Ingabe inhliziyo yakho iqala ukushaya ngokushesha ngokuzumayo? Ake sixoxe nge-PSVT (Paroxysmal Supraventricular Tachycardia)!

Wake wabhekana nokwanda okungazelelwe kwesilinganiso senhliziyo yakho, ukushaya kwesifuba sakho, bese kuba umzuzwana omfushane wokuphila ngendlela evamile? Kungenzeka ukuthi uke wacabanga ukuthi lokhu kuyinto evamile nje, noma into eyenzekayo uma wesaba kancane. Kodwa-ke, ngezinye izikhathi akunjalo. Namuhla sizokhuluma ngesimo esibizwa ngokuthi 'i-Paroxysmal Supraventricular Tachycardia' noma 'i-PSVT', esibangela izinguquko ezisheshayo esilinganisweni senhliziyo. Ungakhathazeki, sizoxoxa ngalokhu ngendlela elula ongayiqonda.

Iyini i-PSVT?

Kalula nje, i-'PSVT' iwukungahleleki kwesigqi senhliziyo yethu, okungukuthi, iphethini yokushaya kwenhliziyo yethu ('arrhythmia'). Kulesi simo, inhliziyo iqala ukushaya ngokushesha okukhulu. Bese, ngokuzumayo, ukushaya kwenhliziyo kuyehla kube yisivinini sayo esijwayelekile futhi. Lokhu sibiza ukushaya kwenhliziyo okusheshayo okusheshayo ngokuthi 'ama-paroxysms'. Lesi simo sibangelwa umsebenzi kagesi ongajwayelekile oqala emakamelweni amabili aphezulu enhliziyo, abizwa ngokuthi 'i-atria'. Sibiza amakamelo amabili aphansi enhliziyo, abizwa ngokuthi 'ama-ventricle'. La makamelo amane asebenza ndawonye ukupompa igazi emzimbeni wethu wonke.

Ngakho-ke, i-'PSVT' ibangelwa umsebenzi kagesi ongajwayelekile kulezi zindawo zokuphefumula, okwenza zinciphe ngokushesha okukhulu nangokuqhubekayo. Kodwa into ebalulekile ukuthi i-'PSVT' akuyona njalo isifo esidinga ukwelashwa noma esisongela ukuphila. Ngezinye izikhathi ingelashwa ngaphandle kokwelashwa. Uma kudingeka, odokotela bazoncoma imithi, ukwelashwa kwenhliziyo, futhi akuvamile, i-'pacemaker'. Uma uzizwa into engavamile ngendlela inhliziyo yakho eshaya ngayo, kungcono kakhulu ukubona udokotela bese uyihlola.

Inhliziyo yethu isebenza kanjani ngokujwayelekile?

Ngaphambi kokuba siqonde ukuthi iyini i-PSVT, ake sibheke ukuthi inhliziyo yethu isebenza kanjani ngokujwayelekile. Enhliziyweni enempilo, ukushaya kwenhliziyo kuqala engxenyeni encane yezicubu ku-atria. Siyibiza ngokuthi i-sinoatrial node (i-SA node). Yilokhu okusebenza njenge-pacemaker yemvelo yenhliziyo.

Le `node ye-SA` ithumela izimpawu zikagesi ezibangela ukuthi i-atria inciphe futhi ipompe igazi. Lezi zimpawu zibe sezihamba ziye kuma-ventricle ngesinye isixha esincane samaseli esibizwa ngokuthi i-`node ye-atrioventricular` (i-node ye-AV). I-`node ye-AV` ithumela izimpawu zikagesi kuma-ventricle ukuze anciphe. Lena yindlela inhliziyo yethu eshaya ngayo ngokuhlelekile.

Ingabe zikhona izinhlobo ze-PSVT?

Yebo, kunezinye izimo eziningi ngaphansi kwesigaba esibanzi se-'PSVT'. Lokhu kungabangelwa ukuba khona kokuxhumeka kukagesi okungaphezu kokukodwa okuvela emakamelweni aphezulu enhliziyo kuya emakamelweni aphansi, kungaba ngokuqondile noma nge-'AV node'. Lokhu kubangela ukuthi inhliziyo ishaye ngokushesha ('tachycardia'). Ngezinye izikhathi, lokhu kushaya kwenhliziyo okusheshayo kungaphinde kuqale 'ekugxileni okucasulayo' emakamelweni aphezulu enhliziyo.

