Isifo sentliziyo seCyanotic

Isifo sentliziyo seCyanotic sibhekisa kwiqela leziphene ezahlukeneyo zentliziyo ezikhoyo ngexesha lokuzalwa (ngokuzalwa). Zikhokelela kwinqanaba eliphantsi leoksijini yegazi. I-Cyanosis ibhekisa kumbala oluhlaza okwesibhakabhaka kunye nenwebu yangaphakathi.

Ngokwesiqhelo, igazi liyabuya emzimbeni kwaye lihamba liphuma entliziyweni nasemiphungeni.

• Igazi eliphantsi kwioksijini (igazi eliluhlaza okwesibhakabhaka) libuyela emzimbeni liye kwicala lasekunene lentliziyo.
• Icala lasekunene lentliziyo limpompa igazi lisiya kwimiphunga, apho lithatha khona ioksijini engaphezulu lize libe bomvu.
• Igazi elinentabalala yeoksijini libuya kwimiphunga liye kwicala lasekhohlo lentliziyo. Ukusuka apho, impontshelwa kuwo wonke umzimba.

Iziphene zentliziyo abantwana abazalwa benazo zinokutshintsha indlela igazi elihamba ngayo entliziyweni nasemiphungeni. Ezi ziphene zinokubangela ukuba igazi elingaphantsi liye emiphungeni. Banokubangela ukudityaniswa kwegazi oluhlaza okwesibhakabhaka nobomvu. Oku kubangela ukuba igazi elingena oxygen lifakwe emzimbeni. Nje ngeziphumo:

• Igazi eliqokelelweyo emzimbeni liphantsi kwioksijini.
• I-oksijini encinci ehanjisiweyo emzimbeni inokwenza ulusu lubonakale luhlaza okwesibhakabhaka (cyanosis).

Ezinye zeziphene zentliziyo zibandakanya iivelves zentliziyo. Ezi ziphene zinyanzela igazi eliluhlaza ukudibanisa negazi elibomvu ngokusebenzisa imijelo yentliziyo engaqhelekanga. Ivalvu zentliziyo ziyafumaneka phakathi kwentliziyo kunye nemithambo yegazi emikhulu ezisa igazi ngaphakathi nasentliziyweni. Ezi zivalo zivula ngokwaneleyo ukuze igazi liphume. Emva koko bayavala, bagcina igazi ukuba lingabuyi umva.

Iziphene zentliziyo yevalvu ezinokubangela icyanosis zibandakanya:

• Ivalve yeTricuspid (ivelufa phakathi kwamagumbi ama-2 kwicala lasekunene lentliziyo) isenokungabikho okanye ingakwazi ukuvula ivuleke ngokwaneleyo.
• Ivalvu yepulmonary (ivelufa phakathi kwentliziyo nemiphunga) isenokungabikho okanye ingakwazi ukuvula ivuleke ngokwaneleyo.
• I-aortic valve (ivelufa ephakathi kwentliziyo kunye nomthambo wegazi kuwo wonke umzimba) ayikwazi ukuvula ngokwaneleyo ngokwaneleyo.

Ezinye iziphene zentliziyo zinokubandakanya ukungaqheleki kuphuhliso lwevalve okanye kwindawo kunye nonxibelelwano phakathi kwemithambo yegazi. Eminye imizekelo ibandakanya:

• Ukudibana okanye ukuphazamiseka okupheleleyo kwe-aorta
• Ukungasebenzi kakuhle kuka-Ebstein
• Isifo sentliziyo esekho Hypoplastic
• Tetralogy yoBuxoki
• Iyonke imbuyekezo yemiphunga yemiphunga
• Ukutshintshwa kwemithambo enkulu
• Truncus arteriosus

Iimeko ezithile zonyango kumama zinokunyusa umngcipheko wezifo zentliziyo ze-cyanotic kusana. Eminye imizekelo ibandakanya:

• Ukuvezwa kwemichiza
• Ii-syndromes ze-Genetic kunye ne-chromosomal, ezifana ne-Down syndrome, i-trisomy 13, i-Turner syndrome, i-Marfan syndrome kunye ne-Noonan syndrome
• Usulelo (njenge-rubella) ngexesha lokukhulelwa
• Ukulawulwa kakubi kwezinga leswekile kubasetyhini abanesifo seswekile ngexesha lokukhulelwa
• Amayeza amiselweyo ngumboneleli wakho wokhathalelo lwempilo okanye athenga ngokwakho kwaye asetyenziswa ngexesha lokukhulelwa
• Iziyobisi ezitalatweni ezisetyenziswa ngexesha lokukhulelwa

Ezinye iziphene zentliziyo zibangela iingxaki ezinkulu kanye emva kokuzalwa.

