Kuvamile ukuzizwa wesaba futhi ushaqekile lapho ingane yakho itshelwa udokotela ukuthi inesici senhliziyo esizalwa naso. Kodwa ungakhathazeki. Uma wazi kahle ngesimo esizokhuluma ngaso namuhla, esibizwa ngokuthi i-Coarctation of the Aorta, ungabhekana naso ngempumelelo. Ake sibheke kalula ukuthi siyini, kungani senzeka, nokuthi yini engenziwa.
Kuyini ukuhlanganiswa kwe-Aorta (CoA)?
Kalula nje, i-Coarctation of the Aorta (CoA) yisimo senhliziyo esizalwa naso . Kwenzeka lapho ingxenye ye-aorta, umthambo wegazi oyinhloko othwala igazi elinomoya-mpilo lisuka enhliziyweni yethu liye kuwo wonke umzimba wethu, incipha . Igama elithi “coarctation” ngokwezwi nezwi lisho “ukuncipha.”
Cabanga ukuthi bekuzokwenzekani uma umzila owodwa womgwaqo uvalwa ngokuzumayo ngesikhathi sokuminyana okukhulu kwezimoto emgwaqweni iColombo-Galle? Zonke izimoto bezizoqala ukuhamba, bese kuba nokuminyana okukhulu kwezimoto. Yilokho okwenzekayo lapho omunye wemithambo yegazi emikhulu emzimbeni wethu uvaleka. Igazi ngeke likwazi ukugeleza kahle.
Lokhu kuvinjelwa kuvame ukwenzeka ngaphambi kokuba imithambo ethwala igazi iye ezingxenyeni ezingezansi zomzimba ihlukane. Lokhu kubangela ukuthi umfutho wegazi osuka enhliziyweni uye ezingxenyeni ezingaphezulu (izingalo, ikhanda) wande, kanye nomfutho wegazi osuka egazini uye ezingxenyeni ezingezansi zomzimba (imilenze) wehle. Eqinisweni, lo mehluko omkhulu udokotela azowubona lapho ehlola umfutho wegazi ezingalweni nasemilenzeni yengane yakho ungenye yezinkomba eziyinhloko zokuhlonza lesi sifo.
Ziyini izimpawu? Ingabe kukhona umehluko phakathi kwezinsana nezingane ezindala?
Izimpawu ziyahlukahluka kuye ngokuthi ukuvaleka kukhulu kangakanani. Uma ukuvaleka kukhulu, umntwana angase aqale ukukhombisa izimpawu zingakapheli isonto noma amabili ezelwe. Kodwa-ke, uma ukuvaleka kuncane kakhulu, izimpawu zingase zingaveli kuze kube yilapho ingane isikhulile, noma nhlobo.
| Iqembu lobudala | Izimpawu ezivame ukubonakala |
|---|---|
| Izinsana ezisanda kuzalwa (izinsana) |
|
| Izingane kanye nabantu abadala |
|
Ezinye izingane zingase zingaziboni izimpawu. Ngezinye izikhathi, isikhathi sokuqala lapho zithola le nkinga yilapho udokotela ehlola umfutho wegazi wazo emtholampilo ojwayelekile bese ebona ukuthi uphakeme.
Kungani lokhu kwenzeka? Yiziphi izizathu?
Nakuba imbangela eqondile yalokhu ingaziwa, odokotela bakholelwa ukuthi inesakhi sofuzo . Lokhu kusho ukuthi ezinye izinguquko zofuzo ezenzeka ngesikhathi umntwana esakhula esibelethweni zingase zivimbele i-aorta ukuthi yakheke kahle.
Esinye isizathu esiyinhloko salokhu ushintsho endleleni umthambo wegazi omncane obizwa ngokuthi i-ductus arteriosus ovaleka ngayo.
