Ukuqhekeka kwe-Aorta: Izimpawu, Izimbangela, Nokwelashwa

Ukuqhekeka kwe-aorta kwenzeka lapho izingxenye yangaphakathi ye-aorta yakho (umthambo omkhulu kakhulu emzimbeni wakho) iqhekeka, kuvumela igazi ukuthi ligeleze phakathi kwezingxenye zethumbu lomthambo. Lokhu kudala isimo esiyingozi lapho igazi lingathatha indlela engafanele ngomthambo wakho esikhundleni sokugeleza ngokujwayelekile eziphileni zakho.

Cabanga nge-aorta yakho njengomthambo wokusika ingadi onamaqhezu amaningi. Lapho izingxenye yangaphakathi iqhekeka, igazi lingacindezela phakathi kwamaqhezu, mhlawumbe livimba ukugeleza kwegazi okujwayelekile noma libenze umthambo uqhekeke. Lena yingozi yezokwelapha eqinile edinga ukunakekelwa okusheshayo, kodwa ngokwelashwa okusheshayo, abantu abaningi bayaphila kahle.

Ziyini izimpawu zokuqhekeka kwe-aorta?

Isibonakaliso esivamile kakhulu yibuhlungu obukhulu, obukhulu esifubeni noma emuva abantu abavame ukubiza ngokuthi yibuhlungu elibi kunazo zonke abake balibona. Lobu buhlungu buqala ngokuzumayo futhi buzwakala njengokuqhekeka noma ukuqhekeka.

Nazi izimpawu ezibalulekile okufanele uzilinde:

• Ubuhlungu obukhulu, obukhulu esifubeni obungaqonda emuva
• Ubuhlungu obukhulu, obukhulu phakathi kwamaphethilolo akho
• Ubuhlungu obuhamba phansi emuva njengoba ukuqhekeka kuqhubeka
• Ukuqina komoya noma ukuqina kokuphefumula
• Ukubila nokuphazamiseka kwesisu
• Ubuthakathaka noma ukungakwazi ukuhamba ngakwesinye uhlangothi lomzimba wakho
• Ukuncipha kokukhuluma noma ukushintsha kokubona
• I-pulse ebuthakathaka engalweni eyodwa uma iqhathaniswa nenye
• Ubuhlungu obukhulu besisu (uma ukuqhekeka kuqhubeka phansi)

Abanye abantu bahlushwa ukuphelelwa yimfucumfucu noma ukulahlekelwa yikwazi uma ukugeleza kwegazi ebuchosheni kuchaphazelekile. Iphethini yobuhlungu ingasiza odokotela ukuthi baqonde ukuthi ukuqhekeka kusekuphi nokuthi kuyeka kuphi.

Ziyini izinhlobo zokuqhekeka kwe-aorta?

Odokotela bahlukanisa ukuqhekeka kwe-aorta zibe izinhlobo ezimbili eziyinhloko kuye ngokuthi kwenzeka kuphi e-aorta yakho. Lokhu kuhlukaniswa kusiza ekuqondeni ukuphazamiseka kokwelashwa nendlela engcono kakhulu.

Ukuqhekeka kwe-Type A kuhilela i-aorta eyenyukayo, okuyigazi lokuqala le-aorta njengoba liphuma enhliziyweni yakho. Lezi zibhekwa njengezingozi kakhulu ngoba zingachaphazela ukugeleza kwegazi kwemisipha yenhliziyo yakho nengqondo. Zivame ukudinga ukuhlinzwa okusheshayo ngaphakathi kwamahora ambalwa.

Ukuqhekeka kwe-Type B kwenzeka e-aorta ehlehlayo, okuyigazi elihamba phansi ngesifuba sakho nesisu. Nakuba kusengozini, lezi zingaphathwa ekuqaleni ngemithi yokulawula igazi, nakuba ezinye zingadinga ukungenelela kokwelashwa kamuva.

Yini ebangela ukuqhekeka kwe-aorta?

Ukuqhekeka kwe-aorta kwenzeka lapho udonga lwe-aorta yakho luqala ukuqina ngokuhamba kwesikhathi, okwenza kube lula ukuthi liqhekeke ngaphansi kokucindezela. Igazi eliphezulu liyimbangela evamile, njengoba libeke ukucindezela okuqhubekayo odongeni lomthambo.

