Ingabe inhliziyo yakho ibuthakathaka? Ake sifunde ngokuhluleka kwenhliziyo okubangelwa yi-Systolic.

Ingabe ngezinye izikhathi uzizwa uphelelwa umoya? Ingabe uzizwa ukhathele ngisho nangemva kokusebenza kancane? Noma ingabe imilenze yakho iyavuvukala? Lokhu kungaba izimpawu zokuthi inhliziyo yakho ibuthakathaka kancane. Namuhla, sizoxoxa ngalesi sifo senhliziyo, 'i-Systolic Heart Failure'. Nakuba lokhu kuyinkinga enkulu, kuyisimo esingalawulwa uma siqashelwa kusenesikhathi futhi selashwa kahle.

Kuyini Ukwehluleka Kwenhliziyo Ye-Systolic?

Kalula nje, inhliziyo yakho inezindawo ezine eziyinhloko. Igumbi elingezansi ngakwesobunxele, elibizwa ngokuthi i-ventricle yesobunxele, liphampa igazi elinomoya-mpilo emzimbeni wonke. Lisebenza njengephampu yamanzi. Manje, kulesi simo esibizwa ngokuthi ukwehluleka kwenhliziyo kwe-systolic, i-ventricle yesobunxele iba buthakathaka. Lokho kusho ukuthi ayikwazi ukuphampa igazi ngendlela efanele nangendlela efanele.

Kwenzekani-ke? Cabanga uma injini yamanzi ingenawo amandla anele, amanzi ngeke ageleze kahle. Ngokufanayo, lapho inhliziyo ingapompi igazi kahle, uketshezi lungaqongelela emaphashini. Yilapho izinto ezifana nobunzima bokuphefumula nokukhathala zivela khona. Ezinye izingxenye zomzimba, ikakhulukazi imilenze, amaqakala, kanye nesisu, nazo zingavuvukala . Lokhu kungenxa yokuthi uketshezi emzimbeni alujikelezi kahle.

Ngakho-ke iyini le Ngxenye Yokukhipha?

Manje ake sixoxe ngokuthi iyini i-Ejection Fraction (EF) . Lokhu kubizwa ngokuthi 'i-Ejection Fraction' ngesiSinhala. Nakuba lokhu kuyigama lezokwelapha kancane, kulula ukuliqonda. Kalula nje, leli yiphesenti lokuthi i-ventricle yakho yesobunxele ifaka igazi elingakanani emzimbeni uma ishaya kanye.

Inhliziyo enempilo, esebenza kahle kufanele ibe nenani le-EF eliphakathi kuka-55% no-70% . Lokhu kusho ukuthi igazi elingaphezu kwengxenye elingena kwi-ventricle yesobunxele yenhliziyo likhishwa kanye. Kodwa-ke, uma leli nani le-EF lehla ngaphansi kuka-40% , kungaba uphawu lokwehluleka kwenhliziyo kwe-systolic. Lokhu kusho ukuthi ikhono lokupompa kwenhliziyo lehlile. Yingakho lesi simo ngezinye izikhathi sibizwa ngokuthi 'Ukwehluleka Kwenhliziyo Okune-Reduced Ejection Fraction' (HFrEF) .

Ubani onamathuba amaningi okuthola lesi simo?

Ukwehluleka kwenhliziyo kwe-Systolic kungathinta noma ubani, kodwa ingozi iyanda njengoba iminyaka ikhula. Kuvamile futhi kubantu abanezinye izimo zenhliziyo, njengokuhlaselwa yinhliziyo ngaphambilini noma umfutho wegazi ophakeme.

Yini ebangela ukwehluleka kwenhliziyo kwe-systolic (HFrEF)?

Ukwehluleka kwenhliziyo kwe-Systolic kuvame ukwenzeka lapho i-ventricle yesobunxele yenhliziyo yonakaliswa esinye isifo. Cabanga ngale ndlela: imisipha yenhliziyo ifana nebhande lerabha. Iyanwebeka futhi ifinyele. Kodwa uma yonakele, ayikwazi ukwenza lowo msebenzi kahle.

