Ingabe inhliziyo yakho izwa sengathi iyancipha? Kungaba yi-Constrictive Pericarditis!

Wake wacabanga ukuthi inhliziyo yethu iyigugu kangakanani nokuthi isebenza kahle kangakanani? Ngezinye izikhathi, hhayi inhliziyo ngokwayo kuphela, kodwa nesembozo esiyisivikelo esiyizungezile singaphazamisa ukusebenza kwenhliziyo yonke. Leso yisimo esizokhuluma ngaso namuhla, esibizwa ngokuthi `(Constrictive Pericarditis)`. Ungakhathazeki, ake sixoxe ngalokhu kalula.

Kuyini lokhu (i-Constrictive Pericarditis)? Dokotela?

Kalula nje, inhliziyo yakho izungezwe ulwelwesi oluncane, njengomcamelo, oluyivikelayo. Siyibiza ngokuthi i-pericardium. Kulesi simo, esikhundleni sokuba iguquguquke ngokujwayelekile, i-pericardium iyaqina futhi iqine. Cabanga ngayo njengephampu, inhliziyo idinga ukukwazi ukukhula nokufinyela ukuze ipompe igazi. Kodwa lapho le pericardium iba lukhuni, inhliziyo ayinayo indawo eyanele yokukhula nokugcwala igazi. Yilapho izinkinga ziqala khona. Lesi yisimo esibi kakhulu esingaholela ngisho nasekuhlulekeni kwenhliziyo . Kodwa izindaba ezinhle ukuthi ivame ukwelashwa futhi yelapheke, ikakhulukazi uma itholakale kusenesikhathi .

Kwenzekani ngempela kulesi simo?

Sixoxe nge-pericardium. Inezendlalelo ezimbili, futhi kukhona uketshezi phakathi. Lolu ketshezi yilona oluvikela inhliziyo, uma kwenzeka ingozi. Ngokuvamile, le pericardium iyanwebeka kakhulu futhi iyaguquguquka. Ngakho-ke, akukho sithiyo ekuyigcwaliseni ngegazi ngenkathi inhliziyo ishaya.

Kodwa kumuntu one-Constrictive Pericarditis, i-pericardium iba nkulu futhi iqine. Ifana nebhande lerabha elidala, futhi ayinwebeki. Ngemuva kwalokho inhliziyo ayitholi ithuba lokugcwala igazi elanele.

Uma inhliziyo ingakwazi ukugcwalisa igazi kahle, iba nobunzima bokupompa igazi elanele emzimbeni. Ukuze kulungiswe lokhu, ingcindezi engaphakathi kwenhliziyo iyakhula. Uma lokhu kuqhubeka, kungaholela ekuhlulekeni kwenhliziyo . Abanye abantu bakubiza nangokuthi `(Restrictive Pericarditis)`, kodwa manje igama elithi `(Constrictive Pericarditis)` selisetshenziswa kakhulu. Zombili ziyisimo esifanayo.

Ubani onamathuba amaningi okuthola lesi sifo?

Nakuba noma ubani angaba nalesi simo (i-Constrictive Pericarditis), abanye abantu basengozini enkulu.

• Kulabo abake bahlinzwa inhliziyo ngaphambilini.
• Kulabo abathole ukwelashwa ngemisebe endaweni yenhliziyo.
• Kulabo abanokuvuvukala kwe-pericardium okungekho sizathu esingatholakala (sikubiza ngokuthi ``idiopathic pericarditis``) noma abaye baba nokuvuvukala kwe-pericardium ngenxa yokutheleleka ngegciwane (``viral pericarditis``).
• Emazweni asathuthuka, njengezwe lethu isibonelo, isifo sofuba (TB) yisona esibangela kakhulu.

Kunamathuba okuthi kukhule kubantu besilisa kabili noma kathathu kunabesifazane. Futhi akuvamile kakhulu ezinganeni ezincane.

Sivame kangakanani lesi simo?

I-Constrictive Pericarditis empeleni iyisimo esingavamile kakhulu . Sivela cishe kubantu abangu-9% abane-acute pericarditis. Futhi ukuthi i-acute pericarditis ibonakala cishe kubantu abangu-5% abeza ekamelweni eliphuthumayo benobuhlungu besifuba. Ngakho ungacabanga ukuthi kuyinto engavamile kangakanani.

Ziyini izimpawu zalesi sifo?