Izinto eziningi zingase zifake isandla kulesi simo:

• Igazi eliphezulu (hypertension)
• Ukuqina kwamagciwane (atherosclerosis)
• Isimo sokuzalwa njenge-Marfan syndrome noma i-Ehlers-Danlos syndrome
• I-valve ye-aorta ye-bicuspid (ukungalingani kwe-valve yenhliziyo)
• Ukuhlinzwa kwenhliziyo kwangaphambili noma izinqubo zenhliziyo
• Ukulimala kwesifuba okuvela ezingozeni noma ekulimaleni
• Ukusetshenziswa kwe-cocaine, okungabangela ukuphakama kwegazi ngokuzumayo
• Ukukhulelwa (kuncane, kodwa kungenzeka ngenxa yokushintsha kwamahomoni)

Ngezinye izikhathi, ukucindezela komzimba okukhulu noma ukwanda kokuzumayo kwegazi kungabangela ukuqhekeka kumuntu osevele enodonga lwe-aorta oluqiniwe. Ukushintsha komzimba okubangelwa ubudala odongeni lomthambo futhi kwenza ukuqhekeka kube lula njengoba siqhubeka sikhulile.

Nini okufanele ubona udokotela ngokuqhekeka kwe-aorta?

Shaya izinsizakalo eziphuthumayo ngokushesha uma uhlushwa yibuhlungu obukhulu, obukhulu esifubeni noma emuva, ikakhulu uma buzwakala njengokuqhekeka noma ukuqhekeka. Lesi akuyona isimo sokulinda ubona.

Kufanele ufunuke unakekelwa ngokuphuthumayo uma uhlushwa yibuhlungu esifubeni kanye nokuncipha komoya, ubuthakathaka ezandleni noma emilenzeni, ukuhlupheka ekukhulumeni, noma ukuphelelwa yimfucumfucu. Lezi zimpawu zingabonisa ukuthi ukuqhekeka kuchaphazela ukugeleza kwegazi eziphileni ezibalulekile.

Uma unezingozi ezifana negazi eliphezulu, izifo zokuxhumana kwamathumbu, noma umlando womndeni wezinkinga ze-aorta, ungangabazi ukufuna ukunakekelwa kwezokwelapha nganoma yiluphi ubuhlungu obungavamile esifubeni noma emuva. Ukuqaphela nokwelashwa kwangaphambi kwesikhathi kungasindisa impilo.

Ziyini izingozi zokuqhekeka kwe-aorta?

Ukuqonda izingozi zakho kungakusiza ukuthi uthathe izinyathelo zokuzivimbela futhi wazi ukuthi nini okufanele uqaphele kakhulu izimpawu. Ubudala nobulili kudlala indima ebalulekile, ngamadoda angaphezu kweminyaka engama-60 engozini enkulu.

Nazi izingozi eziyinhloko okufanele uzazi:

• Igazi eliphezulu, ikakhulu uma lingalawulwa kahle
• Ubudala obungaphezu kweminyaka engama-60
• Ukuba yindoda (amadoda achaphazelekile kakhulu kunabesifazane)
• Umlando womndeni wokuqhekeka kwe-aorta
• Izimo zokuzalwa ezichaphazela ukuxhumana kwamathumbu
• I-valve ye-aorta ye-bicuspid noma ezinye izinkinga ze-valve yenhliziyo
• Ukuhlinzwa kwe-aorta kwangaphambili noma izinqubo zenhliziyo
• Ukubhema, okonakalisa udonga lwemithambo yegazi
• Ukusetshenziswa kwe-cocaine noma i-amphetamine
• Ukuphakamisa izinto ezisindayo noma ukucindezela komzimba

Ukuba nengozi eyodwa noma ngaphezulu akusho ukuthi uzophuthuma uthola ukuqhekeka kwe-aorta. Kodwa-ke, kusho ukuthi kufanele usebenze eduze nodokotela wakho ukuze ulawule izinto ongaziqondisa njengegazi eliphezulu futhi wenze ushintsho lokuziphila olusekela impilo yakho yemisipha yomthambo.

Ziyini izinhlanganisela ezingaba khona zokuqhekeka kwe-aorta?

