Ukuhlaselwa Kwenhliziyo: Incazelo Yako, Izimpawu Nokuphathwa Kwayo

Yini Ukuhlaselwa Yisifo Senhliziyo Futhi Kuthuthuka Kanjani?

Ukuhlaselwa yisifo senhliziyo, olimini lwezokwelapha kubizwa ngokuthi "i-myocardial infarction" futhi kuwukuphazamiseka okukhulu kwezempilo okwenzeka ngenxa yokuvinjelwa okungazelelwe noma ukuvinjelwa okukhulu emithanjeni ye-coronary enikeza inhliziyo igazi elinothe nge-oksijeni. Uma ukugeleza kwe-oksijeni kanye nokudla kunqamuka ngokuzumayo, kungaholela ekulimaleni okungaguquki kwezicubu zenhliziyo emizuzwini embalwa. Lesi simo sivame ukubangelwa ukuvama kwezakhi ezifana namafutha, i-cholesterol nezinye izinto ezibizwa ngokuthi "ama-plaque" odongeni lwemithambo, okunciphisa umthambo noma kubangele ukuqhekeka odongeni lwemithambo okuholela ekwakhekeni kwegazi eliqinile. Uma kungabikho ukungenelela okusheshayo nokufanele, amandla enhliziyo okupompa igazi ayancipha futhi esikhathini esizayo kungavela ukwehluleka kwenhliziyo.

Ukuhlaselwa yisifo senhliziyo kungenye yezimbangela ezihamba phambili zokufa emhlabeni jikelele futhi kudinga ukungenelela kwezokwelapha ngokushesha. Ucwaningo lukhombisa ukuthi ukungelashwa ngesikhathi kokuhlaselwa yisifo senhliziyo kungaholela ekulimaleni okukhulu nokungapheli kwenhliziyo.

Yiziphi Izimpawu Zokuhlaselwa Yisifo Senhliziyo?

Izimpawu zokuhlaselwa yisifo senhliziyo zingahluka kumuntu nomuntu. Kodwa-ke, lezi zimpawu ezilandelayo zivame ukubonakala njengesexwayiso:

• Ubuhlungu obucindezelayo noma obucindezelayo esifubeni; lo muzwa uchazwa njengengcindezi noma isisindo odongeni lwesifuba.

• Ubuhlungu noma ukungakhululeki okusabalala engalweni yesobunxele, entanyeni, emahlombe, emhlane, esiswini noma emhlathini.

• Ukuphelelwa umoya nokukhathala ekuphefumuleni.

• Ukubila okubandayo, izigameko zokubila ngokuzumayo.

• Ukushaya kwenhliziyo okungajwayelekile noma ukungajwayelekile kokushaya kwenhliziyo.

• Ukuzizwa udidekile, isiyezi noma sengathi uzowa.

• Isicanucanu, ukushiswa esiswini, ukungaphatheki kahle kokugaya ukudla kanye nokukhwehlela okuhlobene nohlelo lokugaya ukudla.

• Ukukhathala ngokuzumayo, buthakathaka, ikakhulukazi ukukhathala okuvela ngaphandle komzamo omkhulu.

• Ukuvuvukala ezinyaweni noma emilenzeni.

• Ukushaya kwenhliziyo okusheshayo, okungajwayelekile nokunamandla.

• Ukungakhululeki okungachazeki esifubeni noma engxenyeni engenhla yomzimba.

Izimpawu Zokuhlaselwa Yisifo Senhliziyo Kwabesifazane

Izimpawu zokuhlaselwa yisifo senhliziyo kwabesifazane zingavela ngaphandle kobufakazi bokubuhlungu besifuba obujwayelekile. Ezinye izimpawu ezivame kakhulu kwabesifazane yilezi:

• Ukukhathala okude nokungachazeki isizathu,

• Izinkinga zokulala kanye nezikhathi zokukhathazeka (ukukhathazeka okukhulu),

• Ubuhlungu emhlane ongaphezulu, emahlombe noma esiswini esingezansi,

• Isicanucanu, ukungaphatheki kahle kokugaya ukudla nokuphelelwa umoya.

Kufanele kukhunjulwe ukuthi abesifazane bangaba nezimpawu ezingajwayelekile, okungukuthi ezingavamile, zokuhlaselwa yisifo senhliziyo.

