Cardiomyopathy Ehlisiwe

I-cardiomyopathy ehlisiweyo uhlobo lwesifo senhliziyo esenza ukuba amakamelo enhliziyo (ama-ventricle) anciphe futhi aoluleke, akhule. Ngokuvamile iqala ekamelweni elikhulu lokupompa kwenhliziyo (i-left ventricle). I-cardiomyopathy ehlisiweyo yenza kube nzima enhliziyweni ukupompa igazi emzimbeni wonke.

Abanye abantu abane-cardiomyopathy ehlalisiwe abanawo noma yimaphi ama-sign noma izimpawu ezigabeni zokuqala zesifo. Ama-sign nezimpawu ze-cardiomyopathy ehlalisiwe angafaka:

• Ukukhathala
• Ukuphefumula kanzima (dyspnea) ngesikhathi somsebenzi noma ulele phansi
• Ukuncipha kokusebenza komzimba
• Ukukhuluphala (edema) ezinyaweni, ezinkulungeni, ezinyaweni noma esiswini (isisu)
• Ubuhlungu noma ukungakhululeki esifubeni
• Ukushushuluza, ukubhebhetheka noma ukushaya kwenhliziyo okukhulu (palpitations)

Uma uthukuthelele emoyeni noma unezinye izimpawu ze-cardiomyopathy ebanziwe, vakashela umhlinzeki wakho wezinsizakalo zezempilo ngokushesha okukhulu. Shaya u-911 noma inombolo yakho yokuphuthuma kwendaweni uma unezinhlungu zifuba ezihlala isikhathi esingaphezu kwemizuzu embalwa noma unezinkinga ezinzima zokuphefumula.

Uma ilungu lomndeni likhulelwe i-cardiomyopathy ebanziwe, xoxa nomhlinzeki wakho wezinsizakalo zezempilo. Amanye ama-cardiomyopathy abanziwe adluliselwa emindenini (awuzuzwa). Ukuhlolwa kwe-genetic kungase kunconywe.

Kungaba nzima ukuqonda imbangela ye-cardiomyopathy ehlalisiwe. Noma kunjalo, izinto eziningi zingabangela ukuthi i-ventricle yasekhohlo ihlale futhi ibuthakathaka, okuhlanganisa:

• Ukutheleleka okuthile
• Izinkinga zokukhulelwa kwesigaba esiphezulu
• I-Diabetes
• I-Iron eningi enhliziyweni nakwezinye izitho (hemochromatosis)
• Izinkinga zesivinini senhliziyo (arrhythmias)
• Ukuphindwa kwegazi (hypertension)
• Ukukhuluphala
• Isifo se-valve yenhliziyo, njenge-mitral valve noma i-aortic valve regurgitation

Ezinye izimbangela ezingaba khona ze-cardiomyopathy ehlalisiwe zihlanganisa:

• Ukusebenzisa kabi utshwala
• Ukubhekana nezinto eziyingozi, njenge-lead, i-mercury ne-cobalt
• Ukusetshenziswa kwezidakamizwa ezithile ze-kansa
• Ukusetshenziswa kwezidakamizwa ezingasemthethweni, njenge-cocaine noma i-amphetamines

Izimbangela ezingozi ze-cardiomyopathy ehlalisiweyo zihlanganisa:

• Ukonakala kwemisipha yentliziyo okuvela ezifweni ezithile, ezifana ne-hemochromatosis
• Umlando womndeni we-cardiomyopathy ehlalisiweyo, ukwehluleka kwentliziyo noma ukuqhekeka kwenhliziyo okuzumayo
• Isifo se-valve yentliziyo
• Ukuvuvukala kwemisipha yentliziyo okuvela ezifo ze-immune system, ezifana ne-lupus
• Ukusebenzisa utshwala oluningi isikhathi eside noma ukusebenzisa izidakamizwa ezingasemthethweni
• Uxinzelelo lwegazi oluphezulu isikhathi eside
• Izifo ze-neuromuscular, ezifana ne-muscular dystrophy

Izinkinga ze-cardiomyopathy ehlisiweyo zihlanganisa:

• Ukwehluleka kwenhliziyo. Inhliziyo ayikwazi ukupompa igazi elanele ukuhlangabezana nezidingo zomzimba. Uma ingalashwa, ukwehluleka kwenhliziyo kungaba yingozi eyingozi empilweni.
• I-valve yenhliziyo eleka (ukubuyela emuva kwe-valve yenhliziyo). I-cardiomyopathy ingenza kube nzima kuma-valve enhliziyo ukuvala. Igazi lingase liphume emuva nge-valve yenhliziyo.
• Ukushona kwenhliziyo okungajwayelekile (arrhythmias). Ukushintsha usayizi nosuka kwenhliziyo kungaphazamisa ijubane lenhliziyo.
• Ukumima kwenhliziyo okungazelelwe. I-cardiomyopathy ehlisiweyo ingabangela ukuthi inhliziyo iyeke ukushaya ngokuzumayo.
• Ama-blood clots. Ukubuthana kwegazi ekamelweni elingaphansi kwesobunxele lenhliziyo kungabangela ama-blood clots. Uma ama-clots engeza egazini, angavimba ukugeleza kwegazi kwamanye amalungu, kuhlanganise nenhliziyo nobuchopho. Ama-blood clots angabangela isiguli, ukuhlaselwa yinhliziyo noma ukonakala kwamanye amalungu. Ama-arrhythmias angabangela ama-blood clots.

