Sonke sesilizwile igama elithi "ukuhlaselwa yinhliziyo" kaningi, akunjalo? Mhlawumbe omunye wamalungu omndeni wethu noma umngane uke waba nalo. Kodwa bewazi ukuthi kunezinhlobo ezahlukene zokuhlaselwa yinhliziyo? Namuhla sizokhuluma ngohlobo olubi kakhulu futhi oludinga ukwelashwa ngokushesha. Odokotela balubiza ngokuthi i-STEMI. Ungakhathazeki, ake sixoxe ngalokhu kalula.
Kungani ibizwa ngokuthi i-STEMI? Kusho ukuthini?
Kalula nje, ukuhlaselwa yinhliziyo kwenzeka lapho umthambo wegazi ohambisa igazi enhliziyweni uvaleka ngokuzumayo, unqande ukugeleza kwegazi emisipheni yenhliziyo. Ngokwezokwelapha, lokhu kubizwa ngokuthi ``Myocardial Infarction''.
Manje ake sibone ukuthi igama elithi STEMI livela kanjani. Cishe uke wabona i-ECG ithathwa esibhedlela. Lokho ukuhlolwa okuhlola ukusebenza kukagesi kwenhliziyo. Kulokhu, ukushaya kwenhliziyo kuboniswa njengegrafu yomugqa. Kufana nomugqa ogobile, njengegquma noma umthambeka.
Kukhona ingxenye ekhethekile yale ECG, ebizwa ngokuthi ``isigaba se-ST''. Kumuntu ophilile, le ngxenye ivame ukuba yisicaba. Kodwa-ke, lapho umthambo omkhulu ohambisa igazi enhliziyweni uvalekile ngokuphelele, okungukuthi, lapho kwenzeka ukuhlaselwa yinhliziyo okukhulu, le ngxenye ye-ST iyaphakama. Njengegquma elincane.
Lokhu kubizwa ngokuthi i-ST-Elevation Myocardial Infarction ngoba ingxenye ye-ST ku-ECG iphakeme. Isifinyezo sayo yi -STEMI .
Lolu shintsho lwe-ECG luwuphawu olubaluleke kakhulu kodokotela, ngoba lusho ukuthi ingxenye enkulu yenhliziyo ayitholi igazi elanele, nokuthi leyo ngxenye yenhliziyo iyafa. Lokhu kusho ukuthi ukwelashwa kumele kuqalwe ngokushesha, ngaphandle kokulibazisa ngisho nomzuzu .
Kwenzeka kanjani i-STEMI? Kwenzekani ngaphakathi emzimbeni?
Esikhathini esiningi, lokhu kubangelwa yi-plaque, ukunqwabelana kwamafutha ne-cholesterol ngaphakathi kwemithambo yegazi yenhliziyo (imithambo ye-coronary). Cabanga ngakho njengokugqwala okwakheka ngaphakathi kwepayipi lamanzi.
Lawa ma-plaque ayakhula kancane kancane. Ngolunye usuku, elinye lala ma-plaque lingaqhuma ngokuzumayo. Bese umzimba wethu ucabanga ukuthi kukhona ukulimala lapho. Ngakho-ke kwenza ihlule legazi ukuze kuphulukiswe lokho kulimala. Kodwa leli hlule legazi liyakhula ngokuzumayo futhi livimbe ngokuphelele lowo mthambo.
Yilapho inkinga yangempela iqala khona.
1. Uma umthambo uvalekile ngokuphelele, amangqamuzana emisipha yenhliziyo athola igazi kuwo ancishwa umoya-mpilo. Lesi simo sisibiza ngokuthi `(ischemia)`.
2. Ngaphandle komoya-mpilo, lezi zingcezu zenyama ziqala ukufa kancane kancane.
3. Uma ingxenye enkulu yenhliziyo yehluleka ngale ndlela, inhliziyo ayikwazi ukupompa igazi elanele emzimbeni. Lokhu kungaholela esimweni esibulalayo esibizwa ngokuthi "ukushaqeka kwenhliziyo".
4. Futhi, imisipha yenhliziyo eyonakele ingaphazamisa ukusebenza kukagesi kwenhliziyo, okubangela ukuba inhliziyo iyeke ukushaya ngokuzumayo (ukuma kwenhliziyo).
I-STEMI ivame ukuba ukuhlaselwa yinhliziyo okukhulu kakhulu. Yingakho kubalulekile ukuya esibhedlela ngokushesha nje lapho izimpawu ziqala. Uma ungavula ngokushesha umthambo ovalekile futhi ubuyisele ukugeleza kwegazi, unganciphisa kakhulu umonakalo enhliziyweni.
Uyini umehluko phakathi kwe-STEMI ne-NSTEMI?