Uphawu oluphambili yi-cyanosis ngumbala oluhlaza okomlomo, weminwe, kunye neenzwane ezibangelwa ngumxholo weoksijini osegazini. Inokwenzeka ngelixa umntwana ephumla okanye kuphela xa umntwana esebenza.

Abanye abantwana baneengxaki zokuphefumla (iDyspnea). Banokungena kwindawo yokuhluthwa emva kokuzilolonga ukuze banciphise ukungaphefumli.

Abanye banomlingo, apho imizimba yabo ilamba nge-oksijini ngequbuliso. Ngexesha lokuthakatha, iimpawu zinokubandakanya:

• Ixhala
• Ukuphefumla ngokukhawuleza (hyperventilation)
• Ukwanda ngesiquphe ngombala oluhlaza okwesibhakabhaka kulusu

Iintsana zinokudinwa okanye zibile xa zityisayo kwaye zisenokungafumani bunzima buninzi njengoko kufanele.

Ukuphelelwa amandla (syncope) kunye nentlungu yesifuba inokwenzeka.

Ezinye iimpawu zixhomekeke kudidi lwesifo sentliziyo, kwaye zinokubandakanya:

• Iingxaki zokondla okanye ukunciphisa ukutya, okukhokelela ekukhuleni okungalunganga
• Isikhumba esingwevu
• Amehlo akhukhumeleyo okanye ubuso
• Ukudinwa ngalo lonke ixesha

Uvavanyo lomzimba luqinisekisa i-cyanosis. Abantwana abadala banokuba neminwe eklabhu.

Ugqirha uya kuphulaphula intliziyo kunye nemiphunga nge-stethoscope. Izandi zentliziyo engaqhelekanga, ukumbombozela kwentliziyo, kunye nokuqhekeka kwemiphunga kunokuvakala.

Uvavanyo luya kwahluka ngokuxhomekeka kwisizathu, kodwa kunokubandakanya:

• I-x-ray yesifuba
• Ukujonga inqanaba leoksijini egazini usebenzisa uvavanyo lwegesi yegazi okanye ngokulijonga kulusu nge-oximeter yempompo
• Gcwalisa ubalo lwegazi (CBC)
• I-ECG (i-electrocardiogram)
• Ukujonga ukwakheka kwentliziyo kunye nemithambo yegazi usebenzisa i-echocardiogram okanye iMRI yentliziyo
• Ukugqithisa ityhubhu ecekeceke (catheter) kwicala lasekunene okanye lasekhohlo lentliziyo, ihlala ivela kwi-groin (catheterization yentliziyo)
• Ukujonga oksijini okwexeshana (ukubetha kwentsimbi)
• Echo-Doppler

Abanye abantwana banokufuna ukuhlala esibhedlele emva kokuzalwa ukuze bafumane ioksijini okanye babekwe kumatshini wokuphefumla. Banokufumana amayeza:

• Lahla ulwelo olongezelelekileyo
• Nceda impompo yentliziyo ibe nzima
• Gcina imithambo ethile yegazi ivulekile
• Phatha ukubetha kwentliziyo okungaqhelekanga okanye isingqisho

Unyango olukhethiweyo kwizifo zentliziyo yokuzalwa kukuhlinzwa ukwenza isiphako. Zininzi iintlobo zotyando, kuxhomekeka kuhlobo lwesiphene sokuzalwa. Utyando lunokufuneka kwakamsinya emva kokuzalwa, okanye kunokubambezeleka iinyanga okanye iminyaka. Olunye utyando lunokufakwa njengoko umntwana ekhula.

