Ingabe uhlangothi lwesobunxele lwenhliziyo yakho nalo lubuthakathaka? (Ukwehluleka Kwenhliziyo Ohlangothini Lwesobunxele) - Ake sixoxe ngalokhu!

Ingabe ngezinye izikhathi uzizwa uphelelwa umoya? Noma uzizwa uphelelwa umoya uma uhamba, ugoba, noma wenza umsebenzi othile? Ingabe kufanele uhlale phansi ebusuku ngoba uzizwa ucishiwe lapho ulala? Ingabe uvuvukele emilenzeni nasemaqakaleni akho? Lokhu kungaba ngezinye izikhathi izimpawu zohlangothi lwesobunxele olubuthakathaka lwenhliziyo. Namuhla, ake sixoxe ngalesi simo esibizwa ngokuthi `(Left-Sided Heart Failure)` ngendlela elula ongayiqonda. Ungesabi, kubaluleke kakhulu ukuqaphela lokhu.

Kuyini Ukwehluleka Kwenhliziyo Okuhlangothini Lwesobunxele?

Kalula nje, lokhu kusho ukuthi uhlangothi lwesobunxele lwenhliziyo yethu alukwazi ukwenza umsebenzi walo, okuwukupompa igazi emzimbeni wonke, ngendlela efanele. Cabanga ngakho njengephampu yamanzi. Uma ingasebenzi kahle, amanzi ngeke aye ethangini. Yileyo ndlela esebenza ngayo. Kunezinhlobo ezimbili eziyinhloko zalokhu:

1. Ukwehluleka kwenhliziyo kwe-Systolic: Lokhu kwenzeka lapho igumbi eliyinhloko lokupompa ohlangothini lwesobunxele lwenhliziyo, elibizwa ngokuthi i-ventricle yesobunxele, lifinyela futhi libe buthakathaka ngokwanele ukupompa igazi emzimbeni wonke. Lokhu kusho ukuthi inani legazi elipompa inhliziyo (ingxenye yokukhipha) liyancipha. Njengoba nje lapho amandla enjini enganele, ingcindezi epompa amanzi iyancipha.

2. Ukwehluleka kwenhliziyo okubangelwa yi-diastolic: Lesi yisimo esihlukile. Nakuba i-ventricle yesobunxele inamandla, ayiphumuli kahle futhi ayeluli kakhulu njengoba kufanele ukuze igcwale igazi. Lokhu kusho ukuthi igumbi lenhliziyo liyaqina. Kufana nokuzama ukugcwalisa ibhaluni eliqinile nelingenakuguquguquka ngamanzi, futhi kuba nobunzima bokugcwalisa ngegazi. Kulesi simo, inani legazi eliphampa inhliziyo (ingxenye yokukhipha) lingase libe elijwayelekile.

Usuyaqonda umehluko phakathi kwalezi zinhlobo ezimbili manje?

Izinhlangothi zesobunxele nesokudla zenhliziyo yethu zisebenza kanjani?

Inhliziyo yethu iyisitho esimangalisayo ngempela. Isebenza njengephampu enamandla, isebenza ngokungayeki. Inezinhlangothi ezimbili eziyinhloko, uhlangothi lwesobunxele nohlangothi lwesokudla. Uhlangothi ngalunye lwenza umsebenzi ohlukile.

• Uhlangothi lwesobunxele: Lolu hlangothi luyisici esiyinhloko endabeni yethu. Uhlangothi lwesobunxele lwenhliziyo luthola igazi elihlanzekile elinomoya-mpilo elivela emaphashini. Leli gazi bese lisakazwa kuwo wonke umzimba, kusukela ebuchosheni kuya ezinyaweni, kuzo zonke izitho, imisipha, kanye nezicubu. Lo moya-mpilo unikeza yonke ingxenye yomzimba wethu amandla nokuphila ekudingayo ukuze yenze umsebenzi wayo.

• Uhlangothi lwesokudla: Uhlangothi lwesokudla luqoqa igazi elisetshenziswe emzimbeni, okungukuthi, igazi elilahlekelwe umoya-mpilo kanye ne-carbon dioxide eqongelelekile, bese lilibuyisela emaphashini ukuze lihlanzwe. Kusemaphashini lapho sikhipha khona i-carbon dioxide bese sengeza umoya-mpilo omusha egazini.

