Ukwehluleka kwenhliziyo

Ukwehluleka kwenhliziyo yisimo lapho inhliziyo ingasakwazi ukupompa igazi elicebile oksijini kuwo wonke umzimba kahle. Lokhu kudala ukuthi izimpawu zivele emzimbeni wonke.

Ukwehluleka kwenhliziyo kuvame ukuba yisimo sesikhathi eside (esingapheli), kepha kungahle kuvele ngokuzumayo. Kungadalwa yizinkinga eziningi zenhliziyo.

Isimo singathinta kuphela uhlangothi olungakwesokudla noma uhlangothi lwesobunxele kuphela lwenhliziyo. Zombili izinhlangothi zenhliziyo nazo zingabandakanyeka.

Ukwehluleka kwenhliziyo kukhona lapho:

• Imisipha yenhliziyo yakho ayikwazi ukuvumelana kahle kakhulu. Lokhu kubizwa ngokuthi ukwehluleka kwenhliziyo ye-systolic, noma ukwehluleka kwenhliziyo ngengxenyenamba yokukhipha encishisiwe (HFrEF).
• Imisipha yenhliziyo yakho iqine futhi ayigcwali igazi kalula yize amandla okumpompa ejwayelekile. Lokhu kubizwa ngokuthi ukwehluleka kwenhliziyo ye-diastolic, noma ukwehluleka kwenhliziyo ngengxenyenamba yokukhipha egcinwe (HFpEF).

Njengoba ukupompa kwenhliziyo kungasebenzi kahle, igazi lingase libuyele emuva kwezinye izindawo zomzimba. Uketshezi lungakheka emaphashini, isibindi, umgudu wamathumbu, izingalo nemilenze. Lokhu kubizwa ngokwehluleka kwenhliziyo okucinana.

Izimbangela ezivame kakhulu zokwehluleka kwenhliziyo yilezi:

• I-Coronary artery disease (CAD), ukuncipha noma ukuvimba kwemithambo yegazi emincane ehambisa igazi ne-oxygen enhliziyweni. Lokhu kunganciphisa imisipha yenhliziyo ngokuhamba kwesikhathi noma ngokuzumayo.
• Umfutho wegazi ophezulu ongalawulwa kahle, okuholela ezinkingeni zokuqina, noma ekugcineni kuholele ekunciphiseni kwemisipha.

Ezinye izinkinga zenhliziyo ezingadala ukwehluleka kwenhliziyo yilezi:

• Isifo senhliziyo esizalwa naso
• Ukuhlaselwa yinhliziyo (lapho isifo semithambo yegazi siholela ekuvaleni okungazelelwe komthambo wenhliziyo)
• Ama-valve enhliziyo avuza noma ancishisiwe
• Ukutheleleka okwenza buthakathaka imisipha yenhliziyo
• Ezinye izinhlobo zesigqi senhliziyo esingajwayelekile (arrhythmias)

Ezinye izifo ezingadala noma zifake isandla ekuhlulekeni kwenhliziyo:

• I-Amyloidosis
• I-Emphysema
• Indlala yegilo eyeqile
• I-Sarcoidosis
• I-anemia enamandla
• Insimbi eningi emzimbeni
• I-thyroid engasebenzi

Izimpawu zokwehluleka kwenhliziyo zivame ukuqala kancane. Ekuqaleni, kungenzeka kuphela uma usebenza kakhulu. Ngokuhamba kwesikhathi, ungaqaphela izinkinga zokuphefumula nezinye izimpawu noma ngabe uphumule. Izimpawu zingavela ngokuzumayo ngemuva kokuthi inhliziyo yonakaliswe yisifo senhliziyo noma enye inkinga.

