Isifo Sokufa Okungazelelwe Sokungalali (SAD)

Wake wezwa ngomuntu owayesemusha futhi ephilile ngokuzumayo eshona? Wake wazibuza ukuthi lokho kungenzeka kanjani? Ngezinye izikhathi kungaba ngenxa yesimo esizokhuluma ngaso namuhla esibizwa ngokuthi i-Sudden Arrhythmic Death Syndrome (SADS) . Lokhu kuyinto engathi sína kakhulu, kodwa kubalulekile ukuqaphela.

Iyini i-Sudden Cardiac Death Syndrome (SADS)?

Kalula nje, lesi yisimo senhliziyo. Esikhathini esiningi, kuyinto oyizuza njengefa , okusho ukuthi ingadluliselwa esizukulwaneni kuya kwesinye. Okwenzekayo kulokhu ukuthi kunenkinga ngohlelo lukagesi enhliziyweni yakho. Cabanga ngakho, inhliziyo yethu isebenza njengejeneretha encane. Yizimpawu zikagesi ezenza inhliziyo ishaye kahle. Ngakho-ke, uma kunenkinga ngalolu hlelo, isigqi senhliziyo siba esingavamile . Uma lokhu kungelashwa kahle, kungase kudingeke ubhekane nokufa ngokuzumayo. Yingakho kuyingozi.

Yiziphi izinhlobo eziyinhloko ze-SADS?

Kunezinhlobo eziningana zalesi simo ezibizwa ngokuthi i-SADS. Ngayinye yazo inomehluko omncane. Ake sibheke ezinye zezinhlobo eziyinhloko:

• I-Brugada syndrome: Lesi yisimo lapho amakamelo aphansi enhliziyo, abizwa ngokuthi i-atria, eba nokushaya kwenhliziyo okusheshayo nokungajwayelekile (i-polymorphic ventricular tachycardia).
• I-Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT): Lesi futhi yisimo lapho amangqamuzana enhliziyo eshaya khona ngokushesha nangokungajwayelekile. Lesi simo singavela ikakhulukazi ngesikhathi sokuzikhandla ngokomzimba noma ukucindezeleka kwengqondo.
• I-Long QT syndrome (LQTS): Yilapho imisipha yenhliziyo yakho ithatha isikhathi eside ukulungiselela ukushaya okulandelayo, okungukuthi, ukushaja kabusha (ukuvuselela noma ukuvuselela kabusha). Kufana nebhethri elithatha isikhathi eside ukushaja. Uma ubheka i-EKG, umehluko phakathi kwamagagasi e-Q ne-T ubizwa ngokuthi isikhawu se-QT. Uma lesi sikhathi side kakhulu, amangqamuzana enhliziyo angaqala ukushaya ngokushesha kakhulu (i-ventricular tachycardia) noma ngokungajwayelekile kakhulu (i-ventricular fibrillation).
• I-Short QT syndrome (SQTS): Lokhu kuphambene ne-long QT. Kusho ukuthi amangqamuzana enhliziyo athatha isikhathi esincane kakhulu ukulungiselela ukushaya okulandelayo. Lokhu kungabangela ukuthi amakamelo aphezulu enhliziyo (i-atrial fibrillation) ashaye ngokungajwayelekile, noma amakamelo aphansi (i-ventricular tachycardia) ashaye ngokushesha, noma aqhaqhazele ngokungajwayelekile (i-ventricular fibrillation).
• I-Timothy syndrome: Lesi yisimo esingavamile kakhulu. Futhi uhlobo lwe-long QT syndrome.
• I-Wolff-Parkinson-White syndrome (WPW):Lokhu kwenzeka lapho kudalwe umzila owengeziwe, ongajwayelekile ukuze izimpawu zikagesi zihambe phakathi kwamakamelo aphezulu (i-atria) namakamelo aphansi (i-mitra). Lokhu kungaphezu komzila ojwayelekile, okungabangela ukuba inhliziyo ishaye ngokushesha kakhulu (i-tachycardia).

Zivame kangakanani lezi zimo ze-SADS?

