Ingabe ivalvu yakho yenhliziyo iyavuza kancane? Ake sifunde nge-Mitral Valve Regurgitation!

Ingabe ngezinye izikhathi uthola kunzima ukuphefumula ngokuzumayo? Noma uzizwa into engavamile, esindayo esifubeni sakho? Ingabe ngezinye izikhathi uzizwa ukhathele ngisho nangemva kokwenza imisebenzi emincane? Esinye sezizathu zalezi zinto kungaba inkinga ngomnyango omncane enhliziyweni yakho, okungukuthi, ivalvu. Namuhla sizokhuluma nge- Mitral Valve Regurgitation, okuyisimo esinjalo. Ungakhathazeki, ake sikuqonde kalula lokhu.

Iyini le valve ye-mitral enhliziyweni? Kwenzekani uma ingasebenzi kahle?

Kalula nje, i -valve ye-mitral ingumnyango ophakathi kwegumbi eliphezulu (i-atrium yesobunxele) kanye negumbi elingezansi (i-ventricle yesobunxele) ohlangothini lwesobunxele lwenhliziyo yakho. Cabanga ngayo njengomnyango endlini yakho. Lo mnyango kufanele uvuleke futhi uvale kahle, uvumele igazi ligeleze lisuka ekamelweni eliphezulu liye ekamelweni elingezansi. Ngemuva kwalokho, lo mnyango kufanele uvalwe kahle ukuze uthumele igazi lisuka ekamelweni elingezansi liye kuwo wonke umzimba wakho. Ngaphandle kwalokho, igazi lizoqala ukuvuza libuyele ekamelweni eliphezulu.

Kodwa ngezinye izikhathi lo mnyango awuvaleki kahle. Njengoba nje iminyango ezindlini zethu ngezinye izikhathi ingakhiyi kahle, okushiya isikhala esincane. Lokhu kungabangelwa inkinga ngomnyango ngokwawo, okungukuthi, izicubu zevalvu. Noma kungabangelwa inkinga ngezindonga ezizungeze umnyango, okungukuthi, amakamelo angakwesobunxele enhliziyo. Kodwa-ke, uma lo mnyango ungavaleki kahle, igazi elithile livuza emuva, okungukuthi, liye ekamelweni eliphezulu. Lokhu yilokho esikubiza ngokuthi i-mitral valve regurgitation noma i-"Mitral Regurgitation - MR".

Cabanga ngakho njengompompi wamanzi. Uma umpompi ungavaliwe kahle, amanzi azovuza, akunjalo? Kunjalo nangalena.

Uma lokhu kuvuza kuncane, okusho ukuthi isikhala esisemnyango sincane kakhulu, kungase kungabi yinkinga enkulu. Inhliziyo yakho ingakwazi ukukusingatha, ngakho-ke ungase ungezwa mehluko. Kodwa-ke, uma lokhu kuvuza kukhulu, okusho ukuthi umnyango uvulekile kakhulu, inhliziyo yakho izwa ukucindezeleka okukhulu. Ngoba inhliziyo kufanele isebenze kanzima kunokujwayelekile ukuze ipompe inani legazi elidingayo ukuze ipompe phambili. Ngokuhamba kwesikhathi, inhliziyo ayisakwazi ukubhekana nalokhu, futhi ungase ube nezimpawu nezinye izinkinga.

Lesi simo sibizwa nangokuthi:

• Ukungasebenzi kahle kwevalvu ye-Mitral (`(Ukungasebenzi kahle kwevalvu ye-Mitral)`)
• Ukungasebenzi kahle kwe-valve ye-mitral
• Ivalvu ye-mitral evuzayo (`(ivalvu ye-mitral evuzayo)`)

Eqinisweni, i-mitral valve prolapse uhlobo oluvame kakhulu lwesifo se-valve yenhliziyo emazweni afana ne-United States. Luvame kakhulu kubantu asebekhulile, ikakhulukazi labo abaneminyaka engaphezu kwengu-65.

Ingabe kukhona izinhlobo zokuvuza kwe-valve ye-mitral?

