Ingabe unezinkinga ngesigqi senhliziyo yakho? Ake sixoxe nge-Heart Block!

Wake waba nobuhlungu esifubeni, ukuphelelwa umoya, noma umuzwa wokuthi inhliziyo yakho ishaya ngendlela engajwayelekile? Kungenzeka ukuthi uke wazizwa unesiyezi noma uqulekile. Lokhu kungaba ngezinye izikhathi izimpawu zesimo esibizwa ngokuthi 'i-heart block', esenzeka lapho izimpawu zikagesi enhliziyweni zingahambi kahle. Namuhla, sizoxoxa ngalokhu ngokuningiliziwe, kodwa kalula, njengokungathi ukhuluma nomngane.

Kuyini i-Heart Block? Kalula nje...

Cabanga ngakho njengomshini omncane odinga ugesi ukuze usebenze. Ngendlela efanayo, inhliziyo yethu nayo inohlelo lwesignali kagesi okufanele ilushaye. Lezi zibonakaliso ziqala emakamelweni amabili aphezulu enhliziyo (esiwabiza ngokuthi `(Atria)`) bese ziya emakamelweni amabili aphansi enhliziyo (`(Ventricles)`). Phakathi kwala makamelo aphezulu naphansi, njengesibani sethrafikhi, kukhona indawo elawula izimpawu. Ibizwa ngokuthi `(AV node)` (atrioventricular node).

Manje, ukuvimba kwenhliziyo yilapho kukhona uhlobo oluthile lokuvinjelwa endleleni izimpawu zikagesi ezihamba ngayo kusukela phezulu kuya phansi kwenhliziyo. Mhlawumbe izimpawu zihamba kancane, noma ezinye zezibonakaliso azifiki emakamelweni aphansi, noma izimpawu ziyeka ukuhamba ngokuphelele.

Kwenzekani-ke? Inhliziyo ingase ingasebenzi kahle. Inhliziyo ingase ishaye kancane, futhi okunye ukushaya kungase kweqiwe. Ezimweni ezimbi kakhulu, lokhu kungaphazamisa ukumpompa kwegazi emzimbeni wonke, okubangela izinkinga ezinkulu. Lesi simo sivame ukwenzeka kamuva ekuphileni, kunokuba sibe khona ekuzalweni. Lokhu kubizwa nangokuthi ``Atrioventricular (AV) block`` futhi ngezinye izikhathi kubizwa ngokuthi ``conduction disorder``.

Ingabe kukhona izinhlobo ze-heart block?

Yebo, lawa ma-heart blocks angafika ngezindlela ezahlukene nangamazinga ahlukene. Okusho ukuthi, ahlukaniswa ngokwezinga lesignali kagesi evalwe ngalo nokuthi kwenzeka kangaki.

• Ukuvinjwa kwenhliziyo kwezinga lokuqala: Kulesi simo, isignali kagesi iya emakamelweni aphansi enhliziyo (ama-ventricle), kodwa ihamba kancane. Kuba nokulibaziseka okuncane njengoba idlula ku-node ye-AV. Lolu uhlobo lokuvinjwa oluthambile kakhulu. Abantu abaningi abazi nokuthi banalo.
• Ukuvinjwa kwenhliziyo kwesigaba sesibili (okungaphelele): Kulokhu, ezinye zezimpawu zikagesi zenhliziyo kuphela ezifinyelela emakamelweni aphansi, hhayi zonke. Kukhona nezinhlobo ezimbili zalokhu:
• Uhlobo I, `(Mobitz Uhlobo I)` noma `(Wenckebach's AV block)`: Lolu uhlobo olungabalulekile kangako. Isignali kagesi yehla kancane kancane, ekugcineni yeqa ukushaya kwenhliziyo okukodwa.
• Uhlobo II (Uhlobo II), `(Uhlobo lwe-Mobitz II)`: Kulokhu, yize iningi lezimpawu liya emakamelweni, ngezinye izikhathi ezinye zezibonakaliso ziyama ngokuzumayo. Bese ukushaya kwenhliziyo kuba okungajwayelekile, kushaya kancane kunokujwayelekile. Lokhu kungathi sína kakhulu , futhi ungadinga `(I-Pacemaker)` (idivayisi encane esiza ukugcina inhliziyo ishaya ngesivinini esijwayelekile).
• Ukuvinjwa kwenhliziyo kwesigaba sesithathu: Lokhu kuvinjwa okuphelele.Izimpawu zikagesi ezivela emakamelweni aphezulu enhliziyo (`(Atria)`) kuya emakamelweni aphansi (`(Ventricles)`) azidluli. Lokhu kuthinta kakhulu indlela inhliziyo epompa ngayo igazi emzimbeni. Lesi yisimo esibi kakhulu , futhi ukwelashwa cishe njalo kudinga i-`(Pacemaker)`.

