Ingabe umthambo omkhulu wenhliziyo wengane yakho unciphile? Ake sifunde ngokuhlanganisa i-Aorta ne-Nirogi Lanka!

Wake wazibuza ukuthi izinhliziyo ezincane zezingane zethu zisebenza kahle kangakanani? Nokho, ngezinye izikhathi, ngenxa yezimo ezithile zokuzalwa, ukusebenza kwenhliziyo kungabhekana nezithiyo ezincane. Esinye isimo senhliziyo esinjalo esingaba khona kwezinye izingane sibizwa ngokuthi "i-Coarctation of the Aorta." Nakuba igama lingase lizwakale liyinkimbinkimbi, sicela ungakhathazeki. Ake sixoxe ngakho ngamazwi alula.

Kuyini ukuhlanganiswa kwe-Aorta? Kalula nje...

Kalula nje, ukuhlangana kwe-Aorta kusho ukuthi ingxenye ye -aorta yengane yakho—umthambo oyinhloko othwala igazi elinomoya-mpilo elisuka enhliziyweni liye emzimbeni wonke—uyancishiswa noma uyancishiswa. Lokhu kuyiphutha lenhliziyo elizalwa nalo, okusho ukuthi likhona kusukela ekuzalweni.

Cabanga ngakho njengomgwaqo omkhulu. Uma izimoto zihamba ngesivinini esikhulu, kodwa ingxenye yomgwaqo incishisiwe ibe umzila owodwa wokwakhiwa, kwenzekani? Izimoto ziyanda, futhi izimoto ziphoqeleka ukuthi zehlise ijubane, akunjalo? Kwenzeka okufanayo kulesi simo. Kuba nzima ukuthi igazi ligeleze kahle lidlule endaweni encane ye-aorta.

Ezimweni eziningi, lokhu kuncipha (ukubumbana) kwenzeka ngaphambi nje kokuba i-aorta iqale ukuhluma ukuze inikeze igazi emzimbeni ongezansi, njengemilenze. Ngenxa yalokhu, umfutho wegazi wengane yakho uyanda emzimbeni ongaphezulu (njengezingalo) kodwa wehle emzimbeni ongezansi (emilenzeni). Lo mehluko omkhulu ekucindezelweni kwegazi phakathi komzimba ongaphezulu nongaphansi uwuphawu oluphawulekayo lwalesi simo. Ngisho noma kungekho ezinye izimpawu ezisobala, lokhu kungafani komfutho wegazi kuvame ukuxwayisa odokotela ngenkinga engaba khona.

Ngokwezibalo zase-US, cishe ingane eyodwa kwezingu-1,700 ezizalwa ngonyaka ingaba ne-Aortic Coarctation. Ezinye izingane zingase zibe nezinye izinkinga zenhliziyo ezizalwa nazo kanye nalesi simo.

Yiziphi izimpawu ezingase ziboniswe yizingane ezincane?

Izimpawu zincike ekutheni i-aorta incishiswe kakhulu kangakanani. Ngokuvamile, uma ukuncipha kukhulu, izimpawu zivela phakathi nesonto lokuqala noma amabili okuphila. Kodwa-ke, uma ukuncipha kuncane, kungase kungabonakali kuze kube yilapho ingane isikhulile, noma ingase ingalokothi ibonise izimpawu nhlobo.

Izimpawu Ezinsaneni Ezisanda Kuzalwa

Uma umntwana osanda kuzalwa enalesi simo (CoA), ungase ubone okulandelayo:

• Ukozela njalo kanye nokudla okungekuhle
• Isilinganiso senhliziyo esisheshayo (ukushaya kwenhliziyo okusheshayo)
• Ukujuluka ngokweqile
• Ukucasuka njalo nokukhala
• Isikhumba esimpunga noma esiphuzi
• Ubunzima bokuphefumula noma ukuphefumula okusheshayo/okukhandlekayo
• Ubunzima bokuncelisa noma ukuncelisa ngebhodlela

Uma usana luncipha kakhulu i -aorta (ukuqina okukhulu kwemithambo yegazi) futhi lungatholakali futhi lungalashwa ngokushesha, umntwana angase abe sesimweni sokushaqeka , okusongela ukuphila. Ngakolunye uhlangothi, ezinye izinsana ezinokuncipha okuncane kakhulu zingase zingabonisi zimpawu nhlobo.

