Sibutsetelo
Ukunciphisa umzimba ngokweqile kuyinto engavamile kakhulu kulezi zigaba ezintathu ezijwayelekile ze-cardiomyopathy, noma izifo zesisu senhliziyo. Ezinye izigaba ezimbili zithwala inhliziyo , futhi i- hypertrophic cardiomyopathy .
Ukunciphisa umzimba ngokweqile kubalulekile ngoba kuvame ukuveza ukwehluleka kwenhliziyo , futhi kuye ngokuthi imbangela eyinhloko, ukwehluleka kwenhliziyo kungaba nzima ukuphatha kahle.
Ngenxa yokuthi ukwelashwa kwalesi sifo kungaba yinkimbinkimbi, noma ubani onomzimba wokuvimbela umzimba kufanele abe ngaphansi kwengane ye-cardiologist.
Incazelo
Nge-cardiomyopathy yokuvimbela, ngesinye sezizathu isisindo senhliziyo siqala "ukuqina" okungavamile. Ngenkathi isisindo senhliziyo esicindezelekile sisakwazi ukuvumelanisa ngokujwayelekile, ngakho-ke sikwazi ukupompa igazi, asikwazi ukuphumula ngokugcwele ngesikhathi sesigaba se-diastolic senhliziyo. (I-Diastole yiyona "isigaba sokugcwalisa" somjikelezo wenhliziyo-isikhathi esiphakathi kwezinyosi zenhliziyo, lapho ama -ventricles egcwalisa ngegazi.) Ukuhluleka ukuphumula kwenza kube nzima kakhulu ukuthi ama-ventricles agcwalise ngokwanele ngegazi ngesikhathi se-diastole.
Ukugcwaliselwa kwenhliziyo (okunikeza lesi simo igama layo) kubangela igazi ukuba "livuselele" njengoba lizama ukufaka ama-ventricles, angenza ukuhlanganiswa emaphashini nakwamanye amalungu.
Enye igama lokugcwala kwenhliziyo ngesikhathi sokudla i-diastole "ukungasebenzi kahle kwe-diastolic," futhi uhlobo lokuhluleka kwenhliziyo olukhiqizayo lubizwa ngokuthi i-diastolic inhliziyo yokuhluleka.
Ngokuyinhloko, ukuvimbela umzimba ngokweqile kungenye yezimbangela eziningi zokuhluleka kwenhliziyo ye-diastolic, nakuba kungavamile.
Izimbangela
Kunezimo eziningana ezingase zenze ukukhubazeka komzimba. Kwezinye izimo, asikho imbangela ecacile engabonakala, lapho kwenzeka khona ukuthi ukukhubazeka komzimba kuthiwa "yi-idiopathic." Kodwa-ke, ukukhathazeka kwe-cardiovascular contraceptive idiopathic kufanele kutholakale kuphela uma zonke ezinye izimbangela ezikhona zingabhekwa, futhi zikhishwe ngaphandle.
Lezi ezinye izimbangela zihlanganisa:
- Izifo ezithathelwanayo ezifana ne- amyloidosis , i- sarcoidosis , i- Hurler syndrome , isifo se-Gaucher kanye nokungena kwamanoni.
- Izifo eziningana zomndeni eziphathelene nemvelo, kuhlanganise ne-pseuoxanthoma elasticum.
- Izifo zesitoreji kuhlanganise nesifo se-Fabry , isifo sokugcina i-glycogen, ne- hemochromatosis .
- Ezinye izimo ezihlukahlukene ezihlanganisa i- scleroderma , i- hypereosinophilic syndrome , i-endomyocardial fibrosis, i- carcinoid syndrome , umdlavuza we-metastatic, i-radiation therapy noma i-chemotherapy.
Yiziphi zonke lezi zifo ezivame ukubhekana nazo ukuthi zikhiqiza inqubo ethile ephazamisa ukusebenza okujwayelekile kwemisipha yenhliziyo, njengokungena kweselula okungavamile, noma ukufaka imali engavamile. Lezi zinqubo zivame ukungaphazanyiswa kakhulu ngokuchotshozwa kwenhliziyo, kodwa zinciphisa ukuqina kwesisu senhliziyo futhi ngaleyo ndlela zivimbela ukugcwaliswa kwe-ventricles ngegazi.
