Amaqiniso Athakazelisayo Ngenhliziyo Yenja

Isifo senhliziyo ezinjeni asivamile futhi sitholakala kangcono ngaphambi kokuba kuvele izimpawu zokuqala.

Inhliziyo idlala indima ebalulekile ekuhlinzekeni umzimba wonke. Iqinisekisa ukuthi igazi eligcwele umoya-mpilo kanye nezakhamzimba limpontshelwa ngemikhumbi liye kuzo zonke izitho kanye nokuthi imikhiqizo engcolile ye-metabolic kanye ne-carbon dioxide iyasuswa futhi. Uma inhliziyo inesifo, ngokushesha noma kamuva ngeke isakwazi ukwenza lo msebenzi. Imiphumela ngokuvamile ivela kancane kancane. Izinja ezinesifo senhliziyo ngokuvamile azizimisele kangako ukusebenza, ukukhwehlela noma ukuphefumula ngokushesha kunangaphambili. Iziphonso zokuquleka kungazelelwe ngezinye izikhathi zingabonwa, futhi ezimweni ezingavamile kanye nezigaba ezithuthukisiwe ngisho nokuphefumula. Ulwelwesi lwamafinyila oluluhlaza noma isisu esivuvukele uketshezi nakho kungabonisa inhliziyo engasebenzi ngokwanele.

Kubalulekile nokho ukuthi lezi zimpawu zingenzeka nakwezinye izifo, okungukuthi aziqondile. Udokotela wezilwane kuphela ongahlonza ukuthi inja inaso yini isimo senhliziyo futhi, uma kunjalo, siyini ngemva kokuhlolwa okuphelele.

Isifo se-valve yenhliziyo yesokunxele, okuthiwa yi-mitral endocarditis, sivame kakhulu ezilwaneni ezindala zezinhlobo zezinja ezincane. Enjaneni enempilo, ama-valve enhliziyo avimbela igazi ukuthi lingagelezi ngendlela engafanele phakathi kwenhliziyo. Uma i-valve yesokunxele ingasavaleki kahle, igazi ligeleza libuyele ku-atrium yangakwesobunxele, elingase lidlulele emaphashini.

Izinhlobo ezinkudlwana zisengozini enkulu yokuba buthakathaka kwemisipha yenhliziyo, i-dilated cardiomyopathy, noma i-DCM okwesikhashana. Kulesi sifo, imisipha yenhliziyo ibuthakathaka kakhulu ukumpompa igazi elanele ngesimiso sokujikeleza kwegazi. Umzimba uzama ukunxephezela lokhu ngokwandisa umthamo wegazi, phakathi kwezinye izinto. Nokho, ngenxa yokuthi inhliziyo ayinawo amandla okumpompa amanani amakhulu, ama-ventricles agcwala igazi eliningi. Lokhu kwelula izindonga zamakamelo. Ziya ngokuncipha futhi zibe mncane futhi ekugcineni ziguge. I-DCM ingathinta nezinja ezincane.

Izinja nazo zingazalwa zinenhliziyo ekhubazekile, ngisho noma ingabonakali ngokushesha. Ngakho-ke kubalulekile ukulalela imidlwane njalo ukuze ukwazi ukungenelela kusenesikhathi. Ngoba uma inja ikhombisa izimpawu, isivele sekwephuze kakhulu ukungenelela.

Isifo senhliziyo ngokuvamile sihlotshaniswa nokulahlekelwa umsebenzi. Ekuqaleni kokugula, inja ngokuvamile ayiboni lutho, ngoba inhliziyo ingakwazi ukukhokhela ngempumelelo ukusebenza kwayo okuncishisiwe. Ngeshwa hhayi ngokuhamba kwesikhathi, ngoba ngokuhamba kwesikhathi lezi zindlela eziyisinxephezelo zibeka ubunzima obukhulu enhliziyweni evele igula. Ngokushesha noma kamuva, ngakho-ke, kuholela ekuwohlokeni okuqhubekayo kanye nezimpawu ezibonakalayo.