Izimpawu Ezinganeni Nasebancane

Ezinganeni ezindala kanye nabantu abadala abasebasha abane-Aortic Coarctation, ungase ubone:

• Ubuhlungu bekhanda obuvamile
• Umfutho wegazi ophakeme
• Ukopha igazi njalo
• Ubuhlungu bomlenze ngesikhathi sokuzivocavoca, ukugijima, noma umsebenzi womzimba

Ezinye izingane azinazo izimpawu ezibonakalayo. Ngokuvamile, lesi simo siqala ukutholakala ngesikhathi sokuhlolwa njalo lapho kutholwa umfutho wegazi ophakeme .

Uma kuvela izimpawu kumuntu omdala, kuvame ukukhombisa ukuncipha okuphindaphindiwe (ukuvuselelwa kwe-aorta) ngemva kokwelashwa kwangaphambilini. Akuvamile kakhulu ukuthi i-(CoA) ingatholakali kuze kube yilapho umuntu emdala.

Kungani lokhu kwenzeka? Ziyini izimbangela?

Nakuba imbangela eqondile (i-CoA) ingakacaci, ochwepheshe bakholelwa ukuthi kukhona ingxenye yezakhi zofuzo . Lokhu kusho ukuthi izinguquko ezithile zezakhi zofuzo ezenzeka ngesikhathi umntwana esesibelethweni zingabangela ukuthi i-aorta ingakheki kahle.

Ngezinye izikhathi lokhu kuhlukahluka kwezakhi zofuzo kungazuzwa njengefa. Ucwaningo lubonisa ukuthi uma uke waba ne-(CoA), amathuba okuba ingane yakho ibe ne-(CoA) noma esinye isifo senhliziyo aphezulu kunakumuntu ongenaso lesi simo.

Ngaphezu kwalokho, ezinye izifo zofuzo zandisa ingozi. Isibonelo, izingane ezizalwa ne-Turner syndrome cishe azigcini nje ngokuba ne-Aortic Coarctation kodwa futhi nezinye izinkinga zokuzalwa nazo, njenge-bicuspid aortic valve.

Izimbangela Zokuhlukaniswa (i-CoA)

Ezimweni lapho kungekho khona ezinye izinkinga zenhliziyo ("i-CoA ehlukanisiwe"), isici esiyinhloko ukuvalwa okungavamile komthambo omncane obizwa ngokuthi i-ductus arteriosus ngesikhathi sokukhula komntwana. I-ductus arteriosus umthambo omncane oxhumanisa i-fetal aorta nomthambo wamaphaphu. Njengoba amaphaphu omntwana engasebenzi ngesikhathi esesibelethweni, lo mthambo ubalulekile ekusabalaliseni igazi elinomoya-mpilo.

Uma umntwana esezelwe futhi eqala ukuphefumula, i-ductus arteriosus ayisadingeki futhi ivame ukuvala ngokwemvelo zingakapheli izinsuku ezimbalwa. Kodwa-ke, njengoba ivala, ezinye izicubu ezivela kulo mthambo zingahlangana nezicubu ze-aortic. Uma lokhu kwenzeka, i-ductus arteriosus ingase idonse i-aorta njengoba ivala, okubangela ukuba inciphe (i-coarctation).

Yiziphi izinkinga ezingavela kulesi simo?

