Kugwa k'umutima: Ibisobanuro, Ibimenyetso n'Uburyo bwo Kubitabara

Kuba umutima ni iki kandi gute kibaho?

Kuba umutima, mu rurimi rw’ubuvuzi bita “imyokaride enfarike”, ni ikibazo gikomeye cy’ubuzima kibaho igihe imitsi itwara amaraso ku mutima (koroneri) ifunze bitunguranye cyangwa igakomera cyane, bigatuma amaraso arimo umwuka wa ogisijeni atagera ku gice cy’imitsi y’umutima. Igihe gutembera kw’amaraso n’intungamubiri bihagarara bitunguranye, bishobora gutera kwangirika kudasubirwaho kw’uturemangingo tw’umutima mu minota mike. Ibi akenshi biterwa n’uko ibinure, kolesteroli n’ibindi bisa nabyo byiyongera ku nkuta z’imitsi bikitwa “plaki”, bikagenda byongera gukomera cyangwa bigatera imitsi kwangirika, bigatuma habaho igisebe gituma habaho igitembera cy’amaraso. Niba hatabayeho kwihutira kuvura no kwita ku murwayi, ubushobozi bw’umutima bwo gutera bugabanuka, bikaba byatera kunanirwa k’umutima mu gihe kiri imbere.

Kuba umutima ni imwe mu mpamvu zikomeye z’uruhu rw’abantu ku isi hose kandi bisaba kwitabwaho byihuse n’abaganga. Ubushakashatsi bwerekana ko kutavura vuba kuba umutima bishobora gutera kwangirika gukomeye no kudakira k’umutima.

Ibimenyetso by’uko umutima ugiye guhagarara ni ibihe?

Ibimenyetso by’uko umutima ugiye guhagarara biratandukanye bitewe n’umuntu. Ariko ibi bimenyetso bikurikira ni byo bikunze kugaragara:

• Ububabare bukomeye cyangwa bumera nk’ubufashe mu gituza; ibi biba bisa n’aho hari igitutu cyangwa iremereye mu gituza.

• Ububabare cyangwa kutisanzura byiyongera mu kuboko kw’ibumoso, ijosi, amagufwa y’urutugu, umugongo, mu nda cyangwa ku menyo.

• Kugira ikibazo cyo guhumeka no kumva bigoye guhumeka.

• Kuzana icyuya gikonje, cyangwa icyuya gitunguranye.

• Kumva umutima utera cyane cyangwa gutera kudasanzwe.

• Kuzungera, kumva utameze neza cyangwa kumva ushobora kugwa.

• Kugira isesemi, kumva mu nda hashya, kutamererwa neza mu gifu no gukorora.

• Kumva unaniwe cyane, intege nke, cyane cyane iyo utakoze imirimo ikomeye.

• Kubyimba amaguru cyangwa ibirenge.

• Kumva umutima utera vuba, udasanzwe kandi ukomeye.

• Kutisanzura mu gituza cyangwa mu gice cyo hejuru cy’umubiri utazi impamvu.

Ibimenyetso bya kuba umutima ku bagore

Ku bagore, ibimenyetso bya kuba umutima bishobora kugaragara n’iyo hatabayeho ububabare busanzwe bw’igituba. Ibimenyetso bikunze kugaragara ku bagore ni ibi:

• Kunanirwa igihe kirekire kandi nta mpamvu izwi,

• Ibibazo byo gusinzira no kugira ubwoba butunguranye,

• Ububabare mu mugongo wo hejuru, ku rutugu cyangwa munsi y’inda,

• Kugira isesemi, kutamererwa neza mu gifu no guhumeka bigoye.

Ni ngombwa kwibuka ko abagore bashobora kugira ibimenyetso bitandukanye n’ibisanzwe by’uko umutima ugiye guhagarara.

Ibimenyetso bya kuba umutima igihe usinziriye

Kuba umutima rimwe na rimwe bishobora kubaho umuntu asinziriye kandi ntibimenyekane vuba. Igihe ibi bibaye, ibi bimenyetso bikurikira bishobora kugaragara:

• Kubyuka wumva utisanzuye mu gituza cyangwa wumva gikunze,

• Kumva umutima utera cyane nta mpamvu,

• Kuzana icyuya gikonje no kugira icyuya gitunguranye,

• Ububabare bwiyongera mu ijosi cyangwa ku rutugu,

• Kuzungera no kumva intege nke bitunguranye.

