Uma udokotela ekutshela ukuthi ingane yakho inenkinga yenhliziyo, uzizwa wesaba kakhulu futhi ukhathazekile, akunjalo? Kujwayelekile impela. Kodwa isikhathi esiningi, ezinye zalezi zimo aziyona ingozi njengoba sicabanga. Namuhla sizokhuluma ngesimo esikhethekile esibangelwa ukuzalwa futhi sibonakala emithanjeni yegazi yenhliziyo. Lokhu ngokwezokwelapha kubizwa ngokuthi i-Anomalous Coronary Artery . Ake sixoxe ngalokhu kalula, ngendlela ongayiqonda.
Kalula nje, iyini i-Anomalous Coronary Artery?
Lokhu kulula kakhulu ukukuqonda. Inhliziyo yethu ifana nephampu eyenziwe ngezicubu zemisipha. Lo msipha wenhliziyo udinga igazi elihlanzekile, elinomoya-mpilo ukuze usebenze. Imithambo yegazi enikeza lelo gazi ibizwa ngokuthi imithambo yenhliziyo . Imithambo yenhliziyo engavamile yilapho omunye noma ngaphezulu kwale mithambo yenhliziyo ingakheki kahle lapho ingane ikhula esibelethweni.
Cabanga ngokwenzekayo lapha, njengepayipi lamanzi endlini eliqala endaweni engafanele bese lixhuma endaweni engafanele. Le mithambo yegazi ayiqali lapho kufanele iqale khona, noma ayikho lapho kufanele ibe khona.
Izinhlobo zemithambo yegazi ezingathinteka kakhulu yile nkinga yilezi:
- Umthambo wenhliziyo wesokudla
- Umthambo omkhulu wenhliziyo kwesobunxele
- Umthambo we-circumflex wesobunxele
- Umthambo owehlayo ongaphambili kwesobunxele
Into eyinhloko eyenzekayo uma lo mthambo usendaweni engafanele ukuthi uphazamisa ukugeleza kwegazi okunomoya-mpilo okuvamile emisipheni yenhliziyo. Lokhu kungabangela ukuthi imisipha yenhliziyo ingatholi igazi elanele.
Lesi simo singathinta cishe u-1% wabantu. Kodwa khumbula, iningi lalezi zimo aliyona ingozi. Kodwa-ke, ngezinye izikhathi, singabangela izinkinga ngenxa yokuncipha kokugeleza kwegazi emisipheni yenhliziyo.
Ingabe kunezinhlobo ezahlukene zalokhu?
Yebo, kunezinhlobo eziningana eziyinhloko zalesi simo. Ake sibheke kalula, ngaphandle kokusenza sibe nzima.
- Ngaphandle komthambo omkhulu wesobunxele, eminye imithambo emibili iqala ngqo kwenye indawo. Lolu uhlobo oluvame kakhulu lwalesi simo.
- Umthambo uqala ngakolunye uhlangothi lomzimba esikhundleni salapho kufanele ufike khona. Ngokuvamile, umthambo wesobunxele uqala ohlangothini lwesobunxele kanti umthambo wesokudla uqala ohlangothini lwesokudla. Kodwa kulokhu, kungenzeka ukuthi usushintshile.
- Esikhundleni sokuqala emthanjeni oyinhloko othwala igazi elinomoya-mpilo liye enhliziyweni (i-aorta), kuqala emthanjeni othwala igazi liye emaphashini (umthambo wamaphaphu). Lesi kungaba isimo esiyingozi kakhulu.
- Akuvamile ukuthi kube nezimo lapho umthambo owengeziwe uqala khona epayipini elithwala igazi liye emaphashini.
Ngezinye izikhathi, umthambo otholakala njalo uyasiza ekugcwaliseni indima umthambo ongavamile ongenakukwazi ukuyenza. Yingakho abanye abantu bengabi nazimpawu baze babe badala.
Ziyini izimpawu zalesi simo?
