Lupus, yemwenso amadziwika kuti systemic lupus erythematosus kapena SLE, ndi matenda omwe amatha kukhudza pafupifupi mbali iliyonse ya thupi, koma makamaka khungu, ziwalo, impso, mapapo, ubongo-ndi mtima.
Matenda a mtima amapezeka mwa anthu omwe ali ndi lupus kawirikawiri amagwera m'magulu asanu. Izi ndi:
- Myocarditis
- Matenda a Pericardial
- Cardiac arrhythmias
Matenda a Lupus ndi Coronary Artery
Lupus imakhudzidwa ndi kuwonjezeka kwakukulu kwa matenda a atherosclerosis , kapena kuumitsa kwa mitsempha yomwe imapanga CAD. Chifukwa chake, kawirikawiri CAD imapezeka kwa anthu omwe ali ndi lupus ali aang'ono. Kuwonjezeka kwa chiopsezo cha CAD msanga ndi lupus ndi chachikulu mwa atsikana.
Chifukwa chimene lupus chimachulukitsa ngozi ya CAD ikuwonekera kukhala yowirikiza. Choyamba, anthu omwe ali ndi lupus amakhala ndi zifukwa zambiri zowopsa pamtima: kunenepa kwambiri, moyo wokhala ndi moyo wathanzi, matenda oopsa , kuchuluka kwa mafuta m'thupi , komanso matenda a kagayidwe kake . Chifukwa chake ziwopsezozi ndizofala kwambiri kwa anthu omwe ali ndi lupus angakhale chifukwa cha matenda enieni (omwe angapangitse china chilichonse kukhala chovuta kukhala ndi moyo), kapena mwina kugwiritsa ntchito steroids pochiza lupus.
Chachiwiri, lupus limawonjezera kutupa komwe kumawoneka m'mitsempha ya mitsempha, ndipo kutupa m'mitsempha ya mitsempha ndilo dalaivala wamkulu wa atherosclerosis, ndi kupasuka kwa mabala .
Kupewa CAD , matenda a CAD , ndi chithandizo cha CAD mwa anthu omwe ali ndi lupus ndi ofanana ndi wina aliyense. Komabe, popeza kuchuluka kwa CAD, makamaka kwa achinyamata, ndipamwamba kwambiri mu lupus, ndikofunika kuti iwo omwe ali ndi lupus (ndi madokotala awo) ayang'anire zizindikiro zosonyeza za CAD.
Matenda a Lupus ndi Mtima wa Valve
Lupus imayambitsidwa ndi matenda a valve yamtima. Kutupa kwachibadwa komwe kumagwirizanitsidwa ndi lupus kungayambitse mankhwala osiyanasiyana a kutupa kuti aikidwe pamagetsi a mtima . Zamakono zotupa, zomwe nthawi zambiri zimaphatikizapo zigawo zikuluzikulu zamagazi a magazi, maselo a chitetezo cha mthupi, ndi maselo otupa, akhoza kupanga "zitsamba," zomwe zimakhala ngati kukula kwa wart.
Zomera izi (zomwe zimafala kwambiri pamagetsi a mitral kusiyana ndi ma valves ena a mtima) nthawi zambiri sizimayambitsa mavuto amodzi a mtima. Komabe, anthu ena omwe ali ndi matenda a lupus angakhale aakulu okwanira kuti abwerere m'mbuyo , zomwe zimachititsa kuti mtima ukhale wolephera; iwo akhoza kutenga kachilomboka, kutsogolera ku endocarditis ; kapena iwo akhoza kuyambitsa mapangidwe a magazi, omwe amachititsa kuti aphedwe .
Ngati zamasamba zimakhala zazikulu zokwanira kubweretsa mtima kudandaula (zomwe zimakhala zofala), kachipangizo kameneka kamathandiza kuthandizira kukula kwa zomera. Ngati zili zazikulu, kapena ngati zikuwonetsa kukula kwakukulu kwa nthawi, endocarditis prophylaxis ikhoza kulamulidwa. Nthawi zina, ochepa magazi amatha kupatsidwa mphamvu kuti athe kuchepetsa kupwetekedwa.
Matenda a Lupus ndi Pericardial
Pericardial effusion ndi pericarditis ndizofala mu lupus.
Zovuta zapericardial zikhoza kuwonetsedwa mwa anthu 50 peresenti ya anthu omwe ali ndi lupus pa nthawi ya matenda awo.
