Ukuqina Kwethambo Lehliziyo (Hypertrophic Cardiomyopathy): Izimpawu, Izimbangela, Nokwelashwa

Ukuqina kwethambo lehliziyo kuyisimo lapho ithambo lehliziyo liba qinile ngokweqile, okwenza kube nzima ukuthi ihliziyo iphonse igazi ngokuphumelelayo. Cabanga ngumuntu oqeqesha umzimba, imisipha yakhe ikhule kakhulu kangangokuthi iphazamisa ukunyakaza - ithambo lehliziyo lakho liqina kangangokuthi lingaphambanisa ukugeleza kwegazi okujwayelekile.

Lesi simo esidluliselwa ngezofu sihlupha abantu abangu-1 ku-500 emhlabeni jikelele, nakuba abaningi bangazazi ukuthi banaso. Ukuqina kuvame ukwenzeka odongeni oluhlukanisa amakamelo amabili aphansi ehlinzini lakho, kodwa kungase kwenzeke kuphi kwenye indawo emsinyeni wehliziyo.

Ziyini izimpawu zokuqina kwethambo lehliziyo?

Abantu abaningi abane-hypertrophic cardiomyopathy abanawo nhlobo izimpawu, ikakhulukazi ekuqaleni. Uma izimpawu zivele, zivame ukuvela kancane njengoba ithambo lehliziyo liqhubeka liqina ngokuhamba kwesikhathi.

Izimpawu ezivame kakhulu ongaziqaphela zihlanganisa:

• Ukuthukuthela komoya, ikakhulukazi ngesikhathi somsebenzi womzimba noma ulele phansi
• Ubuhlungu noma ukucindezeleka esifubeni, ikakhulukazi ngesikhathi sokwenza umsebenzi womzimba
• Ukubetha okusheshayo kwehliziyo noma ukuzwa sengathi ihliziyo yakho igija noma ishiya ama-beats
• Ukukhungatheka noma ukukhanya, ikakhulukazi uma ukuma ngokushesha
• Ukukhathala okubonakala kungaphezu kwaleyo ewenzayo
• Ukuwa oluzumayo, ikakhulukazi ngesikhathi noma ngemuva kokwenza umsebenzi womzimba

Izimpawu ezingavamile kodwa ezingathi sína zihlanganisa ukukhula kwezinyawo, izikhokhonkwane, noma izinyawo, nobunzima bokuthukuthela komoya obukhula uma ulele. Lezi zimpawu zibonisa ukuthi ihliziyo yakho iluma kakhulu ukuphonsa igazi ngokuphumelelayo.

Kwezinye izimo ezingavamile, isilwane sokuqala sokuqina kwethambo lehliziyo kungaba ukuyeka kwenhliziyo ngokuzumayo, ikakhulukazi kubadlali abasebasha. Kungakho lesi simo siye saqaphela ezemidlalo, nakuba sisengavamile.

Ziyini izinhlobo zokuqina kwethambo lehliziyo?

Ukuqina kwethambo lehliziyo kuza ngezinhlobo ezimbili eziyinhloko, ngayinye ihlupha ihliziyo yakho ngendlela ehlukile. Uhlobo olukhona kuwe lunquma izimpawu zakho nendlela yokwelashwa.

Ukuqina kwethambo lehliziyo okuvimba kwenzeka lapho ithambo lehliziyo eliqinile livimba ukugeleza kwegazi ephuma ehlinzini lakho. Lokhu kwenzeka cishe ku-70% yezimo futhi kuvame ukubangela izimpawu ezibonakalayo njengobuningi esifubeni nokuthukuthela komoya ngesikhathi somsebenzi womzimba.

Ukuqina kwethambo lehliziyo okungavimbi kusho ukuthi ithambo liqine kodwa alivimbi ukugeleza kwegazi kakhulu. Abantu abanesihlobo esinjalo bavame ukuba nezimpawu ezimbalwa, nakuba ihliziyo isalali kahle phakathi kwama-beats, okungabangela izinkinga ngokuhamba kwesikhathi.

