Matenda a m'mapapo

Pericarditis ndimkhalidwe momwe chofukizira ngati thumba lozungulira mtima (pericardium) chimatupa.

Chifukwa cha pericarditis sichidziwika kapena sichimatsimikizika nthawi zambiri. Amakhudza kwambiri amuna azaka zapakati pa 20 mpaka 50.

Pericarditis nthawi zambiri imayamba chifukwa cha matenda monga:

• Matenda opatsirana omwe amachititsa chifuwa kuzizira kapena chibayo
• Matenda ndi mabakiteriya (ochepa)
• Matenda ena a fungal (osowa)

Vutoli lingawoneke ndi matenda monga:

• Khansa (kuphatikizapo khansa ya m'magazi)
• Zovuta zomwe chitetezo chamthupi chimagunda minofu yabwinobwino mosazindikira
• HIV ndi Edzi
• Chithokomiro chosagwira ntchito
• Impso kulephera
• Rheumatic malungo
• TB (TB)

Zina mwa zifukwa zake ndi izi:

• Matenda amtima
• Kuchita opaleshoni yamtima kapena kupwetekedwa mtima pachifuwa, kum'mero, kapena pamtima
• Mankhwala ena, monga procainamide, hydralazine, phenytoin, isoniazid, ndi mankhwala ena omwe amachiza khansa kapena kupondereza chitetezo cha mthupi
• Kutupa kapena kutupa kwa minofu yamtima
• Thandizo la radiation pachifuwa

Kupweteka pachifuwa nthawi zambiri kumakhalapo. Ululu:

• Zitha kumveka pakhosi, paphewa, kumbuyo, kapena pamimba
• Nthawi zambiri kumawonjezeka ndikupuma kwambiri ndikugona pansi, ndipo kumatha kuwonjezeka ndikutsokomola ndi kumeza
• Amamva kukhala akuthwa komanso obaya
• Nthawi zambiri amamasulidwa kukhala pansi ndikutsamira kapena kuweramira patsogolo

Mutha kukhala ndi malungo, kuzizira, kapena thukuta ngati vutoli limayambitsidwa ndi matenda.

Zizindikiro zina zitha kuphatikiza:

• Ankolo, mapazi, ndi kutupa kwa mwendo
• Nkhawa
• Kupuma kovuta kugona
• Chifuwa chowuma
• Kutopa

Mverani mtima ndi stethoscope, wothandizira zaumoyo amatha kumva phokoso lotchedwa pericardial rub. Zomveka pamtima zitha kusokonekera kapena kutali. Pakhoza kukhala zizindikilo zina zamadzimadzi owonjezera mu pericardium (pericardial effusion).

Ngati matendawa ndi oopsa, pakhoza kukhala:

• Ming'alu m'mapapu
• Kuchepetsa mpweya kumveka
• Zizindikiro zina zamadzimadzi pamalo ozungulira mapapo

Mayesero otsatirawa atha kuchitika kuti aunike mtima ndi mawonekedwe ozungulira (pericardium):

• Kujambula pachifuwa cha MRI
• X-ray pachifuwa
• Zojambulajambula
• Electrocardiogram
• Mtima MRI kapena mtima CT scan
• Kujambula kwa radionuclide

Kuti muwone kuwonongeka kwa minofu yamtima, wothandizirayo atha kuyitanitsa troponin yomwe ndimayesa. Mayeso ena a labotale atha kukhala:

• Antinuclear antibody (ANA)
• Chikhalidwe chamagazi
• Zamgululi
• Mapuloteni othandizira C
• Mlingo wa sedimentation wa erythrocyte (ESR)
• Kuyezetsa HIV
• Chifuwa cha nyamakazi
• Kuyesedwa kwa khungu la tuberculin

Zomwe zimayambitsa matenda a pericarditis ziyenera kudziwika, ngati zingatheke.

Mankhwala osagwiritsidwa ntchito poletsa kutupa (NSAIDs) monga ibuprofen nthawi zambiri amaperekedwa ndi mankhwala otchedwa colchicine. Mankhwalawa amachepetsa kupweteka kwanu ndikuchepetsa kutupa kapena kutupa m'thumba mozungulira mtima wanu. Mudzafunsidwa kuti muwatenge masiku kapena milungu kapena kupitilira apo.

Ngati chifukwa cha pericarditis ndi matenda:

• Maantibayotiki adzagwiritsidwa ntchito pamagulu amabakiteriya
• Mankhwala osokoneza bongo adzagwiritsidwa ntchito pa fungal pericarditis

Mankhwala ena omwe angagwiritsidwe ntchito ndi awa:

• Corticosteroids monga prednisone (mwa anthu ena)
• "Mapiritsi amadzi" (okodzetsa) kuti achotse madzimadzi owonjezera

Ngati kuchuluka kwa madzimadzi kumapangitsa mtima kugwira bwino, chithandizo chitha kuphatikizira:

• Kutulutsa madzi kuchokera m'thumba. Njirayi, yotchedwa pericardiocentesis, itha kuchitidwa pogwiritsa ntchito singano, yomwe imatsogozedwa ndi ultrasound (echocardiography) nthawi zambiri.
• Kudula bowo laling'ono (zenera) mu pericardium (subxiphoid pericardiotomy) kuloleza madzi amtunduwu kulowa m'mimba. Izi zimachitika ndi dotolo.

Kuchita opaleshoni yotchedwa pericardiectomy kungakhale kofunikira ngati matenda a pericarditis atenga nthawi yayitali, amabwerera pambuyo pa chithandizo, kapena amayambitsa zipsera kapena kukhwimitsa minofu kuzungulira mtima. Kuchita izi kumakhudza kudula kapena kuchotsa gawo la pericardium.

Pericarditis imatha kuyambira kudwala kofewa komwe kumadzichira pakokha, ndikuwopseza moyo. Madzi amadzimadzi ozungulira pamtima komanso kusagwira bwino ntchito kwa mtima kumatha kuthana ndi vutoli.

Zotsatira zake ndi zabwino ngati matenda a pericarditis amachiritsidwa nthawi yomweyo. Anthu ambiri amachira pakatha milungu iwiri mpaka miyezi itatu. Komabe, pericarditis imatha kubwerera. Izi zimatchedwa kubwereza, kapena kwanthawi yayitali, ngati zizindikilo kapena zigawo zikupitilira.

Kupunduka ndi kukulitsa kwa chofunda ngati thumba ndi minofu yamtima kumatha kuchitika vuto likakhala lalikulu. Izi zimatchedwa constrictive pericarditis. Zitha kuyambitsa mavuto ataliatali ofanana ndi a mtima.

Itanani omwe akukuthandizani ngati muli ndi matenda a pericarditis. Matendawa sawopseza moyo nthawi zambiri. Komabe, zitha kukhala zowopsa ngati sichichiritsidwa.

Milandu yambiri sitingapewe.

• Zowonjezera
• Matenda a m'mapapo

Chabrando JG, Bonaventura A, Vecchie A, ndi al. Kuwongolera kwa pericarditis yovuta komanso yabwinobwino: Kuwunika Kwambiri kwa JACC. J Ndine Coll Cardiol. Kukonzekera. 2020; 75 (1): 76-92. PMID: 31918837 pubed.ncbi.nlm.nih.gov/31918837/.

Knowlton KU, Savoia MC, Oxman MN. Myocarditis ndi pericarditis. Mu: Bennett JE, Dolin R, Blaser MJ, olemba., Eds. Mandell, Douglas, ndi Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020: chap 80.

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.