Pericarditis - pambuyo pamtima

Pericarditis ndikutupa ndi kutupa kwa kuphimba kwa mtima (pericardium). Zitha kuchitika m'masiku kapena milungu itadwala matenda amtima.

Mitundu iwiri ya pericarditis imatha kuchitika pambuyo podwala mtima.

Matenda oyambilira a pericarditis: Fomuyi imapezeka pakadutsa masiku 1 kapena 3 mutadwala mtima. Kutupa ndi kutupa kumayamba pamene thupi limayesa kutsuka minofu yamtima yodwalayo.

Kuchedwa kwa pericarditis: Izi zimatchedwanso Dressler syndrome. Amatchedwanso matenda ovulala pambuyo pamtima kapena postcardiotomy pericarditis). Nthawi zambiri zimachitika patatha milungu ingapo kapena miyezi ingapo kudwala kwa mtima, opaleshoni yamtima, kapena zowawa zina pamtima. Zitha kuchitika patatha sabata mutavulala mtima. Matenda a Dressler amalingaliridwa kuti amapezeka pamene chitetezo cha mthupi chimagunda minofu yathanzi mwangozi.

Zinthu zomwe zimakuyikani pachiwopsezo chachikulu cha matenda a pericarditis ndi monga:

• Matenda amtima am'mbuyomu
• Tsegulani opaleshoni yamtima
• Kupweteka pachifuwa
• Matenda amtima omwe akhudza kukula kwa minofu yanu yamtima

Zizindikiro zake ndi izi:

• Nkhawa
• Zowawa pachifuwa zotupa pericardium zikupukuta pamtima. Ululu ukhoza kukhala wakuthwa, wolimba kapena wopundula ndipo umatha kusunthira m'khosi, paphewa, kapena pamimba. Kupweteka kumatha kukulirakulira mukamapuma ndikupita mukatsamira patsogolo, kuyimirira, kapena kukhala tsonga.
• Kuvuta kupuma
• Chifuwa chowuma
• Kuthamanga kwa mtima (tachycardia)
• Kutopa
• Fever (yodziwika ndi mtundu wachiwiri wa pericarditis)
• Malaise (kudwala)
• Kupindika nthiti (kugwada kapena kugwira pachifuwa) ndikupuma mwamphamvu

Wothandizira zaumoyo amvera mtima wanu ndi mapapo anu ndi stethoscope. Pakhoza kukhala phokoso lopaka (lotchedwa pericardial friction rub, osasokonezedwa ndi kung'ung'uza kwamtima). Zomveka pamtima nthawi zonse zimakhala zofooka kapena zomveka kutali.

Kukhazikika kwamadzi okutira pamtima kapena malo ozungulira mapapo (pericardial effusion) sikofala pambuyo podwala mtima. Koma, nthawi zambiri zimachitika mwa anthu ena omwe ali ndi matenda a Dressler.

Mayeso atha kuphatikiza:

• Zizindikiro zovulaza mtima (CK-MB ndi troponin zitha kuthandiza kufotokozera za pericarditis kuchokera pamtima)
• Chifuwa cha CT
• Chifuwa cha MRI
• X-ray pachifuwa
• Kuwerengera kwathunthu kwa magazi (CBC)
• ECG (electrocardiogram)
• Zojambulajambula
• ESR (sedimentation rate) kapena C-reactive protein (njira zotupa)

Cholinga cha mankhwalawa ndikuti mtima ugwire bwino ntchito ndikuchepetsa ululu ndi zizindikilo zina.

Aspirin atha kugwiritsidwa ntchito pochiza kutupa kwa pericardium. Mankhwala otchedwa colchicine amagwiritsidwanso ntchito.

Nthawi zina, madzi owonjezera ozungulira mtima (pericardial effusion) angafunike kuchotsedwa. Izi zimachitika ndi njira yotchedwa pericardiocentesis. Ngati zovuta zikuyamba, gawo la pericardium nthawi zina limafunikira kuchotsedwa ndi opaleshoni (pericardiectomy).

Vutoli limatha kubweranso nthawi zina.

Mavuto omwe angakhalepo a pericarditis ndi awa:

• Tamponade yamtima
• Kulephera kwa mtima
• Kupweteka kwa pericarditis

Itanani omwe akukuthandizani ngati:

• Mumakhala ndi matenda a pericarditis mutadwala matenda amtima
• Mwapezeka kuti muli ndi pericarditis ndipo zizizindikiro zimapitilira kapena kubwerera ngakhale mutalandira chithandizo

Matenda a Dressler; Post-MI pericarditis; Matenda ovulala pambuyo pamtima; Postcardiotomy pericarditis

• MI yovuta
• Zowonjezera
• Post-MI pericarditis
• Zowonjezera

Maulendo NJ. Matenda a Pericardial ndi myocardial. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: chap 72.

LeWinter MM, matenda a Imazio M. Pericardial. 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: mutu 83.

Maisch B, Ristic AD. Matenda a Pericardial. Mu: Vincent JL, Abraham E, Moore FA, Prime Minister wa Kochanek, MP wa Fink, eds. Buku Lopereka Chithandizo Chachikulu. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: mutu 84.