Ingabe inhliziyo yakho ishaya ngokushesha ngokuzumayo? Ake sifunde ngalokhu (Junctional Tachycardia) !

Ingabe wena noma othile emndenini wakho, ikakhulukazi ingane encane, wake wabhekana nokushaya kwenhliziyo okusheshayo okungazelelwe? Noma ingabe wesaba kancane lapho udokotela ekutshela igama elithi (Junctional Tachycardia)? Ungakhathazeki. Lesi yisimo esingavamile, kodwa uma ususiqonda kalula, uzozizwa ukhululekile kakhulu. Ake sixoxe ngakho ngokuningiliziwe namuhla.

Kuyini (Junctional Tachycardia)? Kalula nje...

Kalula nje, (Junctional Tachycardia) yisimo lapho isigqi senhliziyo yethu, okungukuthi, iphethini yokushaya kwenhliziyo yethu, sihlukile kancane, futhi senzeka ngokushesha. Ukuze kube sobala, okwenzekayo lapha ukuthi ukushaya kwenhliziyo akuqali endaweni efanele, kodwa kuqala endaweni ehlukile bese kuqala ukugijima ngokushesha.

Cabanga nje, inhliziyo yethu inohlelo lukagesi. Yilokhu okunikeza inhliziyo isignali yokushaya ngesikhathi esifanele. Ngokuvamile, lesi signali siqala endaweni encane ebizwa ngokuthi (i-Sinoatrial node) phezulu kwenhliziyo. Kufana neswishi enkulu endlini yethu. Ukusuka lapho, umyalezo kagesi uhamba kuyo yonke inhliziyo futhi ubangele ukuthi imisipha yenhliziyo ifinyele futhi ishaye. Lokhu sikubiza ngokuthi (I-Normal Sinus Rhythm).

Kodwa-ke, ngezinye izikhathi uma kwenzeka okuthile kule (i-Sinoatrial node), ayikwazi ukusebenza kahle. Njengomdlali we-play lapho umdlali oyinhloko egula, enye indawo enhliziyweni, okungukuthi, i-(i-Atrioventricular node) etholakala phakathi kwamakamelo aphezulu nangaphansi enhliziyo (lokhu kungabizwa nangokuthi "ukuhlangana" kwenhliziyo), kuthatha umthwalo wokuqala ukushaya kwenhliziyo. Ngale ndlela, inhliziyo eshaya ngokushesha iqala kusukela ekuhlanganeni kwenhliziyo ibizwa ngokuthi (Junctional Tachycardia).

Ngokuvamile, uma siphumule, inhliziyo yethu ishaya izikhathi eziphakathi kuka-60 no-100 ngomzuzu. Kodwa-ke, kumuntu one-"Junctional Tachycardia", inhliziyo ishaya izikhathi ezingaphezu kuka-100 ngomzuzu, ngezinye izikhathi ishesha kakhulu.

Yiziphi izinhlobo eziyinhloko ze-(Junctional Tachycardia)?

Lokhu kuphazamiseka kwesigqi senhliziyo kungenzeka ngezindlela ezimbili eziyinhloko.

1. I-Primary noma i-Congenital (i-Junctional Tachycardia)

Lolu uhlobo olungavamile kakhulu. Ezinye izingane zingaba nalesi simo lapho zizalwa. Uma lokhu kwenzeka, amakamelo aphansi ('ama-ventricles') enhliziyo yengane angashaya ngesivinini esikhulu kakhulu, cishe izikhathi ezingu-200 kuya kwezingu-250 ngomzuzu. Lesi yisimo esibi kakhulu.

2. I-Secondary noma i-Postoperative (Junctional Tachycardia)

Lolu uhlobo oluvame kakhulu. Lungenzeka, ikakhulukazi ezinganeni ezincane ezinenkinga yenhliziyo ezizalwa nazo ngemva kokuhlinzwa ukuze kulungiswe. Isibonelo, ezinye izingane ezihlinzwa ukuze kulungiswe isimo senhliziyo esibizwa ngokuthi iTetralogy of Fallot zingase zibe nalesi simo. Lungenzeka phakathi kuka-5% no-11% wezingane ezihlinzwayo.

Ingabe i-(Junctional Tachycardia) iyi-(SVT)?

Yebo, (Junctional Tachycardia) uhlobo lwe-(SVT). (SVT) imele (Supraventricular Tachycardia). Okusho ukuthi, ukushaya kwenhliziyo okusheshayo okuqala emakamelweni aphezulu enhliziyo (ngaphezu kwe-Ventricles).

Ubani othinteka kakhulu yilesi simo?

I-Junctional Tachycardia ayivamile kubantu abadala. Kodwa-ke, ivame kakhulu ezinsaneni nasezinganeni ezincane. Njengoba kushiwo ngaphambili, ingenzeka ngenxa yesizathu sokuzalwa (esingavamile kakhulu) noma ngemva kokuhlinzwa kwenhliziyo.

Ziyini izimpawu? Sizibona kanjani?

