Mtima kulephera

Kulephera kwa mtima ndimkhalidwe womwe mtima sungathenso kupopera magazi olemera ndi oxygen ku thupi lonse moyenera. Izi zimapangitsa kuti zizindikilo zizioneka mthupi lonse.

Kulephera kwa mtima nthawi zambiri kumakhala kwanthawi yayitali, koma kumatha kubwera mwadzidzidzi. Zitha kuyambitsidwa ndi mavuto amitima yambiri.

Vutoli limakhudza mbali yakumanja kapena lamanzere lokha la mtima. Mbali zonse za mtima zingathenso kutenga nawo mbali.

Kulephera kwa mtima kulipo pamene:

• Minofu yanu yamtima imatha kuchita bwino. Izi zimatchedwa systolic mtima kulephera, kapena mtima kulephera ndi kachigawo kakang'ono kotulutsira ejection (HFrEF).
• Minofu yanu yamtima ndi yolimba ndipo siyodzaza magazi mosavuta ngakhale mphamvu yakupopa ndiyabwino. Izi zimatchedwa kuti diastolic mtima kulephera, kapena kulephera kwa mtima wokhala ndi gawo lotulutsira ejection (HFpEF).

Pamene kupopa kwa mtima kumayamba kuchepa, magazi amatha kubwerera m'mbali zina za thupi. Madzi amatha kulowa m'mapapu, chiwindi, m'mimba, ndi mikono ndi miyendo. Izi zimatchedwa congestive mtima kulephera.

Zomwe zimayambitsa kufooka kwa mtima ndi izi:

• Matenda a Coronary (CAD), kuchepa kapena kutsekeka kwa mitsempha yaying'ono yamagazi yomwe imapereka magazi ndi mpweya pamtima. Izi zitha kufooketsa minofu ya mtima pakapita nthawi kapena mwadzidzidzi.
• Kuthamanga kwa magazi komwe sikuyendetsedwa bwino, kumabweretsa mavuto kuuma, kapena kumapeto kwake kumapangitsa kufooka kwa minofu.

Mavuto ena amtima omwe angayambitse mtima kulephera ndi awa:

• Matenda amtima obadwa nawo
• Matenda amtima (matenda amitsempha yamitsempha yamitsempha atha kutsekeka mwadzidzidzi kwamitsempha yamtima)
• Mavavu amtima omwe amatuluka kapena kupapatiza
• Matenda omwe amachepetsa minofu ya mtima
• Mitundu ina yamitundumtima yosazolowereka (arrhythmias)

Matenda ena omwe angayambitse kapena kuchititsa mtima kulephera:

• Amyloidosis
• Emphysema
• Chithokomiro chopitilira muyeso
• Sarcoidosis
• Kuchepa kwa magazi m'thupi
• Zitsulo zambiri m'thupi
• Chithokomiro chosagwira ntchito

Zizindikiro za kulephera kwa mtima nthawi zambiri zimayamba pang'onopang'ono. Poyamba, zimatha kuchitika mukakhala otanganidwa kwambiri. Popita nthawi, mutha kuwona mavuto opuma komanso zizindikiro zina ngakhale mutapuma. Zizindikiro zitha kuwonekeranso mwadzidzidzi mtima ukawonongeka ndi vuto la mtima kapena vuto lina.

Zizindikiro zodziwika ndi izi:

• Tsokomola
• Kutopa, kufooka, kukomoka
• Kutaya njala
• Muyenera kukodza usiku
• Kugunda komwe kumamveka mwachangu kapena mosasinthasintha, kapena kumverera kwakumva kugunda kwa mtima (palpitations)
• Kupuma pang'ono mukamagwira ntchito kapena mutagona
• Kutupa (kukulitsidwa) chiwindi kapena pamimba
• Kutupa mapazi ndi akakolo
• Kudzuka kutulo patatha maola angapo chifukwa cha kupuma movutikira
• Kulemera

Wothandizira zaumoyo wanu adzakufunsani ngati muli ndi zofooka za mtima:

• Kupuma mofulumira kapena kovuta
• Kutupa kwamiyendo (edema)
• Mitsempha yama khosi yomwe imatuluka (yasokonekera)
• Zikumveka (zotsekemera) kuchokera kumadzi amadzimadzi m'mapapu anu, zimamveka kudzera mu stethoscope
• Kutupa kwa chiwindi kapena pamimba
• Kugunda kwamtima kosafanana kapena kofulumira komanso kumveka kwamtima kosazolowereka

Mayeso ambiri amagwiritsidwa ntchito pozindikira komanso kuwunika kulephera kwa mtima.

Echocardiogram (echo) nthawi zambiri ndimayeso oyamba abwino kwambiri kwa anthu pakayesedwa kulephera kwa mtima. Wopereka wanu adzaigwiritsa ntchito kutsogolera chithandizo chanu.

