Kulephera kwa mtima - mayeso

Kuzindikira kwa kulephera kwa mtima kumapangidwa makamaka pazizindikiro za munthu ndikuwunika kwakuthupi. Komabe, pali mayesero ambiri omwe angathandize kupereka zambiri zokhudza vutoli.

Echocardiogram (echo) ndiyeso lomwe limagwiritsa ntchito mafunde amawu kuti apange chithunzi chosuntha cha mtima. Chithunzicho chimafotokozedwa bwino kwambiri kuposa chithunzi cha x-ray.

Kuyesaku kumathandiza wothandizira zaumoyo wanu kuti adziwe zambiri za momwe mtima wanu umagwirira ntchito komanso kumasuka. Imaperekanso chidziwitso chokhudza kukula kwa mtima wanu komanso momwe ma valve amtima akugwirira ntchito.

Echocardiogram ndiyeso labwino kwambiri ku:

• Dziwani mtundu wamtima wosalimba (systolic, diastolic, valvular)
• Onetsetsani kulephera kwa mtima wanu ndikuwongolera chithandizo chanu

Kulephera kwa mtima kumatha kupezeka ngati echocardiogram ikuwonetsa kuti ntchito yopopera yamtima ndiyotsika kwambiri. Izi zimatchedwa gawo la ejection. Gawo laling'ono lochotsera pafupifupi 55% mpaka 65%.

Ngati mbali zina za mtima sizikuyenda bwino, zitha kutanthauza kuti pamitsempha yamtima pamakhala chotchinga chomwe chimapereka magazi kuderalo.

Mayesero ena ambiri amagwiritsidwa ntchito kuti awone momwe mtima wanu umatha kupopera magazi komanso kukula kwa minofu yamtima.

Mutha kukhala ndi x-ray pachifuwa muofesi ya omwe amakupatsani ngati zizindikiro zanu zikuipiraipira mwadzidzidzi. Komabe, x-ray pachifuwa sichingazindikire kulephera kwa mtima.

Ventriculography ndi mayeso ena omwe amayesa kufinya kwathunthu kwa mtima (gawo lotulutsa). Monga echocardiogram, imatha kuwonetsa ziwalo za mtima zomwe sizikuyenda bwino. Chiyesochi chimagwiritsa ntchito x-ray kusiyanasiyana kwamadzimadzi kudzaza chipinda chopopera chamtima ndikuwunika momwe imagwirira ntchito. Nthawi zambiri zimachitika nthawi imodzi ndi mayeso ena, monga coronary angiography.

MRI, CT, kapena PET zowunika pamtima zitha kuchitidwa kuti muwone kuchuluka kwa minofu yamtima yomwe ilipo. Zitha kuthandizanso kuzindikira chifukwa chodwala mtima kwa wodwala.

Kuyesedwa kwa kupsinjika kumachitika kuti muwone ngati minofu yamtima ikupeza magazi okwanira komanso mpweya wabwino ikamagwira ntchito molimbika (mopanikizika). Mitundu yamayeso opanikizika ndi monga:

• Kuyesa kwa kupsinjika kwa nyukiliya
• Chitani masewera olimbitsa thupi
• Kupsinjika kwa echocardiogram

Wothandizira anu amatha kuyitanitsa kutsekemera kwa mtima ngati mayeso ena azithunzi akuwonetsa kuti mwachepa m'mitsempha yanu, kapena ngati mukumva kupweteka pachifuwa (angina) kapena kuyesedwa kotsimikizika kukufunika.

Mayeso osiyanasiyana amwazi angagwiritsidwe ntchito kuti mumve zambiri za matenda anu. Mayeso amachitika kuti:

• Thandizani kuzindikira chomwe chimayambitsa ndikuwunika kulephera kwa mtima.
• Dziwani zomwe zingayambitse matenda amtima.
• Fufuzani zifukwa zomwe zingayambitse mtima wanu kapena mavuto omwe angapangitse mtima wanu kulephera.
• Onetsetsani zotsatira zoyipa zamankhwala omwe mwina mukumwa.

Magazi a urea nitrogen (BUN) ndi serum creatinine amayesa kuwunika momwe impso zanu zikugwirira ntchito. Mudzafunika mayesowa pafupipafupi ngati:

• Mukumwa mankhwala omwe amatchedwa ACE inhibitors kapena ma ARB (angiotensin receptor blockers)
• Wothandizira anu amasintha pamlingo wa mankhwala anu
• Mukulephera mtima kwambiri

Magulu a sodium ndi potaziyamu m'magazi anu amafunika kuyezedwa pafupipafupi pakakhala zosintha pamankhwala ena kuphatikiza:

• ACE inhibitors, ma ARB, kapena mitundu ina yamapiritsi amadzi (amiloride, spironolactone, ndi triamterene) ndi mankhwala ena omwe angapangitse kuchuluka kwa potaziyamu kwambiri
• Mitundu ina yambiri yamapiritsi amadzi, yomwe imatha kupanga kuti sodium ikhale yotsika kwambiri kapena potaziyamu wanu kwambiri

Kuchepa kwa magazi, kapena kuchuluka kwama cell ofiira ofiira, kumatha kukulitsa mtima wanu kulephera. Wothandizira anu amayang'ana CBC yanu kapena kuchuluka kwamagazi pafupipafupi kapena matenda anu akakulirakulira.

CHF - mayesero; Kulephera kwa mtima - mayesero; Cardiomyopathy - mayesero; HF - mayesero

Greenberg B, Kim PJ, Kahn AM. Kuyesa kuchipatala kwa kulephera kwa mtima Mu: Felker GM, Mann DL, ma eds. Kulephera kwa Mtima: Wothandizana naye ku Matenda a Mtima a Braunwald. Wolemba 4. Philadelphia, PA: Elsevier, 2020: chap 31.

Mann DL. Kuwongolera odwala omwe ali ndi vuto la mtima ndi gawo lochepetsedwa. 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 Saunders; 2019: chap 25.

Yancy CW, Jessup M, Bozkurt B, ndi al. 2017 ACC / AHA / HFSA idasinthiratu malangizo a 2013 ACCF / AHA owongolera kuwonongeka kwa mtima: lipoti la American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. J Kulephera Kwa Mtima. 2017; 23 (8): 628-651. PMID: 28461259 www.ncbi.nlm.nih.gov/pubmed/28461259. (Adasankhidwa)

Yancy CW, Jessup M, Bozkurt B, ndi al.Chitsogozo cha ACCF / AHA cha 2013 chothandizira kuwonongeka kwa mtima: lipoti la American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. Kuzungulira. 2013; 128 (16): e240-e327. PMID: 23741058 www.ncbi.nlm.nih.gov/pubmed/23741058.

• Kulephera Kwa Mtima