Umutima Munini

Umutima munini (cardiomegaly) si indwara, ahubwo ni ikimenyetso cy'ubundi burwayi. Ijambo "cardiomegaly" risobanura umutima munini ugaragara kuri buri suzuma y'amashusho, harimo n'igipimo cya X-ray cy'ibituza. Ibindi bipimo nibyo bikenewe kugira ngo hamenyekane icyateye umutima munini.

Mu bamwe, umutima munini (cardiomegaly) ntabwo uterwa ibimenyetso cyangwa ibimenyetso. Abandi bashobora kugira ibi bimenyetso bya cardiomegaly:

• Guhumeka nabi, cyane cyane iyo uri kuryama
• Kubyuka uhumeka nabi
• Umutima udadoda neza (arrhythmia)
• Kubyimba (edema) mu nda cyangwa mu maguru

Umutima munini ushobora koroha kuvurwa iyo ubonetse hakiri kare. Ganira n'abaganga bawe niba ufite impungenge ku mutima wawe.

Hamagara 911 cyangwa nimero y'ubufasha bw'ihutirwa muri aka karere niba ufite ibimenyetso by'igitero cy'umutima gishobora kubaho:

• Kubabara mu gituza
• Kubabara mu bindi bice by'umubiri wo hejuru, birimo ukuboko kumwe cyangwa ukoresha, umugongo, ijosi, akanwa cyangwa igifu
• Guhumeka nabi cyane
• Kugwa

Umukaya munini w'umutima (cardiomegaly) ushobora guterwa n'akaga k'umutima cyangwa ikindi kibazo cyose gituma umutima utera cyane kurusha uko bisanzwe, harimo no gutwita. Hari igihe umutima ukura ukaba mwaraga kubera impamvu zitazwi. Iyi ndwara yitwa cardiomyopathy idiopathic.

Uburwayi bujyana n'umutima munini burimo:

• Indwara y'umutima ibaho kuva umuntu avuka (congenital heart defect). Ibibazo by'imiterere n'imikorere y'umutima bishobora gutuma umutima ukura ukaba mwaraga.
• Akaga kavuye mu gufatwa n'indwara y'umutima. Ibikomere n'ibindi bikomere by'umutima bishobora gutuma bigorana ko umutima utera amaraso ahagije mu mubiri. Umuhamagaro ushobora gutuma umutima uba umunini kandi ukarangirika.
• Indwara z'umutima (cardiomyopathy). Cardiomyopathy ikunze gutuma umutima ukomera cyangwa ukaba ukomeye. Bishobora gutuma bigorana ko umutima utera amaraso.
• Kuvumba amazi mu gice cy'umutima (pericardial effusion). Amazi avumbira mu gice kirimo umutima ashobora gutuma umutima ukura, kandi ibyo bigaragara kuri X-ray y'ibituza.
• Indwara y'amavavu y'umutima. Amavavu ane mu mutima atuma amaraso agenda mu buryo bukwiye. Indwara cyangwa akaga ku mavavu yose bishobora kubangamira imiterere y'amaraso kandi bigatuma ibice by'umutima bikura.
• Umuvuduko ukabije w'amaraso (hypertension). Niba ufite umuvuduko ukabije w'amaraso, umutima ushobora gukenera gukora cyane kugira ngo utere amaraso mu bindi bice by'umubiri. Umuhamagaro ushobora gutuma umutima ukura ukaba mwaraga.
• Umuvuduko ukabije w'amaraso mu mitsi yo mu bihaha (pulmonary hypertension). Umutima ugomba gukora cyane kugira ngo wimure amaraso hagati y'ibihaha n'umutima. Umuhamagaro ushobora gutuma uruhande rw'iburyo rw'umutima rukura cyangwa rukaba rukomeye.
• Ubwinshi buke bw'utubuto tw'amaraso atukura (anemia). Muri anemia, habamo ubuke bw'utubuto tw'amaraso atukura dufite ubuzima bwiza bwo gutwara umwuka uhagije mu mubiri. Umutima ugomba gutera amaraso menshi kugira ngo ubone uburyo bwo kubura umwuka mu maraso.
• Indwara z'umwijima. Umuwijima udakora neza (hypothyroidism) n'umwijima ukora cyane (hyperthyroidism) bishobora gutuma haba ibibazo by'umutima, harimo n'umutima munini.
• Ibyuma byinshi mu mubiri (hemochromatosis). Ibyuma bishobora kuvumbira mu ngingo zitandukanye, harimo n'umutima. Ibi bishobora gutuma igice cyo hasi cy'ibumoso cy'umutima kivumba.
• Ibinure bidasanzwe by'amaprotéine mu mutima (cardiac amyloidosis). Iyi ndwara idasanzwe ituma proteine yitwa amyloid itera amaraso kandi ikaguma mu ngingo z'umubiri, harimo n'umutima. Ibinure bya proteine ya Amyloid mu mutima bituma urukuta rw'umutima rukura mu buryo budasubira inyuma. Umutima ugomba gukora cyane kugira ngo wuzuke amaraso.
• Imikino ngororamubiri. Mu bakinnyi bamwe, umutima ukura nk'igisubizo cyo gukora imyitozo ngororamubiri kenshi kandi igihe kirekire. Ubusanzwe, uyu mutima munini ntabwo ufatwa nk'indwara kandi ntukeneye kuvurwa.
• Ibinure biri ku mutima. Bamwe bafite ibinure byinshi biri ku mutima bishobora kugaragara kuri X-ray y'ibituza. Keretse hari izindi ndwara z'umutima zifitanye isano, nta kuvurwa bikenewe.