Mayeso ena ojambula angayang'ane momwe mtima wanu umatha kupopera magazi, komanso kuchuluka kwa minofu ya mtima.

Mayeso ambiri amwazi amathanso kugwiritsidwa ntchito:

• Thandizani kuzindikira ndikuwunika kulephera kwa mtima
• Dziwani zoopsa zamitundu yosiyanasiyana yamatenda amtima
• Fufuzani zifukwa zomwe zingayambitse mtima wanu, kapena mavuto omwe angapangitse mtima wanu kulephera
• Onetsetsani zotsatira zoyipa za mankhwala omwe mungakhale mukumwa

KUYANG'ANIRA NDI KUSANGALALA

Ngati muli ndi vuto la mtima, omwe amakupatsani amayang'anira mosamala. Mudzakhala ndi maulendo obwereza osachepera miyezi itatu kapena isanu ndi umodzi, koma nthawi zina nthawi zambiri. Muyeneranso kuyesedwa kuti muwone momwe mtima wanu ukugwirira ntchito.

Kudziwa thupi lanu komanso zizindikilo zakuti mtima wanu ukulephera kukuthandizani kukhala athanzi komanso kutuluka mchipatala. Kunyumba, yang'anani kusintha kwa kugunda kwa mtima, kugunda, kuthamanga kwa magazi, ndi kunenepa kwanu.

Kulemera, makamaka kupitirira tsiku limodzi kapena awiri, kungakhale chizindikiro choti thupi lanu likungogwiritsabe madzi ena amtima ndipo kulephera kwa mtima wanu kukukulirakulira. Lankhulani ndi omwe amakupatsani zomwe muyenera kuchita ngati kulemera kwanu kukwera kapena mumakhala ndi zizindikiro zambiri.

Chepetsani mchere womwe mumadya. Wothandizira anu amathanso kukupemphani kuti muchepetse kuchuluka kwa madzi omwe mumamwa masana.

Zosintha zina zofunika kusintha pamoyo wanu:

• Funsani omwe akukuthandizani zakumwa zoledzeretsa zomwe mungamwe.
• Osasuta.
• Khalani achangu. Yendani kapena mukwere njinga yokhazikika. Wothandizira anu akhoza kukupatsani dongosolo lochita masewera olimbitsa thupi lotetezeka komanso lothandiza. Musamachite masewera olimbitsa thupi masiku omwe kulemera kwanu kwachuluka chifukwa chamadzimadzi kapena simukumva bwino.
• Kuchepetsa thupi ngati muli wonenepa kwambiri.
• Chepetsa cholesterol yanu posintha moyo wanu.
• Pumulani mokwanira, kuphatikizapo mutatha kuchita masewera olimbitsa thupi, kudya, kapena kuchita zina. Izi zimaloleza mtima wanu kuti nawonso upumule.

MANKHWALA, KUGWIRITSA NTCHITO, NDI MACHITIDWE

Muyenera kumwa mankhwala kuti muchepetse mtima wanu. Mankhwala amathetsa zizindikilozo, amalepheretsa mtima wanu kulephera, ndikuthandizani kuti mukhale ndi moyo wautali. Ndikofunikira kwambiri kuti mumwe mankhwala anu monga momwe amathandizire azachipatala.

Mankhwala awa:

• Thandizani mapampu amtundu wamtima bwino
• Sungani magazi anu kuti asagundane
• Lembetsani mafuta m'thupi mwanu
• Tsegulani mitsempha yamagazi kapena muchepetse kugunda kwa mtima wanu kuti mtima wanu usamagwire ntchito molimbika
• Kuchepetsa kuwonongeka kwa mtima
• Kuchepetsa chiopsezo cha nyimbo zosadziwika bwino
• Bwezerani potaziyamu
• Chotsani thupi lanu madzi owonjezera ndi mchere (sodium)

Ndikofunika kwambiri kuti mumwe mankhwala anu monga momwe adanenera. Musamwe mankhwala ena aliwonse kapena zitsamba musanafunse kaye wothandizira anu za izo. Mankhwala omwe angapangitse mtima wanu kulephera ndi awa:

• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve, Naprosyn) Malangizo

Opaleshoni ndi zida zotsatirazi zitha kulimbikitsidwa kwa anthu ena omwe ali ndi vuto la mtima:

• Opaleshoni ya Coronary (CABG) kapena angioplasty yokhala ndi stenting kapena yothandiza ingathandize kuti magazi aziyenda bwino pamitengo ya mtima yowonongeka kapena yofooka.
• Opaleshoni yamagetsi yamtima imatha kuchitika ngati kusintha kwa valavu yamtima kukuyambitsa mtima wanu.
• Wopanga pacemaker amatha kuthandiza kuthana ndi kugunda kwa mtima pang'onopang'ono kapena kuthandizira mbali zonse ziwiri za mgwirizano wamtima wanu nthawi yomweyo.
• Makina otetezera makina amatumiza mphamvu zamagetsi kuti aletse maphokoso amtima wowopsa omwe angawopseze moyo.

