Kumelwe ukuba wesaba kakhulu lapho udokotela ekutshela ukuthi ingane yakho inomsindo omncane enhliziyweni yayo, 'ukububula kwenhliziyo'. Noma, ingabe useminyakeni yakho engama-40 futhi usazizwa uphelelwa umoya futhi ukhathele ngaso sonke isikhathi, ngisho noma uvivinya umzimba kancane? Mhlawumbe imbangela yalezi zinto zombili imbobo encane enhliziyweni. Ngokwezokwelapha, lokhu sikubiza ngokuthi 'i-Atrial Septal Defect' noma i-ASD. Ungesabi uma uzwa leli gama. Lesi yisimo senhliziyo esivamile kakhulu sokuzalwa naso. Ake sixoxe ngakho konke kalula nangendlela enobungane namuhla.
Kalula nje, iyini le mbobo enhliziyweni (ASD)?
Kulungile, ukuze siqonde lokhu, ake sicabange ngenhliziyo yethu njengendlu enamakamelo amane. Le ndlu inamakamelo amabili phezulu namakamelo amabili phansi. Kwezokwelapha, la makamelo amabili phezulu siwabiza ngokuthi i-atria . Okusho ukuthi, i-atrium yangakwesokudla kanye ne-atrium yangakwesokunxele. Kukhona udonga phakathi kwala makamelo amabili aphezulu. Sibiza lolu donga ngokuthi i-atrial septum .
Okuvamile ukuthi igazi lomzimba elingenawo umoya-mpilo, elingcolile lingena e-atrium yangakwesokudla, liye emaphashini, lihlanzwe (lifakwe umoya-mpilo), bese libuyela e-atrium yangakwesokunxele. Leli gazi elihlanzekile nelicebile ngomoya-mpilo libe selimpontshwa emzimbeni wonke.
Manje cabanga, bekuzokwenzekani uma bekukhona imbobo encane odongeni (septum) ehlukanisa amakamelo amabili aphezulu? Bese kuthi, elinye igazi elihle eligcwele umoya-mpilo elivela ekamelweni lesobunxele ligeleze ngale mbobo liye ekamelweni lesokudla. Bese kuthi, leli gazi elihle lihlangane negazi elingcolile elivela kwesokudla. Ngenxa yalokho, igazi elingadingekile lizoqongelela ohlangothini lwesokudla, futhi uhlangothi lwesokudla lwenhliziyo kuzodingeka lusebenze kanzima ukupompa lelo gazi elengeziwe libuyele emaphashini. Yilokho i-ASD eyikho.
Okubalulekile: Abanye abantu badidanisa i-ASD nesimo esibizwa ngokuthi i-Patent Foramen Ovale (PFO). Lezi zimo ezimbili azifani, kodwa zimbili ezihluke ngokuphelele.
Ingabe zikhona izinhlobo eziyinhloko ze-ASD?
Yebo, kunezinhlobo ezine eziyinhloko ze-atrial fibrillation, kuye ngokuthi imbobo ikuphi odongeni lwenhliziyo. Lokhu kubalulekile ukwazi, njengoba izinketho zokwelapha ngezinye izikhathi zincike ohlotsheni.
| Uhlobo lwe-ASD | Incazelo |
|---|---|
| I-Secundum ASD | Lolu uhlobo oluvame kakhulu . Abantu abayisishiyagalombili kwabayishumi abane-ASD banalolu hlobo. Imbobo itholakala maphakathi nodonga phakathi kwe-atria. |
| I-ASD Eyinhloko | Lo mgodi utholakala engxenyeni engezansi yodonga. Ezinye izingane ezinalolu hlobo zingase zibe nezinye izinkinga kuma-valve enhliziyo noma odongeni oluphakathi kwamakamelo angaphansi (ama-ventricle). |
| I-Sinus Venosus ASD | Lo mgodi uvame ukutholakala phezulu noma ngemuva kodonga. Lolu hlobo ngezinye izikhathi lungahlotshaniswa nokukhubazeka emithanjeni eyinhloko ethwala igazi liye enhliziyweni. |
| I-Coronary Sinus Engaphahlazekile | Lolu uhlobo olungavamile kakhulu . Kwenzeka lapho udonga oluphakathi kweqembu lemithambo exhumanisa nenhliziyo kanye ne-atrium yangakwesobunxele lungekho noma lungaphelele. |
Ziyini izimpawu zalesi simo?