Izimpawu zalesi sifo zivela kancane kancane. Ngezinye izikhathi zingavela ngokuzumayo. Izimpawu eziyinhloko ezibonakala yilezi:

• Ubunzima bokuphefumula (ukuphelelwa umoya): Ukuzizwa uphelelwa umoya uma ukhathele kancane, noma ngisho nokuma nje.
• Ubuhlungu besifuba : Ubuhlungu bokucindezela, ukucindezelwa.
• Ukukhathala, ukukhathala : Ukuzizwa ukhathele kangangokuthi awukwazi ukwenza lutho.
• Ukuzungeza : Kuzwakala sengathi ikhanda lakho liyazungeza, ngezinye izikhathi sengathi usuzolahlekelwa ingqondo.
• Ukuvuvukala : Uketshezi luyaqoqana futhi luvuvuke, ikakhulukazi ezindaweni ezifana nesisu nemilenze (ezungeze amaqakala).
• Ubuthakathaka bemisipha kanye nokuwohloka : Umzimba ulahlekelwa yimisipha.
• Ukulahlekelwa yisifiso sokudla kanye nokuzizwa usuthi ngisho nangemva kokudla kancane : Awuzizwa sengathi ufuna ukudla, kodwa uzizwa usuthi ngisho nangemva kokudla kancane.

Ingabe kunezinhlobo ezahlukene zalesi sifo?

Yebo, kunezinhlobo eziningana ezahlukene ze-`(Constrictive Pericarditis)`. Ake sibone ukuthi ziyini:

• Uhlobo olubukhali : Kulolu hlobo, ukushaqeka kwe-pericardium kwenzeka ngokushesha okukhulu, ezinsukwini ezimbalwa.
• Uhlobo lwe-Subacute : Lolu hlobo lufana nohlobo lwe-acute, kodwa izimpawu azizimbi kangako.
• I-Effusive-constrictive pericarditis : Lolu hlobo lwe-pericarditis lubangelwa uketshezi oluqongelela ngaphakathi kwe-pericardium (i-pericardial effusion). Njengoba lolu ketshezi luqoqana, lubeka ingcindezi enhliziyweni. Lokhu kubizwa ngokuthi i-cardiac tamponade. Cabanga ngakho njengebhaluni ngaphakathi kwebhaluni, futhi uma ugcwalisa ibhaluni langaphandle ngamanzi, ibhaluni langaphakathi lizocindezelwa. Ekugcineni, inhliziyo ingase iyeke ukushaya. Uma uketshezi olwengeziwe lususwa kodwa ingcindezi engaphakathi kwenhliziyo ihlala iphezulu, lokhu kubizwa ngokuthi i-effusive constriction.
• I-Transient constrictive pericarditis : Lokhu kuvame ukuba uhlobo olubi lwe-pericarditis, okuyisimo lapho i-pericardium ivuvukala futhi inciphe. Ingelashwa ngemithi yokulwa nokuvuvukala .
• I-Occult constrictive pericarditis : Kwezokwelapha, igama elithi "occult" lisho "okufihliwe." Leli gama livela eqinisweni lokuthi lolu hlobo kunzima ukulubona. Luvame ukutholakala ngengozi kwezinye izivivinyo.

Yini ebangela lokhu?

I-Constrictive Pericarditis yisimo lapho i-pericardium iba nkulu futhi iqine. Lokhu kubangelwa kakhulu yizicubu zesilonda ezivela ezimweni zezokwelapha zangaphambilini. Kunezizathu eziningana zokuthi kungani le pericardium ingaba lukhuni:

• Ukutheleleka : Emazweni asathuthuka, isifo sofuba yisifo esivame kakhulu esibangelwa amagciwane. Cishe u-20% kuya ku-30% wamacala e-pericarditis ehlobene nesifo sofuba angadlulela kulesi simo. Emazweni athuthukile, ukutheleleka ngegciwane kuvame kakhulu.
• Izifo zenhliziyo nezinkinga zesistimu yokujikeleza kwegazi : Ukuhlaselwa yinhliziyo noma ezinye izimo ezithinta imithambo yegazi emikhulu eduze kwenhliziyo.
• Ukulimala : Ukuvuvukala okubangelwa ukulimala esifubeni (njengokushaywa, inxeba lokugwazwa, noma inxeba lokudutshulwa) kungaphenduka izibazi kamuva.
• Izifo zesimiso somzimba noma izimo zokuvuvukala : Isibonelo, izifo ezifana ne-`(Lupus)`, `(Rheumatoid arthritis)`, noma `(Sjögren's syndrome)`.
• Izimbangela zezokwelapha : I-pericardium ingaqina futhi ibe nezibazi ngemva kokuhlinzwa kwenhliziyo, ukwelashwa ngemisebe yomdlavuza, noma njengomphumela ongemuhle wemithi ethile.
• Umdlavuza : Umdlavuza we-pericardium uqobo noma umdlavuza osakazeke usuka kwenye indawo emzimbeni.
• Ezinye izimbangela : Ngezinye izikhathi, akukho sizathu esingatholakala se-"Constrictive Pericarditis." Odokotela bavame ukucabanga ukuthi lokhu kubangelwa ukutheleleka ngegciwane, noma bahlanganisa izimbangela ezingaziwa kanye nezimbangela zegciwane ndawonye ngezibalo.

