Endocarditis ndi matenda aakulu (kapena kutupa) kwa mtima. Mwachidziwitso, endocarditis ndi matenda kapena kutupa kwa endocardium, yomwe ili mkati mwa mtima. Izi zikutanthauza endocarditis ndi matenda a valves pamtima. Ikhoza kuthandizanso zipangizo (zotupa zitsulo, opibrillators, ndi mawaya awo) komanso ma valve opangira.
Zomwe zimachitika
M'malo otchedwa endocarditis, zamasamba-kapena masango a tizilombo toyambitsa matenda ndi tizilombo ta munthu ndi timapepala timene timagwiritsira ntchito timagetsi timene timagwira pamtima. Iwo amayendayenda mmbuyo ndi mtsogolo pamene valavu imatsegula ndi kutseka. Zomera zimenezi zingakhudze magazi. Iwo akhoza kuchoka ndi kupweteka kumbali zina za thupi. Izi zikhoza kuwononga ubongo ndi mapapo. Zomera zimenezi zimapangidwa ndi mateleti, fibrin, ndi mabakiteriya (kapena bowa) omwe amachititsa matendawa. Amatha kukula ndikukula mpaka mankhwala oyamba atayambika.
Kodi Zimakhala Zofanana Motani?
Sizinali zachilendo. Ku US, zimakhudza 1 pa 10,000 mpaka 1 pa 20,000 Achimereka pachaka. Komabe, pakati pa omwe amagwiritsa ntchito mankhwala osokoneza bongo (monga heroin), 1-2 pa 1000 adzakhala ndi kachilombo (ndi zina zambiri).
Amene Amalandira
Ambiri amene amapeza kale anali ndi vuto ndi mtima wawo. Zovuta za mtima zomwe zilipo kale zimapezeka mu 3 mwa 4 omwe amapanga matope. Kawirikawiri, izi zikutanthawuza kuti chinachake chinali cholakwika ndi valves pamtima kapena anali ndi bowo mu mtima mwawo.
Ena amatha kukhala ndi mtima wakuwombera kapena kubadwa ndi mtima wosadziwika. Mavuto amenewa amatengedwa nthawi zambiri pamene dokotala amva kung'ung'udza. Zingathenso kutengedwa kupyolera mwa kuyesedwa, monga ultrasound ya mtima yotchedwa Echo (Echocardiogram). Muyenera kufunsa dokotala wanu za izi ngati muli ndi mafunso.
Pali magetsi osiyanasiyana ndi mitundu yosiyanasiyana ya mavuto. Ma valve ena ndi olimba kwambiri-stenosis. Ma valve ena ali otsetsereka kwambiri. Mwa iwo omwe amayamba matenda otchedwa endocarditis, oposa 40% adzakhala ndi vuto la mitral valve (makamaka mitral regurgitation), pamene opitirira 25% adzakhala ndi vuto la a valtic valve (aortic regurgitation) omwe ali onse mavuto omwe amakhala nawo.
Ena adzalandira endocarditis chifukwa amakhala ndi mabakiteriya akuyenda m'magazi awo. Kukhala ndi mabakiteriya m'magazi amatha kukhala ndi mabakiteriya pamtunda. Mabakiteriya amapezeka m'magazi pang'onopang'ono chifukwa chazing'ono za nthawi, koma nthawi zina mabakiteriyawa amatha kutalika kwambiri. Izi zikhoza kuchitika pamene anthu ali ndi njira zamankhwala kapena zamano. Nthawi iliyonse singano kapena khungu lakumwala limapyola pakhungu, pali chiopsezo cha mabakiteriya a khungu (kapena singano kapena scalpel) adzalowa mkati. Anthu amene ali ndi hemodialysis amakhala pachiopsezo (ochepa oposa 8% a odwala endocarditis ali pa dialysis).
Ena omwe ali pachiopsezo ndi omwe amagwiritsa ntchito singano pofuna kugwiritsa ntchito mankhwala osokoneza bongo. Pafupifupi 10 peresenti ya milandu ya endocarditis ili mwa iwo omwe amagwiritsa ntchito mankhwala osokoneza bongo , monga heroin.
Zimene Zimamveka
Pali mitundu yosiyanasiyana ya endocarditis.
Mitundu iyi imadalira pa chiopsezo chimene chikukukhudzani - komanso ngati ndi vesi kapena zachilengedwe zomwe zili ndi kachilomboka.
Kusiyanitsa kwakukulu kuli pakati pa matenda a acute ndi subacute . Mabakiteriya ena nthawi zambiri amachititsa matenda mwamsanga. Mabakiteriya ena amachititsa kuti pang'onopang'ono matenda azikhala pang'onopang'ono, pomwe kuwonongeka kwakukulu kungachitike munthu asanadziwe kuti pali vuto.
Kugonjetsa kwapachilombo koopsa kumatha kudziwika ndi kutentha kwakukulu, kugwedezeka, kutopa kwambiri komanso kupweteka pachifuwa, kupuma pang'ono komwe kungabwere modzidzimutsa.
Subacute Infective Endocarditis imatenga nthawi yaitali kuti izindikiridwe, kawirikawiri osachepera masabata awiri, koma nthawizina nthawi yochuluka.
