Kulephera kwa mtima ndi chikhalidwe chomwe mtima sungathe kugwira ntchito yofunikira kuti ukhale ndi zosowa za thupi. Zizindikiro zowonjezereka zimaphatikizapo kupuma pang'ono ndi kutopa. Ngakhale kuti ikhoza kuyendetsedwa ndi mankhwala ndipo, nthawi zina, opaleshoni kapena njira zina, kuperewera kwa mtima ndi vuto lalikulu lomwe likukhudzana ndi chiopsezo cha imfa m'zaka zisanu kapena khumi.
Kulephera kwa mtima ndi zotsatira za mapeto a moyo wamtima wautali, monga matenda a mitsempha ya m'mimba komanso mtima wosagwirizana.
Pali ma syndromes awiri omwe amagwiritsidwa ntchito ndi mtima kulephera:
Kusweka mtima kwa mtima : Izi ndizo zomwe anthu akunena pamene akulankhula za kulephera kwa mtima. Ndi mtundu uwu, ntchito yofooka yamtima imayambitsa chisokonezo cha magazi m'mapapo ndi thupi lonse. Zakale zimakhala ndi mpweya wochepa, pamene mapetowa amachititsa kutupa kwa miyendo komanso mwina manja.
Kutsika kochepa mtima kusalimba: Nthawi zina, anthu omwe ali ndi vuto la mtima akhoza kukhala ndi mpweya wochepa kapena wopanda mapapo. Muzochitika izi, vuto lalikulu limakhala kuti minofu ya mtima yayamba kwambiri moti mtima sungathe kupopera magazi okwanira ku ziwalo za thupi.
Anthu omwe mtima wawo umalephera kwenikweni kutulutsa mtima mtima kulephereka kukhala ndi mphamvu yotsika ya magazi, kumutu, ndi syncope.
Kutsika kochepa mtima kusagonjetsa kawirikawiri ndi chizindikiro cha mtima wosagwedezeka kwambiri ndipo umagwirizanitsidwa ndi matenda ovuta kwambiri.
Zizindikiro
Kulephera kwa mtima koyamba kungabweretse zizindikiro zosiyanasiyana . Ngati mukuyamba kufooketsa mtima, ngakhale pachiyambi, muli ndi mwayi wochuluka kuti mwakhala mukudwala matenda a mtima kwa zaka zambiri.
Kulephera kwa mtima kumakhudza akuluakulu koma kumachitika kwa ana chifukwa cha matenda a mtima (congenital).
Zizindikiro zofala kwambiri za matenda a mtima ndizo:
- Dyspnea : Kupuma pang'ono, makamaka pakuchita mwakhama
- Edema: Kutupa, kawirikawiri miyendo ndi mabotolo. Edema ikhoza kukhala pitting edema yomwe imadziwika ndi chidziwitso mu malo otumphuka pambuyo poyesedwa, nthawi zambiri kumakhala kwa mphindi zingapo.
- Kufooka ndi kutopa, makamaka ndi khama
- Kuthamanga mobwerezabwereza
- Kusokonezeka chifukwa cha kupuma pang'ono
- Kuthamanga kwa magazi
- Lightheadedness
Kwa anthu ambiri omwe ali ndi vuto la mtima, dyspnea ndi edema ndizozizindikiro kwambiri. Mpweya wochepa umatha kukhala ndi malo ena, ndipo mungathe kupeza zina kapena zonsezi:
- Orthopnea (kupuma pang'ono komwe kumachitika pamene wagona)
- Paroxysmal usiku dyspnea kapena PND, yomwe imapezeka mwadzidzidzi pakati pa tulo
- Bendopnea , yomwe imapezeka pamene ikugwedezeka
Zizindikiro ndizovuta kwambiri ndipo zimapitirizabe kulephera kwa mtima, zomwe zimatchedwanso ESRD (kutha kwa mtima mtima kulephera). Kuonjezera apo, pamene vuto la mtima lifika pamapeto pamtima mtima, zizindikiro zina zikuyembekezeredwa, monga:
- Kupuma mpumulo pa mpumulo
- Kufooka ndi kutopa, ngakhale popanda khama
- Chisokonezo chimene mtima wanu ukuthamanga
- Kupuma ndi kukakokera
- Kuchepetsa njala kapena kusowa kwa njala
- Syncope
- Kusokonezeka
Zimayambitsa
Pali mitundu yambiri ya kulephera kwa mtima ndipo onse amadziwika kuti akulephera kupopera minofu ya mtima, zomwe zimabweretsa kusungunuka kwa madzi. Kuwonjezeka kwa madzimadzi komwe kumawonekera kumayambitsa dyspnea ndi edema ya mtima kulephera. Kukumana kwa madziku kumayambitsanso kusokonezeka, komwe kumakhala kofala kwambiri m'mapapu ndi m'munsi mwake, kuchititsa mpweya wochepa ndi mphamvu yochepa.