Ngale ndlela, izinhlangothi zombili zisebenza ndawonye ukugcina ukujikeleza kwegazi okufanele emzimbeni wethu.

Yini ebangela ukuthi uhlangothi lwesobunxele lwenhliziyo lube buthakathaka?

Cabanga nje, bekuzokwenzekani uma besisebenzisa iphampu yamanzi endlini yethu iminyaka eminingi ngaphandle kokulungiswa noma isevisi? Kancane kancane, izingxenye zayo zizoguga, ukusebenza kwayo kuzoncipha, futhi ekugcineni ingayeka ukusebenza, akunjalo? Yilokho kanye ngenhliziyo yethu. Ezinye izifo nemikhuba yethu emibi kungalimaza uhlangothi lwesobunxele lwenhliziyo ngokuhamba kwesikhathi, kuyenze ibe buthaka. Nazi ezinye zezizathu eziyinhloko:

• Isifo semithambo yegazi: Lokhu kwenzeka lapho kwakheka amafutha ngaphakathi kwemithambo yegazi (imithambo yegazi) ehambisa igazi enhliziyweni. Lokhu kuvimbela imisipha yenhliziyo ekutholeni umoya-mpilo nezakhamzimba ezidingayo.
• Ukuhlaselwa yinhliziyo: Ukuhlaselwa yinhliziyo ukuphazamiseka okungazelelwe kokugeleza kwegazi enhliziyweni. Lokhu kubangela ukuthi ingxenye yenhliziyo ife, okunciphisa ikhono lenhliziyo lokupompa.
• Umfutho wegazi ophezulu (`Umfutho wegazi ophezulu`) awulawulwa isikhathi eside: Uma umfutho wegazi uphakeme njalo, inhliziyo kufanele isebenze kanzima ukupompa igazi. Ngokuhamba kwesikhathi, inhliziyo iyakhathala futhi ibe buthaka.
• Ukukhubazeka kwevalvu yenhliziyo (`isifo senhliziyo seValvular`): Uma amavalvu enhliziyweni engavali noma engavuli kahle, ukugeleza kwegazi kuyaphazamiseka futhi inhliziyo izwa umthwalo owandayo.
• Izigqi zenhliziyo ezingavamile (i-Arrhythmia): Uma inhliziyo ingashayi ngesigqi esifanele, ukusebenza kwayo kahle kokupompa kwehla.
• Ezinye izimo zezokwelapha ezingavamile: Isibonelo, izimo ezifana ne-`(Amyloidosis)` (ukubekwa kweprotheni engajwayelekile enhliziyweni) noma i-`(Sarcoidosis)` (ukwakheka kwamaqhubu amancane enhliziyweni) nazo zingabangela ukuba imisipha yenhliziyo iqine futhi ibe buthaka.

Okubalulekile: Esinye noma ngaphezulu salezi zimbangela singabangela ubuthakathaka ohlangothini lwesobunxele lwenhliziyo.

Ngaphezu kwalokhu, kunezinye izici eziningana eziyingozi ezandisa ingozi . Lokhu kusho ukuthi abantu abanalezi zinto banamathuba amaningi okuba nobuthakathaka ohlangothini lwesobunxele lwenhliziyo:

• Ezinye izindlela zokwelapha ngamakhemikhali zomdlavuza zingabangela imiphumela emibi enhliziyweni (ubuthi benhliziyo).
• Isifo sikashukela.
• Ukukhuluphala ngokweqile.
• Ukuphefumula komoya.
• Njengoba sikhula, ukusebenza kwenhliziyo yethu kungase kwehle kancane ngokwemvelo.
• Ukubhema nokuphefumula intuthu yabanye abantu.
• Ukuqhubeka nokusebenzisa izidakamizwa ezithile neziphuzo ezinikeza amandla, eziyingozi enhliziyweni.
• Akuvamile kakhulu ukuthi eminye imithi esetshenziselwa ukwelapha ezinye izimo (isib. izifo zokuzivikela komzimba, isifo sokungakwazi ukugxilisa ingqondo/sokungasebenzi kahle (ADHD)) nayo ingathinteka.

Ziyini izimpawu zalesi simo?

