I-Long QT Syndrome

I-Long QT disorder, eyaziwa nangokuthi i-long QT syndrome, isifo senhliziyo esinesigqi esingabangela ukushaya kwenhliziyo okusheshayo, okunesiphithiphithi. Ukuqonda i-QT syndrome ende kubalulekile kulabo abathintekile kanye nemindeni yabo. Lesi sihloko esibanzi sizohlola imbangela yesikhawu eside se-QT, okuhlanganisa izici zofuzo kanye nemithi ethile. Sizophinde sixoxe ngezimpawu, izinkinga ezingaba khona, kanye nezinketho zokwelapha ezitholakalayo zesifo senhliziyo eside se-QT. Ukwengeza, sizofaka ukuthi singambona nini udokotela kanye nezinyathelo zokuvimbela izinkinga ezihlobene nalesi simo senhliziyo.

Iyini i-Long QT Syndrome?

I-Long QT syndrome (LQTS) iwukuphazamiseka kwesigqi senhliziyo esithinta uhlelo lukagesi olulawula ukushaya kwenhliziyo. Lesi simo sibangela ukushaya kwenhliziyo okusheshayo, okuyisiphithiphithi okungaba yingozi empilweni. Igama elithi "i-QT ende" livela kuphethini ethile ebonwa kuhlolo lwe-electrocardiogram (ECG), ebonisa ukusebenza kukagesi wenhliziyo.

Enhliziyweni evamile, izimpawu zikagesi zisuka phezulu ziye phansi, zitshele inhliziyo ukuthi icindezele futhi ishaye nini. Ngemva kokushaya kwenhliziyo ngakunye, isistimu iyashajwa ukuze ilungiselele okulandelayo. Nokho, ku-ECG ende ye-QT syndrome, isimiso sikagesi senhliziyo sithatha isikhathi eside kunokujwayelekile ukululama phakathi kokushaywa. Lokhu kulibaziseka kubizwa ngokuthi isikhawu se-QT eside.

Isikhawu se-QT simelela ukusebenza kukagesi emagumbini aphansi enhliziyo (ama-ventricles). Ngokuvamile, lesi sikhawu sithatha cishe ingxenye yesithathu yomjikelezo wokushaya kwenhliziyo ngayinye. Kubantu abane-LQTS, isikhawu se-QT side kunokuvamile, okungase kuphazamise isikhathi esicophelelayo sokushaya kwenhliziyo futhi kubangele izigqi zenhliziyo ezingazelelwe, ezingalawuleki, ezisheshayo.

Izimbangela Nezingozi Ze-Long QT Syndrome

I-Long QT syndrome (LQTS) wukuphazamiseka kwesigqi senhliziyo esinomthelela ohlelweni lukagesi olulawula ukushaya kwenhliziyo. Lesi simo senhliziyo singaba sokuzalwa noma sitholwe.

• A. I-Congenital LQTS: Lokhu kukhona kusukela ekuzalweni futhi kubangelwa izinguquko ze-DNA ezizuzwe njengefa. Okulandelayo yizinhlobo eziyinhloko ze-LQTS yokuzalwa: 
  • I-Romano-Ward Syndrome: Iwuhlobo oluvame kakhulu lwe-QT syndrome ende, futhi umzali oyedwa kuphela one-QT syndrome ende. Ingane ngayinye inethuba elingama-50% lokuthola isakhi sofuzo esingajwayelekile.
  • I-Jervell ne-Lange-Nielsen Syndrome: Inzima kakhulu futhi ibangela isithulu.
  • I-Timothy Syndrome: Kuyindlela engavamile ye-QT syndrome ende ethinta inhliziyo nezinye izingxenye zomzimba.
• B. I-LQTS Etholiwe: Iqala ngokuhamba kwesikhathi empilweni ngenxa: 
  • Imithi: Imithi ethile elwa namagciwane, imithi ye-antifungal, i-diuretics, nemithi yesigqi senhliziyo. 
  • Izimo Zezempilo: Izimo ezithile zesistimu ezifana i-hypothermia kanye nezinkinga zegilo.
  • Ukungalingani Kwamaminerali: Izinguquko emazingeni amaminerali omzimba, kuhlanganise namazinga aphansi e-calcium, i-magnesium, noma potassium egazini 
• Izici eziningana zingandisa amathuba okuba nesifo se-QT eside. Lokhu kubandakanya:
  • Umlando womndeni walesi simo 
  • Ukuba ngowesifazane 
  • Umlando wokuboshwa kwenhliziyo
  • Ukuhlanza kakhulu noma isifo sohudo 
  • kwemikhuba yokudla