Izimpawu
Izimpawu abantu ababhekana nazo nge-cardiomyopathy ezivimbelayo zifana nezimpawu ezenzeka nezinye izinhlobo zokuhluleka kwenhliziyo . Izimpawu zibangelwa ukuhlanganiswa kwamapayipi, ukuxubana kwamanye amalungu, nokuhluleka ukwandisa ngokwanele inani legazi amaphampu enhliziyo ngesikhathi sokusebenza.
Ngenxa yalokho, izibonakaliso ezivelele kakhulu nge-cardiomyopathy ezithintekayo ziyi- dyspnea (ukuphefumula okuncane), i-edema (ukuvuvukala kwezinyawo nezinyawo), ubuthakathaka, ukukhathala, ukubekezelelana okuncishisiwe kakhulu kokuzivocavoca, kanye nokuphazamiseka . Nge-cardiomyopathy eqinile, ukuhlanganiswa kwezitho zangasese kungase kwenzeke, ukhiqiza isibindi esikhulu nesipere, nama- ascites (ukuqoqwa kwamanzi emgodini wesisu.)
Ukuxilongwa
Njengezinhlobo eziningi zokuhluleka kwenhliziyo, ukuxilongwa kwe-cardiomyopathy okuvimbelayo kuxhomeke kuqala kudokotela ukuba aqaphele ukuthi kungenzeka ukuthi le nkinga ingaba khona uma wenza umlando wezokwelapha nokuhlolwa ngokomzimba.
Abantu abane-cardiomyopathy ebaluleke kakhulu bangase babe ne- tachycardia ethandanayo (isilinganiso senhliziyo esiphuthumayo) ekuphumuleni, nokuboshwa kwemithanjeni entanyeni. Lokhu okutholakala ngokomzimba, kanye nezimpawu, kuvame ukufana nalabo abonwayo nge- pericarditis enamandla. Eqinisweni, ukuhlukanisa ukucindezeleka kwe-cardiomyopathy kusuka ku-pericarditis eyinkimbinkimbi kuyinkinga yeklasi ukuthi izazi ze-cardiologists zibhekene nezimo ezivivinyweni zokuqinisekisa izitifiketi zabo. (Esivivinyweni, impendulo ihlobene nenhliziyo esoteric imisindo evezwa yizimo ezimbili - i-"s3 gallop" ne-cardiomyopathy yokuvimbela ngokumelene "nokushaya komuntu ngokuqondile" nge-pericarditis enamandla.)
Ukuxilongwa kwe-cardiomyopathy okuvimbelayo kuvame ukuqinisekiswa ngokwenza i- echocardiography , ebonisa ukukhubazeka kwe-diastolic nobufakazi bokugcwaliswa kwemigomo ye-ventricles. Uma imbangela eyinkimbinkimbi isifo esibangela ukungenwa kwesifo esinjengama-amyloidosis, ukuhlolwa kwe-echo kungabonisa nobufakazi bokufaka imali engavamile emisipha ye-ventricular. Ukuskena kwe- MRI ye-cardiac kungasiza futhi ukwenza ukuxilongwa, futhi kwezinye izimo, kungasiza ekuboneni imbangela eyimbangela. Inhliziyo ye-muscle biopsy nayo ingasiza kakhulu ekwenzeni ukuxilongwa uma isifo sokungena ngaphakathi noma sesitoreji sikhona.
Ukwelapha
Uma imbangela eyimbangela yokucindezeleka kwe-cardiomyopathy ikhonjisiwe, ukwelapha ngokucindezela lesi sizathu esiyinhloko kungasiza ukuguqula noma ukumisa ukuqhubekela phambili kokunciphisa umzimba. Ngeshwa, akekho ukwelashwa okuqondile okwenqabela ngokuqondile ukucindezeleka kwe-cardiomyopathy ngokwayo.
