Ingabe inhliziyo yakho ishaya ngokuzumayo ngendlela exakile? Ingabe kungaba yi-Brugada Syndrome?

Wake walahlekelwa ingqondo ngokuzumayo, wazizwa unesizungu? Noma waba nomuzwa wokushaya kwenhliziyo okusheshayo, noma ubunzima bokuphefumula? Ngezinye izikhathi lokhu kungabangelwa yinto engatheni kangako. Kodwa-ke, ezimweni ezingavamile, kungaba izimpawu zesifo senhliziyo esibizwa ngokuthi i-Brugada Syndrome. Ake sixoxe ngalokhu kancane namuhla, ngoba kubalulekile ukukuqaphela.

Iyini i-Brugada Syndrome?

Kalula nje, i-Brugada Syndrome yisimo esibangela ukusebenza kukagesi okungajwayelekile emakamelweni aphansi enhliziyo yakho, okubizwa ngokuthi ama-ventricle. Lokhu kungabangela ukuthi inhliziyo yakho ilahlekelwe isigqi sayo ngokuzumayo . Lokhu kubizwa ngokuthi i-ventricular fibrillation noma i-v-fib . Cabanga ngenhliziyo yakho iqhuma esikhundleni sokupompa igazi kahle. Lokhu kubangela ukuthi ubuchopho bakho bungatholi igazi elanele. Yilapho ulahlekelwa khona ukwazi (i-syncope) .

Lokhu kungaba yisimo esiyingozi, ngoba le `v-fib` ingaholela ngisho nasekufeni kwenhliziyo ngokuzumayo . Esikhathini esiningi, lokhu kwenzeka uma uphumule noma ulele. Abacwaningi bathi i-Brugada Syndrome iyimbangela cishe engu-4% yokufa kwenhliziyo ngokuzumayo emhlabeni jikelele.

Kodwa lesi akusona isifo esivame kakhulu. Cishe abantu abathathu kuya kwabane kwabayizinkulungwane eziyishumi banalesi simo.

Yiziphi izimpawu ezibonakala?

Izimpawu ze-Brugada Syndrome zingavela kunoma yimuphi ubudala. Kodwa-ke, zivame ukuqala cishe eminyakeni engama-40. Abanye abantu bangase bangakhombisi nhlobo izimpawu. Abantu abangaphezu kuka-70% kuthiwa abanazo izimpawu. Kodwa-ke, uma izimpawu zivela, zingase zihlanganise:

• Ukushaya kwenhliziyo okungavamile (`i-ventricular arrhythmia`) : Lokhu kusho ukuthi isigqi senhliziyo siyaphazamiseka.
• I-Syncope: Ukulahlekelwa yingqondo ngokuzumayo kanye nokuwa.
• Isiyezi : Umuzwa wokuzungeza.
• Ubunzima bokuphefumula .
• Ukushaya kwenhliziyo : Umuzwa wokuphaphazela noma wokujikeleza esifubeni.
• Ukuma kwenhliziyo : Lokhu ngezinye izikhathi kuyisibonakaliso sokuqala esibonakala. Abanye abantu bangase bafe belele ngenxa yalokhu.

Okubalulekile: Uma uhlangabezana nolunye noma ngaphezulu kwalezi zimpawu njalo, kungcono ukubona udokotela ukuze akunike iseluleko.

Yiziphi izimbangela ze-Brugada syndrome?

Izinto ezithile zingabangela ukuthi izimpawu ze-Brugada syndrome zivele ngokuzumayo noma zibe zimbi kakhulu. Lokhu sikubiza ngokuthi 'izimbangela'.

• Umkhuhlane : Lezi zimpawu zingavela uma umuntu one-Brugada syndrome eba nomkhuhlane.Kubaluleke kakhulu ukwehlisa umkhuhlane ngokushesha . Ngisho noma une-defibrillator ye-cardioverter efakwa emzimbeni (i-ICD), kusadingeka unciphise umkhuhlane. Lokhu kungenziwa ngemithi yokunciphisa umkhuhlane etholakala ekhemisi.
• Ukukhathala kokushisa / Ukuphelelwa amanzi emzimbeni : Ukugcinwa kwamanzi emzimbeni, ukukhathala ngenxa yokushisa okukhulu.
• Eminye imithi :
• Ama-blocker eziteshi ze-sodium.
• I-Lithium.
• Ama-antidepressant e-Tricyclic.
• Utshwala : Ukuphuza utshwala obuningi kakhulu.
• Izidakamizwa : Ukusebenzisa izidakamizwa ezifana ne-cocaine nensangu.

