Izinsizakalo zenhliziyo nemithambo yegazi

Isimiso somzimba senhliziyo, noma sokujikeleza kwegazi, senziwa ngenhliziyo, igazi, nemithambo yegazi (imithambo nemithambo).

Izinsizakalo zenhliziyo nemithambo yegazi ibhekisa egatsheni lezokwelapha eligxile ohlelweni lwezinhliziyo.

Umsebenzi omkhulu wenhliziyo ukupompa igazi elinomoya-mpilo emzimbeni ngemuva kokupompa igazi elingenawo umoya-mpilo emaphashini. Imvamisa ikwenza lokhu izikhathi ezingama-60 kuya kwayi-100 ngomzuzu, amahora angama-24 ngosuku.

Inhliziyo yenziwa ngamakamelo amane:

• I-atrium efanele ithola igazi elingenawo umoya-mpilo emzimbeni. Lelo gazi bese ligelezela ku-ventricle efanele, elimpompa liye emaphashini.
• I-atrium engakwesobunxele ithola igazi elinomoya-mpilo emaphashini. Ukusuka lapho, igazi ligobhoza liye ku-ventricle yangakwesobunxele, ekhipha igazi lisuke enhliziyweni liye kuwo wonke umzimba.

Ngokubambisana, imithambo yegazi nemithambo ibizwa ngokuthi uhlelo lwe-vascular. Ngokuvamile, imithambo yegazi isusa igazi lisuke enhliziyweni kanti imithambo ibuyisela igazi liye enhliziyweni.

Uhlelo lwezinhliziyo luhambisa umoya-mpilo, izakhi zomzimba, ama-hormone, nezinye izinto ezibalulekile kumaseli nasezitho zomzimba. Idlala indima ebalulekile ekusizeni umzimba ukuhlangabezana nezidingo zomsebenzi, ukuzivocavoca, kanye nengcindezi. Kuyasiza nokugcina ukushisa komzimba, phakathi kwezinye izinto.

UMUTHI WOKUPHAKATHI KWE-CARDIOVASCULAR

Imithi yenhliziyo ibhekisa egatsheni lezokunakekelwa kwezempilo eligxile ekwelapheni izifo noma izimo ezibhekene nezinhliziyo nezinhlelo zemithambo yegazi.

Izinkinga ezivamile zifaka:

• I-aneurysm yesisu esiswini
• Ukukhubazeka kwenhliziyo okuzalwa
• Isifo semithambo yegazi, kufaka phakathi i-angina nesifo senhliziyo
• Ukwehluleka kwenhliziyo
• Izinkinga ze-valve yenhliziyo
• Umfutho wegazi ophakeme kanye ne-cholesterol ephezulu
• Isigqi senhliziyo esingajwayelekile (arrhythmias)
• Isifo semithambo eseceleni (PAD)
• Unhlangothi

Odokotela ababandakanyeka ekwelapheni izifo ezijikeleza noma zemithambo yegazi zifaka:

• Ama-Cardiologists - Odokotela abathole ukuqeqeshwa okwengeziwe ekwelapheni ukuphazamiseka kwenhliziyo nemithambo yegazi
• Abahlinzayo be-Vascular - Odokotela abathole ukuqeqeshwa okwengeziwe ekuhlinzweni kwemithambo yegazi
• Abahlinzayo benhliziyo - Odokotela abathole ukuqeqeshwa okwengeziwe ekuhlinzweni okuhlobene nenhliziyo
• Odokotela bokunakekelwa okuyisisekelo

Abanye abahlinzeki bezempilo ababambe iqhaza ekwelapheni izifo ezijikeleza noma zemithambo yegazi zifaka:

• Abahlengikazi (ama-NPs) noma abasizi bodokotela (ama-PA), abagxila ezigulini zenhliziyo nemithambo yegazi
• Izazi zokudla okunomsoco noma izazi zokudla
• Abahlengikazi abathola ukuqeqeshwa okukhethekile ekuphathweni kweziguli ezinalezi zinkinga

Ukufanekisa izivivinyo ezingenziwa ukuxilonga, ukuqapha noma ukwelapha izifo zohlelo lokujikeleza kwegazi nemithambo yegazi zifaka:

• I-Cardiac CT
• I-MRI yezinhliziyo
• I-Coronary angiography
• I-CT angiography (CTA) kanye ne-magnetic resonance angiography (MRA)
• I-Echocardiogram
• Ukuhlolwa kwe-PET kwenhliziyo
• Ukuhlolwa kwengcindezi (izinhlobo eziningi zokuhlolwa kwengcindezi zikhona)
• I-Vascular ultrasound, efana ne-carotid ultrasound
• I-venous ultrasound yezingalo nemilenze

UKUHLOLA NOKUNGENELELA

Izinqubo ezingezinhle ezingenziwa zingenziwa ukuxilonga, ukuqapha noma ukwelapha izifo zenhliziyo nezinhlelo zemithambo yegazi.

