I-endocarditis yisifo esithathelwanayo (noma ukuvuvukala) kwenhliziyo. Ngokusemthethweni, i-endocarditis yisifo noma ukuvuvukala kwe-endocardium, okuyinto engaphakathi enhliziyweni. Lokhu kusho ukuthi i-endocarditis isifo se-valves yenhliziyo. Kungaphinda kuthinte amadivayisi (ama-pacemakers, defibrillators, nezintambo zawo) kanye nama-valve okufakelwayo.
Kwenzakalani
E-endocarditis, izimila-noma amaqoqo ama-microbes ne-fibrin yabantu nama-platelet-ahlangane namagesi. Bahamba phambili nangapha njengoba i-valve ivula futhi ivale. Lezi zitshalo zingathinta ukugeleza kwegazi. Bangakwazi ukuhlukana nokulimaza baye kwezinye izingxenye zomzimba. Lokhu kungasho ukulimaza ubuchopho namaphaphu. Lezi zitshalo zakhiwa ngeqoqo le-motley lama-platelet, fibrin, nama-bacteria (noma isikhunta) esibangela ukutheleleka. Zingakhula zikhudlwana futhi zikhudlwana kuze kuqalwe ukwelashwa okufanele.
Kufana Kanjani?
Akusikho okuvamile. E-US, kuthinta 1 ku-10,000 kuya ku-1 kuma-20,000 aseMelika ngonyaka. Kodwa-ke, phakathi kwalabo abasebenzisa izidakamizwa ezinjenge-heroin, 1-2 kuya ku-1000 bazosuselwa igciwane (futhi mhlawumbe ngaphezulu).
Ubani Owutholayo
Abaningi abatholayo kakade babe nenkinga ngenhliziyo yabo. Ukukhubazeka kwenhliziyo okukhona ngaphambili kutholakala ku-3 ku-4 okuthuthukisa i-endocarditis. Ngokuvamile, lokhu kusho ukuthi kukhona okungahambi kahle ngezimpawu zezinhliziyo zabo noma babe nomgodi enhliziyweni yabo.
Abanye kungenzeka babe nokufakelwa inhliziyo noma bazalwa ngenhliziyo engavamile. Lezi zinkinga ze-valve zivame ukutholwa lapho udokotela ezwa ukukhononda. Kungabuye kuthathwe ngokuhlolwa okuqondile, njenge-ultrasound yenhliziyo ebizwa nge-Echo (Echocardiogram). Kufanele ubuze udokotela wakho ngalokhu uma unemibuzo.
Kukhona ama-valve ahlukene nezinhlobo ezahlukene zezinkinga. Amanye ama-valve aqinile kakhulu-stenosis. Amanye ama-valve nawo-floppy-regurgitation. Kulabo abahlakulela i-endocarditis, abangaphezu kuka-40% bazobe benenkinga ye-mitral valve (ngokuqondile ukubuyiswa kwe-mitral), kanti ngaphezulu kuka-25% kuyobe nenkinga ye-aortic valve (aortic regurgitation) okubili izinkinga ezijwayelekile ze-valve.
Abanye bazothola i-endocarditis ngoba cishe banamabhaktheriya ageleza egazini labo. Ukuba nama-bacteria emaqenjini egazi kuyingozi ukuthi amabhaktheriya ahlale emhlabeni emagodini. Ama-bacterium angatholakala egazini ngezingcosana ezincane zezinkinobho ezincane zesikhathi, kodwa ngezinye izikhathi lezi zigeleza zebhaktheriya zingaba isikhathi eside. Lokhu kungenzeka uma abantu benenqubo yezokwelapha noma yamazinyo. Noma kunini lapho inaliti noma i-scalpel ihlaba ngesikhumba, kunengozi yebhaktheriya esikhumbeni (noma inaliti noma isikhalazo) sizofaka ngaphakathi. Labo abane- hemodialysis basengozini ikakhulukazi (iziguli ezingaphansi kuka-8% ze-endocarditis zi-dialysis).
Abanye abasengozini yilabo abasebenzisa izinaliti zokusetshenziswa kwezidakamizwa. Amaphesenti angu-10% we-endocarditis aphakathi kwalabo abasebenzisa izidakamizwa ezinjenge-heroin.
Lokho Okukuzwayo
Kunezinhlobo ezahlukene ze-endocarditis.
Lezi zinhlobo zixhomeke kulokho okukukhushulwa yi-bug - futhi nokuthi ngabe kuyisivalo esingokwemvelo (somdabu) noma isakhi esithathelwanayo.
Ukuhlukana okuphawulekayo kuphakathi kokutheleleka kwe- acute nokuziphendulela . Amanye amagciwane ngokuvamile adala ukugula ngokushesha. Amanye amabhaktheriya avame ukubangela ukugula kancane futhi ngokungenasiphelo, lapho umonakalo omkhulu ungenzeka ngaphambi kokuba noma ubani azi ukuthi kunenkinga.
I-infective endocarditis ingabonakaliswa yi-fever ephezulu, ukuphazamisa amahlumela, ukukhathala okwedlulele kanye nobuhlungu besifuba, ukuphefumula okungafiki ngokuzumayo.
I-Subacute i-Endective Endocarditis ithatha isikhathi eside ukuze ibonakale, ngokuvamile okungenani amasonto amabili, kepha ngezinye izikhathi isikhathi eside.
Izifo ezithathelwanayo zibhekwa ngemifula ephansi, ukukhathala okuvamile, ukufisa ukudla, ukuncipha kwesisindo, ubuhlungu bokubuyela emuva, ukujula ebusuku, ukubola okuncane, ukuphathwa ikhanda, nobuhlungu emisipha noma emalungwini. Ngezinye izikhathi kuphawuliwe futhi kukhona amancane, amathenda eminwe noma izinzwane kanye nemithambo yegazi ephukile eminwebeni noma izintambo (noma amehlo).