Ngokumangalisayo, nakuba i-ASD iyisimo sokuzalwa, abantu abaningi ababi nezimpawu kuze kube yiminyaka kamuva, mhlawumbe bafinyelele eminyakeni ephakathi. Uma imbobo incane kakhulu (ngaphansi kwamamilimitha angu-5), ingase ingabi nemiphumela ebalulekile enhliziyweni noma emaphashini, ngakho-ke kungase kungabi nazimpawu.
Izimpawu ezinganeni ezincane
Ngokuvamile, uphawu lokuqala lokuthi ingane encane ine-ASD umsindo wenhliziyo ongajwayelekile (ukububula kwenhliziyo) udokotela awuzwa ngesikhathi sokuhlolwa kwe-stethoscope. Leso yisibonakaliso esivame kakhulu.
Ngaphezu kwalokho, ezinye izingane zingase zibonise izimpawu ezifana nalezi:
- Ukwehla kwesisindo okufanele ubudala kanye nokubuyela emuva ekukhuleni.
- Izifo zokuphefumula ezivame ukwenzeka (njengomkhuhlane, i-pneumonia).
- Ukukhathala ngokushesha ngenkathi udlala.
- Ubunzima bokuphefumula.
- Ukungalingani kwesigqi senhliziyo (i-arrhythmias) - kodwa lokhu akuvamile ezinganeni.
Izimpawu kubantu abadala
Uma unembobo enkulu engatholakalanga ngesikhathi usengumntwana, izimpawu zingase ziqale ukuvela cishe eminyakeni engu-40. Lokhu kungenxa yokuthi uhlangothi lwesokudla lwenhliziyo namaphaphu belusebenza kanzima iminyaka eminingi futhi lukhathele.
Abantu abadala bangase babe nezimpawu ezifana nalezi:
- Ukukhathala ngokweqile ngaphandle kwesizathu.
- Ubunzima bokuphefumula, njengalapho uhamba ibanga elifushane noma ukhuphuka izitebhisi.
- Ukuzwa ukushaya kwenhliziyo okungajwayelekile (ukushaya kwenhliziyo).
- Ukushaya kwenhliziyo okusheshayo (i-tachycardia).
- Ukuvuvukala (ukuvuvukala) kwemilenze, amaqakala, kanye nezandla.
- Ngezinye izikhathi izindebe nesikhumba kuba luhlaza okwesibhakabhaka (i-cyanosis).
Uma unezinye zalezi zimpawu, sicela ubone udokotela wakho ngokushesha. Lezi kungaba izimpawu ze-ASD engelashwanga, noma kungaba izimpawu zesinye isimo senhliziyo. Uma uzwa ubuhlungu esifubeni, hamba ngokushesha emnyangweni wezimo eziphuthumayo esibhedlela (ETU).
Kungani lesi simo senzeka?
Imbangela eqondile yalokhu ayaziwa okwamanje. Kodwa-ke, iningi lalezi ziphazamiso zokuzalwa zibangelwa izinguquko zofuzo ezenzeka ngesikhathi sokukhula komntwana esibelethweni. Izinguquko ezakhiweni zofuzo ezifana ne-NKX2.5/CSX, i-GATA4, kanye ne-TBX5 zitholakale zihlotshaniswa ne-ASD.
Futhi, ngezinye izikhathi izingane ezine-ASD zingaba nezinye izinkinga zenhliziyo noma ezinye izimo zofuzo, njenge-Down syndrome.
Izinto ezandisa ingozi ngesikhathi sokukhulelwa
Uma umama okhulelwe enezimo ezithile, ingane ingaba sengozini enkulu yokuba nesifo senhliziyo esizalwa naso.