Izimpawu ezivelayo zingahluka kuye ngohlobo lokungajwayelekile. Ngezinye izikhathi, izimpawu aziveli ezinganeni ezincane, kodwa kubantu abadala. Ake sibone lokhu ngokucacile etafuleni.
| Uhlobo lokungajwayelekile | Izimpawu ezivame ukubonakala |
|---|---|
| Umthambo oqala endaweni engafanele (AAOCA) | Izingane eziningi azinazo izimpawu. Ngezinye izikhathi uphawu lokuqala luba ukuminyana kwenhliziyo okungazelelwe (i-SCA) okwenzeka ngesikhathi sokuzivocavoca. Le ngozi iphezulu kakhulu kubantu abasha abaneminyaka ephakathi kweyi-10 nengama-30.
|
| I-aorta yesokudla evela emthanjeni wamaphaphu (i-ARCAPA) | Izimpawu zingase zivele lapho umntwana ezalwa noma phakathi kweminyaka engama-40-60. |
| I-aorta yesobunxele evela emthanjeni wamaphaphu (i-ALCAPA) | Lesi yisimo esibi kakhulu. Izimpawu zivame ukuvela ebuntwaneni, phakathi nonyaka wokuqala. |
Iyini imbangela yalokhu?
Imbangela eqondile yalokhu ayikatholakali. Lena inkinga yokuzalwa nayo . Lokhu kusho ukuthi lesi simo senzeka ngenxa yephutha elithile elenzeka lapho imithambo yenhliziyo yakheka ngenyanga yokuqala ngemva kokukhulelwa.
Into ebaluleke kakhulu ukuthi ucwaningo aluzange lufakazele ukuthi lesi yisifo esidluliselwa ngofuzo. Ngakho-ke, ungacabangi ukuthi lokhu kuyiphutha lakho.
Udokotela usithola kanjani lesi sifo ngqo?
Kungaba nzima kancane ukubona ngoba abanye abantu abanazo izimpawu futhi konke kubukeka kuphilile ngesikhathi sokuhlolwa okuvamile kwezokwelapha. Kodwa-ke, uma udokotela wakho esola lesi simo, uzoncoma ukuhlolwa okumbalwa okufana nalokhu.
- I-CT Angiogram (i-Computed Tomography Angiogram): Lokhu kukuvumela ukuthi uthathe izithombe zemithambo yegazi yenhliziyo ezinobukhulu obuthathu (3D) bese ubona ngqo ukuthi imithambo yegazi ikuphi.
- I-X-ray yesifuba
- I-Transthoracic Echocardiogram: Iskeni sokubheka umsebenzi kanye nesakhiwo senhliziyo.
- Ukuhlolwa kwe-ECG (i-Electrocardiogram): Ukuhlolwa kokuhlola ukusebenza kukagesi kwenhliziyo.
- Ukuskena kwe-MRI yenhliziyo
- Ukufakwa kwe-Catheterization Yenhliziyo: Ithubhu elincane lidlula emithanjeni yegazi liye enhliziyweni ukuhlola ukucindezeleka kanye nendawo yemithambo yegazi.
- Ukuhlolwa Kokucindezeleka: Ukuqapha indlela inhliziyo esebenza ngayo ngesikhathi sokuzivocavoca.
Yiziphi izindlela zokwelapha lokhu?
Ukwelashwa kuncike ohlotsheni lokungajwayelekile, ubukhali balo, nokuthi ngabe kunezimpawu noma cha.
Kubantu abaningi, ikakhulukazi abasebasha, abanempilo enhle abangenazo izimpawu, odokotela batusa ukuhlinzwa ukuze kuvinjelwe izinkinga zesikhathi esizayo. Ukuhlinzwa kuyadingeka kakhulu kulabo abanezimo ezibucayi, njenge-left atrial appendage (LAPA).
Kodwa-ke, ezinye izinhlobo, isibonelo, ukukhubazeka okuncane ku-atrium efanele, zingase zingadingi ukuhlinzwa ngaphandle kokuba kunezimpawu.
