Endocarditis

I-Endocarditis iwukuvuvukala okubulalayo kokugqoka kwangaphakathi kwamakamelo nenhliziyo yephaphu. Le ngubo ibizwa ngokuthi i-endocardium.

I-Endocarditis ivame ukubangelwa ukutheleleka. Amabhaktheriya, amagciwane noma ezinye izinambuzane zingena egazini futhi zinamathele ezindaweni ezonakele enhliziyweni. Izinto ezenza kube lula ukuthola i-endocarditis yiziphaphu zenhliziyo ezakhiwe, iziphaphu zenhliziyo ezonakele noma ezinye izifo zenhliziyo.

Ngaphandle kokwelashwa okusheshayo, i-endocarditis ingalimaza noma yonakalise iziphaphu zenhliziyo. Ukwelashwa kwe-endocarditis kuhlanganisa imithi nokuhlinzwa.

Izimpawu ze-endocarditis zingase zihluke kumuntu ngamunye. I-Endocarditis ingase iqale kancane noma ngokuzumayo. Kuxhomeke ekuhlolweni kwezifo ezibangela ukutheleleka nokukhona kwezinye izinkinga zenhliziyo.

Izimpawu ezivamile ze-endocarditis zihlanganisa:

• Ubuhlungu bezingqondo namathambo
• Ubuhlungu esifubeni uma uphefumula
• Ukukhathala
• Izimpawu ezifana ne-influenza, njengoba kubanda nokufiphaza
• Ukubila ebusuku
• Ukuphefumula kancane
• Ukukhula ezinyaweni, emilenzeni noma esiswini
• Umsindo omusha noma oshintshile we-whooshing enhliziyweni (murmur)

Izimpawu ze-endocarditis ezingavamile zingabandakanya:

• Ukwehla kwesisindo okungachazeki
• Igazi emanzini
• Ubuhlungu phansi kwesigxobo sokunxele (ispleen)
• Amabala abomvu, aluhlaza okwesibhakabhaka noma abomvu abangenabuhlungu ezinyaweni noma ezandleni (Janeway lesions)
• Ama-bumps noma ama-patches abomvu noma aluhlaza okwesibhakabhaka abubuhlungu noma ama-patches aluhlaza okwesibhakabhaka (hyperpigmented) eziphepheni zezinzwane noma ezinzwane (Osler nodes)
• Amabala amancane aluhlaza okwesibhakabhaka, abomvu noma abomvu asendaweni (petechiae), ezinhlangothini ezimhlophe zamehlo noma ngaphakathi emlonyeni

Uma unezimpawu zokuthi uqaphele i-endocarditis, vakashela umhlinzeki wakho wezempilo ngokushesha okukhulu — ikakhulukazi uma une-congenital heart defect noma umlando we-endocarditis. Isimo esingathí síbe sibi singabangela izimpawu ezifanayo. Ukuhlolwa okuqondile ngumhlinzeki wezempilo kuyadingeka ukuze wenze ukuxilongwa.

Uma usuqondiwe ukuthi une-endocarditis futhi unezinye zezimpawu ezilandelayo, tshela umhlinzeki wakho wokunakekelwa. Lezi zimpawu zingasho ukuthi ukutheleleka kuya kubi:

• Ukuthandaza
• Ukuqina
• Izinhlungu zikhanda
• Ubuhlungu beJoints
• Ukuqina komoya

I-Endocarditis ivame ukubangelwa ukutheleleka ngamabhaktheriya, ama-fungi noma ezinye izinzalo. Lezi zinsolo zingena egazini ziye enhliziyweni. Enhliziyweni, zinamathela ezicabha zehliziyo ezilimele noma ethunjini lenhliziyo elilimele.

Ngokuvamile, uhlelo lokukhulula lomzimba lubhubhisa noma yimaphi amabhaktheriya abangela ubuhlungu angena egazini. Noma kunjalo, amabhaktheriya okhulelwe olweleni noma emlonyeni, ehlombe noma esibindini (amathumbu) angangena egazini abangele i-endocarditis ngaphansi kwezimo ezifanele.

Izinto eziningi ezahlukene zingabangela ukuba amagciwane angene egazini futhi ahole ekupheleni kwesisu. Ukuba nevalvu yentliziyo enesici, egulayo noma elilimaziwe kukhuphula ingozi yesimo. Noma kunjalo, i-endocarditis ingase ibe khona kulabo abangenazo izinkinga zevalvu yentliziyo.

