Myocarditis - Dokotala

Matenda a myocarditis ndikutupa kwa minofu yamtima mwa khanda kapena mwana wakhanda.

Myocarditis imapezeka kawirikawiri mwa ana ang'onoang'ono. Ndizofala kwambiri kwa ana okalamba komanso achikulire. Nthawi zambiri zimakhala zoyipa kwambiri kwa ana obadwa kumene komanso makanda achichepere kuposa ana azaka zopitilira 2.

Nthawi zambiri ana amayamba chifukwa cha kachilombo kamene kamafika pamtima. Izi zingaphatikizepo:

• Fuluwenza (chimfine) kachilombo
• Kachilombo ka Coxsackie
• Parovirus
• Adenovirus

Zikhozanso kuyambitsidwa ndi matenda a bakiteriya monga matenda a Lyme.

Zina mwazomwe zimayambitsa ana myocarditis ndi monga:

• Thupi lawo siligwirizana ndi mankhwala ena
• Kuwonetsedwa ndi mankhwala m'chilengedwe
• Matenda chifukwa cha bowa kapena majeremusi
• Mafunde
• Matenda ena (autoimmune matenda) omwe amayambitsa kutupa mthupi lonse
• Mankhwala ena

Minofu yamtima imatha kuwonongeka mwachindunji ndi kachilomboka kapena bakiteriya omwe amaipatsira. Kuyankha kwa chitetezo cha mthupi kumathanso kuwononga minofu yamtima (yotchedwa myocardium) pokonzekera kulimbana ndi matendawa. Izi zitha kubweretsa zizindikilo za kulephera kwa mtima.

Zizindikiro zimakhala zofatsa poyamba komanso zovuta kuzizindikira. Nthawi zina mwa ana obadwa kumene ndi makanda, zizindikilo zimatha kuwoneka modzidzimutsa.

Zizindikiro zimaphatikizapo:

• Kuda nkhawa
• Kulephera kukula bwino kapena kunenepa pang'ono
• Kudyetsa zovuta
• Malungo ndi zizindikiro zina za matenda
• Mantha
• Kutulutsa mkodzo wotsika (chizindikiro cha kuchepa kwa ntchito ya impso)
• Wotuwa, manja ndi mapazi ozizira (chizindikiro chosayenda bwino)
• Kupuma mofulumira
• Kuthamanga kwa mtima mwachangu

Zizindikiro za ana opitilira zaka ziwiri zitha kuphatikizaponso:

• Malo am'mimba am'mimba komanso nseru
• Kupweteka pachifuwa
• Tsokomola
• Kutopa
• Kutupa (edema) m'miyendo, mapazi, ndi nkhope

Matenda a myocarditis amatha kukhala ovuta kuwazindikira chifukwa zizindikilo nthawi zambiri zimafanana ndi matenda ena amtima ndi mapapo, kapena vuto la chimfine.

Wopereka chithandizo chamankhwala amatha kumva kugunda kwamtima mwachangu kapena kumveka kwamtima kosamveka akumvera pachifuwa cha mwana ndi stethoscope.

Kuyezetsa thupi kumatha kuwonetsa:

• Madzimadzi m'mapapu ndi kutupa m'miyendo mwa ana okulirapo.
• Zizindikiro za matenda, kuphatikizapo malungo ndi totupa.

X-ray pachifuwa imatha kuwonetsa kukulira (kutupa) kwa mtima. Ngati wothandizirayo akukayikira kuti myocarditis itengera mayeso ndi chifuwa cha x-ray, electrocardiogram itha kuchitidwanso kuti athandizire matendawa.

Mayesero ena omwe angafunike ndi awa:

• Zikhalidwe zamagazi kuti muwone ngati alibe matenda
• Kuyezetsa magazi kuti ayang'ane ma antibodies olimbana ndi mavairasi kapena minofu ya mtima
• Kuyezetsa magazi kuti muwone momwe chiwindi ndi impso zimagwirira ntchito
• Kuwerengera kwathunthu kwa magazi
• Kutsekemera kwa mtima (njira yolondola kwambiri yotsimikizirira matendawa, koma sikofunikira nthawi zonse)
• Mayeso apadera owunikira kupezeka kwa ma virus m'magazi (virus PCR)

Myocarditis palibe mankhwala. Kutupa kwa minofu yamtima nthawi zambiri kumatha yokha.

Cholinga cha chithandizo ndikuthandizira kugwira ntchito kwa mtima mpaka kutupa kutatha. Ana ambiri omwe ali ndi vutoli amalowetsedwa kuchipatala. Zochita nthawi zambiri zimayenera kuchepetsedwa pomwe mtima watupa chifukwa umatha kusokoneza mtima.

Chithandizo chingaphatikizepo:

• Maantibayotiki olimbana ndi matenda a bakiteriya
• Mankhwala oletsa kutupa amatchedwa steroids kuti athetse kutupa
• Intravenous immunoglobulin (IVIG), mankhwala opangidwa ndi zinthu (zotchedwa ma antibodies) omwe thupi limatulutsa kuti athane ndi matenda, kuwongolera zotupa
• Makina ogwiritsa ntchito makina kuti athandize mtima kugwira ntchito (zikavuta)
• Mankhwala ochizira matenda a mtima
• Mankhwala ochizira nthenda zachilendo za mtima

Kuchira kuchokera ku myocarditis kumadalira chifukwa cha vutoli komanso thanzi la mwanayo. Ana ambiri amachira kwathunthu ndi chithandizo choyenera. Komabe, ena atha kukhala ndi matenda amtima osatha.

Ana obadwa kumene ali pachiwopsezo chachikulu chotenga matenda akulu komanso zovuta (kuphatikizapo kufa) chifukwa cha myocarditis. Nthawi zambiri, kuwonongeka kwakukulu kwa minofu ya mtima kumafuna kumuika mtima.

Zovuta zingaphatikizepo:

• Kukulitsa kwa mtima komwe kumabweretsa kuchepa kwa mtima (kuchepa kwa mtima)
• Mtima kulephera
• Mavuto amtundu wamtima

Itanani dokotala wa ana anu ngati zizindikiro za matendawa zikuchitika.

Palibe njira yodziwika yopewera. Komabe, kuyesa mwachangu ndi chithandizo kumachepetsa matendawa.

• Myocarditis

Knowlton KU, Anderson JL, Savoia MC, Oxman MN. Myocarditis ndi pericarditis. Mu: Bennett JE, Dolin R, Blaser MJ, olemba., Eds. Mandell, Douglas, ndi Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020: chap 84.

DM wa McNamara. Kulephera kwa mtima chifukwa cha ma virus ndi nonviral myocarditis. Mu: Felker GM, Mann DL, ma eds. Kulephera kwa Mtima: Wothandizana naye ku Matenda a Mtima a Braunwald. Wolemba 4. Philadelphia, PA: Elsevier; 2020: mutu 28.

Kholo JJ, Ware SM. Matenda a myocardium. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: mutu 466.