Ukwehluleka kwenhliziyo - imithi

Iningi labantu abanokwehluleka kwenhliziyo badinga ukuthatha imithi. Eminye yale mithi isetshenziselwa ukwelapha izimpawu zakho. Abanye bangasiza ukuvimbela ukwehluleka kwenhliziyo yakho ekubeni kubi kakhulu futhi bakuvumele uphile isikhathi eside.

Uzodinga ukuthatha iningi lemithi yakho yokwehluleka kwenhliziyo nsuku zonke. Eminye imithi iphuzwa kanye ngosuku. Abanye badinga ukuthathwa izikhathi ezi-2 noma ngaphezulu nsuku zonke. Kubaluleke kakhulu ukuthi uphuze imithi yakho ngesikhathi esifanele nangendlela akutshele ngayo udokotela wakho.

Ungalokothi uyeke ukuthatha imithi yenhliziyo yakho ngaphandle kokukhuluma nomhlinzeki wakho wezokunakekelwa kwempilo kuqala. Lokhu kuyiqiniso nangeminye imithi oyiphuzayo, njengezidakamizwa zesifo sikashukela, umfutho wegazi ophakeme nezinye izimo ezinzima.

Umhlinzeki wakho angakutshela futhi ukuthi uthathe imithi ethile noma ushintshe imithamo yakho lapho izimpawu zakho ziba zimbi kakhulu. UNGAYISHintshi imithi noma imithamo yakho ngaphandle kokukhuluma nomhlinzeki.

Njalo utshele umhlinzeki wakho ngaphambi kokuthatha noma yimiphi imithi emisha. Lokhu kufaka phakathi imishanguzo yamakhompiyutha efana ne-ibuprofen (Advil, Motrin) ne-naproxen (Aleve, Naprosyn), kanye nezidakamizwa ezifana ne-sildenafil (Viagra), i-vardenafil (i-Levitra), ne-tadalafil (i-Cialis).

Phinda utshele umhlinzeki wakho ngaphambi kokuthatha noma yiluphi uhlobo lwemifino noma isengezo.

Ama-ACE inhibitors (ama-angiotensin aguqula ama-enzyme inhibitors) nama-ARB (ama-angiotensin II receptor blockers) asebenza ngokuvula imithambo yegazi nokwehlisa umfutho wegazi. Le mithi inga:

• Nciphisa umsebenzi okufanele wenziwe yinhliziyo yakho
• Siza inhliziyo yakho imisipha futha kangcono
• Gcina ukwehluleka kwenhliziyo yakho kungabi kubi kakhulu

Imiphumela emibi ejwayelekile yale mithi ihlanganisa:

• Ukukhwehlela okomile
• Ubumhlophe
• Ukukhathala
• Isisu esibuhlungu
• I-Edema
• Ubuhlungu bekhanda
• Uhudo

Uma uthatha le mithi, kuzodingeka ukuthi uhlolwe igazi ukubheka ukuthi izinso zakho zisebenza kahle kangakanani futhi ukukala amazinga akho e-potassium.

Isikhathi esiningi, umhlinzeki wakho uzonquma i-ACE inhibitor noma i-ARB. Isigaba esisha semithi esibizwa nge-angiotensin receptor-neprilysin inhibitors (i-ARNI's) sihlanganisa umuthi we-ARB nohlobo olusha lomuthi. Ama-ARNI's angasetshenziswa ukwelapha ukwehluleka kwenhliziyo.

Ama-beta blockers anciphisa izinga lokushaya kwenhliziyo yakho futhi anciphise amandla izinkontileka zemisipha yenhliziyo yakho esikhathini esifushane. Ama-beta blocker wesikhathi eside asiza ukugcina ukwehluleka kwenhliziyo yakho ukuthi kube kubi kakhulu. Ngokuhamba kwesikhathi zingasiza ekuqiniseni inhliziyo yakho.

Ama-beta blocker ajwayelekile asetshenziselwa ukwehluleka kwenhliziyo afaka phakathi i-carvedilol (Coreg), i-bisoprolol (Zebeta), ne-metoprolol (iTrolrol).

Ungayeki ngokungazelelwe ukuthatha le mithi. Lokhu kungakhuphula ubungozi be-angina ngisho nesifo senhliziyo. Eminye imiphumela emibi ifaka ikhanda elikhanyayo, ukudangala, ukukhathala, kanye nokulahleka kwememori.