Uma i-coarctation ye-Aorta ishiywa ingelashwa isikhathi eside, kungase kube nezinkinga ezilandelayo:

• Umfutho wegazi ophakeme ongapheli emzimbeni wonke.
• Ukuqina kwemisipha yenhliziyo (i-hypertrophy ye-ventricular yesobunxele).
• Ukuqongelela kwe-plaque emithanjeni yenhliziyo ngaphambi kwesikhathi (isifo semithambo yenhliziyo).
• Ukwakheka kwe-aneurysm (i-ballooning) noma ukuqhekeka (ukudabuka) ku-aorta.
• Ukwakheka kwe-aneurysm yobuchopho.
• Ukwehluleka kwenhliziyo ngenxa yokuthi inhliziyo ayikwazi ukupompa igazi ngempumelelo.

Qaphela: Uma usola ukuthi kukhona izimpawu eziphuthumayo, sicela uxhumane nezinsizakalo eziphuthumayo (911) ngokushesha noma uqhubekele emnyangweni wezimo eziphuthumayo oseduze.

Lesi simo, i-Coarctation of the Aorta (CoA), siba yingozi kakhulu uma singatholakali futhi singelashwa. Ngakho-ke, kubalulekile ukusibona kusenesikhathi ngangokunokwenzeka—ikakhulukazi ngesikhathi sobuntwana—ukuqinisekisa ukuthi ingane yakho ithola ukungenelela kwezokwelapha okudingekayo kanye nokuqapha njalo.

Odokotela bakuthola kanjani lokhu? (Ukuxilongwa)

Ngokuvamile, odokotela benhliziyo bezingane bangochwepheshe abahlonza i-Coarctation ye-Aorta ezinsaneni noma ezinganeni ezincane. Isivinini sokuxilongwa sincike ebunzimeni bezimpawu.

Izinsana ezinezimpawu ezinzima zivame ukutholakala zingakapheli izinsuku zokuzalwa. Kodwa-ke, lezo ezinezimpawu ezincane noma ezingenazo izimpawu ezibonakalayo zingase zingatholakali kuze kube yilapho sezikhulile lapho kutholakala khona umfutho wegazi ophezulu. Ukuxilongwa lapho sezikhulile akuvamile.

Ezimweni eziningi, i-CoA itholakala ngesikhathi sokuhlolwa ngokomzimba okuvamile lapho udokotela ebona izimpawu ezithile ezibomvu , njenge:

• Umfutho wegazi ophezulu ezingalweni/emzimbeni ongaphezulu uma kuqhathaniswa nomfutho wegazi ophansi kakhulu emilenzeni/emzimbeni ongezansi.
• Umehluko obonakalayo emandleni okushaya kwenhliziyo phakathi kwentamo ne-groin.
• Kutholakale ukububula kwenhliziyo okunzima lapho udokotela elalela isifuba sengane yakho nge-stethoscope.

Ezinye izinsana zitholakala ngisho nangaphambi kokuba izimpawu zivele ngokuhlolwa kwe-pulse oximetry, okuhlola amazinga omoya-mpilo egazini. Uma amazinga omoya-mpilo ephansi, kungase kubonise isimo senhliziyo esibucayi sokuzalwa, okubangela ukuhlolwa okwengeziwe kokuxilonga eNirogi Lanka noma kwesinye isikhungo sesibhedlela esikhethekile.

Ukuze kuqinisekiswe ukuxilongwa kwe-CoA, odokotela ngokuvamile basebenzisa i- echocardiogram (i-ultrasound yenhliziyo). Bangase futhi bacele i-CT scan noma i-MRI ukuze bathole umbono oningiliziwe ngesimo somzimba we-aorta yengane yakho.

Ingabe zikhona ezinye izinkinga zenhliziyo ezihlobene nokuhlangana kwe-Aorta?

Yebo, izingane ezine-CoA zingase zibe nezinye izimo zenhliziyo. Isibonelo, abantu abangu-45% kuya ku-75% abane-CoA nabo bane-valve ye-aortic ye-bicuspid , lapho i-valve elawula ukugeleza kwegazi kusuka enhliziyweni kuya ku-aorta inama-flaps amabili esikhundleni sezintathu ezivamile.

