I-Pericarditis

I-Pericarditis yisimo lapho ukumbozwa okufana nesaka okuzungeze inhliziyo (i-pericardium) kuyavuvukala.

Isizathu se-pericarditis asaziwa noma asivunyelwe ezimweni eziningi. Kuthinta kakhulu abesilisa abaneminyaka engama-20 kuya kwengama-50.

I-Pericarditis imvamisa ingumphumela wokutheleleka okufana nalokhu:

• Ukutheleleka ngegciwane okubangela ukubanda kwesifuba noma i-pneumonia
• Ukutheleleka ngamagciwane (okungajwayelekile)
• Ezinye izifo zokukhunta (ezingavamile)

Isimo singabonakala ngezifo ezinjenge:

• Umdlavuza (kufaka phakathi i-leukemia)
• Ukuphazamiseka lapho amasosha omzimba ehlasela izicubu zomzimba ezinempilo ngephutha
• Ukutheleleka nge-HIV kanye ne-AIDS
• Indlala yegilo engasebenzi
• Ukuhluleka kwezinso
• Umkhuhlane we-rheumatic fever
• Isifo Sofuba (TB)

Ezinye izimbangela zifaka:

• Isifo senhliziyo
• Ukuhlinzwa kwenhliziyo noma ukuhlukumezeka esifubeni, esophagus, noma enhliziyweni
• Imithi ethile, efana ne-procainamide, i-hydralazine, i-phenytoin, i-isoniazid, neminye imithi esetshenziselwa ukwelapha umdlavuza noma ukucindezela amasosha omzimba
• Ukuvuvukala noma ukuvuvukala kwemisipha yenhliziyo
• Ukwelashwa ngemisebe esifubeni

Ubuhlungu besifuba buhlala buhlala bukhona. Ubuhlungu:

• Kungazwakala entanyeni, ehlombe, emuva, noma esiswini
• Imvamisa kukhuphuka ngokuphefumula okujulile nokulala phansi, futhi kungakhuphuka ngokukhwehlela nokugwinya
• Ungazizwa ubukhali futhi ugwaza
• Kuvame ukukhululeka ngokuhlala phezulu nokuncika noma ukugoba phambili

Ungaba nomkhuhlane, ukubanda, noma ukujuluka uma isimo sibangelwa ukutheleleka.

Ezinye izimpawu zingafaka:

• Ukuvuvukala kweqakala, izinyawo nomlenze
• Ukukhathazeka
• Ukuphefumula kanzima lapho ulele phansi
• Ukukhwehlela okomile
• Ukukhathala

Lapho ulalele inhliziyo nge-stethoscope, umhlinzeki wezokunakekelwa kwezempilo angazwa umsindo obizwa nge-pericardial rub. Imisindvo yenhlitiyo ingahle ingafakwanga noma ibe kude. Kungaba nezinye izimpawu zoketshezi oluningi ku-pericardium (pericardial effusion).

Uma lesi sifo sinzima, kungaba khona:

• Ukuqhekeka emaphashini
• Ukwehla komoya kuzwakala
• Ezinye izimpawu zoketshezi esikhaleni esizungeze amaphaphu

Ukuhlolwa kwe-imaging okulandelayo kungenziwa ukubheka inhliziyo kanye nongqimba lwezicubu ezizungezile (pericardium):

• Iskena se-MRI sesifuba
• I-x-ray yesifuba
• I-Echocardiogram
• I-Electrocardiogram
• I-Heart MRI noma i-CT CT scan
• Ukuskena kwe-Radionuclide

Ukubheka ukulimala kwemisipha yenhliziyo, umhlinzeki anga-oda i-troponin engiyivivinyayo. Ezinye izivivinyo zaselebhu zingabandakanya:

• I-antiinuclear antibody (ANA)
• Isiko legazi
• I-CBC
• Amaprotheni asebenza ngo-C
• Izinga le-sedimentation ye-Erythrocyte (ESR)
• Ukuhlolelwa i-HIV
• Isici se-rheumatoid
• Ukuhlolwa kwesikhumba se-tuberculin

Imbangela ye-pericarditis kufanele ikhonjwe, uma kungenzeka.

