakhulu . Kungazwakala sengathi uyacinana, isifuba sakho siqinile, futhi uyaminza. Lokhu kubi kakhulu uma ulele embhedeni futhi uzizwa ungcono kancane uma uhleli. |
| Ukuvuvukala kwemilenze, amaqakala, nezinyawo (i-Edema) | Uma inhliziyo ingakwazi ukupompa igazi kahle, uketshezi luyanqwabelana ezingxenyeni ezingezansi zomzimba. Uma uzicindezela ngomunwe wakho, zizwa sengathi ziyashaya. Ngezinye izikhathi, isisu singase sivuvuke. |
| Ukukhathala ngokweqile nokukhathala | Ukuzizwa ukhathele kakhulu ngisho noma ungenzi lutho noma uthule nje. Ukuzizwa ubuthakathaka kakhulu ukuthi ungavuka ngisho embhedeni. |
| Ukushaya kwenhliziyo okusheshayo noma okungajwayelekile (i-Arrhythmia) | Ukuzizwa sengathi uzwa isifuba sakho sishaya, noma ukuthi isigqi senhliziyo yakho sishintshile. |
| Ubuhlungu besifuba noma ukuqina | Kungazwakala sengathi kukhona umthwalo osindayo ocindezela isifuba sakho, njengokungathi isifuba sakho siyacindezelwa. |
| Ukukhwehlela okuqhubekayo | Ngenxa yoketshezi olugcwalisa amaphaphu, kungase kube nokukhwehlela okune-mucus emhlophe noma epinki. |
| Ukulahlekelwa ingqondo | Ukuzungeza kanye nokulahlekelwa ukwazi kungenzeka ngenxa yokwehla kwenani legazi elifinyelela ebuchosheni. |
Khumbula! Lezi zimpawu zingavela ngokuzumayo. Uma uzibona, ungahlali ekhaya. Umzuzwana ngamunye wempilo yakho uyigugu.
Kungani lokhu kwenzeka? Yiziphi izizathu?
Noma yini ebeka ingcindezi eyengeziwe noma ukucindezeleka enhliziyweni ingabangela lokhu. Nazi ezinye zezimbangela eziyinhloko:
- Isifo Semithambo Yenhliziyo: Ukuvaleka kwemithambo yegazi ehambisa igazi enhliziyweni ngenxa yokufakwa kwe-cholesterol.
- Umfutho wegazi ophakeme: Umfutho wegazi ophakeme ongalawulwayo wenza inhliziyo isebenze kanzima ngokuhamba kwesikhathi.
- Isifo Se-Heart Valve: Uma ama-valve enhliziyweni engavali noma engavuli kahle, igazi liqala ukugeleza libuyela emuva.
- I-Cardiomyopathy: Ubuthakathaka, ukuqina, noma ukwanda kwemisipha yenhliziyo ngenxa yezizathu ezahlukahlukene.
- Ukushaya kwenhliziyo okungajwayelekile (i-Arrhythmia): Ukushaya kwenhliziyo okusheshayo noma okungajwayelekile.
- I-Pulmonary Embolism: Lesi yisimo esiphuthumayo esibangela ukucindezeleka okukhulu okungazelelwe ohlangothini lwesokudla lwenhliziyo.
- Isifo sikashukela esingalawulwa: Isifo sikashukela singalimaza imithambo yegazi kanye nemizwa futhi senze inhliziyo ibe buthaka.
- Isifo sezinso: Uma izinso zingasebenzi kahle, amanzi nosawoti kuyaqoqana emzimbeni, okufaka ukucindezeleka enhliziyweni.
- Ukuphazamiseka Kokusebenzisa Utshwala: Ukuphuza kakhulu isikhathi eside kulimaza ngqo imisipha yenhliziyo.
- Ukutheleleka ngegciwane: Amanye amagciwane (isibonelo, igciwane elihlotshaniswa nesifo senhliziyo esihambisana namathambo) angathinta imisipha yenhliziyo futhi ayibuthakathaka.
Yiziphi izici eziyingozi ezibangela lesi simo?
Ngisho noma unesinye sezimo ezingenhla, izinto ezithile zingabangela ukuqala ngokuzumayo kwe-Acute Heart Failure. Lokhu sikubiza ngokuthi 'izimbangela'.
- Ukungayisebenzisi imithi ebhalwe ngudokotela ngendlela efanele:Uma ungayithathi imithi yakho yomfutho wegazi ophakeme, isifo sikashukela, noma isifo senhliziyo ngendlela efanele, lesi sifo singase sidlulele futhi sibeke ingcindezi enkulu enhliziyweni yakho.
