Izifo Zenhliziyo Ebandayo

I-Congenital heart disease (CHD) yisimo esibucayi senhliziyo esithinta izinkulungwane zezingane ezisanda kuzalwa unyaka ngamunye. Leli qembu lokukhubazeka kwenhliziyo, elikhona lapho lizalwa, lingaphazamisa impilo nentuthuko yengane. Kusukela ezinkingeni ezincane ezingase zizixazulule ngokwazo kuye ezinkingeni ezidinga ukunakekelwa ngokushesha kwezokwelapha, isifo senhliziyo esizalwa sizalwa sihlanganisa izinhlobonhlobo zokungajwayelekile kwenhliziyo. Ake sihlole izinhlobo ezahlukene zesifo senhliziyo esizalwa naso, izimpawu nezimpawu zazo, kanye nezimbangela ezingase zibe khona. 

Siyini Isifo Senhliziyo Esizalwa Naso?

Kubhekiselwa enkingeni eyodwa noma ngaphezulu ngesakhiwo senhliziyo esikhona ngesikhathi sokuzalwa. Lesi simo sithinta ukusebenza okuvamile kwenhliziyo futhi singashintsha indlela igazi eligeleza ngayo kuyo. I-Congenital heart disease ingenye yezinhlobo ezivame kakhulu zokukhubazeka kokuzalwa.

Igama elithi "congenital" lisho ukuthi isimo sikhona kusukela ekuzalweni. Nokho, ezinye izinkinga zenhliziyo ezizalwa nazo zingase zibonakale ngaphambi kokuzalwa ngokuhlolwa ngaphambi kokubeletha, kuyilapho ezinye zingase zingabonisi izimpawu kuze kube kamuva ebuntwaneni noma ngisho nasebudaleni. Lokhu kungahambi kahle kwesakhiwo kwenzeka lapho inhliziyo noma imithambo yegazi ingakhi ngendlela efanele esibelethweni.

Isifo senhliziyo esizalwa naso singabandakanya izakhi zenhliziyo ezihlukahlukene, kuhlanganise nemithambo, ama-valve, amagumbi, noma udonga oluhlukanisa amagumbi. 

Izinhlobo ze-Congenital Heart Disease

Kunezinhlobo okungenani eziyishumi nesishiyagalombili ezihlukene zokuzalwa ukukhubazeka kwenhliziyo, ngayinye inezici zayo kanye nezinkinga ezingase zibe khona.

Okulandelayo ezinye izinhlobo ezivamile zesifo senhliziyo sokuzalwa:

• I-Atrial Septal Defect (ASD): I-ASD yenzeka lapho imbobo ikhona odongeni noma e-septum yamagumbi amabili okuqoqa enhliziyo (i-atria yesokunxele nesokudla). Lokhu kuvumela igazi elinomoya-mpilo ukuthi lingene egunjini legazi elingenawo umoya-mpilo. 
• I-Ventricular Septal Defect (VSD): Kulesi simo, kuvela imbobo phakathi kwamagumbi aphansi enhliziyo okwenza igazi limpontshelwe libuyele emaphashini esikhundleni sokuba libuyele emzimbeni.
• I-Complete Atrioventricular Canal Defect (CAVC): Ku-CAVC, imbobo enkulu ithinta wonke amagumbi amane enhliziyo kanye nokuguqulwa kwemithambo emikhulu, lapho imithambo eyinhloko ethwala igazi kude nenhliziyo, ihlehliswa.
• I-Patent Ductus Arteriosus: Lapho ingane ikhula esibelethweni sikamama, umthambo wegazi obizwa ngokuthi i-ductus arteriosus uxhuma ngqo umthambo wamaphaphu ku-aorta. Uma lokhu kuxhumana kungavaleki kahle ngemva kokuzalwa, amaphaphu ayaphoqeleka ukuthi ampompe igazi eliningi, okwenza inhliziyo namaphaphu kusebenze kanzima.
• Ezimweni ezingavamile, izinsana zingase zibe nokukhubazeka kwe-ventricle eyodwa okuthinta igumbi elilodwa eliphansi lenhliziyo noma izimo eziyinkimbinkimbi njenge-tetralogy ye-Fallot, efaka izinkinga ezine ezihlukene.
• Ezinye izinhlobo zezinkinga zenhliziyo ozalwa nazo zihlanganisa ukuqina kwe-aorta, ukuncipha komthambo omkhulu wegazi (umthambo wegazi) ohambisa igazi emzimbeni, kanye ne-anomaly ka-Ebstein, i-valve yenhliziyo engasebenzi kahle engavaleki kahle. 

