Izimpawu zokuhluleka kwenhliziyo (ukuphefumula, ukuvuvukala) kungalingisa ezinye zezindaba zezempilo. Kubalulekile ukuletha ukunakekelwa okunjalo kudokotela wakho, kodwa uzosebenzisa okungaphezulu kwalokho ukuqinisekisa ukuthi ukwehluleka kwenhliziyo kuyimbangela. Indlela yokwelashwa yendabuko yokuhluleka kwenhliziyo isekelwe ekuhlolweni kokusebenza kwenhliziyo, okuyi- electrocardiogram (EKG) kanye ne- echocardiogram (echo) ngokuyinhloko.
Isilinganiso se-Brain natriuretic peptide (BNP) sitholile ukunakwa ngoba singenziwa ngokusebenzisa ukuhlolwa kwegazi, okulula ukwenza. I-BNP iyasiza, kodwa hhayi njengokwethenjelwa njenge-echo ne-EKG ekutholeni ukuhluleka kwenhliziyo.
I-Self-Checks
Ukuqaphela izimpawu nezimpawu zokuhluleka kwenhliziyo kungakusiza uhlolwe futhi uthole ukunakekelwa kwezokwelapha okudingayo ekuqaleni kokugula ngaphambi kokuba isimo sakho sibucayi. Lezi zingase zihlakaniphile ekuqaleni futhi zingathuthuka kancane, ngakho-ke kulula ukuzibamba noma ukuzichofoza kuze kube yilapho seziguga. Ukwazi lokhu, qiniseka ukuthi uletha ukunakwa kwalokhu kudokotela ngalokhu:
- Ukuphefumula: Lokhu kungenzeka ngokuzama ukulinganisela, ukuhamba, ukulala phansi, ukuguqa, noma ukulala. Ungase uphefumule ngokuphindaphindiwe, ngisho nalapho ungabonisi umzimba.
- Ukukhathala: Ungase ukhathele kalula, ngisho noma ungenzi lutho olufanele lube lukhuni.
- I-Edema : Ungase uzwe ukuvuvukala noma ukubukeka kwezinyawo noma izandla zakho; ngokuvamile, akuyona ebuhlungu noma engakhululekile. Uma ufaka ukucindezela endaweni futhi kuba yinto engavumelekile, isele imizuzwana embalwa noma imizuzu (ebizwa ngokuthi i-pitting), ingase ingabangela umphumela wokuhluleka kwenhliziyo, kunokuba uzuze isisindo noma ukugcinwa kwamanzi okungahambisani.
Ama-Labs nezivivinyo
Uma unezibonakaliso nezimpawu zokuhluleka kwenhliziyo, kanti udokotela wakho usolwa ngesimo, angase ahlole ezinye izivivinyo ukuqinisekisa ukuxilongwa.
I-Heart and lung auscultation: Udokotela wakho uzolalela inhliziyo yakho namaphaphu usebenzisa i-stethoscope kunoma yikuphi ukuvakashelwa kwezokwelapha njalo. Ngokujwayelekile, kufanele ube nephethini yemisindo emibili yenhliziyo nazo zonke izinhliziyo. Ukuhluleka kwenhliziyo ngokuvamile kubangela umsindo wenhliziyo yesithathu. Amapayipi akho angase azwakale egcwele ukuhlolwa kwephunga uma unesifo senhliziyo.
I-EKG: Isivivinyo esivame kakhulu ukusetshenziselwa ukuhlola umsebenzi wenhliziyo, i-EKG ukuhlolwa okungenasidingo okubandakanya ukubeka ama-electrode ebusweni besifuba ukukala umsebenzi kagesi wenhliziyo. Uma unezibonakaliso zesifo senhliziyo, udokotela wakho kungenzeka ukuthi akwazi ukuthenga i-EKG kuwe. Ukumelela okubonakalayo (noma ukulandelela) kwalowo msebenzi kukhishwa ephepheni noma kwikhompyutha. Amaphethini angavamile ku-EKG, kufaka phakathi ukutholakala kwamagagasi e-Q, isikhala segatsha esishiywe esitokisini, ukucindezeleka kwe-ST, ukucindezeleka kwe-ventricular hypertrophy, kanye nama- arrhythmias kubonakala ekuhlulekeni kwenhliziyo. Noma kunjalo, ngenkathi ukwehluleka kwenhliziyo cishe kuhlotshaniswa nenye noma ngaphezulu kwala maphethri, la maphethini awaqondile ngokuhluleka kwenhliziyo futhi akhona kwezinye izimo zenhliziyo.