Izimpawu ze-Long QT Syndrome

Izimpawu ze-QT syndrome ende ngokuvamile ziqala ngesikhathi sobuntwana noma sokuthomba, abantu abaningi bebona izimpawu zabo zokuqala ngaphambi kweminyaka yobudala engama-40. Nokho, ingozi yezimpawu ivame ukuba phezulu ngaphambi kweminyaka yobudala engama-30.

I-Long QT syndrome (LQTS) ingabonakala ngezindlela ezihlukahlukene, abanye abantu bengenazo nhlobo izimpawu. Lesi simo, esaziwa ngokuthi i-LQTS ethule, ngokuvamile sitholakala ngokuhlolwa kwe-electrocardiogram (ECG) noma ukuhlolwa kofuzo. Okulandelayo ezinye izimpawu ezivamile ze-QT syndrome ende:

• Ukuquleka noma i-Syncope: Lolu uphawu oluvame kakhulu olungenzeka ngokuzumayo futhi ngokuvamile lubangelwa ukucindezeleka ngokomzimba noma ngokomzwelo. Zingase zenzeke ngesikhathi sokuzivocavoca, lapho zethuswa imisindo emikhulu, noma ngisho nalapho ulele. 
• Ezinye Izimpawu: 
  • Ukushaya kwenhliziyo okusheshayo
  • ukuquleka 
  • Ukuboshwa kwe-cardiac

Izinkinga

I-Long QT disorder (LQTS) yisimo senhliziyo esibucayi. Kungabangela imiphumela emibi yezokwelapha uma kungelashwa. Lokhu kubandakanya:

• I-Torsades de Pointes: Kulesi simo, amagumbi aphansi enhliziyo ashaya ngokushesha futhi ngaphandle kwesigqi, kunciphisa ukugeleza kwegazi. Lokhu kuntuleka kwegazi ebuchosheni kungabangela ukuquleka kungazelelwe, ngokuvamile ngaphandle kwesixwayiso. Uma isikhathi eside se-QT siqhubeka, ukuquleka kungase kulandelwe ukubanjwa komzimba ogcwele.
• I-Ventricular Fibrillation: Kulesi simo, amagumbi enhliziyo aphansi ashaya ngokushesha kangangokuthi inhliziyo iyaqhaqhazela futhi iyeke ukumpompa igazi. Lokhu kungabangela ngokushesha ukulimala kobuchopho nokufa uma kungalungiswa ngokushesha nge-defibrillator.
• Ukufa Kwenhliziyo Engazelelwe: Lokhu kuqedwa okungalindelekile kwawo wonke umsebenzi wenhliziyo kuye kwaxhunyaniswa ne-LQTS kubantu abasha, uma kungenjalo abanempilo. 

Sifo

• Umlando Wezokwelapha Nokuhlolwa Komtholampilo: Odokotela benhliziyo babuza ngezimpawu, umlando wezokwelapha, nomlando womndeni wezimo zenhliziyo. Baphinde balalele inhliziyo besebenzisa i-stethoscope ukuze babone noma yikuphi ukungahambi kahle.
• I-Electrocardiogram (EKG noma i-ECG): Lolu hlolo lurekhoda amasignali kagesi wenhliziyo futhi lungadalula isikhawu se-QT eside, okuyisici saleso simo. 
• I-Holter Monitor noma Irekhoda Yomcimbi: Uma izimpawu zingavamile, udokotela angase atuse ukugqoka le divayisi ye-ECG ephathekayo isikhathi eside. Lawa madivayisi angathwebula umsebenzi wenhliziyo phakathi nemisebenzi yansuku zonke futhi asize ukuhlonza okungahambi kahle.
• Izivivinyo Zokucindezeleka Zokuzivocavoca: Lezi zivivinyo ngokuvamile zihlanganisa ukuhamba ku-treadmill noma ukuhamba ngebhayisikili ngebhayisikili lokuhlola ngenkathi umsebenzi wenhliziyo uqashwe.