Amanye amagama avamile alezi zinhlobo ze-tachycardia yile:

• "I-atrioventricular nodal re-entrant tachycardia (AVNRT)"
• "I-Orthodromic reciprocating tachycardia (ORT)"
• "I-tachycardia elwa nokuvuvukala kwe-dromic reciprocating"
• `I-tachycardia ye-Atrial`
• `Ukuphaphazela kwe-Atrial`

Nakuba lokhu kungase kubonakale kungokwesayensi kancane, kubalulekile ukuthi odokotela baqonde kahle ukuthi isimo sakho siyini futhi banikeze ukwelashwa okufanele kakhulu.

Kuvamile kangakanani lokhu?

Izinkinga zesigqi senhliziyo (arrhythmias) empeleni zivame kakhulu. Izigidi zabantu eSri Lanka nasemhlabeni jikelele zihlushwa uhlobo oluthile lokuphazamiseka kwesigqi senhliziyo.

I-Supraventricular tachycardias (SVT) uhlobo oluvame kakhulu lokuphazamiseka kwe-cardiac rhythm, ikakhulukazi ezinganeni ezincane nasezinsaneni. Zivame kakhulu nasezinganeni ezinesifo senhliziyo ezizalwa naso.

Kungani le PSVT yenzeka? Ziyini izimbangela?

I-PSVT (ebizwa nangokuthi i-re-entry tachycardia) iyisifo senhliziyo esithinta inhliziyo esenzeka ku-atria. Kwenzeka uma kukhona umsebenzi kagesi ongajwayelekile ku-atria. Lokhu kusho ukuthi indawo ezwela kakhulu ku-atria noma i-short circuit ezindleleni zikagesi zenhliziyo kubangela ukuthi izimpawu zikagesi ziqale ukuhamba ngezindilinga. Yilapho i-atria iqala ukuncipha ngokushesha nangokuqhubekayo.

Lezi zimpawu zikagesi ezingavamile zingavela uma kukhona indlela kagesi eyengeziwe (`indlela eyengeziwe`) phakathi kwe-atria nama-ventricles, kungaba ngqo noma nge-`AV node`. Isibonelo, abantu abanesimo esibizwa ngokuthi i-`Wolff-Parkinson-White syndrome` banale ndlela eyengeziwe ezinhliziyweni zabo. Ngemuva kwalokho, uma izimpawu zikagesi zihamba ngale ndlela eyengeziwe ngokushesha kunokuba zingahamba nge-`AV node` evamile, inhliziyo iqala ukushaya ngokushesha kakhulu.

Njengezinye izinkinga zesigqi senhliziyo (arrhythmias), i-PSVT ingaba yimbangela yofuzo. Lokhu kusho ukuthi uma othile emndenini wakho enayo, kungenzeka ukuthi uyithole. Ngaphezu kwalokho, kunezinye izimbangela eziningi ezingabangela lesi simo. Ake sibheke ukuthi ziyini:

• Ngokuguga: Ngoba inhliziyo iyashintsha ngokuhamba kweminyaka.
• I-anemia: Lapho umzimba ungatholi umoya-mpilo owanele.
• Ukuphelelwa amanzi emzimbeni kanye nokukhathala ngokweqile: Lokhu kungabangela ukucindezeleka enhliziyweni.
• Iziphuzo nokudla okuqukethe i-caffeine: Izinto ezifana netiye, ikhofi, ushokoledi, kanye neziphuzo ezithile ezinikeza amandla.
• Ukudla okuthile: Abanye abantu bangase babe nokushaya kwenhliziyo ngemva kokudla ukudla okunamafutha amaningi, ushukela, noma ama-carbohydrate. Isibonelo, ungase uzizwe isifuba sakho sishaya ngemva kokudla okunzima noma ngemva kwephathi.
• Eminye imithi: Isibonelo, i-pseudoephedrine, etholakala kwezinye izidakamizwa zokuqeda ukuminyana kwamakhala.
• Ukuphuza utshwala ngokweqile.
• Ukuba nokuhlaselwa yinhliziyo ngaphambilini noma ukulimala kwenhliziyo ngenxa yokuhlinzwa kwenhliziyo.
• Isifo senhliziyo: ikakhulukazi isifo semithambo yenhliziyo (CAD).
• Umfutho wegazi ophezulu (i-Hypertension).
• Ukucindezeleka okukhulu nokukhathazeka: Ukucindezeleka okubangelwa izinto ezifana nokuhlolwa okuzayo, izinkinga zomsebenzi, noma izinkinga zomndeni.
• Izinguquko zama-hormone: Ngesikhathi sokunqamuka kokuya esikhathini kwabesifazane, noma ngesikhathi sokukhulelwa. Eqinisweni, ukushaya kwenhliziyo kuvame kakhulu ngesikhathi sokukhulelwa.
• Ukukhuluphala ngokweqile (ukukhuluphala ngokweqile) kanye nokukhuluphala ngokweqile.
• Ukubhema nokusebenzisa imikhiqizo kagwayi.
• Izinkinga zesakhiwo senhliziyo: Isibonelo, isifo se-valve yenhliziyo.
• Izinkinga ze-thyroid: ikakhulukazi i-'Hyperthyroidism' (i-thyroid esebenza ngokweqile).