Izimpawu ezivamile yilezi:

• Khwehlela
• Ukukhathala, ubuthakathaka, ukuquleka
• Ukuphelelwa isifiso sokudla
• Udinga ukuchama ebusuku
• Pulse ezizwa ishesha noma ingajwayelekile, noma umuzwa wokuzwa ukushaya kwenhliziyo (ukushaya kwenhliziyo)
• Ukuphefumula okuncane lapho usebenza noma ngemuva kokulala
• Kuvuvukala (kukhulisiwe) isibindi noma isisu
• Zivuvukile izinyawo namaqakala
• Ukuvuka ebuthongweni ngemuva kwamahora ambalwa ngenxa yokuphefumula okuncane
• Ukuzuza kwesisindo

Umhlinzeki wakho wokunakekelwa kwezempilo uzokuhlolela izimpawu zokwehluleka kwenhliziyo:

• Ukuphefumula okusheshayo noma okunzima
• Ukuvuvukala komlenze (i-edema)
• Imithambo yezintambo ephuma ngaphandle (isuswe)
• Imisindo (imifantu) evela ekwakhiweni ketshezi emaphashini akho, izwakala nge-stethoscope
• Ukuvuvukala kwesibindi noma isisu
• Ukushaya kwenhliziyo okungalingani noma okusheshayo nemisindo yenhliziyo engajwayelekile

Ukuhlolwa okuningi kusetshenziselwa ukuxilonga nokuqapha ukwehluleka kwenhliziyo.

I-echocardiogram (i-echo) imvamisa isivivinyo sokuqala esingcono kunazo zonke kubantu lapho kuhlolwa ukwehluleka kwenhliziyo. Umhlinzeki wakho uzokusebenzisa ukuqondisa ukwelashwa kwakho.

Okunye ukuhlolwa kwe-imaging kungabheka ukuthi inhliziyo yakho ikwazi kanjani ukumpompa igazi, nokuthi imisipha yenhliziyo yonakele kangakanani.

Ukuhlolwa kwegazi okuningi kungasetshenziselwa uku:

• Siza ukuxilonga nokuqapha ukwehluleka kwenhliziyo
• Thola izingozi ezinhlobonhlobo zezifo zenhliziyo
• Bheka izimbangela zokuhluleka kwenhliziyo, noma izinkinga ezingenza ukwehluleka kwenhliziyo yakho kube kubi kakhulu
• Bheka imiphumela emibi yemithi okungenzeka uyayiphuza

UKUQAPHA NOKUZINAKEKELA

Uma unokwehluleka kwenhliziyo, umhlinzeki wakho uzokuqapha eduze. Uzoba nokuvakasha kokulandelela okungenani njalo ezinyangeni ezintathu kuya kweziyisithupha, kepha kwesinye isikhathi kaningi kakhulu. Uzoba nokuhlolwa ukuhlola ukusebenza kwenhliziyo yakho.

Ukwazi umzimba wakho nezimpawu zokwehluleka kwenhliziyo yakho ukuba kubi kakhulu kuzokusiza ukuthi uhlale uphilile futhi uphume esibhedlela. Ekhaya, bukela ushintsho ekushayeni kwenhliziyo yakho, ukushaya kwenhliziyo, umfutho wegazi, nesisindo.

Ukuzuza kwesisindo, ikakhulukazi ngaphezu kosuku noma ezimbili, kungaba uphawu lokuthi umzimba wakho ubambelele kuketshezi olungeziwe futhi ukwehluleka kwenhliziyo yakho kuya ngokuya kuba kubi. Khuluma nomhlinzeki wakho ngalokho okufanele ukwenze uma isisindo sakho sikhuphuka noma uba nezimpawu eziningi.

Nciphisa ukuthi udla usawoti ongakanani. Umhlinzeki wakho angakucela futhi ukuthi ukhawulele ukuthi uphuza okungakanani uketshezi phakathi nosuku.

Olunye ushintsho olubalulekile okufanele lwenziwe endleleni yakho yokuphila:

• Buza umhlinzeki wakho ukuthi ungaphuza kangakanani utshwala.
• UNGABHALI.
• Hlala usebenza. Hamba noma ugibele ibhayisikili elimile. Umhlinzeki wakho angakunikeza uhlelo lokuzivocavoca oluphephile nolusebenzayo kuwe. UNGazivocavoci izinsuku lapho isisindo sakho sesikhuphukile kuketshezi noma ungazizwa kahle.
• Yehlisa isisindo uma ukhuluphele ngokweqile.
• Yehlisa i-cholesterol yakho ngokushintsha indlela ophila ngayo.
• Phumula ngokwanele, kufaka phakathi emva kokuzivocavoca umzimba, ukudla, noma eminye imisebenzi. Lokhu kuvumela nenhliziyo yakho ukuthi iphumule.