Ziyini izimpawu zalokhu?

Izimpawu zokuvinjwa kwenhliziyo zingahluka kumuntu nomuntu, kuye ngokuthi ivinjwa kangakanani nokuthi lithinta kanjani ukusebenza kwenhliziyo.

Izimpawu ezivame ukubonakala yilezi:

• Ubuhlungu besifuba
• Ukukhathala, ukukhathala
• Ubunzima bokuphefumula
• Ukuzizwa sengathi inhliziyo yakho ishaya ngokushesha (ukushaya kwenhliziyo)
• Isilinganiso sokuphefumula esikhulayo
• Isicanucanu
• Isiyezi, ukuzizwa sengathi uyajikeleza.
• Ukulahlekelwa ukwazi (ukuquleka)

Kodwa-ke, abantu abanesifo senhliziyo esibizwa ngokuthi yi-first degree bangase bangabi nazimpawu. Ngezinye izikhathi kutholakala lapho udokotela enza i-electrocardiogram (EKG) ngesikhathi sokuhlolwa okuvamile.

Ekuvinjweni kwenhliziyo kwesigaba sesithathu, izimpawu zingaba zimbi kakhulu, njengoba izinga lokushaya kwenhliziyo lehla kakhulu. Uma unezimpawu ezibucayi, kubalulekile ukufuna usizo lwezokwelapha ngokushesha.

Ziyini izimbangela zokuvinjwa kwenhliziyo?

Kunezinto eziningana ezingaba nomthelela ekuvinjweni kwenhliziyo. Ezinye zezimbangela eziyinhloko yilezi:

• Isifo senhliziyo
• Isifo semithambo ye-Coronary (CAD)
• Isifo semisipha yenhliziyo (`I-Cardiomyopathy`)
• Izifo ze-valve yenhliziyo
• Umonakalo ongachazeki ohlelweni lokubonisana lukagesi lwenhliziyo
• Izinkinga zesakhiwo senhliziyo yokuzalwa
• Ukulimala kwenhliziyo ngesikhathi sokuhlinzwa kwenhliziyo okuvulekile
• Imiphumela emibi yemithi ethile (isb., imithi efana ne-`(Beta-blockers)`, `(Digitalis)`, `(Calcium channel blockers)`)
• Ukuchayeka ebuthi
• Ukuphefumula kobuthongo okuvimbelayo (OSA)
• Isifo se-thyroid
• Ezinye izifo, isibonelo `(isifo seLyme)`
• Izifo ezizenzakalelayo
• Ukukhubazeka kwezakhi zofuzo

Ubani osengozini enkulu yalokhu?

Ungase ube sengozini enkulu yokuba nesifo senhliziyo uma:

• Uma unezinye izifo zenhliziyo, njengesifo semithambo yenhliziyo noma isifo se-valve yenhliziyo.
• Uma wazalwa unesimo senhliziyo esingavamile.
• Uma unesifo esithinta inhliziyo, njenge-`(Rheumatic heart disease)` noma `(Sarcoidosis)`.
• Uma "i-vagus nerve" yakho (i-nerve esiza ukulawula ukushaya kwenhliziyo yakho) isebenza ngokweqile futhi yehlisa ukushaya kwenhliziyo yakho.
• Uma uthatha imithi enciphisa ijubane lezimpawu zikagesi zenhliziyo. Lokhu kungafaka phakathi imithi yesifo senhliziyo kanye nomfutho wegazi ophakeme (isib. `(Beta-blockers)`, `(Diuretics)`, `(Calcium channel blockers)`, `(Digoxin)`), imithi yokushaya kwenhliziyo okungajwayelekile (`(Antiarrhythmics)`), imithi yokuphumula kwemisipha, amaphilisi okulala, kanye nemithi yokucindezeleka kanye nesifo sengqondo.

