I-Lupus, eyaziwa nangokuthi i-systemic lupus erythematosus noma i-SLE, isifo esizimele esisodwa esingathinta cishe noma yikuphi ingxenye yomzimba, kodwa ikakhulukazi isikhumba, amalunga, izinso, amaphaphu, ubuchopho-nenhliziyo.
Izinkinga zenhliziyo ngokuvamile zibonakala kubantu abane-lupus ngokuvamile aba phakathi kwezigaba ezinhlanu. Lezi izi:
- I-Myocarditis
- Isifo se-Pericardial
- I-arrhythmias ye-cardiac
I-Lupus neCoronary Artery Disease
I-Lupus ihlotshaniswa nokwanda okukhulu kwe- atherosclerosis , noma ukuqina kobuchopho obukhiqiza i-CAD. Ngenxa yalokho, i-CAD ivame ukubonakala kubantu abane-lupus ngesikhathi esincane. Ingozi eyengeziwe yokwehlisa i-CAD ne-lupus inkulu kunabesifazane abasebasha.
Isizathu sokuthi i-lupus ikhulisa ingozi ye-CAD ibonakala iphindwe kabili. Okokuqala, abantu abane-lupus bavame ukuba nezinkinga ezingokwemvelo zendabuko: ukukhuluphala, ukuphila ngokweqile, ukucindezeleka komzimba , ukwanda kwama-cholesterol amazinga , nesifo se-metabolic syndrome . Isizathu sokuthi lezi zici eziyingozi zivame kakhulu kubantu abane-lupus kungenzeka ngenxa yesifo ngokwayo (okungenza lutho olungaphezu kwenqubo yokuphila yangasese ibe yinselelo), noma mhlawumbe ukusetshenziswa kwe-steroids ekwelapheni kwe-lupus.
Okwesibili, i-lupus yandisa ukuvuvukala okubonakala emithanjeni yegazi, nokuvuvukala emithanjeni yegazi kuyisidingo esikhulu somshayeli we-atherosclerosis, kanye nokwahlukana kwama-plaques .
Ukuvimbela i-CAD , ukuxilongwa kwe-CAD , kanye nokuphathwa kwe-CAD kubantu abane-lupus kufana nokunye okunye. Kodwa-ke, njengoba ukusabalalisa kwe-CAD, ikakhulukazi kubantu abasha, kuphakama kakhulu e-lupus, kubalulekile kulabo abane-lupus (nodokotela babo) ukuba babheke izimpawu ezibonisa ukuthi i-CAD.
Izifo ze-Lupus ne-Heart Valve
I-Lupus ihlotshaniswa nesifo senhliziyo. Ukuvuvukala okujwayelekile okuhlobene ne-lupus kungabangela imikhiqizo ehlukahlukene yokuvuvukala ukuba ifakwe ezindivinini zenhliziyo . Le mikhiqizo yokuvuvukala, evame ukufaka izingxenye zamagundane egazi, izigulwane zomzimba zomzimba kanye namaseli avuthayo, angakha "imifino," efana nokukhula kwe-wart.
Lezi zitshalo (ezivame kakhulu kwi-valve ye-mitral kunamanye amagagasi ezinhliziyo) ngokuvamile azibangeli izinkinga ezicacile zenhliziyo. Kodwa-ke, kwabanye abantu abane-lupus izimila zingaba zikhulu ngokwanele ukukhiqiza ukuphindaphinda kwe-mitral , okuholela ekuhlulekeni kwenhliziyo; bangase bathole igciwane, beholele ekupheleni kwe- endocarditis ; noma zingabangela ukubunjwa kwegazi, okuholela ekushayweni .
Uma izitshalo zikhulu ngokwanele ukuveza ukukhononda kwenhliziyo (okuyinto evamile), i- echocardiogram ingasiza ekuhloleni ubukhulu bezimila. Uma zikhulu ngokwanele, noma uma zibonisa ukukhula okukhulu esikhathini eside, i- endocarditis prophylaxis ingabekwa. Kwezinye izimo, kungenziwa ukunconywa kwegazi ukunciphisa ingozi yokushaya isisu.
I-Lupus ne-Pericardial Disease
Ukukhishwa kwe- pericardial kanye ne- pericarditis kuvamile ku-lupus.
Ama-pericardial effusions angabonakala kubantu abangamaphesenti angu-50 abantu abane-lupus ngenkathi begula.
