Brugada Syndrome

Sindrome ya Brugada (brew-GAH-dah) ni uburwayi buke ariko bushobora guhitana umuntu bufite aho buhuriye n'umuvuduko w'umutima (arrhythmia) rimwe na rimwe ikaba irangwa mu miryango. Abantu bafite syndrome ya Brugada bafite ibyago byinshi byo kugira umuvuduko w'umutima utari mwiza utangirira mu byumba byo hasi by'umutima (ventricles). Kuvura syndrome ya Brugada birimo ingamba zo kwirinda nko kugabanya umuriro no kwirinda imiti ishobora gutera arrhythmia. Bamwe mu bantu bafite syndrome ya Brugada bakeneye igikoresho cy'ubuvuzi cyitwa implantable cardioverter-defibrillator (ICD).

Sindrome ya Brugada akenshi ntiterwa n'ibimenyetso bifatika. Abantu benshi bafite sindrome ya Brugada ntibaba bazi ko bayifite.

Ibishimisha n'ibimenyetso bishobora kuba bifitanye isano na sindrome ya Brugada birimo:

• Kuzenguruka
• Kugwa
• Guhumeka bigoranye kandi bikomeye, cyane cyane nijoro
• Gukubita kw'umutima hadaciriritse cyangwa guhumeka kwijoro
• Gukubita kw'umutima kwihuta cyane kandi kudahwitse
• Kugwa mu rujijo

Ikimenyetso gikomeye cya sindrome ya Brugada ni ikigereranyo kidahwitse kuri electrocardiogram (ECG), ikizamini gipima ibikorwa by'amashanyarazi y'umutima.

Ibimenyetso n'ibibonwa bya syndrome ya Brugada bisa n'iby'izindi ndwara zifata umutima. Ni ngombwa ko uganira n'abaganga kugira ngo bamenye niba syndrome ya Brugada cyangwa izindi ndwara zifata umutima ari zo ziguteye ibyo bibazo.

Niba ubaye nk'uwo gucika intege kandi ukaba ubona ko bishobora guterwa n'uburwayi bw'umutima, shaka ubufasha bw'abaganga vuba.

Niba umubyeyi wawe, umuvandimwe wawe cyangwa umwana wawe yasanze afite syndrome ya Brugada, ushobora kubaza umuganga wawe niba ukwiye gupimwa kugira ngo urebe niba uri mu kaga ko kuyirwara.

Brugada syndrome ni indwara y'umutima ifitanye isano n'umuvuduko w'umutima. Buri gukubita kw'umutima guterwa n'umuyoboro w'amashanyarazi ukomoka kuri selile zihariye ziri mu gice cyo hejuru cy'iburyo bw'umutima. Udukanwa duto, twitwa imiyoboro, kuri buri imwe muri izi selile tuyobora ibikorwa by'amashanyarazi, bituma umutima ukubita.

Muri Brugada syndrome, impinduka muri iyi miyoboro itera umutima gukubita cyane, bigatera umuvuduko w'umutima w'akaga (ventricular fibrillation).

Niba bimeze bityo, umutima ntabwo upompa amaraso ahagije mu bindi bice by'umubiri. Umuvuduko utari mwiza ukemba igihe gito ushobora gutera umuntu kugwa. Urupfu rutunguranye rw'umutima rushobora kubaho niba umuvuduko utari mwiza w'umutima uhagaze.

Brugada syndrome ishobora guterwa na:

• Ikibazo cy'imiterere y'umutima, gishobora kuba bigoye kubona
• Kubura ubusugire bw'ibintu by'imiti bifasha kohereza umuyoboro w'amashanyarazi mu mubiri (electrolytes)
• Gukoresha imiti imwe n'imwe cyangwa cocaine

Ibintu byongera ibyago byo kwibasirwa na sindorome ya Brugada birimo:

• Amateka y'umuryango wa sindorome ya Brugada. Iyi ndwara ikunda guhererekanywa mu miryango (ikaba ari iy'uburukirabwato). Kugira abagize umuryango barwaye sindorome ya Brugada byongera ibyago byo kuyirwara.
• Kuba umugabo. Abagabo nibo bagaragaraho sindorome ya Brugada kurusha abagore.
• Ubwoko. Sindorome ya Brugada igaragara cyane mu Banyarwanda kurusha abandi bantu b'ubwoko butandukanye.
• Umuhango. Umuhango ntabwo utera sindorome ya Brugada, ariko ushobora kubabaza umutima kandi ugatera umuntu guta ubwenge cyangwa guhagarika umutima mu buryo butunguranye ku barwaye sindorome ya Brugada, cyane cyane abana.

Ingaruka z'indwara ya Brugada zikenera ubutabazi bwihuse bw'abaganga. Ingaruka z'indwara ya Brugada zirimo:

• Guhagarara k'umutima mu buryo butunguranye. Niba bitavuwe vuba, uku guhagarara k'umutima, guhumeka no kubura ubwenge, bikunze kuba mu gihe cyo kuryama, ni bibi cyane. Hamwe no kwitabwaho n'abaganga vuba kandi neza, ubuzima bushobora gukira.
• Kwicuma. Ku muntu ufite indwara ya Brugada, kwicuma bisaba ubutabazi bw'abaganga mu buryo bwihuse.