Eziningi zalezi zinhlobo zezinqubo, i-catheter ifakwa ngesikhumba emgodini omkhulu wegazi. Ezimweni eziningi, izinqubo ezinjalo azidingi i-anesthesia ejwayelekile. Iziguli kaningi akudingeki zilale esibhedlela ubusuku bonke. Bayalulama ezinsukwini ezi-1 kuye kwezi-3 futhi imvamisa bangabuyela emisebenzini yabo ejwayelekile kungakapheli isonto.

Izinqubo ezinjalo zifaka:

• Ukwelashwa kwe-Ablation ukwelapha ama-arrhythmias enhliziyo
• I-Angiogram (kusetshenziswa ama-x-ray kanye nedayi yokuqhathanisa ejojowe ukuhlola imithambo yegazi)
• I-Angioplasty (isebenzisa ibhaluni elincane ukuvula ukuncipha esitsheni segazi) ngokubekwa noma ngaphandle kokuqina
• I-catheterization yenhliziyo (ukulinganisa izingcindezi ngaphakathi naseduze kwenhliziyo)

Ukuhlinzwa kwenhliziyo kungadingeka ukwelapha izinkinga ezithile zenhliziyo noma zemithambo yegazi. Lokhu kungafaka:

• Ukufakelwa kwenhliziyo
• Ukufakwa kwama-pacemaker noma ama-defibrillators
• Umthambo we-coronary ovulekile ovulekile futhi omncane owedlula
• Ukulungiswa noma ukushintshwa kwama-valve enhliziyo
• Ukwelashwa kokuhlinzwa kokukhubazeka kwenhliziyo okuzelwe

Ukuhlinzwa ngemithambo kusho izinqubo zokuhlinza ezisetshenziselwa ukwelapha noma ukuxilonga izinkinga ezitsheni zegazi, njengokuvaleka noma ukuqhekeka. Izinqubo ezinjalo zifaka:

• Ama-grafta we-arterial
• Ama-endarterectomies
• Ukulungiswa kwama-aneurysms (izingxenye ezivulekile / ezandisiwe) ze-aorta namagatsha awo

Izinqubo zingasetshenziswa futhi ukwelapha imithambo yegazi enikezela ubuchopho, izinso, amathumbu, izingalo nemilenze.

UKUVIMBELA KWENHLIZIYO NOKUVUSELELA

Ukuvuselelwa kwenhliziyo ukwelashwa okusetshenziselwa ukuvimbela isifo senhliziyo ukuba singabi sibi kakhulu. Imvamisa kunconywa ngemuva kwemicimbi emikhulu ehlobene nenhliziyo njengokuhlaselwa yinhliziyo noma ukuhlinzwa kwenhliziyo. Kungabandakanya:

• Ukuhlolwa kobungozi benhliziyo
• Ukuhlolwa kwezempilo kanye nokuhlolwa kwempilo
• Ukwelulekwa ngokudla okunomsoco kanye nendlela yokuphila, kubandakanya ukuyeka ukubhema nokufundiswa ngesifo sikashukela
• Ukuvivinya umzimba okugadiwe

Uhlelo lokujikeleza kwegazi; Uhlelo lwe-Vascular; Isistimu yenhliziyo

Iya MR, Starr JE, Satiani B. Ukuthuthuka nokusebenza kwezikhungo zemithambo yegazi ezinhlobonhlobo. Ku: Sidawy AN, Perler BA, ama-eds. Rutherford’s Vascular Surgery and Endovascular Therapy. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2019: isahluko 197.

AmaMills NL, Japp AG, uRobson J. Uhlelo lwezinhliziyo. Ku: Innes JA, Dover A, Fairhurst K, eds. Ukuhlolwa Kwemitholampilo iMacleod. Umhlaka 14. IPhiladelphia, PA: Elsevier Churchill Livingstone; 2018: isahluko 4.