Zomwe zimayambitsa vuto la mtima zimaphatikizapo:
Kusokonezeka kwa mtima: Kusokonezeka kwa mtima ndiko kutha kwa matenda akuluakulu a mtima, monga matenda a mitsempha yambiri komanso matenda a mtima wa valvular. Zimapezeka pamene matenda oopsa a mtima amatha kufooketsa kwambiri minofu ya mtima.
Hypertrophic cardiomyopathy: Mankhwala a hypertrophic cardiomyopathy kawirikawiri amakhala ndi chibadwa ndipo nthawi zambiri amathamanga m'mabanja. Amadziwika ndi kuphulika kwa minofu ya mtima, zomwe zimabweretsa zovuta kwambiri.
Kulephera kwa Diastolic: Kusokonezeka kwa Diastolic kumakhala kofanana ndi hypertrophic cardiomyopathy chifukwa chakuti zimayambitsa kuuma kwa minofu ya mtima, zomwe zimapangitsa kuti munthu asabweretse mtima. Koma mosiyana ndi hypertrophic cardiomyopathy, kulephera mtima kwa mtima wa diastolic nthawi zambiri sikukuphatikizana ndi kuphulika kwa minofu ya mtima ndipo saganiziridwa kuti ndi matenda a chibadwa. Zimakhala zikuchitika kwa anthu achikulire, kawirikawiri akazi ndi anthu omwe ali ndi kuthamanga kwa magazi. Amadziwika ndi maulendo amodzi mwadzidzidzi a mpweya wochepa chifukwa cha kupweteka kwa mapapo.
Palinso mavuto ena azachipatala omwe angathenso kuwatsogolera kapena kuthandizira kukhumudwa mtima, kuphatikizapo matenda a mtima, kuthamanga kwa magazi, matenda a mtima wamagetsi, kusuta fodya, kunenepa kwambiri, shuga, chemotherapy, ndi nkhawa.
Kudziwa
Ngati muli ndi zizindikiro za kufooka kwa mtima, dokotala wanu adzagwiritsa ntchito njira zingapo kuti adziwe ngati mtima uli chifukwa cha zizindikiro zanu. Kuyezetsa magazi kumaphatikizapo:
Kuyezetsa thupi: Kawirikawiri dokotala wanu amatha kumva chisokonezo mwakumvetsera mapapu anu ndikuwona zizindikiro za mtima wosalimba kapena zovuta za mtima pomvera mtima wanu.
Chifuwa cha X-ray: Chifuwa cha X-ray chingasonyeze kuti muli ndi mtima wochulukitsa kapena zizindikiro za kupweteka kwa mapapo.
Echocardiogram: Kutayika ndi kufookera kwa ventricle kumanzere nthawi zambiri kumayesedwa poyesa kachigawo kakang'ono ka ventricular ejection . Chikondwerero cha ejection chimayeza kuchuluka kwa magazi omwe amachitikira ndi ventricle ya kumanzere yomwe imachotsedwa ndi mtima uliwonse. Kawirikawiri, kachigawo ka ejection ndi 50 peresenti kapena kuposa. Ndi kuchepa mtima kwa mtima, mtengo umenewo umachepa.
Mayesero a magazi: Mayesero a magazi sali oyenera kuwonedwa kuti ndi oyenerera pa matenda a mtima. B-mtundu wa natriuretic peptide (BNP), kuyesa magazi komwe kungathandize madokotala kusankha ngati mtima ukuchitika, angaganizidwe nthawi zina.
Chithandizo
Mwamwayi, kupita patsogolo kwakukulu kumapangidwa pochiza mtima kulephera . Ndi mankhwala opweteka, zizindikiro zonsezi ndi chiopsezo chakufa zingathe kuchepetsedwa kwambiri. Mankhwala, komanso njira zina, zingathandizire zizindikiro ndi kuonjezera kupulumuka kwa anthu omwe ali ndi mtima wolephera.
Mankhwala omwe amagwiritsidwa ntchito pochiza mtima kulephera ndi awa:
- ACE (enzyme-converting enzyme) inhibitors: ACE inhibitors kuletsa mapangidwe a angiotensin II. Mankhwalawa amachepetsa kuthamanga kwa magazi ndipo amachepetsa kusungunuka kwa sodium kwa anthu omwe ali ndi mtima wolephera.
- Ophwanya Beta: Otseka Beta amalepheretsa zotsatira za adrenaline pamtima kuti achepetse kupanikizika kochulukira pa mtima wolephera. Mankhwalawa amagwiritsidwa ntchito mobwerezabwereza chifukwa cha kuchepa kwa mtima.
- Diuretics: Kawirikawiri amatchedwa "mapiritsi a madzi," mankhwalawa amachititsa thupi kutaya madzi pogwira impso. Zotsatirazi zimachepetsanso kusungirako madzi ndi edema.