Lezi azivamile kakhulu, kodwa azikho futhi. Isibonelo, i -long QT syndrome (LQTS) okukhulunywe ngayo ngaphambilini kulinganiselwa ukuthi ithinta cishe ingane eyodwa kwezingu-2,000 ezisanda kuzalwa. I-Brugada syndrome ayivamile neze, ithinta abantu abangaphansi kuka-1% wabantu. Isimo esibizwa ngokuthi i-CPVT sithinta cishe eyodwa kweziyizinkulungwane eziyishumi.

Kodwa, sekukonke, abantu ababalelwa ku-200,000 bafa ngenxa yokuma kwenhliziyo okungazelelwe (i-SCA) minyaka yonke e-United States kuphela. Kubikwa nokuthi cishe izingane kanye nabantu abadala abasebasha abangu-4,000 bafa ngenxa yalezi zimo ze-SADS minyaka yonke. Ngakho-ke, akuyona into encane leyo, akunjalo?

Ziyini izimpawu ze-SADS?

Nakuba kunezinhlobo eziningi ezahlukene ze-SADS, kunezinye izimpawu ezivamile. Kodwa-ke, abanye abantu bangase bangabi nazo nhlobo izimpawu.

Izimpawu ezivamile:

• Ukuquleka noma ukuxhuzula kungase kwenzeke ngesikhathi sokuzivocavoca, noma uma ujabule kakhulu noma wesaba.
• Ubuhlungu besifuba bungase buvele ngesikhathi sokuzivocavoca.
• Ungase uzizwe uphelelwa umoya ngesikhathi sokuzivocavoca.

Manje ake sibheke izimpawu ezahlukene ezihlobene nohlobo ngalunye lwe-SADS.

Izimpawu ze-Brugada syndrome

Nakuba abantu abaningi bengenazo izimpawu, abanye bangase babe nalokhu okulandelayo:

• Ukuma kwenhliziyo kungenzeka, ikakhulukazi ngesikhathi ulele.
• Ukuquleka.
• Ukudlikizela.
• Indlela yokuphefumula engajwayelekile.

Izimpawu ze-catecholaminergic polymorphic ventricular tachycardia (CPVT)

Kungase kungabi khona zimpawu kuze kube yilapho kuvela isifo senhliziyo, kodwa abanye abantu bangase bazizwe bephelelwa amandla ngesikhathi sokuzivocavoca.

Izimpawu ze-Long QT Syndrome (LQTS)

Cishe ingxenye yabantu abane-LQTS abanazo izimpawu. Kodwa abanye abantu:

• I-arrhythmia ethile ebizwa ngokuthi i-Torsades de Pointes ingabangela ukuhlaselwa yinhliziyo.
• Ukuquleka.
• Ukudlikizela.

Izimpawu ze-Short QT Syndrome (SQTS)

Cishe abantu abangu-40% abanalesi simo abanazo izimpawu. Kodwa abanye:

• Ukushaya kwenhliziyo .
• Ukuquleka.
• Isifo senhliziyo.

Izimpawu ze-Timothy syndrome

Izici ezingabonakala kulokhu yilezi:

• Ukuquleka.
• Isifo senhliziyo.
• Ngezinye izikhathi kuba neminwe noma izinzwane eziboshwe ngentambo.
• Izinkinga zentuthuko.

Izimpawu ze-Wolff-Parkinson-White syndrome (WPW)

Izimpawu ze-WPW zifaka:

• Ukushaya kwenhliziyo.
• Ukuzizwa unesizungu (ubuhlanya).
• Ubunzima bokuphefumula.
• Ukuquleka.
• Ukudlikizela.

Okubalulekile: Uma wena noma othile omaziyo enesinye salezi zimpawu, kufanele nakanjani ufune iseluleko sezokwelapha.

Ziyini izimbangela ze-SADS?

Ngokuvamile, lapho umuntu osemusha efa ngokuzumayo, futhi isakhiwo senhliziyo yakhe sibonakala sijwayelekile lapho ehlolwa, odokotela basola ukuthi wayene-arrhythmia engatholakali, ukushaya kwenhliziyo okungajwayelekile. Izimo ze-SADS ezibangela la ma-arrhythmia, esikhulume ngazo ngaphambili, zivame ukudluliselwa kusuka kumzali kuya enganeni . Okusho ukuthi, zivela kuma-gene. Amathuba okuthi lezi zimo zidluliselwe ezinganeni angahluka kuye ngofuzo oluhilelekile kanye nengxenye yenhliziyo ethintekile.

