Isifo senhliziyo seCyanotic

Isifo senhliziyo seCyanotic sibhekisa eqenjini lokukhubazeka kwenhliziyo okuhlukahlukene okukhona lapho kuzalwa (kuzalwa). Ziphumela ezingeni eliphansi le-oxygen egazini. I-cyanosis ibhekisa kumbala oluhlaza okwesibhakabhaka nolwelwesi lwamafinyila.

Imvamisa, igazi liyabuya emzimbeni futhi ligeleze lingene enhliziyweni nasemaphashini.

• Igazi elinomoya-mpilo omncane (igazi eliluhlaza okwesibhakabhaka) libuya emzimbeni liye ohlangothini lwesokudla senhliziyo.
• Uhlangothi lwangakwesokudla lwenhliziyo bese lupompa igazi liye emaphashini, lapho lithatha khona umoya-mpilo omningi futhi lube bomvu.
• Igazi eligcwele umoya-mpilo libuya emaphashini liye ohlangothini lwesobunxele lwenhliziyo. Kusuka lapho, kufakwa kuwo wonke umzimba.

Ukukhubazeka kwenhliziyo izingane ezizalwa nakho kungashintsha indlela igazi eligeleza ngayo enhliziyweni nasemaphashini. Lokhu kukhubazeka kungadala ukuthi igazi elincane ligelezele emaphashini. Futhi kungaholela ekuxubeni kwegazi eliluhlaza okwesibhakabhaka nokubomvu. Lokhu kubangela ukuthi igazi elimpofu elinomoya-mpilo likhishelwe emzimbeni. Ngenxa yalokho:

• Igazi elikhishwa emzimbeni liphansi komoya-mpilo.
• I-oxygen encane ehanjiswa emzimbeni ingenza isikhumba sibukeke siluhlaza okwesibhakabhaka (cyanosis).

Okunye kwalokhu kukhubazeka kwenhliziyo kubandakanya ama-valve enhliziyo. Lokhu kukhubazeka kuphoqa igazi eliluhlaza okwesibhakabhaka ukuba lihlangane negazi elibomvu ngemigudu yenhliziyo engajwayelekile. Ama-valve enhliziyo atholakala phakathi kwenhliziyo nemithambo yegazi emikhulu eletha igazi ngaphakathi nasenhliziyweni. La ma-valve avuleka ngokwanele ukuze igazi ligeleze. Ngemuva kwalokho ziyavalwa, kugcinwe igazi lingageleki emuva.

Ukukhubazeka kwe-valve yenhliziyo okungadala i-cyanosis kufaka:

• I-valve ye-Tricuspid (i-valve ephakathi kwamakamelo ama-2 ohlangothini lwesokunene senhliziyo) kungenzeka ingabikho noma ingakwazi ukuvula ngokwanele.
• I-valve yamaphaphu (i-valve ephakathi kwenhliziyo namaphaphu) kungenzeka ingabikho noma ingakwazi ukuvula ivuleke ngokwanele.
• I-aortic valve (i-valve ephakathi kwenhliziyo nomthambo wegazi kuwo wonke umzimba) ayikwazi ukuvuleka ngokwanele.

Okunye ukukhubazeka kwenhliziyo kungabandakanya okungajwayelekile ekukhuleni kwe-valve noma endaweni nokuxhumana phakathi kwemithambo yegazi. Ezinye izibonelo zifaka:

• Ukuhlangana noma ukuphazanyiswa okuphelele kwe-aorta
• I-Ebstein anomaly
• Isifo senhliziyo esine-Hypoplastic
• I-Tetralogy of Fallot
• Inani eliphelele lokubuya kwe-pulmonary venous
• Ukushintshwa kwemithambo emikhulu
• I-Truncus arteriosus

Izimo ezithile zokwelashwa kumama zingakhuphula ubungozi bezifo ezithile zenhliziyo ezinganeni. Ezinye izibonelo zifaka:

• Ukuchayeka ngamakhemikhali
• Ama-syndromes we-Genetic ne-chromosomal, njenge-Down syndrome, i-trisomy 13, i-Turner syndrome, i-Marfan syndrome ne-Noonan syndrome
• Izifo (njenge-rubella) ngesikhathi sokukhulelwa
• Izinga likashukela egazini elilawulwa kabi kwabesifazane abanesifo sikashukela ngesikhathi sokukhulelwa
• Imithi enikezwe umhlinzeki wakho wezokunakekelwa kwempilo noma oyithenge wedwa futhi oyisebenzise ngesikhathi sokukhulelwa
• Izidakamizwa zomgwaqo ezisetshenziswa ngesikhathi sokukhulelwa

Ezinye izinkinga zenhliziyo zidala izinkinga ezinkulu ngemuva nje kokuzalwa.

