I-Atrial septal defect (ASD)

I-Atrial septal defect (ASD) ukukhubazeka kwenhliziyo okukhona lapho kuzalwa (kuzalwa).

Njengoba ingane ikhula esibelethweni, kwakheka udonga (septum) oluhlukanisa ikamelo eliphezulu libe yi-atrium yangakwesokunxele nangakwesokudla. Lapho lolu donga lungakheki kahle, lungaholela ekuthini kukhubazeke okusala ngemuva kokuzalwa. Lokhu kubizwa nge-atrial septal defect, noma i-ASD.

Imvamisa, igazi alikwazi ukugeleza phakathi kwamagumbi amabili aphezulu enhliziyo. Kodwa-ke, i-ASD ivumela lokhu ukuthi kwenzeke.

Lapho igazi ligeleza phakathi kwamagumbi amabili enhliziyo, lokhu kubizwa ngokuthi yi-shunt. Igazi livame ukugeleza lisuka kwesobunxele liye kwesokudla. Uma lokhu kwenzeka uhlangothi lwangakwesokudla lwenhliziyo luyakhula. Ngokuhamba kwesikhathi ingcindezi emaphashini ingakha. Uma lokhu kwenzeka, igazi eligeleza ngesici lizobe selisuka kwesokudla liye kwesobunxele. Uma lokhu kwenzeka, kuzoba khona umoya-mpilo omncane egazini oya emzimbeni.

Amaphutha we-septal septal achazwa njenge-primum noma i-secundum.

• Ukukhubazeka kwe-primum kuxhunyaniswe nokunye ukukhubazeka kwenhliziyo kwe-ventricular septum ne-mitral valve.
• Ukukhubazeka kweSecundum kungaba umgodi owodwa, omncane noma omkhulu. Zingahle zibe ngaphezu komgodi owodwa omncane kuseptum noma odongeni phakathi kwamakamelo womabili.

Ukukhubazeka okuncane kakhulu (ngaphansi kwamamilimitha ama-5 noma ama-) intshi) akunamathuba amancane okudala izinkinga. Ukukhubazeka okuncane kuvame ukutholwa ngemuva kwesikhathi empilweni kunokukhudlwana.

Kanye nosayizi we-ASD, lapho ukukhubazeka kutholakala kudlala indima ethinta ukuhamba kwegazi namazinga e-oxygen. Ukuba khona kokunye ukukhubazeka kwenhliziyo nakho kubalulekile.

I-ASD ayivamile kakhulu.

Umuntu ongenaso esinye isici senhliziyo, noma isici esincane (esingaphansi kwamamilimitha ayisi-5) kungenzeka angabi nazimpawu, noma izimpawu zingaze zivele kuze kube seminyakeni ephakathi nendawo noma kamuva.

Izimpawu ezenzekayo zingaqala nganoma yisiphi isikhathi ngemuva kokuzalwa kuya ebuntwaneni. Zingafaka:

• Ukuphefumula kanzima (i-dyspnea)
• Izifo zokuphefumula njalo ezinganeni
• Ukuzwa ukushaya kwenhliziyo (ukushaya kwenhliziyo) kubantu abadala
• Ukuphefumula ngomsebenzi

Umhlinzeki wezokunakekelwa kwempilo uzohlola ukuthi i-ASD inkulu futhi inkulu kangakanani kuye ngezimpawu, ukuhlolwa komzimba, kanye nemiphumela yokuhlolwa kwenhliziyo.

Umhlinzeki angazwa imisindo yenhliziyo engajwayelekile lapho elalele isifuba nge-stethoscope. Ukububula kungazwakala kuphela ezindaweni ezithile zomzimba. Kwesinye isikhathi, ukububula kungenzeka kungazwakali nhlobo. Ukububula kusho ukuthi igazi aligobhozi ngokushelela enhliziyweni.

Ukuhlolwa komzimba kungakhombisa nezimpawu zokwehluleka kwenhliziyo kwabanye abantu abadala.

I-echocardiogram isivivinyo esisebenzisa amagagasi omsindo ukwakha isithombe esihambayo senhliziyo. Ngokuvamile ukuhlolwa kokuqala okwenziwe. Ucwaningo lwe-Doppler olwenziwe njengengxenye ye-echocardiogram luvumela umhlinzeki wezokunakekelwa kwezempilo ukuthi ahlole inani lokushiswa kwegazi phakathi kwamagumbi enhliziyo.

Olunye uvivinyo olungenziwa lubandakanya:

• I-catheterization yenhliziyo
• I-Coronary angiography (yeziguli ezingaphezu kweminyaka engama-35 ubudala)
• ECG
• Inhliziyo ye-MRI noma i-CT
• I-Transceophageal echocardiography (TEE)

I-ASD ingahle ingadingi ukwelashwa uma kunezimpawu ezimbalwa noma zingenayo, noma uma iphutha lincane futhi lingahlangene nokunye okungajwayelekile. Kuyanconywa ukuhlinza ukuvala isici uma iphutha libangela ukushiywa okuningi, inhliziyo iyavuvukala, noma kuvela izimpawu.