Ukumisa lo mbuthano ononya, kwenziwa imizamo yokukhulula nokuqinisa inhliziyo ngosizo lwemithi. Ngale ndlela, inkambo yesifo kufanele yehliswe futhi ukusebenza kwenhliziyo okusekhona kufanele kugcinwe. Nokho, izinguquko esezenzekile kakade kuma-valve enhliziyo noma izicubu zemisipha yenhliziyo ngokwazo azikwazi ukulungiswa ngisho nangemithi. Ngalo mqondo, ukwelashwa akunakwenzeka. Kodwa ngokwelashwa okufanele kanye nokuhlolwa okuvamile, izinja ezinesifo senhliziyo ngokuvamile zingaphila ukuphila okungenandaba.

Igazi eligcwele umoya-mpilo eliphuma emaphashini lifika ku-atrium yangakwesobunxele bese limpontshelwa lisuka ku-ventricle yangakwesobunxele liye ku-systemic circulation. Uma ukusebenza kwenhliziyo kukhawulelwe kulolu hlangothi, igazi lihlala enhliziyweni. Yakha kuqala ku-atrium yangakwesobunxele futhi ekugcineni ibuyele emithanjeni yegazi yamaphaphu. Ngenxa yalokho, ingcindezi eyandayo iphoqa uketshezi oluphuma emithanjeni luye ezicubu ne-alveoli. Ulimi lwendabuko lukhuluma “ngamanzi emaphashini”. Inja izama ukukhipha uketshezi ngokukhwehlela. Njengoba inqubo iqhubeka, ukuphefumula kanzima kwenzeka. Ukukhwehlela kungase futhi kuqale lapho i-atrium yangakwesobunxele ikhula ngenxa yegazi elinqwabelene futhi icindezela imigudu yokuphefumula yamaphaphu, i-bronchi.

Ngakho-ke ukukhwehlela okuhlobene nenhliziyo kuvame ukuhlotshaniswa nokuba buthakathaka enhliziyweni yesokunxele, okungaba nezimbangela ezihlukene. Isibonelo, i-valve yenhliziyo enesici ingaba ngemuva kwayo, noma ubuthakathaka bokupompa kwe-ventricle yesokunxele.

Ukulalela inhliziyo nge-stethoscope kuyingxenye yakho konke ukuhlolwa okuvamile futhi ngesikhathi esifanayo kuyingxenye ebalulekile yokuhlolwa kwenhliziyo okukhethekile. Udokotela wezilwane unaka imvamisa, isigqi, nokuqina kwemisindo yenhliziyo. Uhlola ukuthi imisindo yenhliziyo ihlukene yini nokuthi ingabe lokho okubizwa ngokuthi ukububula kwenhliziyo nakho kungazwakala ngaphezu kwemisindo yenhliziyo. Uma udokotela wezilwane ethola ukuvungama kwenhliziyo ngesikhathi sokuhlolwa okujwayelekile, isibonelo ngesikhathi sokugoma, kufanele afinyelele ekugcineni kodaba. Ngoba ngemuva kwayo ingakwazi - ngisho nasezilwaneni ezingabonisi zimpawu! – fihla esigabeni sokuqala sesifo senhliziyo. Odokotela bezilwane abanolwazi sebengakwazi kakade ukunquma okuningi ngokulalela. Kodwa ezinye izinto azikwazi ukuhlolwa ngale ndlela, noma azikwazi ukuhlolwa ngokucacile.

Ama-X-ray angasetshenziswa ukuhlola ubukhulu nokuma kwenhliziyo kanye nokuma kwayo esifubeni. Ukunqwabelana koketshezi esikhwameni se-pericardial noma emaphashini nakho kungabonakala ngale ndlela.