Umntwana wakho kungafuneka athathe iipilisi zamanzi (i-diuretics) kunye namanye amayeza entliziyo ngaphambi okanye emva kotyando. Qiniseka ukuba ulandela idosi echanekileyo. Ukulandela rhoqo umboneleli kubalulekile.

Uninzi lwabantwana abaye batyandwa intliziyo kufuneka bathathe i-antibiotics ngaphambili, kwaye ngamanye amaxesha emva kokuba benomsebenzi wamazinyo okanye ezinye iinkqubo zonyango. Qinisekisa ukuba unemiyalelo ecacileyo evela kumboneleli wentliziyo yomntwana wakho.

Buza umboneleli womntwana wakho ngaphambi kokufumana nakuphi na ukugonywa. Uninzi lwabantwana banokulandela izikhokelo ezicetyiswayo zokugonywa kwabantwana.

Imbonakalo ixhomekeke kwisifo esithile kunye nobukrakra baso.

Iingxaki zesifo sentliziyo se-cyanotic zibandakanya:

• Isingqisho sentliziyo esingaqhelekanga kunye nokufa ngesiquphe
• Ixesha elide (elingapheliyo) uxinzelelo lwegazi kwimithambo yegazi yemiphunga
• Ukumelwa yintliziyo
• Usulelo entliziyweni
• Ukubetha
• Ukufa

Shayela umnikezeli wakho ukuba umntwana wakho unayo:

• Ulusu oluhlaza okwesibhakabhaka (cyanosis) okanye isikhumba esingwevu
• Ukuphefumla ubunzima
• Intlungu yesifuba okanye enye intlungu
• Ukuba nesiyezi, ukuphelelwa ngamandla, okanye ukubetha kwentliziyo
• Iingxaki zokondla okanye ukunciphisa ukutya
• Umkhuhlane, isicaphucaphu, okanye ukugabha
• Amehlo akhukhumeleyo okanye ubuso
• Ukudinwa ngalo lonke ixesha

Abasetyhini abakhulelweyo kufuneka bafumane ukhathalelo olulungileyo ngaphambi kokubeleka.

• Kuphephe ukusebenzisa utywala neziyobisi ngexa lokukhulelwa.
• Tshela ugqirha wakho ukuba ukhulelwe ngaphambi kokuba uthathe amayeza.
• Fumana uvavanyo lwegazi kwangethuba ekukhulelweni ukuze ubone ukuba awukhuselekanga kwi-rubella. Ukuba awukhuselekanga, kuya kufuneka uphephe nakuphi na ukubonakaliswa kwi-rubella kwaye kufuneka ugonywe kanye emva kokubeleka.
• Abafazi abakhulelweyo abanesifo seswekile kufuneka bazame ukulawula kakuhle amanqanaba eswekile yegazi.

Ezinye izinto ezizuzwe njengelifa zinokudlala indima kwisifo sentliziyo esibelekwe. Amalungu amaninzi osapho anokuchaphazeleka. Ukuba uceba ukukhulelwa, thetha nomboneleli wakho malunga nokuhlolwa kwezifo zofuzo.

Ekunene ukuya ekhohlo sentliziyo yenhliziyo; Ekunene ukuya ekhohlo ukujikeleza kwegazi

• Icandelo lentliziyo phakathi embindini
• Ukucinywa kwentliziyo
• Intliziyo - umbono wangaphambili
• Tetralogy yoBuxoki
• Iklabhu
• Isifo sentliziyo seCyanotic

Isifo sentliziyo esizalwe sisifo seCyanotic: kuvavanyo lwe-neonate egula kakhulu ene-cyanosis kunye noxinzelelo lokuphefumla. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, MBBS, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; I-2019: isahluko 456.

ILange RA, iHillis LD. Isifo sentliziyo. Ku: iBope ET, Kellerman RD, ii-eds. Unyango lwangoku lukaConn lwango-2018. IPhiladelphia, PA: Elsevier; Ngo-2018: 106-111.

IWebb GD, i-Smallhorn JF, iTherrien J, iRedington AN. Isifo sentliziyo esibelekwe kumntu omkhulu nakwisigulana sabantwana. 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 75.