Ekuqaleni, lapho uhlangothi lwesobunxele lwenhliziyo luqala ukuba buthaka, ungase ungaboni zimpawu ezinkulu. Ungase ucabange ukuthi, "O, umkhuhlane nje" noma "Kuyinto eyenzekayo uma ukhula." Kodwa njengoba ukusebenza kwenhliziyo yakho kuba kubi kakhulu, ungase uqale ukuqaphela izinto ezinjengalezi:

• Ukukhwehlela okuqhubekayo: Kufanele ukhathazeke uma ukhwehlela, ikakhulukazi ebusuku noma uma ulele phansi.
• Ukuphelelwa umoya:
• Uma ngihamba kancane, ngikhuphuka izitebhisi ezimbalwa, bese ngigoba, ngiphathwa yikhanda.
• Uma ngivuka ebusuku, ngizizwa sengathi nginenkinga yokuphefumula, njengokungathi isifuba sami siyacinana.
• Kunzima ukulala uma ulele phansi, futhi kuzwakala kulula ukuphefumula uma uhleli phezulu. (Lokhu kungenxa yokuthi uketshezi oluningi luqoqana emaphashini uma ulele phansi).
• Ukukhuluphala okungazelelwe: Ungase uthole ikhilogremu elilodwa noma amabili ezinsukwini ezimbalwa. Lokhu empeleni akukhuli, kodwa kukugcina uketshezi emzimbeni.
• Ukuvuvukala (i-edema): Ukuvuvukala kwamaqakala, imilenze, futhi ngezinye izikhathi isisu. Lokhu kubangelwa nokugcinwa koketshezi emzimbeni.

Ngokuhamba kwesikhathi, njengoba inhliziyo isebenza kanzima ukwenza umsebenzi wayo, izinkinga ezifana nalezi:

• Ukushaqeka kwenhliziyo: Lesi yisimo esiphuthumayo. Inhliziyo ayikwazi ukupompa igazi elanele, okubangela ukuntuleka kokugeleza kwegazi ezithweni ezibalulekile zomzimba.
• Inhliziyo ekhulisiwe: Uma inhliziyo isebenza kanzima kakhulu, imisipha yayo iyaqina bese inhliziyo iba nkulu.
• Ukuphazamiseka kokushaya kwenhliziyo (`Arrhythmia`): Isigqi senhliziyo singase singabi ngendlela evamile.

Uma unezinye zalezi zimpawu, sicela ubonane nodokotela.

Udokotela ukubona kanjani lokhu?

Uma uya kudokotela, baqala ngokukubuza imibuzo eminingi. Ziyini izimpawu zakho, usunesikhathi esingakanani unazo, ingabe kukhona emndenini wakho onesifo senhliziyo, imiphi imithi oyithathayo, njalo njalo. Bese bekuxilonga. Balalela inhliziyo yakho, bahlole amaphaphu akho, futhi babheke ukuvuvukala.

Ngaphezu kwalokho, izivivinyo ezilandelayo (izivivinyo zelebhu kanye nezifundo zezithombe) zingenziwa ukuqinisekisa isimo esiqondile nokuthola imbangela:

• Ukuhlolwa kwegazi (`Ukuhlolwa kwelebhu`):
• Ukuhlolwa kwegazi kwe-BNP (B-type natriuretic peptide): Lokhu kuyi-biomarker ekhethekile. Lapho ingcindezi emakamelweni enhliziyo ikhuphuka, le hormone ikhishwa iye egazini. Amazinga ayo anganikeza umbono wokuthi inhliziyo ibuthakathaka yini.
• `Iphaneli ye-Metabolic`: Lokhu kuhlola ukusebenza kwezinso nesibindi, kanye namazinga kasawoti egazini, njenge-sodium ne-potassium. Lokhu kubalulekile ezifweni zenhliziyo.