- Ukungalawuli usawoti namanzi athathwayo: Uma udokotela wakho ekutshela ukuthi wehlise usawoti futhi unciphise amanzi athathwayo, kufanele nakanjani umlandele. Ukudla usawoti omningi kubangela ukuthi umzimba wakho ugcine amanzi. Inhliziyo yakho ebuthakathaka kufanele isebenze kanzima ukuze ikhiphe la manzi angaphezulu.
- Ukusetshenziswa kotshwala nezidakamizwa: Lokhu kulimaza inhliziyo ngqo.
- Amanye ama-painkiller (ama-NSAID): Ukusetshenziswa okuqhubekayo kwamanye ama-painkiller, njenge-ibuprofen, ngaphandle kweseluleko sikadokotela nakho akukuhle enhliziyweni.
Udokotela ukubona kanjani lokhu?
Uma uya e-Emergency Treatment Unit (ETU), odokotela bazokuhlola ngokushesha bese bezama ukuthola ukuthi unesifo esingakanani.
1. Bakubuza imibuzo eminingi: mayelana nezimpawu zakho, ezinye izifo onazo, ukuthi ukhona yini emndenini wakho onesifo senhliziyo, imithi oyiphuzayo, nokuthi uyabhema yini.
2. Ukuhlolwa komzimba: Isifuba namaphaphu kulalelwa nge-stethoscope. Imilenze iyahlolwa ukuthi ayinakuvuvukala yini kanti nemithambo entanyeni iyahlolwa. Umfutho wegazi uyalinganiswa.
Ngemuva kwalokho, kwenziwa izivivinyo eziningana ukuqinisekisa ukuxilongwa.
| Ukuhlolwa | Ulindeleni kukho? |
|---|---|
| I-ECG (i-Electrocardiogram) | Iqopha umsebenzi kagesi wenhliziyo. Ingabona izinto ezifana nokuhlaselwa yinhliziyo kanye nokushaya kwenhliziyo okungajwayelekile. |
| I-X-ray yesifuba | Lokhu kusiza ukuhlola ukuthi inhliziyo ikhulisiwe noma amaphaphu agcwele uketshezi. |
| I-Echocardiogram (ukuskena kwenhliziyo) | Lokhu kufana nevidiyo yenhliziyo. Ungabona ngokucacile izinto eziningi njengokuthi inhliziyo ishaya kanjani, ukusebenza kahle kokupompa igazi (i-Ejection Fraction), kanye nomsebenzi wama-valve. |
| Ukuhlolwa Kwegazi kwe-BNP | Uma inhliziyo icindezelekile, imisipha yenhliziyo ikhipha i-hormone egazini. Ngokulinganisa izinga lale hormone egazini, singanquma ukuthi imbangela yokuphelelwa umoya iwukwehluleka kwenhliziyo noma okunye. |
| Okunye ukuhlolwa kwegazi | Izinto ezifana nokusebenza kwezitho ezifana nezinso, isibindi, kanye nendlala yegilo, kanye namazinga kasawoti egazini, ziyahlolwa. |
Yiziphi izindlela zokwelapha lokhu?
Ukwelashwa kungahlukaniswa izingxenye ezimbili: ukwelashwa okuphuthumayo kanye nokuphathwa kwesikhathi eside.
Ukwelashwa okuphuthumayo
Kwa-ETU, umgomo wokuqala wodokotela uwukuzinzisa isimo sakho.
- Ukwelashwa Nge-Oxygen: I-Oxygen inikezwa nge-face mask ukuze kuncishiswe ubunzima bokuphefumula futhi kubuyiselwe amazinga e-oxygen egazini.
- Ama-diuretics - "amaphilisi amanzi": Le mithi inikezwa njengomjovo ukusiza umzimba ukuthi ukhiphe amanzi amaningi emzimbeni ngokushesha ngomchamo. Lokhu kunciphisa inani lamanzi emaphashini, okwenza kube lula ukuphefumula futhi kuncishiswe ukuvuvukala.
- Ama-Vasodilator: Le mithi yandisa imithambo yegazi, inciphisa ukumelana nekhono lenhliziyo lokupompa igazi, futhi inciphise ingcindezi kuyo.
Ukwelashwa nokuphathwa kwesikhathi eside
Ngemva kwesimo esiphuthumayo, isifo esiyisisekelo esisibangele sidinga ukwelashwa.
- Imithi: Kuzodingeka uqhubeke uthatha imithi ehlukahlukene (isib. ama-beta-blockers, ama-ACE inhibitors) athuthukisa ukusebenza kwenhliziyo, alawule umfutho wegazi, futhi avikele inhliziyo.
- Ukuhlinzwa nezinye izindlela: Ngezinye izikhathi imithi yodwa ingase inganele. Kuleso simo, kungase kudingeke usebenzise izinto ezifana nalezi:
- I-Angioplasty kanye ne-Stent: Ukuvula umthambo wenhliziyo ovalekile bese ufaka idivayisi efana ne-mesh (stent) ukuze uvimbele ukuthi ungavaleki futhi.
