Ingabe lokhu kuvuvukala okungavamile kuyayithinta inhliziyo yakho? Ake sifunde nge-Cardiac Sarcoidosis!

Ingabe ngezinye izikhathi uzizwa ukhathele nje? Noma ingabe uzwa ubuhlungu besifuba noma ubunzima bokuphefumula? Ungase ucabange ukuthi lezi yizinto ezivamile. Kodwa-ke, lezi yizimo ezingavamile kakhulu ezithinta inhliziyo. I-Cardiac Sarcoidosis ingenye yezifo ezinjalo, okuyinto eyinkimbinkimbi kancane, kodwa uma unolwazi olufanele, ingalawulwa. Namuhla, sizoxoxa ngalokhu ngendlela elula ongayiqonda.

Kuyini i-Cardiac Sarcoidosis?

Kalula nje, i-Sarcoidosis yisifo sokuvuvukala esingavamile esenzeka emizimbeni yethu. Kulokhu, amangqamuzana amancane okuvuvukala aqoqana futhi akhe amaqhubu (ama-granuloma) ezithweni ezahlukahlukene zomzimba, ikakhulukazi ezindaweni ezifana namaphaphu, ama-lymph node, isikhumba, namehlo. La maqhubu angaphazamisa ukusebenza okuvamile kwalezo zitho.

Manje, uma lesi simo se-sarcoidosis sithinta inhliziyo, yilokho esikubiza ngokuthi i-cardiac sarcoidosis . Lokhu kuyinto engavamile ngisho naphakathi kweziguli ze-sarcoidosis. Kodwa-ke, lapho inhliziyo ithinteka ngale ndlela, izibazi zingakheka emisipheni yenhliziyo nasezindleleni lapho izimpawu zikagesi zihamba khona enhliziyweni. Cabanga ngakho njengesibazi esikhumbeni ngemva kokulimala. Lezi zibazi zingabangela ukushaya kwenhliziyo okungavamile kanye nezinkinga ngokushaya kwenhliziyo.

Sivame kangakanani lesi simo?

I-sarcoidosis yenhliziyo empeleni ayisona isifo esivame kakhulu. Emhlabeni jikelele, odokotela bavame ukuthola ukuthi abantu abane-sarcoidosis kwezinye izindawo emzimbeni bangaba yi-2% kuya ku-5% kuphela abanalesi simo enhliziyweni. Kodwa-ke, ezinye izifundo ziphakamisa ukuthi emazweni afana ne-United States, abantu abangu-20% kuya ku-30% abane-sarcoidosis bangaba nalesi simo enhliziyweni, kodwa bangase bangatholakali.

Lesi simo sivame kakhulu emazweni afana neJapan, lapho abantu abangaphezu kwengxenye abane-sarcoidosis nabo benalesi sifo enhliziyweni yabo. Kodwa-ke, i-cardiac sarcoidosis ayivamile uma iqhathaniswa ne-sarcoidosis ethinta ezinye izitho zomzimba.

Enye into ebalulekile okufanele uyiqaphele ukuthi cishe ingxenye yesithathu yabantu abane-cardiac sarcoidosis ababonisi izimpawu ze-sarcoidosis kwenye indawo emzimbeni. Lokhu kusho ukuthi inhliziyo yakho ingaba yisitho sokuqala esithintekile yilesi sifo.

Ziyini izimpawu zalesi sifo?

Izimpawu ze-Cardiac Sarcoidosis zingahluka kumuntu nomuntu. Abanye abantu bangase bangabi nazo nhlobo izimpawu. Kodwa-ke, kunezimpawu ezithile ezivamile:

• Ubuhlungu besifuba: Kungase kuzwakale njengokucindezelwa noma ukucindezelwa.
• Ukuphelelwa umoya:Ungase uzizwe uphelelwa umoya, kungakhathaliseki ukuthi ukhathele kancane noma uphumule nje.
• Ukuquleka noma isiyezi: Ungase ulahlekelwe ingqondo ngokuzumayo bese uwe.
• Ukukhathala: Ukuzizwa ukhathele ngaso sonke isikhathi, kungakhathaliseki ukuthi wenzani.
• Ukukhwehlela: Kungase kube nokukhwehlela okomile okuqhubekayo.
• Ukuvuvukala emilenzeni yakho: Izindawo ezifana nendawo yeqakala zingase zivuvuke.
• Ukushaya kwenhliziyo okungajwayelekile / Ukushaya kwenhliziyo okungavamile: Isilinganiso senhliziyo singase sikhuphuke ngokuzumayo, sehle, noma sizizwe sengathi asishayi.