Cabanga ngakho, uma umntwana esesiswini sikanina, amaphaphu awasebenzi. Bese kuba nomthambo wegazi okhethekile osiza umntwana ukuthi athole umoya-mpilo. Lapho umntwana ezalwa futhi eqala ukuphefumula, lo mthambo awusadingeki, ngakho uvala ngokuzenzakalelayo ezinsukwini ezimbalwa. Kodwa ngezinye izikhathi lapho lokhu kuvala, ezinye izicubu ezikuwo zingadonswa zingene ku-aorta, futhi i-aorta inganamathelana.
Ngaphezu kwalokho, izingane ezinezimo ezithile zofuzo, njenge -Turner syndrome, zisengozini enkulu yokuthola lesi simo se-CoA.
Yiziphi izinkinga ezingaba khona uma zingelashwa?
Uma lesi simo singatholakali futhi singalashwa kusenesikhathi, izinkinga ezahlukahlukene zingavela ngokuhamba kwesikhathi.
- Umfutho wegazi ophezulu (i-Hypertension) emzimbeni wonke.
- Ukuqina ngokweqile kwemisipha yenhliziyo (i-left ventricular hypertrophy) .
- Ukugcwala kwamafutha emithanjeni yegazi ehambisa igazi enhliziyweni (isifo semithambo yegazi yenhliziyo) ngaphambi kwesikhathi esijwayelekile.
- Ukuvuvukala okufana nebhaluni (i-aneurysm) e-aorta noma emthanjeni wegazi ebuchosheni.
- Isimo lapho inhliziyo ingakwazi ukupompa igazi elanele(ukwehluleka kwenhliziyo) kwenzeka.
Into ebalulekile ukuthi eziningi zalezi zinkinga zenzeka kuphela uma lesi sifo singatholakalanga futhi singalashwa kusenesikhathi. Ngakho-ke, kubaluleke kakhulu ukubona udokotela ngokushesha okukhulu.
Odokotela basithola kanjani lesi sifo ngokunembile?
Odokotela benhliziyo bezingane ngokuvamile yibona abaxilonga lesi sifo. Lokhu kwenziwa kakhulu ngokuhlolwa ngokomzimba komntwana.
- Ukuhlola umehluko ekucindezelweni kwegazi ezingalweni nasemilenzeni .
- Ukuhlola ukushaya kwenhliziyo entanyeni nasesinqeni.
- Ukububula kwenhliziyo umsindo ohlukile ozwakalayo lapho kufakwa i-stethoscope esifubeni nasemhlane.
Ngaphezu kwalokho, kwenziwa i -Echocardiogram (echo) , ukuskena kwenhliziyo, ukuqinisekisa ukuxilongwa nokunquma ubukhulu bokuvimbeka. Ngezinye izikhathi, kungadingeka ukuskena kwe-CT noma i-MRI.
Ezinye izifo zenhliziyo ezingase zenzeke ngalokhu
Cishe u-45% kuya ku-75% wezingane ezine-CoA nazo zinesifo esibizwa ngokuthi i-bicuspid aortic valve . Lokhu kusho ukuthi i-valve ethwala igazi lisuka enhliziyweni liya e-aorta inama-cusps amabili kuphela esikhundleni samathathu. Ngaphezu kwalokho, izimo ezifana nezimbobo enhliziyweni (i-atrial septal defect noma i-ventricular septal defect) nazo zingabonakala ngalesi simo.
Yiziphi izindlela zokwelapha?
Ukwelashwa kunqunywa ngokusekelwe eminyakeni yengane, izinga le-aortic stenosis, kanye nokuthi zikhona yini ezinye izifo zenhliziyo.
Ukuhlinzwa
Ukwelashwa okungcono kakhulu kwezinsana nezingane ezincane ukuhlinzwa.
- Ukususwa kabusha nge-anastomosis kusukela ekuqaleni kuya ekugcineni: Lokhu kuhilela ukusika ingxenye encane yokuvaleka nokuxhumanisa izingxenye ezimbili eziphilile.
