I-myocarditis

I-Myocarditis iyingozi kakhulu inhliziyo isimo esithinta imisipha yenhliziyo. Lesi simo sibangela ukuvuvukala, okungenza inhliziyo ibe buthaka futhi ibe nomthelela ekhonweni layo lokumpompa igazi ngendlela efanele. Lesi sifo singenzeka kunoma ubani, kodwa sivame kakhulu kubantu abadala nasezinganeni. Ukuqonda Isifo senhliziyo I-myocarditis ibalulekile ngoba ingaholela ezinkingeni ezinzima uma ingelashwa. Kulesi sihloko, sizobheka izimbangela zayo, izimpawu, kanye nezinkinga ezingase zibe khona. Sizophinde sixoxe ngokuthi odokotela bayixilonga futhi bayiphathe kanjani i-myocarditis. 

Iyini i-Myocarditis?

\ I-Myocarditis yisimo esibucayi senhliziyo esithinta imisipha yenhliziyo, eyaziwa nge-myocardium. Kwenzeka lapho lolu ungqimba oluphakathi lwemisipha yodonga lwenhliziyo luvuvukala. Lokhu kuvuvukala kuvame ukuvela emzimbeni izivikeli mzimba ukusabela ezibangeni ezihlukahlukene, ezifana nezifo, izifo ezizimele, ukusabela kwezidakamizwa, noma ezinye izimo zokuvuvukala. Abanye abantu bangase bangabi nazo izimpawu ze-myocarditis, kuyilapho abanye bengase babe nezimpawu ezinjengomkhuhlane.

Izinkinga ze-Myocarditis

Lokhu okulandelayo yizimbangela ze-myocarditis ezivamile zenhliziyo:

• Ukutheleleka: I-Myocarditis inezimbangela ezihlukahlukene, izifo ziyimbangela evame kakhulu. Ukusabela komzimba wethu kulezi zifo kungaholela ekuvuvukeni kwemisipha yenhliziyo. Lesi simo singabangelwa izifo ezilandelayo:
  • Ukutheleleka Ngegciwane: Umkhuhlane, i-herpes virus six, i-adenovirus (umkhuhlane ojwayelekile), i-coxsackievirus, i-parvovirus B19, ne-SARS-CoV-2 (COVID-19).
  • Izifo ezibangelwa amagciwane: Streptococcus (strep throat), staphylococcus (staph) 
  • Ukutheleleka kwefungal (okungavamile): I-Candida (i-oral thrush) ne-Aspergillus ingabangela i-myocarditis, ikakhulukazi kubantu abanamasosha omzimba abuthakathaka.
  • Ukutheleleka kweParasitic: Isifo se-Chagas
• Izifo Ezizenzakalelayo: Izimo ezithile ze-autoimmune ezifana ne-lupus kanye ne-rheumatoid arthritis zingabangela i-myocarditis ngokubangela ukuvuvukala. 
• Ukuchayeka Kumakhemikhali noma Ubuthi: Lokhu kufaka phakathi utshwala, i-cocaine, umthofu, nezinye izinsimbi ezisindayo.
• Imithi: Imithi yenhliziyo, i-antidepressants, izidakamizwa zokuquleka, ama-antibiotics, imithi yokunciphisa umzimba, kanye ne-diuretics inamandla okubangela i-myocarditis njengomphumela omubi. 

Izimpawu ze-Myocarditis

I-Myocarditis ingaba nenqwaba yezimpawu, ezihluka ngobunzima kusukela kumuntu nomuntu. Abanye abantu abanesifo esisanda kuzalwa bangase bangabi nazo izimpawu nezimpawu ze-myocarditis, kanti abanye bangase babe nokubonakaliswa okuthambile kuya kokuqina.

Izimpawu ezivamile ze-myocarditis zihlanganisa: 

• Ubuhlungu besifuba obuzwakala njengokucinana noma ukuminya isifuba 
• Lokhu kuphatheka kabi kungase kwenzeke lapho uphumule noma ngesikhathi sokuzivocavoca umzimba 
• Ubuhlungu besifuba ngezinye izikhathi bungasakazekela kwezinye izingxenye zomzimba, njengezingalo, umhlane, intamo, nomhlathi. 
• Ukuphefumula, okungase kubonakale ngesikhathi sokuphumula noma ukuzikhandla ngokomzimba.
• Ukukhathala okungajwayelekile noma ukukhathala 
• Ukushaya kwenhliziyo okusheshayo noma okungajwayelekile (arrhythmias)
• Ukuphelelwa amandla
• Ukuvuvukala emilenzeni, emaqakaleni nasezinyaweni
• Izimpawu ezifana nomkhuhlane imfiva, ikhanda elibuhlungu, ubuhlungu bomzimba, ubuhlungu bamalunga, nomphimbo obuhlungu. 
• Ukunciphisa ukudla 
• Ukungakwazi ukuzivocavoca
• Ubuthakathaka bubonke

