Ingabe unesikhala esincane enhliziyweni yakho? Ake sixoxe nge-(Patent Foramen Ovale - PFO)!

Wake wezwa ukuthi inhliziyo yakho, noma kunalokho, phakathi kwamakamelo amabili aphezulu enhliziyo, ingaba nomgodi omncane ongasala ngemva kokuzalwa? Abantu abaningi bayamangala ukuzwa lokhu. Kodwa kuyiqiniso. Lesi simo sibizwa ngokuthi i-'Patent Foramen Ovale' noma '(PFO)'. Ungakhathazeki, sizokhuluma ngakho kalula, ngendlela ongayiqonda.

Kuyini i-PFO? Masiyiqonde kalula

Kalula nje, i-patent foramen ovale (PFO) iwumgodi omncane, ofana nesembozo phakathi kwamakamelo amabili aphezulu enhliziyo yakho, i-atrium yesokudla kanye ne-atrium yesobunxele. Manje cabanga ukuthi lapho sonke sisesibelethweni sikamama, lo mgodi, obizwa ngokuthi i-foramen ovale, ukhona. Ubalulekile. Kodwa ngokuvamile, uyavaleka ngemva kokuzalwa kwethu. I-PFO yilapho ingavali ngemva kokuzalwa. Igama elithi "patent" lisho "ukuvula."

Esikhathini esiningi, abantu abane-PFO abanazo izimpawu futhi abadingi ukwelashwa. Kodwa-ke, akuvamile kakhulu, izinkinga ezithile, njengesifo sohlangothi, zingahlotshaniswa ne-PFO.

Kungani le foramen ovale ibalulekile? Kwenzekani ngesikhathi sobuntwana?

Ingane esibelethweni, umbungu, ayisebenzisi amaphaphu ayo ukuthola igazi elinomoya-mpilo. Kunalokho, leli gazi elinomoya-mpilo livela kumama nge-placenta, eduze kwe-umbilical cord. Yilokhu okwenziwa yi-foramen ovale, iqondisa igazi elinomoya-mpilo lisuka e-umbilical cord lisuka e-atrium yesokudla yomntwana ngqo liye e-atrium yesobunxele.

Ukusuka lapho, lelo gazi liya ohlangothini lwesobunxele lwenhliziyo yengane, linikeze umoya-mpilo ebuchosheni bengane nakwezinye izitho ezibalulekile. Indlela emangalisayo impela, akunjalo?

Ngemva kokuzalwa kwengane, lapho iqala ukuphefumula yodwa, igazi liya emaphashini ukuze lithole umoya-mpilo. Yilapho-ke leli "foramen ovale" livama ukuvala khona. Bese igazi elinomoya-mpilo liya ohlangothini lwesobunxele lwenhliziyo, bese liphuma lapho liphampelwa emzimbeni wonke.

Ubani ongaba ne-PFO? Kuvamile kangakanani lokhu?

Eqinisweni, i-PFO ingathinta noma ubani, kungakhathaliseki ubulili, uhlanga, noma umbala. Kodwa-ke, kuvame kakhulu phakathi kwamaqembu athile:

• Abatshuzi, ikakhulukazi labo abahlushwa yi-"Decompression sickness - air embolism", isimo lapho amabhamuza omoya evimba khona imithambo yegazi ngenxa yokushintsha kwengcindezi.
• Phakathi kwalabo abaye baba nesifo sohlangothi okungatholakali imbangela yaso ngqo (isifo sohlangothi esifihliwe).

Emhlabeni jikelele, cishe umuntu oyedwa kwabane (25%) angaba ne-PFO. Ngaphezu kwalokho, kutholakale ukuthi phakathi kuka-30% no-40% wabantu abaye baba ne-stroke ngaphandle kwesizathu esibonakalayo bane-PFO. Kodwa-ke, lokhu akusho ukuthi wonke umuntu one-PFO uzoba ne-stroke. Kubalulekile ukukhumbula lokho.

Ingabe ukuba ne-PFO kuyawuthinta umzimba?

Uma une-'PFO', inani elincane legazi ligeleza lisuka ku-atrium yangakwesokudla liye ku-atrium yangakwesokunxele ngalezo zingxenyana ezincane. Ngokuvamile, lokhu akwenzeki ngoba lezi zingxenyana zivaliwe.

Esikhathini esiningi, i-PFO ayibangeli zinkinga. Kodwa-ke, ngezinye izikhathi ihlule legazi lingahamba lisuka ohlangothini lwesokudla lwenhliziyo liye ohlangothini lwesobunxele lwenhliziyo ngale PFO. Uma lokho kwenzeka, inhliziyo ingapompa lelo hlule legazi liye kwezinye izingxenye zomzimba. Cabanga nje, uma lelo hlule legazi liya ebuchosheni, ukuhlinzekwa kwegazi ebuchosheni kungaphazamiseka. Yilapho kwenzeka khona isimo esibizwa ngokuthi i-ischemic stroke. Futhi, leli hlule legazi lingalimaza ezinye izitho njengezinso nenhliziyo.