IMITHI, UKUHLOLA, NAMADIVAYISI

Uzodinga ukuthatha imithi yokwelapha ukwehluleka kwenhliziyo yakho. Imithi ilapha izimpawu, ivimbela ukwehluleka kwenhliziyo yakho ukuba ibe yimbi, futhi ikusize uphile isikhathi eside. Kubaluleke kakhulu ukuthi uphuze umuthi wakho njengokuyalelwa yithimba lakho lezempilo.

Le mithi:

• Siza iphampu yemisipha yenhliziyo kangcono
• Gcina igazi lakho linganqandi
• Yehlisa amazinga akho e-cholesterol
• Vula imithambo yegazi noma wehlise izinga lokushaya kwenhliziyo yakho ukuze inhliziyo yakho ingasebenzi kanzima
• Nciphisa ukulimala enhliziyweni
• Nciphisa ubungozi besigqi senhliziyo esingajwayelekile
• Faka esikhundleni se-potassium
• Susa umzimba wakho kuketshezi oluningi nosawoti (i-sodium)

Kubaluleke kakhulu ukuthi uphuze umuthi wakho njengoba uyalelwe. UNGATHATHI noma imuphi omunye umuthi noma amakhambi ngaphandle kokubuza umhlinzeki wakho ngawo. Izidakamizwa ezingenza ukwehluleka kwenhliziyo yakho zifake:

• I-Ibuprofen (Advil, Motrin)
• I-Naproxen (Aleve, Naprosyn)

Ukuhlinzwa okulandelayo namadivayisi kunganconywa kwabanye abantu abanesifo senhliziyo:

• Ukuhlinzwa kweCoronary bypass (CABG) noma i-angioplasty nge noma ngaphandle kokuthungela kungasiza ekuthuthukiseni ukugeleza kwegazi kuye kwimisipha yenhliziyo eyonakele noma ebuthakathaka.
• Ukuhlinzwa kwe-valve yenhliziyo kungenziwa uma izinguquko ku-valve yenhliziyo zibangela ukwehluleka kwenhliziyo yakho.
• I-pacemaker ingasiza ekwelapheni ukushaya kwenhliziyo okuhamba kancane noma isize izinhlangothi zombili zesivumelwano senhliziyo yakho ngasikhathi sinye.
• I-defibrillator ithumela i-pulse kagesi ukumisa isigqi senhliziyo esesongela impilo.

UKUHLULEKA KWENHLIZIYO YOKUPHELA

Ukwehluleka kwenhliziyo okukhulu kwenzeka lapho ukwelashwa kungasasebenzi. Ukwelashwa okuthile kungasetshenziswa lapho umuntu elinde (noma esikhundleni se) ukufakelwa inhliziyo:

• Iphampu ye-Intra-aortic balloon (IABP)
• Idivayisi yokusiza ye-ventricular engakwesokunxele noma kwesokudla (i-LVAD)
• Ingqikithi yenhliziyo yokufakelwa

Esikhathini esithile, umhlinzeki uzonquma ukuthi kungcono yini ukuqhubeka ephatha ukuhluleka kwenhliziyo ngamandla. Lo muntu, kanye nomndeni wakhe nodokotela, angafuna ukuxoxa ngokunakekelwa okududuzayo noma ukunethezeka ngalesi sikhathi.

Imvamisa, ungalawula ukwehluleka kwenhliziyo ngokuthatha umuthi, ngokushintsha indlela ophila ngayo, nangokwelapha isimo esisidalile.