Izimpawu Zokuhlaselwa Yisifo Senhliziyo Ngesikhathi Sokulala

Ukuhlaselwa yisifo senhliziyo kwesinye isikhathi kungavela ngesikhathi sokulala futhi kungaqashelwa. Ezimweni zokuhlaselwa yisifo senhliziyo ngesikhathi sokulala, lezi zimpawu zingavela:

• Uvuka uzwa ukungakhululeki nesimo sokucindezeleka esifubeni,

• Ukushaya kwenhliziyo okungachazeki,

• Ukubila okubandayo nezikhathi zokubila,

• Ubuhlungu obusabalala entanyeni noma emahlombe,

• Isiyezi nobuthakathaka obuzumayo.

Yiziphi Izimbangela Eziyinhloko Zokuhlaselwa Yisifo Senhliziyo?

Ukuhlaselwa yisifo senhliziyo kuvame ukwenzeka ngenxa yokuvinjelwa komthambo we-coronary owodwa noma eminingi. Izimbangela eziyinhloko zale vinjelwa yilezi:

• I-atherosclerosis (ukuqina kwemithambo): Amafutha ne-cholesterol aqoqekayo emithanjeni ngokuhamba kwesikhathi angavimba umthambo.

• Ukusebenzisa ugwayi nemikhiqizo kagwayi: Abantu abaphefumula ugwayi basengozini enkulu yokuhlaselwa yisifo senhliziyo.

• Izinga eliphezulu le-cholesterol, ikakhulukazi i-LDL ("cholesterol embi") eningi.

• Ushukela (i-diabetes): Kwehlisa ukuguquguquka kodonga lwemithambo futhi kubangele ukulimala kwemithambo.

• Umfutho wegazi ophezulu (i-hypertension).

• Ukukhuluphala kanye nokungazivocavoci okwanele.

• Ukuthambekela kwezifo ngokwemvelo: Ukuba nomlando wesifo senhliziyo noma ukuhlaselwa yisifo senhliziyo emndenini.

• Ubudala: Ubudala obuphambili bukhuphula ingozi yokuphazamiseka kwempilo yemithambo.

• Ukwehla kwehomoni ye-estrogen evikelayo kwabesifazane ngemva kokuyeka iminyaka yokuzala.

• Ukuphakama kwezinkomba zokuvuvukala egazini (isb. i-C-reactive protein, homocysteine).

Ngaphezu kwalokho, ukucindezeleka okuzumayo, umsebenzi onzima womzimba, ukuqhekeka kodonga lwemithambo noma ukwakheka kwegazi eliqinile kungaba izimbangela ezisheshayo.

Yiziphi Izinhlobo Zokuhlaselwa Yisifo Senhliziyo?

Ngokwezokwelapha, ukuhlaselwa yisifo senhliziyo kuhlukaniswa ngezinhlobo ezahlukene:

• STEMI (i-Myocardial Infarction ene-ST Segment Elevation): Ukuvinjelwa okuphelele komthambo we-coronary kubangela ukulimala okukhulu endaweni enkulu yenhliziyo futhi kushintsha okukhulu ku-EKG.

• NSTEMI (i-Myocardial Infarction engena-ST Segment Elevation): Kukhona ukuvinjelwa okukhulu kodwa hhayi okuphelele emithanjeni ye-coronary, kodwa ukwenyuka kwe-ST okujwayelekile kungase kungabonakali ku-EKG.

• I-coronary spasm (i-unstable angina): Kwenzeka ngenxa yokuncipha okwesikhashana kwemithambo ye-coronary. Ivame ukuba yesikhashana futhi ingadlula, kodwa idinga ukuhlolwa ngokucophelela.

Ukuhlolwa Kwenhliziyo: Kwenziwa Kanjani Ukuhlolwa Zokuhlaselwa Yisifo Senhliziyo?

Kubagula abasolwa ngokuhlaselwa yisifo senhliziyo, inqubo yokuhlola kufanele yenziwe ngokushesha nangokunakekela. Amathuluzi okuhlola ajwayelekile yile:

• I-Electrocardiography (EKG): Ihlola umsebenzi kagesi wenhliziyo futhi ingathola izinguquko ezihambisana nokuhlaselwa yisifo senhliziyo.

• Izivivinyo zegazi: Ikakhulukazi amazinga ama-enzyme namaprotheni afana ne-troponin akhombisa ukulimala kwenhliziyo ayalinganiswa.

• Izindlela zokuthwebula izithombe: I-Echocardiography (ECHO), i-X-ray yamaphaphu, kwesinye isikhathi i-CT scan noma i-MRI ingasetshenziswa.

• I-coronary angiography: Ikhombisa ngokunembile indawo nobukhulu bokuvinjelwa. Ingasetshenziswa nasekwelashweni.

Yini Okufanele Kwenziwe Ngesikhathi Sokuhlaselwa Yisifo Senhliziyo?