Ingabe lokhu kuyathelelana?

Cha. Nakuba i-Constrictive Pericarditis ingabangelwa izifo (ezinye zazo ziyathelelana), lesi simo ngokwaso asithelelani .

Odokotela bakuthola kanjani lokhu?

Udokotela angakwazi ukuxilonga lesi simo ngokubheka izimpawu zakho, umlando wakho wezokwelapha (njengezifo zangaphambilini, ukuhlinzwa), ukuhlolwa ngokomzimba, kanye nokuhlolwa okukhethekile. Ngezinye izikhathi kungaba nzima ukuxilonga, ikakhulukazi uma izimpawu zakho zingenzima kakhulu noma uma unezinye izimo ezinezimpawu ezifanayo.

Yiziphi izivivinyo ezenziwayo ngalokhu?

Uma udokotela esola ukuthi une-Constrictive Pericarditis, angenza lezi zivivinyo ezilandelayo:

• Ukuhlolwa kwesifo sofuba .
• Ukuhlolwa kwegazi ukuhlola izifo zesimiso somzimba sokuzivikela .
• I-Echocardiogram (njengokuskena kwenhliziyo nge-ultrasound).
• I-Electrocardiogram (ECG) (ukuhlolwa okuhlola ukusebenza kukagesi kwenhliziyo).
• I-X-ray yesifuba .
• I-CT scan yenhliziyo (i-CT scan) .
• Ukuskena kwe-MRI (i-MRI) ye-Heart magnetic resonance imaging .
• Ukufakwa kwe-catheter kwenhliziyo kwesobunxele nakwesokudla (ukuhlolwa okulinganisa ingcindezi ngokudlulisa ipayipi elincane enhliziyweni).

Ukwelapha kanjani lokhu?Ingabe ingelapheka?

Lesi simo sivame ukwelapheka , futhi sivame ukuphulukiswa.

Ezimweni eziningi, kulandelwa izimiso ezimbili eziyinhloko ukuze kulungiswe lokhu:

• Ukunciphisa ingcindezi enhliziyweni ngenxa yokungakwazi kwenhliziyo ukufinyela.
• Ukwelapha izimbangela eziyisisekelo noma izimpawu ezihambisana nazo.

Yimiphi imithi kanye nokwelashwa kwalokhu?

Ngokuvamile, okulandelayo yizindlela zokwelapha lesi simo:

• Ukuhlinzwa : Ukuhlinzwa okubizwa ngokuthi i-pericardiectomy kususa yonke i-pericardium. Lena yindlela ephumelela kakhulu yokwelapha lesi simo. I-Pericardiectomy ayidingekile ukuze usinde . Iningi labantu liyalulama ekuhlinzweni ngaphandle kwezinkinga noma imiphumela yesikhathi eside.
• Imithi : Kuye ngembangela kanye nezimpawu eziyisisekelo, imithi ehlukahlukene ingasetshenziswa ukwelapha izimpawu zalesi simo ngqo, noma ukuzama ukusilapha ngokumisa imbangela. Kwezinye izimo, singelashwa ngemithi yodwa ngaphandle kwesidingo sokuhlinzwa, noma kulabo abangakwazi ukuhlinzwa, imithi ingasiza ekulawuleni izimpawu.

Yimiphi imithi esetshenziswayo?

