Wake wambona umuntu omaziyo elahlekelwa ingqondo ngokuzumayo? Noma wake wezwa ngomuntu ophilile efa ebuthongweni? Imbangela yalezi zinto ingaba yisimo senhliziyo esifihliwe abantu abaningi abangakaze bezwe ngaso. Namuhla sikhuluma ngesifo esibi nesibalulekile okufanele siqashelwe, i-Brugada Syndrome.
Iyini i-Brugada Syndrome?
Kalula nje, lokhu kuyinkinga ngohlelo lukagesi lwenhliziyo yethu. Inhliziyo yethu ishaya njengohlelo lwesignali kagesi. Kulesi sifo, kukhona ukungalingani kwesignali kagesi eya emakamelweni aphansi enhliziyo (ama-ventricle).
Lokhu kubangela inhliziyo ukuba ishaye ngokushesha okuyingozi, cishe sengathi iyathuthumela. Lokhu kubizwa ngokuthi 'i-Ventricular fibrillation (v-fib)' ngokwezokwelapha. Uma lokhu kwenzeka, inhliziyo ayikwazi ukupompa igazi kahle liye emzimbeni. Ikakhulukazi uma ukugeleza kwegazi ebuchosheni kuphazamiseka, kungenzeka ukuthi umuntu aphelelwe amandla.
Into eyingozi kakhulu ngalesi simo ukuthi singabangela ukufa kwenhliziyo ngokuzumayo. Lokhu kuvame ukwenzeka lapho isiguli siphumule, ikakhulukazi ngesikhathi sokulala. Ucwaningo luthole ukuthi i-Brugada syndrome iyimbangela cishe engu-4% yokufa kwenhliziyo ngokuzumayo emhlabeni jikelele.
Kodwa lesi yisimo esingavamile kakhulu. Ngokwesilinganiso, abantu abaphakathi kuka-3 no-5 kwabayi-10,000 banalesi sifo.
Ziyini izimpawu zalesi sifo?
Nakuba izimpawu ze-Brugada syndrome zingavela kunoma yimuphi ubudala, zivame kakhulu cishe eminyakeni engama-40. Ngokumangazayo, abantu abangaphezu kuka-70% abanalesi simo ababonisi zimpawu . Umuntu othola izimpawu angase abe nalokhu okulandelayo:
| Isibonakaliso | Incazelo elula |
|---|---|
| Ukuquleka/Ukuxhuzula | Ukungajwayelekile kwenhliziyo kungabangela ukuphazamiseka kokunikezwa kwegazi ebuchosheni, okuholela ekulahlekelweni yingqondo ngokuzumayo kanye nokuwa. |
| Isiyezi | Ukuzizwa unesizungu. |
| Ukushaya kwenhliziyo | Ukuzwa kwenhliziyo eshaya ngamandla, umuzwa sengathi inhliziyo ijikeleza ngaphakathi esifubeni. |
| Ubunzima bokuphefumula | Ubunzima bokuphefumula, ikakhulukazi ebusuku. |
| Ukuboshwa Kwenhliziyo | Lokhu kungaba uphawu lokuqala . Yingakho abanye abantu befa belele. |
Yini ekhulisa lesi simo?
Kubalulekile ukuqaphela izinto ezithile ezingadala noma zibe zimbi kakhulu izimpawu kumuntu one-Brugada syndrome.
- Umkhuhlane: Umkhuhlane ungenye yezitha ezinkulu zalesi sifo. Uma une-Brugada syndrome, kubalulekile ukuthatha umuthi ofana ne-paracetamol ngokushesha nje lapho uqala umkhuhlane, njengoba kuqondiswe udokotela wakho.
- Ukuphelelwa amanzi emzimbeni: Uma kungekho manzi anele emzimbeni.
- Ukuphuza ngokweqile: Ukuphuza utshwala obuningi ngesikhathi esisodwa.
- Imithi ethile: Imithi efana ne-'Sodium channel blockers' esetshenziselwa izimo ezithile zenhliziyo, kanye nemithi yezifo zengqondo efana ne-'Lithium' kanye ne-'Tricyclic antidepressants'.
- Izidakamizwa: Izidakamizwa ezifana ne-cocaine nensangu.
Uma udokotela eqinisekisa ukuthi unalesi simo, qiniseka ukuthi ucela udokotela wakho uhlu lwemithi okungafanele uyithathe. Uma uthatha imithi yanoma yisiphi esinye isimo, yazisa udokotela ukuthi unesifo i-Brugada syndrome.
Kungani lesi sifo sivela?
Ezimweni eziningi, cishe ama-70% amacala, awekho imbangela ethile engatholakala yalesi sifo. Kodwa-ke, kwabanye abantu, kungokwezakhi zofuzo. Kalula nje, kuyifa.
- Izimbangela zofuzo: Izinguquko ezakhiweni ezingaphezu kuka-18 emzimbeni wethu zingabangela lokhu. Phakathi kwalezi, ezivame kakhulu ukuguqulwa kwezakhi zofuzo `SCN5A`. Izinguquko kulezi zakhi zofuzo zibangela ukuphazamiseka ekudlulisweni kwezimpawu zikagesi enhliziyweni.
- Ufuzo: Uma umzali oyedwa ene-gene mutation ehlobene nalesi sifo, kunethuba elingu-50% lokuthi ingane izolizuza njengefa.
Ubani osengozini enkulu?
- Kwabesilisa: Lesi sifo sivame kakhulu ngokuphindwe izikhathi ezingu-8-10 kwabesilisa kunakwabesifazane.
- Umlando womndeni: Uma othile emndenini wakho ene-Brugada syndrome, noma uma othile eshona ngokuzumayo esemncane, nawe ungase ube sengozini.