Ni ibihe bintu by’ingenzi bitera kuba umutima?

Kuba umutima akenshi biterwa no gufungwa kw’imwe cyangwa nyinshi mu mitsi itwara amaraso ku mutima (koroneri). Impamvu nyamukuru z’iyo mitsi ifungwa ni izi:

• Ateroskleroze (gukomera kw’imitsi): Ibinure na kolesteroli byiyongera mu mutsi bikawufunga.

• Kunywa itabi n’ibindi bikomoka ku itabi: Abanywa itabi bafite ibyago byinshi byo kuba umutima.

• Urwego rwo hejuru rwa kolesteroli, cyane cyane LDL (“kolesteroli mbi”) nyinshi.

• Diyabete (indwara y’isukari): Igabanya koroshya kw’imitsi no kwangirika kwayo.

• Umuvuduko w’amaraso uri hejuru (hipertansiyo).

• Umubyibuho ukabije no kutagira imyitozo ngororamubiri ihagije.

• Imiterere y’umuryango: Kuba hari abarwaye umutima cyangwa kuba umutima mu muryango.

• Imyaka: Kugira imyaka myinshi byongera ibyago byo kwangirika kw’imitsi.

• Kugabanuka k’umusemburo wa estrogen nyuma yo guhagarika imihango ku bagore.

• Kuba ibimenyetso by’inkomyi mu maraso (nko C-reaktif protein, homosisteine) biri hejuru.

Uretse ibi, stress itunguranye, gukora imirimo iremereye, kwangirika kw’inkuta z’imitsi cyangwa igitembera cy’amaraso gishobora gutuma habaho kuba umutima bitunguranye.

Amoko y’ibyago byo kuba umutima ni ayahe?

Mu buvuzi, kuba umutima bigabanyijemo ibyiciro bitandukanye:

• STEMI (ST Segment Elevation Myocardial Infarction): Umutsi wa koroneri ufunze burundu, bigatera kwangirika gukomeye ku gice kinini cy’umutima kandi bigaragara neza kuri EKG.

• NSTEMI (ST Segment Elevation Negative Myocardial Infarction): Hariho gukomera gukomeye aho gufungwa burundu, ariko EKG ntigaragaza ST izamuka nk’uko bisanzwe.

• Koroneri spazime (Unstable angina): Biterwa no gukomera kw’agateganyo kw’imitsi ya koroneri. Akenshi bimara igihe gito kandi bishobora gushira, ariko bisaba kwitonderwa.

Kumenya niba umuntu afite kuba umutima bikorwa gute?

Ku barwaye bakekwaho kuba umutima, igikorwa cyo gusuzuma kigomba gukorwa vuba kandi neza. Ibikoresho bikunze gukoreshwa ni ibi:

• Elektrokardiyografi (EKG): Igenzura imikorere y’amashanyarazi y’umutima kandi ishobora kugaragaza impinduka zidasanzwe zigaragaza kuba umutima.

• Ibipimo by’amaraso: By’umwihariko bipima urwego rwa za enzim na poroteyine zigaragaza kwangirika k’umutima nka troponine.

• Uburyo bwo kureba imbere mu mubiri: Echokardiyografi (EKO), ifoto y’ibihaha, rimwe na rimwe CT-scan cyangwa MR.

• Koroneri anjiyografi: Igaragaza neza aho imitsi ifunze n’uburemere bwabyo. Irakoreshwa no mu kuvura.

Ibyo gukora igihe umuntu agize kuba umutima

Igihe ibimenyetso bya kuba umutima bitangiye, kwihutira gufata ingamba ni ingenzi cyane. Ibi bikurikira birasabwa:

• Niba wumvise ububabare mu gituza, guhumeka bigoye, kunanirwa bitunguranye, isesemi cyangwa ububabare bugera mu kuboko kw’ibumoso, ugomba guhita ushaka ubufasha bwihuse bw’abaganga (uhamagare serivisi y’ubutabazi).