Izimpawu ze-Congenital Heart Disease

Abanye abantu abazalwa benezinkinga zenhliziyo bangase bangabi nazo izimpawu, kanti abanye bangase babe nezimpawu kamuva ekuphileni noma ngisho neminyaka ngemva kokwelashwa.

Ezimweni ezimbi kakhulu, izimpawu zingase zibonakale ngemva nje kokuzalwa, njenge: 

• I-tinge eluhlaza okwesibhakabhaka esikhumbeni, ezindebeni, nasezinzipho (cyanosis) 
• Ukuphefumula okusheshayo nokushaya kwenhliziyo okusheshayo 
• Ukuphelelwa umoya nokukhathala okukhulu
• Izingane zivame ukubhekana nobunzima bokuthola isisindo ngenxa yokuphelelwa umoya ngesikhathi sokuncelisa
• Izingane zingase zikhathale kalula ngesikhathi sokuzivivinya noma zithole ukuquleka ngesikhathi sokuzivocavoca njengoba zikhula. 
• Ukuvuvukala ezingxenyeni ezihlukahlukene zomzimba, njengemilenze, isisu, izandla, amaqakala nezinyawo
• Abantu abadala abanesifo senhliziyo abazalwa nabo bangase babone ukushaya kwenhliziyo okungajwayelekile (i-arrhythmia) noma bathole ukuphindaphinda kwezimpawu eminyakeni eminingi ngemva kokwelashwa kokuqala. 

Izimbangela Nezingozi Zezifo Zenhliziyo Yokuzalwa

Isizathu esiqondile sama-CHD asaziwa ezimweni eziningi. Kodwa-ke, abacwaningi bathole izici eziningana ezingase zandise ingozi yokuba nalezi zinkinga zenhliziyo:

• Izakhi Zofuzo: Cishe amaphesenti angama-35 amacala abangelwa izimbangela zofuzo. 
• Umlando Womndeni: Ukuba nomzali noma ingane yakini enenkinga yenhliziyo yokuzalwa kwandisa ingozi enganeni. 
• Izimo Zofuzo: I-Down's syndrome, i-Turner syndrome, ne-Noonan syndrome zixhunyaniswa namathuba aphezulu okuba nesifo senhliziyo sokuzalwa.
• Izici Zendawo Ezungezile: Ukuchayeka ezintweni eziyingozi phakathi nokukhulelwa, okuhlanganisa utshwala, intuthu kagwayi, neminye imithi, kungase kuthinte ukukhula kwenhliziyo. 
• Izimo Zezempilo Kamama: Isifo sikashukela esingalawulwa kahle kanye nezifo ezifana ne-rubella nomkhuhlane ngesikhathi sokukhulelwa kuye kwaxhunyaniswa nengozi eyengeziwe yezinkinga zenhliziyo yokuzalwa.

Izinkinga ze-Congenital Heart Disease

Isifo senhliziyo sokuzalwa singaholela ezinkingeni ezihlukahlukene, ezinye zazo ezingase ziphakame ngemva kweminyaka yokwelashwa kokuqala, okuhlanganisa: 

• Ukushaya kwenhliziyo okungajwayelekile noma ama-arrhythmia
• I-Endocarditis (ukutheleleka kolwelwesi lwenhliziyo namavalvu) 
• Ayanda amathuba okuba nesifo sohlangothi
• Umfutho wegazi ophezulu wamaphaphu 
• Ukuhluleka kwenhliziyo 
• Isifo sezinso
• Isifo sesibindi
• Ukwanda kwengozi yokutheleleka komgudu wokuphefumula

Sifo

Inqubo yokuhlonza ngokuvamile iqala ngesikhathi sokukhulelwa, ngokuhlola okujwayelekile kwe-ultrasound okungase kwembule ukungahambi kahle kwenhliziyo. I-Fetal echocardiography, eyenziwa phakathi kwamasonto angu-18 nama-22 okukhulelwa, inikeza ukuhlolwa okunemininingwane okwengeziwe kwesakhiwo senhliziyo.