Kukhona futhi uhlobo olungavamile oluthiwa yi-apical hypertrophic cardiomyopathy, lapho ukuqina kwenzeka ikakhulukazi ekugcineni kwehliziyo. Lolu hlobo luvame kakhulu kubantu abavela eJapane futhi ngokuvamile lubangela izimpawu ezimbalwa kunamanye amafomu.

Yini ebangela ukuqina kwethambo lehliziyo?

Ukuqina kwethambo lehliziyo ikakhulukazi kuyisimo esidluliselwa ngezofu esidluliselwa emindenini. Cishe ama-60% ezimo abangelwa ukuguqulwa kwezofu ezilawula indlela amaprotheni emsinya wehliziyo asebenza ngayo.

Izofu ezithinteka kakhulu zihlanganisa:

• MYH7 ne-MYBPC3, ezenza amaprotheni abalulekile ekunciphiseni kwemisipha yehliziyo
• TNNT2 ne-TNNI3, ezisiza ukulawula ukuthi nini ithambo lehliziyo licindezela futhi liphumule
• TPM1 ne-ACTC1, ezisekela isisekelo somzimba wamaseli emsinya wehliziyo

Uma omunye wabazali bakho enokuqina kwethambo lehliziyo, unethuba elingu-50% lokudlulisela ukuguqulwa kwezofu. Kodwa-ke, ukuba nezofu akuqinisekisi ukuthi uzophumelela izimpawu - abanye abantu bahlala nezofu kodwa ababonisi izimpawu zalesi simo.

Kwezinye izimo ezingavamile, ukuqina kwethambo lehliziyo kungase kwenzeke ngaphandle komlando womndeni. Lokhu kungase kwenzeke ngenxa yokuguqulwa okusha kwezofu noma, ngokungavamile kakhulu, ngenxa yezinye izimo ezifana nezifo ezithile ze-metabolic noma ukucindezeleka kwegazi okuphezulu isikhathi eside.

Nini okufanele ubone udokotela ngokuqina kwethambo lehliziyo?

Kufanele ubheke udokotela ngokushesha uma uhlushwa ubuhlungu esifubeni, ukuthukuthela komoya ngesikhathi semisebenzi evamile, noma ukuwa okuzumayo. Lezi zimpawu zidinga ukuhlolwa kwezokwelapha ngisho noma zibonakala zingenamsebenzi noma ziye ziye.

Funani usizo lwezokwelapha ngokushesha uma unebuhlungu esifubeni esikhulu, ubunzima bokuthukuthela komoya ngesikhathi ukhulu, noma uma uwa ngesikhathi noma ngemuva kokwenza umsebenzi womzimba. Lokhu kungase kubonise ukuthi isimo sakho sihlupha ikhono lehliziyo yakho lokuphonsa igazi ngokuphumelelayo.

Uma unemlando womndeni wokuqina kwethambo lehliziyo, ukufa kwenhliziyo ngokuzumayo, noma ukwehluleka kwenhliziyo okungachazeki, cabanga ngokwelulekwa kwezofu nokuhlolwa ngisho noma ungenawo izimpawu. Ukutholakala kwangaphambi kwesikhathi kungasiza ukuvimbela izinkinga nokuqondisa izinqumo zokuphila.

Ukuhlola okujwayelekile kuba kubaluleke kakhulu uma utholakala une-hypertrophic cardiomyopathy, njengoba isimo sakho singashintsha ngokuhamba kwesikhathi. Udokotela wakho uzofuna ukulandelela ukuthi ihliziyo yakho isebenza kanjani futhi alungise ukwelashwa njengoba kudingeka.

Ziyini izici ezingaba yingozi zokuqina kwethambo lehliziyo?

Isici esikhulu esingaba yingozi sokuthuthukisa ukuqina kwethambo lehliziyo ukuba nemlando womndeni walesi simo. Njengoba ikakhulukazi iyizofu, ingozi yakho iphakeme kakhulu uma umzali, umfowethu, noma ingane itholakele inalesi simo.