Mwamwayi, zovuta zowonongeka sizimabweretsa zizindikilo, ndipo nthawi zambiri zimapezeka pochitika, pakuchita echocardiogram chifukwa china. Sitiyenera kuchitapo kanthu mwatsatanetsatane kuti izi zitheke, ndipo zozizwitsa zomwe zimachitika nthawi zambiri zimathetsa okha.
Kuphatikiza pa zovuta zowonongeka, pericarditis (kutupa kwa peyalayumu yophimba) imatha kuwonanso kwa anthu omwe ali ndi lupus. Pamene pericarditis ilipo, nthawi zambiri izi zimasonyeza bwino kuti lupus ili m'kati mwachangu, ndiye kuti ikubweretsanso mavuto okhudza ziwalo zina.
The pericarditis kawirikawiri imadutsa pamene mpweya wodwala lupus flare umayendetsedwa. Ngati chithandizo chofunikira chikufunika, pericarditis ya lupus kawirikawiri imayankhidwa ndi mankhwala osagwiritsidwa ntchito ndi mankhwala osagwiritsidwa ntchito poletsa kutupa (NSAIDs) .
Lupus ndi Myocarditis
Myocarditis-kutupa kwa minofu ya mtima-ndi, mwatsoka, sizolowezi kwa anthu omwe ali ndi lupus. Lupus myocarditis kawirikawiri imabweretsa zizindikiro mwachindunji, koma pamapeto pake ikhoza kuyambitsa kufooketsa ndi kuchepetsa mtima, ndikumva kusagonjetsedwa ndi masewera a mtima. Ngati ndi choncho, zizindikiro zonse za mtima kulephera zikhoza kukula.
Myocarditis mu lupus kawirikawiri amapezeka kuti mtima wofutukuka umawonekera pa chifuwa cha x-ray kapena echocardiogram, komabe mwina angakayikire ngati tachycardia yosadziwika (kuthamanga kwa mtima pamtima) kupumula kumawonekera.
Mofananamo ndi pericarditis, myocarditis imawoneka pamene lupus ili m'kati mwachangu, nthawi zambiri imakhudzana ndi ziwalo zingapo. Kupititsa patsogolo ntchito ya mtima kwawoneka kwa odwala ena omwe ali ndi lupus myocarditis akamagwiritsidwa ntchito mwamphamvu kuti aphatikize lupus , pogwiritsira ntchito steroid komanso mankhwala osokoneza bongo.
Lupus ndi Arrhythmias
Pambuyo pa nthawi ya lupus myocarditis, mitundu yosiyanasiyana ya mtima wamkati ikhoza kuchitika. Kawirikawiri zigawo izi za mtima wamkati zimakhala zowonongeka komanso zopanda malire, ndipo sizikufuna kugwiritsa ntchito pacemaker .
Kuonjezera apo, tachycardia yosakayika panthawi yopumula ikhoza kuwonetsedwa mwa anthu omwe ali ndi lupus. Tachycardia iyi ikhoza kutulutsa phokoso, ndipo kawirikawiri imawoneka mwa anthu omwe lupus ili panopa yogwira ntchito.
Chidule
Kwa anthu omwe ali ndi lupus, pali mwayi 50-50 kuti mtundu wina wa mtima wokhudzana ndi mtima udzatha. Iwo ndi madokotala awo ayenera kukhala tcheru ku zizindikiro zomwe zingasonyeze mavuto a mtima, makamaka kupweteka kwa chifuwa ndi kupuma kwafupipafupi, ndipo ayenera kufulumira kukwaniritsa mwayi wa matenda a mtima ngati zizindikiro zikuwonekera.
> Zotsatira:
> Doria A, Iaccarino L, Sarzi-Puttini P, et al. Kusintha kwa Cardiac mu Lupus Erythematosus Yodabwitsa. Lupus 2005; 14: 683.
> Hak AE, Karlson EW, Feskanich D, et al. Lupus Erythematosus yowopsa ndi Kuopsa kwa Matenda a Mtima: Zotsatira za Nurses 'Health Study. Arthritis Rheum 2009; 61: 1396.
> Magder LS, Petri M. Kuopsa kwa Zinthu Zowopsa ndi Zoopsa za Zochitika Zapakati pa Maganizo Odwala Odwala Lupus Erythematosus. Am J Epidemiol 2012; 176: 708.
> Schattner A, Liang MH. Matenda a Mtima a Lupus: Chovuta Chovuta. Arch Intern Med 2003; 163: 1507.