Ukuhluleka kwenhliziyo - ukuhlolwa

Ukuxilongwa kokuhluleka kwenhliziyo kwenziwa kakhulu kwizimpawu zomuntu kanye nokuhlolwa komzimba. Kodwa-ke, kunezivivinyo eziningi ezingasiza ukunikeza ulwazi oluthe xaxa mayelana nalesi simo.

I-echocardiogram (i-echo) isivivinyo esisebenzisa amagagasi omsindo ukwakha isithombe esihambayo senhliziyo. Isithombe sinemininingwane eminingi kunesithombe se-x-ray esicacile.

Lokhu kuhlolwa kusiza umhlinzeki wakho wokunakekelwa kwezempilo ukuthi afunde kabanzi mayelana nokuthi inhliziyo yakho ivumelana kanjani nokuthi ikhululeka kanjani. Ibuye inikeze imininingwane ngosayizi wenhliziyo yakho nokuthi asebenza kahle kanjani ama-valve enhliziyo.

I-echocardiogram isivivinyo esihle kakhulu:

• Khomba ukuthi yiluphi uhlobo lokwehluleka kwenhliziyo (systolic, diastolic, valvular)
• Gada ukwehluleka kwenhliziyo yakho futhi uqondise ukwelashwa kwakho

Ukwehluleka kwenhliziyo kungatholakala uma i-echocardiogram ikhombisa ukuthi umsebenzi wokumpompa wenhliziyo uphansi kakhulu. Lokhu kubizwa ngengxenyenamba yokukhipha. Ingxenyenamba yokukhishwa evamile icishe ibe ngama-55% kuye kuma-65%.

Uma ngabe ezinye izingxenye zenhliziyo zingasebenzi kahle, kungasho ukuthi kukhona ukuvinjelwa emthanjeni wenhliziyo oletha igazi kuleyo ndawo.

Ezinye izivivinyo eziningi zokucabanga zisetshenziselwa ukubheka ukuthi inhliziyo yakho ikwazi kangakanani ukumpompa igazi nokuthi lingakanani izinga lokulimala kwemisipha yenhliziyo.

Ungahle ube ne-x-ray yesifuba eyenziwe ehhovisi lomhlinzeki wakho uma izimpawu zakho ziba zimbi ngokuzumayo. Noma kunjalo, i-x-ray yesifuba ayikwazi ukuxilonga ukwehluleka kwenhliziyo.

I-Ventriculography ngesinye isivivinyo esilinganisa amandla okukhama ngenhliziyo (ingxenyenamba yokukhipha). Njenge-echocardiogram, ingakhombisa izingxenye zemisipha yenhliziyo engahambi kahle. Lokhu kuhlolwa kusebenzisa uketshezi lokungafani kwe-x-ray ukugcwalisa ikamelo lokumpompa lenhliziyo nokuhlola ukusebenza kwalo. Kuvame ukwenziwa ngasikhathi sinye nezinye izivivinyo, njenge-coronary angiography.

I-MRI, i-CT, noma i-PET scan yenhliziyo ingenziwa ukubheka ukuthi kungakanani ukulimala kwemisipha yenhliziyo okukhona. Kungasiza futhi ukuthola isizathu sokwehluleka kwenhliziyo yesiguli.

Ukuhlolwa kwengcindezi kuyenziwa ukubona ukuthi ngabe imisipha yenhliziyo ithola ukugeleza kwegazi okwanele ne-oxygen uma isebenza kanzima (ngaphansi kwengcindezi). Izinhlobo zokuhlolwa kwengcindezi zifaka:

• Ukuhlolwa kwengcindezi yenukliya
• Ukuzivocavoca umzimba
• Ukucindezela i-echocardiogram

Umhlinzeki wakho anga-oda i-catheterization yenhliziyo uma noma yikuphi ukuhlolwa kwe-imaging kukhombisa ukuthi unciphile komunye wemithambo yakho, noma uma unezinhlungu esifubeni (i-angina) noma kudingeka ukuhlolwa okucacile.

Ukuhlolwa kwegazi okuhlukahlukene kungasetshenziswa ukufunda kabanzi ngesimo sakho. Ukuhlolwa kwenziwa ku:

• Siza ukuxilonga imbangela yokuqapha ukwehluleka kwenhliziyo.
• Thola izici eziyingozi zesifo senhliziyo.
• Bheka izimbangela zokuhluleka kwenhliziyo noma izinkinga ezingenza ukwehluleka kwenhliziyo yakho kube kubi kakhulu.
• Bheka imiphumela emibi yemithi okungenzeka uyayiphuza.

Ukuhlolwa kwegazi urea nitrogen (BUN) kanye ne-serum creatinine kusiza ukuqapha ukuthi izinso zakho zisebenza kahle kangakanani. Uzodinga lezi zivivinyo njalo uma:

• Uthatha imithi ebizwa nge-ACE inhibitors noma ama-ARB (ama-angiotensin receptor blockers)
• Umhlinzeki wakho wenza izinguquko kwimithamo yemithi yakho
• Unokwehluleka kwenhliziyo okunzima ngokwengeziwe

Izinga le-sodium ne-potassium egazini lakho lizodinga ukulinganiswa njalo lapho kunezinguquko ezenziwe kweminye imithi kubandakanya:

• Ama-ACE inhibitors, ama-ARB, noma izinhlobo ezithile zamaphilisi amanzi (i-amiloride, i-spironolactone, ne-triamterene) neminye imithi engenza amazinga akho e-potassium abe phezulu kakhulu
• Izinhlobo eziningi zamaphilisi amanzi, ezingenza i-sodium yakho iphansi kakhulu noma i-potassium yakho ibe phezulu kakhulu

I-anemia, noma isibalo esiphansi segazi elibomvu, kungenza ukwehluleka kwenhliziyo yakho kube kubi kakhulu. Umhlinzeki wakho uzohlola i-CBC yakho noma aqedele ukubalwa kwegazi njalo noma lapho izimpawu zakho ziba zimbi kakhulu.

CHF - izivivinyo; Ukwehluleka kwenhliziyo yokuqina - ukuhlolwa; I-Cardiomyopathy - izivivinyo; HF - izivivinyo

UGreenberg B, uKim PJ, uKahn AM. Ukuhlolwa kwemitholampilo yokwehluleka kwenhliziyo. Ku: Felker GM, Mann DL, eds. Ukwehluleka Kwenhliziyo: Umngane Wezifo Zenhliziyo zeBraunwald. Umhla wesi-4. IPhiladelphia, PA: Elsevier, 2020: isahluko 31.

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