Ingabe kukhona isizathu esithile esenza i-PFO ikhule?

Abacwaningi abakakatholi ukuthi yini ngempela ebangela i-PFO. Okusho ukuthi, akukacaci ukuthi ngabe kuyizakhi zofuzo, ezemvelo, noma okunye.

Ziyini izimpawu ze-PFO? Bheka ukuthi unazo yini lezi zimpawu

Abantu abaningi abane-PFO ababonisi zimpawu. Kuyiqiniso lokho. Kodwa-ke, ngezinye izikhathi ungase ubone izinto ezinjengalezi:

• Isifo sohlangothi.
• Ukuhlasela Kwe-Ischemic Yesikhashana (i-TIA) noma i-mini-stroke . Lokhu kungabangela ubunzima bokuhambisa isitho, futhi kungathinta izitho ezibalulekile njengobuchopho, amathumbu amancane, amathumbu amakhulu (ikholoni), noma izinso.

Ngaphezu kwalokho, izimo ezingavamile zifaka:

• Ukuhlaselwa yinhliziyo.
• Ukwehla kwamazinga omoya-mpilo egazini (i-Hypoxemia).
• I-Platypnea-orthodeoxia syndrome (PO syndrome): Lesi yisimo lapho izinga lomoya-mpilo egazini lehla khona ngobunzima bokuphefumula ngenkathi uhleli uqonde.

Uthola kanjani ukuthi une-PFO? Yiziphi izivivinyo?

Udokotela wakho uzoqala akubuze ngezimpawu zakho bese ekwenza ukuhlolwa ngokomzimba. Uma kusolwa ukuthi une-PFO, angase akuncomele ukuhlolwa okufana nalokhu:

• I-Transthoracic echocardiogram : I-echocardiogram (noma i-echo) ukuhlolwa okusebenzisa amaza omsindo ukukhiqiza izithombe zamagumbi enhliziyo. Ukuhlolwa kwenziwa ngokubeka ithuluzi ebusweni besifuba.
• I-Transesophageal echocardiogram (TEE) : Kulolu vivinyo, udokotela wakho ufaka ithubhu elincane elifakwe ikhamera emhubheni wakho. Lokhu kungaveza isithombe esicacile se-PFO kune-echo evamile.
• I-ultrasound ye-Transcranial Doppler (TCD) : I-ultrasound ye-TCD isebenzisa amaza omsindo ukubheka ukugeleza kwegazi kuya nangaphakathi ebuchosheni bakho. Ingasiza futhi ekuboneni imivimbo ebangelwa amahlule egazi.

Kanye nalezi zivivinyo, udokotela wakho angase futhi aphakamise "ukuhlolwa kwebhamuza." Lokhu kuhilela ukufaka isixazululo se-saline emthanjeni wakho. Uma la mabhamuza egeleza ngembobo aye ohlangothini lwesobunxele lwenhliziyo yakho ngaphandle kokuhlunga amaphaphu, angabona ukuthi ungaba ne-"PFO."

Ingabe ikhona indlela yokwelapha i-PFO? Ingabe wonke umuntu uyayidinga?

Iningi labantu abane-PFO abadingi ukwelashwa. Kodwa-ke, uma unomlando wesifo sohlangothi noma amahlule egazi, noma usengozini enkulu yaso, udokotela wakho angase akuncome ukwelashwa. Izindlela zokwelapha ze-PFO zifaka:

• Imithi evimbela ukujiya kwegazi : Isibonelo, i-aspirin noma i-warfarin.
• Ukufakwa kwe-Catheter : Kule nqubo, udokotela wenhliziyo ongenelelayo usebenzisa ipayipi elide nelincane (i-catheter) ukuvala i-valve. Le catheter idluliselwa ngomthambo omkhulu osesinqeni iye enhliziyweni bese kusetshenziswa idivayisi ekhethekile (idivayisi yokuvala) ukuvala i-valve. Izifundo zithole ukuthi le nqubo ye-catheter isebenza kangcono kunokuhlinzwa ekwelapheni ama-PFO kubantu abangaphansi kweminyaka engama-60 ubudala.
• Ukuhlinzwa kwenhliziyo : Udokotela ohlinzayo wenza ukusika bese ethunga i-flap ivaliwe. Lokhu kungenziwa uma indlela ye-catheter ingaphumeleli. Lokhu kungenziwa ngokuhlinzwa kwenhliziyo evulekile noma ngokusika okuncane esifubeni okubizwa ngokuthi ukulungiswa kwe-minimally invasive robotically assisted patent foramen ovale.

Ucwaningo lwamuva lubonise ukuthi kubantu abane-PFO abaye baba nesifo sohlangothi esingachazeki, ukuvala i-PFO kungasiza ekuvimbeleni isifo sohlangothi esikhathini esizayo. Kungcono ukukhuluma nodokotela wakho mayelana nokuthi iyiphi indlela yokwelapha efanele wena.

Ingabe ukwelashwa kungaba nemiphumela emibi?