Kubaluleke kakhulu ukuqaphela lezi zinto nokuzigwema ngangokunokwenzeka.

Yiziphi izizathu zalokhu?

Imbangela eqondile ye-Brugada Syndrome ngezinye izikhathi ayaziwa . Noma kungaba yi-genetic . Akukaziwa ukuthi yikuphi ukuguquka kwezakhi zofuzo okubangela lesi sifo kubantu abangaba ngu-70%.

Kodwa-ke, abanye abantu banezinhlobo ezingu-18 noma ngaphezulu zezakhi zofuzo. Okuvame kakhulu kulokhu ukuhlukahluka kwezakhi zofuzo okuthiwa i-SCN5A . Lokhu kuhlukahluka kuphazamisa indlela izimpawu zikagesi enhliziyweni ezihamba ngayo.

Lesi yisifo esingazuzwa kumzali oyedwa kuphela . Okusho ukuthi, ingane yomuntu onokuguqulwa kwezakhi zofuzo okuhlobene ne-Brugada syndrome inethuba elingu-50% lokusithola.

Ubani onamathuba amaningi okuthuthukisa lokhu? (Izici Eziyingozi)

Lesi sifo sivame kakhulu kwabesilisa . Sivame kakhulu kwabesilisa ngokuphindwe kasishiyagalombili kuya kweyishumi kunabesifazane.

Futhi, uma othile emndenini wakho eshonile ngenxa yokuma kwenhliziyo okungazelelwe, noma etholakale ene-Brugada syndrome , kungaba ukuhlakanipha ukuthi nawe uhlolwe lokhu.

Okunye ukuthi kuthiwa lesi sifo sivame kakhulu kubantu bomdabu base-Asia .

Udokotela ukuxilonga kanjani lokhu? (Ukuxilongwa)

Ukuze anqume ukuthi une-Brugada Syndrome, udokotela uzokwenza okulandelayo:

• Uzohlolwa ngokomzimba .
• Umlando wakho wezokwelapha uzobuyekezwa.
• Umlando wempilo yomndeni wakho (umlando womndeni webhayoloji) uzobuzwa, ikakhulukazi uma kukhona umuntu emndenini wakho oye wafa ngokuzumayo ngenxa yesifo senhliziyo.
• Bazokucela ukuthi wenze izivivinyo eziningana ezikhethekile .

Yiziphi izivivinyo ezenziwayo?

Kunezinhlobo eziningana zokuhlolwa okuyinhloko ezisetshenziswa ukuxilonga lesi sifo:

• Ukuhlolwa kofuzo: Lokhu kuhlolwa kunganquma ukuthi une-gene mutation ethile ehlobene ne-Brugada syndrome ngokuthatha isampula yamathe akho noma igazi. Kungumqondo omuhle futhi ukwenza lokhu kuhlolwa ukuze ubone ukuthi abanye abantu emndenini wakho nabo banalo yini lolu shintsho lwe-gene. Ikakhulukazi uma unesihlobo esiseduze (`isihlobo sezinga lokuqala`) esine-Brugada syndrome, njengabazali bakho, izingane zakini, noma izingane, kufanele nakanjani uhlolwe lokhu .
• I-Electrocardiogram (EKG noma i-ECG) : Lokhu kusetshenziselwa ukuqopha umsebenzi kagesi wenhliziyo yakho njengoba ishaya. Odokotela bafuna iphethini ethile (iphethini ye-EKG yohlobo lwe-Brugada syndrome type 1) ku-EKG. Ngezinye izikhathi iphethini ebuthakathaka ebizwa ngokuthi uhlobo 2 noma uhlobo 3 ingabonakala, kodwa lokho kukodwa akukwazi ukuqinisekisa lesi sifo. Kodwa-ke, ngenxa yezimbangela ezibalwe ngenhla (isb. umkhuhlane), le phethini yohlobo 2 noma uhlobo 3 ingashintsha ibe iphethini yohlobo 1. Ngezinye izikhathi le phethini ayibonakali ngokushesha ku-EKG, ngakho udokotela angaphinda i-EKG kabili noma kathathu, eshintsha ama-lead. Ngezinye izikhathi, i-EKG nayo yenziwa ngemva kokudla okugcwele.
• I-EKG ngemithi (ukuhlolwa kwenselele yezidakamizwa) : Ngaphambi kwe-EKG, udokotela wakho angakunika imithi ezosiza i-EKG yakho ukuthi ibonakale ngokucacile uma une-Brugada syndrome. Lokhu kuhlolwa kusetshenziselwa ukubona ukuthi i-EKG yakho inephethini yohlobo 2 noma 3, engashintshela kuphethini yohlobo 1.