Yebo, kunezinhlobo ezimbili ikakhulukazi:

1. Ukubuyela kwesisu okuyinhloko (`(Ukubuyela kwesisu okuyinhloko)`): Kulesi simo, inkinga ikwivalvu uqobo. Ibangelwa umonakalo wesakhiwo engxenyeni eyodwa noma ngaphezulu yevalvu okuvimbela ukuthi ivaleke kahle. Isibonelo, amapheshana evalvu angase aguquguquke kakhulu futhi angakwazi ukuvala kahle, noma angase abe makhulu futhi angakwazi ukuvala kahle.

2. Ukubuyela kwe-mitral kwesibili : Lokhu kubangelwa esinye isimo senhliziyo esithinta amakamelo enhliziyo (i-atrium yesobunxele noma i-ventricle) esekela i-valve. Isibonelo, isifo semisipha yenhliziyo (i-cardiomyopathy) singabangela ukuba inhliziyo ikhule futhi ibe buthakathaka. Lezi zinguquko zingabangela ukuthi i-valve ihambe futhi ingavaleki kahle.

Kungakhathaliseki ukuthi uhlobo luni lokuvuza, kungaba nzima ngokuzumayo (`(Acute)`), noma kungakhula kancane kancane ngokuhamba kwesikhathi (`(Okungalapheki)`).

Yiziphi izimpawu ezingaba khona uma kukhona ukuvuza ku-valve ye-mitral?

Uma ukuvuza kuncane, ungase ungabi nazimpawu. Kodwa lapho ukuvuza kuba kukhulu futhi kuqala ukuthinta ukusebenza kwenhliziyo, uphawu oluvame kakhulu ukushoda komoya (i-dyspnea) . Ungase uzizwe sengathi awukwazi ukuthola umoya owanele emaphashini akho, noma ungase uzizwe uphelelwa umoya uma umi nje, ulele phansi, uzama ukulala, noma wenza imisebenzi elula.

Kungase kube nezinye izimpawu:

• Ubuhlungu besifuba obungavamile.
• Ukukhwehlela.
• Ukuvuvukala kwemilenze noma izinyawo (`(Edema)`).
• Ukuzizwa ukhathele kakhulu (`(Ukukhathala)`).
• Kuzwakala sengathi kuyaphela amandla, kodwa empeleni akwenzeki (`(Presyncope)`).
• Ukuzwa sengathi ukushaya kwenhliziyo yakho kuyashintsha, sengathi isifuba sakho siyashaya (`(Ukushaya kwenhliziyo)`).

Lezi zimpawu zingavela kancane kancane noma ziqale ngokuzumayo.

Lesi yisimo esiphuthumayo! Uma uhlangabezana nalezi zimpawu, hamba uye esibhedlela ngokushesha!

Uma inhliziyo yakho isebenza kanzima kakhulu, ungase ube nezimpawu zokwehluleka kwenhliziyo okukhulu. Lezi zingavela ngokuzumayo, ngakho qaphela lezi zimpawu:

• Ukuphefumula kakhulu.
• Ukuzizwa sengathi uyacinana.
• Ubunzima bokuphefumula uma ulele phansi.
• Ukuzwa ukuqina esifubeni.
• Uma i-pulse oximeter ekhaya ibonisa ukuthi izinga lomoya-mpilo egazini liphansi.

Ukwehluleka kwenhliziyo okukhulu kuyisimo esiphuthumayo sezokwelapha lapho inhliziyo iyeka ukusebenza ngokuzumayo futhi ingaba yingozi empilweni. Ngakho-ke, kubalulekile ukufuna ukwelashwa ngokushesha.

Kungani le valve ye-mitral ingavaleki kahle? Ziyini izizathu?

Njengoba sesixoxile ngaphambili, le nkinga yenzeka uma ivalvu ye-mitral ingavali kahle. Le valve inama-flap amabili (amapheshana). Ayavuleka futhi avalwe ukuze igazi ligeleze lisuka ekamelweni eliphezulu liye ekamelweni elingezansi.

Uma lawa mapheshana noma ezinye izingxenye zevalvu zonakele, noma uma izifo ezahlukahlukene zibangela ukuthi ivalvu ingavali kahle, igazi elincane livuza emuva njalo lapho ivalvu ivala.

Izizathu zalokhu ziyahlukahluka kuye ngohlobo lwe-MR onalo (oluyinhloko noma olwesibili).