Lapho kuqala izimpawu zokuhlaselwa yisifo senhliziyo, kubalulekile ukwenza ngokushesha. Lezi zinyathelo zinconywa:

• Uma uzwa ubuhlungu besifuba, ukuphelelwa umoya, ukukhathala ngokuzumayo, isicanucanu noma ubuhlungu obusabalala engalweni yesobunxele, shesha uxhumane nezinsiza zezempilo eziphuthumayo (shayela i-ambulensi).

• Umuntu kufanele ahlale phansi ngaphandle kokuzikhandla ngokomzimba futhi azame ukuthula.

• Uma ekodwa, kufanele acele usizo kumuntu oseduze noma agcine umnyango uvulekile ukuze odokotela bafinyelele ngokushesha.

• Ukuhambisana nezeluleko zangaphambilini zezokwelapha nokulinda imiyalelo yochwepheshe bezempilo kuyindlela efanele.

• Akufanele uzelaphe noma uzame umsebenzi onzima noma ungazinaki izimpawu ngokuthi "mhlawumbe kuzodlula".

Ukwelashwa Kwenhliziyo: Yiziphi Izindlela Eziqhutshwa?

Ukuhlaselwa yisifo senhliziyo kudinga ukuhlolwa okuphuthumayo nokwelashwa okusheshayo. Izinyathelo ezithathwa ekuqaleni zinquma izinga lokulimala kwenhliziyo. Izindlela ezijwayelekile zokwelapha yilezi:

• Kusetshenziswa imishanguzo evula imithambo kanye nemishanguzo yokunciphisa ukujiya kwegazi ngesikhathi esifushane.

• Uma kutholakala ukuvinjelwa kwemithambo nge-coronary angiography, umthambo uvulwa ngokusebenzisa "i-angioplasty" (ukufakwa kwebhaluni) noma ukufakwa kwe-stent.

• Kwabanye abaguli, "i-bypass surgery" isetshenziswa lapho imithambo ethathwe kwenye ingxenye yomzimba isetshenziswa ukudlula indawo evalekile.

• Zonke lezi zenzo zihlelwa udokotela wenhliziyo kanye/noma udokotela wemithambo yenhliziyo.

Ngemuva kokuhlaselwa yisifo senhliziyo esiyingozi empilweni, kudingeka ukwelashwa kwemishanguzo isikhathi eside kanye nokushintsha indlela yokuphila. Ikakhulukazi ukuyeka ugwayi, ukudla okunempilo nokulinganiselayo, ukuzivocavoca, ukulawula ushukela nomfutho wegazi kanye nokubhekana nengcindezi kunciphisa ingozi.

Yiziphi Izinyathelo Zokuvikela Ukuhlaselwa Yisifo Senhliziyo?

• Gwema ugwayi nemikhiqizo kagwayi.

• Yamukela ukudla okunempilo nokulinganiselayo; gwema ukudla okucutshunguliwe, ukudla okunamafutha amaningi kanye nosawoti omningi.

• Yenza imisebenzi yomzimba njalo (okungenani imizuzu engu-150 ngesonto yokuzivocavoca okulingene kunconywa).

• Lawula isisindo somzimba.

• Landelela njalo umfutho wegazi, ushukela wegazi kanye ne-cholesterol.

• Uma kudingeka, hamba njalo ekubhekweni kwezempilo nasekuhlolweni kodokotela.

• Hlala uthembekile ohlelweni lokwelashwa lwezifo ezingamahlalakhona (umfutho wegazi, ushukela, i-cholesterol ephezulu njll).

Imibuzo Evame Ukubuzwa

Ingabe wonke umuntu ohlaselwa yisifo senhliziyo uzwa ubuhlungu besifuba?

Cha, ubuhlungu besifuba buyisibonakaliso esivamile kodwa akuwona wonke umuntu ongase abe nalesi sifo. Ikakhulukazi kwabesifazane, abantu abane-diabetes noma asebekhulile, kungavela izimpawu ezingajwayelekile ezifana nokuphelelwa umoya, buthakathaka noma izinkinga zesisu.

Ingabe kuwusizo ukuthatha i-aspirin ngesikhathi sokuhlaselwa yisifo senhliziyo?

I-aspirin ingaba wusizo kwabanye abagula ngesifo senhliziyo. Kodwa ukusetshenziswa kwe-aspirin kufanele kwenziwe kuphela ngokwelulekwa udokotela, akukhuthazwa ukuthi ithathwe ngokuzenzakalelayo kuzo zonke izimo.

Izimpawu zesifo senhliziyo zihlala isikhathi esingakanani?

