Ingabe izinkinga zamaphaphu nazo zithinta uhlangothi lwesokudla lwenhliziyo yakho? (Cor Pulmonale / Right-Sided Heart Failure) Ake sixoxe ngalokhu!

Ingabe ngezinye izikhathi uzizwa uphelelwa umoya, noma uzizwa into engavamile esifubeni sakho? Mhlawumbe awucabangi ngisho nangalokho, inkinga ngamaphaphu akho ingathinta nenhliziyo yakho. Yilokho esizokhuluma ngakho namuhla. Lokhu kubizwa ngokuthi 'i-Cor Pulmonale' noma 'ukwehluleka kwenhliziyo ohlangothini lwesokudla'. Ungakhathazeki, sizokhuluma ngalokhu kalula.

Kuyini 'iCor Pulmonale'?

Kalula nje, i-'Cor Pulmonale' yisimo emaphashini akho esibangela ukuthi uhlangothi lwesokudla lwenhliziyo yakho, i-ventricle yesokudla , lukhule futhi lungakwazi ukusebenza kahle, okwenza inhliziyo yakho ibe buthaka kancane kancane. Empeleni lolu uhlobo 'lokwehluleka kwenhliziyo ohlangothini lwesokudla' .

Manje, bheka, yilokhu okwenzekayo ngokuvamile. I-ventricle yangakwesokudla yenhliziyo yakho ipompa igazi liye emaphashini ukuze lithathe umoya-mpilo. Leli gazi lihamba ngomthambo wegazi obizwa ngokuthi umthambo wamaphaphu . Kodwa-ke, ngenxa yezifo ezithile zamaphaphu, umfutho wegazi ngaphakathi kwalo mthambo wamaphaphu uyanda kakhulu. Kufana nepayipi lamanzi elivalekile. Ngemuva kwalokho i-ventricle yangakwesokudla kufanele isebenze kanzima ukuze ipompe igazi liye emaphashini.

Cabanga nje, uzama ukuvula umnyango wemoto ngosuku olunomoya. Kufanele usebenzise amandla amaningi ukuze ucindezele umnyango emoyeni, akunjalo? Yilokho okwenzekayo ku-ventricle efanele. Umthambo wamaphaphu, ovame ukuba nomfutho ophansi, kufanele upompe igazi ngokumelene nomfutho ophezulu. Njengoba uqhubeka usebenza kanzima kanje, i-ventricle efanele iyakhula kancane kancane, imisipha yayo iba buthakathaka, futhi ekugcineni ayikwazi ukusebenza kahle. Yilokho esikubiza ngokuthi 'i-Cor Pulmonale'. Uyaqonda?

Ingabe zikhona izinhlobo eziyinhloko ze-'Cor Pulmonale'?

Yebo, kunezinhlobo ezimbili eziyinhloko ze-'Cor Pulmonale':

• I-'Cor Pulmonale' Engazelelwe ('Acute Cor Pulmonale'): Lesi yisimo sesikhashana, esingazelelwe. Isibonelo, singabangelwa yinto efana nokuqhekeka kwegazi emaphashini ('Pulmonary Embolism').
• I-Chronic Cor Pulmonale: Lolu uhlobo oluvame kakhulu. Lukhula kancane kancane isikhathi eside ngenxa yesifo samaphaphu.

Ivame kangakanani i-'Cor Pulmonale'?

Ngokwezibalo ezivela emazweni afana ne-United States, kuthiwa phakathi kuka-6% no-7% wezifo zenhliziyo zibangelwa yi-'Cor Pulmonale'. Kudingeka sikhathazeke ngalesi simo nasezweni lethu.

Ziyini izimpawu ze-'Cor Pulmonale'?

Ezigabeni zokuqala, ungase ungabi nazimpawu. Kodwa-ke, izimpawu zizoqala ukuvela njengoba isimo siqhubeka. Khumbula, lezi zimpawu zingezezimpawu zesifo samaphaphu esabangela i-Cor Pulmonale.

