Izimpawu Zomdlavuza Wenhliziyo: Ongakulindela

-Delile

• Ukubuka konke
• Izimpawu zomdlavuza wenhliziyo
• 1. Ukuvinjelwa kokugeleza kwegazi
• 2. Ukungasebenzi kwemisipha yenhliziyo
• 3. Izinkinga zokuqhuba
• 4. Umbungu
• 5. Izimpawu zesistimu
• Izimbangela zomdlavuza wenhliziyo
• Ukuxilongwa komdlavuza wenhliziyo
• Izinketho zokwelashwa komdlavuza wenhliziyo
• Izimila ze-Benign
• Izimila ezimbi
• Umdlavuza wenhliziyo wesibili
• Ukubukwa kwezicubu zenhliziyo
• Ukuthatha

Ukubuka konke

Izicubu zenhliziyo eziyinhloko ukukhula okungajwayelekile enhliziyweni yakho. Avamile kakhulu. Ngokusho kwe-European Society of Cardiology (ESC), batholakala ngaphansi kwesidumbu esisodwa kwabangu-2000.

Izicubu zenhliziyo eziyinhloko zingaba ezingezona umdlavuza (ezinobungozi) noma ezinomdlavuza (ezimbi). Izicubu ezinobungozi zikhula zibe izakhiwo eziseduze noma zisakazekele kwezinye izingxenye zomzimba (metastasize), kepha izicubu ezinobungozi azenzi. Iningi lezicubu zenhliziyo eziyisisekelo alinangozi. I-ESC ibika ukuthi amaphesenti angama-25 kuphela anobungozi.

Ezinye izicubu eziyingozi yilezi:

• ama-sarcomas (izicubu ezivela kwizicubu ezihlangene ezinjengemisipha yenhliziyo namafutha), njenge-angiosarcoma ne-rhabdomyosarcoma
• i-cardiac lymphoma eyinhloko
• i-pericardial mesothelioma

Ezinye izicubu ezinobungozi yilezi:

• myxoma
• i-fibroma
• rhabdomyoma

Umdlavuza wesibili wenhliziyo usetshenzisiwe noma usakazekele enhliziyweni kusuka ezithweni eziseduze Ngokusho kwe-ESC, kwenzeka kaningi kaningi kunama-tumors asenhliziyo kodwa namanje akuvamile.

Umdlavuza osakazeka noma uthinte inhliziyo kaningi yile:

• umdlavuza wamaphaphu
• i-melanoma (umdlavuza wesikhumba)
• umdlavuza webele
• umdlavuza wezinso
• i-leukemia
• I-lymphoma (lokhu kuhlukile kune-cardiac lymphoma eyinhloko ngoba iqala kuma-lymph nodes, ubende, noma umnkantsha esikhundleni senhliziyo)

Izimpawu zomdlavuza wenhliziyo

Izilonda zenhliziyo ezimbi zivame ukukhula ngokushesha futhi zihlasele izindonga nezinye izingxenye ezibalulekile zenhliziyo. Lokhu kuphazamisa ukwakheka kwenhliziyo nokusebenza, okudala izimpawu. Ngisho nesimila senhliziyo esibi singadala izinkinga nezimpawu ezinkulu uma sicindezela ezakhiweni ezibalulekile noma lapho sikhona siphazamisa ukusebenza kwenhliziyo.

Izimpawu ezikhiqizwa izicubu zenhliziyo zibonisa indawo yazo, usayizi, nokwakheka kwazo, hhayi uhlobo oluthile lwesicubu. Ngenxa yalokhu, izimpawu zesimila senhliziyo zivame ukulingisa ezinye, ezivamile, izimo zenhliziyo njengokuhluleka kwenhliziyo noma i-arrhythmias. Isivivinyo esibizwa nge-echocardiogram cishe ngaso sonke isikhathi singahlukanisa umdlavuza kwezinye izimo zenhliziyo.

Izimpawu zomdlavuza wenhliziyo oyinhloko zingahlukaniswa ngezigaba ezinhlanu.

1. Ukuvinjelwa kokugeleza kwegazi

Lapho isimila sikhula sibe kwelinye lamagumbi enhliziyo noma nge-valve yenhliziyo, singavimba ukugeleza kwegazi kudlule enhliziyweni. Izimpawu ziyahlukahluka kuye ngendawo yesimila:

• I-Atrium. Isimila egumbini eliphezulu lenhliziyo singavimba ukugeleza kwegazi kungene emakamelweni aphansi (ama-ventricles), kulingisa i-tricuspid noma i-mitral valve stenosis. Lokhu kungakwenza uzizwe uphefumula kanzima futhi ukhathele, ikakhulukazi ngesikhathi sokuzikhandla.
• Ventricle. Isimila esiku-ventricle singavimba ukuphuma kwegazi okuphume enhliziyweni, kulingise i-aortic noma i-pulmonary valve stenosis. Lokhu kungadala ubuhlungu besifuba, isiyezi nokuquleka, ukukhathala nokuphelelwa umoya.

