I-Dextrocardia

I-Dextrocardia yisimo lapho inhliziyo ikhonjiswe khona ngakwesokunene sesifuba. Imvamisa, inhliziyo ikhomba ngakwesobunxele. Isimo sikhona ngesikhathi sokuzalwa (esibelethweni).

Phakathi namasonto okuqala okukhulelwa, inhliziyo yengane iyakhula. Kwesinye isikhathi, iyajika ukuze ikhombe ohlangothini lwesokunene sesifuba esikhundleni sohlangothi lwesobunxele. Izizathu zalokhu azicaci.

Kunezinhlobo eziningana ze-dextrocardia. Izinhlobo eziningi zibandakanya okunye ukukhubazeka kwenhliziyo nendawo yesisu.

Ohlotsheni olulula lwe-dextrocardia, inhliziyo iyisithombe sesibuko senhliziyo ejwayelekile futhi azikho ezinye izinkinga. Lesi simo asivamile. Uma lokhu kwenzeka, izitho zesisu namaphaphu kuzovame ukuhlelwa ngomfanekiso wesibuko. Isibonelo, isibindi sizoba ohlangothini lwesobunxele esikhundleni sokudla.

Abanye abantu abane-dextrocardia yesithombe sesibuko banenkinga ngezinwele ezinhle (i-cilia) ezihlunga umoya zingene emakhaleni nasemikhawulweni yomoya. Lesi simo sibizwa nge-Kartagener syndrome.

Ezinhlotsheni ezivame kakhulu ze-dextrocardia, kukhona nezinye izinkinga zenhliziyo. Okuvame kakhulu kulokhu kufaka:

• I-ventricle yangakwesokudla ephuma kabili (i-aorta ixhuma ku-ventricle engakwesokudla esikhundleni se-ventricle yesobunxele)
• I-Endocardial cushion defect (izindonga ezihlukanisa wonke amakamelo amane enhliziyo akhiwe kahle noma akekho)
• I-pulmonary stenosis (ukunciphisa i-valve yamaphaphu) noma i-atresia (i-valve yamaphaphu ayakheki kahle)
• I-ventricle eyodwa (esikhundleni sama-ventricles amabili, kukhona i-ventricle eyodwa)
• Ukushintshwa kwemikhumbi emikhulu (i-aorta ne-pulmonary artery ishintshiwe)
• Isici se-septal se-Ventricular (imbobo odongeni ehlukanisa ama-ventricles angakwesokudla nangakwesobunxele enhliziyo)

Izitho zesisu nesifuba ezinganeni ezine-dextrocardia zingase zingavamile futhi zingasebenzi kahle. Isifo esibi kakhulu esivela nge-dextrocardia sibizwa nge-heterotaxy. Kulesi simo, izitho eziningi azikho ezindaweni zazo ezijwayelekile futhi kungenzeka zingasebenzi kahle. Isibonelo, ubende kungenzeka bube bungekho ngokuphelele. Ubende yingxenye ebalulekile yamasosha omzimba, ngakho-ke izingane ezizalwa zingenalo lolu sengozini zisengozini yokungenwa yizifo ezibangelwa amagciwane nokufa. Ngenye indlela ye-heterotaxy, kukhona iziphethu eziningana, kodwa kungenzeka zingasebenzi kahle.

IHeterotaxy ingafaka futhi:

• Isistimu ye-gallbladder engavamile
• Izinkinga ngamaphaphu
• Izinkinga ngesakhiwo noma isikhundla samathumbu
• Izinkinga zenhliziyo ezinzima
• Ukungajwayelekile kwemithambo yegazi

Izici ezingaba yingozi ye-dextrocardia zifaka umlando womndeni waleso simo.

Azikho izimpawu ze-dextrocardia uma inhliziyo ijwayelekile.

Izimo ezingafaka i-dextrocardia zingadala lezi zimpawu ezilandelayo:

• Isikhumba esiluhlaza okwesibhakabhaka
• Kunzima ukuphefumula
• Ukwehluleka ukukhula nokuzuza isisindo
• Ukukhathala
• I-jaundice (isikhumba esiphuzi namehlo)
• Isikhumba esiphaphathekile (i-pallor)
• Izifo eziphindaphindiwe zesinus noma zamaphaphu

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu.

Izivivinyo zokuxilonga i-dextrocardia zifaka:

• I-x-ray yesifuba
• Ukuhlolwa kwe-CT kwenhliziyo
• I-Electrocardiogram
• I-MRI yenhliziyo
• I-Echocardiogram

Isibuko esiphelele se-dextrocardia esingenakho ukukhubazeka kwenhliziyo asidingi ukwelashwa. Kubalulekile, noma kunjalo, ukwazisa umhlinzeki wezokunakekelwa kwempilo yengane ukuthi inhliziyo isesandleni sokudla sesifuba. Lolu lwazi lungabalulekile kwezinye izivivinyo kanye nokuhlolwa.