• Izifundo zokuthatha izithombe:
• I-Electrocardiogram (ECG/EKG): Lokhu kurekhoda umsebenzi kagesi wenhliziyo. Kungabona izinto ezifana nokuhlaselwa yinhliziyo noma inkinga yesigqi senhliziyo.
• I-Echocardiogram (ECHO): Lokhu kufana nokuskena kwenhliziyo nge-ultrasound. Kungabona ngokucacile izinto eziningi, njengobukhulu bamakamelo enhliziyo, ukujiya kwezindonga, ukusebenza kwama-valve, kanye nendlela inhliziyo epompa ngayo igazi (ingxenye yokukhipha igazi).
• I-angiography yenhliziyo:Ukuhlolwa okukhethekile kwe-"(X-ray)`` ukuze kubonakale ukuthi kukhona yini ukuvaleka kwemithambo yenhliziyo ehambisa igazi enhliziyweni.
• I-Cardiac MRI (Cardiac Magnetic Resonance Imaging): Lokhu kungathatha izithombe ezicacile nezinemininingwane zenhliziyo. Kungasiza ekuboneni izinto ezifana nesimo semisipha yenhliziyo kanye nezindawo zomonakalo.

Ngokusekelwe olwazini olutholakale kulezi zivivinyo, udokotela uzonquma ukuthi hlobo luni lwesimo onaso nokuthi yiluphi ukwelashwa okungcono kakhulu kwaso.

Yelashwa kanjani? Yimiphi imithi etholakalayo?

Izindaba ezinhle ukuthi kunezindlela eziningi zokwelapha ukwehluleka kwenhliziyo kwesobunxele. Ukwelashwa okufanele kuzoncika ekutheni une-"Systolic heart failure" eshiwo ngaphambilini noma "Diastolic heart failure", kanye nobunzima besimo.

Imithi ivame ukuba yindlela yokwelapha eyinhloko. Le mithi isiza ekuthuthukiseni ukusebenza kwenhliziyo, ukunciphisa izimpawu, kanye nokwandisa impilo. Nazi ezinye zemithi esetshenziswa kakhulu:

• Ama-ACE inhibitors (ama-angiotensin-converting enzyme inhibitors), ama-Angiotensin II receptor blockers (ama-ARB), ama-Angiotensin-receptor neprilysin inhibitors (ama-ARNI): Lawa makilasi emithi asebenza ngokukhulula imithambo yegazi, ukwehlisa umfutho wegazi, nokusiza inhliziyo ukuthi ivuseleleke.
• Ama-Aldosterone antagonists: Lawa alawula ama-hormone ahlobene nokucindezeleka futhi avimbele izimpawu ukuthi zingabi zimbi kakhulu. Aphinde asize ekunciphiseni ukuvuvukala ngokunciphisa ukugcinwa kwamanzi (i-diuretic emnene).
• Ama-Beta blocker: Le mithi yehlisa izinga lokushaya kwenhliziyo futhi yehlise umthwalo womsebenzi enhliziyweni, okungukuthi, inani lomsebenzi okufanele iwenze.
• I-Digoxin: Lo muthi usiza abanye abantu, ikakhulukazi labo abanezinkinga ezithile zesigqi senhliziyo, ukuthi bazizwe bengcono futhi balawule ukushaya kwenhliziyo yabo.
• Ama-Diuretics: Lawa asebenza ngokukhipha uketshezi oluningi emzimbeni ngomchamo, okunganciphisa izimpawu ezifana nokuphelelwa umoya nokuvuvukala.
• Izithibi zokuthutha i-Sodium-glucose protein 2 (SGLT2): Lolu hlobo olusha lwemithi luwusizo kakhulu kubantu abanesifo sikashukela nabangenaso abanesifo senhliziyo. Zisiza futhi ekunciphiseni uketshezi oluningi emzimbeni futhi zivikele inhliziyo.

Khumbula: Kubalulekile ukuthatha le mithi njengoba nje udokotela wakho ekuyalele, ngesilinganiso esifanele, nangesikhathi esifanele. Ungalokothi uyeke ukuthatha imithi noma ushintshe umthamo ngaphandle kweseluleko sikadokotela wakho.

Ingabe abanye abantu kufanele baphathwe ngendlela ekhethekile ('izinqubo')?