Kuye ngemiphumela yakho ye-EKG, kungase kwenziwe ezinye izivivinyo:

• Ukuhlolwa kwe-Electrophysiology (EP) : Lokhu kuhilela ukudlulisa ipayipi elincane (i-catheter) ngomthambo omkhulu osemlenzeni wakho (umthambo we-femoral) enhliziyweni yakho ukuze kulinganiswe umsebenzi kagesi ongaphakathi kwenhliziyo yakho. Lokhu kungenziwa uma ukuxilongwa kungacaci ngemva kokunye ukuhlolwa.
• Ukuhlolwa kwelebhu: Ukuhlolwa kwegazi kwenziwa ukuhlola amazinga ama-electrolyte afana ne-potassium, i-calcium, ne-magnesium egazini, nokuhlola ezinye izimbangela ezingaba khona zokushaya kwenhliziyo okungajwayelekile.

Ukwelashwa kanjani? (Ukwelashwa)

Umgomo oyinhloko wokwelapha i-Brugada Syndrome ukuvimbela ukwenzeka kwe -ventricular arrhythmias kanye nokuwalawula ngokushesha uma evele.

Ungazinika ukwelashwa okufana nalokhu:

• Imithi efana ne -Isoproterenol .
• Imithi efana ne -quinidine .
• Ithuluzi elincane elifakwe enhliziyweni (Implantable Cardioverter Defibrillator - ICD): Uma uke waba nokuhlaselwa yinhliziyo (i-ventricular tachycardia), ukuphelelwa amandla, noma ukumiswa kwenhliziyo, ungase ufake i-ICD. Le divayisi ithola isigqi senhliziyo esiyingozi futhi ilethe ukushaqeka okuncane kukagesi enhliziyweni ukuze ibuyisele esimweni sayo esijwayelekile.
• Ukukhipha igazi ( kwezinye izimo): Lokhu kuhilela ukuhlonza nokubhubhisa izindawo enhliziyweni ezibangela izimpawu zikagesi ezingavamile.

Ngisho noma ungenazo izimpawu, udokotela wakho anganquma ukufaka i-ICD ngokusekelwe emlandweni womndeni wakho kanye nemiphumela yokuhlolwa. Abanye odokotela banganquma ukukuhlola njalo futhi bakwelaphe kuphela uma uba nezimpawu. Kodwa-ke, abanye odokotela bangase bangavumelani nale ndlela, njengoba uphawu lwakho lokuqala lungaba ukufa kwenhliziyo okungazelelwe.

Ingabe kukhona izinkinga ekwelashweni?

Ama-ICD awawona amadivayisi angenaphutha ngokuphelele. Ngezinye izikhathi izinto ezinjengalezi zingenzeka:

• Ungashaqeka ngesikhathi esingafanele .
• Kungase kube nephutha komunye wezintambo emshinini.
• Ukutheleleka kungase kwenzeke eduze komshini.

Ngakho-ke, ngemva kokufakelwa i-ICD, kubaluleke kakhulu ukuya kohlolwa njengoba nje udokotela encoma.

Kuthatha isikhathi esingakanani ukuphulukiswa?

Ngemva kokufakwa kwe-ICD, ungenza iningi lemisebenzi yakho evamile zingakapheli izinsuku ezimbalwa. Kodwa-ke, kuzodingeka uyeke ukushayela cishe isonto. Ungenza umsebenzi onzima nsuku zonke, kodwa ungawenzi kuze kube yilapho ukhathala. Ungaphakamisi izinsimbi noma wenze ukuzivocavoca okunzima kuze kube yilapho udokotela wakho ekuyala ukuba wenze kanjalo.

Ingabe lokhu kungavinjelwa? (Ukuvimbela)

Uma uzuze i-Brugada Syndrome njengefa kubazali bakho, ayinakushintshwa. Kodwa-ke, uma wazi ukuthi othile emndenini wakho une-Brugada Syndrome, wena nezihlobo zakho ningenza ukuhlolwa kofuzo ukuze kubonakale ukuthi ninayo yini.