Uma unesinye noma ngaphezulu salezi zimpawu, ungazinaki. Kungcono ukufuna iseluleko sezokwelapha.

Kungani i-Cardiac Sarcoidosis yenzeka?

Eqinisweni, odokotela abakayitholi imbangela ethile yalesi sifo. Kodwa-ke, abacwaningi bakholelwa ukuthi ukwakheka kwezakhi zofuzo zabanye abantu kanye nezici zemvelo kungaba nendima. Okusho ukuthi, imizimba yabanye abantu ingasabela kokuthile okusemvelweni (isibonelo, igciwane, igciwane, noma uthuli) okubangela lesi simo sokuvuvukala. Kodwa-ke, lokhu kusesesigabeni socwaningo.

Lesi sifo sitholakala kanjani?

Uma usola ukuthi une-cardiac sarcoidosis, udokotela wakho uzoqala ngokukuhlola ngokomzimba. Bese ebuza ngomlando wakho wezokwelapha . Lokhu kusho izinto ezifana nezifo zakho zangaphambilini nokuthi ngabe kukhona yini emndenini wakho oke waba nezimo ezifanayo.

Ngaphezu kwalokho, kuzohlolwa izivivinyo ezahlukene ukuze kuhlolwe ukushaya kwenhliziyo okungajwayelekile. Udokotela uzohlola izimpawu ze-sarcoidosis kwenye indawo emzimbeni wakho, kanye nobufakazi bezimpawu ezifanayo enhliziyweni yakho.

Yiziphi izivivinyo zokuxilonga?

Kunezinhlobo eziningana zokuhlolwa ukuze kutholakale lesi sifo ngokunembile:

• I-Electrocardiogram (EKG/ECG): Lokhu kurekhoda ukusebenza kukagesi kwenhliziyo yakho njengephethini. Kungabona noma yikuphi ukukhubazeka kwesigqi senhliziyo yakho.
• I-Echocardiogram: Lokhu kufana nokuskena kwenhliziyo. Kusebenzisa amaza omsindo ukubheka ukuma nobukhulu benhliziyo, ukuthi amakamelo nama-valve enhliziyo asebenza kanjani, nokuningi. Ngezinye izikhathi kwenziwa i-echo edlula esifubeni.
• I-Holter monitor: Lena idivayisi encane oyigqoka amahora angama-24 kuya kwangu-48. Kuyasiza ukuqopha njalo umsebenzi wenhliziyo yakho ngenkathi uqhubeka nemisebenzi yakho yansuku zonke.
• I-Positron Emission Tomography (i-PET scan):Lokhu ukuskena okukhethekile. Kuwusizo kakhulu ekuboneni izindawo zokuvuvukala kanye nezibazi enhliziyweni.
• I-Heart MRI (I-Cardiac Magnetic Resonance Imaging): Lokhu kusebenzisa amasimu kazibuthe namagagasi omsakazo ukukhiqiza izithombe ezinemininingwane zenhliziyo. Lokhu kungasiza futhi ekuboneni ngokucacile umonakalo kanye nezibazi emisipheni yenhliziyo.

I-Sarcoidosis ivame ukutholakala kwezinye izingxenye zomzimba ngokuthatha i-biopsy (isampula encane yezicubu bese uyihlola ngaphansi kwe-microscope). Kodwa-ke, lokhu akuvamile enhliziyweni, njengoba kunzima ukuthola isampula endaweni eqondile yenhliziyo lapho inkinga ikhona khona.

Lezi zivivinyo zezithombe zisiza odokotela ukuthola izigaba ze-cardiac sarcoidosis. Ingahluka kusukela kwencane kuya kwenzima kakhulu. Ingathuthuka ngezigaba zokuqala, izigaba eziqhubekayo, kanye nezigaba ezisebenzayo, okuholela ekuphazamisekeni kwenhliziyo kanye ne-fibrosis.

Yiziphi izindlela zokwelapha?

