I-Peripartum cardiomyopathy

I-Peripartum cardiomyopathy sisifo esinqabileyo apho intliziyo yomfazi okhulelweyo iba buthathaka kwaye yandiswe. Ikhula kwinyanga ephelileyo yokukhulelwa, okanye kwiinyanga ezintlanu emva kokuba umntwana ezelwe.

I-Cardiomyopathy yenzeka xa kukho umonakalo entliziyweni. Ngenxa yoko, isihlunu sentliziyo siba buthathaka kwaye asimpompi kakuhle. Oku kuchaphazela imiphunga, isibindi kunye nezinye iinkqubo zomzimba.

I-Peripartum cardiomyopathy luhlobo lwe-cardiomyopathy ehlaziyiweyo apho kungekho sizathu sokwenza buthathaka kwentliziyo sinokufunyanwa khona.

Inokwenzeka ukuba ibe nokuzala abafazi bayo nayiphi na iminyaka, kodwa ixhaphake kakhulu emva kweminyaka engama-30.

Imiba yomngcipheko wale meko ibandakanya:

• Ukutyeba kakhulu
• Imbali yobuqu yokuphazamiseka kwentliziyo efana ne-myocarditis
• Ukusetyenziswa kwamayeza athile
• Ukutshaya
• Utywala
• Ukukhulelwa okuninzi
• Iminyaka emidala
• Preecclampsia
• Inzala yase-Afrika yaseMelika
• Ukutya okungalunganga

Iimpawu zingabandakanya:

• Ukudinwa
• Imvakalelo yokubaleka kwentliziyo okanye ukutsiba ukubetha (ukubetha kwentliziyo)
• Ukwanda kwexesha lokuchama ebusuku (nocturia)
• Ukuphefumla okufutshane ngomsebenzi kunye naxa ulele phantsi
• Ukudumba kwamaqatha

Ngexesha lovavanyo lomzimba, umboneleli wokhathalelo lwempilo uya kujonga iimpawu zolwelo emiphungeni ngokuchaphazela nokucofa iminwe. I-stethoscope iya kusetyenziselwa ukumamela ukuqhekeka kwemiphunga, ukubetha kwentliziyo ngokukhawuleza, okanye izandi zentliziyo engaqhelekanga.

Isibindi sinokunyuswa kwaye imithambo yentamo inokudumba. Uxinzelelo lwegazi lunokuba sezantsi okanye lunokwehla xa umile.

Ukwandiswa kwentliziyo, ukuxinana kwemiphunga okanye imithambo emiphungeni, ukunciphisa ukuphuma kwentliziyo, ukuncipha kokuhamba okanye ukusebenza kwentliziyo, okanye ukusilela kwentliziyo kunokuvela:

• I-x-ray yesifuba
• Isifuba se-CT scan
• I-Coronary angiography
• Echocardiogram
• Ukuskena kwentliziyo yenyukliya
• I-MRI yeentliziyo

I-biopsy yentliziyo inokunceda ukumisela ukuba oyena nobangela we-cardiomyopathy sisifo sentliziyo (myocarditis). Nangona kunjalo, le nkqubo ayenzi rhoqo.

Umfazi kusenokufuneka ahlale esibhedlele de iimpawu ezibukhali zinciphe.

Kuba kuhlala kunokwenzeka ukubuyisela ukusebenza kwentliziyo, kwaye abantu basetyhini abanale meko bahlala bebancinci kwaye basempilweni, ukhathalelo luhlala lunoburhalarhume.

Xa kuvela iimpawu ezinzima, oku kunokubandakanya amanyathelo agqithisileyo anje ngala:

• Ukusetyenziswa kwempompo yentliziyo yokuncedisa (i-aortic counterpulsation balloon, isixhobo sasekhohlo se-ventricular assist)
• Unyango lwe-Immunosuppressive (njengamayeza asetyenziselwa ukunyanga umhlaza okanye ukuthintela ukwaliwa komzimba otshintshiweyo)
• Ukufakelwa kwentliziyo ukuba ukungaphumeleli kwentliziyo enkulu kuyaqhubeka

Uninzi lwabasetyhini, nangona kunjalo, unyango lujolise ikakhulu ekupheliseni iimpawu. Ezinye iimpawu zihamba zodwa ngaphandle konyango.