- Imvelaphi yase-Asia: Lesi sifo sitholakale sivame kakhulu kubantu basemazweni ase-Asia kunasemazweni aseNtshonalanga.
Indlela yokuxilonga lesi sifo ngokunembile?
Ngemva kokulalela izimpawu zakho kanye nomlando womndeni, udokotela wakho uzoyala ukuhlolwa okuningana ukuqinisekisa ukuthi unalesi sifo.
| Ukuhlolwa | Wenzani ngayo? |
|---|---|
| I-Electrocardiogram (EKG) | Ukuhlolwa okubonisa umsebenzi kagesi wenhliziyo kugrafu yomugqa. Odokotela bafuna iphethini ethile kule phethini ehlotshaniswa nalesi sifo. Ngezinye izikhathi le phethini ayibonakali ngaso sonke isikhathi, ngakho-ke i-EKG ingadinga ukwenziwa izikhathi eziningana. |
| Ukuhlolwa kwe-EKG ngemithi (Ukuhlolwa Kwenselele Yezidakamizwa) | Uma i-EKG evamile ibonisa iphethini esolisayo, umuthi okhethekile ufakwa emthanjeni ukuze kuzanywe ukuveza iphethini efihliwe ye-Brugada. Lokhu kwenziwa endaweni ephephile, njengeyunithi yokunakekelwa okujulile esibhedlela. |
| Ukuhlolwa Kwezakhi Zofuzo | Isampula yamathe noma igazi lakho lingasetshenziswa ukuthola ukuthi une-genetic mutation ehlobene nalesi sifo. Uma othile emndenini wakho enalesi sifo, nabanye bangathola lolu vivinyo. |
| I-Electrophysiology (Ukuhlolwa kwe-EP) | Lokhu kuhlolwa kwenziwa uma ukuxilongwa kungacaci ngemva kokunye ukuhlolwa. Lokhu kuhilela ukufaka i-cannula (i-catheter) encane kakhulu ngemithambo esemlenzeni enhliziyweni bese kulinganiswa umsebenzi kagesi ngaphakathi kwenhliziyo. |
Iphathwa kanjani?
I-Brugada syndrome ayikwazi ukwelapheka ngokuphelele. Kodwa-ke, ukwelashwa kunganikezwa ukuvimbela ukufa kwenhliziyo ngokuzumayo. Umgomo oyinhloko wokwelashwa ukuvimbela ukungalingani kwenhliziyo okuyingozi (ama-ventricular arrhythmias) ukuthi kwenzeke kanye nokukulawula uma kwenzeka.
Ukwelashwa okuyinhloko nokuphumelela kakhulu ukufakwa kwedivayisi ye-ICD .
- I-ICD (I-Implantable Cardioverter Defibrillator): Lena idivayisi encane. Ifana ne-pacemaker. Ifakwa ngaphansi kwesikhumba, eduze kwenhliziyo, esifubeni ngokuhlinzwa okuncane. Ihlala iqapha isigqi senhliziyo. Uma isigqi senhliziyo sishintsha ngendlela eyingozi, le divayisi iyayibona bese ikhipha ukushaqeka okuncane kagesi ukuze kubuyiselwe isigqi. Lena idivayisi esindisa impilo.
- Imithi: Eminye imithi, njenge-'Quinidine', ingalawula ukushaya kwenhliziyo okungajwayelekile. Kodwa-ke, le mithi ayifanele wonke umuntu.
- Ukususwa kwezicubu: Kwezinye izimo ezikhethekile, indlela yokwelapha ethola indawo yezibonakaliso zikagesi ezingajwayelekile enhliziyweni bese izibhubhisa ngamagagasi omsakazo.
Odokotela banquma ukuthi kufanele yini belaphe iziguli ezingenazo izimpawu ngokusekelwe kumarekhodi e-EKG, umlando womndeni, kanye neminye imiphumela yokuhlolwa. Ngenxa yokuthi ngezinye izikhathi uphawu lokuqala ukufa ngokuzumayo , kubalulekile ukuhlola ingozi bese welapha ngokufanele.
Kufanele uye nini e-Emergency Treatment Unit (ETU)?
Uma uhlaselwa yinhliziyo ngokuzumayo (ukuboshwa kwenhliziyo), uzodinga usizo lwezokwelapha ngokushesha. Njengoba ungeke ukwazi ukubiza usizo ngaleso sikhathi, kubaluleke kakhulu ukuthi umndeni wakho nabathandekayo bakho baziswe ngalokhu.
Uma usengozini yokuma kwenhliziyo, tshela umndeni wakho nabangane abaseduze ukuthi bafunde ukwenza i-CPR (ukuvuselelwa kwenhliziyo). Uma kwenzeka isimo esiphuthumayo, shayela u-1990 bese ushayela i-ambulensi. Lokhu kwazi kungasindisa impilo yakho.
Umlayezo Wokuya Nawe Ekhaya
- I-Brugada syndrome yisimo esibi kakhulu esenzeka ohlelweni lukagesi lwenhliziyo futhi singaholela ngisho nasekufeni ngokuzumayo.
- Umkhuhlane uyimbangela enkulu eyenza lesi sifo sibe sibi kakhulu. Uma uhlaselwa umkhuhlane, wehlise ngokushesha okukhulu.
- Uma othile emndenini wakho eshone ngokuzumayo esemncane noma uvame ukulahlekelwa ingqondo, bona udokotela ngokushesha bese uthola ukuhlolwa kwe-EKG.
- Ukufaka idivayisi ye-ICD kuyindlela engcono kakhulu yokwelapha ukusindisa izimpilo kulesi sifo.
- Uma unalesi sifo, hlala uqaphela uhlu lwemithi udokotela wakho akunika yona engafanele ukuyisebenzisa.
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