Bradycardia

I-Bradycardia, eboniswe ngakwesokudla, iwumjikelezo wenhliziyo ohamba kancane kunokujwayelekile, oluqala kaningi endaweni yenhliziyo ebizwa ngokuthi i-sinus node. Ujikelezo olujwayelekile lenhliziyo luboniswe esithombeni esisekhohlo.

I-Bradycardia (brad-e-KAHR-dee-uh) iwumjikelezo wenhliziyo ohamba kancane. Izinhliziyo zabantu abadala abaqabukile zivame ukushaya phakathi kuka-60 no-100 ngomzuzu. Uma une-bradycardia, inhliziyo yakho ishaya ngaphansi kuka-60 ngomzuzu.

I-Bradycardia ingaba yinkinga enkulu uma umjikelezo wenhliziyo uhamba kancane kakhulu futhi inhliziyo ingakwazi ukupompa igazi elinokulinganisela lokufinyelela okwanele emzimbeni. Uma lokhu kwenzeka, ungase uzizwe udumazele, ukhathele kakhulu noma ubuthakathaka, futhi ube nomoya omfushane. Ngezinye izikhathi i-bradycardia ayibangeli izimpawu noma izinkinga.

Umgijimoyo ohamba kancane awulona njalo ukukhathazeka. Ngokwesibonelo, umjikelezo wenhliziyo oqabukile phakathi kuka-40 no-60 ngomzuzu kuyinto evamile kwabanye abantu, ikakhulukazi abantu abadala abasebasha abaphilile nabagijimi abaqeqeshwe. Kuyinto evamile nakakhulu ngesikhathi sokulala.

Uma i-bradycardia iyingozi, kungase kudingeke i-pacemaker ukusiza inhliziyo ukuba ishaye ngesilinganiso esifanele.

Ukuphazamiseka kwenhliziyo okusheshayo kunokujwayelekile kubizwa ngokuthi i-bradycardia. Uma ukuphazamiseka kwenhliziyo ekuhambeni kancane kuvimba ubuchopho nezinye izitho ekutholeni oksijini olukhulu, izimpawu zingafaka: Ubuhlungu esifubeni. Ukuphazamiseka noma izinkinga zememori. Ukukhungatheka noma ukukhanya. Ukuzizwa ukhathele kakhulu, ikakhulukazi ngesikhathi somsebenzi womzimba. Ukuhlanza noma ukusondela ekuhlanzweni. Ukuphefumula okusheshayo. Izinto eziningi zingabangela izimpawu ze-bradycardia. Kubalulekile ukuthola ukuxilongwa okusheshayo, okuchane ngokunembile nokukhathalela okufanele. Yenza i-aphoyintimenti yokuhlolwa kwempilo uma ukhathazekile ngesivinini senhliziyo ehambayo kancane. Uma uhlanza, unokungaphefumuli kahle noma unebuhlungu esifubeni isikhathi esingaphezu kwemizuzu embalwa, shayela u-911 noma izinsizakalo zezokwelapha eziphuthumayo.

Izinto eziningi zingabangela izimpawu ze-bradycardia. Kubalulekile ukuthola ukuxilongwa okusheshayo, okuchane ngokunembile kanye nokunakekelwa okufanele. Yenza i-aphoyintimenti yokuhlolwa kwempilo uma ukhathazekile ngesivinini sokubetha kwentliziyo elipholile. Uma uwa, uhlushwa ukuphefumula noma unezinhlungu esifubeni isikhathi esingaphezu kwemizuzu embalwa, shayela u-911 noma izinsizakalo zokwelapha eziphuthumayo.

Esikhundleni senhliziyo evamile, iqembu elincane lamakhemikhali e-sinus node lithumela isignali yombane. Isignali bese ihamba nge-atria iye e-atrioventricular (AV) node bese idlula e-ventricles, ibangele ukuba ihlangane futhi iphompe igazi.