- Ukususwa kabusha ngokuhlinzwa okunwetshiwe kusukela ekuqaleni kuya ekugcineni: Uma kukhona ukuvaleka eceleni kwe-aorta, kwenziwa lokhu kuhlinzwa okuyinkimbinkimbi kakhulu.
Izingane ezinezimpawu ezinzima lapho zizalwa zingadinga ukunikezwa imithi efana ne -prostaglandin (PGE-1) ukuze ziqinise isimo somntwana ngaphambi kokuhlinzwa.
Ukufakwa kwe-Catheterization Yenhliziyo
Lena indlela elula kunokuhlinzwa. Le ndlela isetshenziswa uma ukuvaleka kuncane, noma uma ukuvaleka kuphinde kwenzeka ngemva kokuhlinzwa.
- I-angioplasty yebhaluni: Idivayisi encane efana nebhaluni ifakwa emthanjeni wegazi bese ivuvukala ukuze kwandiswe indawo evinjiwe.
- I-angioplasty yebhaluni enokubekwa kwe-stent: Umthambo ovalekile uyandiswa ngebhaluni, bese kufakwa ithubhu elincane elifana ne-mesh (stent) ngaphakathi ukuze livinjwe lingaphinde livaleke.
Lizoba njani ikusasa lengane yami?
Ngezindlela zokuxilonga ezithuthukisiwe zanamuhla kanye nokwelashwa, ingane ene-CoA ingaphila impilo evamile nenempilo. Nakuba esikhathini esidlule isilinganiso sokuphila kwalezi ziguli sasiyiminyaka engaba ngu-35, manje zingaphila impilo enempilo iminyaka engama-60 noma ngaphezulu.
Into ebaluleke kakhulu ukuthi, ngisho nangemva kokwelashwa, udinga ukuya emtholampilo kadokotela wenhliziyo impilo yakho yonke.
Bese kuthi, Dokotela,
- Umfutho wegazi wengane uhlolwa njalo.
- Ukuhlolwa okufana nokuskena kwenziwa ukuhlola ukusebenza kwenhliziyo.
- Inikeza izeluleko mayelana nezindlela zokudla ezinempilo kanye nokuzivocavoca umzimba.
- Unikeza imithi uma kudingeka.
Uma uthola ukuthi ingane yakho inalesi simo, ungase ube nemibuzo eminingi. Ungase uzibuze ukuthi kungani lokhu kwenzeke. Khumbula njalo, lokhu akulona iphutha lakho. Udokotela wakho kanye nethimba lezokwelapha bazokwenza konke okusemandleni abo ukukusiza wena nengane yakho. Unganqikazi ukubabuza imibuzo nokukhuluma ngokwesaba kwakho.
Umlayezo Wokuya Nawe Ekhaya
- Ukuhlangana kwe-Aorta (CoA) yisifo senhliziyo esizalwa naso lapho umthambo wegazi omkhulu emzimbeni uvaleka khona.
- Izinsana ezisanda kuzalwa zingase zibonise izimpawu ezifana nobunzima bokudla, ukozela ngokweqile, kanye nobunzima bokuphefumula.
- Uphawu olukhulu lwalesi sifo umehluko omkhulu ekucindezelweni kwegazi phakathi kwezingalo nemilenze.
- Akulona iphutha lakho leli. Ungakhathazeki, bona udokotela.
- Lesi simo singelashwa ngempumelelo enkulu ngokuhlinzwa kanye nezinye izindlela zokwelapha zesimanje.
- Nakuba ingane ingaphila impilo evamile nenempilo ngemva kokwelashwa, ukuvakashela imitholampilo yezokwelapha impilo yonke kuyimpoqo.
Ukuhlanganiswa kwe-Aorta Sinhala, Ukuhlanganiswa kwe-Aorta, Isifo senhliziyo esizalwa naso, Isifo senhliziyo sengane, Isifo senhliziyo sezingane, Umfutho wegazi ophakeme, Isifo senhliziyo esizalwa naso Sinhala
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