- Umama wayenesifo sikashukela ngaphambi kokukhulelwa.
- Ukutheleleka ngegciwane njenge-flu ngesikhathi sokukhulelwa.
- Ukusetshenziswa kotshwala nogwayi.
- Ukusetshenziswa kwemithi ethile ngaphandle kweseluleko sikadokotela.
- Ukusetshenziswa kwezidakamizwa ezifana ne-cocaine.
Yiziphi izinkinga ezingaba khona uma zingelashwa?
Imbobo encane ngeke idale umonakalo omkhulu. Kodwa-ke, uma imbobo enkulu ingelashwa isikhathi eside, ingabangela izinkinga ezinkulu zempilo. Lokhu kungenxa yokuthi uhlangothi lwesokudla lwenhliziyo namaphaphu luhlala lusebenza kanzima, okulimaza wona.
- Ukukhula kwenhliziyo kwesokudla: Uma lokhu kuqhubeka, kungaholela ekuhlulekeni kwenhliziyo.
- Ukuphazamiseka kwesigqi senhliziyo (i-Arrhythmia): Cishe ingxenye yabantu abane-ASD abangaphezu kweminyaka engama-40 bahlushwa ukuphazamiseka kwesigqi senhliziyo (njenge-atrial fibrillation).
- Isifo sohlangothi: Ngezinye izikhathi, amahlule egazi amancane akheka enhliziyweni angadlula kulo mgodi aye ebuchosheni, okubangela isifo sohlangothi.
- Umfutho wegazi ophezulu wamaphaphu: Umfutho wegazi ophezulu emithanjeni yegazi ethwala igazi liye emaphashini. Lesi yisimo esiyingozi.
- I-Eisenmenger Syndrome: Isifo esithathelwanayoInkinga enkulu eyenzeka lapho kukhona i-ASD enomfutho wegazi ophezulu wamaphaphu.
Odokotela bakuthola kanjani lokhu?
Bazokubuza ngezimpawu zakho, bahlole umzimba, bese benza izivivinyo eziningana ukuhlola ukusebenza kanye nokwakheka kwenhliziyo yakho.
| Ukuhlolwa | Ufundani kulokho? |
|---|---|
| I-ECG (i-Electrocardiogram) | Umsebenzi kagesi wenhliziyo uyaqoshwa. Lokhu kunganikeza izinkomba mayelana nokushaya kwenhliziyo okungajwayelekile noma ukuthi uhlangothi lwesokudla lwenhliziyo lukhulisiwe yini. |
| I-X-ray yesifuba | Ungahlola ukuthi amakamelo angakwesokudla kwenhliziyo akhulisiwe yini nokuthi amaphaphu ayathinteka yini. |
| I-Echocardiogram (i-Echocardiogram - TTE) | Lesi isivivinyo esibaluleke kakhulu nesibaluleke kakhulu . Kufana nokuskena kwenhliziyo. Ubukhulu nendawo yembobo, indlela igazi eligeleza ngayo, kanye nomphumela walo enhliziyweni kungabonakala ngokucacile. |
| I-Trans-esophageal Echo (TEE) | Ukuhlolwa okukhethekile kwe-ultrasound okuhilela ukudlulisa ikhamera encane elakeni. Lokhu kusiza ukuthola imininingwane ecacile mayelana nomgodi. |
Kwezinye izimo, ukuhlolwa kwe-CT noma i-MRI yenhliziyo nakho kungadingeka.
Yiziphi izindlela zokwelapha lokhu?
Nakuba imithi inganikezwa ukulawula ezinye zezimpawu ze-ASD, ayikwazi ukuvala imbobo. Kunezindlela ezimbili zokuvala imbobo: ukuhlinzwa noma ukuvalwa kwembobo ngaphandle kokuhlinzwa (ukulungiswa kwesikhumba).
- Ama-ASD Amancane:Imigodi emincane kakhulu, ikakhulukazi ezinganeni, cishe izozivaleka yodwa. Uma kungenjalo, futhi ingabangeli monakalo, udokotela uzoncoma "ukulinda ngokuqapha," okusho ukungenzi lutho ngaphandle kokuhlola njalo.