Ukulawula ukukhubazeka komzimba kuqondiswa ekulawuleni ukunyanyiswa kwamaphaphu kanye ne-edema ukuze unciphise izimpawu. Lokhu kufezwa ngokusebenzisa izidakamizwa eziningi ezifanayo ezisetshenziselwa ukwehluleka kwenhliziyo ngenxa ye-cardiomyopathy ehlanjululwe .
Ama-Diuretics , afana ne-Lasix (furosemide), avame ukunikeza inzuzo ecacile kakhulu ekuphatheni abantu abanezinkinga zokuhlukumezeka komzimba. Kodwa-ke, kungenzeka ukuthi abantu abanalo nalesi simo "bome kakhulu" nge-diuretics, okunye kunciphise ukugcwaliswa kwama-ventricles ngesikhathi se-diastole. Ukuqapha ngokucophelela isimo sabo kuyadingeka, kulinganisa isisindo okungenani nsuku zonke futhi ukuhlola ngezikhathi ukuhlolwa kwegazi ukufuna ubufakazi bokungcola kwamanzi okungapheli. I-dose efanele ye-diuretics ingashintsha ngokuhamba kwesikhathi, ngakho-ke lokhu kuqapha kuyimfuneko engapheliyo.
Ukusetshenziswa kwama- blockers we- calcium kungaba usizo ngokuthuthukisa ngokuqondile umsebenzi we-diastolic wenhliziyo, nangokunciphisa izinga lokushaya kwenhliziyo ukuvumela isikhathi esengeziwe sokugcwalisa ama-ventricles phakathi kwezinsimbi zezinhliziyo. Ngezizathu ezifanayo, i- beta-blockers ingaba usizo.
Kunobunye ubufakazi bokuthi i- ACE inhibitors ingase ibe nenzuzo okungenani abanye abantu abanezinkinga zokucindezeleka, mhlawumbe ngokunciphisa ukuqina komfutho wenhliziyo.
Uma i-fibrillation ye-atrial ikhona, kubalulekile ukulawula isilinganiso senhliziyo ukuvumela isikhathi esanele ukugcwalisa ama-ventricles. Ukusetshenziswa kwe-block calcium channel blockers kanye ne-beta blockers kungavame ukufeza lo mgomo.
Uma ukwelashwa kwezokwelapha kwehluleka ukulawula izimpawu zokuvimbela umzimba, ukuguqulwa komzimba kungase kube yinketho okufanele icatshangelwe.
Ukuchazwa kwesifo sokukhubazeka komzimba kunzima kakhulu kubantu, kubantu abaneminyaka engaphezu kwengu-70 ubudala, nakubantu abanesifo sengqondo esibangelwa yisimo esinokukhubazeka okubi, okufana ne-amyloidosis.
Isifingqo
Ukunciphisa umzimba ngokweqile kuyindlela engavamile yokuhluleka kwenhliziyo. Noma ubani onalesi simo udinga umsebenzi ophelele wezokwelapha-ukuze afune izimbangela eziyinhloko, futhi udinga ukuphathwa ngokucophelela nokuqhubekayo kwezokwelapha ukuze kuncishiswe izimpawu futhi kwenziwe ngcono imiphumela yesikhathi eside.
> Imithombo:
> Elliott P, Andersson B, Arbustini E, et al. Ukuhlukaniswa kwe-Cardiomyopathies: Isitatimende Esikhundleni se-European Society Of Cardiology Ukusebenza Iqembu Ezimayini Zama-Myocardial and Pericardial. I-Eur Heart J 2008; 29: 270.
> Karamitsos TD, Francis JM, Myerson S, et al. Indima Yomfanekiso We-Cardiovascular Resonance Imaging in Ukuhluleka Kwezinhliziyo. J Am Coll Cardiol 2009; 54: 1407.
> Kushwaha SS, Fallon JT, Fuster V. Yokunciphisa Cardiomyopathy. N Engl J Med 1997; 336: 267.