Ukushaqeka kwe-Cardiogenic

Ukushaqeka kwe-Cardiogenic kwenzeka lapho inhliziyo yonakaliswe kakhulu kangangoba ayikwazi ukuletha igazi elanele ezithweni zomzimba.

Izimbangela ezivame kakhulu izimo zenhliziyo ezimbi. Eziningi zazo zenzeka ngesikhathi noma ngemuva kokuhlaselwa yinhliziyo (i-myocardial infarction). Lezi zinkinga zifaka:

• Isigaba esikhulu semisipha yenhliziyo esingasahambi kahle noma esinganyakazi nhlobo
• Ukuqhekeka (ukuqhekeka) kwemisipha yenhliziyo ngenxa yokulimala ekuhlaselweni yinhliziyo
• Isigqi senhliziyo esiyingozi, njenge-ventricular tachycardia, i-ventricular fibrillation, noma i-tachycardia engaphezulu
• Ingcindezi enhliziyweni ngenxa yokwakheka koketshezi okuyizungezile (i-pericardial tamponade)
• Izinyembezi noma ukuqhuma kwemisipha noma imisipha esekela ama-valve enhliziyo, ikakhulukazi i-mitral valve
• Ukudabuka noma ukuqhekeka kodonga (septum) phakathi kwama-ventricles angakwesokunxele nangakwesokudla (amakamelo enhliziyo aphansi)
• Isigqi senhliziyo esisheshayo (bradycardia) noma inkinga ngohlelo lukagesi lwenhliziyo (ibhlokhi yenhliziyo)

Ukushaqeka kwe-Cardiogenic kwenzeka lapho inhliziyo ingakwazi ukupompa igazi eliningi njengoba umzimba udinga. Kungenzeka noma ngabe bekungekho ukuhlaselwa yinhliziyo uma kwenzeka enye yalezi zinkinga futhi umsebenzi wenhliziyo yakho wehla ngokungazelelwe.

Izimpawu zifaka:

• Ubuhlungu besifuba noma ingcindezi
• I-Coma
• Ukwehlisa ukuchama
• Ukuphefumula ngokushesha
• Ishayela okusheshayo
• Ukujuluka okunzima, isikhumba esimanzi
• Ubumhlophe
• Ukulahlekelwa kokuqwashisa nokukwazi ukugxila
• Ukuphumula, ukuphazamiseka, ukudideka
• Ukuphelelwa umoya
• Isikhumba esizizwa sipholile uma usithinta
• Umbala wesikhumba okhanyayo noma isikhumba esimnyama
• I-pulse ebuthakathaka (thready)

Ukuhlolwa kuzokhombisa:

• Umfutho wegazi ophansi (imvamisa ungaphansi kwe-90 systolic)
• Umfutho wegazi owela ngaphezu kwamaphoyinti ayi-10 lapho usukuma ngemuva kokulala phansi (i-orthostatic hypotension)
• I-pulse ebuthakathaka (thready)
• Isikhumba esibandayo nesimbumbulu

Ukuthola ukushaqeka kwenhliziyo, i-catheter (ithubhu) ingafakwa emthanjeni wamaphaphu (i-catheterization yenhliziyo engakwesokudla). Ukuhlolwa kungakhombisa ukuthi igazi liyabuyela emaphashini futhi inhliziyo ayipomki kahle.

Izivivinyo zifaka:

• I-catheterization yenhliziyo
• I-x-ray yesifuba
• I-Coronary angiography
• I-Echocardiogram
• I-Electrocardiogram
• Iskena senhliziyo senhliziyo

Ezinye izifundo zingenziwa ukuthola ukuthi kungani inhliziyo ingasebenzi kahle.

Ukuhlolwa kwelebhu kufaka phakathi:

• Igazi legazi lomzimba
• Amakhemikhali egazi (chem-7, chem-20, electrolyte)
• Ama-enzyme enhliziyo (troponin, CKMB)
• Qedela ukubalwa kwegazi (CBC)
• Ihomoni ekhuthaza i-thyroid (TSH)

Ukushaqeka kwe-Cardiogenic kuyisimo esiphuthumayo sezokwelapha. Uzodinga ukuhlala esibhedlela, imvamisa kakhulu e-Intensive Care Unit (ICU). Inhloso yokwelashwa ukuthola nokwelapha imbangela yokwethuka ukusindisa impilo yakho.

Ungadinga imithi yokwandisa umfutho wegazi nokuthuthukisa ukusebenza kwenhliziyo, kufaka phakathi:

• Dobutamine
• UDopamine
• I-Epinephrine
• Levosimendan
• I-Milrinone
• I-Norepinephrine
• IVasopressin

Le mithi ingasiza esikhathini esifushane. Azisetshenziswa kaningi isikhathi eside.

Lapho ukuphazamiseka kwesigqi senhliziyo (i-dysrhythmia) kuyinto embi, ukwelashwa okuphuthumayo kungadingeka ukubuyisela isigqi senhliziyo esijwayelekile. Lokhu kungafaka:

• Ukwelashwa kukagesi "ukushaqeka" (defibrillation noma i-cardioversion)
• Ukufaka i-pacemaker yesikhashana
• Imithi enikezwa ngomthambo (IV)

Ungase futhi uthole:

• Umuthi wezinhlungu
• Oxygen
• Uketshezi, igazi, nemikhiqizo yegazi ngomthambo (IV)

Ezinye izindlela zokwethuka zingabandakanya:

• I-catheterization yenhliziyo ene-angioplasty coronary kanye ne-stenting
• Ukuqapha kwenhliziyo ukuqondisa ukwelashwa
• Ukuhlinzwa kwenhliziyo (ukuhlinzwa ngokudlula komthambo we-coronary, ukufaka i-valve yenhliziyo, idivayisi yokusiza ye-ventricular)
• Intra-aortic balloon counterpulsation (IABP) ukusiza inhliziyo isebenze kangcono
• I-Pacemaker
• Idivayisi yokusiza ye-Ventricular noma okunye ukwesekwa kwemishini

Esikhathini esedlule, izinga lokufa kusuka ekushayweni kwe-cardiogenic lisuka ku-80% laya ku-90%. Ezifundweni zakamuva nje, leli zinga lehle laya ku-50% laya ku-75%.

Lapho ukwelashwa kwe-Cardiogenic kungalashwa, umbono awubi kahle.

Izinkinga zingafaka:

• Ukulimala kobuchopho
• Ukulimala kwezinso
• Ukulimala kwesibindi

Iya egumbini labezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (efana ne-911) uma unezimpawu zokushaqeka kwenhliziyo. Ukushaqeka kwe-Cardiogenic kuyisimo esiphuthumayo sezokwelapha.

Unganciphisa ubungozi bokushaqeka kwe-cardiogenic ngo:

• Ukwelapha ngokushesha imbangela yayo (njengokuhlaselwa yinhliziyo noma inkinga ye-valve yenhliziyo)
• Ukuvimbela nokwelapha izinto ezinobungozi zesifo senhliziyo, njengesifo sikashukela, umfutho wegazi ophakeme, i-cholesterol ephezulu kanye ne-triglycerides, noma ukusetshenziswa kukagwayi

Ukushaqeka - i-cardiogenic

• Inhliziyo - isigaba phakathi nendawo

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.

IHollenberg SM. Ukushaqeka kwe-Cardiogenic. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 99.