Ukuhluleka kwenhliziyo yisimo lapho inhliziyo ingakwazi ukwenza umsebenzi odingekayo ukuze uhambisane nezidingo zomzimba. Izimpawu ezivame kakhulu zihlanganisa ukuphefumula nokukhathala. Ngenkathi ikwazi ukuphathwa ngemithi futhi, kwezinye izimo, ukuhlinzwa noma ezinye izinqubo, ukwehluleka kwenhliziyo yisimo esibi esihambisana nengozi yokufa eminyakeni emihlanu kuya kweyishumi.
Ukuhluleka kwenhliziyo yisiphumo sokuphela kwesimo sezinhliziyo zenhliziyo eside, njenge-coronary artery disease kanye nesimo senhliziyo esingavamile.
Kukhona ama-syndromes amabili ajwayelekile emitholampilo ahlobene nokuhluleka kwenhliziyo:
Ukuhluleka kwenhliziyo ukukhumula : Lokhu kuvame ukukhulunywa ngabantu lapho bekhuluma ngokuhluleka kwenhliziyo. Ngalolu hlobo, imiphumela yezinhliziyo ezibuthakathaka imiphumela ekuhlanganiseni kwegazi ukugeleza emaphashini nasemzimbeni wonke. Okokuqala kubangela ukuphefumula, kuyilapho lesi siphetho sibangela ukuvuvukala kwemilenze mhlawumbe nezandla.
Ukwehluleka kwenhliziyo ephumayo: Ngesinye isikhathi, abantu abanesifo senhliziyo bangase babe nokuncintisana okuncane noma okungabikho kwamaphaphu. Kulezi zimo, inkinga enkulu ijwayele ukuba ukuthi imisipha yenhliziyo isuke ibuthakathaka kakhulu kangangokuba inhliziyo ayisakwazi ukushaya igazi elanele ezithombeni zomzimba.
Abantu abanokuhluleka kwenhliziyo ngokuyinhloko okukhipha okwehluleka kwenhliziyo kungenzeka ukuthi banomfutho wegazi ophansi, ikhanda eliphansi, ne-syncope.
Ukwehluleka kwenhliziyo okukhipha ngokujwayelekile ngokuvamile kuyisibonakaliso sokuhluleka kwenhliziyo okukhulu futhi kuhlotshaniswa nokuhlushwa okubi kakhulu.
Izimpawu
Ukuhluleka kwenhliziyo ekuqaleni kungaveza izimpawu eziningi . Uma uhlakulela ukwehluleka kwenhliziyo, ngisho nasesiteji sokuqala, kunethuba elihle lokuthi ngabe usuvele utholile noma isifo senhliziyo esingatholakali iminyaka eminingi.
Ukuhluleka kwenhliziyo kuvame ukuthinta abantu abadala kodwa kungase kwenzeke ezinganeni ngenxa yokuzalwa (kusukela ekuzalweni) isifo senhliziyo.
Izimpawu ezivame kakhulu zesifo senhliziyo zihlanganisa:
- I-Dyspnea : Ukuphefumula, ikakhulukazi ngokuzikhandla ngokomzimba
- I-Edema: Ukuvuvukala, ngokuvamile emilenzeni nasemagqumeni. I-Edema kungenzeka ibeke i-edema ekhonjiswe ngendlebe endaweni evuvukale ngemva kokucindezelwa isetshenziswa, ngokuvamile ihlala isikhathi esincane.