2. Ukungasebenzi kwemisipha yenhliziyo

Lapho isimila sikhula sibe yizindonga zemisipha yenhliziyo, zingaba lukhuni futhi zingakwazi ukupompa igazi kahle, zilingise i-cardiomyopathy noma ukwehluleka kwenhliziyo. Izimpawu zingafaka:

• ukuphelelwa umoya
• imilenze evuvukele
• ubuhlungu besifuba
• ubuthakathaka
• ukukhathala

3. Izinkinga zokuqhuba

Izicubu ezikhula ngaphakathi kwemisipha yenhliziyo ezungeze uhlelo lokuqhuba kwenhliziyo zingathinta ukuthi inhliziyo ishaya ngokushesha kangakanani futhi njalo, ilingise ama-arrhythmias. Imvamisa, bavimba indlela ejwayelekile yokuqhuba phakathi kwe-atria nama-ventricles. Lokhu kubizwa ngenhliziyo. Kusho ukuthi ama-atria nama-ventricle ngamunye azibekela ijubane lawo esikhundleni sokusebenza ndawonye.

Kuye ngokuthi kubi kangakanani, kungenzeka ungakuqapheli, noma ungazizwa sengathi inhliziyo yakho yeqa amabhithi noma ishaya kancane. Uma ihamba kancane, ungaquleka noma uzizwe ukhathele. Uma ama-ventricles eqala ukushaya ngokushesha eyedwa, kungaholela ekufakweni kwe-ventricular fibrillation kanye nokuboshwa okungazelelwe kwenhliziyo.

4. Umbungu

Ucezu oluncane lwesimila oluqhamukayo, noma iqhwa legazi elenzekayo, lingahamba lisuke enhliziyweni liye kolunye uhlangothi lomzimba bese lilala emthanjeni omncane. Izimpawu zizohluka ngokuya ngokuthi i-embolus iphelela kuphi:

• Amaphaphu. I-embolism ye-pulmonary ingadala ukuphefumula, ubuhlungu besifuba obubukhali, nokushaya kwenhliziyo okungajwayelekile.
• Ubuchopho. Isifo sohlangothi esingumfuziselo sivame ukudala ubuthakathaka noma ukukhubazeka ohlangothini olulodwa lomzimba, ubuso obusohlangothini olulodwa, izinkinga zokukhuluma noma ukuqonda amagama akhulunyiwe noma abhaliwe, nokudideka.
• Ingalo noma umlenze. I-embolism ye-arterial ingaholela esithweni esibandayo, esibuhlungu, nesingashayi.

5. Izimpawu zesistimu

Izicubu ezimbalwa zenhliziyo eziyinhloko zingadala izimpawu ezingafani ngqo, zilingise ukutheleleka. Lezi zimpawu zingafaka:

• umkhuhlane namakhaza
• ukukhathala
• ukujuluka ebusuku
• ukuncipha komzimba
• ubuhlungu obuhlangene

Izilonda ze-metastatic zomdlavuza wesibili wenhliziyo zivame ukuhlasela ulwelwesi oluzungeze ingaphandle lenhliziyo (pericardium). Lokhu kuvame ukuholela ekwakhiweni koketshezi oluzungeze inhliziyo, kwakheke ukubola okuyingozi kwe-pericardial.

Njengoba inani loketshezi landa, licindezela enhliziyweni, kunciphise inani legazi elingalipompa. Izimpawu zifaka phakathi ubuhlungu besifuba obukhali njengoba uphefumula futhi uphefumula kancane, ikakhulukazi uma ulala phansi.

Ingcindezi enhliziyweni ingakhuphuka kakhulu kuze kuphume igazi elincane. Lesi simo esisongela impilo sibizwa nge-cardiac tamponade. Ingaholela kuma-arrhythmias, ukushaqeka, nokuboshwa kwenhliziyo.

Izimbangela zomdlavuza wenhliziyo

Odokotela abazi ukuthi kungani abanye abantu bethola umdlavuza wenhliziyo kanti abanye abawutholi. Kunezici ezimbalwa kuphela eziyingozi ezaziwayo zezinhlobo ezithile zamathumba enhliziyo:

• Ubudala. Ezinye izimila zenzeka kaningi kubantu abadala, kanti ezinye zivame ukwenzeka ezinganeni nasezinganeni.
• Ufuzo. Abambalwa bangakwazi ukugijima emindenini.
• Ama-syndromes womdlavuza wezofuzo. Iningi lezingane ezine-rhabdomyoma zine-tubular sclerosis, isifo esibangelwa ukuguqulwa (kuguquka) ku-DNA.
• Amasosha omzimba alimele. I-cardiac lymphoma eyinhloko yenzeka kaningi kubantu abanamasosha omzimba angasebenzi kahle.