Nazi ezinye zezizathu eziyinhloko ezingathinta lokhu:

• Isifo Semithambo Yenhliziyo: Lesi yisona sizathu esivame kakhulu. Imithambo yegazi ehambisa igazi enhliziyweni (imithambo yegazi yenhliziyo) iyancishiswa noma ivinjwe yizinqwaba zamafutha, okuvimbela imisipha yenhliziyo ekutholeni umoya-mpilo nezakhamzimba ezidingayo. Lokhu kubangela ukuba imisipha ibe buthaka.
• Umfutho wegazi ophezulu (Umfutho wegazi ophakeme): Uma umfutho wegazi uphezulu isikhathi eside, inhliziyo kufanele isebenze kanzima ukupompa igazi. Kufana nokupompa amanzi emthanjeni ovalekile. Ngokuhamba kwesikhathi, lokhu kungabangela ukuba imisipha yenhliziyo ikhule futhi ekugcineni ibe buthaka.
• Ukuhlaselwa yinhliziyo kwangaphambilini: Ukuhlaselwa yinhliziyo kwenzeka lapho ukugeleza kwegazi engxenyeni ethile yenhliziyo kunqanyulwa, okubangela ukuba amangqamuzana emisipha afe. ​​Indawo efile ibe isiba nezibazi, okunciphisa ikhono lenhliziyo lokupompa.
• Isifo Sikashukela: Isifo sikashukela singalimaza imithambo yegazi futhi sithinte ngqo imisipha yenhliziyo.
• Isigqi Senhliziyo Esingavamile: Uma ukushaya kwenhliziyo kungahambi kahle, inhliziyo ayikwazi ukupompa igazi kahle.
• Isifo Se-Heart Valve: Uma ama-valve enhliziyweni engasebenzi kahle, igazi lingageleza emuva noma phambili, okungabeka ukucindezeleka okwengeziwe enhliziyweni.
• I-Myocarditis: Ukuvuvukala kwemisipha yenhliziyo. Lokhu kungabangelwa izinto ezifana nokutheleleka ngegciwane.

Lo monakalo ungabangela izibazi emisipheni yenhliziyo, ukuvuleka, noma ukuqina kwama-ventricle. Zonke lezi zinto zenza buthaka i-ventricle yesobunxele futhi zinciphise i-EF. Izindaba ezinhle ukuthi ezimweni eziningi, uma imbangela eyisisekelo iphathwa kahle, ukusebenza kwenhliziyo kungathuthukiswa kancane.

Ziyini izimpawu zalesi simo?

Nokho, wazi kanjani ukuthi kungenzeka ukuthi unale nkinga? Nazi ezinye izimpawu okufanele uziqaphele:

• Ukuphelelwa umoya (Dyspnea): Ungase ube nobunzima bokuphefumula, ikakhulukazi lapho uzivocavoca, ukhuphuka izitebhisi, noma ulele embhedeni. Uma udinga ukulala unemicamelo emibili noma emithathu ebusuku, lokho nakho kuyisibonakaliso.
• Ukukhathala nobuthakathaka obuvamile: Uma uzizwa ukhathele kakhulu ngisho nangemva kokwenza imisebenzi eyayilula ngaphambili.
• Ukuvuvukala emilenzeni, emaqakaleni nasezinyaweni: Lokhu kuvuvukala kungenzeka ngenxa yokugcina uketshezi emzimbeni. Ngezinye izikhathi isisu singavuvukala.
• Ukushaya kwenhliziyo okusheshayo noma okungajwayelekile: Uma uzizwa ushintsho endleleni inhliziyo yakho eshaya ngayo.
• Ukukhwehlela okuqhubekayo noma ukuphefumula: Ukukhwehlela okuhambisana kakhulu ne-mucus emhlophe.
• Ukwehla kwamandla okuzivocavoca.
• Ukucanuzela kwenhliziyo noma ukungabi nesifiso sokudla.
• Ubuhlungu besifuba: Lokhu kungabangwa yimbangela efana nesifo semithambo yenhliziyo.
• Isiyezi.