Kungenzeka ukuthi uke wezwa nge-NSTEMI. Kukhona umehluko omkhulu phakathi kwalokhu okubili.
| Isici | I-STEMI (uhlobo olunzima) | I-NSTEMI (uhlobo olungelubi kakhulu) |
|---|---|---|
| Ukuvaleka kwemithambo yegazi | Kuvimbekile ngokuphelele. Ukugeleza kwegazi kume ngokuphelele. | Ingxenye yayo kuphela evinjiwe. Ukugeleza kwegazi okuthile kusaqhubeka. |
| Ushintsho lwe-ECG | Ingxenye ye-ST iphakeme ngokusobala (ST-Elevation). | Ukuphakama kwesigaba se-ST akukho. Ezinye izinguquko ezincane zingase zibonakale. |
| Ukulimala kwenhliziyo | Ngokuvamile kwenzeka umonakalo omkhulu. | Umonakalo uphansi kakhulu. |
| Ukuhlonza | Kungatholakala ngokushesha nge-ECG. | Ukuze kutholakale, kudingeka ukuhlolwa okubheka i-enzyme ebizwa ngokuthi i-Troponin egazini. |
Ubani osengozini enkulu yokuthuthukisa lokhu?
Izici eziyingozi zokuba nesifo senhliziyo zingahlukaniswa ngezigaba ezimbili: lezo esingazilawula kanye nalezo esingenakuzilawula.
| Izici eziyingozi esingazishintsha | Izici eziyingozi esingenakuzishintsha |
|---|---|
| 🚬 Ukubhema: Lesi yisitha esikhulu kunazo zonke. | 👴 Ubudala: Ingozi iyanda njengoba iminyaka ikhula. |
| 🍔 I-cholesterol ephezulu: Ukudla okunamafutha amaningi. | 👨👩👧 Umlando womndeni: Abazali, izingane zakubo ezinesifo senhliziyo zisencane. |
| 🩺 Umfutho Wegazi Ophakeme: Ongalawulwa. | 🧍♂️ Ubulili: Amadoda ngokuvamile asengozini enkulu esemncane. Abesifazane basengozini enkulu ngemva kokunqamuka kokuya esikhathini. |
| 🍬 Isifo sikashukela: Ukungalawuli amazinga kashukela egazini. | 🧬 Izimbangela zofuzo: Ezinye izimo eziba khona lapho kuzalwa. |
| ⚖️ Ukukhuluphala ngokweqile kanye nesisu esivele ngaphandle. | |
| 🏃 Ukuntuleka kokuzilolonga kanye nendlela yokuphila yokungahlali phansi. | |
| 😥 Ukucindezeleka ngokweqile. |
Yiziphi izimpawu ezingabonakala?
Izimpawu zokuhlaselwa yinhliziyo azifani kuwo wonke umuntu, kodwa izimpawu ezivame kakhulu yilezi:
- Ubuhlungu besifuba noma ukungakhululeki: Lolu uphawu oluyinhloko. Kungazwakala sengathi umuzwa oqinile, osindayo, noma ocindezelayo phakathi kwesifuba. Lobuhlungu bungase buhlale isikhathi esingaphezu kwemizuzu embalwa.
- Ubuhlungu busakazekela kwezinye izindawo: Ubuhlungu besifuba bungasakazekela engalweni yesobunxele, zombili izingalo, amahlombe, intamo, umhlathi, umhlane, noma isisu esingaphezulu.
- Ubunzima bokuphefumula: Ungase uzizwe uphelelwa umoya, noma ubuhlungu besifuba noma ungenabo.
- Ukujuluka: Ungase uzizwe ubanda ngokuzumayo bese uqala ukujuluka.
- Isicanucanu nokuhlanza: Kungazwakala sengathi isisu esibuhlungu, njenge-gastritis.
- Ukuzizwa unesizungu nokuquleka: Ukuzizwa unesizungu futhi ungakwazi ukuma.
- Ukuzwa ukwesaba okukhulu: Ungase uzizwe ukwesaba okukhulu, ngisho nokwesaba ukufa, ngaphandle kwesizathu.
Izici ezithile eziqondene nabesifazane
Abesifazane ngezinye izikhathi bangase bangazizwa ubuhlungu besifuba obuvamile bube bukhulu kangaka. Kunalokho, bangase babe nezimpawu ezinjengalezi.
- Ukukhathala okungavamile: Ukuzizwa ukhathele kakhulu izinsuku eziningana.
- Ukungalali.
- Ubunzima bokuphefumula.
- Ubuhlungu emhlane, emahlombe, nasemhlathini.
- Isicanucanu nokuhlanza.
Into ebaluleke kakhulu ukuthi, uma uhlangabezana nezimpawu ezinjengalezi, ungacabangi nje ukuthi, "Lokhu kungaba yisifo sofuba," kodwa hamba uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela ngokushesha.
