Cardiomyopathie Ya Dilatée

Cardiomyopathy yagutse ni uburwayi bw'imitima butuma ibice by'umutima (ventricles) bicika kandi bikagagara, bikakura. Ubusanzwe bitangira mu gice gikomeye cyo kubomba amaraso y'umutima (ventricle y'ibumoso). Cardiomyopathy yagutse bituma umutima ugomba gukora cyane kugira ngo utume amaraso ajya mu bindi bice by'umubiri.

Abantu bamwe bafite cardiomayopathy yaguka nta bimenyetso cyangwa ibimenyetso bagira mu bihe byambere byindwara.

Ibyimenyetso n'ibimenyetso bya cardiomayopathy yaguka bishobora kuba birimo:

• Umunaniro
• Guhumeka nabi (dyspnea) mu gihe cy'imikino cyangwa uri kuryamye
• Kugabanuka k'ubushobozi bwo gukora imyitozo
• Kubyimba (edema) mu maguru, mu birenge, mu birenge cyangwa mu nda (igifu)
• Kubabara mu gituza cyangwa kudatuza
• Gukubita cyane, guhindagurika cyangwa guhunda umutima (palpitations)

Niba ufite ikibazo cyo guhumeka cyangwa indi ndwara y'umutima udakomeye, reba umuganga wawe vuba bishoboka. Hamagara 911 cyangwa nimero y'ubufasha bw'ihutirwa muri aka karere niba ufite ububabare bw'ibituza buramara iminota irenga mike cyangwa ugira ikibazo gikomeye cyo guhumeka.

Niba umuntu wo mu muryango afite indwara y'umutima udakomeye, vugana n'abaganga bawe. Amwe mu moko y'indwara y'umutima udakomeye arandurirwa mu miryango (arazirwa). Ibizamini bya genetike bishobora gusabwa.

Kugera ku mpamvu y'indwara y'umutima wa dilated cardiomyopathy bishobora kuba bigoye. Ariko rero, ibintu byinshi bishobora gutuma umutima wa ventricle uba munini kandi ugabanya imbaraga zawo, birimo:

• Indwara zimwe na zimwe
• Ingaruka z'inda y'iheruka
• Diabete
• Umuti mwinshi w'amabuye y'umutwe mu mutima n'izindi ngingo (hemochromatosis)
• Ibibazo by'umutima (arrhythmias)
• Umuvuduko ukabije w'amaraso (hypertension)
• Kubyibuha
• Indwara z'amavavu y'umutima, nka mitral valve cyangwa aortic valve regurgitation

Izindi mpamvu zishoboka za dilated cardiomyopathy zirimo:

• Gukoresha inzoga nabi
• Kwihanganira uburozi, nka plomb, mercure na cobalt
• Gukoresha imiti imwe na imwe yo kuvura kanseri
• Gukoresha ibiyobyabwenge bitemewe, nka cocaïne cyangwa amphétamines

Ibintu byongera ibyago byo kurwara Cardiomyopathy ikwirakwira birimo:

• Kwangirika kw'imitsi y'umutima biterwa n'indwara zimwe na zimwe, nka hemochromatosis
• Amateka y'umuryango wa Cardiomyopathy ikwirakwira, gucika intege kw'umutima cyangwa guhagarara k'umutima k'umwijima
• Indwara z'amavavu y'umutima
• Kubyimba kw'imitsi y'umutima biterwa n'indwara z'urukuta rw'umubiri, nka lupus
• Kunywa inzoga cyangwa ibiyobyabwenge bitemewe igihe kirekire
• Umuvuduko ukabije w'amaraso igihe kirekire
• Indwara z'imitsi n'imiterere y'imbere, nka muscular dystrophy

Ingaruka z'indwara y'umutima udakora neza (cardiomyopathy) zirimo:

• Gucika intege kw'umutima. Umutima udashobora gutera amaraso ahagije kugira ngo umubiri ukore neza. Niba utaravuwe, gucika intege kw'umutima bishobora kuba bibi cyane.
• Ibibabi by'umutima bidakora neza (heart valve regurgitation). Cardiomyopathy ishobora gutuma ibibabi by'umutima bigorana gufunga. Amaraso ashobora gusubira inyuma mu kibabi cy'umutima.
• Gukubita kw'umutima kudakora neza (arrhythmias). Impinduka mu bunini n'isura y'umutima bishobora kubangamira uburyo umutima ukubita.
• Guhagarara k'umutima kudasubira inyuma. Cardiomyopathy ishobora gutuma umutima uhagarara gukubita mu buryo butunguranye.
• Ibisubiramo by'amaraso. Amaraso ateranira mu gice cyo hasi cy'umutima ibumoso bishobora gutera ibisubiramo by'amaraso. Niba ibyo bisubiramo byinjira mu maraso, bishobora kubuza amaraso kugera ku zindi nzego z'umubiri, harimo umutima n'ubwonko. Ibisubiramo by'amaraso bishobora gutera umwijima, guhagarara kw'umutima cyangwa kwangirika kw'izindi nzego z'umubiri. Arrhythmias na yo ishobora gutera ibisubiramo by'amaraso.