Ngenhlanhla, ama-pericardial effusions ngokuvamile awavezi izibonakaliso, futhi ngokuvamile atholakale ngesigameko, lapho enza i-echocardiogram ngesizathu esithile. Ukwelashwa okucacile kulezi zinkinga ngokuvamile akudingekile, futhi ukukhwabanisa okungajwayelekile ngokuvamile kuvumelana ngokwabo.
Ngaphandle kokusebenza kahle kwe-pericardial, i-pericarditis (ukuvuvukala kwendwangu ye-pericardial) ingabonakala nakwabantu abane-lupus. Uma i-pericarditis ikhona, lokho kuvame ukukhombisa ukuthi i-lupus isigaba esisebenzayo, okungukuthi, futhi sikhiqiza izinkinga ezibandakanya ezinye izinhlelo zesakhiwo.
I-pericarditis ngokuvamile iyanqamuka njengoba i-lupus flare ejwayelekile ilawulwa. Uma ukwelashwa okuqondile kuyadingeka, i-pericarditis ye-lupus ngokuvamile isabela ekwelashweni ngezidakamizwa ezingekho-steroidal eziphikisayo (ama-NSAID) .
I-Lupus ne-Myocarditis
I-Myocarditis-ukuvuvukala kwemisipha yenhliziyo-kungenhlanhla, kuvamile kubantu abane-lupus. I-Lupus myocarditis ngokwayo ayikhiqizi izimpawu ngokuqondile, kodwa ekugcineni ingabangela ukuba buthakathaka nokuhlenga kwenhliziyo, futhi kuhloswe ukuhluleka nokuhleleka kwe-cardiac arrhythmias. Uma kunjalo, zonke izimpawu zokuhluleka kwenhliziyo zingathuthuka.
I-myocarditis e-lupus ivame ukutholwa ngemuva kokuba inhliziyo ekhulisiwe ibonakala e-x-ray yesifuba noma i-echocardiogram, kodwa futhi kungenzeka ukuthi kungenzeka ukuthi uma i- tachycardia engacacisiwe (izinga lokushaya kwenhliziyo eliphuthumayo) liphunywe.
Ngokufanayo ne-pericarditis, i-myocarditis ivame ukubonakala lapho i-lupus isesimweni esisebenza ngokujwayelekile, ngokuvamile ehilela izinhlelo eziningana zomzimba. Ukuthuthukiswa komsebenzi wenhliziyo kubonwe kwezinye iziguli ezine-lupus myocarditis uma ziphathwa ngokuhlukumeza nge-lupus esebenzayo , zisebenzisa i-steroids kanye nezidakamizwa ze-immunosuppressant.
I-Lupus ne-Arrhythmias
Ngemuva kwesiqephu se-lupus myocarditis, izinhlobo ezahlukene ze- block block zingenzeka. Ngokuvamile lezi ziqephu ze-block block zithinta kakhulu futhi zizinzimele, futhi azidingi ukusetshenziswa kwe- pacemaker .
Ngaphezu kwalokho, i-tachycardia engapheli ngesikhathi sokuphumula ingabonakala kubantu abane-lupus. Le tachycardia ingase ivelise izilonda, futhi ivame ukubonakala kubantu abaphethwe i-lupus njengamanje esigabeni esisebenzayo.
Isifingqo
Kubantu abane-lupus, kunethuba elingu-50-50 ukuthi uhlobo oluthile lokubandakanya inhliziyo luzogcina lube khona. Bona kanye nodokotela bazo kufanele baqaphele izimpawu ezingase zibonise izinkinga zenhliziyo, ikakhulukazi isifuba esifubeni nokuphefumula, futhi kufanele sisheshe ukuphishekela ukuthi kungenzeka yini isifo senhliziyo uma izimpawu zivela.
> Imithombo:
> Doria A, Iacacino L, uSarzi-Puttini P, et al. Ukubandakanyeka kwe-Cardiac kwi-Systemic Lupus Erythematosus. Lupus 2005; 14: 683.
> Hak AE, Karlson EW, Feskanich D, et al. I-Systemic Lupus Erythematosus kanye Nengozi Yezifo Zenhliziyo: imiphumela Evela ku-Nurses 'Health Study. I-Arthritis Rheum 2009; 61: 1396.
> Magder LS, Petri M. Ukukhubazeka Kwezingozi Nezikhongozo Zezimo Ezimbi Zezinhliziyo Phakathi kweziguli ezine-Systemic Lupus Erythematosus. Am J Epidemiol 2012; 176: 708.
> Schattner A, Liang MH. Umthwalo Wezinhliziyo Ze-Lupus: Inselele Enzima. I-Arch Intern Med 2003; 163: 1507.