Odokotela bathola kanjani i-SADS?

Uma umuntu osemusha enezimpawu ezishiwo ngenhla, futhi uma othile emndenini wakhe eye washona ngokuzumayo ngendlela engachazeki ngaphambi kokuba afinyelele eminyakeni engu-40, udokotela angase asole i-SADS. Izindlela zokuxilonga ziyahlukahluka kuye ngohlobo lwe-SADS.

Izindlela zokuxilonga ezisetshenziswa kakhulu:

• I-Electrocardiogram (EKG): Lokhu kuhlola ukusebenza kukagesi kwenhliziyo.
• Ukuhlolwa kofuzo: Lokhu kuhlolwa kokwehluka kofuzo okuhlobene ne-SADS.
• Ukuhlolwa kokucindezeleka kwe-Treadmill: Lokhu kuhlola indlela inhliziyo esabela ngayo ekuzivocavoceni.
• Ukuhlolwa kokukhuthazwa kwe-Catecholamine: Kunikezwa umuthi okhethekile bese kuqashelwa impendulo yenhliziyo.
• I-Holter monitor: Idivayisi eqopha njalo ukushaya kwenhliziyo isikhathi esingamahora angama-24.
• I-Echocardiogram: Lokhu ukuskena kwe-ultrasound okubheka isakhiwo kanye nomsebenzi wenhliziyo.
• I-ultrasound yengane esesiswini: Lokhu kungenziwa ngesikhathi ingane isesesibelethweni.
• Ukuhlolwa kokuxilonga kwe-catheterization yenhliziyo: Ukuhlolwa lapho kufakwa khona ipayipi elincane enhliziyweni.
• Ucwaningo lwe-Electrophysiologic: Kulolu cwaningo, izintambo ezincane zidluliselwa enhliziyweni ukuze kuhlolwe ngokujulile uhlelo lukagesi lwenhliziyo.

Yiziphi izindlela zokwelapha i-SADS?

Ukwelashwa kuyahlukahluka kuye ngohlobo lwe-SADS, ngakho-ke kubalulekile ukuthola ukuthi hlobo luni oluqondile onalo.

Ukwelashwa kwe-Brugada syndrome

• I-ICD (i-ICD) efakwa esikhumbeni: Lona umshini omncane ofakwa ngaphansi kwesikhumba. Uma izinga lokushaya kwenhliziyo liba elingajwayelekile ngendlela eyingozi, liletha ukushaqeka okuncane kagesi ukuze kubuyiselwe izinga lokushaya kwenhliziyo.
• Imithi efana ne -Quinidine .
• Gwema ukusebenzisa imithi evimba imigudu ye-sodium enhliziyweni.

Ukwelashwa kwe-Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT)

• Laba bantu banikezwa uhlobo lomuthi olubizwa ngokuthi ama-beta-blockers .
• Uma kudingeka, kuzofakwa i-ICD.

Ukwelashwa kwe-Long QT Syndrome (LQTS)

Lokhu kungenziwa ngezinto ezifana nemithi noma ukuhlinzwa:

• Ama-beta-blocker.
• I- ICD .
• Ukuhlinzwa kwenhliziyo kwesobunxele okubangela ukucindezeleka: Lokhu kuyindlela encane yokuhlinzwa enquma futhi isuse ezinye zezinzwa ezizimele eziya enhliziyweni.
• Gwema ukusebenzisa imithi ethile enweba isikhathi se-QT ku-EKG yakho.

Ukwelashwa kwe-Short QT Syndrome (SQTS)

Kukhona umuthi kanye nethuluzi lalokhu:

• I- ICD .
• I-Quinidine.

Ukwelashwa kwe-Timothy syndrome

Lokhu kusebenzisa umuthi kanye nedivayisi:

• Ama-beta-blocker.
• I- ICD .
• Gwema ukusebenzisa imithi enweba isikhathi se-QT ku-EKG yakho.