Ziyini izimpawu ze-PSVT?

Izimpawu ze-PSVT zivame ukuqala ngokuzumayo futhi ziphele ngokuzumayo. Zingaba mnene kwabanye abantu, futhi zibe zimbi kwabanye. Ungase uzizwe lokhu kushaya kwenhliziyo okusheshayo ngemva kokuzivocavoca kanzima, ngemva kosuku lokungalali kahle, noma ngesikhathi sokucindezeleka okukhulu.

Izimpawu eziyinhloko yilezi:

• Isilinganiso senhliziyo esisheshayo nesingavamile. Ngokuvamile singaphezu kwama-beats ayi-100 ngomzuzu (BPM), kodwa ngezinye izikhathi sifinyelela kuma-250 BPM. Izingane ezincane ezine-PSVT zingase zibe nesilinganiso senhliziyo esiphakeme nakakhulu.
• Ukuzwa umuzwa wokushaya, ukushaya, noma ukushaya esifubeni, emphinjeni, noma entanyeni (`ukushaya kwenhliziyo`). Abanye abantu bathi kuzwakala sengathi "isigubhu siyashaya ngaphakathi esifubeni." Ungase uzwe ukushaya kwenhliziyo okunamandla nokusheshayo.
• Izinguquko ezisheshayo ekushayeni kwenhliziyo. Inhliziyo yakho ingase ishaye ngokushesha imizuzu embalwa noma amahora ambalwa, bese ngokuzumayo iqala ukushaya ngendlela evamile futhi. (Izinga lokushaya kwenhliziyo elivamile kumuntu omdala liphakathi kwama-beats angu-60 no-100 ngomzuzu.)

Uma lesi simo se-`PSVT` sivela, ungase ubhekane nezinye izimpawu eziningana:

• Ukuzizwa ukhathazekile futhi unesiyezi.
• Ubuhlungu besifuba, ukungakhululeki, noma umuzwa wokuqina esifubeni.
• Ubunzima bokuphefumula noma ukuphelelwa umoya (i-dyspnea).
• Isiyezi kanye nokukhanya kwekhanda, amehlo aluhlaza okwesibhakabhaka.
• Ukulahlekelwa ukwazi (i-syncope) noma ukuquleka.
• Ukukhathala noma ukukhathala okukhulu.
• Isicanucanu.

Wazi kanjani ukuthi une-PSVT?

Uma uya kudokotela, uzoqala ngokukubuza ngezimpawu zakho bese elalela inhliziyo yakho nge-stethoscope. Ngemuva kwalokho, bazo-oda ukuhlolwa kwegazi. Lokhu kuhlolwa kwegazi kuhlola ukusebenza kwe-thyroid yakho kanye nezinye izinkinga egazini lakho.

Okulandelayo, udokotela wakho uzokwenza i-electrocardiogram (EKG noma i-ECG). Lokhu ukuhlolwa okungenziwa ehhovisi likadokotela futhi kuthatha cishe imizuzu eyi-15. I-EKG iqopha umsebenzi kagesi wenhliziyo yakho kanye nokushaya kwenhliziyo yakho ngezinzwa ezibekwe esikhumbeni sakho. Ngezinye izikhathi, uma uzwa i-PSVT ngesikhathi sokuzivocavoca okunzima, ungase ucelwe ukuthi wenze ukuhlolwa kokucindezeleka kokuzivocavoca.