END-STAGE MTIMA Kulephera

Kulephera kwamtima kwakukulu kumachitika pamene mankhwala sagwiranso ntchito. Mankhwala ena atha kugwiritsidwa ntchito ngati munthu akuyembekezera (kapena m'malo mwake) kumuika mtima:

• Pampu ya bulloon yapakatikati (IABP)
• Chida chothandizira kumanzere kapena kumanja (LVAD)
• Mtima wochita kupanga wonse

Nthawi ina, wothandizirayo amasankha ngati kuli bwino kupitiriza kuchitira kulephera kwa mtima mwamphamvu. Munthuyo, limodzi ndi abale ake komanso madotolo, atha kukambirana za chithandizo chochepetsera kapena chotonthoza panthawiyi.

Nthawi zambiri, mutha kuwongolera kulephera kwa mtima pomwa mankhwala, kusintha moyo wanu, ndikuchiza zomwe zidayambitsa.

Kulephera kwa mtima kumatha kukulira chifukwa cha:

• Ischemia (kusowa kwa magazi mpaka kuminyewa yamtima)
• Kudya zakudya zamchere
• Matenda amtima
• Matenda kapena matenda ena
• Kusamwa mankhwala molondola
• Nyimbo yatsopano, yachilendo

Nthawi zambiri, kulephera kwa mtima ndimatenda osachiritsika. Anthu ena amakhala ndi vuto la mtima. Pakadali pano, mankhwala, chithandizo china, komanso opaleshoni sizithandizanso.

Anthu omwe ali ndi vuto la mtima atha kukhala pachiwopsezo chokomera mtima. Anthu awa nthawi zambiri amalandila chikhazikitso choikidwiratu.

Itanani omwe akukuthandizani mukayamba:

• Kuchuluka kwa chifuwa kapena phlegm
• Kunenepa mwadzidzidzi kapena kutupa
• Kufooka
• Zizindikiro zina zatsopano kapena zosadziwika

Pitani kuchipinda chodzidzimutsa kapena itanani nambala yadzidzidzi yakomweko (monga 911) ngati:

• Mukukomoka
• Muli ndi kugunda kwamtima mwachangu komanso mosasinthasintha (makamaka ngati mulinso ndi zina)
• Mukumva kupweteka kwakanthawi pachifuwa

Nthawi zambiri kulephera kwa mtima kumatha kupewedwa ndikukhala moyo wathanzi ndikuchitapo kanthu pochepetsa chiopsezo cha matenda amtima.

CHF; Kulephera kwa mtima; Kulephera kwamtima kwamanzere; Kulephera kwa mtima kumanja - cor pulmonale; Cardiomyopathy - mtima kulephera; HF

• Zoletsa za ACE
• Mankhwala osokoneza bongo - P2Y12 inhibitors
• Kukhala achangu mukakhala ndi matenda amtima
• Opaleshoni ya mtima - kutulutsa
• Kulephera kwa mtima - kutulutsa
• Mtima kulephera - madzi ndi okodzetsa
• Kulephera kwa mtima - kuwunika nyumba
• Kulephera kwa mtima - zomwe mungafunse dokotala wanu
• Mtima pacemaker - kutulutsa
• Chodetsa cha mtima wamafuta - kutulutsa

• Mtima - gawo kupyola pakati
• Mtima - kuwonera kutsogolo
• Kuzungulira kwa magazi kudzera mumtima
• Kutupa phazi

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Felker GM, Teerlink JR. Kuzindikira ndikuwunika kwa kulephera kwamtima. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 24.

Wopanga DE, Sanderson BK, Josephson RA, Raikhelkar J, Bittner V; American College of Cardiology's Prevention of Cardiovascular Disease Gawo. Kulephera kwa mtima monga matenda omwe angavomerezedwe pakukonzanso mtima: zovuta ndi mwayi. J Ndine Coll Cardiol. 2015; 65 (24): 2652-2659. PMID: 26088305 pubed.ncbi.nlm.nih.gov/26088305/.

Mann DL. Kuwongolera kwa odwala olephera mtima omwe ali ndi gawo lochepetsedwa. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 25.

Yancy CW, Jessup M, Bozkurt B, ndi al. 2017 ACC / AHA / HFSA idasinthiratu malangizo a 2013 ACCF / AHA owongolera kuwonongeka kwa mtima: lipoti la American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Kuzungulira. 2017; 136 (6): e137-e161. [Adasankhidwa] PMID: 28455343 pubmed.ncbi.nlm.nih.gov/28455343/.

Zile MR, Litwin SE. Kulephera kwa mtima ndi kachigawo kakang'ono kotulutsidwa. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: chaputala 26.