Ingabe uzwa ubuhlungu esifubeni futhi kunzima ukuphefumula? Lokhu kungaba yi-pericarditis!

Wake wazizwa ubuhlungu obukhulu, obuhlabayo phakathi kwesifuba sakho, okwenza kube nzima ukuphefumula? Lokhu kungenzeka ngisho nangemva kokuba usululame emkhuhlaneni ovamile noma emkhuhlaneni. Abantu abaningi besaba ukuthi lesi yisimo senhliziyo. Eqinisweni, kungaba ukuvuvukala kwesikhwama esizungeze inhliziyo. Namuhla, sizoxoxa ngalesi simo ngokuningiliziwe esibizwa ngokuthi "i-pericarditis."

Uyazi ukuthi iyini i-pericarditis?

Kalula nje, i-'Pericarditis' ukuvuvukala noma ukuvuvukala kwe-'pericardium', isikhwama esincane kakhulu, esinezingqimba ezimbili, esigcwele uketshezi esizungeze inhliziyo yethu. Kufana nokusikeka esikhumbeni sethu okubangela ukuba indawo ibe bomvu futhi ivuvuke. Umsebenzi oyinhloko wale 'pericardium' ukuvikela inhliziyo nokuyinika ukuthambisa okudingekayo lapho ishaya. Ngenxa yalokhu kuvuvukala, ngezinye izikhathi uketshezi olwengeziwe lungaqongelela phakathi kwezingqimba ze-pericardium. Lokhu kubizwa ngokuthi 'i-pericardial effusion'.

I-Pericarditis ivame ukwenzeka ngokuzumayo. Kodwa-ke, ngezinye izikhathi ingahlala amasonto kuya ezinyangeni. Ngokuvamile, lesi simo siyaphela zingakapheli izinyanga ezintathu, kodwa kwabanye abantu, singahlala iminyaka.

Kunezinhlobo eziningana ze-pericarditis, akunjalo?

Yebo, kunezinhlobo ezahlukene ze-'Pericarditis'. Ake sibone ukuthi yiziphi izinhlobo eziyinhloko:

• I-Acute Pericarditis: Lolu uhlobo oluvame kakhulu. Lokhu kuvuvukala kwenzeka ngokuzumayo, kanye nezimpawu.
• I-Pericarditis Engapheli: Leli igama elinikezwa ukuvuvukala okuqhubeka izinyanga ezintathu noma ngaphezulu ngemva kwesigameko sokuqala esibi.
• I-Constrictive Pericarditis: Lesi yisimo esibi kakhulu. Okwenzekayo lapha ukuthi izendlalelo ze-pericardium ezivuvukele ziyaqina kancane kancane, kwakheka izicubu zesilonda, futhi zinamathelane. Kunjengokungathi inhliziyo iyaqina. Lokhu kuphazamisa kakhulu ukusebenza okuvamile kwenhliziyo. Lesi simo sivame ukwenzeka ngemva kwesikhathi eside se-'Acute Pericarditis'.
• I-Pericarditis Ethelelanayo: Lesi simo singabangelwa ukutheleleka ngegciwane, amagciwane, isikhunta, noma ama-parasites.
• I-Idiopathic Pericarditis: Ngezinye izikhathi imbangela yalokhu ayaziwa . Yingakho ibizwa kanje.
• I-Traumatic Pericarditis: Lesi simo singavela ngemva kokulimala esifubeni, isibonelo ngemva kwengozi yemoto.
• I-Uremic Pericarditis: Lokhu kungenzeka kubantu abanezinso ezingasebenzi kahle.
• I-Pericarditis Ebulalayo:Lesi simo singase sivele ngenxa yomdlavuza okhula kwenye indawo emzimbeni.

Uyini umehluko phakathi kwe-Myocarditis ne-Pericarditis?

Zombili ziyizimo zokuvuvukala kwenhliziyo, kodwa zenzeka ezindaweni ezimbili. I-Myocarditis ukuvuvukala kwemisipha yenhliziyo. I-Pericarditis ukuvuvukala kwesikhwama esizungeze inhliziyo, esibizwa ngokuthi i-pericardium. Zombili zivame ukubangelwa yigciwane. Zombili zingabangela ubuhlungu besifuba. Kodwa-ke, nge-pericarditis, ubuhlungu besifuba kufanele buncishiswe uma ugoba phambili. Nge-myocarditis, uzozizwa ukhathele futhi ubuthakathaka kakhulu.