Uma i-EKG ingakhombisi ukushaya kwenhliziyo okungajwayelekile, udokotela wakho cishe uzokunika i-ambulatory monitor, eyaziwa nangokuthi i-Holter monitor noma i-patch monitor, ukuze uyigqoke izinsuku ezimbalwa noma ngisho nenyanga. Lena idivayisi encane ongayigqoka emzimbeni wakho. Iqopha njalo ukushaya kwenhliziyo yakho kanye nanoma yikuphi ukushaya kwenhliziyo okungajwayelekile (uma kukhona).

Iphathwa kanjani i-PSVT?

Kuye ngempilo yakho iyonke kanye nezimpawu, ungase ungadingi ukwelashwa. Uma une-cardiac rhythm engajwayelekile (i-`arrhythmia`), uzothunyelwa ku-`cardiologist`. Angase akuncome okulandelayo:

• Gwema utshwala ne-caffeine (itiye, ikhofi, iziphuzo ezibandayo). Futhi, yeka ukuthatha eminye imithi equkethe i-pseudoephedrine, njengemithi yokunciphisa ukuminyana.
• Lala kahle uphumule.
• Phuza amanzi amaningi ukuze ugcine amanzi enele emzimbeni.
• Thola usizo lokunciphisa ukucindezeleka nokukhathazeka, futhi wenze izivivinyo zokuphumula.
• Uma ukhuluphele ngokweqile (ukhuluphele ngokweqile), yehlisa isisindo futhi ugcine isisindo esinempilo.
• Uma ubhema, yeka ngokuphelele.

Futhi, uma ubhekene nalesi simo se-'PSVT', ungabuza udokotela wakho ngezindlela ezithile zokunciphisa ijubane lokushaya kwenhliziyo yakho okwesikhashana. Lezi zibizwa ngokuthi 'izindlela zokushaya kwenhliziyo'. Izibonelo:

• Ukuthela amanzi abandayo ebusweni bakho ngesikhathi esisodwa.
• Ukukhwehlela ngendlela ekhethekile.
• Vala amehlo akho bese ucindezela kancane ezinkopheni zakho.

Okubalulekile: Ungalokothi uzame lezi 'zindlela zokuzivocavoca zesitho sangasese sowesifazane' wedwa, ngaphandle kokuqeqeshwa okufanele. Kufanele nakanjani uthintane nodokotela wakho futhi uzenze njengoba ekutshela.

• Indlela ethi 'Valsalva maneuver' ingenye indlela enjalo. Kulokhu, uphefumula, ucindezele impumulo yakho, uyibambe sengathi usuthi, bese ukhipha umoya ngokushesha, sengathi ufutha ibhaluni. Lokhu kunganciphisa nokushaya kwenhliziyo yakho kancane.

Uma izinga lokushaya kwenhliziyo yakho lishintsha njalo, uma likubangela ukungakhululeki, noma uma unezinye izinkinga zenhliziyo, udokotela wakho angase akuncomele ukwelashwa. Ukwelashwa okunjalo kufaka phakathi:

• `Ukususwa kwe-catheter`:Lokhu kuhilela ukudala umonakalo omncane engxenyeni yezicubu zenhliziyo ethumela izimpawu zikagesi ezingajwayelekile. Lokhu kuyindlela yokwelapha ehilela ukufaka ithubhu elincane (i-catheter) ngomthambo, ngaphandle kokwenza ukusikwa okukhulu.
• `Ukubhucungwa kwe-Carotid sinus`: Kulokhu, udokotela ucindezela kancane endaweni ethile entanyeni yakho ukuze anciphise ukushaya kwenhliziyo yakho. Lokhu kufanele kwenziwe udokotela kuphela, futhi akufanele ukwenze ekhaya.
• Amadivayisi: Ngezinye izikhathi idivayisi efana ne-`Implantable Cardioverter Defibrillator (ICD), `i-subcutaneous ICD` noma `i-permanent pacemaker` inganconywa ukuthi ifakwe enhliziyweni.
• I-Electrical cardioversion: Kulokhu, inhliziyo inikezwa ukushaqeka kukagesi okuphephile (ukuqhuma kwamandla), okumisa isigqi esingajwayelekile nokuvumela inhliziyo ukuthi ishaye ngendlela evamile.
• Imithi: Kunemithi engabuyisela isigqi senhliziyo futhi ivimbele ukungalingani kwesigqi senhliziyo.

Unganciphisa kanjani ingozi ye-PSVT?