- Ubuthakathaka nokukhathala, ikakhulukazi ngokuzikhandla
- Ukuvuthwa njalo
- Ukukhathazeka ukulala ngenxa yokuphefumula
- Umfutho wegazi ophansi
- Lightheadedness
Kubantu abaningi abanesifo senhliziyo, i-dyspnea ne-edema yizimpawu ezivelele kakhulu. Ukuphefumula kungahle kwenzeke ngezikhundla ezithile, futhi ungase uhlangabezane nokunye noma konke lokhu:
- I-Orthopnea (ukuphefumula okukwenzekayo lapho ulele phansi)
- I-Paroxysmal nocturnal dyspnea noma i-PND, eyenzeka ngokuzumayo phakathi kokulala
- I-bendopnea , eyenzeka lapho iguqa
Izimpawu zinzima kakhulu futhi ziphikelela ekuhlulekeni kwenhliziyo ephakeme, futhi kubizwa ngokuthi i-ESRD (ukuphela kwe-heart failure). Ngaphezu kwalokho, lapho ukwehluleka kwenhliziyo kuqhubeka nokuhluleka kwenhliziyo ekugcineni, kunezilingo ezengeziwe ezilindelekile, kubandakanya:
- Ukuphefumula kokuphumula
- Ubuthakathaka nokukhathala, ngisho ngaphandle kokuzikhandla
- Inzwa inhliziyo yakho egijima ngayo
- Ukugaya nokukhwehlela
- Ukunciphisa ukudla noma ukulahlekelwa ukudla
- I-Syncope
- Ukudideka
Izimbangela
Kunezinhlobo eziningana zokwehluleka kwenhliziyo futhi zonke zibhekene nokuphambanisa okungenakwanela kwemisipha yenhliziyo, okuholela ekuqongeni okuketshezi. Ukuqoqwa kwamanzi okujwayelekile kwenza i-dyspnea ne-edema yehluleka kwenhliziyo. Lokhu kuqoqa oketshezi kubangelwa ukuxubana, okuyinto evame ukuvelela kakhulu emaphashini nasemiphakathini engezansi, okwenza kube nokuphefumula kanye nezinga elincane lezamandla.
Izimbangela ezivame kakhulu zokuhluleka kwenhliziyo zihlanganisa:
I-cardiomyopathy ehlukumezayo: I-cardiomyopathy ehlukumezayo yimbangela yokuphela kwezifo ezinhlobonhlobo zezinhliziyo, njenge-coronary artery isifo nesifo se-valvular. Kuyenzeka lapho isifo senhliziyo esiphezulu sigcina senza ukukhubazeka okukhulu kwensimu yenhliziyo ngokwayo.
I-cardiomyopathy ye-hypertrophic: I-cardiomyopathy ye-hypertrophic ngokuvamile isimo somzimba futhi ngokuvamile igijima emindenini. Kubonakala ngokuqina komzimba we-muscle, okuholela ekuqhumeni okuqinile.
Ukukhubazeka kwe-Diastolic: Ukungasebenzi kahle kwe- Diastolic kufana nokukhathazeka kwe-hypertrophic in ngoba kubangelwa ukuqina komfutho wezinhliziyo, okuholela ekutheni ugcwalise inhliziyo. Kodwa ngokungafani ne-cardiomyopathy ye-hypertrophic, ukwehluleka kwenhliziyo ye-diastolic ngokuvamile akuhambisani nokuqina kwesisu senhliziyo futhi akucatshangwa ukuthi kuyisifo se-genetic. Kuvame ukuvela kubantu abadala, kaningi kubabesifazane nabantu abane-high blood pressure. Kubonakala ngeziqephu ezincane ngokungazelelwe zokuphefumula okukhulu ngenxa yokuphefumula kwamaphaphu.
Kunezinkinga eziningi zezokwelapha ezingase ziholele noma zenze isandla ekuhlulekeni kwenhliziyo, kuhlanganise nokuhlaselwa kwenhliziyo, ukucindezeleka kwegazi, isifo senhliziyo, ukubhema, ukukhuluphala, isifo sikashukela, i-chemotherapy, nokucindezeleka.
Ukuxilongwa
Uma unezimpawu zokuhluleka kwenhliziyo, udokotela wakho uzosebenzisa izindlela eziningana ukuze anqume ukuthi ukuhluleka kwenhliziyo kuyimbangela yezibonakaliso zakho. Ukuhlolwa kwesifo senhliziyo kuhlanganisa:
Ukuhlolwa komzimba: Ngokuvamile udokotela wakho angazwa ukuxhuma ngokulalela amaphaphu akho futhi abone izimpawu zokuhluleka kwenhliziyo noma ukulinganisela kwenhliziyo ngokulalela inhliziyo yakho.