Izici ezingozi ze-endocarditis zihlanganisa:

• Ubudala obukhulu. I-Endocarditis iqala kakhulu kubantu abadala abangaphezu kweminyaka engama-60.
• Amavalvu entliziyo angokwenziwa. Amagciwane anethuba elikhulu lokubopha evalvu yentliziyo enziwe (i-prosthetic) kunavalvu yentliziyo evamile.
• Amavalvu entliziyo alimale. Izimo ezithile zezokwelapha, njengoba kubangelwa umkhuhlane we-rheumatic noma ukutheleleka, zingalimaza noma zibeke izigxobo kwenye noma ngaphezulu kwamavalvu entliziyo, zikhuphule ingozi yokutheleleka. Umlando we-endocarditis ubuye ukhuphule ingozi yokutheleleka.
• Ukuntuleka kokuzalwa kwentliziyo. Ukudalwa ngezinhlobo ezithile zezinkinga zentliziyo, njengentliziyo engavamile noma amavalvu entliziyo alimale, kukhuphula ingozi yokutheleleka kwentliziyo.
• Idivayisi yentliziyo efakwe. I-Bacteria ingabopha kudivayisi efakwe, njenge-pacemaker, ibangele ukutheleleka kokugqoka kwentliziyo.
• Ukusetshenziswa okungekho emthethweni kwezidakamizwa ze-intravenous (IV). Ukusebenzisa izimpumputhe ze-IV ezingcolile kungabangela ukutheleleka njenge-endocarditis. Izimpumputhe nezinsimbi ezingcolile ziyinkathazo ekhethekile kubantu abasebenzisa izidakamizwa ze-IV ezingekho emthethweni, njenge-heroin noma i-cocaine.
• Impilo embi yemazinyo. Umlomo ophilile nama-gums aphilile kubalulekile empilweni enhle. Uma ungagezi futhi ungagqokisi njalo, amagciwane angakhula emlonyeni wakho futhi angangena egazini lakho ngokusika emagumeni akho. Amanye ama-procedure ezinyo angasika ama-gums angavumela futhi amagciwane angene egazini.
• Ukusetshenziswa kwe-catheter isikhathi eside. I-catheter iyithyube elithin ekusetshenziswa kokwenza amanye ama-procedure ezokwelapha. Ukuba ne-catheter esikhundleni isikhathi eside (i-catheter indwelling) kukhuphula ingozi ye-endocarditis.

Kuma-endocarditis, izikhula ezingajwayelekile ezenziwe ngamagciwane nezingcezu zezisele zenza iqhwa enhliziyweni. Lezi zicucu zibizwa ngokuthi i-vegetations. Zingaphula futhi ziye ebuchosheni, emaphashini, ezimpungwini nezinye izitho. Zingaya futhi ezandleni nasemiileni.

Izinkinga ze-endocarditis zingafaka:

• Ukwehluleka kwenhliziyo
• Ukonakala kwevalvu yenhliziyo
• Isiguli
• Izikhwama ze-pus eziqoqekile (ama-abscesses) azithuthukisa enhliziyweni, ebuchosheni, emaphashini nezinye izitho
• I-blood clot e-lung artery (pulmonary embolism)
• Ukonakala kwesibindi
• Ukuqina kwespleen

Ungenza izinyathelo ezilandelayo ukusiza ukuvimbela i-endocarditis:

• Yazi izimpawu nezimpawu ze-endocarditis. Bheka umhlinzeki wakho wezinsizakalo zezempilo ngokushesha uma uthola noma iyiphi impikiswano yokutheleleka — ikakhulukazi ubushushu obungapheli, ukukhathala okungachazwanga, noma iyiphi uhlobo lokutheleleka kwesikhumba, noma ukukhahlela okungapheli noma izilonda ezingapheli kahle.
• Nakekela amazinyo namagxolo akho. Hlambulula futhi uhlanze amazinyo namagxolo akho njalo. Thola ukuhlolwa kweminyaka yonke kwamazinyo. Ukuhlanzeka okuhle kwamazinyo kuyiyingxenye ebalulekile yokugcina impilo yakho yonke.
• Ungasebenzisi izidakamizwa ezingamthetho ze-IV. Izimpumputhe ezingcolile zingathumela amabhaktheriya egazini, zikhulise ingozi ye-endocarditis.