Ngezinye izikhathi lesi simo singaba khona ngaphandle kwezimpawu. Kodwa uma kuvela izimpawu, zingabandakanya:

• Ukushaya kwenhliziyo : Kungase kuzwakale sengathi othile ugijima esifubeni sakho, noma sengathi inhliziyo yakho ishaya kancane noma kabili.
• Ukuzungeza : Ungase uzizwe uzungeza futhi ube nobunzima bokuma.
• Ukuquleka : Ungalahlekelwa ingqondo ngokuzumayo bese uwe.
• Ukuzizwa ukhathele kakhulu : Ungase uzizwe ukhathele kakhulu kangangokuthi awukwazi ukwenza lutho.

Uma lezi zimpawu zikhona, ikakhulukazi enganeni encane, kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha.

Yiziphi izimbangela ze-(Junctional Tachycardia)?

Kunezizathu eziningana ezingaphazamisa "i-Sinoatrial node" enhliziyweni yethu ukuze ikhiqize kahle izimpawu zikagesi. Yingakho kwenzeka i-"Junctional Tachycardia".

Isibonelo, lesi simo singabangelwa ubuthi bomuthi (Digoxin) (amagama omkhiqizo Cardoxin® noma Digitek®).

Nazi ezinye izizathu ezimbalwa:

• I-Myocarditis : Ukuvuvukala kwemisipha yenhliziyo.
• Ukuhlaselwa yinhliziyo .
• Ukufakelwa kwevalvu yenhliziyo noma olunye ukuhlinzwa kwenhliziyo.
• Isifo senhliziyo esizalwa naso : Lesi yimbangela engavamile.
• Ukususwa kwe-catheter kuyindlela yokwelapha enye inkinga yesigqi senhliziyo.
• Isifo seLyme .

Ungayibona kanjani i-(Junctional Tachycardia)?

Isivivinyo esiyinhloko sokuthola lesi simo yi-(Electrocardiogram - ECG). Lokhu kurekhoda umsebenzi kagesi wenhliziyo. Umuntu one-(Junctional Tachycardia) uzoba ne-P wave engekho ku-ECG. Leli P wave liwuphawu lokuthi inhliziyo iqala ukushaya kusukela ku-(Sinoatrial node).

Ngaphezu kwe-ECG, udokotela wakho uzothatha umlando wakho wezokwelapha ophelele. Angase futhi acele ukuhlolwa okwengeziwe, njengokuhlolwa kwegazi kanye ne-echocardiogram, okuyi-ultrasound yenhliziyo.

Iphathwa kanjani?

Ukwelashwa kuncike embangela yesimo kanye nezimpawu zakho. Uma isigqi esingajwayelekile siqale ngemva kokuhlinzwa kwenhliziyo, udokotela wakho angase:

• Ukulungisa ukungalingani kwama-electrolyte emzimbeni.
• Hlola ukuthi unemfiva yini, futhi uma kunjalo, yelaphe.
• Ukunikeza imithi yokwehlisa izinga lokushaya kwenhliziyo.

Kunezinye izindlela zokwelapha:

• Imithi yokwehlisa izinga lokushaya kwenhliziyo noma ukuyibuyisela esilinganisweni esijwayelekile, njenge-(Amiodarone) (amagama omkhiqizo athi Cordarone® noma Pacerone®), inganikezwa.
• Izindlela zokwelapha ezibizwa ngokuthi (Catheter ablation) noma (Cryoablation) nazo ziyi. Kulokhu, kufakwa i-catheter endaweni yenhliziyo ebangela izimpawu zikagesi ezingajwayelekile futhi ibhubhise leyo ndawo. (Cryoablation) iyindlela esebenzisa ukubanda okukhulu.
• Ukuhamba kwe-atrial ngokweqile: Umzamo wokubuyisela isigqi senhliziyo esimweni esijwayelekile usebenzisa idivayisi yangaphandle, njenge-pacemaker.

Ingabe kukhona izinkinga ekwelashweni?

Ngemva kokwelashwa nge-(Catheter ablation), ngezinye izikhathi lesi sigqi esingajwayelekile singabuya. Futhi, nge-(Catheter ablation) kubantu abadala, kunengozi ye-(Atrioventricular block) (okungukuthi, ukuvaleka komqhubi olandelayo ophethe isignali kagesi ngemva kwe-(Sinoatrial node)). Ngenxa yokuthi le ngozi iphansi, odokotela ngezinye izikhathi basebenzisa indlela ye-(Cryoablation). Uma ukwelashwa kwe-(Ablation) kungaphumeleli ngemva kwezikhathi ezimbili, kungadingeka futhi ukuthi ufakwe i-(Pacemaker) (idivayisi encane elawula ukushaya kwenhliziyo).

Kuthatha isikhathi esingakanani ukululama kulezi zindlela zokwelapha?

Ngokuvamile, ngemva kokukhipha i-catheter, ungaya ekhaya bese uqhubeka nemisebenzi yakho evamile ngokushesha. Kodwa-ke, kungase kudingeke ulinde izinsuku ezimbalwa ngaphambi kokwenza noma yimiphi imisebenzi enzima. Udokotela wakho uzokunikeza imiyalelo eqondile ngalokhu.