Ukuhlolwa kwe-ultrasound manje sekuyingxenye yezinga lokuhlolwa kwenhliziyo okujulile. Ngosizo lwabo, umuntu angakwazi ukuhlola ama-valve enhliziyo, ubukhulu bezindonga zenhliziyo, kanye nesimo sokugcwalisa amakamelo amabili enhliziyo kanye ne-atria. Inhliziyo ingalinganiswa “ngomsindo”. Ububanzi bangaphakathi buvame ukunqunywa. Ngalokho okubizwa ngokuthi i-Doppler ultrasound yombala, ungakwazi ngisho nokubheka ukugeleza kwegazi nemisinga ngesikhathi sokusebenza kwenhliziyo. Isibonelo, esimweni sokuntuleka kwe-mitral valve, ukugeleza okubuyela emuva ku-atrium yangakwesobunxele kuyavela.

Phela, i-arrhythmias yenhliziyo ingahlolwa kangcono nge-electrocardiogram (ECG). Uma kwenzeka kuphela ngezikhathi ezithile, kungase kube ukuhlakanipha ukwakha i-ECG yamahora angu-24 (Holter ECG).

Okubizwa ngokuthi imisindo yenhliziyo kwenzeka ngesikhathi sokusebenza okuvamile kwenhliziyo. Konke okuzwakalayo lapho kulalela ukusebenza kwenhliziyo kubizwa ngokuthi ukububula kwenhliziyo. Ukububula kwenhliziyo akuhlali kungavamile, kodwa ezimweni eziningi, kungenxa yenhliziyo egulayo. Ngakho-ke, ukutholakala okunjalo kufanele kucaciswe - ngisho noma inja ibonakala iphilile ngokuphelele. Angase abe esigabeni sokuqala sesifo senhliziyo, lapho inja ingabonakali ngaphandle, kodwa udokotela wezilwane angakwazi kakade ukubona izinguquko zokuqala enhliziyweni. Ngosizo lwezindlela zokuhlola ezikhethekile - njenge-ultrasound - angakwazi ukuhlola kangcono ukuthi kwanele yini ukuqhubeka nokubheka inja okwamanje, noma ngabe ukwelashwa kufanele kuqalwe kakade. Udokotela wezilwane angase futhi adlulisele umnikazi kuchwepheshe wenhliziyo ngalokhu. Ucwaningo lwakamuva lubonisa ukuthi isikhathi sokuphila kwezinja singanwetshwa kakhulu uma, ngokusekelwe kokutholwe okuthile kwenhliziyo, ukwelapha ngezidakamizwa kwaqalwa ngaphambi kokuba kuvele izimpawu zokuqala. Lokhu kungaboniswa ngaphezu kwakho konke lokho okubizwa ngokuthi ama-calcium sensitizers. Lezi yizithako ezisebenzayo ukuthi ngakolunye uhlangothi zandisa amandla enhliziyo, kodwa ngakolunye uhlangothi, ziphinde zikhulule inhliziyo ngokwandisa izitsha. Lokhu kungaboniswa ngaphezu kwakho konke lokho okubizwa ngokuthi ama-calcium sensitizers. Lezi yizithako ezisebenzayo ukuthi ngakolunye uhlangothi zandisa amandla enhliziyo, kodwa ngakolunye uhlangothi, ziphinde zikhulule inhliziyo ngokwandisa izitsha. Lokhu kungaboniswa ngaphezu kwakho konke lokho okubizwa ngokuthi ama-calcium sensitizers. Lezi yizithako ezisebenzayo ukuthi ngakolunye uhlangothi zandisa amandla enhliziyo, kodwa ngakolunye uhlangothi, ziphinde zikhulule inhliziyo ngokwandisa izitsha.

Inhliziyo nezinso kuhlobene eduze. Imisebenzi yazo iyathonya enye nenye, okuba sobala ngokukhethekile lapho esinye sezitho ezimbili sigula. Enjaneni enesifo senhliziyo, ukusebenza kwezinso kufanele kuhlale kukhunjulwa. Ngakolunye uhlangothi, imisebenzi ethile yezinso ingasetshenziswa futhi ekwelapheni ukuze kukhululeke inhliziyo. Izindlela ezisetshenziswa lapha yilezo ezibizwa ngokuthi ama-diuretics nama-ACE inhibitors.