Imithi evame ukusetshenziswa kakhulu ukwelapha lesi simo yile:

• Imithi Yokuhlanza Umzimba : Le mithi isiza izinso zakho ukuthi zikhiphe uketshezi oluningi emzimbeni wakho.
• Ama-NSAID (Imithi elwa nokuvuvukala engeyona i-steroidal) : Lawa anciphisa ukuvuvukala futhi anciphise ubuhlungu. Izibonelo zifaka phakathi `(Ibuprofen)` noma `(Naproxen)`.
• Ama-Steroids : Izakhiwo zokulwa nokuvuvukala zale mithi ziyasiza ekwelapheni lesi simo.
• Imithi ethile yembangela : Isibonelo, ama-antibiotic okutheleleka ngamagciwane njengesifo sofuba.

Yiziphi izinkinga noma imiphumela emibi yokwelashwa?

Izinkinga ezingaba khona ziyahlukahluka kuye ngokwelashwa kanye nemithi. Imbangela noma uhlobo lwe-Constrictive Pericarditis nayo iyakuthinta lokhu. Udokotela wakho ungumuntu ongcono kakhulu ongakhuluma nawe ngemiphumela emibi noma izinkinga ezingaba khona, ikakhulukazi ngemithi. Lokhu kungenxa yokuthi angakunikeza ulwazi oluhambisana nesimo sakho esithile. Uzokutshela nokuthi yini ongayilindela, ukuthi ungazisingatha kanjani lezi zinkinga, nokuthi yini ongayenza ukuze uzivimbele ngokuphelele.

Ezinye zezinkinga ezingase zivele ngenxa yokuhlinzwa yilezi:

• Ukwehluleka kwenhliziyo .
• Ukushaya kwenhliziyo okungajwayelekile (`Arrhythmias`) .
• Ukutheleleka kanye ne-sepsis (ubuthi egazini).
• Ukufa (lokhu akuvamile kakhulu).

Ngingazilawula kanjani izimpawu uma ngingazinakekeli?

I-Constrictive Pericarditis akuyona into okufanele uyenze noma uyiphathe wedwa , njengoba ukuhlolwa nokuskena kubalulekile ukuze uyixilonge. Lokhu kubaluleke kakhulu ngoba ezinye zezimpawu zalesi simo zingavela nasezimweni ezisongela ukuphila njenge-cardiac tamponade noma ukuhlaselwa yinhliziyo. Ngakho-ke, kufanele uqale ukhulume nodokotela bese uthola isiqondiso ngalokho ongakwenza ngalesi simo.

Ngizozizwa ngingcono ngokushesha kangakanani ngemva kokwelashwa?

Kuye ngembangela yesimo kanye nokwelashwa okutholayo, kungathatha izinsuku ezimbalwa noma amasonto ambalwa ukuze uzizwe ungcono. Uma uhlinzwa, kuzodingeka wengeze isikhathi sokululama kusukela ekuhlinzweni esikhathini esithathayo ukuze uzizwe ungcono. Iningi labantu lizizwa lingcono zingakapheli izinyanga ezintathu , kodwa abanye abantu bangathatha izinyanga eziningana ukuze balulame ngokugcwele.

Ngingakuvimbela lokhu noma nginciphise ingozi?

I-Constrictive Pericarditis yisimo esenzeka ngokungalindelekile, ngakho-ke asinakuvinjelwa. Okuwukuphela kwento ongayenza ukunciphisa ingozi yakho yokuthola lesi simo ukugwema izimo ezingaholela kuso. Isibonelo, uma unegciwane, funa ukwelashwa ngokushesha okukhulu. Okunye ukunciphisa umonakalo ku-pericardium yakho ngabasebenzi bezokwelapha uma uthola ukwelashwa ngemisebe.

Yini engingayilindela uma nginalesi simo? Ingabe lokhu kungelapheka?

Umbono wakho kulesi simo uncike esibangweni, ubukhali besimo sakho, ukwelashwa, kanye nezinye izimo zempilo onazo. Udokotela wakho ungumuntu ongcono kakhulu ukukutshela ukuthi yini ongayilindela kulesi simo nokuthi umbono wakho uzoba yini.

Ngenxa yokuthi lesi simo sivame ukwenzeka noma sibangelwa yizifo ezimbi noma ezisongela impilo, isimo singaba sibi. Lokhu kuyiqiniso ikakhulukazi uma sibangelwa ukwelashwa ngemisebe, noma uma unalokhu okulandelayo:

• Isifo sezinso esithuthukile noma ukwehluleka kwezinso .
• Ukwehluleka kwenhliziyo .
• Isifo sesibindi .
• Umfutho wegazi ophezulu wamaphaphu .