Ibintu bishobora kongera ibyago byo kugira umutima munini (cardiomegaly) birimo:

• Amateka y'indwara z'imitsi y'umutima (cardiomyopathy) mu muryango. Ubundi bwoko bwa cardiomyopathy buhererekanywa mu miryango. Vuga umuvuzi wawe niba umubyeyi wawe cyangwa umuvandimwe afite amateka y'umutima ukomeye, ukakaye cyangwa munini.
• Umuvuduko ukabije w'amaraso. Ibi bivuze kugira umuvuduko w'amaraso urenze 140/90 millimeters ya mercury.
• Indwara z'umutima. Iki kibazo cyose kigira ingaruka ku mutima, harimo n'ubumuga bw'umutima wavutse wavukanye cyangwa indwara y'amavavu y'umutima, bishobora gutera umutima gukura. Ni ngombwa gukurikiza imibereho myiza no gukora isuzuma buri gihe kugira ngo ubone uko ubuvuzi bw'indwara y'umutima bugenda.

Ibyago byo kwibasirwa n'indwara y'umutima munini biterwa n'igice cy'umutima cyibasiwe n'icyo yatewe. Ibibazo by'umutima munini bishobora kuba birimo:

• Gucika intege kw'umutima. Gucika intege kw'umutima bishobora kubaho igihe icyumba cyo hasi cy'umutima ibumoso (ventricule y'ibumoso) cyagutse. Mu gucika intege kw'umutima, umutima ntushobora gutera amaraso ahagije mu mubiri wose.
• Ibisasu by'amaraso. Ibisasu by'amaraso bishobora gukorwa mu rwambariro rw'umutima. Isasu ry'amaraso rikorewe ku ruhande rw'iburyo rw'umutima rishobora kujya mu mwijima (pulmonary embolism). Niba isasu rikinga umuyoboro w'amaraso, ushobora kugira ikibazo cy'umutima cyangwa gucika intege.
• Valvule y'umutima isenyuka (regurgitation). Kugura kw'umutima bishobora kubuza valvules z'umutima za mitral na tricuspid gufunga, bigatuma amaraso asubira inyuma. Umucanga w'amaraso uhagaritswe ukorana ijwi ryitwa guhumeka kw'umutima. Nubwo atari ngombwa ko ari bibi, guhumeka kw'umutima bigomba kugenzurwa n'abaganga.
• Guhagarara kw'umutima n'urupfu rutunguranye. Umutima munini ushobora gutuma umutima ukomanga cyane cyangwa buhoro. Gukomanga kw'umutima kudahwitse (arrhythmia) bishobora gutuma umuntu ahuma, umutima uhagarara cyangwa urupfu rutunguranye.

Mubwire umuvuzi wawe niba hari umuntu wo mu muryango wanyu ufite cyangwa wari ufite indwara y'umutima (cardiomyopathy) cyangwa izindi ndwara zateje kubyimbagira kw'umutima. Iyo imenyekanye hakiri kare, kuvura neza indwara y'ibanze bishobora kubuza umutima kubyimbagira kurushaho. Kubaho ubuzima bwiza bw'umutima bishobora gufasha gukumira cyangwa gucunga bimwe mu bibazo bishobora gutera umutima kubyimbagira. Fata ibi bintu kugira ngo wirinde umutima kubyimbagira:

• Kumenya no gucunga umuvuduko ukabije w'amaraso, cholesterol nyinshi na diyabete.
• Fata imiti yose yagutegetswe ukurikije amabwiriza.
• Funga indyo yuzuye, ifite intungamubiri.
• Kora imyitozo ngororamubiri buri gihe.
• Irinde cyangwa ugarukire inzoga.
• Ntukama.
• Ntukore ibiyobyabwenge bitemewe.