I-X-ray yesifuba: I-X-ray yesifuba ingabonisa ukuthi unenhliziyo ekhulisiwe noma izibonakaliso zokuxubana kwamaphaphu.
I-Echocardiogram: Ukuvuthwa nokubuthakathaka kwe-ventricle kwesokunxele kuvame ukulinganiswa ngokulinganisa ingxenyana ye- ventricular ejection engxenyeni yesokunxele. Ingxenyana ye-ejection ilinganisa iphesenti yegazi eliphethwe yi-ventricle engakwesokunxele ekhishwa ngenhliziyo ngayinye. Ngokujwayelekile, ingxenyana ye-ejection ingamaphesenti angu-50 noma ngaphezulu. Nge-cardiomyopathy ehlanjululwe, lelo xabiso liyancipha.
Ukuhlolwa kwegazi: Ukuhlolwa kwegazi akuvamile ukubhekwa njengezinga elijwayelekile ekutholeni ukuhluleka kwenhliziyo. I-B-type ye-peptide ye-natriuretic (BNP), ukuhlolwa kwegazi okungasiza odokotela banqume ukuthi ukuhluleka kwenhliziyo kwenzeke yini, kungacatshangwa kwezinye izimo.
Ukwelapha
Ngenhlanhla, kwenziwa inqubekela phambili enkulu ekwelapheni kwenhliziyo . Ngokwelashwa okunamandla, kokubili izimpawu kanye nobungozi bokufa kunganciphisa kakhulu. Imithi, kanye nezinye izinqubo, zingathuthukisa izimpawu futhi zandise ukusinda kwabantu abanesifo senhliziyo.
Imithi ejwayelekile kakhulu esetshenziswa ekwelapheni ukuhluleka kwenhliziyo ihlanganisa:
- I-ACE (i-angiotensin-converting enzyme) inhibitors: i-ACE inhibitors ivimbela ukwakheka kwe-angiotensin II. Le mithi iyanciphisa ukucindezeleka kwegazi futhi inciphisa ukugcinwa kwe-sodium kubantu abanesifo senhliziyo.
- Abavimbeli be-Beta: Izivimbela ze-Beta zivimbela umphumela we-adrenaline enhliziyweni ukunciphisa ukucindezeleka ngokweqile enhliziyweni ehlulekayo. Lezi mithi zivame ukusetshenziselwa ukuhlukumeza umzimba.
- I-Diuretics: Ngokuvamile ibizwa ngokuthi "amaphilisi amanzi," le mithi yenza umzimba ulahlekelwe amanzi ngokusebenza ezinso. Lo mphumela wehlisa ukugcinwa kwamanzi kanye ne-edema.
Izinqubo zingase zisetshenziselwe ukwehluleka kwenhliziyo, kodwa akusiwo wonke umuntu onokuhluleka kwenhliziyo kulindeleke ukuthi azuze. Ngaphezu kwalokho, abanye abantu abanesifo senhliziyo bangase bangabi nempilo enhle ukuze bakwazi ukubekezelela lezi zinqubo.
Kuye ngenhliziyo yakho, ungase uxoxe ngalezi zinqubo nodokotela wakho.
- I-Pacemaker: I-pacemaker iyisidingo eshukumisa inhliziyo ukupompa. Ngokwejwayelekile, izivunguvungu zitholwa ukugqugquzela uhlangothi olulodwa lwenhliziyo. Lapho ukwelashwa kwehluleka kwenhliziyo, noma kunjalo, i-pacemaker igqugquzela uhlangothi olungakwesokudla nolwesobunxele lwenhliziyo. Lokhu kuvame ukubizwa ngokuthi yi-CRT (ukuguqulwa kokuvuselelwa komzimba).