Ukubuyiselwa kwe-valve ye-mitral eyinhloko kungabangelwa yi:

• I-Mitral valve prolapse (MVP) : Lena yimbangela evame kakhulu emazweni athuthukile.
• Isifo senhliziyo esihambisana nobuhlungu beqolo : Lesi yimbangela ehamba phambili emhlabeni jikelele.
• Izifo zezicubu ezixhumene (`(Izifo zezicubu ezixhumene)`).
• Isifo senhliziyo esizalwa naso esibizwa ngokuthi ``(i-Cleft mitral valve)``.
• Ukutheleleka kolwelwesi lwangaphakathi lwenhliziyo (i-endocarditis).
• Isifo senhliziyo esibangelwa ukwelashwa ngemisebe (`(Isifo senhliziyo ngemisebe)`).
• Ukulimala ngengozi.

Ukubuyela kwe-valve yesibili ye-mitral kungabangelwa yi:

• I-Ischemic cardiomyopathy (lokhu kuvame kakhulu) ibangelwa ukuvaleka kwemithambo yegazi ehlinzeka ngenhliziyo.
• I-fibrillation ye-atrial, ukushaya kwenhliziyo okungajwayelekile.
• I-cardiomyopathy evulekile (isifo semisipha yenhliziyo esibangela ukuba inhliziyo ikhule ngaphandle kwesizathu esaziwayo)
• Isifo esibangelwa ukuqina kwemisipha yenhliziyo (`(Hypertrophic obstructive cardiomyopathy)`).

Yiziphi izinkinga ezingaba khona uma lesi simo siba sibi kakhulu?

Uma ingelashwa, i-mitral valve prolapse ingaba yingozi empilweni. Nazi ezinye zezinkinga ezingase zenzeke:

• Inhliziyo yakho iqala ukushaya ngokungajwayelekile (`(Atrial fibrillation)`), okungase kuholele ekushayweni yisifo sohlangothi ngezinye izikhathi.
• Inhliziyo yakho ayikwazi ukupompa igazi elanele emzimbeni (`(Ukwehluleka kwenhliziyo)`).
• Umfutho wegazi osuka enhliziyweni uyakhuphuka (`(Umfutho wegazi ophakeme wamaphaphu)`).
• Inhliziyo ingayeka ukushaya ngokuzumayo (`(Ukuma kwenhliziyo ngokuzumayo)`).

Udokotela usithola kanjani lesi sifo ngokunembile?

Into yokuqala udokotela ayenzayo ukukuhlola kahle. Lapho:

• Babuza ngezimpawu zakho kanye nezinye izifo onazo.
• Bazohlola izimpawu zakho ezibalulekile, njengomfutho wegazi lakho kanye nesivinini sokushaya kwenhliziyo.
• Bahlola umzimba ukuthi awuvuvukile yini (i-edema).
• I-stethoscope izolalela inhliziyo namaphaphu akho. Uma uzwa umsindo wenhliziyo ongajwayelekile (“ukububula kwenhliziyo”), kungaba uphawu lwesifo se-valve.

Udokotela uzo-oda izivivinyo eziningana ukuze athole ulwazi olwengeziwe.

Yiziphi izivivinyo ezenziwayo ukuze kutholakale lesi sifo?

Odokotela bavame ukwenza isivivinyo esibizwa ngokuthi i-transthoracic echocardiogram (TTE) ukuze babheke ukuvuza ku-valve yakho ye-mitral. Lokhu kuskena okungenabuhlungu, okungangenisi uhlaselo. Kungahlola ukuvuza ku-valve yakho kanye nezinye izinkinga ngesakhiwo noma ukusebenza kwenhliziyo yakho. Uma udokotela wakho efuna ukubhekisisa i-valve yakho, angenza nesivivinyo esibizwa ngokuthi i-transesophageal echocardiogram (TEE).

Udokotela wakho angase acele ukuhlolwa okwengeziwe ukuze anqume ubucayi besimo sakho futhi ahlele ukwelashwa. Lokhu kufaka phakathi:

• I-`(CT scan)` yenhliziyo (`(Cardiac CT scan - computed tomography scan)`).
• I-`(Echocardiogram)` eyenziwa ngesikhathi sokuzivocavoca (`(Ukuzivocavoca nge-echocardiogram yokucindezeleka)`).
• Ukuhlolwa kwe-MRI yenhliziyo (i-magnetic resonance imaging).
• Ukuhlolwa kwe-catheterization yenhliziyo, okwaziwa nangokuthi i-cardiac cath noma i-coronary angiogram.