- Ukuhlinzwa Kokudlula: Ukuhlinzwa ukudala umzila omusha wegazi ukuze ligeleze emthanjeni ovalekile.
- Ukulungiswa/Ukufakwa Kwevalvu: Ukulungiswa kwamavalvu enhliziyo anephutha noma ukufakwa kwevalvu yokwenziwa.
- Ukufakelwa kwedivayisi ye-pacemaker noma ye-ICD: Uma ukushaya kwenhliziyo kungahambi kahle, lawa madivayisi afakwa ngaphansi kwesikhumba sesifuba ukuze sibuyele esimweni saso esijwayelekile.
- Ukufakelwa Inhliziyo:Ukufakelwa inhliziyo enempilo kumuntu ofile engqondweni ezimweni zenhliziyo zesigaba sokugcina ezingenakuphulukiswa nganoma yiluphi olunye ukwelashwa.
Ungaphila kanjani nalesi simo?
Uma ngikhuluma iqiniso, lesi yisimo esibi kakhulu. Umuntu oke waba nalesi simo usengozini enkulu yokuphinde aphinde abe naso. Ezinye izifundo zikhombisile ukuthi inani elikhulu labantu abanalesi simo liyafa phakathi nonyaka.
Kodwa, ungakhathazeki. Akufani kuwo wonke umuntu. Indlela yakho yesikhathi esizayo izonqunywa izinto ezimbalwa:
- Isifo esiyisisekelo esibangele lokhu kanye nobunzima baso.
- Indlela othole ukwelashwa ngokushesha ngayo.
- Impilo yakho iyonke kanye nendlela umzimba wakho osabela ngayo ekwelashweni.
- Okubaluleke kakhulu: ukuzibophezela kwakho endleleni yokuphila enempilo yenhliziyo.
Uma uzibophezele futhi ulandela imiyalelo kadokotela wakho ngqo, ungasiphatha kahle lesi simo futhi uphile impilo ende.
Yini okufanele ngiyenze ngemva kokuphuma esibhedlela?
Ukubuyela ekhaya usuka esibhedlela akusho ukuthi sekuphelile. Eqinisweni, impilo yakho entsha, enempilo yenhliziyo iqala lapho.
- Thatha umuthi wakho ngesikhathi: Ungayeki umthamo owodwa.
- Zikalele njalo ekuseni: Zikalele ngesikhathi esifanayo, unqunu noma ugqoke izingubo ezilula, bese ubhala phansi encwadini. Ukwanda kwesisindo okungazelelwe kwamakhilogremu angu-1-2 ngosuku olulodwa noma ezimbili kungasho ukuthi ugcina amanzi. Uma lokhu kwenzeka, yazisa udokotela wakho ngokushesha.
- Lawula usawoti: Yeka ngokuphelele ukufaka usawoti ekudleni kwakho nokudla ukudla okunosawoti omningi, njengama-pickle, izinhlanzi ezomisiwe, amasosi, namasoseji.
- Amanzi kanye noketshezi: Ungadluli inani loketshezi (kufaka phakathi amanzi, itiye, ubisi, kanye nesobho) udokotela wakho uncoma ukuthi uphuze ngosuku.
- Yeka ukubhema notshwala ngokuphelele.
- Ukuzivocavoca okulula: Zivocavoce kancane njengokuhamba njengoba kunconywe udokotela wakho.
- Iya emitholampilo ngezinsuku ezihleliwe: Qiniseka ukuthi uya kudokotela ngezinsuku akunika zona ukuze umbone.
Umlayezo Wokuya Nawe Ekhaya
- Ukwehluleka Kwenhliziyo Okukhulu kuyisimo esiphuthumayo sezokwelapha . Uma uhlangabezana nezimpawu, ungahlali ekhaya.
- Ukuphefumula kanzima, ukuvuvukala kwemilenze, ukuqina kwesifuba, kanye nokukhathala okukhulu yizimpawu eziyinhloko. Uma lokhu kukhona, hamba uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela ngokushesha.
- Isizathu esiyinhloko salokhu ezinye izimo zezokwelapha ezibeka ingcindezi enhliziyweni, njengomfutho wegazi ophakeme kanye nesifo semithambo yegazi yenhliziyo.
- Uma ukwelashwa okuphuthumayo sekunikezwe esibhedlela futhi isimo sesizinzile, lokhu kufanele kuphathwe isikhathi eside ngemithi kanye nokushintsha indlela yokuphila.
- Impilo yakho isezandleni zakho. Ngokulandela imiyalelo kadokotela (ukuthatha imithi, ukulawula usawoti namanzi athathwayo, nokugwema ukubhema) ncamashi, ungaphila impilo enempilo.
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