Ingabe ukushaya kwenhliziyo yakho akusavumelani? Ake sifunde nge-Ventricular Dyssynchrony ngendlela elula!

Ingabe ngezinye izikhathi uzizwa uphelelwa umoya, ukhathele njalo, noma unemilenze evuvukele? Lokhu kungaba ngezinye izikhathi izimpawu zenkinga ngenhliziyo yakho. Namuhla sizokhuluma ngesimo esithinta ukusebenza kwenhliziyo, kodwa mhlawumbe asikaze sizwe okuningi ngaso. Lokho yi -ventricular dyssynchrony , noma njengoba odokotela bekubiza kanjalo, ``(Ventricular Dyssynchrony)``. Nakuba igama lingase lizwakale liyinkimbinkimbi kancane, ake silichaze kalula.

Kuyini i-Ventricular Dyssynchrony?

Kalula nje, i-ventricular arrhythmia yilapho elinye noma ngaphezulu kwamakamelo aphansi enhliziyo yakho, abizwa ngokuthi ama-ventricles , eshaya ngokungalingani futhi ngaphandle kokuxhumana. Cabanga ukuthi kukhona ukubambezeleka okuncane okungama-millisecond angu-40 phakathi kwezingxenye ezahlukene zamaseli enhliziyo yakho eziqala ukufinyela, noma phakathi kweseli elilodwa eliqala ukufinyela uma kuqhathaniswa nelinye. Lokho kungabhekwa njenge-arrhythmia.

Inhliziyo yethu isebenza kahle kuphela uma imisipha emakamelweni ayo ifinyela ngesikhathi esifanayo nangendlela efanayo. Ngokuvamile, izimpawu zikagesi zihamba enhliziyweni ngendlela ehlelekile kakhulu. Lapho amakamelo amabili amakhulu enhliziyo ethola isignali yokufinyela, imisipha emakamelweni lawo kumele ifinyele ngezinga elifanayo nangesikhathi esifanayo. Ikakhulukazi, i-ventricle yakho yesobunxele, igumbi eliyinhloko lokupompa lenhliziyo, kumele ifinyele ngendlela ehlelekile kakhulu. Kufana nokusunduza kusuka ezinhlangothini zombili kuya enkabeni.

Kodwa-ke, uma lesi siginali singafinyeleli kokubili amangqamuzana enhliziyo ngesikhathi esisodwa, imisipha ayikwazi ukufinyela ngesikhathi esisodwa. Yilokho esikubiza ngokuthi i -dysynchrony .

I-dyssynchrony yamaseli ingathinta umzimba wakho ngezindlela ezilandelayo:

• Kunciphisa ukusebenza kahle kwenhliziyo yakho.
• Ama-valve avame ukusiza ukugeleza kwegazi ohlangothini olulodwa kuphela angabangela ukuthi igazi ligeleze emuva (ngakwesokunene).
• Inani legazi elingapompa inhliziyo yakho (Cardiac Output) liyancipha.

Yiziphi izinhlobo ze-arrhythmias zenhliziyo?

Kunezinhlobo eziningana eziyinhloko ze-asynchrony yamaseli:

• I-Atrioventricular Dyssynchrony: Lokhu kwenzeka lapho amakamelo aphezulu (i-atria) kanye namakamelo aphansi (ama-ventricle) enhliziyo yakho efinyela ngaphandle kokuxhumana.
• I-Interventricular Dyssynchrony: Kulokhu, ama-ventricle akho angakwesokunxele nangakwesokudla (amakamelo aphansi) ayafinyela ngezikhathi ezahlukene.
• I-Intraventricular Dyssynchrony: Kulokhu, imisipha ezingxenyeni ezahlukene zeseli elifanayo iyafinyela ngezikhathi ezahlukene. Cabanga ngakho njengezindonga zegumbi elifinyela ngezikhathi ezahlukene, kunokuba zicindezelwe ngaphakathi ngesikhathi esifanayo.

Ubani othinteka kakhulu yi-asynchrony yamaseli?

Lesi simo sivame ukubonakala kubantu abanezimo zezokwelapha ezilandelayo:

• Abantu abanesifo senhliziyo.
• Ibhulokhi Legatsha Le-Left Bundle (LBBB).
• Ibhulokhi Legatsha Le-Bundle Yesokudla (RBBB).
• Isifo semisipha yenhliziyo `(Cardiomyopathy)`.
• Umfutho wegazi ophezulu.
• Ezinye izifo zenhliziyo.