Ukuhlolwa kwe-B ye-B ye-B-peptide (BNP): Lokhu kuhlolwa kwegazi okuvame kakhulu okusetshenziselwa ukwehluleka kwenhliziyo. I-BNP, i-hormone yamaprotheni, ikhishwa ekujikelezeni kwegazi ngamaseli ezinhliziyo zomzimba noma nini lapho ingcindezi yangaphakathi yomzimba iphakama kakhulu. I-BNP ibangela ukuthi izinso zikhishwe usawoti namanzi futhi kuncishiswe ukucindezelwa kwegazi ukubuyisela izinto ezijwayelekile.
Kubantu abanempilo, amazinga e-BNP ngokuvamile angaphansi kuka-100 pg / ml, futhi amazinga angaphezu kuka-400 pg / ml ahlobene nokuhluleka kwenhliziyo. Amazinga e-BNP phakathi kuka-100 pg / ml no-400 pg / ml kunzima ukuwahumusha, yingakho lokhu kuvivinywa kungabhekwa njengokuhlola ukuhluleka kwenhliziyo, ukusekela nje.
Ngenxa yokuthi ayinokwethenjelwa kakhulu, udokotela wakho angeke abheke ukuthi kuyasiza ekuhloleni isimo sakho.
Ukucabanga
Ukucubungula ukuhlolwa kungaba usizo ekubukeni izinguquko zesimanje nokusebenza enhliziyweni, kanye nezinguquko ezithile emaphashini, okungahlukanisa ukuhluleka kwenhliziyo kwezinye izinkinga zenhliziyo kanye negazi. Izinketho eziningi zingacatshangwa.
I-X-ray: I-X-ray yesifuba yisimo sokuhlola esisheshayo ngokushesha esivame ukusiza kakhulu ekuhloleni isifo senhliziyo. I-X-ray yakho esifubeni ingabonisa ukuthi inhliziyo yakho ibonakala ikhulisiwe noma ingabonisa izimpawu zokungqubuzana emaphashini akho uma unesifo senhliziyo. Uma udokotela wakho ekhathazekile ngezinkinga zamaphaphu noma zenhliziyo, kungenzeka ukuthi uzoba ne-X-ray esifubeni.
I-Echocardiogram: I-echocardiogram, evame ukubizwa ngokuthi i-echo, iyivivinyo elingavumelekile lokuhlolwa kwe-ultrasound elibonisa inhliziyo ngenkathi lisasebenza. I-probe encane ifakwa esifubeni sakho, lapho ochwepheshe eyohamba khona ukuze athathe isenzo senhliziyo yakho amagagasi namagumbi njengenhliziyo yakho imijikelezo yemvelo. I-echo yakho ingahlinzeka ngolwazi oluningi mayelana nenhliziyo yakho. Esimweni sokuhluleka kwenhliziyo ngokuqondile, ukuqina kwenhliziyo yakho, ukugcwaliswa nokukhipha ikamelo ngalinye, futhi isigqi senhliziyo kulindeleke ukuba singavamile. Udokotela wakho angalalela i-echocardiogram uma unesimo senhliziyo esingavamile noma ukungajwayelekile kwenhliziyo.
Ukucabangela kwe-nyukliya: Lezi zivivinyo zokucabanga, kufaka phakathi ukuhlolwa kwe-positron (PET) kanye ne-single photon emission computer (SPECT), okubandakanya umjovo wama-radioactive amashintshi ashintsha umbala ekuphenduleni izinguquko ekusetshenzisweni kwe-metabolism, ukunyakaza, nokusebenza kwenhliziyo yakho. Lezi zinguquko zombala zingasiza udokotela wakho ukuthi ahlole ukuthi imisipha ethile yenhliziyo yakho ayikwazi ukupompa njengoba ejwayelekile. I-PET ne-SPECT zombili zisetshenziselwa ukusiza ekutholeni izimo zenhliziyo, kuhlanganise ne-CAD nokuhluleka kwenhliziyo.
Isivivinyo sokucindezeleka : Isivivinyo sokucindezeleka sisebenzisa ukuzivocavoca okulawulwa ukuvula izinkinga zenhliziyo ezingase zikhishwe ngokuzikhandla. Kuwusizo ngokukhethekile ekuhloleni i-angina (ubuhlungu besifuba) obubangelwa yi-coronary artery disease. Udokotela wakho angase acabangele ukuhlolwa kokucindezeleka uma unezibonakaliso ezimbi kakhulu ngokuzikhandla. Ngokuvamile, abantu abanokuhluleka kwenhliziyo ephakeme abakwazi ukubekezelela ukuhlolwa kokucindezeleka, kodwa kungase kubonakale nokuhluleka kwenhliziyo ekuqaleni.