Ukwelashwa kwe-Long QT Syndrome

Ukwelashwa kwesifo eside se-QT kuhlose ukuvimbela ukushaya kwenhliziyo okungajwayelekile nokufa kwenhliziyo kungazelelwe, okuhlanganisa: 

• Izinguquko Zendlela Yokuphila: Lezi ngokuvamile ziyisinyathelo sokuqala sokulawula i-QT syndrome ende. Lokhu kungase kuhlanganise ukugwema izinto ezibangela ukushaya kwenhliziyo okungajwayelekile, njengemisebenzi ethile engokomzimba noma ukucindezeleka ngokomzwelo.
• Imithi: Ama-Beta-blockers ajwayele ukunikezwa ukunciphisa ukushaya kwenhliziyo futhi anciphise amathuba esiqephu eside se-QT. Kwezinye izimo, i-mexiletine (umuthi wesigqi senhliziyo) ingasetshenziswa kanye ne-beta blocker ukusiza ukunciphisa isikhawu se-QT nokwehlisa ingozi yokuquleka, ukuquleka, noma ukufa ngokuzumayo kwenhliziyo.
• Ukuqedwa Kwezidakamizwa: Ngokuthola i-QT syndrome ende ebangelwa imithi, ukumisa umuthi owonayo kungase kwanele ukwelapha lesi sifo. 
• Ukuhlinzwa: I-cardioverter-defibrillator (ICD) efakelwayo ingafakwa ngaphansi kwesikhumba eduze kwe-clavicle (collarbone) ukuqapha isigqi senhliziyo futhi ilethe ukushaqeka uma kudingeka. Ukuhlinzwa kwe-Left Car sympathetic Denervation (LCSD) kungenye inketho yalabo abangaphenduli kahle kuma-beta blockers. Le nqubo isusa izinzwa ezithile ohlangothini lwesobunxele lomgogodla ukusiza ukwehlisa ingozi yokufa ngokuzumayo kwenhliziyo.

Uzoyibona Nini Udokotela

Yenza isikhathi sokubonana nodokotela wakho uma: 

• Uma unenhliziyo eshaya ngamandla, esheshayo, noma engavamile
• Umlando womndeni wokufa kwenhliziyo kungazelelwe
• Umlando weziqephu zokuquleka (syncope)
• Kubantu abatholakala bene-QT syndrome ende, ukuhlolwa okuvamile kubalulekile. 
• Uma unedivayisi etshaliwe yokuphatha isimo sakho, ukuvakasha kwaminyaka yonke kuyadingeka ukuze uqinisekise ukuthi isebenza ngendlela efanele.
• Izingane ezine-QT syndrome ende zingadinga ukuhlolwa kaningi. Kufanele babone umhlinzeki izikhathi ezingaphezu kwesisodwa ngonyaka ukuze balungise imithamo yemithi ngokusekelwe esisindweni.

Prevention

Nakuba i-congenital long QT syndrome ingenakuvinjelwa, kunezinyathelo zokuphatha lesi simo nokunciphisa ingozi yezinkinga, njenge:

• Izinguquko Zendlela Yokuphila: Uma une-QT syndrome ende, kubalulekile ukugwema ukuvivinya umzimba okukhandlayo, imidlalo yasemanzini, nomsindo omkhulu ongazelelwe. 
• Imithi: Njalo yazisa udokotela wakho mayelana nesimo sakho ngaphambi kokuthatha imithi emisha noma izithasiselo. 
• Ukudla: Khulisa ukudla kwakho okunothe nge-potassium njengobhanana, imifino, nama-pulses. 
• Gwema iziphuzo ezine-caffeine neziphuzo ezinamandla ngoba zingakhuphula izinga lokushaya kwenhliziyo futhi zibe zimbi kakhulu izimpawu.