Cabanga ngoMalume uSomapala wasedolobhaneni lakithi. Ubesehlushwa yi-`(Heart Failure)` isikhathi esithile. Muva nje, ubelokhu enenkinga yokuphefumula nokukhathala kakhulu. Lapho udokotela emhlola, wathi naye unalesi simo esibizwa ngokuthi `(Ventricular Dyssynchrony)` enhliziyweni yakhe, yingakho izimpawu zakhe ziye zaba zimbi kakhulu.

Sivame kangakanani lesi simo?

Cishe ingxenye eyodwa kwezintathu yabantu abanohlobo oluthile lokwehluleka kwenhliziyo bangase babe nalolu hlobo lokungalingani kwamaseli. Cishe u-2% wabantu abadala emazweni athuthukile bahlushwa ukwehluleka kwenhliziyo. Futhi, phakathi kuka-6% no-10% wabantu abangaphezu kweminyaka engu-65 banesifo senhliziyo. Ngakho-ke, lesi simo siyinto ebonakala ngokuhlobene nalokho.

Ziyini izimpawu?

I-cellular dyssynchrony ingenza izimpawu zokwehluleka kwenhliziyo zibe zimbi kakhulu, noma ibangele izimpawu ezihlukile kuyo. Lezi yizona eziyinhloko:

• Ubunzima bokuphefumula (ikakhulukazi uma ukhathele).
• Ukuzizwa ukhathele kakhulu (ngisho noma umzuzwana nje).
• Ukukhwehlela (okungenzeka kuqhubeke njalo).
• Ukuvuvukala (i-edema) emzimbeni (ikakhulukazi ezindaweni ezifana nemilenze nasemaqakaleni).

Yiziphi izimbangela zokungavumelani kwamaseli?

Izinkinga eziningana ezahlukene zenhliziyo zingabangela lokhu. Ezinye zazo yilezi:

• Ukungasebenzi kahle kwe-Ventricular.
• Izicubu zezibazi ezibangelwa ukuhlaselwa yinhliziyo.
• Ukulibaziseka Kokuqhutshwa Kogesi, okuhlanganisa izimo ezifana neBloko Legatsha Le-Left Bundle kanye neBloko Legatsha Le-Right Bundle.
• Imisipha yenhliziyo enesifo.
• Ukugeleza kwegazi okunganele emisipheni yenhliziyo (i-Ischemia).

Yiziphi izivivinyo ezenziwayo ukuze kutholakale lesi simo?

Udokotela wakho uzoqala akubuze ngezimpawu zakho bese enza ukuhlolwa ngokomzimba ukuhlola ukusebenza kwenhliziyo yakho. Ngezinye izikhathi , ukulalela inhliziyo yakho nge-stethoscope nakho kungakunikeza umbono walokhu kungasebenzisani.

Ukuhlolwa okuyinhloko okusetshenziselwa ukuxilonga izinkinga ohlelweni lokuhambisa ugesi lwenhliziyo yi -electrocardiogram (ECG) . Ingathola izimo ezifana ne-Right Bundle Branch Block kanye ne-Left Bundle Branch Block, ezibangela ukuba inhliziyo ishaye ngendlela engafanele. Uma lezi zimo zitholakala ku-ECG, udokotela uzokudlulisela ukuze uthole ezinye izivivinyo.

Odokotela bavame ukusebenzisa i-echocardiogram ukuthola ukungasebenzi kahle kwenhliziyo . Lokhu kubavumela ukuthi babone ukuthi amakamelo enhliziyo, ama-valve, kanye nemisipha ziyancipha kanjani.

Ezinye izivivinyo zingenziwa futhi:

• Ukuskena kwe-Positron Emission Tomography (PET).
• Ukuskena kwe-Multigated Acquisition (MUGA).
• Isithombe Sokuzwakala Kwenhliziyo Esine-Magnetic (MRI).
• I-Computerized Tomography (CT) scan.
• Ukuskena kwe-Single Photon Emission Computed Tomography (SPECT).

Iphathwa kanjani i-cell asynchrony?

Abahlinzeki bezokunakekelwa kwempilo bangase baphathe isimo sezokwelapha esiyisisekelo esibangela ukungalingani kweseli lakho.