Ama-diuretics akhipha izidakamizwa. Benza ukuthi izinso zikhiphe uketshezi oluningi emchameni. Ngale ndlela, umzimba uncishwa uketshezi olungadingekile olunqwabelene emaphashini noma emzimbeni.

I-ACE inhibitors ivimbela imithambo yegazi ekuncipheni kakhulu. Umzimba uzama ukunxephezela ukuntuleka kokuphuma kwenhliziyo ngokucindezela imithambo yegazi. Nokho, ngokuhamba kwesikhathi kwenza inhliziyo icindezele nakakhulu. Uma izitsha zinwetshwa ngemithi, inhliziyo iyakhululeka ngoba kufanele isebenze ngokumelene nokumelana okuncane.

Ibalulekile enjeni enesifo senhliziyo ethola imithi yayo njalo nangesilinganiso esiqondile. Kodwa, ngisho noma inja iba ngcono ngaphansi kokwelashwa, inhliziyo iyona futhi izohlala ilimele. Akufanele ithweswe umthwalo kungenasidingo. Lokho akusho ukuthi inja ayikwazi ukusebenza; nokho, kufanele anyakaze njalo, ngokulinganayo, nangobunzima besifo. Ukuzikhandla okukhulu ngokomzimba kufanele kugwenywe kunoma yikuphi.

Ukukhuluphala ngokweqile kubangela ubunzima obukhulu enhliziyweni. Ngakho-ke izinja ezinamakhilogremu amaningi kufanele zinciphise isisindo sazo. Lapho uncelisa, kubalulekile futhi ukuqinisekisa ukuthi okuqukethwe kukasawoti ekudleni kuphansi. Usawoti wetafula ubopha amanzi emzimbeni, okubuye kwandise umthwalo enhliziyweni.

Abanikazi kufanele baqaphele inja yabo ekuphileni kwansuku zonke, njengoba beyazi kangcono. Udokotela wezilwane angaphinde abonise umnikazi ukuthi akakala kanjani izinga lokuphefumula lokuphumula. Isebenza njengendlela yokulawula elula nethembekile: Uma imvamisa inyuka, kungenzeka ukuthi uketshezi luqoqwe emaphashini futhi udokotela wezilwane kufanele aziswe ngokushesha. Ingabe inja ikhathala ngokushesha noma ikhwehlela kakhulu? Lokhu kungase futhi kube izimpawu eziyisixwayiso. Ukuhlolwa njalo kudokotela wezilwane kuyimpoqo ezigulini zenhliziyo!

Empeleni, yonke inja ingaba nezinkinga zenhliziyo phakathi nokuphila kwayo. Azikho izinyathelo eziqondile zokuvimbela lokhu. Kodwa isimo sengqondo esifanelekile ngokudla okunempilo, okulinganiselayo nokuzivocavoca okwanele kuyisisekelo esibalulekile nesilungile sempilo yenja enempilo.

Amaqembu athile asengozini angase abe nesifo senhliziyo. Ezifweni ezithile zamavalvu, lezi ikakhulukazi izilwane ezindala zohlobo lwezinja ezincane. Ubuthakathaka bemisipha yenhliziyo (DCM) ikakhulukazi ezinhlotsheni zezinja ezinkulu eziphakathi konyaka owodwa nengxenye kanye nonyaka eyisikhombisa. Isici esikhethekile yi-DCM ye-Doberman ne-Boxer. Kuwubuqili, njengoba izilwane zibonakala ziphilile ngokuphelele isikhathi eside, nakuba ama-arrhythmias enhliziyo ajwayelekile asevele ekhona, okungukuthi umsipha wenhliziyo usulimele kakade. Ukufa okuzumayo akuvamile futhi nezinja ezisinda kulesi sigaba azinaso isikhathi sokuphila isikhathi eside. Nokho, uma lesi sifo sitholakala futhi selashwa ngaphambi kokuba kuvele izimpawu zokuqala, ukuphila kunganwetshwa kakhulu. Lokhu okulandelayo kusebenza kuzo zonke izifo zenhliziyo: uma ukuxilongwa kusenesikhathi, kuba ngcono. Ngakho-ke kubalulekile ukuthi izilwane ezisengozini enkulu zihlolwe inhliziyo njalo ngudokotela wezilwane, okungcono njalo ngonyaka.