Ukwelashwa kwe-Wolff-Parkinson-White syndrome (WPW)

Imithi ingasiza ekuvimbeleni izimpawu ze-WPW. Kukhona nenqubo ebizwa ngokuthi i-ablation therapy . Lokhu kubhubhisa indlela kagesi eyengeziwe. Lokhu ngezinye izikhathi kungayiphulukisa ngokuphelele i-WPW. Odokotela banikeza nemithi ebizwa ngokuthi i-antiarrhythmics ukunciphisa ingozi ye-rhythm yenhliziyo engavamile.

Ingabe ikhona imiphumela emibi kulezi zindlela zokwelapha?

Yebo, ezinye izindlela zokwelapha zingaba nemiphumela emibi emincane.

• Abanye abantu bangase babe nobunzima bokubekezelela ama-beta-blocker anikezwe udokotela wabo.
• Ngemva kwalokho kuhlinzwa kwe -cardiac sympathetic denervation kwesobunxele :
• Ukujuluka okungavamile.
• Izandla ezomile.
• Izinguquko ekushiseni noma kumbala kwezinye izindawo zobuso.
• Kodwa lokhu kuhlinzwa kungathuthukisa kakhulu ikhwalithi yokuphila.
• Ngenxa yokuthi idivayisi ye-ICD ibangela ukushaqeka kukagesi ukubuyisela isigqi senhliziyo, kungaba yinto engakhululekile. Futhi:
• Ukutheleleka kungenzeka.
• Idivayisi ingase ingasebenzi kahle.

Ngingayinciphisa kanjani ingozi yami? Ingabe i-SADS ingavinjelwa?

Uma othile emndenini wakho ene-SADS, amanye amalungu omndeni kufanele enze i-CPR.Uma wazi ukuthi ungakwenza kanjani, futhi uma une -Automatic External Defibrillator (AED) ekhaya, kungaba yinduduzo enkulu kumuntu one-SADS. Ngoba kuhle ukwazi ukuthi kukhona umuntu ozokusiza esimweni esiphuthumayo.

Nakuba i-SADS ingenakuvinjelwa ngokuphelele, uma othile emndenini wakho etholakala enalesi simo, kubalulekile ukuhlolwa ukuze kubonakale ukuthi naye une-genetic mutation. Ungakhuluma nodokotela wakho ukuze unqume ukuthi ubani okufanele ahlolwe. Uma umuntu etholakale enalesi simo, kungathathwa izinyathelo zokuzivikela, kungaba ngemithi noma ngezinye izindlela zokwelapha.

Ikusasa liphetheni ngomuntu one-SADS?

Kuya ngokuthi hlobo luni lwe-SADS onalo, ukuthi lutholakala ngokushesha kangakanani, nokuthi ukwelashwa kuqala ngokushesha kangakanani. Kuyisimo sokuphila konke , futhi ngezinye izikhathi singaba yingozi .

Kodwa-ke, abantu abane- Wolff-Parkinson-White syndrome (WPW) banombono ongcono kakhulu ngoba ukwelashwa nge-ablation kungalungisa inkinga. Abantu abane-long QT syndrome (LQTS) banengozi ephansi kakhulu yokufa ngokuzumayo. Kodwa-ke, abantu abaningi abangazuza nge-ablation ye-ventricular yesobunxele abanayo. Kuncane kakhulu ucwaningo ngezimo ezifana ne- short QT syndrome (SQTS) , njengoba kuneziguli ezimbalwa kuphela (cishe ezingama-200) ezinalesi simo.

Ngakho-ke, ucwaningo olwengeziwe luyadingeka ukuthola izindlela zokwelapha ezingcono kakhulu kubo bonke abane-SADS.

Ukufaka i-ICD kungavimbela ukufa kwenhliziyo okungazelelwe ngoba kwelapha izigqi zenhliziyo ezingavamile. Nakuba kungelaphi lesi simo, kuyindlela ephumelelayo yokunciphisa ingozi yokufa ngenxa yalezi zimo.

Uma une-SADS, uzinakekela kanjani?