Uphawu oluyinhloko i-cyanosis umbala ohlaza okwesibhakabhaka wezindebe, iminwe, nezinzwane okubangelwa okuqukethwe okuphansi komoya-mpilo osegazini. Kungenzeka ngesikhathi ingane iphumule noma lapho ingane isebenza kuphela.

Ezinye izingane zinezinkinga zokuphefumula (i-dyspnea). Bangangena esimweni sokuhlala ngemuva kokuzivocavoca umzimba ukuze banciphise ukuphefumula.

Abanye baneziphonso, lapho imizimba yabo ilamba ngokuzumayo i-oxygen. Phakathi nalezi zinhlamvu, izimpawu zingafaka:

• Ukukhathazeka
• Ukuphefumula ngokushesha okukhulu (i-hyperventilation)
• Ukwanda okungazelelwe kombala oluhlaza okwesibhakabhaka esikhunjeni

Izinsana zingakhathala noma zijuluke ngenkathi zisadla futhi kungenzeka zingatholi isisindo esiningi njengoba kufanele.

Ukuquleka (i-syncope) nobuhlungu besifuba kungenzeka.

Ezinye izimpawu zincike ohlotsheni lwesifo senhliziyo se-cyanotic, futhi zingafaka:

• Izinkinga zokondla noma ukunciphisa isifiso sokudla, okuholela ekukhuleni okungekuhle
• Isikhumba esimpunga
• Amehlo noma ubuso obukhukhumale
• Ukukhathala ngaso sonke isikhathi

Ukuhlolwa komzimba kuqinisekisa i-cyanosis. Izingane ezindadlana zingase zibe neminwe efana neklabhu.

Udokotela uzolalela inhliziyo namaphaphu nge-stethoscope. Imisindo yenhliziyo engajwayelekile, ukukhononda kwenhliziyo, nokuqhuma kwamaphaphu kungazwakala.

Ukuhlolwa kuzohluka ngokuya ngesizathu, kepha kungafaka:

• I-x-ray yesifuba
• Ukuhlola izinga le-oksijini egazini usebenzisa i-arterial blood test test noma ngokulihlola esikhunjeni nge-pulse oximeter
• Qedela ukubalwa kwegazi (CBC)
• I-ECG (electrocardiogram)
• Ukubheka ukwakheka kwenhliziyo nemithambo yegazi usebenzisa i-echocardiogram noma i-MRI yenhliziyo
• Ukudlulisa ishubhu elincane eliguquguqukayo (ipayipi) ohlangothini lwesokunene noma kwesobunxele senhliziyo, imvamisa kusuka ekuguleni (i-catheterization yenhliziyo)
• Ukuqapha oksijini okwedlulayo (i-pulse oximeter)
• I-Echo-Doppler

Ezinye izingane zingadinga ukuhlala esibhedlela ngemuva kokuzalwa ukuze zithole oksijini noma zifakwe emshinini wokuphefumula. Bangathola imishanguzo:

• Susa okunye uketshezi
• Siza ukupompa kwenhliziyo ngamandla
• Gcina imithambo ethile yegazi ivulekile
• Phatha ukushaya kwenhliziyo okungajwayelekile noma isigqi

Ukwelashwa okukhethwa kukho kwezifo zenhliziyo ezalwa kakhulu ukuhlinzwa ukulungisa isici. Kunezinhlobo eziningi zokuhlinzwa, kuya ngohlobo lokukhubazeka kokuzalwa. Ukuhlinzwa kungadingeka ngokushesha ngemuva kokuzalwa, noma kungabambezeleka izinyanga noma ngisho neminyaka. Okunye ukuhlinzwa kungahle kwenziwe lapho ingane ikhula.