- Ukufakelwa kwenhliziyo: Ukufakelwa kwenhliziyo ukuguqulwa kwenhliziyo yakho ngenhliziyo engasebenza kahle. Lokhu akuyona inqubo elula yezizathu eziningana. Uma unesifo senhliziyo, impilo yakho ingenza kube nzima kuwe ukubekezelela amandla omzimba wenqubo. Futhi, kunikezwe ukuthi uzodinga inhliziyo yomnikeli evela kumnikezi onempilo, azikho ubuningi bezitho ezitholakalayo zokufakelwa kabusha.
Ukubhekana
Ukwehluleka kwenhliziyo kubangela ukulinganiselwa emisebenzini yakho, kanye nokukhathala. Ukubhekana nokuhluleka kwenhliziyo kudinga ukulungiswa kwengqondo, kanye nokucabangela okungokoqobo.
Ukulungiswa kwempilo kuhlanganisa ukuqiniseka ukuthi awuhlanganyeli emisebenzini engalimaza isimo sakho, kanye nokuthatha imisebenzi engenza ngcono impilo yakho.
Amanye amasu abalulekile afaka:
Imikhuba: Ukubhema nokusetshenziswa kotshwala kokubili kuhlotshaniswa nesifo senhliziyo futhi kungasusa isimo uma usuvele unayo, ngakho kuyazuzisa ukuyeka le misebenzi uma unesifo senhliziyo.
Ukuphathwa kokudla / usawoti: Ukugcina ukudla okunempilo kubalulekile ekulawuleni ukuhluleka kwenhliziyo. Kubalulekile ukuthola amakholori ananele nezakhi ukuze ugcine amandla akho. Ungase futhi udinga ukuhlangana nomhlengikazi ukuthola iseluleko mayelana nezindaba ezithile ezifana nokulondeka kwesisindo, ukuvinjelwa usawoti, nokuvinjelwa kwamanzi. Ukudla okuncane okusawoti kungasiza ekunciphiseni okunye okwenziwe ngamanzi kagesi okwenzeka ngesifo senhliziyo.
Ukuphathwa kwesisindo: Inhliziyo ebuthakathaka eyenza isifo senhliziyo ayikwazi ukubekezelela kalula izidingo ezibekiwe yi-strain yesisindo esengeziwe. Ukugcina isisindo esihle kungasiza ekunciphiseni omunye umsebenzi owandayo onzima ngenhliziyo ehlukumezayo yokuqhubeka.
Ukuzivocavoca: Umsebenzi womzimba ungaqeqesha inhliziyo yakho ukuba iqine futhi iphumelele ngokwengeziwe. Kodwa-ke, uma unesifo senhliziyo, kufanele uxoxe ngokuzivocavoca nodokotela wakho bese ulandela iseluleko sezokwelapha kule ndawo.
Izwi elivela
Uma wena noma othandekayo wakho ehluleka inhliziyo, kufanele wazi ukuthi awodwa. Lokhu kuyinkinga ejwayelekile kakhulu yezokwelapha, kodwa kuyinkinga yezokwelapha okufanele ithathwe ngokungathí sina.
Ngaphandle kwezimpawu ezibangelwa ukungahambi kahle, njengokuphefumula nokusizivocavoca, kunzima futhi ukulungisa ukunciphisa izinga lomsebenzi obangelwa ukungabi namandla namandla nokukhathala. Ngokuphathwa kahle, ungathola ukuthuthukiswa kwezimpawu zakho.
Uma othandekayo wakho enesifo senhliziyo, kungase kudingeke ukhethe imisebenzi eguquliwe ehambelana nezinga lakho lamandla kanye nezinga lamandla nokubekezelelana komsebenzi wakho othandekayo.
> Umthombo:
> I-Ibrahim NE, Januzzi JL Jr. Ikusasa le-Biomarker-I-Therapy Yokuhluleka Kwezinhliziyo Ngemva kokusayinwa okusekelwe ebufakazini Ukusebenzisa i-Biomarker Ukwelashwa Okunamandla Ekuphelelweni Kwenhliziyo (Isikhokelo-IT) Isifundo. I-Curr Heart Fail Rep. 2018 Apr; 15 (2): 37-43. i-doi: 10.1007 / s11897-018-0381-0.