Iimpawu zomhlaza wentliziyo: Yintoni onokuyilindela

Umxholo

• Ushwankathelo
• Iimpawu zomhlaza wentliziyo
• 1. Ukuphazamiseka kokuhamba kwegazi
• 2. Ukungasebenzi kakuhle kwezihlunu zentliziyo
• 3. Iingxaki zokuqhuba
• 4. Umbungu
• 5. Iimpawu zenkqubo
• Oonobangela bomhlaza wentliziyo
• Ukuchongwa komhlaza wentliziyo
• Unyango ukhetho lomhlaza wentliziyo
• Izidumbu zeBenign
• Amathumba amabi
• Umhlaza wentliziyo wesibini
• Imbonakalo yamathumba entliziyo
• Ukuthatha

Ushwankathelo

Izidumbu zentliziyo yokuqala zikhula ngokungaqhelekanga entliziyweni yakho. Banqabile kakhulu. Ngokwe-European Society of Cardiology (ESC), zifunyenwe kwisithuba esingaphantsi kwesi-1 kwezingama-2000 zoqhaqho.

Izidumbu zentliziyo ezisisiseko zinokuba zingabinomdlavuza (ezinobungozi) okanye ezinomhlaza (ezinobungozi). Izilonda ezinobungozi zikhula zibe zizakhiwo ezikufutshane okanye zisasazeka kwamanye amalungu omzimba (i-metastasize), kodwa izicubu ezinobungozi azenzi njalo. Uninzi lwezona ntlungu zentliziyo zilungile. Iingxelo ze-ESC ziipesenti ezingama-25 kuphela ezimbi.

Ezinye izicubu ezinobungozi zezi:

• I-sarcomas (izicubu ezivela kwizicubu ezinjengentliziyo kunye namafutha), njenge-angiosarcoma kunye ne-rhabdomyosarcoma
• I-lymphoma yentliziyo ephambili
• I-pericardial mesothelioma

Ezinye izicubu ezinobungozi zi:

• myxoma
• ifibroma
• irabhdomyoma

Umhlaza wentliziyo wesibini uye wasasazeka okanye wasasazeka kwintliziyo evela kumalungu akufuphi ngokwe-ESC, kwenzeka ukuya kuthi ga kumaxesha angama-40 ngokufuthi kunezihlunu zentliziyo kodwa kodwa akuqhelekanga.

Umhlaza osasazeka okanye uhle metastasize entliziyweni rhoqo zezi:

• umhlaza wemiphunga
• melanoma (umhlaza wolusu)
• umhlaza webele
• umhlaza wezintso
• Ileukemia
• i-lymphoma (oku kwahlukile kunesifo sokuqala senhliziyo ngokuba iqala kwii-lymph node, spleen, okanye umongo wethambo endaweni yentliziyo)

Iimpawu zomhlaza wentliziyo

Izilonda zentliziyo ezinobungozi zihlala zikhula ngokukhawuleza kwaye zingena ezindongeni nakwezinye iindawo ezibalulekileyo zentliziyo. Oku kuphazamisa ubume bentliziyo kunye nomsebenzi, obangela iimpawu. Nokuba ithumba lentliziyo elinobungozi linokubangela iingxaki kunye neempawu ezinzulu ukuba licinezela kwizakhiwo ezibalulekileyo okanye indawo elikuyo iphazamisa ukusebenza kwentliziyo.

Iimpawu eziveliswa ngamathumba entliziyo zibonisa indawo okuyo, ubungakanani, kunye nolwakhiwo, hayi uhlobo lwethumba oluthile. Ngenxa yoku, iimpawu zentliziyo yesifo zihlala zilingisa ezinye, eziqhelekileyo, iimeko zentliziyo ezinje ngokusilela kwentliziyo okanye i-arrhythmias. Uvavanyo olubizwa ngokuba yi-echocardiogram lunokuhlala luhlulahlula umhlaza kwezinye iimeko zentliziyo.

Iimpawu zomhlaza wentliziyo osisiseko zinokwahlulwa ngokwamacandelo amahlanu.

1. Ukuphazamiseka kokuhamba kwegazi

Xa ithumba likhula liye kwelinye lamagumbi entliziyo okanye ngevalufa yentliziyo, linokuthintela ukuhamba kwegazi entliziyweni. Iimpawu ziyahluka ngokuxhomekeka kwindawo yethumba:

• Iatrium. Ithumba kwigumbi eliphezulu lentliziyo linokuthintela ukuhamba kwegazi liye kumagumbi asezantsi (ii-ventricles), elingisa i-tricuspid okanye i-mitral valve stenosis. Oku kunokubangela ukuba uzive uphefumla kancinci kwaye udiniwe, ngakumbi ngexesha lokuzikhandla.
• Ventricle. I-tumor kwi-ventricle inokuthintela ukuphuma kwegazi entliziyweni, ukuxelisa i-aortic okanye i-pulmonary valve stenosis. Oku kunokubangela iintlungu esifubeni, isiyezi kunye nokuphelelwa ngamandla, ukudinwa, kunye nokuphefumla okufutshane.

