I-Peripartum cardiomyopathy

I-Peripartum cardiomyopathy yisifo esingajwayelekile lapho inhliziyo yowesifazane okhulelwe iba buthakathaka futhi ikhuliswe khona. Ikhula ngenyanga yokugcina yokukhulelwa, noma kungakapheli izinyanga ezinhlanu ingane izelwe.

I-Cardiomyopathy yenzeka lapho kukhona ukulimala enhliziyweni. Ngenxa yalokhu, imisipha yenhliziyo iba buthakathaka futhi ayimpompi kahle. Lokhu kuthinta amaphaphu, isibindi, nezinye izinhlelo zomzimba.

I-Peripartum cardiomyopathy iyindlela yokuqina kwe-cardiomyopathy lapho kungatholakali esinye isizathu sokuthamba kwenhliziyo.

Kungenzeka kwabesifazane abazala noma yibuphi ubudala, kepha kuvame kakhulu ngemuva kweminyaka engama-30.

Izici ezinobungozi zalesi simo zifaka:

• Ukukhuluphala ngokweqile
• Umlando womuntu siqu wokuphazamiseka kwenhliziyo njenge-myocarditis
• Ukusetshenziswa kwemithi ethile
• Ukubhema
• Ukuphuza ngokweqile
• Ukukhulelwa okuningi
• Ukuguga
• Preecclampsia
• Umdabu wase-Afrika waseMelika
• Ukondleka okungafanele

Izimpawu zingafaka:

• Ukukhathala
• Ukuzwa kwenhliziyo ukugijima noma ukweqa amabhithi (ukushaya kwenhliziyo)
• Ukwanda kokuchama ebusuku (nocturia)
• Ukuphefumula okuncane ngomsebenzi nalapho ulele phansi
• Ukuvuvukala kwamaqakala

Ngesikhathi sokuhlolwa komzimba, umhlinzeki wezokunakekelwa kwempilo uzobheka izimpawu zoketshezi emaphashini ngokuthinta nangokuthinta ngeminwe. I-stethoscope izosetshenziselwa ukulalela ukuqhekeka kwamaphaphu, ukushaya kwenhliziyo okusheshayo, noma imisindo yenhliziyo engajwayelekile.

Isibindi singakhuliswa futhi imithambo yentamo ingahle ivuvuke. Umfutho wegazi ungaba phansi noma wehle lapho umile.

Ukwandiswa kwenhliziyo, ukuminyana kwamaphaphu noma imithambo emaphashini, ukwehla kokukhipha inhliziyo, ukwehla kokuhamba noma ukusebenza kwenhliziyo, noma ukwehluleka kwenhliziyo kungavela ku:

• I-x-ray yesifuba
• Isikena se-CT esifubeni
• I-Coronary angiography
• I-Echocardiogram
• Iskena senhliziyo yenukliya
• I-MRI yezinhliziyo

I-biopsy yenhliziyo ingasiza ekunqumeni ukuthi imbangela eyinhloko ye-cardiomyopathy isifo sokutheleleka kwemisipha yenhliziyo (myocarditis). Noma kunjalo, le nqubo ayenziwa kaningi.

Owesifazane angadinga ukuhlala esibhedlela kuze kuphele izimpawu eziyingozi.

Ngoba kuvame kakhulu ukubuyisa ukusebenza kwenhliziyo, futhi abesifazane abanalesi simo bavame ukuba bancane futhi babe nempilo, ukunakekelwa kuvame ukuba nolaka.

Lapho kuvela izimpawu ezinzima, lokhu kungafaka izinyathelo ezimbi kakhulu ezifana nalezi:

• Ukusetshenziswa kwepompo yenhliziyo esizayo (ibhaluni ye-aortic counterpulsation, idivaysi yokusiza ye-ventricular kwesokunxele)
• Ukwelashwa kwe-immunosuppressive (njengemithi esetshenziselwa ukwelapha umdlavuza noma ukuvimbela ukwenqatshwa kwesitho esifakelwe kabusha)
• Ukufakelwa kwenhliziyo uma ukwehluleka okukhulu kwenhliziyo kuqhubeka

Kwabesifazane abaningi, noma kunjalo, ukwelashwa kugxile ekwehliseni izimpawu. Ezinye izimpawu zihamba zodwa ngaphandle kokwelashwa.