Ingabe ingozi ye-(Junctional Tachycardia) ingancishiswa?

Odokotela banganciphisa ingozi yokuthola i-Junctional Tachycardia ngokunikeza imithi ethile ngaphambi noma ngesikhathi sokuhlinzwa. Isibonelo:

• (I-Magnesium)
• (Propranolol) (amagama omkhiqizo Inderal®XL noma InnoPran®XL)
• (Dexmedetomidine) (Ngezinye izikhathi lokhu kusetshenziswa ngesikhathi sokuhlinzwa kwenhliziyo ezinganeni ezincane)

Yini umuntu one-(Junctional Tachycardia) angayilindela?

Uma imbangela yalesi sigqi esingavamile isitholakele futhi selashwa, izimpawu zizothuthuka kancane kancane. Kodwa-ke, kuzodingeka uhlale esibhedlela kuze kube yilapho isimo sakho se-"Junctional Tachycardia" sithuthuka.

Umphumela (Umbono) walesi simo uyahlukahluka kuye ngohlobo.

• I-Primary noma Congenital (Junctional Tachycardia)Lesi simo kunzima ukuselapha. Singabangela nezimo ezibucayi ezifana (Ukwehluleka kwenhliziyo) (ukwehluleka kwenhliziyo), (Ukuvinjwa kwenhliziyo okuphelele) (ukuvinjwa ngokuphelele kwezimpawu zikagesi zenhliziyo), kanye (I-Ventricular fibrillation) (ukushaya okungalawulwa kwamagumbi angaphansi enhliziyo). Uma kungelashwa, kunethuba elingu-9% lokufa. Kodwa-ke, uma lesi sigqi siqala ngemva kwezinyanga eziyisithupha zokuqala zokuphila, umphumela uba ngcono kakhulu.
• I-Secondary noma i-Postoperative Junctional Tachycardia ivame ukwenzeka ezinsukwini ezimbili kuya kwezintathu ngemva kokuhlinzwa, kodwa ivame ukuphela phakathi nesonto. Ingabangela umfutho wegazi ophansi, isiyezi, kanye nokulahlekelwa ukwazi.

Kufanele ngimbone nini udokotela?

Kufanele ubone udokotela wakho ukuze uthole i-aphoyintimenti yokulandelela emavikini amabili ngemuva kokubuya esibhedlela. Kufanele futhi uqhubeke nokuthola ukwelashwa kwesimo esiyisisekelo esibangele i-junctional tachycardia.

Kufanele ngiye nini egumbini lezimo eziphuthumayo (ER)?

Uma uke wakhishwa i-catheter, funa iseluleko sezokwelapha ngokushesha uma uba nanoma yiziphi izimpawu ezilandelayo endaweni yokufaka i-catheter (ngokuvamile i-groin):

• Uma kungazelelwe kuvuvukala.
• Uma ukopha kungayeki ngisho nangemva kokukucindezela nokubamba.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma uthola ukuthi wena noma ingane yakho inalesi simo, kuyinto evamile ukuba nemibuzo eminingi. Ungesabi ukubuza udokotela wakho ngalezi zinto:

• Uhlobo luni lwe-Junctional Tachycardia ingane yami/mina enalo?
• Yikuphi ukwelashwa okungcono kakhulu kwesimo sami?
• Ingabe kukhona ithuba lokuthi nezinye izingane zami nazo zizoba nalesi simo?

Uma ingane yakho ine-Junctional Tachycardia, buza udokotela wakho ngezimpawu bese uziqonda. Ngemuva kwalokho, uma kwenzeka into efana nale futhi, ungayibona ngokushesha. Ungesabi ukubuza imibuzo mayelana nokwelashwa ingane yakho ekutholayo kanye nezingozi ezihilelekile. Ukuqaphela konke lokhu kuzokusiza ukuthi wenze izinqumo ezinhle kakhulu ngenhlalakahle yengane yakho.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Ungesabi uma uzwa igama elithi (Junctional Tachycardia). Lena inkinga ngesigqi senhliziyo, kodwa:

• Lokhu kungatholakala. Lokhu kungatholakala ngokuhlolwa okufana ne-ECG.
• Kunezindlela zokwelapha. Kuye ngembangela, ingalawulwa ngemithi noma izindlela ezifana nokuthi (Ablation).
• Uhlobo oluvelayo, ikakhulukazi ngemva kokuhlinzwa, luvame ukuba olwesikhashana. Luzophola ezinsukwini ezimbalwa.
• Khuluma nodokotela wakho ngokukhululekile. Khuluma nodokotela wakho ngayo yonke imibuzo yakho kanye nokwesaba kwakho bese uzizwa ukhululekile.

Into ebaluleke kakhulu ukukhumbula ukuthi awuwedwa. Odokotela nabasebenzi bezempilo bahlala bekulungele ukukusiza.

Ngikufisela impilo enhle wena nomndeni wakho!

Ukushaya kwenhliziyo , Isifo Senhliziyo, I-Tachycardia, Isifo Senhliziyo Sezingane, I-ECG, Ukuhlinzwa Kwenhliziyo, I-Junctional Tachycardia