Abanye abantu bangase babe nezinkinga ngenxa yokwelashwa kwe-PFO. Lezi zinkinga ziyahlukahluka kuye ngendlela yokwelashwa:

Izinto ezingenzeka ngemithi

Uma uthatha imithi efana ne-Aspirin noma i-Warfarin, okulandelayo kungenzeka:

• Ukopha.
• Ukopha okuya ebuchosheni (i-Intracranial hemorrhage).

Yini engenzeka ngesikhathi sokwelashwa nge-catheter?

Izinkinga ezivamile zokufakwa kwe-catheter:

• Amahlule egazi.
• Ukulimala kwemithambo yegazi.
• Idivayisi yokuvala ikhululekile.
• Ukutheleleka kwenhliziyo noma `i-endocarditis`.
• I-`PFO` ayivali kahle.
• `Ukugoba kwegazi emaphashini (i-Pulmonary embolism)`.

Izinkinga ezingavamile:

• Ukusha kwe-air embolism.
• Ukuphazamiseka kwenhliziyo (i-Arrhythmia).
• `I-Atrial fibrillation (Afib)`.
• I-tamponade yenhliziyo (ukwakheka koketshezi oluzungeze inhliziyo).

Izinto ezingenzeka ngokuhlinzwa

Ukuhlinzwa ukuze kuvalwe i-PFO kungabangela izinkinga ezifana nalezi:

• `I-Atrial fibrillation (Afib)`.
• Ukopha.
• Izifo.
• Isifo sohlangothi.

Ingabe ikhona indlela yokunciphisa ingozi yokwakheka kwe-PFO?

Akukho lutho ongakwenza ukunciphisa ingozi yokuba ne-PFO. Akuyona into esingayilawula. Kodwa-ke, uma une-stroke engachazeki (i-cryptogenic stroke), kubalulekile ukuthi uhlolwe lesi simo. Ngemuva kwalokho, uma kudingeka, ungathola ukwelashwa ngokushesha.

Sinjani isimo sempilo somuntu one-PFO? Ingabe kuyinto okufanele ukhathazeke ngayo?

Ezimweni eziningi, isivalo sengane ene-PFO sivaleka ngokuphelele eminyakeni emithathu yokuqala yokuphila. Abantu abaningi abane-PFO baphila impilo egcwele, enempilo ngaphandle kwezinkinga lapho sebekhulile. Ngakho-ke ungakhathazeki ngakho ngokungadingekile .

Uma ngine-PFO, ngingayinakekela kanjani impilo yami?

Ungagcina inhliziyo yakho iphilile futhi unciphise ingozi yakho yokushaywa yisifo sohlangothi ngokulandela lezi zinyathelo:

• Gwema ukusebenzisa utshwala noma ezinye izidakamizwa.
• Yidla ukudla okunempilo okunempilo kwenhliziyo.
• Lawula umfutho wegazi ophakeme (i-Hypertension) noma amazinga aphezulu e-cholesterol.
• Gcina isisindo esinempilo.
• Yeka ukubhema nokusebenzisa imikhiqizo kagwayi.
• Thola ukwelashwa okufanele kwezinye izimo zempilo ezandisa ingozi yakho yokushaywa unhlangothi, njenge-atrial fibrillation (Afib).

Futhi, ukungahlali endaweni efanayo isikhathi eside kakhulu kunganciphisa ingozi yokuqhekeka kwegazi.

Yiziphi izikhathi ezinhle kakhulu zokuya kudokotela?

Uma unezinye zezimpawu zesifo sohlangothi , bona udokotela ngokushesha noma ushayele u-911 (noma inombolo yakho yesimo esiphuthumayo yasendaweni). Lezi zimpawu zingase zihlanganise:

• Ubunzima bokukhuluma noma ukuqonda.
• Isiyezi noma ukulahlekelwa yibhalansi.
• Ukuba ndikindiki noma ubuthakathaka ebusweni, engalweni, noma emlenzeni.
• Ubunzima bokubona ngeso elilodwa noma zombili.
• Ikhanda elibuhlungu kakhulu ngokuzumayo.

Umlayezo Wokuya Nawe Ekhaya

I-patent foramen ovale (PFO) iwumgodi omncane enhliziyweni phakathi kwamakamelo enhliziyo angakwesokudla nakwesobunxele. Ithinta cishe umuntu oyedwa kwabane (25%) . Esikhathini esiningi, i-PFO ayibangeli zimpawu futhi ayidingi ukwelashwa. Kodwa-ke, ngezinye izikhathi ingaba uphawu lwesifo sohlangothi noma isifo sohlangothi esincane. Uma unomlando wesifo sohlangothi noma amahlule egazi, udokotela wakho angase atuse ukwelashwa. Izinketho zokwelapha zifaka phakathi imithi, ukufakwa kwe-catheter, kanye nokuhlinzwa. Into ebalulekile ukuthi abantu abaningi abane-PFO bangaphila impilo egcwele, enempilo. Uma unenkinga, ungangabazi ukukhuluma nodokotela wakho.

'I-PFO, i-patent foramen ovale, umgodi enhliziyweni, isifo sohlangothi, ihlule legazi, isifo senhliziyo, i-foramen ovale