Isiphetho

Nakuba i-QT syndrome ende ingaba yingozi empilweni, ukuxilongwa okufanele nokwelashwa kunganciphisa kakhulu ingozi yezinkinga. Ukuhlolwa njalo, ukushintsha indlela yokuphila, nokuphathwa kwemithi kudlala indima ebalulekile ekulawuleni ukugula. Ngokuhlala unolwazi nokusebenzisana eduze nodokotela, abantu abane-QT syndrome ende bangaphila impilo egcwele futhi ekhuthele kuyilapho benciphisa ingozi yezehlakalo zenhliziyo engazelelwe.

Imibuzo Evame Ukubuzwa

1. Ingakanani iminyaka etholwa yi-QT ende?

I-Long QT syndrome ingatholakala kunoma ibuphi ubudala, kodwa izimpawu zivame ukuqala ebuntwaneni noma ebusheni. Abantu abaningi bathola izimpawu zabo zokuqala ngaphambi kweminyaka engama-40. 

2. Indlela yokulungisa i-QT syndrome ende?

Nakuba i-QT syndrome ende ingakwazi 'ukulungiswa' ngendlela evamile, ingaphathwa ngempumelelo. Izinketho zifaka phakathi izinguquko zendlela yokuphila, imithi efana ne-beta blockers, futhi, kwezinye izimo, imishini yokufakelwa kwezokwelapha noma ukuhlinzwa. 

3. Ingakanani iminyaka yokuphila komuntu one-QT syndrome ende?

Ngokuphathwa okufanele, abantu abaningi abane-QT syndrome ende bangaphila impilo evamile, esebenzayo. 

4. Ingabe i-QT ende ibonakala ku-ECG?

Yebo, i-QT syndrome ende ibonakala ku-ECG. Ukuhlolwa kuveza isikhawu se-QT eside, esimela isikhathi esisithathayo ukuze isimiso sikagesi senhliziyo sigcwale kabusha phakathi kwamabhithi. Nokho, ngenxa yokuthi isikhawu se-QT singashintsha ngokuhamba kwesikhathi, ama-ECG amaningi noma imonitha ye-ECG yamahora angu-24 ingase idingeke ukuze kuxilongwe isimo ngokunembile.

5. Ingabe i-QT ende ingaba yesikhashana?

Nakuba i-congenital long QT syndrome iyisimo sempilo yonke, i-QT syndrome etholakala isikhathi eside ingaba yesikhashana. Imithi ethile noma izimo zezokwelapha zingabangela ukutholwa kwe-QT ende. Ukumisa isidakamizwa esiyimbangela nokwelapha izimo zesistimu ezingaphansi kungalapha izimo ezinde ze-QT.

6. Uyini umehluko phakathi kwe-QT syndrome emfushane neyende?

Ku-QT syndrome ende, isikhawu se-QT siyandiswa, sithatha isikhathi eside kunokujwayelekile ukuthi inhliziyo igcwale kabusha phakathi kokushaywa. Ngokuphambene, i-QT syndrome emfushane ibonakala ngesikhawu se-QT esifushane ngokungavamile. Zombili lezi zimo zingaholela esigqi senhliziyo esiyingozi, kodwa zinezimbangela nemithi ehlukene.

7. Ingabe ukukhathazeka kungabangela i-QT ende?

Nakuba ukukhathazeka ngokwako kungabangeli i-QT syndrome ende, kungase kubangele izimpawu kubantu asebevele banaso lesi simo. 

UDkt. Chanakya Kishore Kammaripalli

MBBS, MD, DM (Cardiology) (AIIMS), FACC, FSCAI
CARE Medical Center, Tolichowki, Hyderabad, CARE Hospitals, HITEC City, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

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