Kungase kungenzeki ukuvimbela ngokuphelele i-PSVT. Kodwa-ke, unganciphisa ingozi yakho ngokulandela indlela yokuphila enempilo nokuhlala uphilile. Nazi ezinye izinto ongazenza ukuze unciphise ingozi yakho:

• Landela ukudla okunempilo kwenhliziyo ( okunamafutha amancane, usawoti, noshukela, kanye nemifino eminingi, izithelo, kanye nemifino eluhlaza).
• Uma unezinto (`izibangeli`) ozaziyo ukuthi zibangela lesi simo se-`PSVT`, zigweme.
• Vivinya umzimba kahle, hlala umatasa, futhi uzame ukulondoloza ukuqina komzimba.
• Uma ukhuluphele ngokweqile, yehlisa isisindo, khuluma nodokotela wakho, futhi ugcine isisindo sakho siphilile.
• Uma unomfutho wegazi ophakeme (umfutho wegazi ophakeme), yilawule.
• Gcina amazinga e-cholesterol anempilo.
• Uma ubhema, yeka ngokuphelele.
• Uma wena noma ingane yakho ninesifo senhliziyo esanda ingozi ye-PSVT, khuluma nodokotela wakho ngaso. Uzokunikeza iseluleko esiqondile sokuthi ungahlala kanjani uphilile futhi unciphise ingozi yesifo senhliziyo.

Kwenzekani kumuntu one-PSVT? Liyini ikusasa?

Umbono womuntu one-PSVT uncike ezintweni eziningana, okuhlanganisa iminyaka yakho kanye nempilo yakho iyonke. Ungasiza ekulawuleni izimpawu zakho ngokwenza izinguquko endleleni yokuphila kanye nokudla.

Ngokuhamba kwesikhathi, i-PSVT ingabuthakatha imisipha yenhliziyo. Ezimweni ezimbi kakhulu, i-PSVT ingabangela ukulahlekelwa ingqondo ngisho nokuma kwenhliziyo ngokuzumayo. Ngakho-ke, uma une-PSVT, kubaluleke kakhulu ukubona udokotela wakho njalo ukuze aqaphe impilo yenhliziyo yakho.

Izindaba ezinhle ukuthi ezimweni eziningi, i-PSVT ingelapheka ngokuphelele ngokwelashwa okubizwa ngokuthi i-catheter ablation.

Kufanele ngimbone nini udokotela mayelana ne-PSVT?

Uma unenkinga mayelana nokushaya kwenhliziyo yakho, noma uma unezimpawu zokushaya kwenhliziyo okungajwayelekile (i-arrhythmia), qiniseka ukuthi ukhuluma nodokotela. Uma kutholakale ukuthi une-PSVT, kubaluleke kakhulu ukubona udokotela wakho wenhliziyo njalo.

Uma lezi zinto zenzeka, funa iseluleko sezokwelapha ngokushesha:

• Uma uzizwa ukhathele kakhulu ngokuzumayo ngaphandle kwesizathu esicacile.
• Uma uzizwa uphelelwa amandla noma ulahlekelwa ingqondo.
• Uma uzwa ubuhlungu esifubeni, ubunzima bokuphefumula, noma ukuphelelwa umoya.

Okokugcina, okufanele ukukhumbule (Umyalezo Wokuya Ekhaya)

I-Paroxysmal Supraventricular Tachycardia (PSVT) ingaba yinto eyesabekayo uma yenzeka. Kodwa-ke, ngokuvamile ayisongeli impilo noma isongela impilo. Kodwa-ke, uma unemibuzo noma ukukhathazeka mayelana nokushaya kwenhliziyo yakho, kungcono ngaso sonke isikhathi ukubona udokotela ukuze akuhlole ngokugcwele ukuqinisekisa ukuthi ayikho inkinga enkulu yempilo.

Nakuba i-PSVT ingadingi ukwelashwa njalo, kunezindlela zokwelapha ezitholakalayo uma uzidinga. Ngokuhlala usebenza, unciphise izinto ezifana ne-caffeine notshwala, ulandele indlela yokuphila enempilo, futhi ubonane nodokotela wakho wenhliziyo ngesikhathi, unganciphisa ingozi yakho yezinkinga ezivela ku-PSVT. Ngakho-ke, nakekela inhliziyo yakho, ngoba iyigazi lakho lokuphila!

Ukushaya kwenhliziyo okusheshayo, ukushaya kwenhliziyo okusheshayo, i-PSVT, i-Paroxysmal Supraventricular Tachycardia, i-arrhythmia, isifo senhliziyo, ubuhlungu besifuba, i-tachycardia