Izici eziningana zingathinta indlela isimo sithuthuka futhi siqhubeka ngayo:

• Ubudala - izimpawu zivame ukuvela eminyakeni yobusha noma ekuqaleni kokukhula, nakuba zingase zithuthuke kunoma yiliphi iminyaka
• Ubulili - amadoda avame ukuthuthukisa izimpawu ezinkulu nezingozi kunabesifazane
• Uhlanga - abantu abathile, kuhlanganise nabantu abavela e-Afrika, bangaba nezinhlobo ezahlukile zezofu
• Ukucindezeleka kwegazi okuphezulu - nakuba kungesona isizathu, kungenza isimo sibe sibi uma sikhonjwe

Ngokuthakazelisayo, awukwazi ukuvimbela ukuqina kwethambo lehliziyo ngokwenza izinguquko zokuphila njengoba kuyizofu. Kodwa-ke, ukuhlala uqine ngokomzimba nokulawula ezinye izici ezingaba yingozi enhliziyweni kungakusiza ukuba uphile kangcono nalesi simo.

Kwezinye izimo ezingavamile, ezinye izimo zezokwelapha ezifana ne-Noonan syndrome noma izifo ezithile ze-metabolic zingandisa ingozi yakho yokuthuthukisa ukuqina kwemisipha yehliziyo okufana nokuqina kwethambo lehliziyo.

Ziyini izinkinga ezingase zenzeke ngokuqina kwethambo lehliziyo?

Nakuba abantu abaningi abane-hypertrophic cardiomyopathy baphila impilo evamile, lesi simo ngezinye izikhathi singabangela izinkinga ezinkulu. Ukuqonda lezi zinto ezingase zenzeke kukusiza ukusebenza nodokotela wakho ukuze uzivimbele noma uzilawule ngokuphumelelayo.

Izinkinga ezivame kakhulu zihlanganisa:

• I-Atrial fibrillation - i-rhythm engenamkhawulo yenhliziyo eyandisa ingozi yesifo sokuqina
• Ukwehluleka kwenhliziyo - lapho ihliziyo yakho ingakwazi ukuphonsa igazi ngokuphumelelayo ukuze ihlangabezane nezidingo zomzimba wakho
• Ukuyeka kwenhliziyo ngokuzumayo - nakuba kungavamile, lena yinkinga enkulu kakhulu engase ibe khona
• Ama-blood clots - ikakhulukazi uma uthuthukisa i-atrial fibrillation
• Izinkinga ze-Mitral valve - ithambo eliqinile lingathinta indlela ama-valves enhliziyo yakho asebenza ngayo

Izinkinga ezingavamile kodwa ezingathi sína zingase zihlanganise i-infective endocarditis, lapho amabhaktheriya ekuthinta ama-valves enhliziyo yakho, nokuphazamiseka okukhulu kokukhishwa okudingayo ukusebenza okuyisikhathi eside.

Ingozi yokuyeka kwenhliziyo ngokuzumayo, nakuba kuyesabekisa ukucabanga ngayo, ihlupha abantu abangaphansi kuka-1% abane-hypertrophic cardiomyopathy unyaka ngamunye. Udokotela wakho angahlola ingozi yakho siqu futhi ancome izindlela zokuvimbela uma kudingeka, njengokuqeda imithi ethile noma ucabange nge-implantable defibrillator.

Ukuqina kwethambo lehliziyo kuxilongwa kanjani?

Ukuqonda ukuqina kwethambo lehliziyo ngokuvamile kuqala ngodokotela wakho olalele ihliziyo yakho futhi ebuza ngezimpawu zakho nembali yomndeni. Bafuna imisindo ethile yenhliziyo ne-murmurs ebonisa ukugeleza kwegazi okungavamile.

Ivivinyo eliyinhloko lokuqonda yi-echocardiogram, esebenzisa amaza omsindo ukwenza izithombe eziningi zenhliziyo yakho. Leli vivinyo elingenani ubuhlungu libonisa ukuthi ithambo lehliziyo lakho liqine kangakanani, ukuthi ihliziyo yakho iphonsa igazi kangcono kangakanani, nokuthi ukugeleza kwegazi kuvinjelwe yini.