Ngemva kokuzalwa, odokotela bangase babone izimpawu nezimpawu zokukhubazeka kwenhliziyo yokuzalwa ngesikhathi sokuhlolwa komzimba osanda kuzalwa. Nokho, ezinye iziphambeko zingase zingabonisi izimpawu izinyanga noma ngisho neminyaka. Uma kusolwa isifo senhliziyo sokuzalwa, ngokuvamile kuyadingeka ukuhlolwa okwengeziwe ukuze kuqinisekiswe ukuxilongwa, okufana nalokhu:

• I-Echocardiography ukwenza izithombe ezinemininingwane yokwakheka nokusebenza kwenhliziyo. 
• Ama-Electrocardiograms (ECGs) akala umsebenzi kagesi wenhliziyo
• Chest X-ray veza usayizi nokuma kwenhliziyo namaphaphu
• I-Pulse oximetry iyisivivinyo esingahlaseli ukuhlaziya amazinga e-oksijeni yegazi, okungabonisa izinhlobo ezithile zesifo senhliziyo sokuzalwa. 
• Kwezinye izimo, i-catheterization yenhliziyo ingadingeka ukuze uthole ulwazi oluningiliziwe mayelana nokugeleza kwegazi nokucindezela ngaphakathi kwenhliziyo.

Ukwelashwa Kwesifo Senhliziyo Esizalwa Naso

Izinkinga eziningi zenhliziyo ezithambile zingase zingadingi ukwelashwa futhi zingathuthuka ngokuhamba kwesikhathi. Nokho, izimo ezimbi kakhulu ngokuvamile zidinga ukungenelela kwezokwelapha.

Kwezinye izingane ezisanda kuzalwa ezine-patent ductus arteriosus, odokotela basebenzisa imithi ukuvala isikhala. Ezimweni lapho imithi ingasebenzi, ukucwiliswa kwenhliziyo noma ukuhlinzwa kungase kudingeke.

Ukuze uthole ukukhubazeka okuyinkimbinkimbi, odokotela benza ukuhlinzwa kwenhliziyo evulekile. Lokhu kungase kuhlanganise ukulungisa izimbobo enhliziyweni, ukulungisa imithambo yegazi emincane, noma ukufaka ama-valve anephutha. 
Kwezinye izimo, ukufakelwa inhliziyo kungase kudingeke, ikakhulukazi ezinganeni ezinokukhubazeka okuyinkimbinkimbi okungenakulungiseka ngokuhlinzwa noma uma inhliziyo yehluleka ngemva kokuhlinzwa.

Uzoyibona Nini Udokotela

Kubalulekile ukufuna usizo lwezempilo uma kukhona ukukhathazeka ngesifo senhliziyo ozalwa naso. Abazali kufanele babonane nodokotela:

• Uma bebona noma yiziphi izimpawu noma izimpawu enganeni yabo, njengokubonakala okuluhlaza okwesibhakabhaka esikhumbeni noma ezindebeni, ukuphefumula ngokushesha, noma ubunzima bokudla ngokushesha ngemva kokuzalwa.
• Abantu abadala abazalwa benesifo senhliziyo kufanele benze izikhathi zokuhlolwa kwezempilo njalo nge i-cardiologist or udokotela ohlinza inhliziyo abaqeqeshelwe ukwelapha isifo senhliziyo abazalwa nabo, ngisho noma bengahlangabezananga nezinkinga. 
• Uma izimpawu zivela ebuntwaneni noma lapho usumdala, njengokukhathala ngokweqile, ukuphelelwa umoya ngesikhathi sokuzivocavoca, noma ukuvuvukala ezingxenyeni ezihlukahlukene zomzimba.