Mu kugira ngo hamenyekane umutima munini, umuvuzi azakora isuzuma ngarukazi kandi abaze ibibazo ku bimenyetso byawe n'amateka yawe y'ubuzima.Ibizamini bishobora gukorwa kugira ngo bigufashe kumenya umutima munini (cardiomyopathy) n'icyawuteye birimo:

Ubugenzuzi bw'umutima hakoreshejwe mudasobwa (CT scan) cyangwa iskaniriya ya magnétique (MRI). Mu gihe cy'ubushakashatsi bwa CT scan y'umutima, usanzwe uba uri ku meza uri mu mashini imeze nk'igitambambuga. Iyo tube ya X-ray iri muri iyo mashini ikizunguruka ku mubiri wawe ikusanya amashusho y'umutima wawe n'ibituro byawe.

Mu iskaniriya ya MRI y'umutima, usanzwe uba uri ku meza uri mu mashini ndende imeze nk'impera ikoresha ikirere cya magnétique n'amahano ya radiyo kugira ngo ikore ibimenyetso bikora amashusho y'umutima wawe.

• Ibizamini by'amaraso. Ibizamini by'amaraso bishobora gufasha kwemeza cyangwa guhakana ibibazo bishobora gutera umutima munini. Niba umutima munini ubayeho ufite ububabare mu gituza cyangwa ibindi bimenyetso by'igitero cy'umutima, ibizamini by'amaraso bishobora gukorwa kugira ngo harebwe urwego rw'ibintu biri mu maraso biterwa n'akaga k'imitsi y'umutima.
• X-ray y'ibituro. X-ray y'ibituro ishobora gufasha kwerekana imiterere y'ibihaha n'umutima. Niba umutima munini uri kuri X-ray, ibindi bizamini bizakenerwa kugira ngo bimenye niba ubwo bwongeze ari ukuri kandi hamenyekane icyabuteye.
• Electrocardiogram (ECG cyangwa EKG). Iki kizamini cyihuse kandi kitababaje kipima ibikorwa by'amashanyarazi y'umutima. Ibitambara bito (electrodes) bihambirwa ku gituza rimwe na rimwe no ku maboko n'amaguru. Imisatsi ihuza electrodes na mudasobwa, igaragaza ibisubizo by'ikizamini. Electrocardiogram (ECG) ishobora kwerekana niba umutima ukubita cyane cyangwa buhoro. Umuvuzi arashobora kureba imiterere y'ibimenyetso by'imitsi y'umutima ikomeye (hypertrophy).
• Echocardiogram. Iki kizamini kitagira ingaruka ikoresha amajwi kugira ngo ikore amashusho y'ingano y'umutima, imiterere n'imikorere. Echocardiogram igaragaza imiterere y'amaraso mu byumba by'umutima kandi ifasha kumenya neza uko umutima ukora.
• Ibizamini byo kwiruka cyangwa ibizamini byo kwishima. Ibi bizamini bikunze kuba birimo kugenda kuri treadmill cyangwa kugendera kuri velo ihagaze mu gihe umutima uri gukurikiranwa. Ibizamini byo kwiruka bifasha kugaragaza uko umutima usubiza ibikorwa by'umubiri. Niba udashobora kwiruka, ushobora guhabwa imiti igereranya ingaruka zo kwiruka ku mutima wawe.
• Ubugenzuzi bw'umutima hakoreshejwe mudasobwa (CT scan) cyangwa iskaniriya ya magnétique (MRI). Mu gihe cy'ubushakashatsi bwa CT scan y'umutima, usanzwe uba uri ku meza uri mu mashini imeze nk'igitambambuga. Iyo tube ya X-ray iri muri iyo mashini ikizunguruka ku mubiri wawe ikusanya amashusho y'umutima wawe n'ibituro byawe.

Mu iskaniriya ya MRI y'umutima, usanzwe uba uri ku meza uri mu mashini ndende imeze nk'impera ikoresha ikirere cya magnétique n'amahano ya radiyo kugira ngo ikore ibimenyetso bikora amashusho y'umutima wawe.