Yebo, kwezinye izimo, uma izimpawu zingenakulawuleka ngemithi yodwa, noma uma ukuhlolwa kukhombisa ukuthi isimo senhliziyo siya siba sibi kakhulu, udokotela angase ancome izinqubo ezikhethekile noma ukuhlinzwa. Nazi ezinye zazo:

• Ukwelashwa kabusha kwenhliziyo (i-CRT): Lokhu kuhilela ukufaka idivayisi encane (njenge-pacemaker) ngaphansi kwesikhumba eletha ukuvuselelwa kagesi ukusiza amakamelo enhliziyo angakwesobunxele nakwesokudla afinyele ngesikhathi esisodwa. Lokhu kubizwa nangokuthi i-biventricular pacemaker. Lokhu kwenza isenzo sokupompa kwenhliziyo sisebenze kahle kakhulu.
• Ukuguqulwa kwenhliziyo ngogesi: Ukwelashwa okuletha ukushaqeka kukagesi esifubeni ukuze kubuyiselwe isigqi senhliziyo esijwayelekile lapho inhliziyo ingajwayelekile.
• I-ICD (i-ICD) efakwa ngaphansi kwesikhumba: Lokhu futhi kuyithuluzi elifakwa ngaphansi kwesikhumba. Libona ukungalingani kwenhliziyo okuyingozi futhi lithumela ngokuzenzakalelayo izimpawu zikagesi ukuze lizibuyisele esimweni salo esijwayelekile.
• Idivayisi yokusiza ye-ventricular yesobunxele (LVAD): Lena iphampu efakwa ngokuhlinzwa ngaphakathi kwenhliziyo ukusiza inhliziyo ukupompa igazi. Isetshenziselwa abantu abanenkinga enkulu yenhliziyo abalinde ukufakelwa inhliziyo.
• Ukufakelwa inhliziyo: Ezigulini ezinezinhliziyo ezibuthakathaka kakhulu eziye zahluleka kuzo zonke ezinye izindlela zokwelapha, ukufakelwa inhliziyo enempilo evela kumnikeli oshonile kuyindlela yokugcina.

Yini esingayenza ukuze sigweme lesi simo? (Ukuvimbela)

Kukhona isisho esithi "Ukuvimbela kungcono kunokwelapha." Lokho kuyasebenza nalapha. Ukulandela indlela yokuphila enempilo yenhliziyo kunganciphisa kakhulu ingozi yokwehluleka kwenhliziyo ohlangothini lwesobunxele. Uma usuvele unalesi simo, imikhuba emihle ingasiza ekuvimbeleni izinkinga zesikhathi esizayo nokuphatha lesi simo.

Nazi ezinye izinto ongazenza:

• Gcina umfutho wegazi lakho, amazinga e-cholesterol, nesifo sikashukela kulawulwa uma unazo. Thatha imithi oyinikwa udokotela wakho.
• Vivinya umzimba njalo. Yenza ukuzivocavoca okulula njengokuhamba okungenani imizuzu engama-30 ngosuku.
• Zinike isikhathi sokulala kahle ebusuku . Udinga amahora angu-7-8 okulala ngosuku.
• Gcina isisindo somzimba siphilile. Ukukhuluphala ngokweqile kuwumthwalo omkhulu enhliziyweni.
• Yidla ukudla okunempilo. Yidla izithelo eziningi, imifino, ubhontshisi, nokudla okucebile nge-fiber. Nciphisa usawoti, ushukela, namafutha.
• Nciphisa ukucindezeleka. Yenza izinto ezifana ne-yoga, ukuzindla, ukuvivinya umzimba ngokuphefumula ('amasu okuphumula'). Zibandakanye nomsebenzi wokuzilibazisa owuthandayo.
• Uma ubhema, yeka ngokushesha. Hlala kude nezindawo lapho abanye abantu bebhema khona (`intuthu ebhemayo`).
• Nciphisa noma uyeke ngokuphelele ukusebenzisa utshwala .

Impilo izoba njani uma uhlangothi lwesobunxele lwenhliziyo luba buthakathaka? Yiziphi izinkinga ezingaba khona?

Uma ulandela imiyalelo kadokotela wakho kahle, usebenzisa imithi yakho ngendlela efanele, futhi uya ezikhungweni zokulandelela ngesikhathi, ungalondoloza impilo yakho kahle kakhulu. Iningi labantu lingaphila impilo evamile.