Uma ukuhlinzwa kungeyona inketho, udokotela wakho angatshela ingane yakho ukuthi inciphise ukuzivocavoca futhi angase futhi anikeze imithi, njenge-beta-blockers, yokunciphisa umthwalo womsebenzi enhliziyweni.
Kunezinhlobo eziningana eziyinhloko zokuhlinzwa ezisetshenziswayo:
- Ukubuyisela umthambo endaweni yawo efanele nokuwuxhumanisa kabusha.
- Ukuvulwa kophahla lwe-coronary.
- Ukudluliselwa komthambo wamaphaphu.
- Ukufakelwa kwemithambo ye-coronary bypass.
Kuzokwenzekani ngemva kokuhlinzwa nangale kwalokho?
Ngemva kokuhlinzwa, ingane kuzodingeka ihlale esibhedlela izinsuku ezimbalwa. Ingase icelwe ukuthi iphuze imithi efana ne-aspirin cishe izinyanga ezintathu. Ngokuvamile ivunyelwe ukuhlanganyela kwezemidlalo futhi ngemva kwezinyanga ezintathu.
Njengoba lesi kuyisimo sokuzalwa, kubaluleke kakhulu ukuhlolwa njalo kwezokwelapha impilo yonke, noma ngabe kwenziwa ukuhlinzwa.
Ithemba lomuntu ophila nalesi simo livame ukuba lihle. Ikakhulukazi esimweni esibucayi njenge-ALCAPA, esinethuba elingama-90% lokufa uma singelashwa, singelashwa ngokuphelele uma sitholakala kusenesikhathi futhi selashwa kahle . Ukuhlinzwa kunganciphisa izimpawu futhi kuvimbele ukufa okuzumayo.
Ngingayibona nini udokotela?
Udinga ukuqaphela kakhulu ngalezi zici.
Uma ingane yakho inalezi zimpawu:
- Uma uhlala ukhala ngaphandle kwesizathu.
- Uma isikhumba sibukeka simhlophe.
- Uma uzizwa sengathi uphefumula ngokushesha okukhulu.
Uma unalezi zimpawu, bona udokotela ngokushesha.
Uma umuntu omdala:
Uma unesihlungu esifubeni futhi uphefumula kanzima , hamba uye e -Emergency Treatment Unit (ETU) esibhedlela ngokushesha. Lokhu kungaba uphawu lokuhlaselwa yinhliziyo, ngakho ungalibali.
Kunemizwa eminingi efika engqondweni uma uthola ukuthi ingane yakho inenkinga yenhliziyo. Kodwa ingxenye engcono kakhulu ukuthi lesi simo se-Anomalous Coronary Artery ngokuvamile asinangozi. Khuluma ngokukhululekile nodokotela wengane yakho ngesimo sengane yakho. Uzokunikeza iseluleko osidingayo. Into ebaluleke kakhulu ukuthumela ingane yakho ukuthi iyohlolwa njalo njengoba udokotela wakho encoma.
Umlayezo Wokuya Nawe Ekhaya
- I-Anomalous Coronary Artery yisimo sokuzalwa. Akuyona into ebangelwa yiphutha labazali.
- Abantu abaningi abanalesi simo baphila impilo ejwayelekile ngaphandle kwezimpawu.
- Ungalokothi uzishaye indiva izimpawu ezifana nobuhlungu besifuba noma ukuphelelwa umoya, ikakhulukazi uma uzivocavoca. Bonana nodokotela ngokushesha.
- Uma umntwana ekhala njalo noma enenkinga yokuphefumula ngesikhathi encelisa, khathazeka.
- Ukuxilongwa okufanele kanye nokwelashwa (ngokuvamile ukuhlinzwa) kuyaphumelela kakhulu. Ngakho-ke asikho isidingo sokwesaba.
- Landela imiyalelo kadokotela wakho ngokucophelela, ikakhulukazi mayelana nemikhawulo yokuzivocavoca kanye nokuhlolwa njalo.
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