Izimpawu eziyinhloko ezingabonakala yilezi:

• Ubunzima bokuphefumula:Hhayi nje kuphela uma ukhathele kancane, kodwa ngezinye izikhathi ngisho noma umile nje, ungase uzizwe sengathi uphelelwa umoya.
• Imithambo yentamo evuvukele: Lokhu kungabonakala ikakhulukazi uma ulele phansi ikhanda lakho liphakeme kancane.
• Ukuvuvukala kwemilenze noma isisu: Amaqakala nezinyawo kungavuvukala. Ngezinye izikhathi isisu singavuvukala njengokungathi sigcwele amanzi.
• Ukuzizwa ukhathele kakhulu (`Ukukhathala`): Ungase uzizwe ukhathele kakhulu futhi ukhathele kangangokuthi awukwazi ukwenza lutho.
• Ubuhlungu besifuba: Abanye abantu bangase babe nokuqina kwesifuba noma ubuhlungu.
• Izigameko zokuquleka: Nakuba zingavamile, abanye abantu bangase baquleke futhi bawe.

Yiziphi izimbangela ze-'Cor Pulmonale'?

Imbangela eyinhloko ye-'Cor Pulmonale' izifo ezahlukahlukene zamaphaphu ezibangela umfutho wegazi ophezulu emaphashini (`Umfutho wegazi ophezulu wamaphaphu`). Okusho ukuthi, lesi simo singabangelwa yinoma yisiphi isifo samaphaphu esanda umfutho wegazi ngaphakathi kwemithambo yegazi yamaphaphu.

Nazi ezinye zezizathu eziyinhloko:

• I-COPD (`Isifo Esingapheli Sokuvimbela Amaphaphu`): Lesi yimbangela eyinhloko ye-`Chronic Cor Pulmonale`. I-COPD, uma siyibeka kalula, yisifo lapho amaphaphu onakala khona ngokuhamba kwesikhathi futhi kancane kancane kuba nzima ukuphefumula. Ivame ukubonwa phakathi kwababhemayo.
• I-Pulmonary Embolism: Ihlule legazi elakheka emthanjeni wegazi emaphashini. Lokhu kuyimbangela yokuma kwenhliziyo ngokuzumayo.
• Ukuhlinzwa noma izingozi zokususwa kwezicubu zamaphaphu: Uma ingxenye yamaphaphu kufanele isuswe ngenxa yokuhlinzwa noma ingozi.
• Umonakalo obangelwa ukuphefumula komshini: Ngezinye izikhathi iziguli ezisegumbini lokunakekelwa okujulile zingabhekana nalezi zimo.
• I-Scleroderma: Isifo esibangela ukuqina kwesikhumba kanye nezicubu ezixhumeneyo.
• I-Cystic Fibrosis: Isifo esibangelwa ufuzo esibangela ukuthi ulwelwesi lomzimba luqine.
• Izinkinga zemisipha ezithinta ukuphefumula: Ubunzima bokuphefumula ngenxa yezifo ezenza imisipha ibe buthaka.
• Ukuvaleka kwemithambo emaphashini.
• I-Pulmonary Fibrosis: Ukusha kwamanxeba emaphashini.
• I-Obstructive Sleep Apnea: Abantu abaningi abahogelayo bangase babe nale nkinga. Uma ungaphefumuli kahle, ingcindezi emaphashini akho iyanda.
• I-Kyphosis: Ukugoba komgogodla phambili okuvimbela amaphaphu ukuthi akhule kahle.

Yiziphi izici eziyingozi ze-'Cor Pulmonale'?

Kunezici eziningana ezandisa ingozi yalesi simo:

• Ukusetshenziswa kwemikhiqizo kagwayi (njengokubhema, ukuhlafuna i-betel nut): Lesi yisici esiyinhloko esiyingozi.
• Ukuphefumula umoya ongcolile nothukile: Ukungcola kwemvelo nakho kunomthelela.
• Ukuba nezifo zamaphaphu ezibangela umfutho wegazi ophezulu emaphashini.

Yiziphi izinkinga ezingaba khona ze-'Cor Pulmonale'?

Uma isimo esithi `Cor Pulmonale` singelashwa kahle, kungaba nezinkinga ezinkulu. Lokhu kusho ukuthi amathuba okuthola ezinye izifo aphezulu.

• Izigqi zenhliziyo ezingavamile.
• Ukwehluleka kwenhliziyo kwesokudla.
• Ukwehla kwamazinga omoya-mpilo emzimbeni (`Hypoxia`).
• Ukulahlekelwa ulwazi njalo.
• Isifo sezinso.
• Isifo sesibindi.
• Ngeshwa, ngisho nokufa kungenzeka.