Imikhuba yokuphila impilo enhle ingasiza ekunqobeni noma ekunciphiseni izinkinga ze-cardiomyopathy ehlisiwe. Zama lezi zindlela ezihlakaniphile zenhliziyo:

• Gwema noma ubeke umkhawulo ethezi.
• Ungabhemi.
• Ungasebenzisi i-cocaine noma ezinye izidakamizwa ezingekho emthethweni.
• Dla ukudla okunempilo okune-sodium encane.
• Thola ukulala okwanele nokuphumula.
• Thola umsebenzi womzimba ojwayelekile.
• Gcina isisindo esinempilo.
• Lawula ukucindezeleka.

Ukuthola i-cardiomyopathy ehlisiweyo, umhlinzeki wakho wezempilo uzokwenza ukuhlolwa komzimba futhi abuze imibuzo mayelana nomlando wakho wezokwelapha wabantu siqu nowomndeni. Umhlinzeki uzosebenzisa idivayisi ebizwa ngokuthi yi-stethoscope ukulokothela inhliziyo nemiphunga yakho. Ungase uqondiswe kudokotela oqeqeshwe ekwelapheni izifo zenhliziyo (i-cardiologist).

Izivivinyo zokuthola i-cardiomyopathy ehlisiweyo zihlanganisa:

• I-Echocardiogram. Lona yivivinyo eliyinhloko lokuthola i-cardiomyopathy ehlisiweyo. Amaza omsindo akhiqiza izithombe zenhliziyo ehambayo. I-echocardiogram ibonisa ukuthi igazi lihamba kanjani liyangena futhi liphuma enhliziyweni nasezibalazweni zenhliziyo. Lingabonisa ukuthi i-ventricle yangakwesobunxele ikhulu kangakanani.
• Izivivinyo zegazi. Izivivinyo ezahlukene zegazi zingase zenziwe ukuhlola ukutheleleka, izinto noma izifo—njengesihlalo sikashukela noma i-hemochromatosis—ezibangela i-cardiomyopathy ehlisiweyo.
• I-X-ray yesifuba. I-X-ray yesifuba ibonisa ukuma nesimo senhliziyo nemiphunga. Ingabonisa ukugcwala kwamanzi ngaphakathi noma ngaphandle kwemiphunga.
• I-Electrocardiogram (ECG noma EKG). Lo mvivinyo osheshayo nolula uqopha umsebenzi wama-elekthrikhi wenhliziyo. I-electrocardiogram (ECG) ingabonisa ukuthi inhliziyo ishaya ngokushesha kangakanani noma kancane kangakanani. Izindlela ezikumazinga zingasiza ekubeni kutholakale isifo sokubetha kwenhliziyo noma ukunciphisa ukugcwala kwegazi.
• I-Holter monitor. Le divayisi ephathekayo ingagqokwa usuku olulodwa noma ngaphezulu ukuqopha umsebenzi wenhliziyo phakathi kwemisebenzi yansuku zonke.
• Ukuhlolwa kokucindezela komzimba. Lo mvivinyo uhlanganisa ukuhamba ebhande noma ukuqhubela ibhayisikili elimi ngenkathi inhliziyo ilokotheliwe. Izivivinyo zokuzivocavoca zisiza ekuboniseni ukuthi inhliziyo iphendula kanjani emisebenzini yomzimba. Uma ungakwazi ukuzivocavoca, ungase unikezwe imithi ebonisa umphumela wokuzivocavoca enhliziyweni.
• I-CT scan noma i-MRI scan yenhliziyo (cardiac). Lezi zivivinyo zokuthola izithombe zingabonisa usayizi nomsebenzi wezindlu zokupompa zenhliziyo. I-CT scan yenhliziyo isebenzisa uchungechunge lwe-X-rays ukwenza izithombe ezinemininingwane yenhliziyo. I-MRI yenhliziyo isebenzisa ama-magnetic fields namaza omsakazo.
• I-Cardiac catheterization. Phakathi nalesi senzo, imvamisa eyodwa noma ngaphezulu yemiyeyo emide emincane (i-catheters) ifakwa esithangwini segazi, ngokuvamile emadolweni, futhi iqondiswe enhliziyweni. Umenzi ugeleza nge-catheter ukuze usize ama-artery enhliziyo abonakale ngokucacile ezithombeni ze-X-ray. Phakathi ne-cardiac catheterization, isampula yethishu (i-biopsy) ingathathwa ukuhlola ukulimala kwemisipha yenhliziyo.
• Ukuhlolwa kwe-genetic noma ukwelulekwa. I-Cardiomyopathy ingadluliselwa emindenini (iyadluliselwa). Buza umhlinzeki wakho wezempilo uma ukuhlolwa kwe-genetic kulungele wena. Ukuhlolwa komndeni noma ukuhlolwa kwe-genetic kungase kuhlanganise abantu abaseduze—abazali, abazalwane nabantwana.