Imikorere myiza y'ubuzima ishobora gufasha kwirinda cyangwa kugabanya ingaruka z'indwara y'umutima ikomeye (cardiomyopathy). Gerageza izi ngamba zikomeza umutima:

• Irinde cyangwa gabanuka kunywa inzoga.
• Kureka itabi.
• Kureka gukoresha cocaïne cyangwa ibindi biyobyabwenge bitemewe.
• Kurya indyo yuzuye ifite umunyu muke (sodium).
• Kuruhuka bihagije no gusinzira.
• Gukora imyitozo ngororamubiri buri gihe.
• Kugira ibiro bikwiye.
• Kumenya guhangana n'umunaniro.

Kugira ngo hamenyekane indwara y'umutima udakomeye (cardiomyopathy dilatée), umuvuzi wawe azakora isuzuma ng'amaso kandi akubaze ibibazo ku mateka yawe bwite n'ay'umuryango wawe. Umuvuzi azakoresha igikoresho cyitwa stethoscope ngo yumve umutima na pulmoni. Ushobora koherezwa kwa muganga w'inzobere mu ndwara z'umutima (cardiologue).

Ibizamini byo kumenya indwara y'umutima udakomeye birimo:

• Echocardiogram. Iri ni ikizamini nyamukuru cyo kumenya indwara y'umutima udakomeye. Amashanyarazi atanga amashusho y'umutima uri gukora. Echocardiogram igaragaza uko amaraso yinjirira mu mutima no kuyavamo ndetse n'amavavu y'umutima. Ishobora kugaragaza niba umutima uri ibumoso (ventricule gauche) waragutse.
• Ibizamini by'amaraso. Ibizamini bitandukanye by'amaraso bishobora gukorwa kugira ngo harebwe indwara, ibintu cyangwa indwara - nka diyabete cyangwa hemochromatose - bishobora gutera indwara y'umutima udakomeye.
• X-ray y'ibituza. X-ray y'ibituza igaragaza imiterere n'imiterere y'umutima na pulmoni. Ishobora kugaragaza amazi ari mu bihaha cyangwa hafi yabyo.
• Electrocardiogram (ECG cyangwa EKG). Iri kizamini cyihuse kandi cyoroshye cyandika ibikorwa by'amashanyarazi by'umutima. Electrocardiogram (ECG) ishobora kugaragaza umuvuduko w'umutima cyangwa umuvuduko muke w'umutima. Imiterere y'ibimenyetso ishobora gufasha kumenya indwara y'umutima cyangwa kugabanuka kw'amaraso.
• Holter monitor. Iki gikoresho gifunzwe gishobora kwambarwa umunsi umwe cyangwa irenga kugira ngo cyandike ibikorwa by'umutima mu bikorwa bya buri munsi.
• Isuzuma ry'umutima mu gihe cy'imyitozo. Iri kizamini akenshi ririmo kugenda kuri tapis roulant cyangwa kugendera kuri velo ihagaze mu gihe umutima uri gukurikiranwa na. Ibizamini by'imyitozo bifasha kugaragaza uko umutima uhangana n'imirimo ngororamubiri. Niba udashobora gukora imyitozo ngororamubiri, ushobora guhabwa imiti igereranya ingaruka z'imyitozo ngororamubiri ku mutima.
• Scan ya CT cyangwa MRI y'umutima. Aya masuzuma y'amashusho ashobora kugaragaza ubunini n'imikorere y'ibice byo kubomba amaraso by'umutima. Scan ya CT y'umutima ikoresha uburyo bwa X-ray kugira ngo ikore amashusho arambuye y'umutima. MRI y'umutima ikoresha uburyo bwa magnétique n'amashanyarazi.
• Cardiac catheterization. Muri ubu buryo, imiyoboro miremire myiza (catheters) imwe cyangwa nyinshi ishyirwa mu mubiri w'amaraso, akenshi mu gice cy'imbere, kandi ijyanywa mu mutima. Ibara ritembera mu muyoboro kugira ngo rifashe imitsi y'umutima kugaragara neza ku mashusho ya X-ray. Mu gihe cya cardiac catheterization, urugero rw'umubiri (biopsy) rushobora gufatwa kugira ngo harebwe kwangirika kw'imitsi y'umutima.
• Isuzuma ry'imiterere cyangwa inama ku muryango. Cardiomyopathy ishobora guherwa mu muryango (ihera mu miryango). Baza umuvuzi wawe niba ibizamini by'imiterere bikubereye. Isuzuma ry'umuryango cyangwa ibizamini by'imiterere bishobora kuba harimo abavandimwe ba hafi - ababyeyi, abavandimwe n'abana.