Izidakamizwa zisiza umzimba wakho ukuthi ulahle uketshezi olungeziwe. Ezinye izinhlobo ze-diuretics nazo zingasiza ngezinye izindlela. Le mithi ivame ukubizwa ngokuthi "amaphilisi amanzi." Kunezinhlobo eziningi zemikhiqizo yokwelapha isisu. Ezinye zithathwa kanye ngosuku. Ezinye zithathwa izikhathi ezimbili ngosuku. Izinhlobo ezivame kakhulu yilezi:

• AmaThiyazide. I-Chlorothiazide (Diuril), i-chlorthalidone (i-Hygroton), i-indapamide (i-Lozol), i-hydrochlorothiazide (i-Esidrix, i-HydroDiuril), ne-metolazone (i-Mykrox, i-Zaroxolyn)
• I-Loop diuretics. I-Bumetanide (Bumex), i-furosemide (i-Lasix), ne-torasemide (i-Demadex)
• Ama-potassium-sparing agents. I-Amiloride (Midamor), i-spironolactone (i-Aldactone), ne-triamterene (iDyrenium)

Uma uthatha le mithi, uzodinga ukuhlolwa kwegazi njalo ukuze ubheke ukuthi izinso zakho zisebenza kahle kangakanani futhi ulinganise amazinga akho e-potassium.

Abantu abaningi abanesifo senhliziyo bathatha i-aspirin noma i-clopidogrel (i-Plavix). Le mithi isiza ukuvimbela amahlule egazi ekwakhekeni emithanjeni yakho. Lokhu kunganciphisa ingozi yokushaywa unhlangothi noma isifo senhliziyo.

I-Coumadin (iWarfarin) inconyelwa iziguli ezinokwehluleka kwenhliziyo ezinengozi enkulu yamahlule egazi.Uzodinga ukuhlolwa igazi elengeziwe ukuze uqiniseke ukuthi umthamo wakho ulungile. Ungadinga futhi ukwenza izinguquko ekudleni kwakho.

Izidakamizwa ezisetshenziswa ngokujwayelekile ukwehluleka kwenhliziyo zifaka:

• I-Digoxin ukusiza ukukhulisa amandla okupompa kwenhliziyo nokunciphisa izinga lokushaya kwenhliziyo.
• I-Hydralazine ne-nitrate ukuvula imithambo futhi kusize iphampu yemisipha yenhliziyo kangcono. Le mithi isetshenziswa kakhulu yiziguli ezingakwazi ukubekezelela i-ACE inhibitors kanye ne-angiotensin receptor blockers.
• Izivimbeli zesiteshi seCalcium ukulawula umfutho wegazi noma i-angina (ubuhlungu besifuba) kusuka ku-coronary artery disease (CAD).

Kusetshenziswa izitatimende nezinye izidakamizwa zokwehlisa i-cholesterol uma kudingeka.

Imithi ye-antiarrhythmic kwesinye isikhathi isetshenziswa yiziguli ezingasebenzi kahle zenhliziyo ezinesigqi senhliziyo esingajwayelekile. Esinye sezidakamizwa ezinjalo i-amiodarone.

Umuthi omusha, i-Ivabradine (Corlanor), usebenza ukwehlisa izinga lokushaya kwenhliziyo futhi ungasiza abantu abanezinhliziyo ukwehluleka ngokunciphisa umthwalo wezinhliziyo.

CHF - imithi; Ukwehluleka kwenhliziyo yokuqinisa - imithi; I-Cardiomyopathy - imithi; HF - imithi

UMann DL. Ukuphathwa kweziguli ezinokwehluleka 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 Saunders; 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. J Ukwehluleka Kwenhliziyo. 2017; 23 (8): 628-651. I-PMID: 28461259 www.ncbi.nlm.nih.gov/pubmed/28461259.

UYancy CW, uJessup M, uBozkurt B, et al. Umhlahlandlela we-ACCF / AHA ka-2013 wokuphathwa kokuhluleka kwenhliziyo: umbiko we-American College of Cardiology Foundation / American Heart Association Task Force on Guidelines Practice. Ukujikeleza. 2013; 128 (16): e240-e327. I-PMID: 23741058 www.ncbi.nlm.nih.gov/pubmed/23741058.

• Ukwehluleka Kwenhliziyo