- Ama-ASD Amakhulu: Uma imbobo inkulu, kungcono ukuyivala, noma ngabe azikho izimpawu. Lokhu kungavimbela izinkinga ezinkulu ezingase zenzeke esikhathini esizayo. Ngokuvamile, uma uhlangothi lwesokudla lwenhliziyo lukhulisiwe, noma uma igazi eliningi livuza ngembobo, ukwelashwa kuyanconywa nakanjani.
Izindlela zokwelapha
1. Ukuvalwa Kwedivayisi Ehamba Ngesikhumba: Lena yindlela esetshenziswa kakhulu manje. Ithubhu elincane (i-catheter) lifakwa ngomthambo omkhulu emlenzeni, liqondiswe enhliziyweni, bese kufakwa idivayisi encane (idivayisi) efana nesambulela ukuvala imbobo. Lokhu akudingi ukusikwa okukhulu. Isikhathi sokuhlala esibhedlela singusuku olulodwa noma ezimbili kuphela. Le ndlela ayitholakali kuzo zonke izinhlobo ze-ASD.
2. Ukuhlinzwa Kwenhliziyo Evulekile: Lokhu kuhlinzwa kwenziwa ezimbotsheni ezingenakuvalwa ngezindlela ezingenhla noma ezimbotsheni ezihlotshaniswa nezinye izinkinga zenhliziyo. Lapha, isifuba siyavulwa bese imbobo enhliziyweni ivalwa ngezitishi noma nge-patch. Lokhu manje sekuyindlela yokuhlinzwa ephephile kakhulu futhi ephumelelayo.
Ngemva kokwelashwa, udokotela wakho uzokutshela ukuthi uthathe imithi yokunciphisa igazi kanye nama-antibiotic ukuvimbela ukutheleleka kwenhliziyo cishe izinyanga eziyisithupha.
Impilo injani nge-ASD?
Kuvamile ukuzizwa wesaba lapho wena noma ingane yakho ithola ukuthi ine-ASD. Kodwa izindaba ezinhle ukuthi ngesayensi yezokwelapha ethuthukisiwe yanamuhla, lesi simo singelashwa ngempumelelo futhi abantu bangaphila impilo enempilo ngokuphelele, evamile .
Ingane evalwe umgodi izokwazi ukudlala, ukugijima, nokudlala imidlalo njengezinye izingane ngemva kokululama. Ngisho noma isikhulile, ingaqhubeka nemisebenzi yayo evamile ngemva kokwelashwa.
Into ebaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo bese uya emitholampilo ukuze uyohlolwa ngesikhathi. Ikakhulukazi, ukuba ngaphansi kokuqondisa kukachwepheshe wezifo zenhliziyo ozalwa nazo njengalona kubaluleke kakhulu empilweni yakho.
Umlayezo Wokuya Nawe Ekhaya
- I-Atrial Septal Defect (ASD) imbobo odongeni ehlukanisa amakamelo amabili aphezulu enhliziyo. Yisimo esivamile, esizalwa naso.
- Abantu abaningi, ikakhulukazi uma umgodi mncane, ababi nazo izimpawu iminyaka eminingi.
- Ezinganeni, umsindo wenhliziyo ongajwayelekile (ukububula) ungase uzwakale, kanti kubantu abadala, ukukhathala ngokweqile kanye nobunzima bokuphefumula kungaba yizimpawu eziyinhloko.
- Uma ingelashwa, izimbobo ezinkulu zingalimaza inhliziyo namaphaphu ngokuhamba kwesikhathi.
- Lesi simo singelapheka ngokuphelele ngokwelashwa okuthuthukile kwanamuhla (okungahlinzwa noma okuhlinzwa).
- Ngokwelashwa okufanele, akukho okuvimba izingane kanye nabantu abadala ukuba baphile impilo egcwele, enempilo nesebenzayo. Themba udokotela wakho bese ulandela iseluleko sakhe.
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