Ubani okungenzeka kakhulu ukuthi athole i-Pericarditis?

Noma ubani angaba nesifo senhliziyo esibizwa ngokuthi i-pericarditis. Kodwa-ke, sivame kakhulu kwabesilisa abaneminyaka ephakathi kuka-16 no-65. Ngokwezibalo, lesi simo senzeka kubantu abangaba ngu-28 kwabangu-100,000 ngonyaka.

Kwenzekani emzimbeni uma kwenzeka i-pericarditis?

Uma une-pericarditis, ulwelwesi oluzungeze inhliziyo yakho luba bomvu futhi luvuvuke. Kufana nesikhumba esizungeze isilonda engalweni noma emlenzeni wakho esivuvukele. Le pericardium ibaluleke kakhulu. Ithambisa inhliziyo, iyivikele ezifweni kanye nomdlavuza, futhi isiza ukuyigcina isendaweni yayo esifubeni. Iphinde ivimbele inhliziyo ukuthi ibe nkulu kakhulu lapho inani legazi likhuphuka. Lokhu kusiza inhliziyo ukuthi isebenze kahle kakhulu.

Ziyini izimpawu ze-pericarditis? Uzibona kanjani?

Uphawu oluyinhloko lwe-pericarditis ubuhlungu besifuba. Lobuhlungu bunezici eziningana ezithile:

• Ubuhlungu obuhlabayo nobubukhali (lokhu kubangelwa ukukhuhla kwenhliziyo e-pericardium evuvukele).
• Lobuhlungu bungakhula uma ukhwehlela, ugwinya, uphefumula kakhulu, noma ulala phansi.
• Kodwa-ke, uma uhlala phansi futhi ugoba phambili, kufanele uzizwe ubuhlungu buphela. Lesi uphawu olubaluleke kakhulu.

Ngezinye izikhathi ungase uzizwe udinga ukugoba phambili noma ukubamba isifuba sakho ukuze kube lula ukuphefumula.

Kunezinye izimpawu:

• Ubuhlungu emhlane, entanyeni, noma ehlombe lesobunxele.
• Kunzima ukuphefumula uma ubambekile.
• Ukukhwehlela okomile.
• Ukushaya kwenhliziyo kuwumuzwa wenhliziyo ishaya ngokushesha noma ngokungajwayelekile.
• Ukuzizwa ukhathazekile futhi ukhathele njalo.
• Imfiva.
• Ezimweni ezimbi kakhulu, ukuvuvukala kwemilenze, amaqakala nezinyawo.

Uma imilenze, izinyawo, namaqakala akho kuvuvukile, noma unenkinga yokuphefumula ngisho nalapho wenza imisebenzi emincane, kungaba uphawu lwesimo esibi esibizwa ngokuthi i-Constrictive Pericarditis. Lokhu kwenzeka lapho i-pericardium iqina futhi ivimbela inhliziyo ukuthi ikhule kahle. Lokhu kuvimbela inhliziyo ukuthi ipompe igazi kahle. Lokhu kungabangela ukuthi amaphaphu, isisu, nemilenze kugcwale igazi futhi kuvuvuke, okufana nezimpawu ze-Congestive Heart Failure. Izinga lenhliziyo elingajwayelekile nalo lingenzeka.

Uma unezimpawu ze-'Acute Pericarditis', bona udokotela wakho ngokushesha. Uma ucabanga ukuthi izimpawu zakho ziyisimo esiphuthumayo, funa ukwelashwa esibhedlela esiseduze.

Kungani i-Pericarditis yenzeka? Ziyini izimbangela?

Ngokumangalisayo, ezimweni ezingaba ngu-90 kweziyi-100, akukho mbangela ethile engatholakala yale "pericarditis." Lokhu kubizwa ngokuthi "idiopathic pericarditis."