• Uma udokotela wakho ekunike imithi, yithathe njengoba uyalelwe, ungaphuthelwa usuku olulodwa. Kunjalo nangomntwana one-SADS. Kudingeka anikezwe imithi yakhe ngesikhathi, futhi akuwona umqondo omuhle ukweqa umthamo owodwa.
• Buza udokotela wakho noma usokhemisi njalo ngaphambi kokuqala umuthi omusha. Imithi eminingi, okuhlanganisa ama-antibiotic avamile kanye nemithi yokulwa nesicanucanu, ingasebenzisana nemithi yakho yenhliziyo. Ingathinta futhi isikhathi se-QT, okwandisa ingozi yokufa ngokuzumayo kumuntu onesifo se-QT eside.
• Qonda ukuthi i-ICD yakho (noma yengane yakho) isebenza kanjani. Futhi, yihlole njalo ngudokotela wakho. Ezinye izinqubo zezokwelapha kanye namadivayisi kagesi avamile kungaphazamisa ukusebenza kwe-ICD yakho. Ngakho-ke, yazi ukuthi yini okufanele uyigweme.
• Uma ingane yakho ine-SADS, buza udokotela ukuthi ingakwazi yini ukudlala imidlalo ehambisana nesimo sayo.

Kufanele uye nini kudokotela? Kufanele uye nini egumbini lezimo eziphuthumayo?

Uma une-SADS, ukuhlolwa njalo kubaluleke kakhulu. Lokhu kwenzelwa ukuqinisekisa ukuthi uphuza inani elifanele lemithi. Uma ingane yakho ine-SADS, umthamo wemithi kungadingeka ukhushulwe njengoba ikhula futhi ikhuluphala. Yingakho kubaluleke kakhulu ukuthi izingane zihlolwe njalo. Uma une-ICD, bona udokotela wakho okungenani kabili ngonyaka.

Uma kwenzeka isimo esiphuthumayo:

• Uma othile enesifo sokuma kwenhliziyo , shayela u-911 (noma inombolo yezimo eziphuthumayo yezwe lakini) ngokushesha bese wenza i-CPR.
• Uma uhlangabezana nanoma yiziphi zalezi zimpawu, iya ekamelweni eliphuthumayo noma ushayele u-911 ngokushesha:
• Uma uzizwa ubuthakathaka, unesiyezi, noma ushaya ngamandla.
• Uma uzwa ubuhlungu besifuba obungazelelwe noma ubunzima bokuphefumula.

Yimiphi imibuzo ebalulekile okufanele uyibuze udokotela wakho?

Uma wena noma othile emndenini wakho ene-SADS, kubaluleke kakhulu ukubuza udokotela wakho le mibuzo:

• Nginaluphi uhlobo lwe-SADS?
• Yikuphi ukwelashwa okuncomayo ngesimo sami esithile?
• Ungangisiza yini ukuthola ukuthi obani emndenini wami okudingeka bahlolwe lokhu?
• Ingabe ngidinga i-defibrillator?
• Ingabe ikhona imithi okufanele ngiyigweme ngesimo sami?

Ekugcineni, khumbula lezi zinto!

Nakuba i-SADS iyisimo esibucayi, ukuqaphela lokhu nokuthatha izinyathelo ezifanele kungakuvikela wena nabathandekayo bakho. Ukuqaphela ukuxilongwa kwakho kungakusiza uqonde izinketho zakho. Sebenzisana nodokotela wakho ukuze unqume ukuthi yikuphi ukwelashwa okungcono kakhulu kuwe noma kothandekayo wakho. Ukuhlolwa njalo, ikakhulukazi uma une-ICD, kubalulekile. Ukuba ne-AED ekhaya nokuqinisekisa ukuthi wonke umuntu uyazi ukuthi ayisebenzisa kanjani futhi enze i-CPR kungakusiza wena nomndeni wakho. Ungesabi, ukuqaphela kuyindlela engcono kakhulu yokuzivikela.

Isifo Sokufa Okungazelelwe, i-SADS, isifo senhliziyo, ukushaya kwenhliziyo okungavamile, isifo sofuzo, ukufa okuzumayo, uhlelo lukagesi lwenhliziyo