Peripartum cardiomyopathy

Peripartum cardiomyopathy ndimatenda achilendo pomwe mtima wa mayi wapakati umafooka ndikukula. Zimayamba mwezi watha woyembekezera, kapena pakatha miyezi 5 mwana akabadwa.

Cardiomyopathy imachitika pakakhala kuwonongeka kwa mtima. Zotsatira zake, minofu yamtima imafooka ndipo sichipopa bwino. Izi zimakhudza mapapu, chiwindi, ndi machitidwe ena amthupi.

Peripartum cardiomyopathy ndi mtundu wamatenda ochepetsa mtima omwe palibe chifukwa china chofooketsa mtima chomwe chingapezeke.

Zitha kuchitika pakubereka ana azaka zilizonse, koma ndizofala kwambiri pambuyo pa zaka 30.

Zowopsa za vutoli ndizo:

• Kunenepa kwambiri
• Mbiri yaumwini yamatenda amtima monga myocarditis
• Kugwiritsa ntchito mankhwala ena
• Kusuta
• Kuledzera
• Mimba zingapo
• Ukalamba
• Preecclampsia
• Mbadwa zaku Africa American
• Chakudya choperewera

Zizindikiro zimaphatikizapo:

• Kutopa
• Kumverera kwa kuthamanga kwa mtima kapena kudumphadumpha (palpitations)
• Kuchulukitsa kwamadzulo usiku (nocturia)
• Kupuma pang'ono ndi zochitika komanso pogona pansi
• Kutupa kwa akakolo

Mukayezetsa thupi, wothandizira zaumoyo amayang'ana zizindikilo zamadzimadzi m'mapapu mwa kukhudza ndikugwira zala. Stethoscope idzagwiritsidwa ntchito kumvera mabala am'mapapu, kuthamanga kwa mtima mwachangu, kapena kumveka kwamtima kosazolowereka.

Chiwindi chikhoza kukulitsidwa ndipo mitsempha ya khosi ikhoza kutupa. Kuthamanga kwa magazi kumatha kukhala kotsika kapena kutsika mukaimirira.

Kukulitsa mtima, kuchulukana kwa mapapo kapena mitsempha m'mapapu, kuchepa kwa mtima, kuchepa kwa magwiridwe antchito kapena kugwira ntchito kwa mtima, kapena kulephera kwa mtima kumatha kuwonekera:

• X-ray pachifuwa
• Chifuwa cha CT
• Zowonera Coronary
• Zojambulajambula
• Kusanthula mtima kwa nyukiliya
• MRI yamtima

Kusanthula mtima kumatha kudziwa ngati chomwe chimayambitsa matenda a mtima ndi matenda am'mimba (myocarditis). Komabe, njirayi siyachitika kawirikawiri.

Mayi angafunike kukhala mchipatala mpaka zizindikilo zoopsa zitatha.

Chifukwa nthawi zambiri zimatheka kubwezeretsanso mtima, ndipo azimayi omwe ali ndi vutoli nthawi zambiri amakhala achichepere komanso athanzi, chisamaliro chimakhala chankhanza.

Pakakhala zizindikilo zowopsa, izi zitha kuphatikizira njira zowopsa monga:

• Kugwiritsa ntchito mpope wothandizira mtima (aortic counterpulsation balloon, chipangizo chothandizira chamitsempha chamanzere)
• Mankhwala osokoneza bongo (monga mankhwala omwe amagwiritsidwa ntchito pochiza khansa kapena kupewa kukana chiwalo choikidwa)
• Kuika mtima ngati mtima ukugundika kwambiri ukupitilira

Kwa amayi ambiri, komabe, chithandizo chimangoganizira zokhazokha. Zizindikiro zina zimatha zokha popanda chithandizo.

Mankhwala omwe amagwiritsidwa ntchito nthawi zambiri ndi awa:

• Digitalis kuti ilimbikitse kutulutsa kwa mtima
• Okodzetsa ("mapiritsi amadzi") kuti achotse madzimadzi owonjezera
• Oletsa-beta-blockers ochepa
• Mankhwala ena a kuthamanga kwa magazi

Chakudya chamchere wochepa chingalimbikitsidwe. Madzi amatha kukhala oletsedwa nthawi zina. Zochita, kuphatikizapo kuyamwitsa mwana, zitha kukhala zochepa pakakhala zizindikiro.

Kulemera kwa tsiku ndi tsiku kungalimbikitsidwe. Kulemera kwa mapaundi 3 mpaka 4 (1.5 mpaka 2 kilograms) kapena kupitirira masiku 1 kapena 2 kungakhale chizindikiro cha kuchuluka kwa madzi.

Amayi omwe amasuta komanso kumwa mowa amalangizidwa kuti asiye, chifukwa zizolowezizi zimatha kukulitsa zizindikilozo.

Pali zotulukapo zingapo zomwe zingachitike mu peripartum cardiomyopathy. Amayi ena amakhala okhazikika kwakanthawi, pomwe ena zimawonjezeka pang'onopang'ono.

Ena amakula msanga kwambiri ndipo atha kukhala ofuna kulandira mtima. Pafupifupi 4% ya anthu adzafunika kumuika mtima ndipo 9% amatha kufa mwadzidzidzi kapena kufa chifukwa cha zovuta za njirayi.

Maonekedwe ake ndi abwino mtima wamayi ukabwerera mwakale mwana akabadwa. Ngati mtima umakhalabe wachilendo, kutenga mimba mtsogolo kumatha kubweretsa kulephera kwa mtima. Sizikudziwika momwe tinganenere kuti ndani adzachira komanso ndani angadwale mtima kwambiri. Pafupifupi theka la azimayi adzachira kwathunthu.

Amayi omwe amakhala ndi peripartum cardiomyopathy ali pachiwopsezo chachikulu chotenga vuto lomwelo ndikakhala ndi pakati mtsogolo. Mlingo wobwereza ndi pafupifupi 30%. Chifukwa chake, azimayi omwe akhala ndi vutoli ayenera kukambirana ndi olera awo za njira zolerera.

Zovuta zimaphatikizapo:

• Matenda a mtima (amatha kupha)
• Kulephera kwa mtima
• Mapangidwe amkati mumtima omwe amatha kuphatikiza (kupita kumadera ena a thupi)

Itanani omwe akukuthandizani ngati muli ndi pakati kapena mwangobereka kumene mwana ndipo mukuganiza kuti mungakhale ndi zizindikilo za mtima.

Pezani chithandizo chamankhwala nthawi yomweyo ngati mukudwala pachifuwa, kupweteka, kukomoka, kapena zizindikilo zina zatsopano kapena zosadziwika.

Idyani chakudya choyenera komanso muzichita masewera olimbitsa thupi nthawi zonse kuti mtima wanu ukhale wolimba. Pewani ndudu ndi mowa. Wothandizira anu akhoza kukulangizani kuti mupewe kutenga pakati ngati mwakhala mukulephera mtima panthawi yapakati.

Cardiomyopathy - peripartum; Cardiomyopathy - mimba

• Mtima - gawo kupyola pakati
• Mtima - kuwonera kutsogolo
• Peripartum cardiomyopathy

Blanchard DG, Daniels LB. Matenda amtima. Mu: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, olemba. Creasy ndi Resnik's Maternal-Fetal Medicine: Mfundo ndi Kuchita. 8th ed. Philadelphia, PA: Elsevier; 2019: chap 52.

McKenna WJ, Mtsogoleri wa Elliott. Matenda a myocardium ndi endocardium. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 54.

Silversides CK, Chenjezo CA. Mimba ndi matenda a mtima. 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 90.