I-myocarditis - ezingane

I-myocarditis yezingane ukuvuvukala kwemisipha yenhliziyo enganeni noma enganeni esencane.

I-myocarditis ayivamile ezinganeni ezisencane. Kuvame kakhulu ezinganeni ezindala nakubantu abadala. Kuvame ukuba kubi kakhulu ezinganeni ezisanda kuzalwa nasezinsaneni ezisencane kunezingane ezingaphezulu kweminyaka emibili.

Izimo eziningi ezinganeni zibangelwa igciwane elifinyelela inhliziyo. Lokhu kungafaka:

• Igciwane lomkhuhlane
• Igciwane le-Coxsackie
• I-Parovirus
• I-Adenovirus

Kungabangelwa nokutheleleka kwamagciwane njengesifo seLyme.

Ezinye izimbangela ze-myocarditis yezingane zifaka:

• Ukungezwani komzimba nemithi ethile
• Ukuchayeka kumakhemikhali asemvelweni
• Ukutheleleka ngenxa yefungus noma izimuncagazi
• Imisebe
• Ezinye izifo (ukuphazamiseka komzimba) ezibangela ukuvuvukala emzimbeni wonke
• Ezinye izidakamizwa

Imisipha yenhliziyo ingalimala ngqo yigciwane noma amabhaktheriya alithelayo. Impendulo yomzimba womzimba nayo ingalimaza imisipha yenhliziyo (ebizwa nge-myocardium) ngenkathi kuliwa nokutheleleka. Lokhu kungaholela ezimpawu zokuhluleka kwenhliziyo.

Izimpawu zingaba mnene ekuqaleni futhi kube nzima ukuzibona. Kwesinye isikhathi ezinganeni ezisanda kuzalwa nezinsana, izimpawu zingavela ngokuzumayo.

Izimpawu zingafaka:

• Ukukhathazeka
• Ukwehluleka ukuchuma noma ukuthola isisindo esibi
• Ukondla ubunzima
• Imfiva nezinye izimpawu zokutheleleka
• Ukungabi nalutho
• Ukukhishwa komchamo ophansi (isibonakaliso sokwehla kokusebenza kwezinso)
• Okuphaphathekile, izandla nezinyawo ezipholile (uphawu lokujikeleza okungafanele)
• Ukuphefumula ngokushesha
• Ukushaya kwenhliziyo okusheshayo

Izimpawu ezinganeni ezingaphezu kweminyaka engu-2 zingafaka futhi:

• Ubuhlungu bendawo yaseBelly nesicanucanu
• Ubuhlungu besifuba
• Khwehlela
• Ukukhathala
• Ukuvuvukala (i-edema) emilenzeni, ezinyaweni, nasebusweni

I-myocarditis yezingane ingaba nzima ukuyixilonga ngoba izimpawu nezimpawu zivame ukulingisa ezinye izifo zenhliziyo namaphaphu, noma isifo esibi somkhuhlane.

Umhlinzeki wezokunakekelwa kwempilo angase ezwe ukushaya kwenhliziyo okusheshayo noma imisindo yenhliziyo engajwayelekile ngenkathi elalele isifuba sengane nge-stethoscope.

Ukuhlolwa ngokomzimba kungakhombisa:

• Uketshezi emaphashini nokuvuvukala emilenzeni ezinganeni ezindala.
• Izimpawu zokutheleleka, kufaka phakathi umkhuhlane kanye nokuqubuka.

I-x-ray yesifuba ingakhombisa ukukhuliswa (ukuvuvukala) kwenhliziyo. Uma umhlinzeki esola ukuthi i-myocarditis isuselwa ekuhlolweni nasesifubeni i-x-ray, i-electrocardiogram nayo ingenziwa ukusiza ukwenza ukuxilongwa.

Olunye uvivinyo olungadingeka lungafaka:

• Amasiko egazi ukuhlola ukutheleleka
• Ukuhlolwa kwegazi ukubheka amasosha omzimba alwa namagciwane noma imisipha yenhliziyo uqobo
• Ukuhlolwa kwegazi ukuhlola ukusebenza kwesibindi nezinso
• Qedela ukubalwa kwegazi
• I-biopsy yenhliziyo (indlela enembile kunazo zonke yokuqinisekisa ukuxilongwa, kepha akudingeki njalo)
• Ukuhlolwa okukhethekile ukuhlola ubukhona begciwane egazini (i-viral PCR)

Alikho ikhambi le-myocarditis. Ukuvuvukala kwemisipha yenhliziyo kuvame ukuhamba ngokwakho.

Inhloso yokwelashwa ukusekela ukusebenza kwenhliziyo kuze kube yilapho ukuvuvukala kuphelile. Izingane eziningi ezinalesi simo zingeniswa esibhedlela. Umsebenzi uvame ukudinga ukulinganiselwa ngenkathi inhliziyo ivuvuka ngoba ingayicindezela inhliziyo.

Ukwelashwa kungafaka:

• Ama-antibiotics ukulwa nokutheleleka kwamagciwane
• Imithi elwa nokuvuvukala ebizwa ngama-steroids ukulawula ukuvuvukala
• I-immunoglobulin (IVIG) efakwa ngaphakathi, umuthi owenziwe ngezinto (ezibizwa ngama-antibodies) umzimba owukhiqizayo ukulwa nezifo, ukulawula inqubo yokuvuvukala
• Ukusekelwa kwemishini kusetshenziswa umshini ukusiza ukusebenza kwenhliziyo (ezimweni ezimbi kakhulu)
• Imithi yokwelapha izimpawu zokwehluleka kwenhliziyo
• Imithi yokwelapha isigqi senhliziyo esingajwayelekile

Ukubuyiselwa kusuka ku-myocarditis kuncike embangela yenkinga nasempilweni ephelele yengane. Iningi lezingane zilulama ngokuphelele ngokwelashwa okufanele. Kodwa-ke, abanye bangaba nesifo senhliziyo esihlala njalo.

Izingane ezisanda kuzalwa zinengozi enkulu yezifo ezinzima kanye nezinkinga (kufaka phakathi ukufa) ngenxa ye-myocarditis. Ezimweni ezingavamile, ukulimala okukhulu emisipha yenhliziyo kudinga ukufakelwa inhliziyo.

Izinkinga zingafaka:

• Ukwandiswa kwenhliziyo okuholela ekunciphiseni ukusebenza kwenhliziyo (i-cardiomyopathy ehlanjululwayo)
• Ukwehluleka kwenhliziyo
• Izinkinga zesigqi senhliziyo

Shayela udokotela wezingane wengane yakho uma izimpawu noma izimpawu zalesi simo zenzeka.

Akukho ukuvimbela okwaziwayo. Kodwa-ke, ukuhlolwa nokwelashwa okusheshayo kunganciphisa ubungozi besifo.

• I-myocarditis

UKnowlton KU, Anderson JL, Savoia MC, Oxman MN. I-myocarditis ne-pericarditis. Ku: Bennett JE, Dolin R, Blaser MJ, ama-eds. Mandell, Douglas, kanye neBennett's Principles and Practice of Infectious Diseases. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2020: isahluko 84.

UMcNamara DM. Ukwehluleka kwenhliziyo njengomphumela we-myocarditis yegciwane kanye ne-nonviral. Ku: Felker GM, Mann DL, eds. Ukwehluleka Kwenhliziyo: Umngane Wezifo Zenhliziyo zeBraunwald. Umhla wesi-4. IPhiladelphia, PA: Elsevier; 2020: isahluko 28.

Umzali JJ, Ware SM. Izifo ze-myocardium. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 466.