Yiziphi izindlela zokwelapha ukuvuza kwe-valve ye-mitral?

Ayikho into ebizwa ngokuthi ukwelashwa "okufanela wonke umuntu". Odokotela bazokwenza ukwelashwa kuhambisane nezidingo zakho. Bazocabangela okulandelayo:

• Uhlobo lokubuyela kwesisu okubangelwa yi-mitral (okuyinhloko noma okwesibili).
• Ubunzima besimo sakho. Kungachazwa ngokuthi isigaba A, B, C, D. Isigaba D sinzima kakhulu.
• Ingozi yezinkinga ezivela ekuhlinzweni.

Udokotela wakho uzochaza izinketho zakho zokwelapha, okuhlanganisa izinzuzo nezinkinga zazo. Qiniseka ukuthi ubuza imibuzo uma kukhona ongakuqondi. Ngaleyo ndlela, ungenza isinqumo esinolwazi.

Ukubuyela kwe-mitral kuyisizathu sesibili esivame kakhulu sokuhlinzwa kwe-valve yenhliziyo emazweni aseNtshonalanga (esokuqala yi-aortic valve stenosis).

Kunezinketho eziningana zokwelapha:

Ukulungiswa kwevalvu ye-Mitral (`(ukulungiswa kwevalvu ye-Mitral)`)

Izinketho zalokhu:

• Ukuhlinzwa kwenhliziyo evulekile.
• Ukuhlinzwa kwenhliziyo kusetshenziswa imicu emincane (`(Ukuhlinzwa kwenhliziyo okungenasivikelo kakhulu)`).
• Ukulungiswa kwe-Mitral transcatheter onqenqemeni kuya onqenqemeni (TEER): Kule nqubo, udokotela usebenzisa ithubhu elide nelincane (i-catheter) ukunamathisela i-clip encane kumapheshana akho e-valve. Lesi siqeshana sisiza amapheshana ukuthi avaleke kahle.

Ukufakwa esikhundleni kwevalvu ye-Mitral (`(ukufakwa esikhundleni kwevalvu ye-Mitral)`)

Izinketho zalokhu:

• Uzonikezwa ukuhlinzwa kwenhliziyo evulekile (`(ukuhlinzwa kwenhliziyo evulekile)`) bese kufakwa ivalvu entsha ye-mitral. Le valve ingenziwa ngensimbi (`(mechanical)`) noma yenziwe ngezicubu zezilwane (`(bioprosthetic)`).
• Ukufakwa esikhundleni kwe-Transcatheter mitral valve (TMVR) kuyindlela encane kakhulu yokungenelela.

Ukwelashwa kokwehluleka kwenhliziyo

Lokhu kungafaka:

• Imithi efana ne-diuretics .
• Ukufakelwa kwedivayisi yokusiza i-ventricular yesobunxele (i-LVAD).
• Ukunakekelwa kobuhlungu.

Ukwelashwa kwe-fibrillation ye-atrial

Lokhu kungafaka:

• Imithi.
• Izinqubo.
• Ukuhlinzwa.

Impilo yami izoba njani uma ngithola lesi sifo?

Ziningi izinto ezithinta indlela impilo yakho ezoba ngayo. Isibonelo:

• iminyaka yakho.
• Ingabe unezimpawu nokuthi zimbi kangakanani?
• Ubukhulu bokuvuza.
• Ingabe ivalvu yakho ingalungiswa?
• Ubukhulu bomonakalo enhliziyweni yakho.

Ngenxa yokuthi zonke lezi zici zithinta isimo sakho, isimo sakho singase sihluke kwesabanye. Udokotela wakho ungumuntu ongcono kakhulu ukwazi kahle ukuthi isimo sakho sizoqhubeka kanjani. Uyakwazi wena, umlando wakho wezokwelapha, kanye nezinketho zokwelashwa ezingakusiza.

Lokhu kuvuza kwe-valve ye-mitral kukhula ngokushesha kangakanani?

Kwabanye abantu, lokhu kuqhubeka kancane. Kwabanye, kungase kuqhubeke ngokushesha. Udokotela wakho uzokutshela ukuthi isimo sakho sinjani, ukuthi kufanele ubonane kangaki nodokotela ukuze ahlolwe, nokuthi lesi simo singathinta kanjani impilo yakho yonke.

Zikhona yini izindlela zokuvimbela lesi sifo?