Ngenxa yalezi zingozi, imiphumela emihle kakhulu itholakala ngokuxilongwa nokwelashwa kusenesikhathi . Ngisho noma kwenzeka okwesikhashana, imiphumela emihle inamathuba amaningi. Ngisho nalapho, cishe abantu abangu-5% - 10% abahlinzwa bangase bangasindi (imiphumela ngokuvamile iba ngcono ezibhedlela ezikhethekile zezifo zenhliziyo).

Kodwa-ke, abantu abaningi bayalulama futhi baphila kahle . Cishe abantu abangu-80% abahlinzwa ngenxa yalesi simo baphila okungenani iminyaka emihlanu, kanti cishe abangu-60% baphila okungenani iminyaka eyishumi.

Kuzoba isikhathi esingakanani lokhu? Ngizokwazi nini ukuqhubeka nemisebenzi yami evamile?

Ukuthi lesi simo sihlala isikhathi esingakanani kuncike ohlotsheni, imbangela, kanye nokwelashwa okutholayo. Kwezinye izimo, lesi simo sizophela ngokwaso noma ngemithi. Ngokuvamile kuthatha amasonto ambalwa kuya ezinyangeni ezimbalwa. Uma isimo noma imbangela inzima kakhulu, kulapho kuzothatha isikhathi eside khona ukuthi ululame.

Ngizinakekela kanjani?

Uma unalesi simo, kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho. Lokhu kuhlanganisa:

• Thatha imithi njengoba uyalelwe : Umuthi onikezwe lesi simo kufanele uthathwe njengoba uyalelwe, futhi akuwona umqondo omuhle ukuyeka phakathi ngoba nje uzizwa ungcono.
• Landela iseluleko sokudla : Abantu abaningi kuzodingeka banciphise ukudla kwabo usawoti. I-sodium etholakala kusawoti ingabangela ukugcinwa koketshezi emzimbeni, okungenza lesi simo sibe sibi kakhulu.
• Nciphisa umsebenzi womzimba uma kudingeka : Lokhu kusiza ukunciphisa ukucindezeleka enhliziyweni yakho futhi kuvimbele futhi kunciphise umonakalo emisipheni yenhliziyo.

Kufanele ngimbone nini udokotela wami? Kufanele ngifune nini usizo lwezokwelapha?

Iningi labantu kuzodingeka liqhubeke nokubona udokotela walo kuze kube yilapho selilulama kulesi simo. Njengoba isimo sakho sithuthuka, udokotela wakho uvame ukuncoma ukunciphisa inani lezivakashi ozivakashelayo.

Uma uzizwa izimpawu zakho zibuya, noma uma izimpawu zakho zishintsha futhi ziqala ukuthinta imisebenzi yakho evamile, kufanele ushayele udokotela wakho ucingo noma wenze i-aphoyintimenti.

Kufanele ngiye nini eMnyangweni Wezimo Eziphuthumayo (i-ETU) ?

Izimpawu eziningi zalesi sifo zingavela nasezimweni eziphuthumayo zezokwelapha ezisongela ukuphila. Ngakho-ke, kufanele ufune usizo lwezokwelapha ngokushesha uma unezinye zezimpawu ezilandelayo:

• Ubunzima bokuphefumula (i-Dyspnea) .
• Ubuhlungu besifuba .
• Ukuzizwa unesizungu noma uzizwa ukhathazekile .
• Ukuquleka noma ukuquleka .

Okokugcina, izinto okufanele uzikhumbule

I-Constrictive Pericarditis yisifo esingavamile futhi esingalindelekile. Izimpawu zaso zifana nezinye izifo eziningi, ngakho-ke ngezinye izikhathi kungaba nzima ukusithola. Ngenhlanhla, ngokuthuthuka kwesayensi yezokwelapha kanye nobuchwepheshe, manje sekulula ukuhlonza lesi sifo ngeziskeni ezithile. Ukwelashwa kwalesi sifo nakho kuthuthuke kakhulu. Lokhu kusho ukuthi ezimweni eziningi, lesi sifo singelashwa, futhi ngezinye izikhathi size silapheke ngokuphelele. Ngakho-ke, uma unalezi zimpawu, kungcono ukubona udokotela bese ucela iseluleko ngaphandle kokwesaba.

I- Constrictive Pericarditis, ukuvaleka kwe-pericardium, isifo senhliziyo, ubuhlungu besifuba, ukuphelelwa umoya, ukuhlinzwa kwenhliziyo, ukuhlinzwa kwe-pericardium