Ngakho-ke, isimo esithi `Cor Pulmonale` akufanele sithathwe kalula. Uma unezimpawu, kubalulekile ukufuna iseluleko sezokwelapha ngokushesha.

Ungayibona kanjani i-'Cor Pulmonale'?

Uma uya kudokotela, uzokubuza ngezimpawu zakho futhi akuhlole. Angase alalele isifuba sakho nge-stethoscope futhi ezwe imisindo yenhliziyo engavamile. Uzobe eseyala ukuhlolwa okuningana ukuqinisekisa ukutholakala kwe-'Cor Pulmonale'.

Yiziphi izivivinyo zokuxilonga?

• I-Echocardiogram: Lokhu kufana nokuskena kwenhliziyo nge-ultrasound. Kungabonisa ukuthi amakamelo enhliziyo makhulu kangakanani, ukuthi izindonga zenhliziyo zijiyile kangakanani, nokuthi inhliziyo iphampa igazi kahle kangakanani. Kungabonisa nokuthi i-ventricle yesokudla ikhulisiwe yini.
• I-X-ray yesifuba: Lokhu kunganikeza umbono oqondile ngesimo samaphaphu kanye nobukhulu benhliziyo.
• I-Electrocardiogram (ECG): Lokhu kuhlola ukusebenza kukagesi kwenhliziyo. Uma i-ventricle yesokudla ikhulisiwe, izinguquko zingabonakala ku-ECG.
• Ukuthwebula izithombe ngemithi yenuzi: Lokhu kunganikeza ulwazi oluthile mayelana nokugeleza kwegazi enhliziyweni nasemaphashini.
• I-CT Angiogram: Lokhu kubaluleke kakhulu ukuhlola amahlule egazi emithanjeni yegazi yamaphaphu (i-Pulmonary Embolism).
• I-MRI Yenhliziyo: Kungatholakala isithombe esicacile sesakhiwo kanye nomsebenzi wenhliziyo.
• I-VQ scan: Ukuhlolwa okubheka ubudlelwano phakathi komoya nokugeleza kwegazi emaphashini.
• Ukufakwa kwe-catheter yenhliziyo kwesokudla: Lokhu ukuhlolwa okuyinkimbinkimbi kancane. Ipayipi elincane (i-catheter) lidluliselwa emthanjeni wegazi liye ohlangothini lwesokudla lwenhliziyo bese kulinganiswa ingcindezi lapho. Lokhu kusiza ekunqumeni ukuthi une-hypertension yamaphaphu nokuthi inzima kangakanani.

Iphathwa kanjani i-'Cor Pulmonale'?

Umgomo oyinhloko wokwelashwa kwe-'Cor Pulmonale' ukwelapha isifo samaphaphu esibangele lesi simo.Ngoba, kuphela uma leyo nkinga ixazululwa kuqala lapho umthelela enhliziyweni ungancishiswa khona.

Imigomo eyinhloko yokwelashwa yile:

• Ukunikeza inani elidingekayo lomoya-mpilo ezicutshini zomzimba wakho.
• Ukusiza i-ventricle efanele yenhliziyo yakho ukuthi isebenze kangcono.
• Ukuvimbela ukuminyana okungadingekile kwemithambo yegazi emaphashini nokuvumela igazi ukuthi ligeleze kalula.

Kubaluleke kakhulu ukuqala ukwelashwa kusenesikhathi ngaphambi kokuba kwenzeke umonakalo ongapheli enhliziyweni.

Yimiphi imithi noma izindlela zokwelapha ezithile ezisetshenziswayo?