Kodwa-ke, kunezinye izizathu eziningi zokuthi kungani i-pericarditis ingenzeka:

• Njengenkinga yokutheleleka ngegciwane (ngokuvamile igciwane lokugaya ukudla).
• Ukutheleleka ngamagciwane, isibonelo, isifo sofuba.
• Ukutheleleka kwesikhunta.
• Ukutheleleka okuvela ku-parasite.
• Ngenxa yezinye 'Izifo Ezizimele', isibonelo 'Lupus', 'Rheumatoid Arthritis', 'Scleroderma'.
• Ukulimala esifubeni, njengangemva kwengozi yemoto.
• Ngenxa 'Yokwehluleka Kwezinso'.
• Ngenxa yomdlavuza ofana ne-'Lymphoma'.
• Ngenxa yezifo zofuzo ezifana ne-'Familial Mediterranean Fever (FMF)'.
• Ngenxa yemithi ethile ecindezela amasosha omzimba (lokhu akuvamile kakhulu).

Futhi, ingozi yokuthola i-Pericarditis iphakeme ngemva kwalezi zinto ezilandelayo:

• Ngemva 'kokuhlaselwa yinhliziyo'.
• Ngemva kokuhlinzwa kwenhliziyo okuvulekile (Ukuhlinzwa Kwenhliziyo Okuvulekile / Isifo Se-Postpericardiotomy).
• Ngemva kokwelashwa ngemisebe.
• Ngemva kokwelashwa okuthile okufana ne-'Cardiac Catheterization' noma i-'Radiofrequency Ablation (RFA)'.

Kulezi zimo, i-pericarditis ingabangelwa inkinga ngendlela umzimba osabela ngayo ekuhlinzweni noma esimweni esithile. Ngezinye izikhathi, kungathatha amasonto amaningana ukuthi izimpawu ze-pericarditis zivele ngemva kokuhlinzwa kwe-bypass. Khuluma nodokotela wakho ohlinzayo ngalokhu.

Dokotela, uyixilonga kanjani i-pericarditis?

Ubuhlungu obukhulu esifubeni sakho nangemuva kwamahlombe akho, ikakhulukazi uma ugoba phambili, kanye nobuhlungu esifubeni uma uphefumula yizimpawu ezimbili ezinkulu zokuthi ungaba ne-pericarditis. Lokhu kungakusiza ukuthi uthole ukuthi akuyona yini isifo senhliziyo. Udokotela wakho uzokubuza ngezimpawu zakho, ukuthi ngabe uke wagula muva nje, noma yiziphi izifo ezidlule, noma yikuphi ukuhlinzwa oke wakwenza, kanye nanoma yiziphi ezinye izinkinga zempilo ezingase zandise ingozi yakho yokuthola i-pericarditis.

Udokotela uzobe eselalela inhliziyo yakho. Lapho izingqimba ezivuvukele ze-pericardium zigudlana, uzozwa umsindo ofana namaqabunga amabili egudlana, noma izingcezu ezimbili zesikhumba esomile zigudlana . Lokhu kubizwa ngokuthi "i-pericardial rub." Lo msindo uzwakala kahle uma ugoba phambili, ubamba umoya wakho, bese uphefumula kancane. Kuye ngobukhulu bokuvuvukala, ungase uzwe "ukuqhekeka" emaphashini. Lokhu kusho ukuthi kukhona uketshezi esikhaleni esizungeze amaphaphu, noma kukhona uketshezi olwengeziwe ku-pericardium.

Yiziphi izivivinyo ezenziwayo ngalokhu?