Udokotela wakho angase futhi ancome:

• I-Electrocardiogram (ECG) ukuhlola umsebenzi womgogodla wehliziyo yakho
• Ivivinyo lokucindezela komsebenzi womzimba ukuze ubone ukuthi ihliziyo yakho iphendula kanjani emsebenzini womzimba
• I-Cardiac MRI yezithombe eziningi zesakhiwo senhliziyo yakho
• I-Holter monitor ukurekhoda i-rhythm yenhliziyo yakho ngamahora angu-24-48
• Ukuhlolwa kwezofu ukuze ubone ukuguqulwa okuthile nokuhlola amalungu omndeni

Kwezinye izimo, udokotela wakho angase enze i-cardiac catheterization, lapho i-tube encane ifakwa ehlinzini lakho ukuze ilinganise ukucindezeleka futhi ihlole ukugeleza kwegazi ngokuqondile. Lokhu ngokuvamile kugcinelwa izimo eziyinkimbinkimbi noma lapho kukhona ukusebenza okuyisikhathi eside.

Izivivinyo zegazi zingasiza ekuqedeni ezinye izimo ezingase zibangele izimpawu ezifanayo, njengezinkinga ze-thyroid noma ezinye izifo zenhliziyo.

Iyini indlela yokwelapha ukuqina kwethambo lehliziyo?

Ukwelapha ukuqina kwethambo lehliziyo kugxile ekulawuleni izimpawu, ukuvimbela izinkinga, nokusiza ukuba ugcine impilo esebenzayo, ezele ukwaneliseka. Uhlelo lwakho oluthile lokwelashwa luxhomeke ezimpawu zakho, ububi besimo sakho, nezici zakho siqu ezingaba yingozi.

Imithi ngokuvamile iyindlela yokuqala yokwelapha futhi ingase ihlanganise:

• Ama-Beta-blockers afana ne-metoprolol ukuze aphungule isivinini senhliziyo yakho futhi unciphise izimpawu
• Ama-Calcium channel blockers afana ne-verapamil ukuze asize ihliziyo yakho iphumule phakathi kwama-beats
• Imithi yokulwa ne-arrhythmic uma uthuthukisa ama-rhythm angenamkhawulo enhliziyo
• Imithi yokuncipha kwegazi uma unesingozi yama-blood clots
• Ama-Diuretics ukunciphisa ukwakheka kwamanzi uma uthuthukisa izimpawu zokwehluleka kwenhliziyo

Kwezimo eziqina kakhulu ezingaphenduli emithi, izinketho zokusebenza zingase zidingeke. I-Septal myectomy ihlanganisa ukususa ingxenye yemisipha eliqinile ukuze ilungise ukugeleza kwegazi, kuyilapho i-alcohol septal ablation isebenzisa utshwala ukunciphisa ithishu enenkinga.

Kwezinye izimo ezingavamile lapho unesingozi enkulu yokuyeka kwenhliziyo ngokuzumayo, udokotela wakho angase ancome i-implantable cardioverter defibrillator (ICD). Le divayisi ilawula i-rhythm yenhliziyo yakho futhi inganikeza umsindo osindisa impilo uma kwenzeka ama-rhythm ayingozi.

Indlela entsha yokwelapha yi-mavacamten, imithi eklanywe ngokukhethekile yokuqina kwethambo lehliziyo engase inciphise ukuqina kwemisipha yehliziyo futhi ilungise izimpawu kwabanye abantu.

Indlela yokuphatha ukuqina kwethambo lehliziyo ekhaya?

Ukuphila kahle nokuqina kwethambo lehliziyo kuhlanganisa ukwenza izinqumo zokuphila eziqondisiwe ezisekela impilo yakho yenhliziyo. Izinqumo ezincane zansuku zonke zingathinta kakhulu indlela ozizwa ngayo nokuthi usebenza kanjani.

Ukuhlala uthambile kubaluleke kakhulu ngoba ukungabi namanzi kungenza izimpawu zibe sibi. Phuza amanzi amaningi usuku lonke, ikakhulukazi ngaphambi nangemuva kokwenza umsebenzi womzimba noma uma sekushisa.