Ngokungafani ne-pleural mesothelioma eyenzeka kulayini (mesothelium) wamaphaphu, ukuxhumana phakathi kokuvezwa kwe-asbestos kanye ne-pericardial mesothelioma akukasungulwa.

Ukuxilongwa komdlavuza wenhliziyo

Ngenxa yokuthi zivame kakhulu futhi izimpawu zivame ukufana nezimo zenhliziyo ezivamile, izicubu zenhliziyo kungaba nzima ukuzithola.

Ukuhlolwa okuvame ukusetshenziselwa ukuthola umdlavuza wenhliziyo kufaka:

• I-Echocardiogram. Lokhu kuhlolwa kusebenzisa umsindo ukudala isithombe esihambayo esibonisa ukwakheka nokusebenza kwenhliziyo. Yisivivinyo esivame ukusetshenziswa kakhulu ukuxilongwa, ukuhlela ukwelashwa, nokulandelwa minyaka yonke.
• Iskena se-CT. Lezi zithombe zingasiza ukuhlukanisa izicubu ezinobungozi nezibi.
• I-MRI. Lokhu kuskena kunikeza izithombe ezinemininingwane eminingi yesimila, okungasiza udokotela wakho ukuthi anqume uhlobo lwaso.

Isampula lesicubu (i-biopsy) imvamisa alitholakali ngoba i-imaging ingahle inqume uhlobo lwe-tumor, futhi inqubo ye-biopsy ingasabalalisa amangqamuzana omdlavuza.

Izinketho zokwelashwa komdlavuza wenhliziyo

Uma kunokwenzeka, ukususwa kokuhlinzwa kungukwelashwa kokuzikhethela kwazo zonke izicubu zenhliziyo eziyinhloko.

Izimila ze-Benign

• Eziningi zazo zingalapheka uma isimila singasuswa ngokuphelele.
• Lapho isimila sikhulu kakhulu noma kunezimila eziningi, ukususa ingxenye yaso engekho ngaphakathi kwezindonga zenhliziyo kungathuthukisa noma kuqede izimpawu.
• Ezinye izinhlobo zingalandelwa ngama-echocardiograms waminyaka yonke esikhundleni sokuhlinzwa uma zingabangeli izimpawu.

Izimila ezimbi

• Ngoba zikhula ngokushesha futhi zihlasela izakhiwo zenhliziyo ezibalulekile, kungaba nzima kakhulu ukuzelapha.
• Ngeshwa, iningi alitholakali kuze kube yilapho ukukhishwa kokuhlinzwa kungasenakwenzeka.
• I-Chemotherapy kanye nokwelashwa ngemisebe kwesinye isikhathi kusetshenziselwa ukuzama ukwehlisa ukukhula kwesimila nokwenza ngcono izimpawu (ukunakekelwa kwe-palliative), kepha kaningi akusebenzi kumdlavuza wenhliziyo oyinhloko.

Umdlavuza wenhliziyo wesibili

• Ngesikhathi kutholakala imastastase yenhliziyo, umdlavuza uvame ukusabalala nakwezinye izitho futhi awelapheki.
• Isifo se-Metastatic enhliziyweni asikwazi ukukhishwa ngokuhlinzwa
• Ukunakekelwa kwe-palliative nge-chemotherapy kanye ne-radiation therapy kuvame ukuphela kwendlela.
• Uma kuvela i-pericardial effusion, ingasuswa ngokubeka inaliti noma idreyini encane eqoqweni le-fluid (pericardiocentesis).

Ukubukwa kwezicubu zenhliziyo

Umbono awumuhle ngezimila zenhliziyo eziyingozi. Ucwaningo olulodwa lubonise amazinga alandelayo okusinda (amaphesenti abantu abaphilayo ngemuva kwesikhathi esinikeziwe):

• unyaka owodwa: amaphesenti angama-46
• iminyaka emithathu: amaphesenti angama-22
• iminyaka emihlanu: amaphesenti ayi-17

Umbono ungcono kakhulu kwizicubu ezinobungozi. Omunye uthole ukuthi isilinganiso sokusinda esimaphakathi kwaba:

• Izinyanga ezingu-187.2 zezimila ezinobungozi
• Izinyanga ezingama-26.2 zamathumba amabi

Ukuthatha

Umdlavuza wenhliziyo oyinhloko ungaba isimila esiyingozi noma esibi noma isimila sesibili se-metastatic. Izimpawu zincike kusayizi nendawo yesimila futhi zilingise izimo zenhliziyo ezivamile.

Umdlavuza wenhliziyo oyinhloko onobungozi unesimo esingesihle kepha uyivelakancane ngokweqile. Izicubu ze-Benign zivame kakhulu futhi zingelashwa ngokuhlinzwa.