• Umuntu agomba kwicara ataruhije umubiri kandi agerageza gutuza.

• Niba ari wenyine, agomba gusaba ubufasha hafi cyangwa agafungura umuryango kugira ngo abaganga babone uko binjira vuba.

• Kugendera ku nama z’abaganga zabanje no gutegereza amabwiriza y’abaganga b’inzobere ni byo byiza.

• Ntugomba na rimwe gufata imiti ku giti cyawe, gukora imirimo iremereye cyangwa kwirengagiza ibimenyetso wibwira ko bizashira.

Uburyo bwo kuvura kuba umutima: Ni izihe nzira zikoreshwa?

Kuba umutima bisaba gusuzumwa no kuvurwa byihuse. Ibyemezo bifatwa hakiri kare bigena uko umutima uzangirika. Uburyo busanzwe bwo kuvura ni ubu:

• Bahita batanga imiti ifungura imitsi n’iyoroshya amaraso mu gihe gito.

• Niba habonetse gufungwa kw’imitsi muri koroneri anjiyografi, hakorwa “anjiyopilastike” (gushyiramo baluni) cyangwa “stent” kugira ngo imitsi ifunguke.

• Ku barwayi bamwe, hakorwa “kubaga bypass” aho bafata indi mitsi mu mubiri bakayikoresha kugira ngo amaraso anyure hirya y’aho hafunze.

• Ibi byose bikorwa hifashishijwe muganga w’inzobere mu mutima cyangwa muganga w’imitsi y’umutima.

Nyuma yo kugira kuba umutima, hakenewe imiti y’igihe kirekire no guhindura imikorere y’ubuzima. By’umwihariko, kureka itabi, kurya neza kandi ku rugero, gukora imyitozo ngororamubiri, kugenzura diyabete n’umuvuduko w’amaraso no guhangana n’umunaniro bigabanya ibyago.

Ni izihe ngamba wafata ngo wirinde kuba umutima?

• Kwirinda itabi n’ibikomoka ku itabi.

• Kugira indyo yuzuye kandi iboneye; kwirinda ibiribwa byatunganyijwe cyane, ibinure byinshi n’umunyu mwinshi.

• Kugira imyitozo ngororamubiri buri gihe (byibuze iminota 150 y’imyitozo yoroheje buri cyumweru irasabwa).

• Kugenzura ibiro byawe.

• Kugenzura umuvuduko w’amaraso, isukari n’urwego rwa kolesteroli buri gihe.

• Niba bikenewe, kujya ukora isuzuma rusange n’igenzura rya muganga buri gihe.

• Kugira ubudahemuka ku mugambi wo kuvura indwara zidakira (nko umuvuduko w’amaraso, diyabete, kolesteroli nyinshi).

Ibibazo bikunze kubazwa

Ese buri wese ugize kuba umutima agira ububabare mu gituza?

Oya, ububabare bwo mu gituza ni kimwe mu bimenyetso bisanzwe ariko si buri wese ububabare abugira. By'umwihariko ku bagore, abantu bafite diyabete cyangwa abageze mu zabukuru, hashobora kugaragara ibimenyetso bitari bisanzwe nko guhumeka nabi, kugira intege nke cyangwa ibibazo by'inda.

Ese gufata aspirin igihe habayeho umutima uhagaze bifite akamaro?

Aspirin ishobora kugira akamaro ku barwayi bamwe bagize ikibazo cy'umutima. Ariko ikoreshwa rya aspirin rigomba gukorwa gusa nyuma yo kugisha inama muganga kandi ku busabe bwe, ntibigomba gufatwa nk'itegeko muri buri gihe.

Ibimenyetso by'umutima uhagaze bimara igihe kingana iki?

Ibimenyetso rimwe na rimwe bimara iminota mike cyangwa amasaha make. N'ubwo ibimenyetso byaba bishize, ibyago byo kugira ikibazo cy'umutima ntibiba byarangiye burundu. Ni yo mpamvu ugomba guhita ushaka ubufasha bw'abaganga igihe ibimenyetso bitangiye.