Kunezindlela eziningana zokwelapha i-'Cor Pulmonale':

• Ukwelashwa nge-oxygen: Uma amazinga e-oxygen emzimbeni ephansi, i-oxygen inikezwa ngepayipi elifakwa ekhaleni noma nge-mask yomlomo.
• Ama-Bronchodilator: Le mithi yandisa imigudu yomoya emincane emaphashini, okwenza kube lula ukuphefumula. Isetshenziselwa ukwelapha izifo ezifana ne-asthma kanye ne-COPD.
• Ama-Corticosteroids: Le mithi isiza ekunciphiseni ukuvuvukala emaphashini.
• Ama-diuretics (amaphilisi amanzi): Le mithi isiza ekususeni uketshezi oluningi emzimbeni ngomchamo. Isetshenziselwa ukwelapha izimo ezifana nokuvuvukala kwemilenze kanye nokuvuvukala.
• Ama-Anticoagulant (ama-blood thinner): Le mithi inikezwa ukuvimbela ama-blood clots ukuthi akheke noma ancibilikise ama-clots akhona. Lokhu kubalulekile ezimweni ezifana ne-Pulmonary Embolism.
• Ukuvuselelwa kwenhliziyo: Uhlelo oluhlanganisa ukuzivocavoca, imfundo, kanye nokwelulekwa. Lokhu kusiza ukuthuthukisa impilo yenhliziyo.
• Ukuhlinzwa kwe-Embolectomy: Uma kwenzeka i-pulmonary embolism, ngezinye izikhathi kudingeka ukuhlinzwa ukuze kususwe ihlule elikhulu legazi eliye lahlala emaphashini.
• Ama-vasodilator e-pulmonary: Lena imithi ekhethekile esiza ukulawula umfutho wegazi ophezulu wamaphaphu ngokwandisa imithambo yegazi emaphashini.
• Ukufakelwa kwamaphaphu noma inhliziyo namaphaphu: Kucatshangelwa ezimweni ezimbi kakhulu lapho kungekho okunye ukwelashwa okusebenzayo.

Ingabe kukhona izinkinga noma imiphumela emibi yokwelashwa?

Njenganoma yikuphi ukwelashwa kwezokwelapha, kunemiphumela emibi noma izinkinga ezingaba khona ngesikhathi sokwelashwa kwe-'Cor Pulmonale'. Imithi oyonikezwa yona izohluka kuye ngokwelashwa okutholayo. Udokotela wakho uzokuchazela lokhu. Uma ubona noma yini engavamile, kufanele utshele udokotela wakho ngokushesha.

Hlobo luni lwempilo umuntu ono-'Cor Pulmonale' angalulindela?

Eqinisweni, abantu abaningi abane-'Cor Pulmonale' bangase babhekane nekhwalithi yokuphila enciphile kancane. Ngoba izinto ezifana nokuphelelwa umoya nokukhathala kungenza kube nzima ukwenza imisebenzi yansuku zonke. Ngisho noma ukwelashwa kwelashwa, izimpawu zingase zibuye.

I-'Cor Pulmonale' ihlala isikhathi esingakanani?

I-Cor Pulmonale ivame ukuba yisimo sesikhathi eside. Kodwa-ke, i-cor pulmonale ebukhali, ebangelwa umonakalo ovela kumshini wokuphefumula noma isimo esiphuthumayo njenge-pulmonary embolism, ingaba yesikhashana, okusho ukuthi ingelapheka uma imbangela eyinhloko isilashiwe.

Iyini inhloso ye-'Cor Pulmonale'?

Umbono (noma isibikezelo) somuntu one-cor pulmonale sincike esifweni samaphaphu esiyisisekelo. Okusho ukuthi, isifo samaphaphu sokuqala sibi kangakanani nokuthi selashwa kahle kangakanani.

Isibonelo, uma i-COPD ibangela i-'Cor Pulmonale', umbono awubi muhle kakhulu uma isifo samaphaphu singaphathwa kahle. Ngokwezibalo, abantu abangu-30% kuphela abathola i-'Cor Pulmonale' ngenxa ye-COPD abazophila eminye iminyaka emihlanu. Ngakho-ke, kubalulekile ukwelapha lesi sifo sokuqala ngendlela efanele.

Ingabe i-'Cor Pulmonale' ingavinjelwa?

Yebo, ngokugwema izifo zamaphaphu ezibangela i-'Cor Pulmonale', ungavimbela ne-'Cor Pulmonale'. Unganciphisa ingozi yakho ngokuthi:

• Gwema imikhiqizo kagwayi nogwayi ngokuphelele. Akukuhle futhi ukuba sezindaweni lapho abanye abantu bebhema khona.
• Gwema ukungcoliswa komoya. Hlala ezindaweni ezinomoya ohlanzekile ngangokunokwenzeka.
• Gwema izinto ezibangela umfutho wegazi ophezulu emaphashini.
• Uma unesifo samaphaphu, selashwe ngokushesha nangendlela efanele. Thatha umuthi wakho njengoba nje udokotela wakho ekutshelile, bese ulandela imiyalelo yakhe.

