Amyloidosis yamtima

Cardiac amyloidosis ndi vuto lomwe limayambitsidwa ndi madontho a mapuloteni achilendo (amyloid) amkati mwa mtima. Izi zimapangitsa kuti zikhale zovuta kuti mtima ugwire bwino ntchito.

Amyloidosis ndi gulu la matenda momwe ma protein omwe amatchedwa amyloid amakhala m'matupi amthupi. Popita nthawi, mapuloteniwa amalowa m'malo mwa minofu yabwinobwino, zomwe zimabweretsa kulephera kwa chiwalo. Pali mitundu yambiri ya amyloidosis.

Mtima amyloidosis ("mtima wouma mtima") umachitika ma deposits amyloid atenga malo amtundu wathanzi wamtima. Ndiwo mtundu wodziletsa kwambiri wama cardiomyopathy. Mtima amyloidosis ungakhudze momwe zizindikiritso zamagetsi zimadutsira mumtima (kondomu). Izi zitha kubweretsa kugunda kwamtima (arrhythmias) ndi ziwonetsero zolakwika za mtima (block block).

Vutoli limatha kubadwa nalo. Izi zimatchedwa banja amyloidosis wamtima. Zitha kupanganso chifukwa cha matenda ena monga mtundu wa khansa ya mafupa ndi magazi, kapena chifukwa chazovuta zina zamankhwala zomwe zimayambitsa kutupa. Amyloidosis wamtima ndiofala kwambiri mwa amuna kuposa azimayi. Matendawa ndi osowa mwa anthu ochepera zaka 40.

Anthu ena sangakhale ndi zizindikilo. Zikakhalapo, zizindikilo zimatha kuphatikiza:

• Kukodza kwambiri usiku
• Kutopa, kuchepetsa mphamvu zolimbitsa thupi
• Kupindika (kutengeka kwa kugunda kwamtima)
• Kupuma pang'ono ndi zochitika
• Kutupa kwa mimba, miyendo, akakolo, kapena gawo lina la thupi
• Kuvuta kupuma mutagona

Zizindikiro za mtima amyloidosis zitha kukhala zokhudzana ndi zochitika zosiyanasiyana. Izi zitha kupangitsa kuti vutoli lidziwike.

Zizindikiro zimatha kuphatikiza:

• Kumveka kosazolowereka m'mapapu (mapiko am'mapapu) kapena kung'ung'uza mtima
• Kuthamanga kwa magazi komwe kumakhala kotsika kapena kutsika mukaimirira
• Kukulitsa mitsempha ya khosi
• Kutupa chiwindi

Mayesero otsatirawa akhoza kuchitika:

• Chifuwa kapena mimba ya CT scan (yomwe imadziwika kuti "golide" yothandiza kuzindikira vutoli)
• Zowonera Coronary
• Electrocardiogram (ECG)
• Zojambulajambula
• Kujambula kwa maginito (MRI)
• Kusanthula mtima wa nyukiliya (MUGA, RNV)
• Positron umuna tomography (PET)

ECG ingawonetse mavuto ndi kugunda kwamtima kapena siginecha yamtima. Itha kuwonetsanso ma siginolo otsika (otchedwa "low voltage").

Chidziwitso cha mtima chimagwiritsidwa ntchito kutsimikizira matendawa. Zomwe zimachitika mdera lina, monga pamimba, impso, kapena mafupa, zimachitikanso.

Wothandizira zaumoyo wanu akhoza kukuwuzani kuti musinthe zakudya zanu, kuphatikizapo kuchepetsa mchere ndi madzi.

Mungafunike kumwa mapiritsi amadzi (okodzetsa) kuti mthupi lanu muchotse madzimadzi owonjezera. Woperekayo angakuuzeni kuti muyese tsiku lililonse. Kulemera kwa mapaundi atatu kapena kupitilira apo (kilogalamu imodzi kapena kupitilira apo) kupitirira masiku 1 mpaka 2 kungatanthauze kuti pali madzi ambiri mthupi.

Mankhwala ophatikizapo digoxin, calcium-channel blockers, ndi beta-blockers atha kugwiritsidwa ntchito kwa anthu omwe ali ndi matenda a atrial fibrillation. Komabe, mankhwalawa ayenera kugwiritsidwa ntchito mosamala, ndipo mlingowo uyenera kuyang'aniridwa mosamala. Anthu omwe ali ndi mtima amyloidosis amatha kukhala omvera pazovuta za mankhwalawa.

Mankhwala ena atha kukhala:

• Chemotherapy
• Chokhazika mtima chosintha mtima (AICD)
• Pacemaker, ngati pali mavuto ndi zizindikilo za mtima
• Prednisone, mankhwala odana ndi zotupa

Kuika mtima kumaganiziridwa kwa anthu omwe ali ndi mitundu ina ya amyloidosis omwe ali ndi vuto losautsa mtima. Anthu omwe ali ndi cholowa cha amyloidosis angafunike kumuika chiwindi.

M'mbuyomu, mtima amyloidosis amalingaliridwa kuti ndi matenda osachiritsika komanso owopsa. Komabe, gawo likusintha mwachangu. Mitundu yosiyanasiyana ya amyloidosis imatha kukhudza mtima m'njira zosiyanasiyana. Mitundu ina imakhala yovuta kwambiri kuposa ina. Anthu ambiri atha kuyembekezera kupulumuka ndikukhala ndi moyo wabwino kwazaka zingapo atapezeka ndi matenda.

Zovuta zingaphatikizepo:

• Matenda a Atrial kapena ma ventricular arrhythmias
• Kulephera kwa mtima
• Zamadzimadzi zimakhazikika m'mimba (ascites)
• Kuchulukitsa chidwi cha digoxin
• Kuthamanga kwa magazi ndi chizungulire chifukwa chokodza kwambiri (chifukwa cha mankhwala)
• Matenda odwala sinus
• Syndromeomatic mtima conduction system matenda (arrhythmias yokhudzana ndi mayendedwe achilendo am'mimba mwa mtima)

Itanani omwe akukuthandizani ngati muli ndi vutoli ndikupanga zizindikiro zatsopano monga:

• Chizungulire mukasintha malo
• Kulemera kwambiri (madzimadzi) phindu
• Kuchepetsa kwambiri kunenepa
• Kukomoka
• Mavuto akulu kupuma

Amyloidosis - mtima; Pulayimale amyloidosis - mtundu wa AL; Secondary mtima amyloidosis - AA mtundu; Ouma mtima matenda; Senile amyloidosis

• Mtima - gawo kupyola pakati
• Kuchepetsa mtima
• Catheter ya biopsy

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.