Niba umuntu wo mu muryango wanyu afite indwara ya Brugada, ibizamini bya genetika bishobora gukorwa kugira ngo bimenye niba ufite iyo ndwara, cyangwa niba uri mu kaga ko kuyirwara.

Sindrome ya Brugada isanzwe imenyekana mu bakuru, rimwe na rimwe no mu bangavu. Ntibisanzwe kuyimenya mu bana bato kuko ibimenyetso bikunze kudasobanuka.

Kugira ngo umuganga amenye syndrome ya Brugada, azakora isuzuma ngaruka mbere, yumve umutima akoresheje stetoskope. Ibizamini bikorwa kugira ngo barebe uko umutima ukora, bamenye cyangwa bemeze syndrome ya Brugada.

Electrocardiogram (ECG) ifite imiti cyangwa idafite imiti. Electrocardiogram (ECG) ni ikizamini cyihuse, kitababaje, cyandika ibimenyetso by'amashanyarazi mu mutima. Mu gihe cy'ikizamini, ibikoresho byo gupima (electrode) bihambirwa ku gatuza, rimwe na rimwe no ku birenge. Iki kizamini gishobora gufasha kumenya ibibazo by'umuvuduko w'umutima n'imiterere yawo.

Niba umutima ukora neza mu gihe cy'ikizamini, intambwe ikurikira ishobora kuba ukwambara igikoresho cyo gupima umutima iminsi yose n'ijoro. Ubwo bwoko bw'ikizamini bwitwa ikizamini cya Holter cy'amasaha 24.

Bamwe bagira ibimenyetso bya syndrome ya Brugada ariko ibisubizo by'ibizamini byabo bya mbere bya electrocardiogram (ECG) n'ibizamini bya Holter by'amasaha 24 biri mu rwego rusanzwe. Abo bantu bashobora gukora ibizamini by'inyongera bya ECG birimo imiti itangwa mu buryo bwa IV ishobora gutera umuvuduko w'umutima utari mwiza.

Isuzuma rya Electrophysiological (EP) no gupima. Iki kizamini, kandi cyitwa ubushakashatsi bwa electrophysiologic (EP), gishobora gukorwa kuri bamwe bafite amakenga ya syndrome ya Brugada.

Muri iki kizamini, umuganga ashyira imiyoboro myiza, ndende (catheter) ifite electrode ku mpera, mu mitsi y'amaraso yerekeza ahantu hatandukanye mu mutima. Iyo igeze aho igomba kuba, electrode ishobora kwerekana uko amashanyarazi akwirakwira mu mutima.

• Electrocardiogram (ECG) ifite imiti cyangwa idafite imiti. Electrocardiogram (ECG) ni ikizamini cyihuse, kitababaje, cyandika ibimenyetso by'amashanyarazi mu mutima. Mu gihe cy'ikizamini, ibikoresho byo gupima (electrode) bihambirwa ku gatuza, rimwe na rimwe no ku birenge. Iki kizamini gishobora gufasha kumenya ibibazo by'umuvuduko w'umutima n'imiterere yawo.

  Niba umutima ukora neza mu gihe cy'ikizamini, intambwe ikurikira ishobora kuba ukwambara igikoresho cyo gupima umutima iminsi yose n'ijoro. Ubwo bwoko bw'ikizamini bwitwa ikizamini cya Holter cy'amasaha 24.

  Bamwe bagira ibimenyetso bya syndrome ya Brugada ariko ibisubizo by'ibizamini byabo bya mbere bya electrocardiogram (ECG) n'ibizamini bya Holter by'amasaha 24 biri mu rwego rusanzwe. Abo bantu bashobora gukora ibizamini by'inyongera bya ECG birimo imiti itangwa mu buryo bwa IV ishobora gutera umuvuduko w'umutima utari mwiza.

• Echocardiogram. Echocardiogram ikoresha amajwi kugira ngo ikore amashusho y'umutima. Iki kizamini ntikishobora kumenya syndrome ya Brugada ubwacyo, ariko gishobora gufasha kumenya ibibazo by'imiterere y'umutima.

• Isuzuma rya Electrophysiological (EP) no gupima. Iki kizamini, kandi cyitwa ubushakashatsi bwa electrophysiologic (EP), gishobora gukorwa kuri bamwe bafite amakenga ya syndrome ya Brugada.

  Muri iki kizamini, umuganga ashyira imiyoboro myiza, ndende (catheter) ifite electrode ku mpera, mu mitsi y'amaraso yerekeza ahantu hatandukanye mu mutima. Iyo igeze aho igomba kuba, electrode ishobora kwerekana uko amashanyarazi akwirakwira mu mutima.