Ubuvuzi bwa cardiomyopathy yaguze biterwa n'impamvu zayo. Intego y'ubuvuzi ni ugabanya ibimenyetso, kunoza umusaraba w'amaraso no gukumira ibindi byangiza umutima. Ubuvuzi bwa cardiomyopathy yaguze bushobora kuba harimo imiti cyangwa kubaga kugira ngo bashyiremo igikoresho cy'ubuvuzi gifasha umutima gukubita cyangwa gutera amaraso.

Uruvange rw'imiti rushobora gukoreshwa mu kuvura cardiomyopathy yaguze no gukumira ingaruka zayo. Imiti ikoreshwa mu:

Imiti ikoreshwa mu kuvura gucika intege kw'umutima na cardiomyopathy yaguze irimo:

Kubaga bishobora kuba bikenewe kugira ngo bashyiremo igikoresho gicunga umuvuduko w'umutima cyangwa gifasha umutima gutera amaraso. Ubwoko bw'ibikoresho bikoresha mu kuvura cardiomyopathy yaguze birimo:

Niba imiti n'ubundi buvuzi bwa cardiomyopathy yaguze bitakimaze akamaro, gushimura umutima bishobora kuba bikenewe.

• Kucunga umuvuduko w'umutima

• Gufasha umutima gutera neza

• Kugabanya umuvuduko w'amaraso

• Gukumira imikaya y'amaraso

• Kugabanya amazi mu mubiri

• Imiti igabanya umuvuduko w'amaraso. Ubwoko butandukanye bw'imiti bushobora gukoreshwa mu kugabanya umuvuduko w'amaraso, kunoza umusaraba w'amaraso no kugabanya umuvuduko ku mutima. Iyo miti irimo beta-blockers, angiotensin-converting enzyme (ACE) inhibitors na angiotensin II receptor blockers (ARBs).

• Sacubitril/valsartan (Entresto). Iyi miti ifatanya angiotensin two receptor blocker (ARB) n'ubundi bwoko bw'imiti mu gufasha umutima gutera amaraso neza mu bindi bice by'umubiri. Ikoreshwa mu kuvura abarwaye gucika intege kw'umutima igihe kirekire.

• Amapasipile y'amazi (diuretics). Diuretic ikuraho amazi n'umunyu byinshi mu mubiri. Amazi menshi mu mubiri ashyira umuvuduko ku mutima kandi bishobora gutuma guhumeka bigorana.

• Digoxin (Lanoxin). Iyi miti ishobora gukomeza imikaya y'umutima. Nanone ishobora kugabanya umuvuduko w'umutima. Digoxin ishobora kugabanya ibimenyetso byo gucika intege kw'umutima no koroshya gukora imirimo.

• Ivabradine (Corlanor). Gake, iyi miti ishobora gukoreshwa mu gucunga gucika intege kw'umutima biterwa na cardiomyopathy yaguze.

• Imiti igabanya imikaya y'amaraso (anticoagulants). Iyi miti ifasha gukumira imikaya y'amaraso.

• Biventricular pacemaker. Iki gikoresho ni cyo gikoresha abantu bafite gucika intege kw'umutima n'umuvuduko w'umutima udakomeye. Biventricular pacemaker ishyira imbaraga mu byumba byombi byo hasi by'umutima (uruhande rw'iburyo n'uruhande rw'ibumoso) kugira ngo umutima ukubite neza.

• Implantable cardioverter-defibrillators (ICD). Implantable cardioverter-defibrillator (ICD) ntivura cardiomyopathy ubwayo. Ikurikirana umuvuduko w'umutima kandi itanga amashanyarazi niba umuvuduko w'umutima udakomeye (arrhythmia) ugaragaye. Cardiomyopathy ishobora gutera arrhythmias z'akaga, harimo n'izituma umutima uhagarara.

• Left ventricular assist devices (LVAD). Iki gikoresho cy'imashini gifasha umutima waciye intege gutera neza. Left ventricular assist device (LVAD) isanzwe igerwaho nyuma y'uko ubundi buryo butavunnye butabashije kugira icyo bukora. Ishobora gukoreshwa nk'ubuvuzi bw'igihe kirekire cyangwa nk'ubuvuzi bw'igihe gito mu gihe cyo gutegereza gushimura umutima.