UMitral Stenosis

I-valve ye-mitral itholakala emakamelweni angakwesokunxele senhliziyo. Ilawula ukugeleza kwegazi ukusuka ku-atrium yangakwesobunxele kuya ku-ventricle yesokunxele. Ngokuvamile, lapho ivula, indawo 3-4 cm2; lapho ivala, ayivumeli igazi ukuba lihlehlise ukugeleza lisuka ku-ventricle yesokunxele liye ku-atrium yangakwesobunxele. Ngenxa yezifo ezithile, ukuvulwa kwe-valve mitral kuyancipha, ukuncipha kwe-valve yokuvula-mitral stenosis. Le stenosis ye-mitral iphumela ekwandiseni ikamelo le-atrium yangakwesobunxele, ukwanda komfutho wokujikeleza kwamaphaphu, kanye nezimpawu zokuncipha kokujikeleza kwegazi.

I-Mitral valve stenosis iyingozi kakhulu isimo senhliziyo lokho kuthinta isibalo esincane kuphela sabantu. Iziguli ezinalesi sifo zivame ukuzizwa zikhathele futhi kunzima ukuphefumula ngenxa yokuthi amagumbi azo angakwesobunxele enhliziyo ayancipha. 

Izimpawu ze-Mitral Stenosis

Abantu bavame ukuqaphela izimpawu ngemuva kokuthi i-mitral valve yabo inciphe kakhulu. Izimpawu zokuqala zivame ukuvela ngesikhathi sokuzivocavoca noma lapho umzimba ucindezelekile. Izimpawu ezivamile ze-mitral stenosis zihlanganisa:

• Izinkinga zokuphefumula, ikakhulukazi ngesikhathi sokuzivocavoca
• Ukuzizwa ekhathele futhi ebuthakathaka
• Ukushaya kwenhliziyo noma ukushaya okungajwayelekile
• Ubuhlungu besifuba noma ukungakhululeki
• Ukukhwehlela kwesinye isikhathi kukhuphula igazi
• Izinyawo ezivuvukele noma amaqakala

Izimpawu zingathatha iminyaka eyi-15-20 ukuthi zivele ngemva kwemfiva yasekuqaleni ye-rheumatic fever.

Izinkinga ze-Mitral Stenosis

• Ngokuvamile, kubangelwa ukutheleleka komphimbo okubangelwa amagciwane e-Streptococcus.
• Kuvame kakhulu emaqenjini ezenhlalo nezomnotho eziphansi, izimo zokuphila eziminyene, izingane, nabesifazane.
• Ukutheleleka kwe-Streptococcus ebusheni kubangela i-mitral stenosis kubantu abadala. 
• Ezinye izimbangela ezingavamile i-lupus, congenital, noma ezinye izidakamizwa.

Izingozi Zezingozi

Ezinye izici zikwenza ube namathuba amaningi okuthuthukisa i-mitral stenosis:

• Abesifazane babhekene nengozi enkulu. 
• Abantu abahlala ezifundeni ezisathuthuka babona izimo eziningi ngenxa yokuthi i-rheumatic fever ihlala ivamile lapho.

I-Mitral Stenosis Izinkinga

I-Mitral stenosis iholela ezinkingeni zempilo ezimbi ngaphandle kokwelashwa. 

• Ezinye iziguli zenza i-atrial fibrillation, eyenza imivimbo kungenzeka kakhulu. 
• Umfutho uyakhula emithanjeni yamaphaphu bese udala umfutho wegazi ophakeme wamaphaphu. 
• Inhliziyo yakho ingase yehluleke ngoba ayikwazi ukugcina ukugeleza kwegazi okuvamile. 
• Ukungahambi kahle kwegazi kungadala amahlule egazi abangela imivimbo noma ezinye izehlakalo ze-embolic.

Ukuxilongwa kwe-mitral stenosis

Odokotela badinga ukuhlolwa okuningana ukuze baqinisekise ukuxilongwa kwe-mitral valve ewumngcingo. Okuhlangenwe nakho kwakho kokunakekelwa kwezempilo kuqala ngokuhlolwa okuningiliziwe. Udokotela ulalela ukububula kwenhliziyo okuhlukile okubonisa lesi simo.

Ukuhlolwa okuningana okubalulekile kusiza odokotela bathole i-mitral stenosis:

• I-Echocardiogram: Lokhu kuhlolwa kwe-ultrasound kwakha izithombe ezinemininingwane yenhliziyo yakho futhi kukhombisa ukwakheka kwevalvu nokugeleza kwegazi. Ukuhlolwa kuveza ubunzima be-stenosis ngokulinganisa indawo yevalvu yakho (imvamisa engu-4-5 cm²). I-stenosis enzima ibonisa indawo engu-1.5 cm² noma ngaphansi.
• I-Electrocardiogram (ECG): Lokhu kuhlolwa kuqopha ukusebenza kukagesi kwenhliziyo yakho. Ingabonisa ukukhuliswa kwe-atrial kwesokunxele noma i-atrial fibrillation, ethinta iziguli eziningi.
• I-X-ray yesifuba: Imiphumela ingase ibonise i-atrium yangakwesobunxele ekhulisiwe, imikhumbi evelele yamaphaphu, noma uketshezi emaphashini.
• Ukuhlolwa kokuzivocavoca: Lokhu kuhlola kusiza odokotela ukuthi bahlole ukuthi izimpawu zishintsha kanjani ngesikhathi sokusebenza komzimba.
• Izimo eziyinkimbinkimbi zingadinga ukufakwa kwe-catheterization yenhliziyo noma izithombe ezikhethekile njenge-MRI yenhliziyo.