Odokotela bazokwenza izivivinyo ezahlukene ukuhlola i-pericarditis, kanye nezinkinga ezifana ne-pericardial effusion noma i-constrictive pericarditis. Kungadingeka wenze okukodwa noma ngaphezulu kwalokhu okulandelayo:

• I-X-ray yesifuba: Hlola ubukhulu benhliziyo bese ubona ukuthi kukhona yini uketshezi emaphashini.
• I-Electrocardiogram (ECG noma EKG): Ihlola izinguquko esigqini senhliziyo. Cishe ingxenye yabantu abane-pericarditis bazoba nezinguquko ezithile eziphawulekayo ku-ECG yabo. Abanye abantu bangase bangabi nazo nhlobo izinguquko.
• I-Echocardiogram (Echo): Ukubona ukuthi inhliziyo isebenza kahle kangakanani nokuthi kukhona yini uketshezi oluzungeze inhliziyo (i-pericardial effusion). I-echo ingabonisa izimpawu ze-constrictive pericarditis, okuyisikhwama esiqinile nesiqinile esizungeze inhliziyo.
• I-MRI Yenhliziyo: Ukuhlola uketshezi olwengeziwe, ukuvuvukala, ukuqina, noma ukukhononda kwenhliziyo ku-pericardium . Into ekhethekile ebizwa ngokuthi i-`Gadolinium` ifakwa enhliziyweni.
• I-CT Scan: Ukubona ukuthi kukhona yini ama-calcium deposits, uketshezi, ukuvuvukala, amathumba, noma ezinye izifo ku-pericardium. Lokhu kusebenzisa udayi oqukethe i-'Iodine'. Funda kabanzi mayelana nokuvuvukala. Lokhu kuhlolwa kubaluleke kakhulu uma udinga ukuhlinzwa kwe-'Constrictive Pericarditis'.
• Ukuhlolwa kwe-Catheterization Yenhliziyo: Kuhlola ingcindezi ngaphakathi kwenhliziyo. Lokhu kungaqinisekisa ukuthi une-Constrictive Pericarditis.
• Ukuhlolwa Kwegazi: Ukuqinisekisa ukuthi awunaso isifo senhliziyo, ukubona ukuthi inhliziyo yakho isebenza kahle kangakanani, ukuhlola uketshezi oluku-pericardium, nokusiza ekutholeni imbangela ye-pericarditis. Uma une-pericarditis, amazinga akho e-ESR (Erythrocyte Sedimentation Rate) kanye namazinga e-C-reactive protein (CRP) avame ukuba phezulu kunokuvamile. Ezinye izivivinyo zingenziwa futhi ukuhlola izifo ezizimele njenge-lupus kanye ne-rheumatoid arthritis.

Yiziphi izindlela zokwelapha i-pericarditis?

Ezimweni eziningi, imithi yodwa yanele kubantu abane-pericarditis, kuye ngokuthi imbangela ikuphi. Kodwa-ke, uma uketshezi luqongelelene ku-pericardium yakho, kungadingeka lususwe. Uma une-pericarditis egobile, kungase kudingeke ukuhlinzwa.

Imithi ye-Pericarditis

I-acute pericarditis iphathwa ngemithi yobuhlungu nokuvuvukala, njenge-ibuprofen noma i-aspirin enesikali esiphezulu. Kuye ngembangela ye-pericarditis, ungadinga ama-antibiotic noma imithi ye-antifungal.

Uma unezimpawu ezinzima isikhathi esingaphezu kwamasonto amabili, noma uma zibuya ngemva kokuba usuphilile, udokotela wakho angase akunike nomuthi wokulwa nokuvuvukala obizwa ngokuthi i-Colchicine (Colcrys® noma i-Gloperba®). I-Colchicine ingasiza ekulawuleni ukuvuvukala futhi ivimbele i-pericarditis ukuthi ingabuyi amasonto noma izinyanga. Uma unesifo sezinso, udokotela wakho angase akunike ne-steroid ebizwa ngokuthi i-Prednisone, engenza kube nzima ukuthatha i-ibuprofen ne-colchicine.

Uma kufanele uthathe imithamo ephezulu ye-'Ibuprofen', udokotela wakho uzokunikeza neminye imithi yokunciphisa ukungakhululeki kwamathumbu. Uma uthatha imithamo ephezulu ye-'NSAIDs (Izidakamizwa Ezingavuvukalisi Ama-steroidal)', kuzodingeka ukuthi ube nokuhlolwa 'kokuLandelela' njalo ukuze uhlole izinguquko ekusebenzeni kwezinso nesibindi.