Imithi evame ukusetshenziswa ifaka phakathi:

• I-Digitalis yokuqinisa ikhono lokupompa kwenhliziyo
• Izidakamizwa ("amaphilisi amanzi") ukususa uketshezi oluningi
• Ama-beta-blockers anomthamo ophansi
• Eminye imithi yengcindezi yegazi

Kunganconywa ukudla okunosawoti omncane. Uketshezi lungavinjelwa kwezinye izimo. Imisebenzi, kufaka phakathi ukuncelisa ingane, ingahle ikhawulelwe lapho kuvela izimpawu.

Kunganconywa ukuba nesisindo sansuku zonke. Ukuzuza kwesisindo samakhilogremu ama-3 kuye kwayi-4 (1.5 kuya ku-2 kilograms) noma ngaphezulu kwezinsuku ezi-1 noma ezi-2 kungaba uphawu lokwakheka oketshezi.

Abesifazane ababhemayo nabaphuza utshwala bazokwaziswa ukuthi bayeke, ngoba le mikhuba ingenza izimpawu zibe zimbi kakhulu.

Kunemiphumela eminingana engenzeka ku-peripartum cardiomyopathy. Abanye besifazane bahlala bezinzile isikhathi eside, kuyilapho abanye beba bheda kancane.

Abanye baba babi ngokushesha okukhulu futhi bangaba ukhetho lokufakelwa inhliziyo. Cishe u-4% wabantu uzodinga ukufakelwa inhliziyo futhi u-9% angafa ngokuzuma noma afe ngenxa yezinkinga zenqubo.

Umbono muhle lapho inhliziyo yowesifazane ibuyela kokujwayelekile ngemuva kokuzalwa kwengane. Uma inhliziyo ihlala ingavamile, ukukhulelwa esikhathini esizayo kungaholela ekuhlulekeni kwenhliziyo. Akwaziwa ukuthi ungabikezela kanjani ukuthi ngubani ozolulama nokuthi ngubani ozoba nokuhluleka kwenhliziyo okunzima. Cishe ingxenye eyodwa yabesifazane izolulama ngokuphelele.

Abesifazane abahlakulela i-peripartum cardiomyopathy basengozini enkulu yokuthola inkinga efanayo ngokukhulelwa okuzayo. Izinga lokuphindaphinda cishe liyi-30%. Ngakho-ke, abesifazane abake baba nalesi simo kufanele baxoxe ngezindlela zokulawula ukubeletha nomhlinzeki wabo.

Izinkinga zifaka:

• Ama-arrhythmias enhliziyo (angabulala)
• Ukwehluleka kwenhliziyo yokubopha
• Ukwakheka kwehlwili enhliziyweni okungafakela (ukuya kwezinye izingxenye zomzimba)

Shayela umhlinzeki wakho uma ngabe ukhulelwe njengamanje noma usanda kubeletha ingane bese ucabanga ukuthi ungaba nezimpawu ze-cardiomyopathy.

Thola usizo lwezokwelapha khona manjalo uma uba nobuhlungu besifuba, ukushaya ngamandla, ukuquleka, noma ezinye izimpawu ezintsha noma ezingachazwanga.

Yidla ukudla okunomsoco futhi uvivinye umzimba njalo ukusiza ukugcina inhliziyo yakho iqinile. Gwema ugwayi notshwala. Umhlinzeki wakho angakweluleka ukuthi ugweme ukukhulelwa futhi uma uke wahluleka yinhliziyo ngesikhathi sokukhulelwa kwangaphambilini.

I-Cardiomyopathy - i-peripartum; I-Cardiomyopathy - ukukhulelwa

• Inhliziyo - isigaba phakathi nendawo
• Inhliziyo - ukubuka kwangaphambili
• I-Peripartum cardiomyopathy

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UMcKenna WJ, u-Elliott PM. Izifo ze-myocardium ne-endocardium. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 54.

I-Silversides CK, iWarnes CA. Ukukhulelwa nesifo senhliziyo. 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 90.