Imiyalo yokwenza umsebenzi womzimba ibalulekile kodwa ihlukile. Nakuba kufanele uhlale usebenza, gwema imidlalo ecindezela kakhulu nemisebenzi ebangela ukuthukuthela komoya okukhulu noma ubuhlungu esifubeni. Ukuhamba, ukuqubha, nokuqeqeshwa kokumelana okulula ngokuvamile kuyizinketho eziphephile.

Ukulawula ukucindezeleka ngezindlela zokuphumula, ukulala okwanele, nemisebenzi ejabulisayo kungasiza ekuqedeni izimpawu. Ukucindezeleka okuqhubekayo kungenza izimpawu zokubetha okusheshayo kwehliziyo nezinye izimpawu ongaziqaphela zibe sibi.

Qaphela izimpawu zomzimba wakho futhi uhlale uma udinga. Ukucindezela ngokukhathala okukhulu noma ukuthukuthela komoya akusizi futhi kungase kubonise ukuthi udinga ukunakekelwa kwezokwelapha.

Gwema izinto ezithile ezingenza isimo sakho sibe sibi, kuhlanganise utshwala olukhulu, izikhuthazi, nemithi yokunciphisa ukugcwala engase ikhulise isivinini senhliziyo yakho noma ukucindezeleka kwegazi.

Kufanele ulungiselele kanjani i-appointment yakho nodokotela?

Ukulungiselela i-appointment yakho kusiza ukuqinisekisa ukuthi uthola okuningi ngesikhathi sakho nomhlinzeki wakho wezokunakekelwa kwezempilo. Qala ngokubhala zonke izimpawu zakho, kuhlanganise nokuthi zenzeka nini nokuthi yini ezibangela.

Letha uhlu oluphelele lwemithi yakho, kuhlanganise nemithi yokuthengwa ngaphandle kokubhalwa komtholampilo kanye nezinye izinto ezengeziwe. Ezinye imithi ingase ihlangane nezinye izimo zenhliziyo noma ukwelashwa, ngakho udokotela wakho udinga lolu lwazi.

Butha imbali yakho yomndeni yezokwelapha, ikakhulukazi noma yimiphi izihlobo ezinezinkinga zenhliziyo, ukufa kwenhliziyo ngokuzumayo, noma ukuwa okungachazeki. Lolu lwazi lwezofu lubalulekile ekuqondeni isimo sakho nengozi.

Lungiselela imibuzo mayelana nesimo sakho siqu, njengamanqanaba okwenza umsebenzi womzimba ophephile, izimpawu zokuqaphela, nokuthi udinga ukunakekelwa okujwayelekile kangakanani. Zibhale phansi ukuze ungazikhohlwa ngesikhathi se-appointment.

Uma lokhu kuyivivinyo lokuqala, qaphela noma yiziphi izinguquko ezimpawu zakho noma indlela ophendula ngayo ekwelapheni. Yiba eqotho mayelana nokusetshenziswa kwemithi nanoma yiziphi izimpawu ezihlangothini ozibhekana nazo.

Iyini into ebalulekile mayelana nokuqina kwethambo lehliziyo?

Ukuqina kwethambo lehliziyo kuyisimo senhliziyo esilawuleka esidluliselwa ngezofu esithinta umuntu ngamunye ngendlela ehlukile. Nakuba ukuxilongwa kungase kuzwakale kukhulu ekuqaleni, abantu abaningi abanesimo esinjalo baphila impilo egcwele, esebenzayo ngokunakekelwa kwezokwelapha okufanele nokulungiswa kokuphila.

Ukuhlala kahle nokuqina kwethambo lehliziyo ukwakha ubudlelwane obuqinile neqembu lakho lokunakekelwa kwezempilo. Ukuqapha okujwayelekile kuvumela ukutholakala kwangaphambi kwesikhathi kwezinguquko nokwenza izinguquko ekwelapheni njengoba kudingeka.