Prevention

Nakuba isifo senhliziyo sokuzalwa singenakuvinjelwa ngokuphelele, kunezinyathelo ongazithatha ukuze unciphise ingozi, njenge: 

• Abesifazane abakhulelwe noma labo abahlela ukukhulelwa kufanele bagxile ekugcineni impilo enempilo futhi balandele izeluleko zezokwelapha.
• I-folic acid 400 micrograms nsuku zonke ibalulekile, ngisho nangaphambi kokukhulelwa. 
• Gwema utshwala nogwayi ngesikhathi sokukhulelwa, njengoba lezi zinto zingase zandise ingozi yokukhubazeka kwenhliziyo nezinye izinkinga zempilo enganeni.
• Abesifazane abanesifo sikashukela kufanele balawule amazinga kashukela ngaphambi nangesikhathi sokukhulelwa. Labo abane-phenylketonuria kufanele balandele uhlelo lokudla olukhethekile ukuze balawule isimo sabo.
• Abesifazane abakhulelwe kufanele babonane nodokotela wabo mayelana nanoma yimiphi imithi abayithathayo, kuhlanganise nezitolo ezithengiswayo nezamakhambi. 
• Ukugcina isisindo esinempilo, ukugomela izifo ezifana ne-rubella, nokugwema ukuchayeka ezintweni eziyingozi njengezincibilikisi eziphilayo nakho kungasiza ekunciphiseni ingozi yesifo senhliziyo sokuzalwa.

Isiphetho

Ukuphatha isifo senhliziyo esizalwa nakho kudinga indlela ebanzi ehlanganisa ukutholwa kusenesikhathi, ukwelashwa okufanele, nokunakekelwa okuqhubekayo. Intuthuko kwezobuchwepheshe bezokwelapha kanye nokuqonda lezi zimo kuba nomthelela omkhulu ekuthuthukisweni kwemiphumela yalabo abathintekile. Kusukela ekuxilongweni kwangaphambi kokubeletha kuya ekuqashweni impilo yonke, odokotela badlala indima ebalulekile ekuqondiseni abazali, iziguli kanye nemindeni ebunzimeni bezinkinga zenhliziyo abazalwa nazo. 

Imibuzo Evame Ukubuzwa

1. Kuthatha isikhathi esingakanani ukululama kulokhu kwelashwa?

Ngokungenelela okuncane, okufana nokwelashwa okusekelwe ku-catheter, ukululama kungase kuthathe izinsuku ezimbalwa ukuya emavikini. Kodwa-ke, ukuhlinzwa kwenhliziyo evulekile ngokuvamile kudinga ukululama isikhathi eside, kusukela emavikini ambalwa kuya ezinyangeni. 

2. Ingabe isifo senhliziyo esizalwa naso singelapheka?

Nakuba izinkinga eziningi zenhliziyo ezizalwa nazo zingelapheka ngokuphelele, indlela yokwelapha efanele ingazilawula ngempumelelo. Intuthuko ku ukunakekelwa kwenhliziyo yezingane zibe nemiphumela ethuthuke kakhulu, njengoba u-90% wezingane ezizalwe zinezinkinga zenhliziyo manje okulindeleke ukuba ziphile isikhathi eside. 

3. Sibi kangakanani isifo senhliziyo sokuzalwa?

Ubunzima buyahlukahluka kakhulu, kusukela ekushiyekeni okuncane okungase kungadingi ukwelashwa kuya ezimeni eziyinkimbinkimbi ezidinga ukunakekelwa kwezokwelapha ngokushesha. 

4. Ingabe i-ECG ingakwazi ukubona isifo senhliziyo sokuzalwa?

I-electrocardiogram (ECG) ingasiza ekutholeni ezinye izinhlobo zesifo senhliziyo esizalwa nayo, kodwa ayisho ngaso sonke isikhathi. Izinguquko ze-ECG zingase zibe khona kwezinye iziphambeko zenhliziyo zokuzalwa, ngokuvamile ezihlobene nokugcwala kwe-atrial noma i-ventricular kanye nokwanda. 

CARE Medical Team

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