Matenda a Subacute amadziwika ndi kutentha pang'ono, kutopa kwathunthu, kusala kudya, kupweteka kwa thupi, kupweteka kwa ululu, kutuluka usiku, kutentha pang'ono, kupweteka mutu, ndi ululu m'misungo kapena m'magulu. Nthawi zina amadziwikanso kuti ndi ochepa, amathothokanso m'magawo kapena chala, komanso mitsempha ya magazi yomwe imathyoka m'magawo kapena maso (kapena maso).
Matenda oterewa amatha kuyambitsa Staph Aureus . Subacute kawirikawiri imayambitsa mabakiteriya a Streptococcal (Strep), makamaka viridian streptococci, komanso nthawi zina ndi entococci komanso mitundu ya Staph.
Matenda a Subacute amachokera ku mbali zina za thupi kumene amapezeka mwa anthu abwino. Matenda opatsirana nthawi zambiri amatuluka kuchokera pakamwa pamagetsi kapena ntchito yamazinyo. Matenda ena amatha kutuluka m'matumbo ndi entococci nthawi zambiri amapezeka m'kapepala kameneka. Mabakiteriyawa akhoza kutha m'magazi kuchokera kuchipatala kapena opaleshoni.
Mitundu
Pambuyo pa zovuta ndi zovuta, pali mitundu yosiyanasiyana ya matenda malinga ndi) a valve omwe amakhudzidwa b) ndi mabakiteriya kapena bowa zomwe zimakhudzidwa c) momwe matendawa aliri aakulu. Ma valve amakhudzidwa ndi Aortic ndi Mitral kawirikawiri (kumanzere kwa mtima) ndi Tricuspid ndi Pulmonic (kumanja kwa mtima).
Anthu omwe ali ndi kachilombo koyambitsa jekeseni nthawi zambiri amakhala ndi matenda opatsirana (makamaka Tricuspid) pamene izi zimakhala zosiyana kwambiri ndi ena.
Zotsatira Zotsatira
Imodzi mwaziopsyezo zazikulu ndikuti zamasamba zimatha kufalitsa zigawo zina ku mbali zina za thupi. Izi zimatchedwa emboli. Mitsuko iyi ikhoza kuphimba zitsulo kulikonse kumene magazi akuyenda-komwe kulikonse, malingana ndi mbali yina ya mtima yomwe valve imayambira. (Mbali ya kumanzere kawirikawiri amapumphukira thupi ndi ubongo, pomwe mbali yakumanja pamapapu). Izi zingayambitse kuwonongeka kwakukulu ndi matenda m'mapapo ndi ubongo, kuyambitsa zikwapu, komanso ziwalo zina zambiri za thupi, kuphatikizapo impso, chiwindi, mpeni, ndi mitsempha yofunikira ya magazi.
Matendawa akhoza kukhala ovuta kufalitsa ndi kupitirirabe mbewu mabakiteriya m'magazi, zomwe zimayambitsa matenda aakulu, osatetezeka.
Matendawa amatha kuwononga ma valve mosalekeza ndipo akhoza kukhumudwitsa mtima.
Chithandizo
Ambiri adzafunikira masabata angapo a antibiotic. Mitundu yosiyana malinga ndi matenda (ndi valve) kuyambira masabata awiri mpaka 6 . Izi zimagwiritsa ntchito mabakiteriya momveka bwino ndi antibiotic.
Ena amafunika opaleshoni. Izi nthawi zambiri zimaphatikizapo omwe ali ndi valve zopangira, matenda osapitirira, matenda osowa mtima, abambo amtima ngati matenda amalowa m'mtima kuchokera ku valve.
Kupewa ndi Vuto Lomwe Lilipo
Ena omwe ali pangozi yaikulu adzalandira maantibayotiki asanakhale ndi mankhwala kapena opaleshoni. Ndikofunika kuti mulankhule ndi dokotala wanu kapena namwino, ndi dokotala wanu wa mano za chiopsezo chanu ndi zodetsa zanu musanayambe ndondomeko. Anthu amene amaonedwa kuti ndi omwe ali pachiopsezo chachikulu, ali ndi valavu ya prosthetic (yokumbidwa), yapitalo Infective Endocarditis, matenda ena amtima obadwa nawo (matenda a mtima omwe mumabadwa nawo) ndi omwe ali ndi matenda a mtima omwe ali ndi vuto la valve.
Ngati muli ndi nkhawa yokhudza kukhala pangozi, chonde lankhulani ndi katswiri wa zamankhwala.
Kodi Kutentha kwa Magazi Kumayambitsa Mavuto a Mtima?
Inde, ndithudi. Chifuwachi chimayambitsa kutupa mumtima mwathu, koma ngati matendawa akupitirizabe pali fibrosis ya valve, yomwe ingayambitse kukhala yolimba kwambiri kapena seplate (stenosis kapena regurgitation). Amayambitsa matenda a Gulu A strep.
Pamene Icho Chiribe Cholandira
Ikhozanso kukhala yopanda matenda. Nthawi zina izi zingagwirizane ndi matenda a rheumatologic ndi mavuto omwe amadziwika nawo.
Kodi Ndi Mavenda Omwe Ali Ndi Matenda Aakulu?
Matendawa angaphatikizepo mbali zina zamkati mwa mtima kuphatikizapo "dzenje mu mtima" (monga chilema m'makoma akulekanitsa zipinda zosiyanasiyana za mtima) ndi zingwe (chordae tendineae) zomwe zili pamagetsi.