Uma unesinye noma ngaphezulu salezi zimpawu, sicela ungazinaki bese ubona udokotela. Uma usheshe uzibone, kulula ukuzelapha.

Odokotela bakuthola kanjani lokhu?

Uma uya kudokotela, uzokwenza izivivinyo eziningana ukuze anqume ukuthi une-systolic heart failure. Into ebaluleke kakhulu ukuthola ukuthi iyini imbangela eyinhloko ukuze ukwazi ukuyelapha ngendlela efanele.

Le nqubo yokuhlola ivame ukufaka okulandelayo:

1. Ukuhlolwa komzimba:

• Udokotela uzokubuza ngezimpawu zakho (ukuthi sezinesikhathi esingakanani zikhona, ukuthi zizizwa kanjani).
• Babuza ngezifo zakho zangaphambilini, njengokuthi ngabe kukhona yini emndenini wakho onesifo senhliziyo.
• I-stethoscope isetshenziswa ukulalela inhliziyo namaphaphu (ukuhlola imisindo engavamile kanye noketshezi emaphashini).
• Umfutho wegazi lakho uyalinganiswa.
• Uzolinganiswa (ukuze kubonakale ukuthi ukhuluphele ngokuzumayo, ngenxa yokugcinwa koketshezi emzimbeni).

2. Ukuhlolwa kwegazi (Umsebenzi wegazi):

• Lokhu kuhlolwa kwegazi kungahlola ukuthi ezinye izitho zomzimba (njengezinso nesibindi) zithintekile yini yilobu buthakathaka enhliziyweni.
• Ngokuvamile, izinto ezifana ne-'Albumin' (uhlobo lweprotheni), i-'Creatinine' (isilinganiso somsebenzi wezinso), kanye ne-sodium ne-potassium (ama-electrolyte) ziyalinganiswa.
• Kukhona ukuhlolwa kwegazi okukhethekile okubizwa ngokuthi i-BNP (B-type Natriuretic Peptide). Uma inhliziyo icindezelekile, izinga lale BNP egazini liyakhuphuka. Lokhu kusiza kakhulu ekuxilongeni ukwehluleka kwenhliziyo.

3. Ukuhlolwa kwezithombe zenhliziyo:

• Lezi zivivinyo zingahlola izinto eziningi, njengokuma nobukhulu benhliziyo, ukuthi izindonga zamaseli zinobukhulu obungakanani, ukuthi ama-valve asebenza kahle yini, nokuthi ngabe kube nomonakalo obangelwe ukuhlaselwa yinhliziyo kwangaphambilini.
• I-X-ray yesifuba: Ukubona ukuthi inhliziyo ikhulisiwe noma ukuthi uketshezi luqongelelene emaphashini.
• `I-Echocardiogram (Echo)`: Lolu vivinyo olubaluleke kakhulu. Lufana nokuskena kwenhliziyo nge-ultrasound. Lungalinganisa ngokunembile inani le-EF. Lungabona ngokucacile ukusebenza kwamakamelo nama-valve enhliziyo.
• I-Electrocardiogram (EKG/ECG): Ukuhlolwa okuqopha umsebenzi kagesi wenhliziyo. Kungathola izinto ezifana nesigqi kanye nesivinini sokushaya kwenhliziyo, kanye nezimpawu zokuhlaselwa yinhliziyo kwangaphambilini.
• Ngezinye izikhathi, ezinye izivivinyo ezikhethekile ezifana ne-'Cardiac MRI', 'Cardiac CT scan', 'Cardiac Catheterization' (i-Angiogram), 'Exercise Stress Test' noma 'Nuclear Exercise Stress Test', 'Multigated Acquisition Scan' (MUGA)` nazo zingenziwa.

Kuphathwa kanjani lokhu?

Kulungile, manje ake sibheke ukuthi singayelapha kanjani lesi simo sokwehluleka kwenhliziyo kwe-systolic. Kunezinhloso eziningana eziyinhloko zokwelashwa:

• Ukunciphisa izimpawu (njengokuphelelwa umoya, ukuvuvukala).
• Ukuvimba noma ukulawula inhliziyo ukuthi ingaqhubeki nokuba buthaka.
• Ukuthuthukisa ikhwalithi yokuphila.
• Kusiza ekwandiseni impilo.