Ukwelapha i-cardiomyopathy ehlisiweyo kuncike ezizathwini. Izinjongo zokwelapha ukunciphisa izimpawu, ukuthuthukisa ukugeleza kwegazi nokuvimbela ukonakala kwenhliziyo okuqhubekayo. Ukwelapha i-cardiomyopathy ehlisiweyo kungafaka imithi noma ukuhlinzwa kokufaka idivayisi yezokwelapha esiza inhliziyo ukuba ishaye noma iphonse igazi.

Ukuhlanganiswa kwemithi kungase kusetshenziswe ukwelapha i-cardiomyopathy ehlisiweyo nokuvimbela noma yiziphi izinkinga. Imithi isebenza uku:

Imithi esetshenziswa ukwelapha ukwehluleka kwenhliziyo ne-cardiomyopathy ehlisiweyo ihlanganisa:

Ukuhlinzwa kungase kudingeke ukufaka idivayisi yokulawula ijubane lenhliziyo noma ukusiza inhliziyo iphonse igazi. Uhlobo lwamadivayisi asebenza ekwelapheni i-cardiomyopathy ehlisiweyo luhlanganisa:

Uma imithi nezinye izindlela zokwelapha i-cardiomyopathy ehlisiweyo ingasebenzi, ukutshalwa kwenhliziyo kungase kudingeke.

• Ukulawula ijubane lenhliziyo

• Ukusiza inhliziyo iphonse kangcono

• Ukuncipha kwegazi

• Ukuvimbela ukugqwala kwegazi

• Ukuncipha koketshezi emzimbeni

• Imithi yegazi. Izinhlobo ezahlukene zemithi zingase zisetshenziswe ukunciphisa igazi, ukuthuthukisa ukugeleza kwegazi nokunciphisa ukucindezela enhliziyweni. Imithi enjalo ihlanganisa i-beta-blockers, i-angiotensin-converting enzyme (ACE) inhibitors ne-angiotensin II receptor blockers (ARBs).

• Sacubitril/valsartan (Entresto). Lolu daba luhlanganisa i-angiotensin two receptor blocker (ARB) nezinye izinhlobo zemithi ukusiza inhliziyo iphonse kangcono igazi kwenye ingxenye yomzimba. Isebenza ekwelapheni labo abane-heart failure ehlala njalo.

• Amapilisi amanzi (diuretics). I-diuretic isusa uketshezi okugqamile nesawoti emzimbeni. Uketshezi okuningi emzimbeni kucindezela inhliziyo futhi kwenza kube nzima ukuphefumula.

• Digoxin (Lanoxin). Lolu daba lungaqinisa ukushaya kwemisipha yenhliziyo. Futhi luthanda ukunciphisa ukushaya kwenhliziyo. I-Digoxin inganciphisa izimpawu zokwehluleka kwenhliziyo futhi kwenze kube lula ukuba usebenze.

• Ivabradine (Corlanor). Ngokungavamile, lolu daba lungasetshenziswa ukuphatha ukwehluleka kwenhliziyo okubangelwa yi-cardiomyopathy ehlisiweyo.

• Abaphuli-gazi (anticoagulants). Le mithi ikusiza ukuvimbela ukugqwala kwegazi.

• I-Biventricular pacemaker. Le divayisi ibalelwe kubantu abane-heart failure nokushona okungajwayelekile kwenhliziyo. I-biventricular pacemaker ikhuthaza kokubili amachambers aphansi enhliziyo (i-right ne-left ventricles) ukwenza inhliziyo ishaye kangcono.

• Ama-Implantable cardioverter-defibrillators (ICD). I-Implantable cardioverter-defibrillator (ICD) ayilwelaphi i-cardiomyopathy ngokwayo. Ilinganisa ijubane lenhliziyo futhi inikeza imithambeka ye-elekthrikhi uma kukhona ukushaya kwenhliziyo okungajwayelekile (arrhythmia) kutholakala. I-Cardiomyopathy ingabangela i-arrhythmias eyingozi, kuhlanganise nalezo ezibangela ukuyeka kwenhliziyo.

• Ama-Left ventricular assist devices (LVAD). Le divayisi yomshini ikusiza inhliziyo ebuthakathaka iphonse kangcono. I-Left ventricular assist device (LVAD) ngokuvamile icatshangelwa ngemuva kokuba izindlela ezingenasici zingaphumeleli. Ingasetshenziswa njengokwelapha isikhathi eside noma njengokwelapha isikhathi esifushane ngenkathi ulinde ukutshalwa kwenhliziyo.