Amayeza ahlala esetyenziswa aquka:

• I-Digitalis yokomeleza amandla okupompa kwentliziyo
• I-diuretics ("iipilisi zamanzi") ukususa ulwelo oluninzi
• I-beta-blockers yedosi ephantsi
• Amanye amayeza oxinzelelo lwegazi

Ukutya okunetyuwa encinci kunokucetyiswa. Ulwelo lunokuthintelwa kwezinye iimeko. Imisebenzi, kubandakanya ukonga umntwana, inokuthintelwa xa iimpawu zikhula.

Ubunzima bemihla ngemihla bunokucetyiswa. Ukufumana ubunzima beephawundi ezi-3 ukuya kwezi-4 (i-1.5 ukuya kwi-2 yeekhilogram) okanye ngaphezulu kweentsuku ezi-1 okanye ezi-2 kunokuba ngumqondiso wokwakhiwa kolwelo.

Abasetyhini abatshayayo nabaselayo utywala baya kucetyiswa ukuba bayeke, kuba ezi zinto zinokuzenza mandundu iimpawu.

Kukho iziphumo ezininzi ezinokubakho kwi-peripartum cardiomyopathy. Abanye abantu basetyhini bahlala bezinzile ixesha elide, ngelixa abanye besiba mandundu ngokuthe kratya.

Abanye baba mandundu ngokukhawuleza kwaye banokuba ngabagqatswa ekufakweni kwentliziyo. Phantse iipesenti ezi-4 zabantu ziya kufuna ukufakelwa kwentliziyo kwaye i-9% inokufa ngesiquphe okanye isweleke ngenxa yeengxaki zenkqubo.

Imbonakalo intle xa intliziyo yomfazi ibuyela esiqhelweni emva kokuba umntwana ezelwe. Ukuba intliziyo ihlala ingaqhelekanga, ukukhulelwa okuzayo kunokubangela ukusilela kwentliziyo. Ayaziwa indlela yokuqikelela ukuba ngubani oza kuphila kwaye ngubani oza kuphuhlisa ukusilela kwentliziyo. Ukuya kuthi ga kwisiqingatha sabasetyhini baphinde bachache ngokupheleleyo.

Abasetyhini abaphuhlisa i-peripartum cardiomyopathy basemngciphekweni omkhulu wokufumana ingxaki efanayo nokukhulelwa kwangaphambili. Izinga lokuphindaphinda malunga ne-30%. Ke ngoko, abantu basetyhini abakhe banayo le meko kufuneka baxoxe ngeendlela zolawulo lokuzalwa kunye nomnikezeli wabo.

Iingxaki zibandakanya:

• I-Cardiac arrhythmias (inokubulala)
• Ukusilela kwentliziyo
• Ukwenziwa kwengubo kwintliziyo enokuzidibanisa (ukuya kwamanye amalungu omzimba)

Fowunela umboneleli wakho ukuba ukhulelwe ngoku okanye usandula ukuhambisa umntwana kwaye ucinga ukuba unokuba uneempawu zentliziyo.

Fumana uncedo lwezonyango kwangoko ukuba ukhula iintlungu esifubeni, ukubetha, ukuphelelwa ngamandla, okanye ezinye iimpawu ezintsha okanye ezingachazwanga.

Yitya ukutya okunezondlo kwaye wenze imithambo rhoqo ukuze ugcine intliziyo yakho yomelele. Gwema iigarethi kunye notywala. Umboneleli wakho unokukucebisa ukuba uphephe ukukhulelwa kwakhona ukuba uye wasilela kwentliziyo ngexesha lokukhulelwa kwangaphambili.

Cardiomyopathy - peripartum; Cardiomyopathy - ukukhulelwa

• Icandelo lentliziyo phakathi embindini
• Intliziyo - umbono wangaphambili
• I-Peripartum cardiomyopathy

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UMcKenna WJ, uElliott PM. Izifo ze-myocardium kunye ne-endocardium. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 54.

I-Silversides CK, isilumkiso CA. Ukukhulelwa kunye nesifo sentliziyo. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 90.