2. Ukungasebenzi kakuhle kwezihlunu zentliziyo

Xa ithumba likhula liye kwiindonga zemisipha yentliziyo, zinokuba lukhuni kwaye zingakwazi ukumpompa igazi kakuhle, zilingise i-cardiomyopathy okanye ukusilela kwentliziyo. Iimpawu zingabandakanya:

• ukuqhawukelwa ngumphefumlo
• imilenze idumbile
• iintlungu zesifuba
• ubuthathaka
• ukudinwa

3. Iingxaki zokuqhuba

Izidumba ezikhula ngaphakathi kwentliziyo yemisipha ejikeleze inkqubo yokuqhutywa kwentliziyo inokuchaphazela indlela ekhawulezayo kwaye rhoqo ukubetha kwentliziyo, ukuxelisa ii-arrhythmias. Rhoqo, bayayithintela indlela yesiqhelo yokuqhuba phakathi kwe-atria kunye nee-ventricles. Oku kubizwa ngokuba yibloko yentliziyo. Kuthetha ukuba i-atria kunye nee-ventricles nganye zibeka isantya sazo endaweni yokusebenza kunye.

Kuxhomekeka ekubeni kubi kangakanani, ungayiqapheli, okanye ungaziva ngathi intliziyo yakho itsibela ukubetha okanye ukubetha kancinci. Ukuba iyacotha, unokuphelelwa ngamandla okanye uzive udiniwe. Ukuba ii-ventricles ziqala ukubetha ngokukhawuleza zodwa, zinokukhokelela kwi-ventricular fibrillation kunye nokubanjwa kwentliziyo ngesiquphe.

4. Umbungu

Isiqwenga esincinci sethumba esiqhekezayo, okanye iqhekeza legazi elenzayo, sinokuhamba sisuka entliziyweni siye kwelinye ilungu lomzimba size silale emthanjeni omncinci. Iimpawu ziya kwahluka ngokuxhomekeka apho iphele khona embolus:

• Imiphunga. I-pulmonary embolism inokubangela ukuphefumla okufutshane, iintlungu ezibukhali esifubeni, kunye nentliziyo engaqhelekanga.
• Ingqondo. Ukubethwa ngumzimba kuhlala kubangela ubuthathaka okanye ukukhubazeka kwelinye icala lomzimba, icala elinye lobuso, iingxaki zokuthetha okanye ukuqonda amagama athethwayo okanye abhaliweyo, kunye nokudideka.
• Ingalo okanye umlenze. Ukudityaniswa kombilini kungakhokelela kwilungu elibandayo, elibuhlungu, nelokungafumani pulse.

5. Iimpawu zenkqubo

Izimbilini ezimbalwa eziphambili zentliziyo zingabangela iimpawu ezingafaniyo, ukuxelisa isifo. Ezi zimpawu zinokubandakanya:

• umkhuhlane kunye nokugodola
• ukudinwa
• ukubila ebusuku
• ukuhla ukusinda
• intlungu edibeneyo

Izilonda ze-metastatic zomhlaza wesibini wentliziyo zivame ukuhlasela umgca ngaphandle kwentliziyo (pericardium). Oku kuhlala kukhokelela ekwakhiweni kolwelo olujikeleze intliziyo, ukwenza ukunganyaniseki okuyingozi.

Njengokuba inani lolwelo lonyuka, lityhala entliziyweni, linciphisa inani legazi elinokumpompa. Iimpawu zibandakanya iintlungu ezibukhali esifubeni njengoko uphefumla kunye nokuphefumla okufutshane, ngakumbi xa ulala phantsi.

Uxinzelelo entliziyweni lunokuphakama kangangokuba kude kuphume igazi ngaphandle kwegazi. Le meko isongela ubomi ibizwa ngokuba yi-tamponade yentliziyo. Ingakhokelela kwi-arrhythmias, ukothuka kunye nokubanjwa kwentliziyo.

Oonobangela bomhlaza wentliziyo

Oogqirha abazi ukuba kutheni abanye abantu befumana umhlaza wentliziyo kwaye abanye bengenalo. Zimbalwa kuphela izinto ezinobungozi ezaziwayo kwezinye iintlobo zentliziyo yamathumba:

• Ubudala. Ezinye izicubu zivela rhoqo kubantu abadala, kwaye ezinye zenzeka rhoqo kwiintsana nasebantwaneni.
• Ilifa. Abambalwa banokubaleka kwiintsapho.
• Iimpawu zomhlaza wemfuza. Uninzi lwabantwana abane-rhabdomyoma bane-tubular sclerosis, isifo esibangelwa lutshintsho kwi-DNA.
• Ukonakaliswa kwenkqubo yomzimba yokuzikhusela. I-lymphoma ye-cardiac yaseprayimari ivela rhoqo kubantu abane-immune system engasebenzi kakuhle.