Imithamo ephezulu yezidakamizwa ezingezona ukuvuvukala (ama-NSAID) njenge-ibuprofen ivame ukunikezwa ngomuthi obizwa nge-colchicine. Le mithi izokwehlisa ubuhlungu bakho futhi yehlise ukuvuvukala noma ukuvuvukala esikhwameni esizungeze inhliziyo yakho. Uzocelwa ukuthi ubathathe izinsuku ukuya emasontweni noma ngaphezulu kwezinye izimo.

Uma imbangela ye-pericarditis isifo:

• Ama-antibiotic azosetshenziselwa ukutheleleka ngamagciwane
• Imithi yokubulala amagciwane izosetshenziselwa i-fungic pericarditis

Eminye imithi engasetshenziswa yilena:

• Ama-Corticosteroids afana ne-prednisone (kwabanye abantu)
• "Amaphilisi amanzi" (isisu) ukususa uketshezi oluningi

Uma ukwakheka koketshezi kwenza inhliziyo isebenze kahle, ukwelashwa kungafaka:

• Ukukhipha uketshezi kusuka esikhwameni. Le nqubo, ebizwa nge-pericardiocentesis, ingenziwa kusetshenziswa inaliti, eqondiswa yi-ultrasound (echocardiography) ezimweni eziningi.
• Ukusika imbobo encane (iwindi) ku-pericardium (subxiphoid pericardiotomy) ukuvumela uketshezi olunegciwane ukuthi lungene emgodini wesisu. Lokhu kwenziwa udokotela ohlinzayo.

Ukuhlinzwa okubizwa nge-pericardiectomy kungadingeka uma i-pericarditis ihlala isikhathi eside, ibuya ngemuva kokwelashwa, noma ibangele ukusikeka noma ukuqina kwezicubu ezizungeze inhliziyo. Ukuhlinzwa kufaka ukusika noma ukususa ingxenye ye-pericardium.

I-Pericarditis ingaba kusuka ekuguleni okuncane okuba ngcono ngokwakho, kuya esimweni esisongela impilo. Ukwakhela uketshezi okuzungeze inhliziyo nokusebenza okungalungile kwenhliziyo kungasicindezela lesi sifo.

Umphumela muhle uma i-pericarditis yelashwa ngokushesha. Iningi labantu liyalulama emavikini amabili kuya ezinyangeni ezintathu. Noma kunjalo, i-pericarditis ingabuya. Lokhu kubizwa ngokuphindaphindiwe, noma okungapheli, uma izimpawu noma iziqephu ziqhubeka.

Ukuqhuma nokuqina kwesembozo esifana nesaka kanye nemisipha yenhliziyo kungenzeka uma inkinga inzima. Lokhu kubizwa ngokuthi yi-constrictive pericarditis. Kungadala izinkinga zesikhathi eside ezifana nalezo zokuhluleka kwenhliziyo.

Shayela umhlinzeki wakho uma unezimpawu ze-pericarditis. Lesi sifo asisongeli impilo isikhathi esiningi. Kodwa-ke, kungaba yingozi kakhulu uma kungelashwa.

Amacala amaningi awakwazi ukuvinjelwa.

• I-Pericardium
• I-Pericarditis

UChabrando JG, Bonaventura A, Vecchie A, et al. Ukuphathwa kwe-pericarditis ebukhali nephindaphindayo: Ukubuyekezwa kwe-JACC State-of-the-art. UJ Am Coll Cardiol. 2020; 75 (1): 76-92. I-PMID: 31918837 pubmed.ncbi.nlm.nih.gov/31918837/.

UKnowlton KU, uSavoia MC, u-Oxman MN. I-myocarditis ne-pericarditis. Ku: Bennett JE, Dolin R, Blaser MJ, ama-eds. Mandell, Douglas, kanye neBennett's Principles and Practice of Infectious Diseases. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2020: isahluko 80.

I-LeWinter MM, izifo ze-Imazio M. Pericardial. 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 83.