Yiziphi izinkinga ezingabangelwa yilokhu?

Uma ukuvinjwa kwenhliziyo kungelashwa kahle, kungaholela ezinkingeni ezingasongela impilo. Lokhu kufaka phakathi:

• Ukwehluleka kwenhliziyo (ukungakwazi kwenhliziyo ukupompa igazi elanele emzimbeni)
• Ukushaya kwenhliziyo okungajwayelekile (`Arrhythmia`)
• Isifo senhliziyo
• Ukuma kwenhliziyo ngokuzumayo (ukuyeka kwenhliziyo ngokuzumayo)

Indlela yokuxilonga i-heart block?

Ukuze athole ukuthi unesifo senhliziyo, udokotela wakho uzokwenza okulandelayo:

• Umlando wakho wezokwelapha uzobuyekezwa.
• Buza ngomlando wempilo yomndeni wakho.
• Bazokubuza imibuzo mayelana nempilo yakho iyonke, imikhuba yokudla, imikhuba yokuzivocavoca, kanye nezimpawu.
• Babuza ngemithi oyithathayo (yomibili leyo oyinikezwe udokotela wakho kanye naleyo oyithenga ekhemisi).
• Bayakubuza ukuthi uyabhema noma usebenzisa ezinye izidakamizwa.
• Bazolalela inhliziyo yakho futhi bahlole ukushaya kwenhliziyo yakho.
• Hlola izimpawu zokuhlaselwa yinhliziyo (isib. ukuvuvukala emilenzeni nasemaqakaleni).

Udokotela wakho wenhliziyo angakudlulisela ku-electrophysiologist (uchwepheshe wokusebenza kukagesi kwenhliziyo).

Hlobo luni lokuhlolwa oluzokwenziwa?

Ukuze uhlole lesi simo ngokunembile, ungenza izivivinyo ezilandelayo:

• Ukuhlolwa kwegazi
• Ukuhlolwa kofuzo
• I-Electrocardiogram (EKG)
• I-Ambulatory monitor (idivayisi encane eqopha izinga lokushaya kwenhliziyo yakho izinsuku eziningana)
• I-Loop recorder (idivayisi eqapha ukushaya kwenhliziyo isikhathi eside)
• Ucwaningo lwe-Electrophysiology (indlela ekhethekile ehlola uhlelo lukagesi lwenhliziyo)
• Isivivinyo sokucindezeleka kokuzivocavoca (`Isivivinyo sokucindezeleka kokuzivocavoca` - sibheka ukuthi inhliziyo isebenza kanjani ngesikhathi sokuzivocavoca)

Iphathwa kanjani?

Ukwelashwa kokuvinjwa kwenhliziyo kuyahlukahluka kuye ngomuntu nomuntu. Ungase ulaliswe esibhedlela ukuze uqaphe inhliziyo yakho. Ukuze uphathe isimo sakho, udokotela wakho wenhliziyo uzocabangela okulandelayo:

• Uhlobo luni lwe-heart block olunayo?
• Kubaluleke kangakanani?
• Kuthinta kanjani ukusebenza kwenhliziyo yakho?
• Ziyini izimpawu zakho?

Ngezinye izikhathi, ukuvinjelwa kwenhliziyo kuyaphela uma ushintsha imithi oyithathayo noma welapha esinye isifo senhliziyo. Kodwa abanye bangadinga i-pacemaker, okwesikhashana noma unomphela, ukuze bathumele izimpawu zikagesi enhliziyweni.

• Ukuvinjelwa kwezinga lokuqala: Cishe ngeke udinge ukwelashwa.
• Ukuvaleka kwezinga lesibili: Uma unohlobo I, cishe ngeke udinge ukwelashwa. Kodwa uma unezimpawu, ungase udinge i-pacemaker yesikhashana noma ehlala njalo ukuze ugcine inhliziyo yakho ishaya kahle.
• Ukuvaleka kwezinga lesithathu: Abantu abanalolu hlobo cishe njalo badinga i-pacemaker.