Uhlobo lokwelashwa oludingekayo luxhomeke enhliziyweni noma ezinkingeni zomzimba ingane engaba nazo ngaphezu kwe-dextrocardia.

Uma ukukhubazeka kwenhliziyo kukhona ne-dextrocardia, ingane izodinga ukuhlinzwa. Izingane ezigula kakhulu zingadinga ukuphuza imithi ngaphambi kokuba zihlinzwe. Le mithi isiza ingane ukuthi ikhule ibe nkulu ngakho ukuhlinza kulula ukuyenza.

Imithi ifaka:

• Amaphilisi wamanzi (isisu)
• Izidakamizwa ezisiza ukupompa imisipha yenhliziyo ngamandla amakhulu (ama-inotropic agents)
• Izidakamizwa ezehlisa umfutho wegazi futhi zinciphise umthwalo enhliziyweni (ACE inhibitors)

Ingane nayo ingadinga ukuhlinzwa ukulungisa izinkinga ezithweni zesisu.

Izingane ezine-Kartagener syndrome zizodinga ukwelashwa okuphindaphindiwe ngama-antibiotic wezifo zesono.

Izingane ezine-spleen ezingekho noma ezingavamile zidinga ama-antibiotic wesikhathi eside.

Zonke izingane ezinokukhubazeka kwenhliziyo zingadinga ukuthatha ama-antibiotic ngaphambi kokuhlinzwa noma ukwelashwa kwamazinyo.

Izingane ezine-dextrocardia elula zinesikhathi esijwayelekile sokuphila futhi akufanele zibe nezinkinga ezihlobene nendawo yenhliziyo.

Lapho i-dextrocardia ivela nezinye iziphutha enhliziyweni nakwezinye izindawo emzimbeni, ukuthi ingane yenza kahle kangakanani kuncike ebukhulwini bezinye izinkinga.

Izingane nezingane ezingenabo ubende zingase zibe nokutheleleka okuvamile. Lokhu okungenani kungavinjelwa kancane ngemithi elwa namagciwane yansuku zonke.

Izinkinga zincike ekutheni i-dextrocardia iyingxenye yesifo esikhudlwana yini, nokuthi ngabe zikhona yini ezinye izinkinga emzimbeni. Izinkinga zifaka:

• Amathumbu avinjiwe (ngenxa yesimo esibizwa ngokuthi ukungasebenzi kahle kwamathumbu emathunjini)
• Ukwehluleka kwenhliziyo
• Ukutheleleka (i-heterotaxy engenayo ubende)
• Ukungabi nenzalo kwabesilisa (i-Kartagener syndrome)
• I-pneumonia ephindaphindiwe
• Ukutheleleka okuphindaphindiwe kwesono (i-Kartagener syndrome)
• Ukufa

Shayela umhlinzeki wakho uma ingane yakho:

• Kubonakala njengokuthola izifo njalo
• Kubonakala sengathi akunesisindo
• Amathayi kalula

Funa ukunakekelwa okuphuthumayo uma ingane yakho ine:

• Umbala oluhlaza okwesibhakabhaka esikhunjeni
• Ukuphefumula kanzima
• Isikhumba esiphuzi (i-jaundice)

Amanye ama-syndromes afaka i-dextrocardia angahle asebenze emindenini. Uma unomlando womndeni we-heterotaxy, khuluma nomhlinzeki wakho ngaphambi kokukhulelwa.

Azikho izindlela ezaziwayo zokuvimbela i-dextrocardia.Kodwa-ke, ukugwema ukusetshenziswa kwezidakamizwa ezingekho emthethweni (ikakhulukazi i-cocaine) ngaphambi nangesikhathi sokukhulelwa kunganciphisa ubungozi bale nkinga.

Khuluma nomhlinzeki wakho uma unesifo sikashukela. Lesi simo singafaka engcupheni yokuba nengane enezinhlobo ezithile ze-dextrocardia.

I-cyanotic heart defect - i-dextrocardia; Ukukhubazeka kwenhliziyo okuzalwa - i-dextrocardia; Isici sokuzalwa - i-dextrocardia

• I-Dextrocardia

IPark MK, i-Salamat M. Chamber okwenziwa kwasendaweni kanye nokungahambi kahle kwenhliziyo. Ku: Park MK, Salamat M, eds. I-Park's Pediatric Cardiology Yabasebenzi. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2021: isahluko 17.

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.