Ngokungafaniyo ne-pleural mesothelioma eyenzeka kwimigca (mesothelium) yemiphunga, unxibelelwano phakathi kokuvezwa kwe-asbestos kunye ne-pericardial mesothelioma ayikasekwa.

Ukuchongwa komhlaza wentliziyo

Ngenxa yokuba zinqabile kwaye iimpawu zihlala zifana neemeko zentliziyo eziqhelekileyo, izicubu zentliziyo kunokuba nzima ukuzifumanisa.

Uvavanyo oluqhele ukusetyenziswa ekuchongeni umhlaza wentliziyo kubandakanya:

• Echocardiogram. Olu vavanyo lusebenzisa isandi ukwenza umfanekiso ohambayo obonisa ubume kunye nokusebenza kwentliziyo. Olu lolona vavanyo lusetyenziswa ngokuxhaphakileyo lokufumanisa isifo, ukucwangcisa unyango, kunye nokulandela unyaka nonyaka.
• Ukuskena i-CT. Le mifanekiso inokunceda ukwahlula izilonda ezinobungozi kunye nezibi.
• IMRI. Olu scan lubonelela ngemifanekiso eneenkcukacha zethumba, ezinokunceda ugqirha wakho amisele uhlobo.

Isampuli yethishu (i-biopsy) ihlala ingafunyanwa ngenxa yokuba imaging inokuhlala ichonga uhlobo lwethumba, kwaye inkqubo ye-biopsy inokusasaza iiseli zomhlaza.

Unyango ukhetho lomhlaza wentliziyo

Xa kunokwenzeka, ukususwa kotyando lunyango lokhetho kuzo zonke izicubu zentliziyo ezisisiseko.

Izidumbu zeBenign

• Uninzi lwezi luyanyangeka ukuba ithumba linokususwa ngokupheleleyo.
• Xa ithumba likhulu kakhulu okanye kukho amathumba amaninzi, ukususa inxenye yalo engekho ngaphakathi kweendonga zentliziyo kunokuphucula okanye kuphelise iimpawu.
• Ezinye iintlobo zinokulandelwa ngee-echocardiograms zonyaka endaweni yotyando ukuba azibangeli zimpawu.

Amathumba amabi

• Ngenxa yokuba zikhula ngokukhawuleza kwaye zingena kwizakhiwo ezibalulekileyo zentliziyo, kunokuba nzima kakhulu ukuzinyanga.
• Ngelishwa, uninzi alufumaneki de ukususwa kotyando akunakwenzeka.
• I-Chemotherapy kunye nonyango lwe-radiation ngamanye amaxesha zisetyenziselwa ukuzama ukucothisa ukukhula kwethumba kunye nokuphucula iimpawu (ukhathalelo lokunyanga), kodwa rhoqo azisebenzi kumhlaza wentliziyo osisiseko.

Umhlaza wentliziyo wesibini

• Ngexesha lokufunyanwa kwentliziyo, umhlaza uhlala usasazeka kwamanye amalungu kwaye awunyangeki.
• Isifo seMetastatic entliziyweni asinakususwa ngotyando
• Unonophelo lokunyanga ngamayeza ngamayeza kunye nonyango lwemitha luhlala lukuphela kwendlela onokukhetha ngayo.
• Ukuba i-pericardial effusion ikhula, inokususwa ngokubeka inaliti okanye idreyini encinci kwingqokelela yolwelo (pericardiocentesis).

Imbonakalo yamathumba entliziyo

Imbonakalo ihlwempuzekile kwizifo zentliziyo zokuqala ezinobungozi. Olunye uphononongo lubonise la manqanaba okusinda alandelayo (ipesenti yabantu abaphilayo emva kwexesha elinikiweyo):

• Unyaka omnye: iipesenti ezingama-46
• Iminyaka emithathu: iipesenti ezingama-22
• Iminyaka emihlanu: iipesenti ezili-17

Imbonakalo ilunge ngakumbi kwizicubu ezinobungozi. Omnye wafumanisa ukuba umndilili wokusinda yayingu:

• Iinyanga ezingama-187.22 zamathumba anobungozi
• Iinyanga ezingama-26.2 zamathumba amabi

Ukuthatha

Umhlaza wentliziyo oyintloko unokuba sisifo esibi okanye esibi esisisiseko okanye ithumba lesibini lemastastatic. Iimpawu zixhomekeke kubukhulu kunye nendawo yethumba kunye nokulinganisa iimeko zentliziyo eziqhelekileyo.

Umhlaza wentliziyo oyintloko unesimo sengqondo esibi kodwa unqabile kakhulu. Amathumba eBenign aqhelekile kwaye anokunyanga ngoqhaqho.