Ukuhlonza okuhlukile
Uma unezimpawu zokuhluleka kwenhliziyo, ithimba lakho lezokwelapha lingase libheke ezinye izimo ezibangelwa ukuphefumula noma ukuvuvukala kwemiphetho. Esikhathini esiningi, kunezivivinyo zokuxilonga ezingahlukanisa phakathi kwalezi zimo nokuhluleka kwenhliziyo. Nokho, ukuxilongwa kungase kube nzima uma unesifo senhliziyo kanye nesinye isimo sezokwelapha.
Isifo se-Chronic obstructive pulmonary (COPD) : Lesi simo sibangela ukuphefumula, okubi nakakhulu ngokuzikhandla. I-COPD ibuye ibangele isondo nokukhwehlela okuvame ukuhlotshaniswa ne-mucus. Nakuba ezinye zezimpawu zifana nezokuhluleka kwenhliziyo, i-COPD ingahlukaniswa nokuhluleka kwenhliziyo ngokwezifiso ezingavamile ezivivinyweni zomsebenzi wamaphayiphu. Ngokuvamile i-COPD ibangelwa ukubhema futhi idinga ukwelashwa nge-oksijeni ngezigaba eziseduze.
I-PE (i-PE) : i-PE, i- clot yegazi kwelinye lemithambo yegazi yamapayipi, ibangela ubunzima bokuphefumula nobuhlungu besifuba. Izici zobuhlungu be-dyspnea nesifuba abantu ababhekana nazo zivame ukuhluka phakathi kwe-PE nokuhluleka kwenhliziyo futhi zinganikeza izici mayelana nesizathu sezimpawu. Kodwa-ke, ukuhlolwa kokuhlola kuyadingeka ukuze wenze ukuxilongwa okulungile.
Ukuhluleka kwezinso: Ukuhluleka kwezinso, njengokuhluleka kwenhliziyo, kungathatha isikhathi sokuthuthukisa, okubangela izimpawu eziqhubekayo ezibucayi. Uma izinso zingasebenzi ngendlela efanele, ukukhathala kanye ne-edema yemilenze nezingalo zingathuthuka, njengokwehluleka kwenhliziyo. Ngokuvamile, ukwehluleka kwezinso kubangela ushintsho emazingeni e-electrolyte egazini, elingabonakali ekuhlulekeni kwenhliziyo.
I-thrombosis ejulile ye-vein (DVT): I-DVT iyi-clot yegazi evame ukubangela i-edema futhi ekugcineni ingabangela i-PE. Umehluko omkhulu phakathi kwe-edema ye-DVT kanye nokwehluleka kwenhliziyo yilokho ku-DVT, i-edema ngokuvamile ihilela umlenze owodwa nje kuphela futhi awujwayele ukuphoqa. I-DVT ingabangela ukushisa okwebuthakathaka emlenzeni othintekayo, kungatholakala ukuthi i-ultrasound yomlenze futhi kufanele iphathwe ngegazi elimhlophe.
> Imithombo:
> Fu S, Ping P, Wang F, Luo L. Synthesis, ukufihla, umsebenzi, ukumisa umzimba kanye nokusetshenziswa kwama-peptide angenawo enhliziyweni ukuhluleka kwenhliziyo. J Biol Eng. 2018 Jan 12; 12: 2. i-doi: 10.1186 / s13036-017-0093-0. eCollection 2018.
> Hunter BR, Martindale J, Abdel-Hafez O, Pang PS. Indlela yokwehluleka kwenhliziyo eqondile eMnyangweni Wezimo Eziphuthumayo. I-Prog Cardiovasc Dis. 2017 Sep - Oct; 60 (2): 178-186. doi: 10.1016 / j.pcad.2017.08.008. I-Epub 2017 Septhemba 1.
> Lishmanov Y, Minin S, Efimova I, et al. Indima engenzeka ye-imaging yenukliya ekuhloleni ukusebenza kwe-carynac therapy ukuphumelela kweziguli ezinokuhluleka kwenhliziyo ngokulinganisela. U-Ann Nucl Med. 2013 Meyi; 27 (4): 378-85. i-doi: 10.1007 / s12149-013-0696-6. I-Epub 2013 Mar 1.
> Minami Y, Kajimoto K, Sato N. Intuthuko yesithathu ekhanda esibhedlela iziguli ezinokuhluleka kwenhliziyo: ulwazi oluvela ku-ATTEND lokufunda. I-Int J Clin Pract. 2015 Aug; 69 (8): 820-8. i-doi: 10.1111 / ijcp.12603. Epub 2014 Dec 18.