Kufanele ngizinakekele kanjani?

Uma une-'Cor Pulmonale', kubaluleke kakhulu ukuthi uzinakekele.

• Thatha umuthi onikezwe udokotela ngesikhathi esifanele. Ungaphuthelwa ngisho nosuku olulodwa.
• Gcina zonke izikhathi zokulandelela nodokotela wakho. Ungesabi ukubuza imibuzo uma unayo.
• Uma usebenzisa imikhiqizo kagwayi, yeka manje. Cela usizo kudokotela wakho.
• Ukuzivocavoca. Kodwa, buza udokotela wakho ukuthi yikuphi ukuzivocavoca okufanele wena nokuthi kufanele ukwenze isikhathi esingakanani.
• Thola imijovo engavimbela umkhuhlane noma ezinye izifo ezithinta amaphaphu.

Ingabe kukhona izinto ongeke uzidle noma uziphuze uma usebenzisa i-'Cor Pulmonale'?

Udokotela wakho angase afune ukuthi unciphise inani likasawoti kanye noketshezi oluphuzayo (njengamanzi, itiye, ikhofi, kanye nejusi yezithelo). Lokhu kungenxa yokuthi usawoti kanye noketshezi oluningi kakhulu kungabangela ukuthi umzimba wakho ugcine amanzi futhi kwandise ukuvuvukala. Ngakho-ke, landela imiyalelo kadokotela wakho ngqo.

Kufanele ngimbone nini udokotela wami?

Uma uke walaliswa esibhedlela ngenxa ye-'Cor Pulmonale', kuzodingeka ubone 'udokotela wenhliziyo' kanye 'nodokotela wezifo zamaphaphu'. Bangase bakucele ukuthi ubuye ngemva kwesonto noma amabili. Uma kukhona ushintsho ezimpawini zakho, isibonelo, uma unenkinga yokuphefumula, ukuvuvukala emilenzeni yakho, noma ubuhlungu besifuba, bona udokotela ngokushesha.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Buza udokotela wakho noma yimiphi imibuzo noma ukukhathazeka ongase ube nakho mayelana ne-'Cor Pulmonale'. Isibonelo:

• Yini engenza ngibe ne-'Cor Pulmonale'?
• Yikuphi ukwelashwa okungcono kakhulu kimi?
• Iyini ikusasa lesimo sami?
• Ngingawuvivinya kangakanani umzimba futhi hlobo luni lokuzivocavoca engingakwenza?
• Ingabe akhona amaqembu okusekelana asiza abantu ababhekene nalolu hlobo lwesimo?

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

I-'Cor Pulmonale' yisifo samaphaphu lapho i-ventricle yesokudla yenhliziyo ikhula khona futhi iba buthaka. Kuvamile ukuzizwa udabuke futhi ukhungathekile uma unesifo esenza kube nzima ukwenza imisebenzi yansuku zonke. Ezimweni ezinjalo, ungangabazi ukucela usizo emndenini nakubangane.

Udokotela wakho uzochaza izindlela zokwelapha ezifanele wena. Uma kukhona ongakuqondi nge-'Cor Pulmonale', ungesabi ukubuza. Ngokuthola isifo kusenesikhathi, ukwelashwa okufanele, kanye nokushintsha kwendlela yokuphila, ungaphila impilo enhle ngalesi simo. Izindlela ezinhle kakhulu zokuvimbela i-'Cor Pulmonale' ukuyeka ukubhema ngokuphelele nokuthola ukwelashwa kusenesikhathi kwezifo zamaphaphu.

I- Cor Pulmonale, Ukwehluleka Kwenhliziyo Okuhlangothini Lokudla, Isifo Samaphaphu, Isifo Senhliziyo, Ubunzima Bokuphefumula, I-COPD, Ukucindezeleka Komfutho Wegazi Lamaphaphu, Ukucindezeleka Komfutho Wegazi Lamaphaphu