Ezimweni eziningi, ukwelashwa kokuvumelanisa inhliziyo (i-CRT) (okubizwa nangokuthi i-CRT noma i-biventricular pacemaker) kungasiza inhliziyo ukuthi iphampe kangcono ngokulawula isigqi sezinhlangothi zombili zenhliziyo. Kodwa-ke, lokhu kwelashwa kuthuthukisa izimpawu kuphela kubantu abangu-50% kuya ku-70% abathola lokhu kwelashwa. Abantu abane-asynchrony enzima banamathuba amaningi okuphumelela.

Izinkinga zokwelashwa kwe-CRT

Izinkinga ezilandelayo zingase zenzeke lapho kufakwa i-`CRT` (i-bi-polar pacemaker) (lezi azivamile, kodwa kuhle ukuziqaphela):

• I-Pneumothorax.
• Ukuqongelela kwegazi phakathi kodonga lwesifuba namaphaphu (i-Hemothorax).
• Ukubhoboza kwenhliziyo.
• Ukuvuselelwa kwemisipha ngaphandle kwenhliziyo.
• Ama-pacemaker ahamba endaweni yawo.

Ngizozizwa ngingcono ngokushesha kangakanani ngemva kokwelashwa?

Ukwelashwa kwe-CRT kunciphisa ukungalingani kwamaseli cishe ngokushesha. Abanye abantu baqala ukuzizwa bengcono emavikini ambalwa okufakelwa idivayisi. Kukhona nezinzuzo zesikhathi eside:

• Ukuthuthukisa inani legazi elimpontshelwa yinhliziyo yakho (Cardiac Output).
• Ukunciphisa ukuvuza kwegazi okuphuma emuva kusuka ku-valve ye-mitral.
• Ukuthuthukisa ikhwalithi yempilo yakho.
• Ibanga ongalihamba ngemizuzu eyisithupha liyakhula.

Yimuphi umuthi osetshenziswayo?

Ezimweni ezibangela i-atrial fibrillation, njengokwehluleka kwenhliziyo, i-cardiomyopathy, noma umfutho wegazi ophakeme, udokotela angase anikeze imithi efana nalokhu:

• Ama-inhibitor e-Angiotensin-Converting Enzyme (ACE).
• Ama-Angiotensin II Receptor Blockers (ama-ARB).
• Ama-Beta-blocker.
• Ama-diuretics (ama-diuretics).

Nakuba le mithi ingase ithuthukise ukusebenza kwenhliziyo yakho ngezinga elithile, ayikwazi ukuguqula ngokuphelele ukungavumelani okubangelwa ukungasebenzi kahle kokuhambisa ugesi. Yingakho kudingeka ukwelashwa okufana ne-CRT.

Ungayinciphisa kanjani ingozi yokungalingani kwamaseli?

Into engcono kakhulu ongayenza ukunakekela inhliziyo yakho kahle. Uma wenza kanjalo, uzokwazi ukuvimbela ezinye zezimo ezibangela ukungalingani kwamaseli.

Ezinye izindlela zokuvikela inhliziyo yakho:

• Yidla ukudla okunamafutha agcwele aphansi (nciphisa amafutha nokudla okuthosiwe).
• Vivinya umzimba okungenani imizuzu engama-30 cishe izinsuku eziningi (ngisho nokuhamba ngezinyawo kuhle).
• Ukugcina isisindo sakho siphilile.
• Ukuthatha umuthi njengoba nje udokotela emyalile.

Kwenzekani uma ngine-cell asynchrony?

I-Left Ventricular Dyssynchrony (LVD) ayiphathwa, futhi umphumela awumuhle kangako. Abantu abane-LVD basengozini enkulu yezehlakalo zenhliziyo kunalabo abangenaso lesi simo. Ungaba ne-dysynchrony kunoma iyiphi (noma kokubili) yama-ventricle akho, kodwa i-left ventricle yakho iyingxenye eyinhloko epompa igazi elinomoya-mpilo emzimbeni wakho wonke. Lona umsebenzi obaluleke kakhulu.

Ukwelashwa okubizwa ngokuthi i-`CRT` (i-dual-cell pacemaker) kungasiza abantu abanesifo senhliziyo ukunciphisa ukuhlala esibhedlela futhi baphile isikhathi eside.