Ingane yakho ingadinga ukuphuza amaphilisi amanzi (isisu) neminye imithi yenhliziyo ngaphambi noma ngemuva kokuhlinzwa. Qiniseka ukuthi ulandela isilinganiso esifanele. Ukulandela njalo umhlinzeki kubalulekile.

Izingane eziningi ezihlinzwe inhliziyo kumele zithathe ama-antibiotic ngaphambili, futhi kwesinye isikhathi ngemuva kokuthola umsebenzi wamazinyo noma ezinye izinqubo zokwelashwa. Qiniseka ukuthi unemiyalo ecacile evela kumhlinzeki wenhliziyo yengane yakho.

Buza umhlinzeki wengane yakho ngaphambi kokuthola noma yimiphi imigomo. Iningi lezingane lingalandela imihlahlandlela enconyelwe ukugonywa kwengane.

Umbono uncike ekuphazamisekeni okuthile nobukhulu bawo.

Izinkinga zesifo senhliziyo se-cyanotic zifaka:

• Isigqi senhliziyo esingajwayelekile nokufa okungazelelwe
• Isikhathi eside (esingapheliyo) umfutho wegazi ophezulu emithanjeni yegazi yamaphaphu
• Ukwehluleka kwenhliziyo
• Ukutheleleka enhliziyweni
• Unhlangothi
• Ukufa

Shayela umhlinzeki wakho uma ingane yakho ine:

• Isikhumba se-Bluish (cyanosis) noma isikhumba esimpunga
• Ubunzima bokuphefumula
• Ubuhlungu besifuba noma obunye ubuhlungu
• Isizungu, ukuquleka, noma ukushaya kwenhliziyo
• Izinkinga zokondla noma ukunciphisa ukudla
• Umkhuhlane, isicanucanu, noma ukuhlanza
• Amehlo noma ubuso obukhukhumale
• Ukukhathala ngaso sonke isikhathi

Abesifazane abakhulelwe kufanele bathole ukunakekelwa okuhle ngaphambi kokubeletha.

• Gwema ukusebenzisa utshwala nezidakamizwa ngesikhathi ukhulelwe.
• Tshela udokotela wakho ukuthi ukhulelwe ngaphambi kokuthatha noma yimiphi imithi oyibekelwe.
• Thola ukuhlolwa kwegazi ekuqaleni kokukhulelwa ukuze ubone ukuthi awunalo yini igciwane le-rubella. Uma ungavikelekile emzimbeni, kufanele ugweme noma yikuphi ukuvezwa i-rubella futhi kufanele ugonywe ngemuva nje kokubeletha.
• Abesifazane abakhulelwe abanesifo sikashukela kufanele bazame ukulawula kahle izinga labo likashukela egazini.

Ezinye izinto ezizuzwe njengefa zingadlala indima ekuzalweni kwesifo senhliziyo. Amalungu amaningi omndeni angathinteka. Uma uhlela ukukhulelwa, khuluma nomhlinzeki wakho mayelana nokuhlolwa kwezifo zofuzo.

Ukushiya kwesokudla senhliziyo kuye kwesokunxele; I-shunt ejikeleza kwesokudla iye kwesokunxele

• Inhliziyo - isigaba phakathi nendawo
• I-catheterization yenhliziyo
• Inhliziyo - ukubuka kwangaphambili
• I-Tetralogy of Fallot
• Ukubhuqa
• Isifo senhliziyo seCyanotic

UBernstein D. Isifo senhliziyo esizalwa naso seCyanotic: ukuhlolwa kwe-neonate egula kakhulu nge-cyanosis nokucindezeleka kokuphefumula. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, MBBS, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2019: isahluko 456.

ILange RA, iHillis LD. Isifo senhliziyo esizalwa naso. Ku: Bope ET, Kellerman RD, eds. Ukwelashwa Kwamanje kukaConn 2018. IPhiladelphia, PA: Elsevier; 2018: 106-111.

I-Webb GD, iSmallhorn JF, uTherrien J, uRedington AN. Isifo senhliziyo esizalwa naso esigulini esidala nesingane. 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 75.