Endocarditis

Endocarditis ndikutupa kwa mkati mwa zipinda zamtima ndi ma valve amtima (endocardium). Amayambitsidwa ndi bakiteriya kapena, samakhala ndi matenda a fungal.

Endocarditis itha kuphatikizira minofu ya mtima, mavavu amtima, kapena kuyika kwa mtima. Anthu ena omwe amakhala ndi endocarditis ali ndi:

• Chibadwa cha kubadwa kwa mtima
• Kuwonongeka kapena kupindika kwa valavu yamtima
• Mbiri ya endocarditis
• Valavu yatsopano yamtima mutatha opaleshoni
• Parenteral (intravenous) mankhwala osokoneza bongo

Endocarditis imayamba pamene majeremusi amalowa m'magazi ndikupita kumtima.

• Matenda a bakiteriya ndi omwe amayambitsa matenda a endocarditis.
• Endocarditis amathanso kuyambitsidwa ndi bowa, monga Candida.
• Nthawi zina, palibe chifukwa chomwe chingapezeke.

Majeremusi amatha kulowa m'magazi nthawi:

• Mizere yolowera pakati
• Kugwiritsa ntchito jakisoni wogwiritsa ntchito mankhwala osokoneza bongo, kugwiritsa ntchito singano zosayera (zosakhazikika)
• Opaleshoni yaposachedwa yamano
• Opaleshoni ina kapena njira zazing'ono zopumira, thirakiti, khungu lomwe lili ndi kachilombo, kapena mafupa ndi minofu

Zizindikiro za endocarditis zimatha kuyamba pang'onopang'ono kapena mwadzidzidzi.

Malungo, kuzizira, ndi thukuta ndizizindikiro zambiri. Izi nthawi zina zimatha:

• Khalani nawo masiku ambiri zizindikiro zina zisanachitike
• Bwera, pita, kapena uziwonekera kwambiri nthawi yamadzulo

Muthanso kukhala ndi kutopa, kufooka, zopweteka ndi zopweteka m'minyewa kapena m'malo olumikizirana mafupa.

Zizindikiro zina zitha kuphatikiza:

• Madera ang'onoang'ono otaya magazi pansi pa misomali (kukha mwazi)
• Mawanga ofiira, opanda ululu padzanja ndi pamiyendo (zotupa za Janeway)
• Zofiira, zopweteka m'miyendo ya zala ndi zala (Osler node)
• Kupuma pang'ono ndi zochitika
• Kutupa kwa mapazi, miyendo, pamimba

Wopereka chithandizo chazachipatala atha kuzindikira kung'ung'udza kwamtima kwatsopano, kapena kusintha kwakanthawi kung'ung'udza mtima.

Kuyezetsa diso kumatha kuwonetsa kutuluka kwa magazi mu diso komanso pakatikati poyeretsa. Kupeza uku kumatchedwa malo a Roth. Pakhoza kukhala madera ang'onoang'ono, otchulira magazi kunja kwa diso kapena zikope.

Mayeso omwe angachitike ndi awa:

• Chikhalidwe chamagazi chothandiza kuzindikira mabakiteriya kapena bowa zomwe zimayambitsa matendawa
• Kuwerengera kwathunthu kwa magazi (CBC), C-reactive protein (CRP), kapena erythrocyte sedimentation rate (ESR)
• Echocardiogram kuti ayang'ane mavavu amtima

Mungafunike kukhala mchipatala kuti mupeze maantibayotiki kudzera mumitsempha (IV kapena kudzera m'mitsempha). Chikhalidwe cha magazi ndi mayeso adzakuthandizani omwe akukuthandizani kusankha mankhwala abwino kwambiri.

Mudzafunika chithandizo chamankhwala chamtundu wautali.

• Anthu nthawi zambiri amafunikira chithandizo kwa milungu 4 mpaka 6 kuti aphe mabakiteriya onse ochokera muzipinda zamtima ndi mavavu.
• Mankhwala a maantibayotiki omwe ayamba kuchipatala adzafunika kupitilizidwa kunyumba.

Kuchita opaleshoni m'malo mwa valavu yamtima nthawi zambiri kumafunikira pamene:

• Matendawa akung'amba tating'onoting'ono, ndikupangitsa sitiroko.
• Munthuyo amakhala ndi vuto la mtima chifukwa cha mavavu amtima owonongeka.
• Pali umboni wowonongeka kwambiri kwa ziwalo.

Kupeza chithandizo cha endocarditis nthawi yomweyo kumathandiza kuti pakhale zotsatira zabwino.

Mavuto akulu omwe angakhalepo ndi awa:

• Kutupa kwa ubongo
• Zowonjezeranso kuwonongeka kwa ma valve amtima, kuchititsa kulephera kwa mtima
• Kufalitsa kachilomboka kumadera ena a thupi
• Sitiroko, yomwe imayambitsidwa ndimatenda ang'onoang'ono kapena zidutswa za matendawa zimayamba kupita kuubongo

Itanani omwe akukuthandizani ngati muwona izi:

• Magazi mkodzo
• Kupweteka pachifuwa
• Kutopa
• Malungo omwe samachoka
• Malungo
• Kunjenjemera
• Kufooka
• Kuchepetsa thupi popanda kusintha zakudya

American Heart Association imalimbikitsa maantibayotiki oteteza kwa anthu omwe ali pachiwopsezo cha matenda opatsirana a endocarditis, monga omwe ali ndi:

• Zofooka zina zakubadwa za mtima
• Kuika mtima ndi mavuto a valavu
• Mavavu amtima wopangika (mavavu amtima omwe amalowetsedwa ndi dokotala wa opaleshoni)
• Mbiri yakale ya endocarditis

Anthuwa ayenera kulandira maantibayotiki akakhala ndi:

• Njira zamano zomwe zimayambitsa magazi
• Njira zokhudzana ndi njira yopumira
• Njira zokhudzana ndi dongosolo la kwamikodzo
• Njira zokhudzana ndi kugaya chakudya
• Njira zotetezera khungu ndi matenda ofewa

Valavu matenda; Staphylococcus aureus - endocarditis; Enterococcus - endocarditis; Streptococcus viridans - endocarditis; Candida - endocarditis

• Opaleshoni ya valve yamtima - kutulutsa

• Mtima - gawo kupyola pakati
• Mtima - kuwonera kutsogolo
• Janeway lesion - kutseka
• Janeway chotupa pa chala
• Mavavu amtima

Baddour LM, Freeman WK, Suri RM, Wilson WR. 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 73.

Baddour LM, Wilson WR, Bayer AS, ndi al. Matenda opatsirana mwa akulu: matenda, mankhwala ophera tizilombo toyambitsa matenda, ndi kasamalidwe ka zovuta: mawu asayansi azachipatala ochokera ku American Heart Association. Kuzungulira. 2015; 132 (15): 1435-1486. PMID: 26373316 www.ncbi.nlm.nih.gov/pubmed/26373316. (Adasankhidwa)

Fowler VG, Bayer AS, Baddour LM. Matenda opatsirana endocarditis. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. Wolemba 25. Philadelphia, PA: Elsevier Saunders; 2016: chap 76.

Fowler VG, Scheld WM, Bayer AS. Endocarditis ndi matenda opatsirana m'mimba. Mu: Bennett JE, Dolin R, Blaser MJ, olemba., Eds. Mandell, Douglas, ndi Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015: chap 82.