Kodwa-ke, uma lesi simo singalawulwa kahle, kungase kube nezinkinga ezithile. Nazi ezinye zazo:

• Ukungahambi kahle kwesigqi senhliziyo (`Arrhythmias`): Isibonelo, ``ventricular tachycardia`` (ukushaya kwenhliziyo okusheshayo), ``atrial fibrillation / Afib`` (ukushaya kwenhliziyo okungajwayelekile kwe-atrium).
• I-apnea yokulala (i-apnea yokuvimbela kanye ne-central sleep).
• Izinkinga zamavalvu enhliziyo (`isifo samavalvu enhliziyo`), njengokuvuza kwegazi emuva ngamavalvu.
• Isifo sesibindi: Uma inhliziyo ingaphampi igazi kahle, isibindi naso singathinteka.
• Ukwehluleka kwenhliziyo ohlangothini lwesokudla: Uma uhlangothi lwesobunxele lwenhliziyo luba buthakathaka, kungathinta nohlangothi lwesokudla.
• Ubuthakathaka kanye nobuthakathaka bemisipha.
• I-anemia.
• Isifo sezinso: Uma inhliziyo iba buthaka, inani legazi eligeleza ezinso liyancipha, okungathinta ukusebenza kwazo.
• Ukucindezeleka noma Ukukhathazeka: Ukuphila nesifo sesikhathi eside kungaba nemiphumela engokwengqondo.

Yini okudingeka siyishintshe ngenkathi siphila nalesi simo?

Uma uphila nokungasebenzi kahle kwe-ventricular yangakwesobunxele, kunezinguquko ezibalulekile endleleni yokuphila ongayenza ukusiza ekuphatheni isimo sakho, ukunciphisa izimpawu, nokwenza impilo ibe lula.

• Yiba nomzimba osebenzayo kancane kunangaphambili: Zivocavoce ngendlela efanele wena, njengoba kunconywe udokotela wakho.
• Hlola umfutho wegazi lakho nsuku zonke: Libhale phansi njengoba udokotela wakho ekutshela.
• Qhubeka uphuza imithi yakho yokwehluleka kwenhliziyo njengoba uyalelwe: ungaphuthelwa ngisho usuku olulodwa.
• Bona udokotela wakho ngesikhathi bese uya emitholampilo: Lokhu kuzosiza udokotela ukuthi aqaphe isimo sakho futhi enze noma yiziphi izinguquko ezidingekayo.
• Nciphisa usawoti ekudleni kwakho: Usawoti ungandisa ukugcinwa kwamanzi emzimbeni, okuholela ekuvuvukeni nasekuphefumuleni kanzima.
• Zikalele njalo ekuseni: ngesikhathi esifanayo, ngendlela efanayo (isib., ngemva kokusebenzisa indlu yangasese, ngaphambi kokugqoka). Uma wenyuka ikhilogremu elilodwa noma amabili ngosuku olulodwa noma ezimbili, kungaba ukugcinwa kwamanzi. Uma lokho kwenzeka, tshela udokotela wakho.
• Phuza kuphela inani loketshezi olunikezwe wena ngosuku (njengamanzi, itiye, isobho): Abanye abantu badinga ukulawula uketshezi abaludlayo.

Okokugcina, okufanele ukukhumbule (Umyalezo Wokuya Ekhaya)

Kalula nje, i-Left-Sided Heart Failure yisimo lapho ikhono lenhliziyo lokupompa igazi lincipha khona, futhi kuyinto okufanele ikhathazwe. Lokhu kuvame kakhulu kubantu abanezinkinga zenhliziyo ezifana nomfutho wegazi ophakeme, isifo semithambo yegazi yenhliziyo, kanye nokwehluleka kwenhliziyo.

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Kodwa-ke, asikho isizathu sokwesaba. Uma ubona izimpawu zalesi simo kusenesikhathi, usiphathe kahle ngokweseluleko sezokwelapha, usebenzise imithi oyinikezwe udokotela, futhi ulandele indlela yokuphila enempilo yenhliziyo, ungaphila kahle futhi ukhululekile ngalesi simo.

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Ngakho-ke, uma unezinye zezimpawu okukhulunywe ngazo kulesi sihloko, into engcono kakhulu ongayenza wena ukubona udokotela ofanelekayo ngokushesha bese ucela iseluleko ngaphandle kokusinaka. Uma lesi sifo sitholakala ngokushesha, kulapho ukwelashwa kuzophumelela khona. Ngikufisela impilo enhle!

Ukwehluleka kwenhliziyo , Ukwehluleka kwenhliziyo ohlangothini lwesobunxele, Ukuphelelwa umoya, Ukuvuvukala, Isifo senhliziyo, Ukuhlaselwa yinhliziyo, Umfutho wegazi ophezulu