Kwenziwe inqubo yokuvala isici (uma kungekho okunye okungajwayelekile) ngaphandle kokuhlinzwa kwenhliziyo okuvulekile.

• Le nqubo ifaka ukufaka into yokuvalwa kwe-ASD enhliziyweni ngamashubhu abizwa ngokuthi ama-catheters.
• Umhlinzeki wezokunakekelwa kwempilo usika okuncane emgodini, bese efaka ama-catheters emthanjeni wegazi aze afike enhliziyweni.
• Idivayisi yokuvala ibekwa ngaphesheya kwe-ASD bese iphutha livalekile.

Kwesinye isikhathi, kungadingeka ukuhlinzwa kwenhliziyo evulekile ukulungisa iphutha. Uhlobo lokuhlinzwa ludingeka kakhulu uma kukhona ezinye izinkinga zenhliziyo.

Abanye abantu abanokukhubazeka kwezilonda emzimbeni bangakwazi ukwenza le nqubo, kuya ngosayizi nendawo yesici.

Abantu abanenqubo noma ukuhlinzwa ukuvala i-ASD kufanele bathole ama-antibiotic ngaphambi kwanoma yiziphi izinqubo zamazinyo abanazo esikhathini esilandelayo senqubo. Ama-antibiotic awadingeki kamuva.

Ezinganeni, ama-ASD amancane (angaphansi kuka-5 mm) ngeke adale izinkinga, noma azovala ngaphandle kokwelashwa. Ama-ASD amakhulu (8 kuye ku-10 mm), kaningi awavali futhi angadinga inqubo.

Izici ezibalulekile zifaka usayizi wesici, inani legazi elengeziwe eligeleza ekuvulekeni, ubukhulu bohlangothi lwangakwesokudla senhliziyo, nokuthi ngabe umuntu unazo yini izimpawu.

Abanye abantu abane-ASD bangaba nezinye izimo zenhliziyo ezizalwe nazo. Lokhu kungafaka i-valve evuzayo noma imbobo kwenye indawo yenhliziyo.

Abantu abane-ASD enkulu noma eyinkimbinkimbi basengozini enkulu yokuthola ezinye izinkinga, kubandakanya:

• Isigqi senhliziyo esingajwayelekile, ikakhulukazi i-fibrillation ye-atrial
• Ukwehluleka kwenhliziyo
• Ukutheleleka kwenhliziyo (endocarditis)
• Umfutho wegazi ophezulu emithanjeni yamaphaphu
• Unhlangothi

Shayela umhlinzeki wakho uma unezimpawu zesici se-atrial septal.

Ayikho indlela eyaziwayo yokuvimbela isici. Ezinye zezinkinga zingavinjelwa ngokusheshe uthole.

Ukukhubazeka kwenhliziyo okuzalwa - ASD; Inhliziyo yokukhubazeka kokuzalwa - ASD; IPrimum ASD; I-Secundum ASD

• Ukuhlinzwa kwenhliziyo yezingane - ukukhishwa

• Isici se-atrial septal

ULiegeois JR, uRigby ML. Isici se-Atrial septal (ukuxhumana kwangaphakathi). Ku: Gatzoulis MA, Webb GD, Daubeney PEF, ama-eds. Ukuxilongwa nokuPhathwa kwezifo zenhliziyo yabantu abadala. 3rd ed. IPhiladelphia, PA: Elsevier; 2018: isahluko 29.

USilvestry FE, uCohen MS, u-Armsby LB, et al. Imihlahlandlela yokuhlolwa kwe-echocardiographic kwephutha le-atrial septal kanye ne-patent foramen ovale: kusuka ku-American Society of Echocardiography kanye ne-Society for Cardiac Angiography and Interventions. UJ Am Soc Echocardiogr. 2015; 28 (8): 910-958. I-PMID: 26239900 pubmed.ncbi.nlm.nih.gov/26239900/.

Sodhi N, Zajarias A, Balzer DT, Lasala JM. Ukuvalwa okwenziwe ngamandla kwepatent formen ovale kanye ne-atrial septal defect. Ku: Topol EJ, Teirstein PS, eds. Incwadi Yemibhalo Yezinhliziyo Eziphakathi. Umhlaka 8. IPhiladelphia, PA: Elsevier; 2020: isahluko 49.

I-Webb GD, iSmallhorn JF, uTherrien J, uRedington AN. Isifo senhliziyo esizalwa naso esigulini esidala nesingane. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 75.