Ukuqhekeka kwe-aorta kungabangela izinhlanganisela eziningi ezinkulu, kuye ngokuthi ukuqhekeka kwenzeka kuphi nokuthi kuqhubeka kanjani. Ingozi ephambili kakhulu ukuthi ukuqhekeka kungavimba ukugeleza kwegazi eziphileni ezibalulekile.

Izinhlanganisela ezingaba khona zihlanganisa:

• Ukuqhekeka kwe-aorta, okungabangela ukuphuma kwegazi elingaphakathi okubulalayo
• Ukuphazamiseka kwenhliziyo uma ukugeleza kwegazi kwemisipha yenhliziyo kunciphile
• Isifo sobuchopho uma ukugeleza kwegazi ebuchosheni kuchaphazelekile
• Ukungasebenzi kwesibindi ngenxa yokunciphisa ukugeleza kwegazi ezibindini
• Ukungakwazi ukuhamba uma ukunikezwa kwegazi kwentamo kuchaphazelekile
• Ukuphuma kwegazi okukhulu esifubeni
• Ukwehluleka kwenhliziyo uma i-valve ye-aorta yonakele
• Izinkinga zesisu uma ukugeleza kwegazi esiswini kunciphile

Izindaba ezinhle ukuthi ngokuqaphela nokwelashwa okusheshayo, izinhlanganisela eziningi zingavimbeka noma ziphathwe kahle. Amathuluzi okuhlinzwa namuhla nokunakekelwa okuqeqeshwe kahle kuye kwathuthukisa kakhulu imiphumela yabantu abane-aorta ephukile.

Ukuqhekeka kwe-aorta kunqunywa kanjani?

Odokotela bavame ukukuthola ukuqhekeka kwe-aorta ngokusekelwe ezimpawini zakho nokuhlolwa komzimba, bese bekuqinisekisa ngokuhlolwa kwezithombe. Inqubo iqhubeka ngokushesha ngoba isikhathi sibalulekile.

Udokotela wakho kuqala uzohlola igazi lakho ezingalweni zombili, njengoba umehluko omkhulu ungaba yisibonakaliso. Uzolalela inhliziyo yakho futhi ahlole i-pulse yakho ezindaweni ezahlukene ukuze abone ukuthi ukugeleza kwegazi kuchaphazelekile yini noma kuphi.

Izivivinyo ezivamile zokuxilonga zihlanganisa i-CT scan ene-contrast dye, engabonisa ukuqhekeka nokuthi kuyeka kuphi. I-echocardiogram ingase yenziwe ukuhlola ukusebenza kwenhliziyo yakho futhi ubone ukuthi ukuqhekeka kuchaphazela i-valve yakho yenhliziyo yini.

Ezimweni ezithile, i-MRI noma i-aortogram (i-X-ray ekhethekile ene-dye) ingase idingeke ukuze uthole izithombe ezinemininingwane. Izivivinyo zegazi zingasiza ekuqedeni ukuphazamiseka kwenhliziyo futhi uhlole ukuthi iziphileni zakho zisebenza kahle kangakanani.

Yini ukwelashwa kokuqhekeka kwe-aorta?

Ukwelashwa kuncike ohlotsheni nendawo yokuqhekeka kwakho, kodwa umgomo oqondile uhlale uvikelwa izinhlanganisela futhi usindise impilo yakho. Ukuqhekeka kwe-Type A kuvame ukudinga ukuhlinzwa okusheshayo, kuyilapho ukuqhekeka kwe-Type B kungaphathwa ngemithi ekuqaleni.

Ngokuqhekeka kwe-Type A, ochwepheshe bokuhlinzwa bazoshintsha ingxenye eyonakele ye-aorta nge-graft ye-synthetic. Lokhu kuyinkulu, kodwa kuvame ukuba yindlela kuphela yokuvimbela izinhlanganisela ezibulalayo ezifana nokuqhekeka noma izinkinga zenhliziyo.

Ukuqhekeka kwe-Type B kuvame ukwelashwa kuqala ngemithi yokunciphisa igazi eliphezulu nokunciphisa amandla okucindezela kwenhliziyo. Lokhu kusiza ekuvimbeni ukuqhekeka ukuba kubi kakhulu. Imithi yobuhlungu ibalulekile futhi ukuze ududuze.

