Kuletsa mtima kwa mtima

Kuletsa mtima kwa mtima kumatanthawuza kusintha kwa momwe minofu yamtima imagwirira ntchito. Kusintha kumeneku kumapangitsa mtima kudzaza bwino (kufala kwambiri) kapena kufinya pang'ono (kofala). Nthawi zina, mavuto onse awiriwa amapezeka.

Pankhani yoletsa mtima, minofu yamtima imakhala yayikulu kapena kukulitsa pang'ono. Nthawi zambiri, imapomphanso bwino. Komabe, sichimakhazikika nthawi yayitali pakati pa kugunda kwamtima magazi akabwerera kuchokera mthupi (diastole).

Ngakhale vuto lalikulu ndikudzaza mtima modzidzimutsa, mtima sungapope magazi mwamphamvu matendawo akapita patsogolo. Ntchito yachilendo ya mtima imatha kukhudza mapapu, chiwindi, ndi machitidwe ena amthupi. Kuletsa mtima kwa mtima kumatha kukhudza mwina kapena zipinda zam'munsi zam'mimba (ma ventricles). Kuletsa mtima kwa mtima ndizovuta kwambiri. Zomwe zimayambitsa kwambiri ndi amyloidosis ndi zipsera za mtima pazifukwa zosadziwika. Zitha kuchitika pambuyo pakuika mtima.

Zina mwazomwe zimalepheretsa cardiomyopathy ndi izi:

• Amyloidosis yamtima
• Matenda a mtima wama Carcinoid
• Matenda amkati mwa mtima (endocardium), monga endomyocardial fibrosis ndi matenda a Loeffler (osowa)
• Iron yodzaza (hemochromatosis)
• Sarcoidosis
• Kusokoneza pambuyo poizoniyu kapena chemotherapy
• Scleroderma
• Zotupa za mtima

Zizindikiro za kulephera kwa mtima ndizofala kwambiri. Zizindikirozi nthawi zambiri zimayamba pang'onopang'ono pakapita nthawi.Komabe, zizindikiro nthawi zina zimayamba modzidzimutsa ndipo zimakhala zovuta.

Zizindikiro zodziwika ndi izi:

• Tsokomola
• Mavuto apuma omwe amapezeka usiku, ndi zochitika kapena pogona
• Kutopa ndi kulephera kuchita masewera olimbitsa thupi
• Kutaya njala
• Kutupa pamimba
• Kutupa kwa mapazi ndi akakolo
• Kugunda kosafanana kapena kofulumira

Zizindikiro zina zitha kuphatikiza:

• Kupweteka pachifuwa
• Kulephera kumvetsetsa
• Kutulutsa mkodzo wotsika
• Muyenera kukodza usiku (mwa akulu)

Kuyezetsa thupi kumatha kuwonetsa:

• Kukulitsa (kusokoneza) kapena kutulutsa mitsempha ya khosi
• Kukulitsa chiwindi
• Mapapu amang'ambika ndikumveka kwachilendo kapena kwakutali kwa mtima pachifuwa kumvedwa ndi stethoscope
• Kusungira kwamadzi m'manja ndi m'mapazi
• Zizindikiro za kulephera kwa mtima

Mayeso oletsa kusintha kwa mtima ndi awa:

• Catheterization yamtima ndi coriary angiography
• Chifuwa cha CT
• X-ray pachifuwa
• ECG (electrocardiogram)
• Echocardiogram ndi Doppler kuphunzira
• MRI yamtima
• Kuunika kwa mtima wa nyukiliya (MUGA, RNV)
• Maphunziro a chitsulo a Serum
• Mayeso a mapuloteni a Seramu ndi mkodzo

Kuletsa mtima kwa mtima kumatha kuwoneka kofanana ndi kupondereza kwa pericarditis. Catheterization yamtima ingathandize kutsimikizira kuti ali ndi matendawa. Nthawi zambiri, nthawi zambiri pamatha kufunsa.

Chomwe chimayambitsa matenda a mtima chimathandizidwa pomwe chingapezeke.

Mankhwala ochepa amadziwika kuti amagwira ntchito bwino poletsa mtima. Cholinga chachikulu cha chithandizo ndikuwongolera zizindikiritso ndikusintha moyo.

Mankhwalawa angagwiritsidwe ntchito kuthana ndi zizindikiro kapena kupewa mavuto:

• Mankhwala ochepetsa magazi
• Chemotherapy (nthawi zina)
• Odzetsa amachotsa madzimadzi ndikuthandizira kupuma bwino
• Mankhwala opewera kapena kuwongolera mayendedwe achilendo amtima
• Steroids kapena chemotherapy pazifukwa zina

Kuika mtima kumatha kuganiziridwa ngati mtima ukugwira ntchito bwino kwambiri ndipo zisonyezo ndizovuta.

Anthu omwe ali ndi vutoli nthawi zambiri amakhala ndi vuto la mtima lomwe limangokulira. Mavuto okhala ndi kugunda kwamtima kapena mavavu amtima "otayikira" amathanso kuchitika.

Anthu omwe ali ndi vuto lokhazikika pamtima atha kukhala ofuna kusintha mtima. Mawonekedwe amatengera zomwe zimayambitsa vutoli, koma nthawi zambiri limakhala losauka. Kupulumuka mutatha kuzindikira kumatha kupitilira zaka 10.

Itanani omwe akukuthandizani ngati muli ndi zizindikilo zoletsa mtima.

Matenda amtima - oletsa; Infiltrative cardiomyopathy; Idiopathic m'mnyewa wamtima fibrosis

• Mtima - gawo kupyola pakati
• Mtima - kuwonera kutsogolo

Falk RH, Hershberger RE. Ma cardiomyopathies ochepetsedwa, oletsa, komanso olowerera. 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 77.

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.