• Cardiac catheterization. Umuvuzi ashyiramo umuyoboro muto (catheter) mu mubiri w'amaraso mu kuboko cyangwa mu gatuza kugera ku mubiri w'umutima kandi ashyiramo ibara rya dye muri uwo muyoboro. Ibi bituma imitsi y'umutima igaragara neza kuri X-ray. Mu gihe cyo gukora cardiac catheterization, igitutu kiri mu byumba by'umutima gishobora gupimwa kugira ngo harebwe imbaraga amaraso apompa mu mutima. Rimwe na rimwe, igice gito cy'umutima gikurwaho kugira ngo gisuzuzwe (biopsy).

Umutima munini (cardiomegaly) uvurwa bitewe n'icyo kibazo cy'umutima.

Iyo cardiomyopathy cyangwa ikindi kibazo cy'umutima ari cyo gituma umutima ukura, umuganga ashobora kugutegurira imiti, irimo:

Iyo imiti idahagije mu kuvura umutima munini, ibyuma by'abaganga n'abaganga bashobora kuba ngombwa.

Ibisabwa cyangwa ibindi bikorwa byo kuvura umutima munini bishobora kuba birimo:

• Imiti igabanya amazi. Iyi miti igabanya umunyu n'amazi mu mubiri, ibyo bikaba bishobora kugabanya umuvuduko w'amaraso.

• Ibindi miti igabanya umuvuduko w'amaraso. Ibiyobyabwenge bya beta blockers, angiotensin-converting enzyme (ACE) inhibitors cyangwa angiotensin II receptor blockers (ARBs) bishobora gukoreshwa kugirango bigabanye umuvuduko w'amaraso kandi binonosore imikorere y'umutima.

• Imiti igabanya amaraso. Imiti igabanya amaraso (anticoagulants) ishobora gutangwa kugirango igabanye ibyago by'amaraso ashobora guteza ikibazo cy'umutima cyangwa umwijima.

• Imiti ivura umuvuduko w'umutima. Nanone bizwi nka anti-arrhythmics, iyi miti ifasha kugenzura umuvuduko w'umutima.

• Pacemaker. Pacemaker ni igikoresho gito gisanzwe gishyirwa hafi y'umutwe. Insinga imwe cyangwa nyinshi zifite iherezo ry'electrode ziva kuri pacemaker zinyura mu mitsi y'amaraso zigera mu mutima. Iyo umuvuduko w'umutima uri hasi cyane cyangwa uhagaze, pacemaker itanga impinduka z'amashanyarazi zikangurira umutima gukora ku muvuduko uhamye.

• Implantable cardioverter-defibrillator (ICD). Iyo umutima munini uteza ibibazo bikomeye by'umuvuduko w'umutima (arrhythmias) cyangwa uri mu kaga ko gupfa bitunguranye, umuganga ashobora gushyiramo implantable cardioverter-defibrillator (ICD). ICD ni igikoresho gikoreshwa na batiri gishyirwa munsi y'uruhu hafi y'umutwe - kimwe na pacemaker. Insinga imwe cyangwa nyinshi zifite iherezo ry'electrode ziva kuri ICD zinyura mu mitsi y'amaraso zigera ku mutima. ICD ikomeza kugenzura umuvuduko w'umutima. Iyo ICD ibonye umuvuduko w'umutima udakwiye, itanga amashanyarazi make cyangwa menshi kugirango yongere umuvuduko w'umutima.

• Ubuganga bw'umutima. Iyo umutima munini uterwa n'indwara y'umutima, ubuganga bushobora kuba ngombwa kugirango usane cyangwa uhindure umutima urimo ikibazo.

• Ubuganga bwo guhindura umutima. Iyo umutima munini uterwa no gufunga imitsi y'umutima, ubu buganga bw'umutima bushobora gukorwa kugirango uhindure inzira y'amaraso atembera mu mutima ufite ikibazo.

• Ikimashini cyo gufasha umutima (LVAD). Iyo ufite ikibazo cy'umutima, umuganga ashobora kugutegurira iki kimashini gishyirwa mu mubiri kugirango gifashe umutima wawe gukora. Ushobora gushyirwamo ikimashini cyo gufasha umutima (LVAD) mu gihe utegereje kubagwa umutima, cyangwa, niba udashobora kubagwa umutima, nk'ubuvuzi bw'igihe kirekire bw'ikibazo cy'umutima.

• Kubagwa umutima. Kubagwa umutima ni uburyo bwa nyuma bwo kuvura umutima munini udashobora kuvurwa mu bundi buryo. Kubera ubuke bw'imitima y'abantu bapfuye, ndetse n'abantu barwaye cyane bashobora gutegereza igihe kirekire mbere yo kubagwa umutima.