Izimpawu zingahlala kusukela emizuzwini embalwa kuya emahoreni ambalwa. Noma izikhalo ziphela, ingozi yokuhlaselwa yisifo senhliziyo ayipheli ngokuphelele. Yingakho kufanele kutholakale usizo lwezokwelapha ngokushesha nje izimpawu ziqala.

Ingabe ukuhlaselwa yisifo senhliziyo kuyafana nokuma kwenhliziyo?

Cha, ukuhlaselwa yisifo senhliziyo (myocardial infarction) kusho ukuthi ingxenye yethishu yenhliziyo ayitholi umoya-mpilo; kanti ukumiswa kwenhliziyo (cardiac arrest) kusho ukuthi inhliziyo iyeka ngokuphelele ukushaya. Ukuhlaselwa yisifo senhliziyo kungaholela ekumisweni kwenhliziyo.

Kufanele kwenziweni uma umuntu ehlaselwa yisifo senhliziyo eyedwa?

Kufanele kushayelwe usizo oluphuthumayo ngokushesha, uma kudingeka kucelwe usizo kumuntu oseduze, bese kulindelwa ngokuthula nangokunganyakazi kuze kufike abasebenzi bezempilo.

Kungani izimpawu zesifo senhliziyo kwabesifazane zivame ukuba ngezehlukile?

Kwabesifazane, ukuhlaselwa yisifo senhliziyo kungavela ngezimpawu ezingajwayelekile ngenxa yokwehluka kwamahomoni nobunjalo bomzimba. Izimpawu ezifana nokukhathala, isicanucanu noma ubuhlungu emhlane zingavela esikhundleni sezimpawu ezijwayelekile.

Ingabe abantu abasha basengozini yokuhlaselwa yisifo senhliziyo?

Yebo, nakuba kungavamile, ngenxa yokufana kwezifo emndenini, izici zobungozi noma ezinye izimo zempilo, abantu abasha nabo bangase bahlaselwe yisifo senhliziyo.

Ngemva kokuhlaselwa yisifo senhliziyo, kungathatha isikhathi esingakanani ukubuyela empilweni evamile?

Kulesi sikhathi, kufanele kulandelwe izeluleko zikadokotela ngokuya ngobukhulu besifo kanye nokwelashwa okwenziwe. Imvamisa kubuyelwa kancane kancane empilweni evamile futhi ukuhlolwa kodokotela okuvamile kubalulekile.

Yiziphi izinguquko zokuphila ezinganciphisa ubungozi?

Ukuyeka ukubhema, ukudla okunempilo, ukuzivocavoca njalo, ukulawula umfutho wegazi kanye nezinga likashukela, ukufunda ukuphatha ingcindezi kunciphisa kakhulu ingozi yokuhlaselwa yisifo senhliziyo.

Kufanele kwenziweni uma kunomlando womndeni wokuhlaselwa yisifo senhliziyo?

Uma unemlando womndeni wesifo senhliziyo, kufanele unake kakhulu indlela ophila ngayo futhi uhlolwe udokotela njalo ukuze unciphise ingozi yakho.

Ingabe izikhalo zesisu zingaba phakathi kwezimpawu zesifo senhliziyo?

Yebo, ikakhulukazi kwabanye abantu, isicanucanu, ukungakhululeki esiswini, ubuhlungu noma ukushisa esiswini kungaba uphawu lokuhlaselwa yisifo senhliziyo.

Ingabe ukuguquka kwesisindo kuthinta ingozi yokuhlaselwa yisifo senhliziyo?

Ukukhuluphala noma ukwehla kwesisindo okungachazeki kungabangela izifo zenhliziyo esikhathini eside. Kubalulekile ukugcina isisindo esinempilo.

Ingabe ukuhlolwa okuvamile kungasiza ukuthola ingozi yokuhlaselwa yisifo senhliziyo?

Ukuhlolwa kwezempilo okuvamile nokuhlolwa okuphelele kungasiza ukuthola izici zobungozi kusenesikhathi futhi kusize ekuthatheni izinyathelo zokuvimbela.

Imithombo

• Inhlangano Yezempilo Yomhlaba (WHO) - Izifo Zenhliziyo Nemithambo Yegazi

• Inhlangano YaseMelika Yezifo Zenhliziyo (AHA) – Izimpawu Nokutholakala Kwehlazo Lenhliziyo

• European Society of Cardiology (ESC) – Imihlahlandlela Ye-Acute Coronary Syndromes

• Centers for Disease Control and Prevention (CDC) – Uhlolojikelele Lwezifo Zenhliziyo

• Izincwadi ezishicilelwe ku-The Lancet kanye ne-Journal of the American College of Cardiology