Ndondomeko zingathenso kugwiritsidwa ntchito kwa mtima wosalimba, koma sikuti aliyense amene ali ndi vuto la mtima amayenera kupindula. Kuwonjezera apo, anthu ena omwe ali ndi vuto la mtima sangakhale ndi thanzi labwino kuti athe kulekerera njirazi.
Malingana ndi ntchito yanu yamtima, mukhoza kukambirana njirazi ndi dokotala wanu.
- Pacemaker: A pacemaker ndi chipangizo chomwe chimalimbikitsa mtima kupopera. Kawirikawiri, amachititsa kuti mtima ukhale umodzi. Pochiza mtima kusagwirizana, komabe, pacemaker imayambitsa mbali yakumanja ndi yamanzere ya mtima. Izi kawirikawiri zimatchedwa CRT (mankhwala opatsirana pogwiritsa ntchito mtima).
- Kuika pamtima: Kuika mtima kumalo osungira mtima kumakhala ndi mtima umene ungagwire ntchito bwino. Iyi si njira yophweka pa zifukwa zingapo. Ngati muli ndi vuto la mtima, thanzi lanu lingakulepheretseni kuti mulekerere kukula kwa njirayi. Ndipo, popatsidwa kuti mufunikira mtima wopereka kuchokera kwa wothandizira wathanzi, palibe ziwalo zambiri zowonjezera.
Kulimbana
Kulephera kwa mtima kumapangitsa kuti mukhale ndi zochepa pazochita zanu, komanso kutopa. Kulimbana ndi kufooka kwa mtima kumafuna kusintha kwa kulingalira, komanso kulingalira.
Kusintha kwa moyo kumaphatikizapo kuonetsetsa kuti simukuchita nawo zinthu zomwe zingawononge mkhalidwe wanu, komanso kutenga zinthu zomwe zingakulitse thanzi lanu.
Njira zina zofunika ndizo:
Zizolowezi: Kusuta ndi kumwa mowa zimagwirizanitsa ndi matenda a mtima ndipo zingathe kulemberatu chikhalidwe ngati muli nacho kale, choncho ndi bwino kusiya ntchito izi ngati muli ndi mtima wolephera.
Kusamalira zakudya / mchere: Kusunga chakudya choyenera ndi kofunikira poyang'anira kulephera kwa mtima. Ndikofunika kupeza makilogalamu okwanira ndi zakudya kuti mukhalebe ndi mphamvu. Mwinanso mungafunike kukumana ndi katswiri wa zamaphunziro kuti mupeze uphungu wokhudza nkhani zina monga kuchepetsa kulemera, kuchepetsa mchere, ndi kuchepetsa madzi. Zakudya zochepa za mchere zingathandize kuchepetsa mphamvu zamadzimadzi zomwe zimachitika ndi matenda a mtima.
Kuthamanga kwa kulemera kwa thupi: Mtima wofooka umene umayambitsa matenda a mtima sungakhoze kulekerera zofuna zomwe zimaikidwa ndi vuto la kulemera kwina. Kukhalabe ndi kulemera kwakukulu kungathandize kuchepetsa ntchito yowonjezera yomwe ili yovuta kwa mtima wolephera kuti mukhale nawo.
Kuchita masewera olimbitsa thupi: Kuchita zinthu zokhudzana ndi thupi kungathandize mtima wanu kuti ukhale wolimba komanso wopambana. Komabe, ngati muli ndi vuto la mtima, muyenera kukambirana zolimbitsa thupi ndi dokotala wanu ndikutsatira malangizo azachipatala m'dera lino.
Mawu Ochokera
Ngati inu kapena wokondedwa wanu muli ndi vuto la mtima, muyenera kudziwa kuti simuli nokha. Izi ndizovuta kwambiri zachipatala, koma ndi vuto lachipatala lomwe liyenera kuthandizidwa mozama.
Kuphatikiza pa zizindikiro zomwe zimapweteka, monga kupuma pang'ono ndi chizungulire, zimakhalanso zovuta kusintha kwa kuchepa kwa chiwerengero cha ntchito chifukwa cha kusowa mphamvu ndi kutopa. Ndi kasamalidwe kabwino, mukhoza kupeza kusintha kwa zizindikiro zanu.
Pamene wokondedwa wanu ali ndi vuto la mtima, mungafunikire kusankha zinthu zosinthidwa zomwe zikugwirizana ndi mphamvu yanu komanso mphamvu yanu ndi kulekerera kwa wokondedwa wanu.
> Chitsime:
> Ibrahim NE, Januzzi JL Jr. Tsogolo la Biomarker-Njira Zothandizira Osowa Mtima Pambuyo Potsata Malangizo Otsogolera Pogwiritsira Ntchito Mankhwala Ogwiritsira Ntchito Biomarker Kuchiza Kuchuluka kwa Mtima Wopanda Phunziro Curr Heart Fail Rep. 2018 Apr; 15 (2): 37-43. lembani: 10.1007 / s11897-018-0381-0.