Uma une-Pericarditis ethi 'Chronic' noma 'Recurrent', kungadingeka ukuthi uphuze 'ama-NSAID' noma 'Colchicine' iminyaka eminingana, noma ngabe uphilile. Ama-'Diuretics' ("amaphilisi amanzi") avame ukusiza ukususa uketshezi olwengeziwe oluqongelela ngenxa ye-'Constrictive Pericarditis'. Uma unenkinga yesigqi senhliziyo, udokotela wakho uzokhuluma nawe mayelana nokwelashwa kwalokho.

Udokotela wakho angase futhi akhulume nawe mayelana nokwelapha isimo sakho ngama-steroid noma eminye imithi, njenge-`Azathioprine (Azasan® noma i-Imuran®)`, `IV Human Immunoglobulins`, noma i-`Anakinra` noma i-`Rilonacept`.

Uma i-pericarditis yakho ibangelwa ukutheleleka, udokotela wakho uzokunikeza imithi ethile yokwelapha leso sifo. Uma sibangelwa umdlavuza, ukwelashwa okungcono kakhulu ukwelapha umdlavuza.

Ukuhlinzwa kanye nezinqubo ze-pericarditis

Uma uketshezi luqoqana phakathi kwezingqimba ze-pericardium, lubangela isimo esibizwa ngokuthi 'i-Pericardial Effusion.' Uma lolu ketshezi luqoqana ngokushesha, lungabangela 'i-Cardiac Tamponade', isimo esibi esibeka ingcindezi enhliziyweni futhi siphazamise ukusebenza kwayo. I-'Cardiac Tamponade' iyisimo esiphuthumayo sezokwelapha esisongela impilo esidinga ukwelashwa ngokushesha.

Lokhu kunqwabelana koketshezi okungazelelwe phakathi kwezingqimba zenhliziyo kungavimbela inhliziyo ukuthi isebenze kahle futhi kubangele ukwehla komfutho wegazi. Lokhu kusongela impilo, ngakho udokotela kumele asuse uketshezi ngokushesha.

Uma unoketshezi emfucumfucwini yakho ye-pericardial, okubangela ingcindezi enhliziyweni yakho, kungadingeka ukuthi wenze inqubo ebizwa ngokuthi i-pericardiocentesis. Lokhu kuhilela udokotela esebenzisa ithubhu elide nelincane elibizwa ngokuthi i-catheter ukuze asuse uketshezi oluningi. Leli thubhu nenaliti kuqondiswa esikhwameni se-pericardial kusetshenziswa i-echocardiogram noma i-CT scan.

Uma uketshezi lungakwazi ukususwa ngenaliti, udokotela uzokwenza inqubo encane yokuhlinzwa ebizwa ngokuthi "ifasitela le-pericardial." Lokhu kuhilela ukwenza i-incision encane esifubeni nokwenza imbobo ku-pericardium ukuze kususwe uketshezi.

Uma une-constrictive pericarditis, ingxenye yesikhwama sakho senhliziyo ingadinga ukususwa. Lokhu kuhlinzwa kubizwa ngokuthi i-pericardiectomy. Kwenzelwa abantu abanezicubu zesilonda esikhwameni senhliziyo. Akuvamile ukwenziwa kubantu abanokuvuvukala okusebenzayo kanye nobuhlungu besifuba obubangelwa yi-pericarditis.

Ukuhlinzwa akuvamile ukusetshenziswa njengokwelashwa kwabantu abane-pericarditis ephindaphindayo, njengoba ukuvuvukala kungenza kube nzima ukululama ngemva kokuhlinzwa. Kodwa-ke, udokotela wakho angaxoxa nawe ngalokhu uma ezinye izindlela zokwelapha zingasebenzi.

Kuthatha isikhathi esingakanani ukululama ngemva kokwelashwa?

Kufanele uphendule ekwelashweni zingakapheli isonto, kodwa kuzodingeka uthathe imithi cishe amasonto amabili. Ukululama ngemva kokuhlinzwa kuthatha isikhathi eside. Kungathatha amasonto noma izinyanga ukululama ngokuphelele kwi-pericarditis. Kubaluleke kakhulu ukuthola ukuphumula okwanele phakathi naleso sikhathi.

Ingabe ukuphinda kwe-pericarditis kungancishiswa?