Ukwelashwa kwe-Mitral Stenosis 

Indlela yokulawula i-mitral valve stenosis incike ekuqineni kwayo. Izimo ezithambile ngokuvamile zidinga ukuqapha njalo. 

• Ukuphathwa kwemithi:
  • Imithi ayikwazi ukulungisa i-valve, kodwa isiza ukulawula izimpawu: 
  • Ama-diuretics anciphisa ukugcwala koketshezi emaphashini akho.
  • Izinto ezinciphisa igazi zivimbela amahlule uma une-atrial fibrillation.
• Izinqubo zokungenelela:
  • I-Balloon valvuloplasty: I-catheter enebhaluni ivuthela ngaphakathi kwevalvu ewumngcingo ukuze inwebe ukuvuleka. 
  • Ukulungiswa kokuhlinzwa: Inqubo inamasu okuhlukanisa amapheshana ahlanganisiwe noma ukususa amadiphozithi e-calcium.
  • Ukushintshwa kwevalvu: Odokotela basebenzisa amavalvu ezicubu zemishini noma zebhayoloji lapho ukulungiswa kungenzeki.

Uzoyibona Nini Udokotela

Kufanele uxhumane nodokotela wakho ngokushesha uma ubona:

• Ukushaya kwenhliziyo okusheshayo, okubhakuzayo noma okushaya ngamandla
• ubuhlungu besifuba
• Ukuphefumula okuba kubi kakhulu, ikakhulukazi ngesikhathi sokusebenza

Ukuqokwa kokulandelela njalo kudlala indima ebalulekile ngemva kokuxilongwa. I-mitral stenosis enzima kakhulu idinga i-echocardiograms yaminyaka yonke. Amacala anzima kakhulu adinga ukuhlolwa njalo eminyakeni emi-3-5.

Thola usizo oluphuthumayo ngokushesha uma uquleka, unezinkinga zokuphefumula kungazelelwe, noma ubuhlungu besifuba obungapheli.

Isiphetho

Abantu abane-mitral stenosis babhekana nezinselele zansuku zonke, kodwa ukunakekelwa kwezokwelapha kwanamuhla kuletha ithemba elisha. Ukuxilongwa okusheshayo nemiphumela engcono kwenzeka uma ubona izimpawu eziyisixwayiso zangaphambi kwesikhathi njengokuphelelwa umoya nokukhathala.

I-Rheumatic fever ibangela izimo eziningi zalesi simo. Ukuhlolwa njalo kwezokwelapha kuthola i-valve incipha ngaphambi kokuba izimpawu zibe zimbi nakakhulu. Amathuluzi esimanje njengama-echocardiograms adala izithombe ezinemininingwane ezisiza odokotela benze izinqumo zokwelashwa ezingcono.

Ukuncishiswa kwe-valve yakho kunquma indlela yakho yokwelapha. Odokotela bangase baqaphe izimo ezithambile, kodwa ezinzima zidinga izinqubo ezifana nebhaluni valvuloplasty noma ukushintshwa kwevalvu. Ukuxhumana okuhle nethimba lakho lokunakekelwa kwezempilo kudlala indima ebalulekile kukho konke ukunakekelwa kwakho.

Iziguli eziningi ziphila kahle ne-mitral stenosis iminyaka. Naka izimpawu zomzimba wakho futhi ungaphuthelwa ama-aphoyintimenti okulandelela. Thola usizo ngokushesha uma unenkinga yokuphefumula. Ungakwazi ukujabulela impilo ngalokhu kuxilongwa lapho uqonda isimo sakho futhi usebenzisana nodokotela ukuze ugcine impilo yenhliziyo.

Imibuzo Evame Ukubuzwa

1. Yiziphi izimpawu eziyinhloko ze-mitral stenosis? 

Izimpawu eziyinhloko zihlanganisa ukuphefumula (ikakhulukazi ngesikhathi sokuzivivinya), ukukhathala, ukushaya kwenhliziyo okungavamile, ukungaphatheki kahle kwesifuba, nokukhwehlela igazi ngezikhathi ezithile. Ukuvuvukala ezinyaweni noma emaqakaleni kungase kwenzeke.

2. Itholakala kanjani i-mitral stenosis? 

Ukuxilongwa ngokuvamile kuhilela ukuhlolwa okuningana, okuhlanganisa i-echocardiogram ukuze ubone ngeso lengqondo ukwakheka kwenhliziyo, i-electrocardiogram (ECG) yokurekhoda umsebenzi wenhliziyo, i-X-ray yesifuba, futhi ngezinye izikhathi ukuhlolwa kokuvivinya umzimba. Ezimweni eziyinkimbinkimbi, i-catheterization yenhliziyo noma i-MRI ingadingeka.

3. Yiziphi izindlela zokwelapha i-mitral stenosis? 

Ukwelashwa kwe-mitral stenosis kuncike ebucayi besimo. Izimo ezibucayi zingadinga kuphela ukuqapha, kuyilapho imithi ingasiza ekulawuleni izimpawu. Ezimweni ezinzima kakhulu, izinqubo ezifana ne-balloon valvuloplasty, ukulungiswa kokuhlinzwa, noma ukushintshwa kwe-valve kungase kudingeke.

4. Umuntu one-mitral stenosis kufanele ahlolwe kangaki? 

Ukuvama kokuhlolwa kuncike ebucayi besimo. Labo abane-mitral stenosis enzima kakhulu kufanele babe ne-echocardiograms yaminyaka yonke, kuyilapho izimo ezimbi kakhulu zingadinga kuphela ukuhlolwa njalo eminyakeni engu-3-5. Ukuqokwa kokulandelela njalo kubalulekile ukuze kuqashwe ukuqhubeka kwesimo.

UDkt. Nitin Modi

MBBS, MD, DNB, DM
Izibhedlela ze-CARE CHL, e-Indore

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