Khumbula ukuthi ukuba nalesi simo akusho ukuthi awukwazi ukwenza lutho - kusho nje ukuthi udinga ukunakekela impilo yakho yenhliziyo. Abantu abaningi baphila impilo enhle emisebenzini, ubudlelwane, nemisebenzi yomzimba ngenkathi bephila nokuqina kwethambo lehliziyo.

Hlala uqaphele isimo sakho, landela uhlelo lwakho lokwelapha, futhi ungangabazi ukuxhumana nodokotela wakho ngemibuzo noma ukukhathazeka. Indlela yakho yokwenza izinto ngokwakho yokuphatha impilo yakho yenza umehluko omkhulu emiphumeleni yakho yesikhathi eside.

Imibuzo evame ukubuzwa mayelana nokuqina kwethambo lehliziyo

Ungaphila impilo evamile nokuqina kwethambo lehliziyo?

Yebo, abantu abaningi abane-hypertrophic cardiomyopathy baphila impilo evamile, ezele ukwaneliseka ngokulawulwa kwezokwelapha okufanele. Nakuba ungase udinga ukwenza izinguquko zokuphila futhi uthathe imithi, isimo asikuvimbeli ekusebenzeni, ukuhambeni, noma ukujabulela ubudlelwane. Ukunakekelwa okujwayelekile okuqhubekayo kusiza ukuqinisekisa ukuthi uhlala uphilile futhi usebenza.

Ingabe ukuqina kwethambo lehliziyo kudluliselwa ngezofu?

Ukuqina kwethambo lehliziyo kuyizofu cishe ku-60% yezimo, okusho ukuthi kungadluliselwa kubazali kubantwana. Uma unesimo, ngamunye wabantwana bakho unethuba elingu-50% lokudlulisela ukuguqulwa kwezofu. Kodwa-ke, ukuhlolwa kwezofu nokuhlola komndeni kungasiza ekutholeni izihlobo ezingozi ngaphambi kwesikhathi, kuvumela ukuqapha okungcono nokwelashwa.

Yimiphi imisebenzi okufanele uyigweme nokuqina kwethambo lehliziyo?

Kufanele ugweme imidlalo ecindezela kakhulu, ikakhulukazi lezo ezidinga ukukhishwa kwamandla ngokuzumayo njengokuqhudelana noma ukuphakamisa izinto ezisindayo. Imisebenzi ebangela ukuthukuthela komoya okukhulu, ubuhlungu esifubeni, noma ukukhungatheka kufanele ibe mncane. Kodwa-ke, umsebenzi womzimba olude njengokuhamba, ukuqubha, nokuqeqeshwa kokumelana okulula ngokuvamile kuwusizo futhi kukhuthazwa ngaphansi kokunakekelwa kwezokwelapha.

Ingabe ukuqina kwethambo lehliziyo kungaba sibi ngokuhamba kwesikhathi?

Ukuqina kwethambo lehliziyo kungase kuqhubeke, kodwa lokhu kuyahluka kakhulu phakathi kwabantu. Abanye abantu bahlala beqinile iminyaka eminingi, kuyilapho abanye bengase bathuthukise izimpawu ezibi noma izinkinga. Ukuqapha okujwayelekile nodokotela wakho wehliziyo kusiza ekuqapheni noma yiziphi izinguquko nokwenza izinguquko ekwelapheni ngokufanele. Ukungenelela kwangaphambi kwesikhathi ngokuvamile kuvimbela noma kunciphise ukuqhubeka.

Iyini ithemba lokuphila nokuqina kwethambo lehliziyo?

Abantu abaningi abane-hypertrophic cardiomyopathy banethemba lokuphila eliqondile noma elisondelene neliqondile, ikakhulukazi ngokwelashwa kwamanje nokuqapha. Nakuba lesi simo sinezingozi ezithile, izinga lokufa minyaka yonke lingaphansi kuka-1% kubantu abaningi. Isimo sakho siqu sixhomeke ezintweni ezifana nobukhulu bezimpawu, imbali yomndeni, nokuphendula ekwelapheni.