Ezinye izimo ezingase zihambisane ne-CoA zifaka:

• Ukukhubazeka kwenhliziyo okufana nokukhubazeka kwe-atrial septal noma i-ventricular septal defect (izimbobo enhliziyweni).
• I-patent ductus arteriosus (umthambo wegazi obekufanele uvaleke ngemva kokuzalwa uhlala uvulekile).
• I-Aortic arch hypoplasia noma i-hypoplastic left heart syndrome (lapho izingxenye zenhliziyo noma i-aorta zingakakhuli kahle).
• I-stenosis ye-aorta noma i-mitral valve (ukuncipha kwama-valve enhliziyo).

Odokotela bethu abahlinza inhliziyo bazohlola isakhiwo senhliziyo yengane yakho ukuze bakhe uhlelo lokwelapha oluqondene nawe. Ukuphatha izinkinga eziningi zenhliziyo kudinga indlela eyinkimbinkimbi kakhulu kunokwelapha i-CoA ehlukanisiwe.

Yiziphi izindlela zokwelapha?

Ukwelashwa kuncike eminyakeni yengane yakho, ubukhulu bokuncishiswa kwe-aorta, kanye nokuba khona kwezinye izinkinga zenhliziyo. Ezinsaneni nasezinganeni ezincane, ukuhlinzwa ngokuvamile kuyindlela yokwelapha ephumelela kakhulu.Ezinganeni ezindala, noma ezimweni lapho ukuncishiswa kungakabi kubi kakhulu, inqubo engangenisi kakhulu ebizwa ngokuthi i-cardiac catheterization ingafaneleka. Lokhu kusetshenziselwa futhi ukuncipha kabusha (ukuvuselela kabusha) noma kubantu abadala.

Ukuhlinzwa

Izindlela zokuhlinzwa eziyinhloko zokulungisa i-CoA zifaka:

• Ukuhlinzwa kabusha nge-anastomosis kusukela ekuqaleni kuya ekugcineni: Udokotela ohlinzayo ususa ingxenye encishisiwe bese ethunga iziphetho eziphilile ze-aorta ndawonye.
• Ukususwa kabusha nge-anastomosis ende kusukela ekuqaleni kuya ekugcineni: Uma i-aortic arch nayo incishisiwe, udokotela ohlinzayo ususa ingxenye encishisiwe bese exhuma i-aorta ehlayo nengxenye ende ye-arch. Lena yindlela ekhethwayo lapho kukhona i-transverse aortic arch hypoplasia.

Izinsana ezinezimpawu ezinzima zingase zizinzile ngaphambi kokuhlinzwa ngemithi, njenge-Prostaglandin (PGE-1) ukugcina i-ductus arteriosus ivulekile, noma eminye imithi yokusekela ukusebenza kwenhliziyo.

Ukufakwa kwe-catheter kwenhliziyo

Uma ingane yakho inomkhuhlane omncane noma ike yaphinde yawuthola, okulandelayo kunganconywa:

• I-angioplasty yebhaluni: Ibhaluni elincane liyafuthwa ngaphakathi kwe-aorta ukuze kwandiswe indawo encishisiwe.
• I-angioplasty yebhaluni enokubekwa kwe-stent: Kufakwa ithubhu elincane, elinwebekayo (i-stent) ukuze kugcinwe ingxenye encane ye-aorta ivulekile.