Ubuvuzi bwa syndrome ya Brugada bushobora kuba burimo imiti, uburyo bwo gukoresha catheter cyangwa kubaga kugira ngo bashyiremo igikoresho kiyobora umutima. Ubuvuzi bwa syndrome ya Brugada bishingiye ku kaga ko kugira ikibazo gikomeye cy'umutima (arrhythmia). Kuba uri mu kaga gakomeye bisobanura kugira:

Iyo ufite syndrome ya Brugada ariko nta bimenyetso, ushobora kutakeneye ubuvuzi bwabugenewe kuko ibyago byo kugira ikibazo gikomeye cy'umutima bishobora kuba bike. Ariko kandi, umuvuzi ashobora kugutegeka gufata ingamba zo kugabanya ibyago byo kugira ikibazo cy'umutima.

Kwirinda imiti ishobora gutera ikibazo cy'umutima. Imiti myinshi ishobora kongera ibyago byo kugira ikibazo cy'umutima, harimo imiti imwe y'umutima n'imiti yo kuvura ihungabana. Alkohol nyinshi na yo ishobora kongera ibyago.

Bwira umuvuzi wawe imiti ukoresha, harimo imiti n'ibindi byongerwamo ugura utabanje kwa muganga.

Bamwe mu bantu bafite syndrome ya Brugada bahabwa imiti, nka quinidine, kugira ngo birinde umuvuduko w'umutima ushobora kuba mubi. Iyi miti ishobora kwandikwa wenyine cyangwa hamwe n'igikoresho cy'ubuvuzi - cyitwa implantable cardioverter-defibrillator (ICD) - kiyobora umutima.

Abantu bafite syndrome ya Brugada bamaze kugira ikibazo cy'umutima cyangwa guta ubwenge biteye impungenge bashobora kuba bakeneye kubagwa cyangwa gukoresha catheter.

Implantable cardioverter-defibrillator (ICD). Iki gikoresho gito, gikoresha batiri, gishyirwa mu gituza kugira ngo gikurikirane umuvuduko w'umutima buri gihe. Gitanga amashanyarazi iyo bibaye ngombwa kugira ngo kiyobore umuvuduko w'umutima udakwiye. Gushyiramo implantable cardioverter-defibrillator (ICD) bisaba gusinzira mu bitaro ijoro rimwe.

Implantable cardioverter-defibrillators (ICDs) ishobora gutanga amashanyarazi iyo atabaye ngombwa, bityo rero ni ngombwa kuganira ku byiza n'ibibi by'ibi bikoresho n'umuvuzi.

Iyo ufite syndrome ya Brugada, ukeneye kujya gusuzuma umubiri buri gihe kugira ngo ube wizeye ko ikibazo cy'umuvuduko w'umutima kiyobowe neza kandi kigenzurwa. Gusuzuma buri gihe bishobora gufasha umuvuzi wawe kubona ibibazo hakiri kare kandi agasanga ari ngombwa guhindura ubuvuzi.

• Amateka y'umuntu ku giti cye y'ibibazo bikomeye by'umutima

• Guta ubwenge

• Gutabara mu gikorwa cy'umutima waguye

• Kuvura umuriro cyane. Umuriro uzwiho gutera ikibazo cy'umutima ku bantu bafite syndrome ya Brugada. Koresha imiti igabanya umuriro ku bimenyetso bya mbere by'umuriro.

• Kwirinda imiti ishobora gutera ikibazo cy'umutima. Imiti myinshi ishobora kongera ibyago byo kugira ikibazo cy'umutima, harimo imiti imwe y'umutima n'imiti yo kuvura ihungabana. Alkohol nyinshi na yo ishobora kongera ibyago.

  Bwira umuvuzi wawe imiti ukoresha, harimo imiti n'ibindi byongerwamo ugura utabanje kwa muganga.

• Kwirinda gukina imikino ihangana. Ibi bishobora kuba ku bantu bari mu kaga gakomeye ko kugira ikibazo gikomeye cy'umutima. Baza umuvuzi wawe niba ukwiye kwirinda ibikorwa nk'ibyo bya siporo.

• Implantable cardioverter-defibrillator (ICD). Iki gikoresho gito, gikoresha batiri, gishyirwa mu gituza kugira ngo gikurikirane umuvuduko w'umutima buri gihe. Gitanga amashanyarazi iyo bibaye ngombwa kugira ngo kiyobore umuvuduko w'umutima udakwiye. Gushyiramo implantable cardioverter-defibrillator (ICD) bisaba gusinzira mu bitaro ijoro rimwe.

  Implantable cardioverter-defibrillators (ICDs) ishobora gutanga amashanyarazi iyo atabaye ngombwa, bityo rero ni ngombwa kuganira ku byiza n'ibibi by'ibi bikoresho n'umuvuzi.

• Catheter ablation. Iyo ICD idakora neza kandi mu mutekano ku bimenyetso bya syndrome ya Brugada, uburyo bwitwa radiofrequency catheter ablation bushobora kuba amahitamo. Umuyoboro muremure, woroshye (catheter) ushyirwa mu mubiri w'amaraso hanyuma ukamanurwa mu mutima. Catheter itanga ingufu nyinshi zisiga cyangwa zirandura umutima utera ikibazo cy'umutima udakwiye.