Ezinye izingxenye ze-Type B zingadinga ukulungiswa kwe-endovascular, lapho i-stent-graft ibekwa ngaphakathi kwe-aorta ngokusika okuncane. Lokhu akunakho ukungena njengokuhlinzwa okuvulekile futhi kungasiza ekuvaleni ukuqhekeka.

Indlela yokuphatha ukuphulukiswa ekhaya ngemuva kokuqhekeka kwe-aorta?

Ukuphulukiswa ngemuva kokwelashwa kokuqhekeka kwe-aorta kudinga ukunakekelwa okucophelelayo kwegazi lakho eliphezulu kanye nezinga lomsebenzi. Iqembu lakho lezokwelapha lizokunika imiyalo ekhethekile, kodwa nazi izimiso ezijwayelekile ezisiza abantu abaningi.

Ukuthatha imithi yakho yegazi njengoba kuyalelwe kubalulekile ekuvimbeni izinkinga zesikhathi esizayo. Le mithi iyasiza ekuqedeni ukucindezela e-aorta yakho futhi ivimbele ukuqhekeka kabusha.

Kufanele ugweme ukuphakamisa izinto ezisindayo nomsebenzi omkhulu womzimba amasonto ambalwa noma izinyanga, kuye ngokwelashwa kwakho. Ukuhamba okuthambile kuvame ukukhuthazwa, kodwa buza udokotela wakho uma kuphephile ukwandisa izinga lomsebenzi wakho.

Ukuhlolwa kwezithombe zokulandelela kubalulekile ekuqondeni i-aorta yakho nokuqinisekisa ukuthi iphulukana kahle. Ungawashiyi la ma-aphoyintimenti, ngisho noma uzizwa kahle.

Kufanele uzilungiselele kanjani i-aphoyintimenti yakho nodokotela?

Uma uhlela i-aphoyintimenti yokulandelela ngemuva kokwelashwa, noma uma unezingozi futhi ufuna ukuxoxa ngokuvimbela, ukulungiselela kungakusiza ukuthi uthole okuningi ekuhambeni kwakho.

Bhala izimpawu zakho, kufaka phakathi ukuthi zaqala nini nokuthi yini ezenza zibe ngcono noma zibe zimbi. Letha uhlu lwemithi yonke oyithathayo, kufaka phakathi imithi yokuthengwa ngaphandle komthetho kanye nezinye izinto.

Lungiselela imibuzo mayelana nesimo sakho, izinketho zokwelashwa, kanye nemisebenzi ephephile kuwe. Buza ngezimpawu zokuqaphela ezifanele zikukhuthaze ukuba ufunuke unakekelwa ngokuphuthumayo.

Uma unezilwane zomndeni ezinezinkinga ze-aorta noma izimo zokuzalwa, letha leyo mininingwane. Umlando womndeni wakho ungabaluleka ekunakekelweni kwakho nasezincomeneni zokuhlola.

Ukuqhekeka kwe-aorta kungavimbeka yini?

Nakuba ungakwazi ukuvimbela zonke izimo zokuqhekeka kwe-aorta, unganciphisa kakhulu ingozi yakho ngokunakekela impilo yakho yemisipha yomthambo. Ukulawula igazi eliphezulu kuyisinyathelo esibaluleke kakhulu ongathatha.

Sebenza nodokotela wakho ukuze ugcine igazi lakho eliphezulu lisezingeni elihle ngemithi, ukudla, kanye noshintsho lokuziphila. Ukuzivocavoca njalo, ukugcina isisindo esinempilo, nokungabemi konke kusiza ekuvikeleni imithambo yegazi yakho.

Uma unesimo sokuzalwa esandisa ingozi yakho, ukuqapha njalo ngokuhlolwa kwezithombe kungasiza ekutholeni izinkinga kwangaphambi kwesikhathi. Abanye abantu abanobungozi obukhulu bangazuza ekuhlinzweni okuvimbelayo ngaphambi kokuba kube khona ukuqhekeka.

Gwema imisebenzi ebangela ukwanda kokuzumayo, okukhulu kwegazi eliphezulu, njengokuphakamisa izinto ezisindayo noma ukusebenzisa izidakamizwa ezishukumisayo. Uma udinga ukwenza umsebenzi onzima, sebenza kancane kancane.