Futhi, uma unethemba lokuba nomntwana, ungahlangana nomeluleki wezakhi zofuzo bese ukhuluma naye ngengozi yokudlulisela lokhu ezinganeni zakho.

Yini ongayilindela uma uphila ne-Brugada syndrome?

Akukho ukwelashwa kwe-Brugada Syndrome. Kodwa-ke, ukwelashwa kunganciphisa kakhulu ingozi yokufa kwenhliziyo ngokuzumayo.

Abantu abane-Brugada syndrome abanezimpawu kodwa abangatholi ukwelashwa basengozini enkulu yokufa ngokuzumayo kwenhliziyo. Le ngozi iphansi kakhulu kubantu abangenazo izimpawu futhi abane-EKG evamile.

Ngizinakekela kanjani? (Ukuzinakekela)

Uma udokotela ekutshela ukuthi une-Brugada Syndrome, into ebaluleke kakhulu ukugwema izinto eziningi ezingaphazamisa leso sigqi ngangokunokwenzeka.

• Vimbela umkhuhlane. Uma uhlaselwa umkhuhlane, wehlise ngokushesha.
• Gwema imithi ethile nezinto ezithile . Cela udokotela wakho uhlu lwemithi ekwenza ungezwani nomzimba.
• Gwema utshwala nezidakamizwa ngokweqile ngokuphelele .
• Phuza amanzi amaningi ukuze ugweme ukuphelelwa amanzi emzimbeni .
• Qaphela lapho wenza imisebenzi enzima .

Kunini lapho udinga ukubonana nodokotela? / Ingabe udinga ukuya ekamelweni lezimo eziphuthumayo?

Uma une-Brugada syndrome, kufanele ubonane nodokotela wakho okungenani kanye ngonyaka ukuze ayohlolwa . Uma une-ICD, kufanele uyihlole okungenani kabili ngonyaka . Uma uzizwa ungavamile, tshela udokotela wakho .

Isimo Esiphuthumayo! Uma unesifo senhliziyo, ngeke ukwazi ukuzisiza. Ngakho-ke, uzodinga umuntu ozokusiza. Uma usengozini yokubanjwa yinhliziyo, tshela umndeni wakho ukuthi ufunde i-CPR (Cardiopulmonary Resuscitation) , bese ushayela ku-1990 (insizakalo ye-ambulensi ephuthumayo yaseSri Lanka) noma inombolo ephuthumayo eseduze. Yazisa futhi indawo yakho yokusebenza ngale ngozi.

Imibuzo ebalulekile okufanele uyibuze udokotela wakho

Uma uya kudokotela, ungakhohlwa ukubuza imibuzo efana nale:

• Ingabe ngidinga i-ICD?
• I-ICD kufanele igcinwe kanjani?
• Ungangitshela ngeqembu lokusekelana lapho abanye abantu abanalesi simo bengahlangana khona?
• Yimiphi imithi okufanele ngiyigweme? Unganginika uhlu lwemithi?
• Ingabe wonke umndeni wami kufanele uhlolwe lokhu?

Umlayezo Wokuya Nawe Ekhaya

Kuvamile ukuzizwa ukhungathekile uma uthola ukuthi unesifo esingaholela ekuhlaselweni yinhliziyo ngokuzumayo. Kodwa-ke, ukwazi ukuthi usengozini kukunika ithuba lokuthatha izinyathelo zokunciphisa leyo ngozi . Udokotela wakho uzokuthola inketho yokwelashwa engcono kakhulu kuwe.

Uma kungenzeka, kungaba impumuzo enkulu uma ikhaya lakho kanye nesikole sengane yakho sine -Automatic External Defibrillator (AED) . Futhi, cela omakhelwane bakho kanye nosebenza nabo ukuthi bafunde i-CPR. Lezi zinto zingasiza ekusindiseni izimpilo. Landela njalo imiyalelo kadokotela wakho, thola ukuhlolwa njalo, futhi ugweme izinto ezisongela impilo .

I- Brugada syndrome, ukungasebenzi kahle kwenhliziyo, ukuboshwa kwenhliziyo okungazelelwe, izifo zofuzo, i-EKG, i-ICD, isifo senhliziyo