Khumbula, imbangela eyisisekelo yokungavumelani nayo ithinta umphumela. Isimo sabanye abantu singase sibe sibi kakhulu kunesabanye.

Ngizinakekela kanjani?

• Uma udokotela wakho ekunike imithi, qiniseka ukuthi uyithatha njengoba kuyalelwe . Thatha imithi njengoba kuyalelwe kuze kube yilapho udokotela wakho ekutshele ukuthi uyeke.
• Uma une-biventricular pacemaker, khumbula ukuya emitholampilo ngezinsuku ezihleliwe . Yilapho udokotela wakho angahlola khona ukuthi i-pacemaker yakho isebenza kahle. Ezinye izibhedlela zinemitholampilo ekhethekile ebizwa ngokuthi imitholampilo ye-CRT. Lapho, odokotela benhliziyo nochwepheshe benhliziyo basebenzisana ukuqinisekisa ukuthi uthola okuningi ku-pacemaker yakho.

Kufanele ngimbone nini udokotela wami?

• Uma ungazizwa ungcono ngemithi oyinikezwe udokotela.
• Uma kunenkinga nge-biventricular pacemaker yakho.

Ezimweni ezinjalo, bonana nodokotela ngokushesha.

Kufanele ngiye nini eMnyangweni Wezimo Eziphuthumayo (i-ETU) ?

Uma uhlangabezana nanoma yiziphi zalezi zimpawu , funa iseluleko sezokwelapha ngokushesha:

• Ubuhlungu besifuba noma ukungakhululeki.
• I-Vertigo (ukuzizwa sengathi uyajikeleza).
• Ubunzima obukhulu bokuphefumula.
• Ubuhlungu besisu, isicanucanu.
• Ubuhlungu emhlane, entanyeni, noma emhlathini.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Ungakhohlwa ukubuza le mibuzo uma ubona udokotela wakho:

• Kungani ngakha i-cell asynchrony?
• Ingabe ngifanelekela ukwelashwa kwe-'CRT'?
• Ingabe akhona amaqembu okusekelana asiza abantu abanesifo senhliziyo?

Kuvamile ukuzizwa ukhathazekile kancane uma uthola ukuthi inhliziyo yakho ayisebenzi kahle. Kodwa ungakhathazeki. Udokotela wakho angathola imbangela ye-arrhythmia yakho futhi akhethe ukwelashwa okungcono kakhulu kuwe. Landela imiyalelo esebhodleleni lomuthi ngqo. Ukuthatha umuthi wakho ngesikhathi esifanayo nsuku zonke kuzokusiza ukuthi ukhumbule ukuwuthatha. Maka izinsuku zakho zokuqokwa ekhalendeni noma usethe isikhumbuzi efonini yakho. Lokhu kuzokusiza ukuthi ugweme ukuziphuthelwa.

Isifinyezo kanye nomyalezo wokuthatha uye ekhaya

Kulungile, ngakho-ke ngithemba ukuthi usuyaqonda kangcono i-"Ventricular Dyssynchrony" esikhulume ngayo namuhla.

Kalula nje, lesi yisimo lapho amakamelo aphansi (amaseli) enhliziyo eshaya khona ngokungalingani, engahambisani. Lokhu kunganciphisa ukusebenza kahle kwenhliziyo, futhi kungabangela nezimpawu ezifana nokuphelelwa umoya nokukhathala.

• Ukuhlolwa okufana ne-`(ECG)` kanye ne-`(Echocardiogram)` kusiza ekuxilongeni lesi simo.
• Njengokwelashwa, ngaphezu kokwelapha isifo esiyisisekelo, ukwelashwa nge-pacemaker okubizwa ngokuthi ``Cardiac Resynchronization Therapy (CRT)`` nakho kubaluleke kakhulu.
• Ukunakekela inhliziyo yakho nokulandela indlela yokuphila enempilo kuhamba ibanga elide ekuvimbeleni izimo ezinjalo.
• Uma unalezi zimpawu, ungangabazi ukufuna iseluleko sezokwelapha. Uma lesi sifo sisheshe sitholakale futhi selashwa, umphumela uba ngcono.

Khumbula, inhliziyo yakho iyimpahla yakho eyigugu kakhulu. Kungumthwalo wakho ukuyivikela.

Isifo senhliziyo, i-ventricular dyssynchrony, i-ventricular tachycardia, ukuhlaselwa yinhliziyo, i-CRT, i-pacemaker