I-tamponade ye-cardiac yisimo esasongela ukuphila lapho kusetshenziselwa khona umonakalo ovamile (okungukuthi, ukuqoqwa kwesamba esingavamile emgodini we-pericardial) noma ukuphuma egazini le-pericardial, kuphazamisa umsebenzi ojwayelekile wenhliziyo. I-tamponade ye-cardiac ingabonakala kahle noma ingaqhubeka kancane kancane. Kunoma yikuphi, izimpawu zivame ukushaya, futhi ukuxazulula izimpawu kudinga ukususwa okusheshayo kokusuka komthamo okweqile kusuka esikhwameni se-pericardial.
I-Tamponade Ye-Cardiac Ikhiqizwa Kanjani?
I-tamponade ye-cardiac kwenzeka lapho ingcindezi eyengeziwe ngaphakathi kwesikhwama se-pericardial, ebangelwa uketshezi okweqile, inokwanela ukuvimbela ukugcwala kwenhliziyo ngesikhathi se-diastole . Njengoba inhliziyo ingakwazi ukugcwalisa ngokuphelele, igazi elingaphansi likhishwa ngenhliziyo ngayinye, futhi inhliziyo kufanele isebenze kanzima ukunikeza izidingo zomzimba. Ngaphezu kwalokho, igazi elizama ukungena enhliziyweni livame ukwenza isipele, lenze ukuxubana emaphashini nasemithanjeni.
Inani le-pericardial fluid elidingekile ukukhiqiza i-tamponade lincike ekutheni lukhulu kangakanani uketshezi oluthile. Uma i-pericardial fluid yanda ngokushesha, i-pericardium ayinaso isikhathi sokuthi "isule," futhi ingcindezi ngaphakathi kwesikhala se-pericardial inganda kakhulu-ngisho nenani elincane elincane. Ngakolunye uhlangothi, uma i-pericardial fluid iqoqa kancane kancane (ithi, esikhathini esithile sezinsuku noma amasonto), i-pericardium inesikhathi sokwelula ukuze ihambisane nomswakama owengeziwe.
Kulesi simo, ukucindezela ngaphakathi kwendawo ye-pericardial angeke kwande kakhulu kuze kube yilapho i-pericardial effusion ikhulu kakhulu, kuze kube yilapho i-pericardium ingakwazi ukwelula noma yikuphi okunye.
Yiziphi Izimbangela Ze-Tamponade Yenhliziyo?
I-tamponade ye-cardiac ingabangelwa yiziphi izimo ezikhiqiza ukuchithwa kwe-pericardial.
Lokhu kufaka:
- I-Pericarditis
- I-Dressler's syndrome
- Izifo (amagciwane, ama-bacterial, noma fungal)
- Izifo ezizenzakalelayo njenge- lupus
- I-traum traum ngenxa yengozi noma ukulimala okuhlinzayo
- I-Cancer
- Ukwelashwa kwezidakamizwa endaweni yesifuba
- I-Hypothyroidism
- Ukususwa kwe-Aortic
- Izidakamizwa (i-hydralazine ikakhulukazi i-isoniazid, ne-procainamide)
Ziyini Izimpawu Ze-Tamponade Yenhliziyo?
Uhlobo nobunzima bezimpawu kuxhomeke ekutheni i-tamponade iye yakhula noma kancane kancane. I-tamponade evamile yilezi zivame ukukhiqizwa yi-chest trauma, ukuhlinzwa kwenhliziyo noma ezinye izinqubo eziyingozi zenhliziyo, njenge- catheterization ye-cardiac , noma i- dissection ye-aortic . Kuzo zonke lezi zimo, igazi lingagcwalisa isisindo se-pericardial ngombuzo wamaminithi noma imizuzu, ukukhiqiza ukukhubazeka okusheshayo nokucindezeleka kwenhliziyo. Ngenxa yokuthi uketshezi okwedlulele (okungukuthi, igazi) esikhwameni se-pericardial siqoqa ngokushesha kulezi zimo, ukuqhuma kungathuthuka ngisho nesilinganiso esincane somswakama. Izimpawu zishaya ngokushesha futhi zikhulu. Ubuhlungu besifuba, ukuphefumula okukhulu, kanye ne- tachycardia kanye ne- palpitations zivamile. Umfutho wegazi ophansi kakhulu ungase uvele, kanye nesikhumba esingavamile, ukukhishwa kwesikhumba se-bluish, kanye nomkhiqizo omncane we-urine.