Hlobo luni lokwelashwa okwenziwa esibhedlela?
Ku-STEMI, isikhathi sibaluleke kakhulu ekusindiseni izimpilo, ngakho-ke ukwelashwa kuyashesha kakhulu.
1. Ukuxilongwa ngokushesha: Lapho nje ulethwa ku-ETU, kuthathwa i-ECG ukuqinisekisa ukuthi ngabe yi-STEMI.
2. Umuthi wokuncibilikisa amahlule egazi: Kwezinye izibhedlela, kunikezwa umjovo (i-thrombolysis) ukuze kuncibilikiswe amahlule egazi abambekile.
3. Ukufakwa kwe-Angioplasty kanye ne-stent (PCI): Lokhu kuyindlela engcono kakhulu nesimanje yokwelapha i-STEMI. Kulokhu, kufakwa ithubhu elincane kakhulu ngomthambo engalweni noma emlenzeni enhliziyweni kuya emthanjeni ovalekile. Bese kuthi, ibhaluni elincane ekugcineni kwethubhu livuthelwe ukuze livule umthambo ovalekile, bese kufakwa idivayisi efana ne-mesh ebizwa ngokuthi i-``stent`` kuleyo ndawo ukuze ivimbele ukuthi ingavimbeki futhi. Lokhu kubizwa ngokuthi ``(Percutaneous Coronary Intervention - PCI)``.
4. Ukuhlinzwa kwe-bypass (CABG Surgery): Uma imithambo yegazi eminingi ivaliwe noma i-PCI ingenzeki, kwenziwa ukuhlinzwa ukuze kudalwe imithambo yegazi emisha. Lokhu kufana nokwakha 'i-flyover' entsha ukuze kudlule umgwaqo ovaliwe.
5. Eminye imithi:Ngaphezu kwalezi zindlela zokwelapha, imithi eminingana, njengemithi yokunciphisa igazi (njenge-aspirin), imithi yokwehlisa i-cholesterol (ama-statin), kanye nemithi elawula izinga lokushaya kwenhliziyo (ama-beta-blockers), kuzodingeka ithathwe impilo yakho yonke.
Yini okufanele ngiyenze uma kukhona isimo esiphuthumayo? Ngishayele ucingo ku-1990? Noma ngihambe ngemoto?
Lona umbuzo obaluleke kakhulu. Uma usola ukuthi wena noma othile oseduze nawe unezimpawu zokuhlaselwa yinhliziyo, ungalokothi uzishayele uye esibhedlela. Ungalokothi ucele omunye umuntu ukuthi akushayele.
Into engcono kakhulu ongayenza ukushayela isevisi ye-ambulensi ngokushesha, njengango-1990.
Kungani kunjalo?
- Izikhulu eziku-ambulensi ziqeqeshwe ngokukhethekile kulezi zinhlobo zezimo eziphuthumayo. Zingaqala ukukunikeza ukwelashwa okuyisisekelo (njengomoya-mpilo) ngenkathi uyiswa esibhedlela.
- Bangazisa i-ETU yesibhedlela kusenesikhathi futhi banikeze imininingwane ngesiguli. Ngemuva kwalokho, lapho ufika, odokotela nabahlengikazi bazobe sebekulungele ukukwelapha. Lokho konga isikhathi esibalulekile.
- Uma kuvela isimo esiphuthumayo, njengokumiswa kwenhliziyo, i-ambulensi inemishini edingekayo (njenge-defibrillator) yokuyelapha. Awukwazi ukwenza lokho emotweni yasekhaya.
Khumbula, umzuzwana ngamunye ubalulekile ku-STEMI. Ngakho-ke ukwenza isinqumo esifanele kungasindisa impilo.
Umlayezo Wokuya Nawe Ekhaya
- I-STEMI uhlobo olubi kakhulu lokuhlaselwa yinhliziyo olubangelwa ukuvaleka ngokuphelele komthambo ohambisa igazi enhliziyweni.
- Izimpawu eziyinhloko ubuhlungu obukhulu phakathi kwesifuba, ukuphelelwa umoya, nokujuluka. Ungakushayi indiva ngoba kuyisifo sohudo.
- Uma uhlangabezana nanoma yiziphi zalezi zimpawu, shayela i-ambulensi ngokushesha bese uya e-Emergency Treatment Unit (ETU) yesibhedlela.
- Isikhathi sibaluleke kakhulu. Uma ukwelashwa kungaqalwa ngokushesha, umonakalo enhliziyweni ungancishiswa kakhulu.
- Lesi simo singavinjelwa ngokugwema ukubhema, ukulawula i-cholesterol, umfutho wegazi, nesifo sikashukela, ukudla ukudla okunempilo, nokuzivocavoca. Khuluma nodokotela wakho ngalokhu njalo.
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