Ungase ungakwazi njalo ukuvimbela lokhu. Kodwa-ke, ungasebenzisana nodokotela wakho ukunciphisa ingozi yakho yokuthola izifo zenhliziyo ezahlukahlukene. Udokotela wakho uzobuyekeza umlando wakho wezokwelapha kanye nezici eziyingozi futhi akunike iseluleko esifanele wena. Ngokuvamile, ungenza okulandelayo:

• Yeka ngokuphelele ukusebenzisa imikhiqizo kagwayi (njengogwayi, ama-beedis).
• Vivinya umzimba njalo.
• Yidla ukudla okunempilo kwenhliziyo.
• Gcina isisindo sakho siphilile.
• Bona udokotela okungenani kanye ngonyaka ukuze akuhlole bese uthola izinkinga ngokushesha.
• Uma uvame ukuba nomphimbo obuhlungu kanye nomkhuhlane, noma uma uke waba nomkhuhlane wamathambo esikhathini esidlule, bona udokotela.

Ngizinakekela kanjani?

Kuhle njalo ukulawula umfutho wegazi lakho nokudla izithelo nemifino eminingi .

Ukubamba iqhaza ohlelweni lokuvuselelwa kwenhliziyo (`(ukuvuselelwa kwenhliziyo)`) ngemuva kokuhlinzwa kwevalvu yenhliziyo kungakusiza ukuthi uqale ukuzivocavoca futhi.

Uma une-valve entsha yokufakelwa, kuzodingeka uthathe imithi ngemuva kwalokho. Kuzodingeka uthathe ama-anticoagulant (ama-blood thinner) impilo yakho yonke ukuze uvimbele ukuqhekeka kwegazi. Kuzodingeka futhi uthathe ama-antibiotic ukuze uvimbele i-endocarditis (ukutheleleka kolwelwesi lwenhliziyo) ngaphambi kwezinqubo zamazinyo kanye nokuhlolwa okuthile kokuphefumula okuphezulu.

Kufanele ngimbone nini udokotela? Yimiphi imibuzo okufanele ngiyibuze?

Udokotela wakho uzokutshela ukuthi udinga ukubona udokotela wakho kangaki ukuze ahlolwe. Uma isimo sakho sibi kakhulu, kulapho kuzodingeka ubona udokotela wakho kaningi futhi wenze izivivinyo zezithombe (ezifana nokuskena). Kubalulekile ukugcina wonke ama-aphoyintimenti akho.Udokotela angakwazi ukuqapha isimo sakho futhi ancome ukwelashwa ngesikhathi esifanele.

Nansi eminye imibuzo ongayibuza udokotela wakho ukuze afunde kabanzi ngesimo sakho:

• Kungakanani ukuvuza kwe-valve yami ye-mitral?
• Yiziphi izindlela zokwelapha ongincomayo?
• Yiziphi izinzuzo kanye nokungalungi kwalezi zindlela zokwelapha?
• Yiziphi izinguquko zendlela yokuphila okudingeka ngizenze?
• Kukangaki ngidinga ukubona udokotela noma ukuhlolwa kwezithombe?
• Impilo yami yesikhathi esizayo izoba njani?

Okuthile okufanele ucabange ngakho

Kuvamile ukuzizwa ucindezelekile uma uzwa ukuthi unesifo senhliziyo. Kodwa njengoba ufunda kabanzi ngesimo sakho futhi uthola ukwelashwa, uzokwazi ukuqhubeka futhi maduze.

Ukwehla kwe-valve ye-Mitral kuthinta wonke umuntu ngendlela ehlukile, ngakho udokotela wakho uzokwenza ukwelashwa kwakho kuhambisane nezidingo zakho. Unganqikazi ukwabelana ngemibuzo yakho nokukhathazeka kwakho nodokotela wakho. Uzokusiza ukuthi uqonde kabanzi ngendlela inhliziyo yakho esebenza ngayo. Uzophinde ancome ukwelashwa kanye nezinguquko zendlela yokuphila ezizokusiza uhlale uphilile futhi uphile impilo engcono kakhulu.

I - valve ye-Mitral, isifo se-valve yenhliziyo, ukuphelelwa umoya, ukuhlaselwa yinhliziyo, ukuhlinzwa kwenhliziyo, i-echocardiogram, ukuvuselelwa kwe-valve ye-mitral