Uma udinga i-pacemaker, udokotela wakho uzokutshela ngayo, uhlobo olufanele wena, nokuthi yini ongayilindela ngaphambi, ngesikhathi, nangemva kokufakwa kwe-pacemaker.

Yiziphi izinkinga/imiphumela emibi yokwelashwa?

Uma une-pacemaker yesikhashana noma ehlala njalo, ungase ube nemiphumela emibi efana nalokhu:

• Izinkinga ngohlelo lwedivayisi
• Ukungasebenzi kahle kwemishini
• Ukutheleleka
• Amahlule egazi
• Ukulimala kwenhliziyo

Kuthatha isikhathi esingakanani ukululama kulokhu kwelashwa?

Ngemva kokufakwa kwe-pacemaker, kuzodingeka uhlale esibhedlela cishe ubusuku obubodwa. Kufanele ukwazi ukuqhubeka nemisebenzi yakho evamile zingakapheli izinsuku noma amasonto ambalwa. Buza udokotela wakho ngalokho okungafanele ukwenze ngemva kokuhlinzwa.

Ingabe ukuhlaselwa yinhliziyo kungavinjelwa?

Ungavimbela ezinye zezimbangela zokwehluleka kwenhliziyo, njengesifo senhliziyo.

Izinto ongazenza ukuze ugcine inhliziyo nomzimba wakho uphilile ngangokunokwenzeka:

• Phila impilo enempilo yenhliziyo. Lokho kusho ukudla ukudla okunempilo kwenhliziyo, ukuvivinya umzimba njalo , ukulala ngokwanele njalo ebusuku, ukunciphisa ukucindezeleka, ukunciphisa utshwala, nokugwema ukubhema nokusebenzisa izidakamizwa.
• Khuluma nodokotela wakho ngemithi kanye nezithasiselo ozithathayo. Angahlola ukuthi kukhona yini okuthathayo okushintsha amazinga ajwayelekile ezinto ezithile emzimbeni wakho (njenge-potassium, i-calcium, ne-magnesium, ezibalulekile ohlelweni lukagesi lwenhliziyo). Udokotela wakho angashintsha imithi yakho uma kudingeka.

Kwenzekani uma nginesifo senhliziyo?

Uma une-heart block yezinga lokuqala, buza udokotela wakho wenhliziyo noma i-electrophysiologist uma udinga ukwenza noma yiziphi izinguquko endleleni yakho yokuphila noma emithini. Lolu hlobo lwe-heart block aluvami ukuphazamisa imisebenzi yakho evamile.

Ngokuvamile, ukuba ne-pacemaker akukunciphisi kakhulu ikhono lakho lokuhlanganyela kwezemidlalo nezinto zokuzilibazisa. Kodwa-ke, kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ukuqinisekisa ukuthi i-pacemaker yakho isebenza kahle.

Kuhlala isikhathi esingakanani ukuvimba kwenhliziyo?

Ukuthi ukuvimba kwenhliziyo yakho kuzohlala isikhathi esingakanani kuncike embangela. Ukufaka omunye umuthi esikhundleni somuthi obangela ukuvimba kwenhliziyo kungase kuxazulule inkinga. Kodwa uma ukuvimba kwenhliziyo kubangelwa okunye, kungenzeka kube yisimo sokuphila konke.

Iyini inhloso yokuvimba kwenhliziyo?

Ukuvaleka kwenhliziyo kuyisimo esingaba yingozi kakhulu. Uma kungelashwa, ukuvaleka kwenhliziyo okukhulu kungaholela ekumisweni kwenhliziyo ngokuzumayo. Kodwa ngokuvamile, ukuvaleka kwenhliziyo okungalashwanga kungabangela isiyezi noma ukuquleka.

Ngokwelashwa, isimo sakho sincike eminyakeni yakho kanye nezinye izimo zezokwelapha onazo.

