Ingxamiseko Yentliziyo: Inkcazo, Iimpawu kunye neendlela Zokungenelela

Yintoni Uhlaselo Lwentliziyo Kwaye Luphuhliswa Njani?

Uhlaselo lwentliziyo, kwilwimi yezonyango lubizwa ngokuba "yi-myocardial infarction" kwaye luyingxaki enkulu yezempilo evela ngenxa yokunqongophala kwegazi elinomsoco-moya kwiithishu zemisipha yentliziyo ngenxa yokuvulwa ngokukhawuleza okanye ukuncipha okukhulu kweendlela zegazi ezondla intliziyo. Ukunqunyulwa ngokukhawuleza kokuhamba kwegazi elinomsoco-moya, kunokubangela umonakalo ongaguqukiyo kwiiseli zemisipha yentliziyo ngemizuzu embalwa. Le meko idla ngokubangelwa kukwanda kwezinto ezifana neoli, ikholesterol kunye nezinye izinto ezibizwa ngokuba "ziiplaki" ezihlala zidibanisa eludongeni lwegazi, zinciphisa indlela okanye zibangela ukuqhekeka eludongeni lwegazi okukhokelela ekubunjweni kwegazi eliqinileyo. Ukuba unyango olukhawulezileyo nolufanelekileyo alwenziwanga, amandla entliziyo okupompa igazi ayancipha kwaye kunokuphuhliswa ukusilela kwentliziyo kwixesha elizayo.

Uhlaselo lwentliziyo, yenye yezona zizathu zokufa eziphambili kwihlabathi liphela kwaye ifuna unyango olukhawulezileyo. Izifundo zibonisa ukuba ukunganyangwa kwangexesha kohlaselo lwentliziyo kunokubangela umonakalo omkhulu nongaguqukiyo kwintliziyo.

Zeziphi Iimpawu ZoUhlaselo Lwentliziyo?

Iimpawu zohlaselo lwentliziyo zingahluka kumntu nomntu. Kodwa ezi mpawu zilandelayo zixhaphake kakhulu njengemiqondiso yesilumkiso:

• Iintlungu ezinzima okanye ezicinezelayo esifubeni; le mvakalelo ichazwa njengoxinzelelo okanye ubunzima eludongeni lwesifuba.

• Iintlungu okanye ukungonwabi okusasazeka kwilungu lasekhohlo, entanyeni, emagxeni, emqolo, esiswini okanye emhlathini.

• Ukuphelelwa ngumoya kunye nemvakalelo yokuba nzima ukuphefumla.

• Ukubila okubandayo, iziqhwithi zokubila ngokukhawuleza.

• Ukubetha kwentliziyo okungaqhelekanga okanye ukungaqhelekanga kokubetha kwentliziyo.

• Ukuphathwa yintloko, ukudideka okanye imvakalelo yokuba uza kuphaphama.

• Ukugabha, ukutsha esiswini, ukunganyamezeli kunye nezikhalazo ezinxulumene nenkqubo yokugaya ukutya ezifana nokukhohlela.

• Ukudinwa ngokukhawuleza, ubuthathaka, ngakumbi ukudinwa okungaveli ngenxa yomsebenzi womzimba.

• Ukudumba ezinyaweni okanye emilenzeni.

• Ukubetha kwentliziyo ngokukhawuleza, okungaqhelekanga nokomeleleyo.

• Ukungonwabi okungachazekiyo esifubeni okanye kumacala aphezulu omzimba.

Iimpawu ZoUhlaselo Lwentliziyo Kwabasetyhini

Iimpawu zohlaselo lwentliziyo kwabasetyhini zinokubonakala ngaphandle kwempawu eziqhelekileyo zentlungu esifubeni. Ezinye iimpawu ezixhaphake ngakumbi kwabasetyhini zezi:

• Ubuthathaka obude kunye nokungachazekiyo kwaso,

• Iingxaki zokulala kunye neziqhwithi zoxinzelelo lwengqondo (uxinzelelo),

• Iintlungu kumqolo ophezulu, emagxeni okanye kwindawo esezantsi esiswini,

• Ukugabha, ukunganyamezeli kunye nokuphelelwa ngumoya.

Kufuneka kukhunjulwe ukuba abasetyhini banokufumana iimpawu ezingaqhelekanga, oko kukuthi, ezingaqhelekanga, zohlaselo lwentliziyo.