Izingane ezisanda kuzalwa kanye nezinsana zisengozini enkulu yesifo se-myocarditis ngoba zithola amagciwane ngesikhathi sokubeletha, futhi amasosha abo omzimba awathuthukisiwe ngokugcwele. Bangase babe nezimpawu ezinzima kakhulu, njenge:

• Ubunzima bokudla
• Ukuphefumula okusheshayo noma okunzima
• Isikhumba esiphezulu
• Ukuthukuthela 
• Ukunyakaza okuncane kanye nobuthakathaka
• Izandla nezinyawo ezibandayo

Izinkinga

Nakuba abantu abaningi belulama ngokunakekelwa okufanele, abanye bangase babe nezinkinga ezinzima kakhulu, ezidinga ukwelashwa okukhethekile. Lokhu kubandakanya:

• Ukwehluleka Kwenhliziyo: Uma ukuvuvukala kulimaza izicubu zenhliziyo, kungenza buthaka ikhono lenhliziyo lokumpompa igazi ngokuphumelelayo, okuholela ekutheni inhliziyo ibe nkulu futhi ingasebenzi kahle, isimo esaziwa ngokuthi i-dilated cardiomyopathy. 
• I-Arrhythmias: Ukulimala kwemisipha yenhliziyo kungaphazamisa isimiso sayo sikagesi, kubangele ukushaya kwenhliziyo okusheshayo noma okungajwayelekile. 
• I-Stroke: Amanye ama-arrhythmias angandisa ingozi yokushaywa unhlangothi futhi angase adinge ukufakwa kwe-pacemaker noma i-cardioverter-defibrillator (ICD) efakelwayo.
• I-Blood Clot: I-Myocarditis ingaholela ekwakhekeni kwegazi emithanjeni yenhliziyo, engabangela ukuhlaselwa yinhliziyo uma ivimbela i-coronary artery noma i-stroke uma iya ebuchosheni. 
• Ukuboshwa Kwenhliziyo: ama-arrhythmia athile amakhulu angaholela ekuboshweni kwenhliziyo kungazelelwe, okungaba yingozi uma kungelashwa ngokushesha.

Sifo

• Ukuhlolwa Komzimba Nokubuyekezwa Komlando Wezokwelapha: Odokotela bazobuza ngezimpawu ezinjengobuhlungu besifuba, ukukhathala, noma ukuphelelwa umoya futhi babuyekeze noma yiziphi izifo zakamuva ezibangelwa amagciwane.
• Ukuhlolwa Kwegazi: Lezi zivivinyo zihlola amaprotheni afana ne-troponin, abonisa ukulimala kwemisipha yenhliziyo. Okunye ukuhlolwa kwegazi kulinganisa amazinga okuvuvukala emzimbeni futhi kuhlolwe izifo ezingase zibangele i-myocarditis.
• Ukuhlolwa Kwezithombe:  
  • I-electrocardiogram (ECG) ikala ukusebenza kukagesi wenhliziyo futhi ikwazi ukubona isigqi esingavamile. 
  • I-X-ray yesifuba ibonisa usayizi wenhliziyo nokuma kwayo futhi ingaveza uketshezi olugcwele enhliziyweni.
  • Ama-Echocardiograms enza izithombe ezinemininingwane yokwakheka nokusebenza kwenhliziyo. 
  • Kwezinye izimo, i-biopsy yenhliziyo ingadingeka. 

Ukwelashwa

Alikho ikhambi eliqondile le-myocarditis, kodwa odokotela benhliziyo bangabhekana nezimbangela eziyisisekelo futhi banikeze imithi yokusiza inhliziyo ukuthi isebenze kangcono. Ezimweni ezibucayi, odokotela bayeluleka ukuphumula, ukunciphisa umsebenzi, kanye nokudla okunosawoti omncane ukuze kuvinjelwe ukunqwabelana koketshezi. Ngakolunye uhlangothi, ezimweni ezimbi kakhulu, kungase kudingeke ukulaliswa esibhedlela. Ukwelashwa kwe-myocarditis kuhlanganisa:

• Imithi:
  • I-Angiotensin-converting enzyme (ACE) inhibitors 
  • I-Angiotensin receptor blockers (ARBs) 
  • Ama-beta blockers 
  • Ama-diuretics anciphisa ukuminyana koketshezi emzimbeni
  • Corticosteroids ukunciphisa ukuvuvukala
• I-ECMO: I-Extracorporeal membrane oxygenation (ECMO) ukuze ifake umoya-mpilo egazini
• Ukufakwa Kwedivayisi: Ukufakwa kwamadivayisi afana nama-pacemaker noma ama-cardioverter-defibrillators (ICDs) afakelwayo ukuze alawule isigqi senhliziyo.
• Ukufakelwa kabusha: Ezimweni ezingavamile lapho ukulimala kwenhliziyo kukhulu, a ukufakelwa kwenhliziyo kungase kucatshangelwe. 