Izindlela zokwelapha zingahlukaniswa ngezigaba eziningana eziyinhloko:

1. Izinguquko endleleni yokuphila

Lokhu kubaluleke kakhulu. Akwanele ukuphuza umuthi nje, udinga ukwenza lezi zinto nawe.

• Nciphisa usawoti odliwayo: Usawoti (i-sodium) ubangela ukuthi umzimba ugcine uketshezi oluningi. Lokhu kwandisa ukuvuvukala futhi kubeka ingcindezi enkulu enhliziyweni. Nciphisa usawoti odliwayo njengoba kuqondiswe udokotela wakho. Ngokuvamile, akukhuthazwa ukudla ama-milligram angaphezu kuka-1500-2000 e-sodium ngosuku.
• Ukunciphisa uketshezi: Abanye abantu batshelwa nokuthi banciphise inani lamanzi abawaphuzayo ngosuku. Lokhu kuyinto okufanele uyixoxe nodokotela wakho bese unquma.
• Gcina isisindo esinempilo: Uma ukhuluphele kakhulu, zama ukunciphisa isisindo. Kungumqondo omuhle ukuzikala nsuku zonke. Uma ukhuluphala ngokuzumayo (ikhilogremu noma amabili ngosuku), kungaba uphawu lokugcinwa koketshezi emzimbeni. Uma lokhu kwenzeka, tshela udokotela wakho .
• Gwema ukubhema: Ukubhema kuyingozi kakhulu enhliziyweni nasemithanjeni yegazi.
• Nciphisa noma uyeke utshwala: Utshwala bungaphinde bunciphise imisipha yenhliziyo.
• Vivinya umzimba njalo: Khuluma nodokotela wakho ngokuthi yikuphi ukuzivocavoca okufanele. Qala kancane kancane bese wandisa kancane kancane umsebenzi wakho. Ukuhamba kuwukuzivocavoca okuhle. Kungaba kuhle uma ungahlanganyela ohlelweni lokuvuselela inhliziyo.
• Nciphisa ukucindezeleka, uphumule kahle, futhi ulale ngokwanele.
• Yidla ukudla okunempilo: yidla imifino, izithelo, ukudla okune-fiber, kanye nokudla okunamafutha amancane.

2. Imithi (izinhlobo zemithi)

Kunemithi eminingi ephumelelayo etholakalayo yokwelapha ukwehluleka kwenhliziyo kwe-systolic. Le mithi ingathuthukisa i-EF yakho, izimpawu, kanye nokusebenza kwenhliziyo iyonke. Udokotela wakho angase akunike eyodwa noma ngaphezulu yale mithi ndawonye.

• Ama-Beta-blocker: Lawa athuthukisa ukusebenza kwenhliziyo ngokunciphisa izinga lokushaya kwenhliziyo, anciphise umsebenzi okufanele wenziwe yinhliziyo. Angasiza ekulawuleni umfutho wegazi, anciphise ingozi yokuhlaselwa yinhliziyo, futhi alawule ukushaya kwenhliziyo okungajwayelekile.
• Izithibi ze-Angiotensin-Converting Enzyme (ACE): Lezi zilawula umfutho wegazi, zikhulisa imithambo yegazi, futhi zivimbele ama-hormone okucindezeleka emzimbeni, zithuthukise ukusebenza kwenhliziyo ngokuhamba kwesikhathi.
• Ama-Angiotensin-II Receptor Blockers (ARBs): Lawa anikezwa abantu abanemiphumela emibi njengokukhwehlela okuvela kuma-ACE inhibitors. Asebenza ngendlela efanayo nama-ACE inhibitors.
• Ama-Angiotensin Receptor-Neprilysin Inhibitors (ARNIs): Lolu uhlobo olusha nolusebenza kahle kakhulu lwemithi. Lokhu kunciphisa nama-hormone okucindezeleka, kuvula imithambo yegazi, futhi kuthuthukise ukusebenza kwenhliziyo.
• Ama-Antagonists e-Aldosterone (Ama-Mineralocorticoid Receptor Antagonists - ama-MRA): Lawa anciphisa ama-hormone okucindezeleka futhi asize izinso zisuse uketshezi oluningi nosawoti emzimbeni. Kudingeka uqaphele amazinga akho e-potassium lapho uthatha le mithi.
• Ama-diuretics (amaphilisi amanzi): Lawa aqeda ngokushesha izimpawu (ikakhulukazi ukuvuvukala nokuphelelwa umoya) ngokususa uketshezi oluningi nosawoti ezinso. Uma uketshezi luncishisiwe, kuba lula ngenhliziyo ukupompa igazi.
• Ama-inhibitor e-SGLT-2: Lawa ekuqaleni awuhlobo lomuthi wesifo sikashukela. Kodwa kamuva kwatholakala ukuthi nawo alungele kakhulu iziguli ezinesifo senhliziyo ezingenaso isifo sikashukela. Akhipha uketshezi oluningi kanye noshukela emchameni.