Iimpawu ZoUhlaselo Lwentliziyo Xa Ulele

Uhlaselo lwentliziyo ngamanye amaxesha lunokuphuhliswa ngexesha lokulala kwaye luhambe lungaqatshelwa. Kwiimeko zohlaselo lwentliziyo ezivelayo ngexesha lokulala, ezi mpawu zinokubonakala:

• Uvuka uziva ungonwabanga esifubeni kunye nemvakalelo yoxinzelelo,

• Ukubetha kwentliziyo okungachazekiyo,

• Ukubila okubandayo kunye neziqhwithi zokubila,

• Iintlungu ezisasazeka entanyeni okanye emagxeni,

• Ukuphathwa yintloko kunye nobuthathaka obukhawulezileyo.

Zeziphi Izinto Eziphambili Ezibangela Uhlaselo Lwentliziyo?

Uhlaselo lwentliziyo luhlala lubangelwa kukuvulwa kwezinye okanye ezininzi zeendlela zegazi ezondla intliziyo. Ezona zizathu ziphambili zale nto zezi:

• Atherosclerosis (ukuba lukhuni kwemithambo yegazi): Iiplaki zeoli kunye nekholesterol ezidibanisa ngaphakathi kwindlela yegazi zinokuyivala.

• Ukusebenzisa ugwayi kunye neemveliso zawo: Umngcipheko wohlaselo lwentliziyo uphakama kakhulu kubantu abatshaya.

• Inqanaba eliphezulu lekholesterol, ngakumbi i-LDL (ikholesterol "embi") eninzi.

• Iswekile (isifo seswekile): Ithoba ukuguquguquka kodonga lwemithambo yegazi kwaye ibangele umonakalo.

• Uxinzelelo lwegazi oluphezulu (hypertension).

• Ukutyeba kakhulu kunye nokungasebenzi komzimba ngokwaneleyo.

• Ukufumana kwintsapho: Ukuba kukho imbali yesifo sentliziyo okanye uhlaselo lwentliziyo kusapho.

• Ubudala: Ukuguga kwandisa umngcipheko wokonakala kwempilo yemithambo yegazi.

• Ukuncipha kwehomoni ye-estrogen ekhuseleka kwabasetyhini emva kokuphela kokuya exesheni.

• Ukuphakama kweempawu zokudumba egazini (umzekelo, i-C-reactive protein, homocysteine).

Ukongeza kwezi, uxinzelelo olukhawulezileyo, umsebenzi onzima womzimba, ukuqhawuka kodonga lwemithambo yegazi okanye ukubunjwa kwegazi eliqinileyo ngaphakathi emithanjeni nako kunokuba zizinto ezibangela uhlaselo lwentliziyo.

Zeziphi Iindidi ZoUhlaselo Lwentliziyo?

Kwezonyango, uhlaselo lwentliziyo luhlulwe lwaba ziindidi ezahlukeneyo:

• STEMI (ST Segment Elevation Myocardial Infarction): Ukuvaleka ngokupheleleyo kwendlela yegazi ezondla intliziyo kubangela umonakalo omkhulu kwindawo enkulu yemisipha yentliziyo kwaye kubonakala utshintsho olucacileyo kwi-EKG.

• NSTEMI (ST Segment Elevation Negative Myocardial Infarction): Endaweni yokuvaleka ngokupheleleyo, kukho ukuncipha okukhulu kwindlela yegazi, kodwa utshintsho lwe-ST oluqhelekileyo kwi-EKG lunokungabonakali.

• Koronari spazm (Unstable angina): Iveliswa kukuncipha okwethutyana kwemithambo yegazi ezondla intliziyo. Idla ngokuba mfutshane kwaye ithotyelwe, kodwa ifuna ukuhlolwa ngononophelo.

Uhlaselo Lwentliziyo Lufunyaniswa Njani?

Kubaguli abasolwayo ngohlaselo lwentliziyo, inkqubo yokufumanisa kufuneka yenziwe ngokukhawuleza nangokucokisekileyo. Izixhobo eziqhelekileyo zokufumanisa zezi:

• Electrocardiography (EKG): Ilinganisela umsebenzi wombane wentliziyo kwaye inokufumanisa utshintsho olukhethekileyo lwohlaselo lwentliziyo.

• Uvavanyo lwegazi: Ingakumbi inqanaba le-enzyme kunye neprotein ezifana ne-troponin ezibonisa umonakalo wentliziyo liyalinganiswa.

• Iindlela zokubonisa: Echocardiography (EKO), i-x-ray yomphunga, ngamanye amaxesha i-computed tomography (CT) okanye i-magnetic resonance imaging (MR) zingasetyenziswa.

• Coronary angiography: Ibonisa ngokuchanekileyo indawo kunye nobunzima bokuvulwa. Ingasetyenziswa nakunyango.

Yintoni Emele Yenziwe Ngexesha LoUhlaselo Lwentliziyo?