Uzoyibona Nini Udokotela

Uma ucabanga ukuthi unezimpawu ze-myocarditis, kubalulekile ukuthintana nodokotela wakho ngokushesha. Xhumana nodokotela wakho: 

• Uma uzwa ubuhlungu besifuba obungachazeki noma ukuphelelwa umoya 
• Uma ubuhlungu besifuba sakho buzwakala buqinile noma bunzima, buhlala ngaphezu kwemizuzu engu-15, busakazeka ezingalweni zakho, emuva, intamo, noma umhlathi,
• Uma futhi uzizwa uphelelwa umoya noma unesicanucanu

Prevention

Nakuba ingekho indlela eqondile yokuvimbela i-myocarditis, ungathatha izinyathelo zokuphepha ukuze wehlise ubungozi bakho. Lokhu kubandakanya:

• Gwema izifo futhi welaphe ngokushesha uma kwenzeka. 
• Geza izandla njalo ukuze uvimbele izifo.
• Ukwenza ucansi oluphephile nokugwema ukwabelana ngezinaliti kungavimbela izifo ezithathelwana ngocansi kanye nezifo.
• Uma ugula, ziqhelelanise nabanye ukuze uvimbele ukubhebhetheka kwezifo.
• Hlala unolwazi lwakamuva ngemithi yokugoma enconyiwe, okuhlanganisa naleyo ye Covid-19 kanye nomkhuhlane. 
• Yamukela indlela yokuphila enempilo, gwema ukubhema, futhi unciphise noma umise ukuphuza utshwala.
• Yehlisa ukudla kwakho kwe-sodium ukuze wehlise umfutho wegazi futhi wehlise ukuvuvukala.

Isiphetho

I-Myocarditis yisimo esibucayi senhliziyo esingaba nomthelela omkhulu empilweni yenhliziyo. Nakuba ingekho indlela engenangqondo yokuvimbela i-myocarditis, ukuhlala unempilo nokugwema izifo kunganciphisa ingozi yakho. Uma ubona noma yiziphi izimpawu eziyinqaba njengobuhlungu besifuba noma ukuphefumula kanzima, ungalindi ukuze uthole usizo. Isenzo esisheshayo singenza umehluko omkhulu endleleni olulama ngayo. Khumbula, impilo yenhliziyo ibalulekile, ngakho-ke kuthathe ngokungathi sína futhi ungangabazi ukukhuluma nodokotela uma kukhona okukukhathazayo.

Imibuzo Evame Ukubuzwa

1. Ubani osengozini ye-myocarditis?

Abantu abasha, ikakhulukazi abesilisa, basengozini enkulu ye-myocarditis. Ezinye izinto eziyingozi zihlanganisa ukuphuza ngokweqile, ukuba nesimiso sokuzivikela komzimba esibuthakathaka, nezimo ezithile zesistimu ezifana nesifo sikashukela noma i-HIV/AIDS. Ezinye izindlela zokwelapha, ezifana ne-dialysis noma i-radiation therapy, nazo zingandisa ingozi.

2. Iyini imbangela ehamba phambili ye-myocarditis?

Izifo ezibangelwa amagciwane ziyimbangela evame kakhulu ye-myocarditis. Lokhu kungabandakanya umkhuhlane, i-herpes virus, i-adenovirus, ne-COVID-19. Ezinye izimbangela zihlanganisa izifo ezibangelwa amagciwane noma fungal, izifo ezithile ezizimele, kanye nokusabela emithini ethile noma ubuthi. Ezimweni eziningi, umthombo oqondile we-myocarditis uhlala ungaziwa.

3. Ingabe i-myocarditis ingelapheka?

Amacala amancane we-myocarditis ngokuvamile azixazulula ngokwawo ngokuphumula nokunakekelwa okusekelayo. Izimo ezinzima kakhulu zingadinga ukuphathwa kwemithi noma okunye ukwelashwa. Nakuba abaningi belulama ngokuphelele, abanye bangase babe nemiphumela yesikhathi eside noma badinge ukuphathwa okuqhubekayo.

4. Yini okufanele uyigweme uma une-myocarditis?

Uma kutholakala ukuthi une-myocarditis, ukugwema ukuvivinya umzimba okukhandlayo kanye nemidlalo okungenani izinyanga ezi-3 kuye kweziyi-6 kubalulekile, noma njengoba udokotela wakho eluleka. Ukunciphisa ukuphuza utshwala nokugwema ukusebenzisa ugwayi nakho kuyanconywa. Landela imiyalelo kadokotela wakho ngokucophelela ukuze uvimbele izinkinga.

5. Yisiphi isikhathi sokululama se-myocarditis?

Isikhathi sokululama siyahluka futhi sincike ebucayi besimo. Abantu abaningi bayathuthuka phakathi kwamasonto kuya ezinyangeni ngokuphumula okufanele kanye nokwelashwa kwe-myocarditis. Nokho, abanye bangase badinge isikhathi eside ukuze balulame ngokugcwele. Ukulandelela njalo nodokotela wenhliziyo kubalulekile ukuze kuqashwe ukuqhubeka nokunquma ukuthi kuphephile nini ukuqalisa kabusha imisebenzi evamile.

UDkt. Nitin Modi

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

Ukuze Ubhukhe Isikhathi, shayela:

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