Iyini into ebalulekile mayelana nokuqhekeka kwe-aorta?

Ukuqhekeka kwe-aorta kuyingozi yezokwelapha eqinile, kodwa ngokwelashwa okusheshayo, abantu abaningi baqhubeka bephila impilo evamile, enempilo. Okubalulekile ukuqaphela izimpawu nokufuna usizo ngokushesha.

Khumbula ukuthi ubuhlungu obukhulu, obukhulu esifubeni noma emuva akufanele buhlale buhlale buqaphelwe, ikakhulu uma unezingozi ezifana negazi eliphezulu noma umlando womndeni wezinkinga ze-aorta. Thembela ezizweni zakho futhi ungangabazi ukubiza usizo oluphuthumayo.

Uma uqeqeshwe ngokuqhekeka kwe-aorta, ukulandela uhlelo lwakho lokwelashwa nokuba nama-aphoyintimenti okuqapha njalo kubalulekile empilweni yakho yesikhathi eside. Ngokunakekelwa okuhle nokuqapha, unganciphisa ingozi yezinhlanganisela zesikhathi esizayo.

Imibuzo evame ukubuzwa mayelana nokuqhekeka kwe-aorta

Ukuqhekeka kwe-aorta kungaphiliswa yini ngokwalo?

Ukuqhekeka okuncane, okuzinzile ngezinye izikhathi kungaphiliswa ngokuphathwa ngokunakekelwa kwezokwelapha, kodwa lokhu kudinga ukuqapha okuqinile ochwepheshe. Iningi lokuqhekeka lidinga ukwelashwa okuqondile ukuvimbela izinhlanganisela ezibulalayo. Ungalokothi ucabange ukuthi ukuqhekeka kuzophulile ngokwalo ngaphandle kokunakekelwa kwezokwelapha okufanele.

Kuthatha isikhathi esingakanani ukuphulukiswa ngemuva kokuhlinzwa kokuqhekeka kwe-aorta?

Isikhathi sokuphulukiswa sihluka kuye ngohlobo lokuhlinzwa nempilo yakho yonke. Abantu abaningi bachitha izinsuku ezimbalwa kuya kwesonto esibhedlela, okulandelelwa amasonto ama-6-12 omsebenzi omncane ekhaya. Ukuphulukiswa okugcwele kungathatha izinyanga eziningi, kodwa abantu abaningi babuyela emisebenzini evamile ngezinguquko ezithile.

Ngingadinga ukwelashwa okuphila kwakho konke ngemuva kokuqhekeka kwe-aorta?

Yebo, abantu abaningi badinga ukuphathwa kwegazi eliphezulu okuphila kwabo konke nokuqapha njalo ngemuva kokuqhekeka kwe-aorta. Lokhu ngokuvamile kuhlanganisa imithi, ukuguqulwa kokuphila, kanye nokuhlolwa kwezithombe okuphindaphindiwe ukuze uhlole i-aorta yakho. Lokhu kunakekelwa okuqhubekayo kusiza ekuvimbeni ukuqhekeka nokuhlanganiswa kwesikhathi esizayo.

Ukucindezeleka kungabangela ukuqhekeka kwe-aorta?

Nakuba ukucindezeleka kwengqondo ngokwalo kungabangeli ukuqhekeka kwe-aorta, kungafaka isandla ngokuphakamisa igazi eliphezulu. Ukucindezela komzimba noma ukucindezela kungabangela ukuqhekeka kumuntu osevele enodonga lwe-aorta oluqiniwe. Ukuphatha ukucindezeleka ngezindlela zokuphila ezempilo kuyiyingxenye yempilo yonke yemisipha yomthambo.

Ukuqhekeka kwe-aorta kuyafa yini?

Ezinye izimo zokuzalwa ezifana ne-Marfan syndrome ne-valve ye-aorta ye-bicuspid zingandisa ingozi yokuqhekeka kwe-aorta, futhi lezi zingadlulela emindenini. Kodwa-ke, iningi lokuqhekeka kwenzeka kubantu abangenalo umlando womndeni. Uma unezihlobo ezinezinkinga ze-aorta, xoxa ngezincomo zokuhlola nodokotela wakho.