Izindaba ezinhle ukuthi kunezindlela zokwelapha i-cardiac sarcoidosis. Udokotela wakho uzokhetha ukwelashwa okufanele kakhulu kwesimo sakho. Nazi ezinye zezindlela zokwelapha ezisetshenziswa kakhulu:

• Imithi ye-corticosteroid: Le mithi isebenza ngokunciphisa ukuvuvukala emzimbeni. I-Prednisolone iwumuthi ovame ukunqunywa kuleli qembu.
• Ezinye izidakamizwa zokucindezela amasosha omzimba: Ngezinye izikhathi, uma ama-corticosteroids ewodwa enganele, noma uma imiphumela yawo emibi imbi kakhulu, eminye imithi inganikezwa ukulawula amasosha omzimba ekubeni asebenze ngokweqile.
• Imithi yokulwa nokushaya kwenhliziyo: Uma ukushaya kwenhliziyo kungahambi kahle, kunemithi ekhethekile yokukulawula.
• I-Pacemaker: Uma inhliziyo ishaya ngokushesha okukhulu, le divayisi encane ifakwa enhliziyweni ukuze ihlale ishesha njalo.
• I-Implantable Cardioverter Defibrillator (ICD): Le divayisi ifakwa lapho kunengozi ye-arrhythmias eyingozi esongela impilo. Ngezikhathi ezinjalo, ibangela ukushaqeka okuncane kukagesi enhliziyweni ukuze kubuyiselwe isigqi esijwayelekile.
• Ukususwa kwe-catheter: Lokhu futhi kuyindlela yokwelapha ukushaya kwenhliziyo okungajwayelekile. Izindawo ezisenhliziyweni ezibangela izimpawu zikagesi ezingajwayelekile zitholakala futhi zibhujiswe kusetshenziswa i-catheter.

Akuvamile kakhulu, uma lesi sifo siba sibi kakhulu kangangokuthi siholele ekuhlulekeni kwenhliziyo , kungadingeka ukufakelwa inhliziyo .

Yimiphi imithi kanye nokwelashwa okuvame ukusetshenziswa kakhulu?

Odokotela bavame ukuqala ngomthamo ophezulu we-corticosteroid ebizwa ngokuthi i-prednisone (amagama emikhiqizo afaka phakathi i-Sterapred® noma i-Rayos®). Lokhu kuthathwa izinyanga eziningana. Umthamo ube usuncishiswa kancane kancane. Uma lesi sifo sitholakala futhi selashwa kusenesikhathi, le mithi ingalawula kakhulu izimpawu.

Ingabe ikhona imiphumela emibi yokwelashwa?

Imithi ye-corticosteroid efana ne-Prednisone ingabangela imiphumela emibi uma isetshenziswa isikhathi eside. Yingakho udokotela wakho ezokuqapha njalo. Imiphumela emibi evame kakhulu yile:

• I-Osteoporosis: Ubuthakathaka bamathambo.
• Ukutheleleka: Ingozi yokuthola izifo inganda njengoba amasosha omzimba ehla.
• Umfutho wegazi ophezulu.
• Ushukela wegazi ophakeme.
• Ukushintshashintsha kwemizwa.
• Ukungalali.

Nakuba ukwelashwa nge-catheter ablation kuphumelele ekuqaleni, abanye abantu, ikakhulukazi labo abane -ventricular tachycardia (ukushaya kwenhliziyo okusheshayo okuqala emakamelweni aphansi enhliziyo), bangase babhekane nokuphindaphinda kwalesi simo ezimweni ezifika ku-86%.

Ingozi ye-cardiac sarcoidosis ephindaphindayo ngemva kokufakelwa inhliziyo ingaphansi kuka-10%.

Ingabe i-Cardiac Sarcoidosis iyisimo esibucayi?

Lokhu kuzohluka kuye ngesimo sakho. Imiphumela emihle kakhulu iyatholakala uma isifo sitholakala kusenesikhathi futhi ukwelashwa kuqalwe kusenesikhathi. Uma ukwelashwa kubambezeleka, isimo singaba sibi kakhulu.

Uma unezimo ezifana nomfutho wegazi ophezulu wamaphaphu ( umfutho wegazi ophakeme emithanjeni ethwala igazi emaphashini) noma i-ventricular aneurysm (ubuthakathaka bodonga lwenye yamakamelo aphansi enhliziyo oluvuvukala njengebhaluni), isibikezelo singase singabi sihle kangako.

Ungaphila isikhathi esingakanani nalesi sifo?

Uma ukwelashwa kuqalwe kusenesikhathi, abantu abaningi baphila kahle.

Izifundo zithole ukuthi phakathi kuka-83% no-93% wabantu abaphila ne-cardiac sarcoidosis basaphila ngemva kweminyaka eyi-10.