Xa iimpawu zohlaselo lwentliziyo ziqala, kubalulekile ukuthatha amanyathelo ngaphandle kokulibazisa. La manyathelo acebisiweyo:

• Xa uziva intlungu esifubeni, ukuphelelwa ngumoya, ukudinwa ngokukhawuleza, ukugabha okanye intlungu esasazeka kwilungu lasekhohlo, kufuneka ufikelele kwangoko kwinkonzo yezempilo engxamisekileyo (fonela i-ambulensi).

• Umntu makahlale phantsi ngaphandle kokuzixina ngokwasemzimbeni aze azame ukuzola.

• Ukuba ukwedwa, cela uncedo kumntu oseduze okanye ushiye ucango luvulekile ukuze abasebenzi bezempilo bakwazi ukufikelela ngokukhawuleza.

• Landela iingcebiso zonyango zangaphambili kwaye ulinde isikhokelo sobuchwephesha bezempilo.

• Ungaze usebenzise amayeza wedwa, ungazixini ngokwasemzimbeni okanye ungazami ukungahoyi iimpawu ucinga ukuba "zinokuphela".

Unyango LoUhlaselo Lwentliziyo: Zeziphi Iindlela Ezisetyenziswa?

Uhlaselo lwentliziyo lufuna uhlolo olukhawulezileyo kunye nonyango olukhawulezileyo. Amanyathelo athathwayo kwixesha lokuqala amisa umonakalo onokwenzeka kwintliziyo. Iindlela zonyango eziqhelekileyo zezi:

• Amayeza avula imithambo yegazi kunye namayeza athinisa igazi anikwa kwixesha elifutshane.

• Ukuba kufunyaniswa ukuvaleka kwemithambo yegazi nge-coronary angiography, imithambo ivulwa ngonyango lwe-"angioplasty" (ukufakwa kwebhaluni) okanye ukufakwa kwe-"stent".

• Kubanye abaguli, "bypass surgery" isetyenziswa, apho imithambo ethathwe kwenye indawo yomzimba isetyenziswa ukudlula indawo evalekileyo.

• Zonke ezi nkqubo zicwangciswa ngugqirha weentliziyo kunye/okanye ugqirha wemithambo yentliziyo.

Emva kohlaselo lwentliziyo olunobungozi obukhulu, umguli ufuna unyango lwamayeza olude kunye notshintsho kwindlela yokuphila. Ingakumbi ukushiya ugwayi, ukutya ngokusempilweni nangokulinganayo, ukwenza umthambo, ukulawula iswekile kunye noxinzelelo lwegazi kunye nokulawula uxinzelelo lwengqondo kunciphisa umngcipheko.

Zeziphi Iindlela Zokuthintela Uhlaselo Lwentliziyo?

• Ukuphepha ugwayi kunye neemveliso zawo.

• Ukuthatha indlela yokutya esempilweni, elinganayo; ukuphepha ukutya okucutshungulweyo, ukutya igrisi eninzi kunye netyuwa eninzi.

• Ukwenza umthambo rhoqo (kucetyiswa ubuncinane imizuzu engama-150 ngeveki yomthambo ophakathi).

• Ukulawula ubunzima bomzimba.

• Ukubeka iliso rhoqo kuxinzelelo lwegazi, inqanaba leswekile kunye nekholesterol.

• Ukuba kuyimfuneko, ukuvavanywa rhoqo kunye nokuhlolwa ngugqirha.

• Ukulandela ngokungqongqo isicwangciso sonyango lwezifo ezingapheliyo (uxinzelelo lwegazi, iswekile, ikholesterol ephezulu njl.).

Imibuzo Ebuziwa Rhoqo

Ngaba Wonke Umntu Ohlaselwe Yintliziyo Uva Intlungu Esifubeni?

Hayi, intlungu esifubeni luphawu oluqhelekileyo kodwa ayingomntu wonke onokuthi abe nesi sifo. Ingakumbi kubasetyhini, abantu abaneswekile okanye abadala, kunokubonakala iimpawu ezingaqhelekanga ezifana nokuphelelwa ngumoya, buthathaka okanye iingxaki zesisu.

Ngaba kuluncedo ukuthatha i-aspirin ngexesha lentlungu yesifo sentliziyo?

I-aspirin inokuba luncedo kwabanye abagula ngesifo sentliziyo. Kodwa ukusetyenziswa kwe-aspirin kufuneka kwenziwe phantsi kweengcebiso zonyango kunye nogqirha, kwaye akucetyiswa ukuba ithathwe ngokuzenzekelayo kuzo zonke iimeko.

Iimpawu zesifo sentliziyo zihlala ixesha elingakanani?

