Mwachidule
Zovuta zokhudzana ndi matenda a mtima ndizosazolowereka kwambiri pamagulu atatu a mtima, kapena matenda a minofu ya mtima. Magulu awiriwa ali ndi mtima wambiri wodwalayo , komanso hypertrophic cardiomyopathy .
Kulepheretsa munthu kukhala ndi mtima wokhudzana ndi matenda n'kofunika chifukwa nthawi zambiri kumapangitsa kuti mtima ukhale wolephera , ndipo malinga ndi chifukwa chomwe chimayambitsa vutoli, mtima ukhoza kukhala wovuta kuchiritsa.
Chifukwa chithandizo cha matendawa chikhoza kukhala chonyenga, aliyense amene ali ndi vuto lokhazika mtima pansi ayenera kukhala pansi pa chisamaliro cha katswiri wa mtima.
Tanthauzo
Chifukwa chodziletsa mtima, chifukwa cha zifukwa zina mtima umakhala ndi "kuuma" kosazolowereka. Ngakhale kuti minofu ya mtima yolimba imatha kugwira ntchito bwino, ndipo motero imatha kupopera magazi, sungathe kumasuka bwino nthawi ya diastolic ya kumenya mtima. (Diastole ndi gawo la "kudzazidwa" kwa mpweya wa mtima - nthawi yomwe imakhala pakati pa mtima, pamene ziphuphu zimadzazidwa ndi magazi.) Kulephera kwachisangalalochi kumapangitsa kuti zikhale zovuta kuti zinyamazi zikhale ndi magazi okwanira pa diastole.
Kuletsedwa kwa mtima (zomwe zimapangitsa kuti vutoli likhale dzina) zimayambitsa magazi kuti "abwerere" pamene akuyesera kulowetsa m'mimba, zomwe zingabweretse chisokonezo m'mapapo ndi ziwalo zina.
Dzina lina loletsa kuletsa mtima pa diastole ndi "kutayika kwa diastolic," ndipo mtundu wa mtima umene umatulutsa umatchedwa diastolic mtima kulephera.
Kwenikweni, kuletsa mtima kwa mtima ndi chimodzi mwa zifukwa zambiri zomwe zimayambitsa mtima wa diastolic, ngakhale kuti ndi yosawerengeka.
Zimayambitsa
Pali zifukwa zingapo zomwe zingabweretse mavuto osokoneza bongo. Nthawi zina, palibe chifukwa chodziwikiratu chomwe chimawoneka kuti, "chiwerengero chodziletsa" chimatchulidwa kuti "chidziwitso." Komabe, kudziletsa kwapachirombo koyenera kumayenera kupezeka kokha ngati zifukwa zina zomwe zingapangidwe zakhala zikuyang'anidwa, ndipo zimatulutsidwa kunja.
Zifukwa zina izi ndizo:
- Matenda opatsirana monga amyloidosis , sarcoidosis , matenda a Hurler , matenda a Gaucher ndi kulowera mafuta.
- Matenda ambiri achibale omwe ali ndi chibadwa, kuphatikizapo pseuoxanthoma elasticum.
- Matenda osungirako kuphatikizapo Fabry matenda , glycogen yosungirako matenda, ndi hemochromatosis .
- Zochitika zina zosiyana monga scleroderma , hypereosinophilic syndrome , endomyocardial fibrosis, matenda a carcinoid , khansa ya metastatic, mankhwala a radiation kapena chemotherapy.
Zomwe matenda onsewa amachititsa kuti azikhala mofanana ndikuti amachititsa njira zina zomwe zimalepheretsa kugwira ntchito kwa minofu ya mtima, monga kusayendetsa maselo osadziwika, kapena malipiro osadziwika. Njirazi zimapangitsa kuti zisokoneze kwambiri ndi kupweteka kwa minofu ya mtima, koma zimachepetsa kutsika kwa minofu ya mtima ndipo motero amaletsa kudzaza kwa mimba.
Zizindikiro
Zizindikiro zomwe anthu amakumana nazo ndi zolepheretsa kugonana zimakhala zofanana ndi zizindikiro zomwe zimachitika ndi mitundu ina ya mtima wosalimba . Zizindikiro zimayambira chifukwa cha kusokonezeka kwa mapapo, kusokonezeka kwa ziwalo zina, komanso kulephera kuwonjezera kuchuluka kwa magazi pamapope a mtima pamene akuyesera.
Chifukwa chake, zizindikiro zodziwika kwambiri ndi zovuta zowonongeka ndi dyspnea (kupuma pang'ono), edema (kutupa kwa mapazi ndi mabotolo), kufooka, kutopa, kulekerera kwakukulu kwa kuchita masewera olimbitsa thupi, ndi kupatsa . Polimbana ndi matenda osokoneza bongo, kuyanjana kwa ziwalo za m'mimba kungathe kuchitika, kutulutsa chiwindi chofutukuka ndi nthenda, ndi ascites (kutuluka kwa madzi m'mimba.)
Kudziwa
Monga momwe zimakhalira ndi zovuta za mtima, kuti munthu adziwe kuti ali ndi vutoli, amadalira kuti dokotala adziŵe kuti mwina vutoli likhoza kukhalapo pochita mbiri yachipatala ndi kuunika.