I-Bradycardia ingabangelwa yi:

• Ukonakala kwezicubu zenhliziyo okuhlobene nobudala.
• Ukonakala kwezicubu zenhliziyo okuvela ekuguleni kwenhliziyo noma ekuhlaselweni kwenhliziyo.
• Isimo senhliziyo ozelwe naso, esibizwa ngokuthi i-congenital heart defect.
• Ukutheleleka kwezicubu zenhliziyo, okubizwa ngokuthi i-myocarditis.
• Ukuhlupheka kokucutshungulwa kwenhliziyo.
• I-gland ye-thyroid engasebenzi kahle, ebizwa ngokuthi i-hypothyroidism.
• Ukushintsha amazinga emigodi yomzimba efana ne-potassium noma i-calcium.
• Ukuphazamiseka kokulala okubizwa ngokuthi i-obstructive sleep apnea.
• Isikhuthazo sesifo, njenge-rheumatic fever noma i-lupus.
• Imithi ethile, kufaka phakathi i-sedatives, i-opioids, nezinye ezisetshenziswa ekwelapheni izimo zenhliziyo nezezingqondo.

Ukuqonda kangcono izimbangela ze-bradycardia, kungasiza ukwazi ukuthi inhliziyo ivamise ukushaya kanjani. Inhliziyo evamile inezingxenye ezine.

• Izingxenye ezimbili eziphezulu zibizwa nge-atria.
• Izingxenye ezimbili eziphansi zibizwa nge-ventricles.

Ngaphakathi kwegumbi eliphezulu lasekunene lenhliziyo kukhona iqembu lamakhemikhali elibizwa nge-sinus node. I-sinus node yiyona pacemaker yemvelo yenhliziyo. Yakha isignali eqala ukushaya kwenhliziyo. I-Bradycardia kwenzeka lapho lezi zikhomba zihamba kancane noma zivaliwe.

Izinto ezibangela ukushintsha ekukhulumiseni kwenhliziyo okungabangela i-bradycardia zifaka:

• I-Bradycardia-tachycardia syndrome. Kubantu abathile, izinkinga e-sinus node phezulu kwenhliziyo zibangela ukushintshashintsha kwezinga lokugijima kwenhliziyo.
• I-Heart block, ebizwa nangokuthi i-atrioventricular block. Kulesi simo, izikhomba zombane zenhliziyo aziniki kahle ezingxenyeni eziphezulu ziye ezingxenyeni eziphansi.

I-Bradycardia ivame ukuxhumene nokonakala kwezicubu zenhliziyo okuvela kuhlobo oluthile lwesifo senhliziyo. Noma yini eyenyusa ingozi yezingqinamba zenhliziyo ingayandisa ingozi ye-bradycardia. Izici ezikhungathekisayo zihlanganisa: Ubudala obukhulu.

Uxinzelelo lwegazi oluphezulu.

Ukubhema.

Ukusetshenziswa okukhulu kotshwala.

Ukusetshenziswa kwezidakamizwa ezingasemthethweni.

Ukuqina nokukhathazeka.

Izingozi ezingase zenzeke ngenxa ye-bradycardia zifaka phakathi:

• Ukuhlushwa njalo yi-syncope.
• Ukwehluleka kwenhliziyo.
• Ukuqina kwenhliziyo okungazelelwe noma ukufa kwenhliziyo okungazelelwe.

Ukuvimbela isifo senhliziyo kungasiza ekuphunguleni ingozi ye-bradycardia. I-American Heart Association iphakamisa lezi zinyathelo:

• Zama ukuzivocavoca njalo. Buza iqembu lakho lokunakekelwa kwezempilo ukuthi yiluphi uhlobo lokuzivocavoca olufanele kuwe nokuthi kufanele uzivocavoce kangakanani.
• Dla ukudla okunomsoco. Dla ukudla okunempilo okune-sodium encane namafutha aqinile, futhi okunamaqabunga, imifino, nezinhlamvu ezigcwele.
• Gcina isisindo esinempilo. Ukukhuluphala kukhulisa ingozi yesifo senhliziyo. Xoxa neqembu lakho lokunakekelwa kwezempilo ukuze nibekele imigomo efanele ye-BMI (Body Mass Index) nesisindo.
• Ungabhemi noma usebenzisi utshaba. Uma ubhema futhi awukwazi ukuyeka wedwa, xoxa nochwepheshe wezempilo ngezindlela noma ngezinhlelo ezingakusiza.
• Khawulela noma ungaphuzi utshwala. Uma ukhetha ukuphuza utshwala, yenza kanjalo ngokulinganisela. Kubantu abadala abaphilile, lokho kusho ukuphuza iziphuzo ezingaphansi kwesisodwa ngosuku kwabesifazane kanye neziphuzo ezingaphansi kwezi-2 ngosuku kwabesilisa.
• Lawula ukucindezeleka. Imizwa eqinile ingathinta izinga lenhliziyo. Ukuzivocavoca okwengeziwe, ukuqeqeshwa kwengqondo nokuhlangana nabanye emaqenjini wokusekela zingazindlela zokunciphisa nokulawula ukucindezeleka.
• Tholani ubuthongo obuhle. Ukuntuleka kokulala kungase kukhulise ingozi yesifo senhliziyo nezinye izimo ezingapheli. Abantu abadala kufanele bafune ukuthola amahora angu-7 kuya kwangu-9 okulala nsuku zonke. Lala uvuke ngesikhathi esifanayo nsuku zonke, kufaka phakathi amaviki ophephukile. Uma unezinkinga zokulala, xoxa nochwepheshe wezempilo ngamathuluzi angakusiza. Kubalulekile ukuhlola impilo njalo. Uma usuvele unesifo senhliziyo, thatha lezi zinyathelo ukuze unciphise ingozi yokungalingani kwenhliziyo:
• Landela uhlelo lwakho lokwelashwa. Qiniseka ukuthi uyayiqonda indlela yakho yokwelashwa. Thatha wonke amaphilisi njengoba uqondiswe yiqembu lakho lokunakekelwa kwezempilo.
• Tshela iqembu lakho lokunakekelwa uma izimpawu zakho zishintsha. Tshela futhi iqembu lokunakekelwa kwezempilo uma unezimpawu ezintsha.

Ukuthola i-bradycardia, ochwepheshe bezempilo bayakuhlola futhi balalele inhliziyo yakho nge-stethoscope. Ngokuvamile ubuzwa imibuzo mayelana nezimpawu zakho kanye nomlando wakho wezokwelapha.

Amathethhu angase enziwe ukuhlola inhliziyo yakho nokufuna izimo ezingabangela i-bradycardia.

• Izivivinyo zegazi. Isibonelo segazi lakho lingase lihlolwe ukuhlola ukutheleleka kanye nezinguquko emakhemikhali omzimba, njenge-potassium. Uvivinyo lwegazi lungase futhi lenziwe ukuhlola umsebenzi wesitho se-thyroid.
• Electrocardiogram (ECG noma EKG). Lona yi-test ebaluleke kakhulu esetshenziswa ukuthola i-bradycardia. I-ECG iqapha umsebenzi womgogodla wenhliziyo. Ibonisa ukuthi inhliziyo ibetha kanjani. Ama-patches amanamathelayo ane-sensors abekwa esifubeni futhi ngezinye izikhathi ezandleni nasezinzwaneni. Izingcingo zixhuma ama-electrodes kukhompyutha, ebonisa noma iphrinta imiphumela.
• I-Holter monitor. Uma i-ECG ejwayelekile ingabonisi ukushaya kwenhliziyo okungajwayelekile, ochwepheshe bakho bezempilo bangase baphakamise i-Holter monitor. Le divayisi ye-ECG ephathekayo igqokwe usuku olulodwa noma ngaphezulu. Ibhalisa umsebenzi wenhliziyo ngesikhathi semisebenzi yansuku zonke.
• Uvivinyo lokusebenza lokucindezela. Ezinye izikhathi zokushaya kwenhliziyo okungajwayelekile zibangelwa noma zenza kube kubi ukwenza umsebenzi. Ngesikhathi sovivinyo lokucindezela, umsebenzi wenhliziyo uqapha ngenkathi ugibele ibhayisikili elimi noma uhamba etreadmill. Uma ungakwazi ukuzivocavoca, ungase unikezwe imithi ethonya inhliziyo njengoba umsebenzi wenza.
• Ucwaningo lobuthongo. Ucwaningo lobuthongo lungase luphakanyiswe uma unemiphumulo ephindaphindayo yokuphefumula ngesikhathi ulele, okuthiwa yi-obstructive sleep apnea. Leso simo singabangela izinguquko ekubetheni kwenhliziyo.