Izinga lokusinda ngemva kokufakelwa inhliziyo lingama-80% noma ngaphezulu ngonyaka owodwa nonyaka emihlanu.

Khumbula, nakuba lezi zibalo zibonisa izimo ezijwayelekile, isimo sakho singase sihluke. Ngakho-ke khuluma nodokotela wakho ukuze uthole ukuqonda okucacile ngesimo sakho.

Ingabe i-Cardiac Sarcoidosis ingaba yingozi?

Yebo, i-cardiac sarcoidosis ingaba yingozi kwabanye abantu. Ingozi yokufa iphezulu, ikakhulukazi uma i-ventricle yesobunxele yenhliziyo yakho ingapompi igazi kahle.

Ukufa kwenhliziyo okungazelelwe kuvame ukubangelwa ukushaya kwenhliziyo okungajwayelekile (ukushaya kwenhliziyo okungajwayelekile emakamelweni aphansi enhliziyo). Uma usengozini, udokotela wakho angase akuncome ukuthi ufake idivayisi ye-ICD.

Kufanele ngizinakekele kanjani?

Ngenxa yokuthi lesi simo singaba sibi kakhulu ngesikhathi esifushane, kubalulekile ukuthatha umuthi njengoba nje udokotela wakho ekuyalile. Kungadingeka ukuthi uthathe umuthi ofana ne-Prednisone kuze kube unyaka. Uma uhlangabezana nanoma yimiphi imiphumela emibi evela emuthini, tshela udokotela wakho. Kodwa ungayeki ukuthatha umuthi ngaphandle kweseluleko sikadokotela.

Kufanele ngimbone nini udokotela?

Kuzodingeka uphinde wenze izivivinyo zezithombe cishe inyanga noma izinyanga eziyisithupha ngemuva kokuqala ukuthatha ama-steroid (isb., i-prednisone). Lokhu kusiza udokotela wakho ukuthi anqume ukuthi umuthi usebenza kahle kangakanani nokuthi kufanele ube nomthamo ongakanani esikhathini esizayo.

Ngisho nangemva kokumiswa kwama-steroid noma umthamo uncishisiwe, kufanele uqhubeke nokuhlolwa okulandelayo nodokotela wakho okungenani iminyaka emithathu. Lokhu kungenxa yokuthi i-cardiac sarcoidosis ingaphinde ivele. Cishe abantu abangu-40% bazophinde babuye lesi sifo ngale ndlela.

Kufanele ngiye nini e-Emergency Treatment Unit (ETU) ?

Uma uhlangabezana nanoma yiziphi zalezi zimpawu ngokuzumayo , iya ekamelweni lezimo eziphuthumayo esibhedlela esiseduze ngokushesha noma ushayele u-1990:

• Ubuhlungu besifuba obuhambisana nobunzima bokuphefumula
• Ukushaya kwenhliziyo okuqhubekayo
• Isiyezi kanye/noma ukuquleka

Lokhu kungaba izimpawu zokuphazamiseka kwenhliziyo okuyingozi.

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Ungakhohlwa ukubuza le mibuzo uma ubona udokotela:

• Ngingakwazi yini ukulawula lesi simo ngemithi yodwa?
• Uyini umbono wami, ikakhulukazi uma ubheka isimo sami samanje?
• I-ventricle yami yesobunxele isebenza kahle kangakanani?
• Ngidinga ukuthatha umuthi isikhathi esingakanani?
• Yiziphi izinguquko engingazishintsha endleleni yokuphila?

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Cardiac Sarcoidosis yigama elithusayo kancane, kodwa kubaluleke kakhulu ukuliqaphela.

Imiphumela emihle kakhulu ingatholakala uma lesi sifo sitholakala kusenesikhathi futhi ukwelashwa kuqala kusenesikhathi.

Ngakho-ke, uma unalezi zimpawu, ungazinaki futhi ufune iseluleko sezokwelapha. Thatha imithi udokotela wakho ayinikezayo ngesikhathi. Khuluma nodokotela wakho ngemiphumela emibi. Hamba uyohlolwa udokotela ngesikhathi. Uma wenza lezi zinto kahle, ungaphila kahle nalesi simo. Awuwedwa, futhi odokotela bakhona ukukusiza.

Isifo senhliziyo, i-sarcoidosis, ukuvuvukala kwenhliziyo, ukuphelelwa umoya, ubuhlungu besifuba, ukushaya kwenhliziyo okungajwayelekile, ama-corticosteroids