Anthu omwe ali ndi vuto lopweteka kwambiri la mtima akhoza kukhala ndi tachycardia yachibale (kuthamanga kwa mtima mofulumira) pa mpumulo, ndi kusokonezeka kwa mitsempha m'khosi. Zomwe zimapezeka, komanso zizindikilo, zimakhala zofanana ndi zomwe zimawonedwa ndi zovuta zowonongeka . Ndipotu, kusiyanitsa zovuta zokhudzana ndi matenda osokoneza bongo kuchokera ku zovuta zowonongeka ndizovuta kwambiri zomwe akatswiri a cardiologists amakumana nazo pamayesero awo ovomerezeka. (Pa mayesero, yankho likugwirizana ndi mtima wa esoteric womwe umamveka chifukwa cha zikhalidwe ziwirizi - "s3 gallop" ndi zovuta zokhudzana ndi mtima wotsutsana ndi "kugogoda" ndi zovuta zowonongeka.)
Zomwe zimawoneka kuti zimapangitsa kuti munthu asamangokhalira kudwala matendawa amatha kutsimikiziridwa pochita zojambulajambula , zomwe zimawonetsa kuwonongeka kwa diastolic ndi umboni wodzetsa kulemba kwa mpweya. Ngati vuto lalikulu ndi matenda opatsirana monga amyloidosis, mayeso a echo angasonyezenso umboni wosadziwika bwino m'matumbo a ventricular. Kujambula kwa MRI ya mtima kungathandizenso kupanga matendawa, ndipo nthawi zina, kungathandize kuzindikira chomwe chimayambitsa. Nthenda yamtima ya mitsempha ingathandizenso kuti muzindikire ngati matenda opatsirana kapena osungirako akupezeka.
Chithandizo
Ngati chinthu chachikulu chomwe chimapangitsa kuti munthu asamangokhalira kudwala matendawa, adziwongolera mofulumira chifukwa chothandizira kuti asinthe kapena kusokoneza chizoloŵezi chokhazikitsa mtima. Mwamwayi, palibe mankhwala enieni omwe amatsutsana mwachindunji ndi zovuta zowononga zokha.
Kusamalira kuchepetsa matendawa kumayendetsa kuyendetsa mpweya wabwino ndi edema pofuna kuchepetsa zizindikiro. Izi zimachitika pogwiritsa ntchito mankhwala ambiri omwe amagwiritsidwa ntchito pamtima chifukwa cha kuchepa kwa mtima .
Diuretics , monga Lasix (furosemide), amakonda kupereka chindunji chodziŵika bwino pochitira anthu zinthu zolepheretsa kugonana. Komabe, n'zotheka kupanga anthu omwe ali ndi matendawa "owuma kwambiri" ndi opatsa mavitamini, kupititsa patsogolo kudzazidwa kwa zamoyo zam'mimba nthawi ya diastole. Kuyang'anitsitsa bwino matenda awo n'kofunika, kuyeza kulemera kwake tsiku ndi tsiku komanso nthawi zonse kufufuza mayesero a magazi kuti apeze umboni wosasintha kwa madzi. Mlingo woyenera wa diuretics ungasinthe pakapita nthawi, kotero kusamala kumeneku ndikofunikira nthawi zonse.
Kugwiritsira ntchito kansalu ka calcium kungakhale kothandiza mwa kusintha mwachindunji ntchito ya diastolic ya mtima, komanso pang'onopang'ono kuthamanga kwa mtima kuti mulole nthawi yambiri yodzaza zinyama pakati pa zida za mtima. Pazifukwa zofanana, beta-blockers ingathandizenso.
Pali umboni wina wosonyeza kuti ACE inhibitors angakhale opindulitsa kwa anthu ena omwe amaletsa mtima, mwina mwa kuchepetsa kupsinjika kwa mtima.
Ngati matenda a atrial alipo, ndikofunika kuti muyambe kuyima mtima kuti mulole nthawi yokwanira kudzaza zinyama. Kugwiritsiridwa ntchito kwa kaccium channel blockers ndi beta blockers kungathe kukwaniritsa cholinga ichi.
Ngati mankhwala azachipatala sathanso kuchepetsa zizindikiro za kuchepetsa kupweteka kwa mtima, kusintha kwa mtima kungakhale chinthu chomwe chiyenera kuganiziridwa.
Zomwe anthu amakhulupirira zokhudzana ndi matendawa zimakhala zovuta kwambiri kwa amuna, mwa anthu oposa zaka makumi asanu ndi awiri, ndi anthu omwe mtima wawo umayambitsidwa chifukwa cha matenda osowa, monga amyloidosis.
Chidule
Kuletsa kugwiritsira ntchito mtima ndi njira yosazolowereka ya mtima. Aliyense amene ali ndi vutoli amafunikira ntchito yothandizira yachipatala kuti ayang'anire zifukwa zomwe zimayambitsa, komanso amafunikira chithandizo chamankhwala mosamala komanso chokhazikika kuti athe kuchepetsa zizindikiro komanso kukwaniritsa zotsatira za nthawi yaitali.
> Zotsatira:
> Elliott P, Andersson B, Arbustini E, et al. Chiwerengero cha Cardiomyopathies: Position Statement kuchokera ku European Society Of Cardiology Gulu logwira ntchito pa Myocardial ndi Pericardial Diseases. Mtima; 29: 270.
> Karamitsos TD, Francis JM, Myerson S, et al. Udindo wa Maginito Magnetic Resonance Imaging In Heart Failure. J Am Coll Cardiol 2009; 54: 1407.
> Kushwaha SS, Fallon JT, Fuster V. Zowonongeka Kwambiri. N Engl J Med 1997; 336: 267.