Kufanele ufune nini usizo lwezokwelapha oluphuthumayo? (Ukulandelela kanye Nesimo Esiphuthumayo)

Ithimba lezokwelapha lengane yakho lizokunikeza isimiso esithile sokuqokwa kokulandelela. Kuyo yonke impilo yengane yakho, izodinga ukuhlolwa njalo ngaphansi kokuqondiswa uchwepheshe wezifo zenhliziyo ezizalwa nazo. Lo chwepheshe uzophatha okulandelayo:

• Ukuqapha njalo umfutho wegazi wengane yakho.
• Ukuhlolwa kwezithombe okwenziwa njalo ukuhlola ukusebenza kwenhliziyo nokuhlola noma yiziphi izimpawu zezinkinga.
• Isiqondiso mayelana nokukhetha ukudla okunempilo kwenhliziyo kanye nokuzivocavoca umzimba okufanele.
• Ukunikeza imithi nokulungisa imithamo njengoba kudingeka.

Ingakanani iminyaka yokuphila komuntu onalesi simo?

Ngenxa yezindlela zokuxilonga zesimanje kanye nokwelashwa okuthuthukisiwe, abantu abane-Coarctation of the Aorta (CoA) bangaphila impilo egcwele nekhiqizayo baze bafike eminyakeni yabo engama-60 nangaphezulu. Esikhathini esidlule, isikhathi sokuphila sasiphansi kakhulu, ngakho-ke lokhu kuyintuthuko yezokwelapha ekhuthazayo kakhulu.

Uma ingane yakho itholakale ine-Coarctation of the Aorta, kungokwemvelo ukuzibuza ukuthi kungani lokhu kwenzeke. Ngokuvamile asikwazi ukuthola imbangela eqondile yokukhubazeka kwenhliziyo okuzalwa nayo. Kodwa-ke, siyazi ukuthi ukuxilongwa kusenesikhathi kanye nokungenelela ngesikhathi kunganciphisa kakhulu umthelela wesikhathi eside empilweni yengane yakho.

Ithimba lakho lezokwelapha eNirogi Lanka lilapha ukuzokusekela kuzo zonke izinyathelo. Bakulungele ukuphendula imibuzo yakho futhi bakusize uqonde kahle ukuthi lokhu kuxilongwa kusho ukuthini enganeni yakho. Ukuxhumana nabanye abazali abanezingane ezibhekene nezimo zenhliziyo ezifanayo nakho kungakunikeza amandla angokomzwelo abalulekile.

Izinto Ezibalulekile Ongazithatha

Sithemba ukuthi uyaqonda kangcono i-Coarctation of the Aorta. Nazi izinto ezibaluleke kakhulu okufanele uzikhumbule:

• Kuyisifo senhliziyo esizalwa naso —ukuncipha kwe-aorta, umthambo oyinhloko othwala igazi lisuka enhliziyweni liye kuwo wonke umzimba.
• Izimpawu zingase zivele ebuntwaneni noma zivele kamuva. Uma ubona ukudinwa ngokweqile, ubunzima bokuphefumula, noma ukungondli kahle enganeni yakho, funa usizo lwezokwelapha oluphuthumayo ngokushesha.
• Ukuxilongwa kusenesikhathi kanye nokungenelela kunikeza ingane yakho ithuba elihle kakhulu lokuphila okuvamile nokunempilo.
• Lesi simo singaphathwa ngempumelelo ngokuhlinzwa kanye nezinye izinqubo zesimanje zezokwelapha.
• Ukubhekwa kochwepheshe impilo yonke kubalulekile, ngisho nangemva kokwelashwa okuphumelelayo.

Ngicela ungakhathazeki; ezokwelapha zesimanje zenze intuthuko emangalisayo. Ithimba lethu lezokwelapha elinekhono lilapha ukuzonikeza ingane yakho ukunakekelwa okusezingeni eliphezulu. Izinyathelo ezibaluleke kakhulu ukuhlala unolwazi, ukuqapha impilo yengane yakho eduze, nokulandela iseluleko sikadokotela wakho.

Amagama angukhiye: Ukuhlangana kwe-Aorta, Isifo Senhliziyo, Ukwelashwa Kwezingane, Ukukhubazeka Kwenhliziyo Okuzalwe Nakho, Ukuncipha Kwe-Aorta, Impilo Yengane, Umfutho Wegazi