I-tamponade evamile iyiphuthumayo yezokwelapha, futhi ukufa okusheshayo kungenzeka uma kungelashwa ngokushesha.
I-tamponade ye-cardiac ephumela ezimweni ngaphandle kokuhlukunyezwa, izinqubo zezokwelapha, noma ukuhlukaniswa kwe-aortic kuvame ukuthuthukisa kancane kancane kancane, ngokuvamile ngaphezu kwezinsuku noma amasonto. Ama-pleural acoustic kulezi zinkinga "ezincane" zivame ukuba zikhulu kakhulu kunama-acute amacala kusukela i-pericardium ngokuvamile inesikhathi sokwelula ukuze kutholakale ukuqongelela okuqhubekayo kwamanzi. Izimpawu nazo zincane kakhulu. Iziguli ezine-tamponade ezincane kakhulu zikwazi ukuthola ukugcwala kwesifuba noma ukunganaki, ukukhathala kalula-ikhono, ukuphefumula okuncane nokusebenza okuncane, ne- edema emilenzeni nasezinyaweni. Kodwa ngenkathi izimpawu zingase zikhule kancane kakhulu kunokuba zenzeke kahle, zingagcina ziba nzima kakhulu.
Lolu hlobo oluthile lwe-tamponade yenhliziyo lungabuye lubulawe, futhi ukwelashwa okusheshayo kusadingeka.
I-Tamponade Ye-Cardiac Ithola Kanjani?
Udokotela uzovame ukusola ukuthi i-tamponade yezinhliziyo ilalele izimpawu zesiguli, ngezimo zomtholampilo (njengokungaba khona okusolakala kwanoma yimiphi imibandela yezokwelapha eyaziwa ukuthi ibangela ukukhwabanisa), kanye nokuhlolwa kwangokwenyama. Izinkomba ezengeziwe zingatholakala nge-x-ray yesifuba ne- electrocardiogram . Uma lesi simo sikholelwa, ukuxilongwa kungaqinisekiswa kalula nge- echocardiogram .
I-Tamponade ye-Cardiac iphathwa kanjani?
Ukwelashwa kwe-tamponade yenhliziyo ukukhipha isisindo esiningi se-pericardial kusuka esikhwameni se-pericardial. Ukukhipha uketshezi kukhulula ukucindezelwa ngaphakathi kwesikhwama se-pericardial futhi kuvumela inhliziyo ukuba iqale ukusebenza kwayo evamile.
Ukususwa kwe-pericardial fluid kuvame ukufezwa nge- pericardiocentesis- okuwukuthi, ukukhipha umthamo nge-catheter eguquguqukayo efakwe endaweni ye-pericardial. Ngenye indlela, ukususwa okuketshezi kungenziwa ngokusebenzisa inqubo yokukhipha amanzi. Ngokuvamile amanzi okugcoba ayenziwa uma, ngaphezu kokukhipha amanzi, i-biopsy ye-pericardium iyadingeka ngezizathu zokuxilonga. Uma i-pericardial effusion ibuya emva kokuba isuliwe, i- pericardiectomy (ukususwa kokuhlinzwa kwe-pericardium) kungadingeka ukuze kuvinjelwe ukuphindaphinda okuqhubekayo.
Uma nje ihlolwe ngokushesha futhi isetshenziselwa ngokushesha, i-tamponade yezinhliziyo cishe njalo ingaphathwa ngendlela ephumelelayo, futhi umphumela wesikhathi eside ngokuvamile kuxhomeke ekutheni isimo nesibindi sokubangela imbangela yezokwelapha.
Imithombo:
I-Maisch B, i-PM yeSeferovic, i-Ristic AD, et al. Izikhombandlela zokuHlola nokuPhathwa kweziNtu eziPhezulu eziPhezulu; I-Task Force ekuHlangeni nasekuPhatheni kweZifo eziPhezulu ze-European Society of Cardiology. I-Eur Heart J 2004; 25: 587.
I-Spodick DH. I-Tamponade yeCardiac elula. N Engl J Med 2003; 349: 684.