Iimpawu ngamanye amaxesha zinokuhlala imizuzu embalwa ukuya kwiiyure ezimbalwa. Nangona izikhalazo zingaphela, umngcipheko wesifo sentliziyo awupheli ngokupheleleyo. Ngenxa yoko, kufuneka kufunyanwe uncedo lwezonyango kwangoko nje xa iimpawu ziqala.

Ngaba isifo sentliziyo kunye nokuma kwentliziyo zizinto ezifanayo?

Hayi, isifo sentliziyo (myocardial infarction) kukungafumani kwecandelo lentliziyo umoya-mpilo; ukuma kwentliziyo (cardiac arrest) kukuma ngokupheleleyo kwentliziyo. Isifo sentliziyo sinokukhokelela ekumeni kwentliziyo.

Yintoni ekufuneka yenziwe xa usisodwa ngexesha lesifo sentliziyo?

Kufuneka kufunyanwe uncedo olungxamisekileyo kwangoko, ukuba kuyimfuneko kucelwe uncedo kumntu oseduze, kwaye kufuneka kulindwe ngokuzolileyo, kungahambi-hambi de kufike amagosa ezempilo.

Kutheni isifo sentliziyo kubasetyhini sivele ngeempawu ezahlukeneyo?

Kubasetyhini, isifo sentliziyo sinokubonakala ngeempawu ezingaqhelekanga ngenxa yeentlobo zehomoni kunye neebhayoloji. Iimpawu ezifana nokudinwa, isicaphucaphu okanye intlungu emqolo zinokubonakala endaweni yeempawu eziqhelekileyo.

Ngaba kukho umngcipheko wesifo sentliziyo kubantu abatsha?

Ewe, nangona kungaqhelekanga, ngenxa yokufana kwezizalwane, izinto zomngcipheko okanye ezinye iimeko zonyango, abantu abatsha nabo banokufumana isifo sentliziyo.

Emva kwesifo sentliziyo, kunini kunokubuyela kubomi obuqhelekileyo?

Kule nkqubo, kufuneka kulandelwe iingcebiso zonyango ngokuxhomekeke kubunzima besifo sentliziyo kunye nonyango olwenziweyo. Ngokuqhelekileyo kubuyelwa kancinci kancinci kubomi obuqhelekileyo kwaye kubalulekile ukulandela ugqirha rhoqo.

Zeziphi iinguqu ezibalulekileyo kwindlela yokuphila ukunciphisa umngcipheko?

Ukuyeka ukutshaya, ukutya ngokusempilweni, ukwenza umthambo rhoqo, ukulawula uxinzelelo lwegazi kunye nenqanaba legazi leswekile, ukufunda ulawulo lwengcinezelo kunciphisa kakhulu umngcipheko wesifo sentliziyo.

Yintoni ekufuneka yenziwe ukuba kukho imbali yesifo sentliziyo kusapho?

Ukuba kukho imbali yesifo sentliziyo kusapho lwakho, kufuneka unikele ingqwalasela ngakumbi kwindlela yakho yokuphila kwaye uqhubele phambili uhlolo logqirha rhoqo.

Ngaba iingxaki zesisu zingabakho phakathi kweempawu zesifo sentliziyo?

Ewe, ngakumbi kwabanye abaguli, isicaphucaphu, ukunganyamezeli ukutya, intlungu esiswini okanye ukutsha zingabonakala njengophawu lwesifo sentliziyo.

Ngaba utshintsho lwesisindo luyachaphazela umngcipheko wesifo sentliziyo?

Ukonyuka okanye ukwehla kwesisindo ngokukhawuleza nangaphandle kwesizathu, kunokubangela isifo sentliziyo kwixesha elide. Kubalulekile ukugcina ibhalansi efanelekileyo yesisindo.

Ngaba umngcipheko wesifo sentliziyo unokufunyanwa nge-check-up?

Uhlolo lwezonyango rhoqo kunye ne-check-up, kunokunceda ekufumaneni izinto zomngcipheko zesifo sentliziyo kwangethuba kwaye kuncede kuthathwe amanyathelo okuthintela.

Imithombo

• Umbutho wezeMpilo weHlabathi (WHO) - Izifo zeNhliziyo neMithambo yegazi

• Umbutho weNhliziyo waseMelika (AHA) – Iimpawu kunye noVavanyo lweSifo seNhliziyo

• European Society of Cardiology (ESC) – Izikhokelo ze-Acute Coronary Syndromes

• Centers for Disease Control and Prevention (CDC) – Uhlaziyo lweSifo seNhliziyo

• Iingcebiso kunye nezifundo zamva nje ezipapashwe kwiLancet nakwiJournal of the American College of Cardiology