I-Endective Endocarditis Eyingozi ingabangelwa nguStaph Aureus . I-Subacute ivame ukubangelwa amabhaktheriya e-Streptococcal (Strep), ikakhulukazi i-viridian streptococci, kanye nangezinye izikhathi nge-entococci kanye nezinhlobo ze-Staph.
Izifo ezithathelwanayo zivame ukuvela ezingxenyeni zomzimba lapho zivame ukutholakala kubantu abanempilo. Izifo ezitholakala emlonyeni zivame ukuvela emlonyeni ngokusebenzisa imithwalo noma umsebenzi wamazinyo. Ezinye izifo zingavela emathunjini nase-enterococci zivame ukutholakala emaphethini we-genitourinary. Lawa ma-bacteria angaqeda egazini esuka ezinyangeni zezokwelapha noma zokuhlinzwa.
Izinhlobo
Ngaphandle kwe-acute ne-subacute, kunezinhlobonhlobo eziningi zokutheleleka kuye ngokuthi a) yiliphi i-valve ethintekile b) yiziphi amagciwane noma i-fungus ehilelekile c) ukuthi isifo sengculaza siyingozi kanjani. Ama-valve abathintekayo yi-Aortic ne-Mitral ngokuvamile (ngakwesokunxele senhliziyo) kanye ne-Tricuspid ne-Pulmonic (ngakwesokudla senhliziyo).
Labo abanesandulela ngethuluzi lokusebenzisa izidakamizwa bavame ukuba nezifo ezithintekayo (ikakhulukazi i-Tricuspid) kuyilapho lokhu kuhlaselwa kwabanye.
Okuqhamuka uma udla imishanguzo
Esinye sezingozi ezinkulu ukuthi izimila zingakwazi ukufiphaza izinto ezibonakalayo kwezinye izingxenye zomzimba. Lezi zibizwa ngokuthi yi-emboli. Lezi zinhlamvu zingagcina izitsha noma yikuphi ukugeleza kwegazi-noma ikuphi, kuye ngokuthi yiliphi uhlangothi lwenhliziyo i-valve ivuliwe. (Ohlangothini lwesobunxele uvame ukuqhuma emzimbeni nasebuchosheni, kanti uhlangothi olufanele lungena emaphashini). Lokhu kungabangela umonakalo omkhulu kanye nokutheleleka emaphashini nasebuchosheni, okwenza imivimbo, kanye nezinye izingxenye zomzimba, kuhlanganise nezinso, isibindi, i-spleen, nemithwalo yegazi ebalulekile.
Izifo zingase kube nzima ukuhlanza nokuqhubeka nokuhlwanyela ama-bacteria egazini, okuholela ekutheleleni okubalulekile, okungalawuleki.
Izifo zingalimaza amagagasi futhi zingabangela ukuhluleka kwenhliziyo.
Ukwelapha
Abaningi bayodinga amasonto ambalwa ngama-antibiotic. Imigomo ehlukene ngokuya ngokutheleleka (kanye ne-valve) ububanzi kusukela emavikini amabili kuya ku-6 . Lokhu kuthatha amabhaktheriya acacile ngamagciwane.
Abanye badinga ukuhlinzwa. Lokhu kuvame ukubandakanya labo abanamagagasi okufakelwa, izifo eziqhubekayo, ukuhluleka kwenhliziyo embi, ama-abscesses enhliziyo njengoba ukutheleleka kungena enhliziyweni kusuka ku-valve.
Ukuvimbela Ngenkinga Yenhliziyo Ekhona
Abanye abasengozini enkulu bayothola ama-antibiotic ngaphambi kwezinqubo ezithile zezokwelapha noma zokuhlinzwa. Kubalulekile ukuthi ukhulume nodokotela wakho noma umhlengikazi, nodokotela wamazinyo ngengozi yakho kanye nokukhathazeka kwakho ngaphambi kwenqubo. Labo ababhekwa njengengozi enkulu kunazo zonke, labo abanesifo se-prosthetic (okokufakelwa), i-Infective Endocarditis esedlule, ezinye izifo zenhliziyo ezizalwa ngaphakathi (nesifo senhliziyo ozalwa nazo) nalabo abanezinhliziyo eziguquguqukayo abanezinkinga ze-valve.
Uma kukhona ukukhathazeka mayelana nokuba usengozini, sicela ukhulume nomsebenzi wezempilo.
Ingabe i-Rheumatic Fever ayibangela izinkinga zenhliziyo?
Yebo kunjalo. I-rheumatic fever ingabangela ukuvuvukala enhliziyweni yonke, kodwa njengoba lesi sifo siphikelela kukhona i-fibrosis ye-valve, engabangela ukuba ibe yinkimbinkimbi kakhulu noma i-floppy (i-stenosis noma i-regurgitation). Kubangelwa izifo ze-Group A strep.
Uma Kungewona Ukwelashwa
Kungaba futhi okungenasifo. Ngezinye izikhathi lokhu kungase kuhlotshaniswe ne-rheumatologic ne-autoimmune disorders.
Ingabe Kukhona Amagciwane Aphethwe Ngayo?
Ukutheleleka nakho kungabandakanya ezinye izingxenye zaphakathi kwenhliziyo kufaka phakathi "emgodini enhliziyweni" (njengenhlawulo ezindongeni ezihlukanisa amakamelo ahlukene ehliziyo) kanye nezintambo (i-chordae tendineae) ezixhunywe kuma-valve.