Into ebaluleke kakhulu ukuthatha umuthi udokotela wakho awunikezayo ngqo, ngesikhathi kanye nomthamo owunikeziwe. Ungalokothi uyeke ukuthatha umuthi noma ushintshe umthamo ngokwakho.

3. Imishini kanye nokuhlinzwa

Ezinye iziguli zingase zingakwazi ukulawula isimo sazo ngemithi kanye nokushintsha indlela yazo yokuphila zodwa. Zingase zidinge izinto ezifana nalezi:

• I-ICD (I-Implantable Cardioverter-Defibrillator): Idivayisi encane ethola ukushaya kwenhliziyo okungajwayelekile okuyingozi (i-arrhythmia) futhi inikeze ukushaqeka okuncane kukagesi enhliziyweni ukuze kubuyiselwe isigqi esijwayelekile. Lokhu kufakwa ngaphansi kwesikhumba sesifuba.
• I-CRT (Ukwelashwa Kokuvumelanisa Inhliziyo) / I-Biventricular Pacemaker: Le divayisi isiza ukulungisa ukungalingani phakathi kwamakamelo enhliziyo angakwesobunxele nangakwesokudla. Lokhu kuthuthukisa nekhono lokushaya kwenhliziyo.
• Ukufakelwa Kwemithambo Yenhliziyo Ene-Coronary Artery Bypass (CABG) noma i-Angioplasty ene-stenting: Yelapha imithambo yenhliziyo evalekile.
• Ukulungiswa noma ukuhlinzwa kwe-valve yenhliziyo.
• Ukufakelwa inhliziyo noma i-LVAD (Idivayisi Yokusiza I-Ventricular Yesobunxele): Lezi yizindlela zokwelapha ezivame ukucatshangelwa kakhulu ezigulini ezigula kakhulu.

Ingancishiswa kanjani ingozi yalesi simo?

Bathi, “Ukuvimbela kungcono kunokwelapha.” Ngakho-ke, kunezinto ongazenza ukuze uvimbele noma unciphise ingozi yokuba nokwehluleka kwenhliziyo kwe-systolic. Imikhuba emihle yempilo iyisihluthulelo.

• Yidla ukudla okunomsoco nokulinganiselayo (usawoti omncane, amafutha amancane, imifino nezithelo eziningi).
• Vivinya umzimba njalo.
• Gcina isisindo esinempilo.
• Gwema ukubhema ngokuphelele.
• Nciphisa ukusetshenziswa kotshwala.
• Uma unezinkinga zezokwelapha ezifana nomfutho wegazi ophakeme, isifo sikashukela, noma i-cholesterol, zilawule kahle. Landela imiyalelo kadokotela wakho ngokucophelela.
• Nciphisa ukucindezeleka futhi ulale ngokwanele.

Yimaphi amathemba ongawaba nawo ngenkathi uphila nalesi simo?