Kufanele ngizinakekele kanjani? (Ikakhulukazi uma une-pacemaker)

Uma une-pacemaker, khumbula lezi zinto ezilandelayo:

• Hlala kude namadivayisi kazibuthe nanoma iyiphi idivayisi ekhipha insimu kagesi. Lokhu kusho ukuhlala okungenani amasentimitha angu-1.5 kude namafoni eselula. Isibonelo, ungagcini ifoni yakho ephaketheni lehembe lakho.
• Uma udlula ezindaweni zokuhlola ezokuphepha (isib. izikhumulo zezindiza, izinkantolo), tshela abahloli ukuthi une-pacemaker futhi kufanele ugweme ukusebenzisa izinduku eziphathwa ngesandla. Hlala uphethe ikhadi elichaza uhlobo lwe-pacemaker yakho.
• Tshela bonke abahlinzeki bakho bezempilo (odokotela, odokotela bamazinyo) ukuthi une-pacemaker. Ezinye izinqubo zezokwelapha, njengokuhlolwa kwe-magnetic resonance imaging (MRI), zingaphazamisa i-pacemaker yakho. Ngemva kwezinhlobo ezithile zokuhlinzwa, udokotela wakho kungadingeka ukuthi ahlele kabusha i-pacemaker yakho.

Kunini lapho udinga ukubonana nodokotela?

Uma une-pacemaker, udokotela wakho wenhliziyo uzoyihlola njalo ukuqinisekisa ukuthi iyaqhubeka nokusebenza kahle. Bangakuqapha ukude, kodwa usazodinga ukuvakashelwa mathupha minyaka yonke lapho udokotela wakho angahlola khona i-pacemaker yakho futhi enze noma yiziphi izinguquko ezidingekayo.

Shayela udokotela wakho uma uhlangabezana nanoma yiziphi zalezi zimpawu:

• Isiyezi noma ukuquleka
• Ubuhlungu besifuba
• Ukushaya kwenhliziyo noma ukushaya kwejubane
• Ubuthakathaka
• Ubunzima bokuphefumula
• Ukuvuvukala kwezinyawo, amaqakala, noma imilenze

Kunini lapho kudingeka uye e-Emergency Treatment Unit (ETU) ?

Uma uhlaselwa yisifo senhliziyo noma ukwehluleka kwenhliziyo, udinga usizo lwezokwelapha ngokushesha. Yazisa umndeni wakho kanye nosebenza nabo ngale ngozi (kanye nezimpawu). Bangashayela u-1990 (noma inombolo yakho yesimo esiphuthumayo yendawo).

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Eminye imibuzo ongayibuza udokotela wakho:

• Uhlobo luni lwe-heart block enginalo?
• Ingabe ngidinga ukwelashwa?
• Yikuphi ukwelashwa okungcono kakhulu kimi?
• Uma ingane yami inesifo senhliziyo esizalwa naso, ingabe izingane zami zesikhathi esizayo nazo zingaba naso?

Kuvamile ukuzizwa wesaba uma unesifo esifubeni noma uphefumula kanzima. Kodwa uma kutholakala ukuthi une-heart block, ungaqonda ukuthi kungani unalezo zimpawu. Izindaba ezinhle ukuthi kulabo abadinga ukwelashwa, imithi noma i-pacemaker kungasiza ukugcina inhliziyo yakho ishaya ngendlela evamile. Lapho uxoxa ngohlelo lwakho lokwelashwa, qiniseka ukuthi ubuza udokotela wakho nganoma yini engacacile.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Ukuvinjwa kwenhliziyo kuyinkinga ohlelweni lukagesi lwenhliziyo. Kungaba yinkinga encane kuya kwenkulu kakhulu. Uma uba nezimpawu, ikakhulukazi ubuhlungu besifuba, ukuphelelwa umoya, noma ukuquleka, bheka udokotela ngokushesha.

Ngenhlanhla, kunezindlela zokwelapha lokhu. Abanye abantu bathola impumuzo ngokushintsha imithi, kanti abanye bangaphila impilo evamile nge-pacemaker. Into ebaluleke kakhulu ukunakekela inhliziyo yakho, ulandele imiyalelo kadokotela wakho, bese ubuza udokotela wakho uma unemibuzo. Awuwedwa, futhi kukhona odokotela abangakusiza kulolu hambo.

Ukuvinjwa Kwenhliziyo , Ukushaya Kwenhliziyo, I-Pacemaker, Izimpawu Zenhliziyo, Isifo Senhliziyo, Impilo Yenhliziyo