Ese umutima uhagaze no guhagarara k'umutima ni kimwe?

Oya, umutima uhagaze (myokaridiyal infarktusi) ni igihe igice cy'imitsi y'umutima kibuze umwuka wa ogisijeni; naho guhagarara k'umutima (kardiyak aresti) ni igihe umutima uhagarara rwose gutera. Umutima uhagaze ushobora gutera guhagarara k'umutima.

Ni iki wakora uri wenyine igihe habayeho umutima uhagaze?

Ugomba guhita uhamagara ubutabazi bwihuse, niba bishoboka ugasaba ubufasha umuntu uri hafi, kandi ukaguma utuje kandi udahindura umwanya kugeza abaganga bahageze.

Kuki ku bagore umutima uhagaze ushobora kugaragara mu bimenyetso bitandukanye?

Ku bagore, umutima uhagaze ushobora kugaragara mu bimenyetso bitari bisanzwe kubera itandukaniro ry'imisemburo n'ibindi bitandukanye by'umubiri. Intege nke, iseseme cyangwa ububabare mu mugongo bishobora kugaragara aho ibimenyetso bisanzwe byari byitezwe.

Ese urubyiruko rushobora kugira ibyago byo kugira umutima uhagaze?

Yego, nubwo biba gake, bitewe n'imiterere y'imiryango, ibyago runaka cyangwa ibindi bibazo by'ubuzima, urubyiruko narwo rushobora kugira umutima uhagaze.

Ni ryari umuntu ashobora gusubira mu buzima busanzwe nyuma yo kugira umutima uhagaze?

Muri iki gihe, bitewe n'ubukana bw'ikibazo cy'umutima n'uburyo bwavuwe, ugomba gukurikiza inama za muganga. Akenshi bigenda gahoro gahoro umuntu asubira mu buzima busanzwe kandi kugenzurwa na muganga kenshi ni ingenzi.

Ni izihe mpinduka mu mibereho zagabanya ibyago?

Kureka itabi, kurya indyo yuzuye, gukora imyitozo ngororamubiri kenshi, kugenzura umuvuduko w'amaraso n'isukari, kwiga guhangana n'umunaniro bigabanya cyane ibyago byo kugira umutima uhagaze.

Iyo mu muryango harimo abigeze kugira umutima uhagaze, ni iki wakora?

Niba mu muryango wawe harimo abigeze kugira indwara y'umutima, ugomba kwitwararika cyane ku mibereho yawe no kujya kwa muganga kenshi kugira ngo ugabanye ibyago.

Ese mu bimenyetso by'umutima uhagaze hashobora kubamo ibibazo by'inda?

Yego, cyane cyane ku barwayi bamwe, iseseme, kutamererwa neza mu nda, ububabare cyangwa kumva ubushyuhe mu nda nabyo bishobora kuba ikimenyetso cy'umutima uhagaze.

Ese impinduka ku biro bigira ingaruka ku byago byo kugira umutima uhagaze?

Kongera cyangwa kugabanya ibiro mu buryo butunguranye kandi budasobanutse, bishobora gutera indwara y'umutima mu gihe kirekire. Ni ingenzi kugumana ibiro biri ku rugero rwiza.

Ese gusuzumwa kenshi byafasha kumenya ibyago byo kugira umutima uhagaze?

Kujya kwa muganga kenshi no gusuzumwa, bifasha kumenya hakiri kare ibyago byatuma umuntu agira umutima uhagaze no gufata ingamba zo kwirinda.

Inkomoko

• Ishami ry’Umuryango w’Abibumbye ryita ku Buzima (WHO) – Indwara z’umutima n’imitsi

• Ihuriro ry’Abanyamerika ryita ku Mutima (AHA) – Ibimenyetso n’isuzuma ry’indwara y’umutima

• Umuryango w’Abanyaburayi wita ku Mutima (ESC) – Amabwiriza ku ndwara z’imitima yihutirwa

• Ikigo cy’Abanyamerika gishinzwe kurwanya indwara (CDC) – Incamake ku ndwara z’umutima

• Amabwiriza n’ubushakashatsi bushya byasohotse mu kinyamakuru The Lancet na Journal of the American College of Cardiology