Ukwehluleka kwenhliziyo kwe-Systolic kuyisimo esingapheli, sesikhathi eside nesibucayi. Kungase kungabi lulapheki ngokuphelele. Kodwa-ke, ngokwelashwa okufanele kanye nokushintsha kwendlela yokuphila, izimpawu zingalawulwa futhi impilo enhle ingaphilwa.

Umphumela uncike ezintweni eziningana:

• Ukuthi isifo senhliziyo sibi kangakanani.
• Impilo yakho iyonke nokuthi unazo yini ezinye izifo (njengesifo sezinso, isifo sikashukela).
• Indlela osabela ngayo ekwelashweni.
• Iyini imbangela eyinhloko yalokhu?

Ngakho-ke, kubaluleke kakhulu ukungesabi noma ukukhungatheka, kodwa ukulandela imiyalelo kadokotela ngqo nokulungisa indlela yakho yokuphila. Sebenzisana nethimba lakho lezokwelapha.

Kunini lapho kufanele ufune khona usizo lwezokwelapha ngokushesha?

Uma uhlangabezana nanoma yiziphi zalezi zimpawu, kufanele ufune usizo lwezokwelapha ngokushesha, okusho ukuthi ngokushesha okukhulu :

• Ubuhlungu besifuba obungazelelwe nobunzima.
• Ukuphefumula okuphuthumayo nokunzima kakhulu.
• Ukuquleka noma ubuthakathaka obukhulu.
• Ubuhlungu besifuba, isiyezi, noma ukuphelelwa umoya okubangelwa ukushaya kwenhliziyo okusheshayo noma okungajwayelekile.
• Ukuvuvukala kwemilenze ngokuzumayo noma ukukhuluphala.

Yimiphi imibuzo ongayibuza udokotela?

Uma ubona udokotela wakho, ungabuza imibuzo efana nale ukuze uqonde kangcono isimo sakho:

• Iyini imbangela yangempela yokwehluleka kwenhliziyo yami kwe-systolic?
• Iyini inani le-ejection fraction yami (EF)? Kusho ukuthini?
• Ingabe lesi simo sithinte ezinye izitho zami zomzimba (njengezinso, isibindi)?
• Yikuphi ukwelashwa okufanele mina? Yiziphi izinzuzo nezinkinga?
• Yiziphi izinguquko ezibaluleke kakhulu okudingeka ngizenze endleleni yami yokuphila?
• Hlobo luni lokudla neziphuzo okufanele ngizidle futhi yini okufanele ngiyigweme?
• Yimiphi imithambo engingayenza? Kufanele ngiyenze isikhathi esingakanani?
• Yini okungafanele ngiyenze?
• Yimiphi imiphumela emibi engaba khona yalo muthi? Yini okufanele ngiyenze uma ivela?
• Kufanele ngize kangaki ukuzohlolwa? Isikolo sami se-EF sizohlolwa nini futhi?
• Yini okufanele ngiyenze uma kunesimo esiphuthumayo?

Izinto ezibaluleke kakhulu okudingeka sizikhumbule

Ukwehluleka kwenhliziyo kwe-Systolic kuyisimo esibi, sesikhathi eside lapho i-ventricle yesobunxele yenhliziyo ingakwazi ukupompa igazi kahle. Uma unezinye zalezi zimpawu, sicela ubonane nodokotela. Uma kusheshe kwabonakala, kulula ukwelapha futhi umphumela uba ngcono.

Ngokwelapha imbangela eyinhloko, ukuthatha imithi udokotela wakho ayinikezayo, kanye nokuthuthukisa imikhuba emihle yokuphila, ungasiza ekulawuleni izimpawu zakho futhi uphile impilo enempilo, esebenzayo, neyesikhathi eside. Ungesabi, hlala uqinile! Awuwedwa, odokotela bakho, umndeni wakho, nabangani bakho bonke bakhona ukukusiza.

Ukuhlaselwa yinhliziyo , ukwehluleka kwenhliziyo kwe-systolic, ingxenye yokukhipha isisu, ubuthakathaka benhliziyo, ukuphelelwa umoya, ukuvuvukala kwemilenze, izimpawu zenhliziyo