Ukuthola i-endocarditis, umhlinzeki wezempilo uqala ngokuhlola umzimba bese ebuza imibuzo mayelana nomlando wakho wezokwelapha kanye nezimpawu. Kwenziwa amavivinyo okusiza ukuqinisekisa noma ukuphika i-endocarditis.

Ivivinyo elisetshenziswa ekutholeni i-endocarditis lihlanganisa:

I-Echocardiogram. Amaza omsindo asebenza ekwenzeni izithombe zenhliziyo ebethayo. Lo mvivinyo ubonisa ukuthi amakamelo nenhliziyo yompompi igazi kangcono kangakanani. Ingabonisa futhi ubukhulu benhliziyo. Umhlinzeki wakho angase asebenzise izinhlobo ezimbili ze-echocardiograms ukuze akusize uthole i-endocarditis.

Kwi-echocardiogram ejwayelekile (i-transthoracic), idivayisi efana nenduku (i-transducer) ihambiswa phezu kwendawo yesifuba. Idivayisi iqondisa amaza omsindo enhliziyweni bese iwabhala njengoba ebuyela emuva.

Kwi-transesophageal echocardiogram, ithubi lokuguquguquka eliqukethe i-transducer liqondiswa phansi komlomo bese liya ethubini elixhuma umlomo esiswini (i-esophagus). I-transesophageal echocardiogram inikeza izithombe ezengeziwe zenhliziyo kunalokho okungenzeka nge-echocardiogram ejwayelekile.

• Uvivinyo lwe-blood culture. Lo mvivinyo uqaphela izinzalo egazini. Imiphumela yalo mvivinyo ikusiza unqume i-antibiotic noma ukuxuba kwe-antibiotics okufanele kusetshenziswe ekwelapheni.

• Ukubalwa kwamagazi okuphelele. Lo mvivinyo uqaphela ukuthi kukhona yini amaseli amhlophe amaningi, okungaba uphawu lokutheleleka. Ukubalwa kwamagazi okuphelele kungasiza futhi ekutholeni amazinga aphansi amaseli abomvu aphilile (i-anemia), okungaba uphawu lwe-endocarditis. Kungenzeka futhi kwenziwe amanye amavivinyo egazi.

• I-Echocardiogram. Amaza omsindo asebenza ekwenzeni izithombe zenhliziyo ebethayo. Lo mvivinyo ubonisa ukuthi amakamelo nenhliziyo yompompi igazi kangcono kangakanani. Ingabonisa futhi ubukhulu benhliziyo. Umhlinzeki wakho angase asebenzise izinhlobo ezimbili ze-echocardiograms ukuze akusize uthole i-endocarditis.

  Kwi-echocardiogram ejwayelekile (i-transthoracic), idivayisi efana nenduku (i-transducer) ihambiswa phezu kwendawo yesifuba. Idivayisi iqondisa amaza omsindo enhliziyweni bese iwabhala njengoba ebuyela emuva.

  Kwi-transesophageal echocardiogram, ithubi lokuguquguquka eliqukethe i-transducer liqondiswa phansi komlomo bese liya ethubini elixhuma umlomo esiswini (i-esophagus). I-transesophageal echocardiogram inikeza izithombe ezengeziwe zenhliziyo kunalokho okungenzeka nge-echocardiogram ejwayelekile.

• I-Electrocardiogram (ECG noma EKG). Lo mvivinyo osheshayo futhi ongenaphimbo ulinganisa umsebenzi womgogodla wenhliziyo. Phakathi ne-electrocardiogram (ECG), izinzwa (ama-electrodes) zinamathele esifubeni futhi ngezinye izikhathi ezandleni noma ezinyaweni. Akusetshenziswa ngokuqondile ekutholeni i-endocarditis, kodwa ingabonisa ukuthi kukhona yini okuthinta umsebenzi womgogodla wenhliziyo.

• Isithombe se-X-ray sesifuba. Isithombe se-X-ray sesifuba sibonisa isimo lamaphunga nenhliziyo. Kungasiza ekuqondeni ukuthi i-endocarditis ibingabangela ukukhula kwenhliziyo noma noma yikuphi ukutheleleka okusakazeke emaphungeni.

• I-Computerized tomography (CT) scan noma i-magnetic resonance imaging (MRI). Ungase udinga ukuskena ubuchopho bakho, isifudu noma ezinye izingxenye zomzimba wakho uma umhlinzeki wakho ecabanga ukuthi ukutheleleka kusakazeke kulezi zindawo.