Nakuba ungeke ukwazi ukuvimbela isiqephu se-'Acute Pericarditis', unganciphisa ingozi yokuthi iphindaphindeke ngokuthola ukwelashwa okusheshayo nokulandela ukwelashwa ngqo. Futhi, landela imiyalelo kadokotela wakho mayelana nokuthi uzoqala nini ukuzivocavoca. Ukuzivocavoca okunamandla ngesikhathi se-'Pericarditis' esebenzayo kungenza isimo sibe sibi kakhulu.

Yini okufanele uyikhumbule uma uphila ne-pericarditis?

Uma usululame kwi-pericarditis, kufanele ukwazi ukubuyela emisebenzini yakho evamile ngaphandle kokukhathazeka. Kodwa-ke, ungaqhubeki nokuzivocavoca okunzima kuze kube yilapho udokotela wakho ekunika imvume. Udokotela wakho uzokutshela okwengeziwe ngalokhu.

I-pericarditis ihlala isikhathi esingakanani?

• I-Acute Pericarditis ihlala phakathi kwamasonto amane kuya kwayisithupha.
• I-'Incessant Pericarditis' (eqhubekayo) ihlala isikhathi eside kunalokho, kodwa ingaphansi kwezinyanga ezintathu.
• I-Pericarditis engapheli ibilokhu ikhona isikhathi esingaphezu kwezinyanga ezintathu.
• Phakathi kuka-15% no-30% wabantu abane-pericarditis bangase babe nezigameko eziphindaphindayo eminyakeni edlule.

Uma belashwa, abantu abane-'Acute Pericarditis' banethuba elikhulu lokululama. Iningi labantu liyalulama ngokuphelele. Uma unesimo esincane, singaphela ngokuphumula. Kodwa-ke, uma singelashwa, abanye abantu bangaba ne-'Chronic Pericarditis'.

Into ebaluleke kakhulu ukuphuza imithi njengoba nje udokotela ekuyalele futhi ubonane nodokotela ngezinsuku ezihleliwe.

Kufanele ubonane nini nodokotela?

Uma unezimpawu ze-'Constrictive Pericarditis', xhumana nodokotela ngokushesha. Lezi zimpawu yilezi:

• Ubunzima bokuphefumula.
• Ukuvuvukala kwemilenze nezinyawo.
• Ukugcinwa kwamanzi emzimbeni.
• Ukushaya kwenhliziyo.
• Ukuvuvukala okukhulu kwesisu.

Nakuba ubuhlungu besifuba buwuphawu oluvamile lwe-pericarditis, bungaba futhi uphawu lokuhlaselwa yinhliziyo. Ngakho-ke, uma uzwa ubuhlungu besifuba, kungaba ukuhlaselwa yinhliziyo, ngakho-ke hamba uye ekamelweni eliphuthumayo ngokushesha.

Okokugcina, ezinye izinto ezibalulekile

Ngithemba ukuthi usuyaqonda kangcono lesi simo esibizwa ngokuthi 'i-Pericarditis'. Khumbula,Uma unezinhlungu esifubeni, ikakhulukazi uma ugoba phambili nalapho uphefumula, kanye nezimpawu ezifana nomkhuhlane nokukhathala, kungaba yi-pericarditis. Uma lokhu kwenzeka, kungcono ukufuna iseluleko sezokwelapha ngaphandle kokwethuka.

Uma uthola ukwelashwa kusenesikhathi, ungalulama ngokuphelele. Uma ulandela ukwelashwa kahle, kungasiza futhi ekuvimbeleni ukuthi lesi simo singaphinde sivele. Ngakho-ke, kubaluleke kakhulu ukusebenzisa imithi udokotela wakho ayinikezayo ngqo nokuya njalo ekuvakasheni okulandelayo. Qaphela izimpawu ze-pericarditis, ukuze uma kwenzeka futhi, uthole ukwelashwa ngokushesha. Ngikufisela ukululama okunempilo!

I- Pericarditis, i-pericarditis, ubuhlungu besifuba, ukuphelelwa umoya, isifo senhliziyo, ukuhlaselwa yinhliziyo, i-Colchicine