Ukwehluleka kwenhliziyo kungaba kubi ngokungazelelwe ngenxa:

• Ischemia (ukuntuleka kokugeleza kwegazi kuye emsipheni wenhliziyo)
• Ukudla ukudla okunosawoti omningi
• Isifo senhliziyo
• Ukutheleleka noma ezinye izifo
• Ukungayiphuzi kahle imithi
• Isigqi senhliziyo esisha, esingajwayelekile

Isikhathi esiningi, ukwehluleka kwenhliziyo yisifo esingelapheki. Abanye abantu baba nokuhluleka kwenhliziyo okunzima. Kulesi sigaba, imithi, ezinye izindlela zokwelapha, nokuhlinzwa akusasisizi isimo.

Abantu abanokwehluleka kwenhliziyo bangaba sengozini yemigqi yenhliziyo eyingozi. Laba bantu bavame ukuthola i-defibrillator efakiwe.

Shayela umhlinzeki wakho uma uhlakulela:

• Ukukhwehlela okwandayo noma i-phlegm
• Ukuzuza kwesisindo ngokungazelelwe noma ukuvuvukala
• Ubuthakathaka
• Ezinye izimpawu ezintsha noma ezingachazwanga

Iya egumbini lezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (njenge-911) uma:

• Uyaquleka
• Unokushaya kwenhliziyo okusheshayo nokungajwayelekile (ikakhulukazi uma unezinye izimpawu)
• Uzwa ubuhlungu obucindezelayo esifubeni

Izimo eziningi zokwehluleka kwenhliziyo zingavinjelwa ngokuphila ngendlela enempilo nokuthatha izinyathelo ezihlose ukunciphisa ubungozi besifo senhliziyo.

CHF; Ukwehluleka kwenhliziyo yokucinana; Ukwehluleka kwenhliziyo emaceleni; Ukwehluleka kwenhliziyo emaceleni angakwesokudla - i-cor pulmonale; I-Cardiomyopathy - ukwehluleka kwenhliziyo; HF

• Ama-ACE inhibitors
• Izidakamizwa ze-antiplatelet - P2Y12 inhibitors
• Ukusebenza lapho unesifo senhliziyo
• Ukuhlinzwa kokudlula kwenhliziyo - ukukhipha
• Ukuhluleka kwenhliziyo - ukukhipha
• Ukuhluleka kwenhliziyo - uketshezi kanye nezidakamizwa
• Ukwehluleka kwenhliziyo - ukuqapha ekhaya
• Ukwehluleka kwenhliziyo - okufanele ubuze udokotela wakho
• Inhliziyo pacemaker - ukukhipha
• I-cardioverter defibrillator engafakelwa - ukukhishwa

• Inhliziyo - isigaba phakathi nendawo
• Inhliziyo - ukubuka kwangaphambili
• Ukujikeleza kwegazi ngenhliziyo
• Ukuvuvuka konyawo

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UFelker GM, Teerlink JR. Ukuxilongwa nokuphathwa kokuhluleka kwenhliziyo okunamandla. 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 24.

UForman DE, uSanderson BK, uJosephson RA, uRaikhelkar J, uBittner V; I-American College of Cardiology's Prevention of Cardiovascular Disease Section. Ukwehluleka kwenhliziyo njengokuxilongwa okusanda kuvunywa kokuvuselelwa kwenhliziyo: izinselelo namathuba. UJ Am Coll Cardiol. 2015; 65 (24): 2652-2659. I-PMID: 26088305 pubmed.ncbi.nlm.nih.gov/26088305/.

UMann DL. Ukuphathwa kweziguli zokwehluleka kwenhliziyo ezinengxenyenamba yokukhipha encishisiwe. 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 25.

UYancy CW, uJessup M, uBozkurt B, et al. Ukubuyekezwa okugxile kwe-2017 ACC / AHA / HFSA komhlahlandlela we-ACCF / AHA ka-2013 wokuphathwa kokuhluleka kwenhliziyo: umbiko we-American College of Cardiology / American Heart Association Task Force ku-Clinical Practice Guidelines kanye ne-Heart Failure Society of America. Ukujikeleza. 2017; 136 (6): e137-e161. I-PMID: 28455343 pubmed.ncbi.nlm.nih.gov/28455343/.

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