Umbuzo Ovame ​​Ukubuzwa

Ishaya kanjani inhliziyo yenja?

Uzozwa ukushaya kwenhliziyo okusheshayo emidlwaneni kunasezinja ezindala nezindala. Ukushaya kwenhliziyo okujwayelekile komdlwane kuphakathi kokushaya kuka-100 no-120 ngomzuzu. Cishe amabhithi angu-90 kuya kwangu-100 ngomzuzu enjeni endala, namabhithi angu-70 kuya kwangu-80 ngomzuzu enjeni endala.

Inja inamavalvu enhliziyo amangaki?

Inhliziyo inamavalvu enhliziyo amane esewonke. Ezimbili zazo zitholakala phakathi kwama-atria amabili enhliziyo namagumbi amabili enhliziyo (ama-ventricles).

Ingakanani inhliziyo yenja?

Silinganise inhliziyo, futhi i-axis longitudinal kanye ne-axis eguquguqukayo yenhliziyo iguqulwa ibe ubude be-thoracic vertebrae ngokusho kokucaciswa okuthile. U-Faust ulinganise ama-vertebrae angu-13.2, evamile inani lika-9-10.5, ngokuhlukahluka okuhlobene nohlobo.

Kungani inhliziyo yenja ikhula?

Isifo se-valvular esingapheli siyimbangela ehamba phambili yokuhluleka kwenhliziyo ezinjeni. Ivela kakhulu ezinjeni ezindala kanye nezinhlobo ezincane njengama-poodle nama-dachshunds. I-valve yenhliziyo ishubile futhi ayivaleki ngokuphelele ngokushaya kwenhliziyo ngakunye. Lokhu kubangela ukuthi igazi ligeleze libuyele emithanjeni nasezithweni.

Yini ebangela ukuboshwa kwenhliziyo ezinjeni?

Uma inja yakho idle inani elikhulu le-caffeine, ingangena ngisho nase-coma futhi ibanjwe inhliziyo. Izimpawu zokuqala zokudakwa kwe-caffeine zivela ngemuva kwamahora ama-2 kuye kwamane.

Kungani izinja zingakwazi ukuhlaselwa yinhliziyo?

Ingozi yokuhlaselwa yinhliziyo ezilwaneni nayo iyancipha ngokunqunywa kofuzo - okuhlukile kwe-lipid metabolism. Ngenxa yalokho, ingozi yokuthuthukisa i-atherosclerosis ezilwaneni iphansi kakhulu, kodwa hhayi zero.

Kungani inja ifa ngokuzumayo?

Kunezizathu eziningi zokuthi isilwane sakho singafa ngokuzumayo. Ngesici esizuzwe njengefa, ngenxa yesifo esingaziwa, noma ngenxa yokulimala. Esinye sezimbangela ezivame kakhulu isifo senhliziyo, ikakhulukazi i-cardiac arrhythmia, amahlule egazi, nesifo se-myocardial.

Kusho ukuthini uma izinja zihefuzela?

Izinja azikwazi ukujuluka futhi kudingeka ziphefumule ukuze zigweme ukushisa ngokweqile. Ngemva kokuzikhandla noma ekushiseni okukhulu, kubalulekile futhi ukuba inja iphefumule kakhulu. Uma inja ibhulukwe ngesikhathi noma ngemva kwenjabulo engokomzwelo, lokhu kungase futhi kuhlukaniswe njengokuziphatha okuvamile.