Izibonakaliso zokuqala zokuhluleka kwenhliziyo yizihloko zendaba. Ukuhluleka kwenhliziyo kungabonakala:
• ukhathala okwandayo - ikakhulukazi ngesimo esibi;
• ukuphefumula - kuqala kubonakala ngokuzikhandla ngokomzimba, kepha ngezigaba kamuva kungase kwenzeke nokuphumula;
■ ukukhwehlela nge-white detectoration emhlophe noma ebomvu, ehambisana nokugcinwa kwamanzi kanye nemicimbi ye-pulmary congestive;
• i-edema - ukuqoqwa kwezidakamizwa ezingaphezu kwamanzi; zitholakale ezigulini zeziguli ezihambahambayo nasesifundeni se-lumbosacral nasezinkalweni - ku-recumbent;
• ukulahlekelwa isisindo - lesi sifo sivame ukuhambisana nokuncipha kwesifiso sokudla, isicanucanu nokuhlanza;
• ubuhlungu besisu - kungenzeka ngenxa yezimo ezinzima esibindi.
Ukuhluleka kwenhliziyo kwenzeka lapho inhliziyo ibhidliziwe noma ilayishwa ngokweqile - isibonelo, ngokumelene nesinye sezifo ezilandelayo:
• Isifo senhliziyo seCoronary - esivame ukuhambisana nesilonda se-myocardium ye-ventricle kwesokunxele senhliziyo;
• Ukugula okungapheli kwesisu senhliziyo - isibonelo, ngenxa yezifo ezibangelwa amagciwane noma utshwala;
• ukushisa komfutho wegazi - kuholela ekunciphiseni kwendonga ebusayo, okuyinkimbinkimbi yomsebenzi wenhliziyo;
• I-myocarditis ephuthumayo noma engapheli (ukuvuvukala kwemisipha yenhliziyo) - ingaba yinkimbinkimbi yezifo ezibangelwa amagciwane nezifo;
■ ukukhubazeka kwenhliziyo - izinguquko ezintsheni zezinhliziyo zendalo noma ezilimazayo;
• Ukuqedwa kwe-aorta - congenital pathology;
• ukungafani komkhiqizo we-cardiac wamaminithi kuya kwezidingo zomzimba - uma isilwane sisebenza ngomthwalo ophezulu ukugcwalisa izicubu nge-oxygen;
• Ukwephulwa kwesiphambano esiyingozi - ngokwesibonelo, ukuqina okungapheli komkhawulo we-pericardium kunciphisa igazi enhliziyweni, ngenxa yalokho ukugcinwa kwe-circulation kusebenza ngokulayisha okuphakanyisiwe.
Imisebenzi yenhliziyo
Inhliziyo iyimpompi ye-muscle ephoqa igazi kuzo zonke izitho, igcwalisa nge-oksijeni nezakhi. Inhliziyo yenza ama-strokes angama-100 000 ngosuku, ukushaya ama-25-30 amalitha wegazi ngomzuzu. Inhliziyo ihlukaniswe engxenyeni yesobunxele nelungile, ngayinye equkethe i-atrium ne-ventricle. Igazi elimpofu okwenziwe umoya ovela emithanjeni engenalutho lingena ku-atrium efanele. Ukusuka lapha kuqhunywe nge-ventricle efanele ezitsheni zamaphaphu. I-atrium yangakwesokunxele ithola igazi le-oxygen-elithuthukisiwe egazini le-pulmonary, bese liyibeka engxenyeni engakwesokunxele, lapho iqhutshelwa khona ukuhanjiswa okukhulu. Ama-valves enhliziyo avimbela ukubuya kwegazi. I-muscle yenhliziyo inegazi layo, elinikezwa yi-artery coronary. Igobolondo lemibala emibili elimboze inhliziyo libizwa ngokuthi i-pericardium. Ukutholakala kokuhluleka kwenhliziyo kwenziwa ngesisekelo semininingwane yomtholampilo, kodwa izifundo ezengeziwe zingacacisa izimbangela zayo futhi zikhethe ukwelashwa okungcono kakhulu. Ukusola ukuhluleka kwenhliziyo kukhona izimpawu ezifana nokuphefumula nokuvuvukala.
Ukuhlolwa
Ngesikhathi kuhlolwa ukuhlolwa okulandelayo kwenziwa:
• Ukuhlolwa kwegazi - ukuhlolwa okukhulu kwegazi, ukuhlolwa kwezinto eziphilayo ukuhlola ukusebenza kwesibindi sesibindi, izinso kanye ne-thyroid; ukuzimisela izinga lezinyimba zenhliziyo (nge-infarction ye-myocardial yanda);
• I-X-ray yesifuba sezingxenyeni zesifuba - ukubona ukunyuka ngobukhulu benhliziyo, ukutholakala kwamanzi emaphashini, ukumboza izindonga ze-arteries;
• i-electrocardiogram (ECG) - ezigulini ezinenhliziyo, izinguquko ezingavamile ze-ECG zivame ukugcinwa;
• I-echocardiography iyisifundo esiyinhloko esihlola umsebenzi we-ventricle kwesokunxele, ama-valve enhliziyo kanye ne-pericardium; umbala wezinhlayiya zombala - usetshenziselwa ukutadisha isimo se-valves yenhliziyo nokugeleza kwegazi okungenayo i-intracardiac;
■ ukuphazamisa inhliziyo - kukuvumela ukuba ulinganise ukucindezela ezinkampanini zenhliziyo kanye nemikhumbi esemqoka;
• Ukulayisha ukuhlolwa - kukuvumela ukuthi uhlole ukuphendula kwenhliziyo emithwalweni yomzimba.
Iziguli ezinokukhubazeka kwenhliziyo ezivuthiwe ngokuvamile ziboniswa esibhedlela. Uma kunokwenzeka, phatha izifo ezibangelwa ukwehluleka kwenhliziyo, njenge-anemia. Ukuhlinzeka ukuphumula kwesiguli kunganciphisa umthwalo enhliziyweni, kodwa uhlale embhedeni kufanele ukhawulelwe ukuze ugweme ukwakheka kwezindwangu zegazi ezitsheni zamalungu angaphansi. Zonke izindlela zokwelapha zenziwa kahle kakhulu endaweni yokuhlala, hhayi phansi. Ukudla kufanele kube izingxenye ezincane, nokuvinjelwa kasawoti. Utshwala nokubhema akufakiwe. Ukwelapha ukuhluleka kwenhliziyo, lezi zidakamizwa ezilandelayo ziyasetshenziswa: izidakamizwa - ukwandisa inani lomkhiqizo, umfutho wegazi ophansi, ukunciphisa ukuvuvukala kanye ne-dyspnea; i-beta-blockers - ivuselela inhliziyo, ihlise izinga lokushaya kwenhliziyo, kodwa ekuqaleni kokungenwa kwayo, ukulawula udokotela kuyadingeka; i-angiotensin-ukuguqula i-enzyme (i-ACE inhibitors) - ingavimbela ukuqhubeka kwesifo, nokunciphisa ukufa okuvela ekuhlulekeni kwenhliziyo okungapheli kanye ne-infarction ye-myocardial. Ukukhethwa kokuqala kwesilinganiso kufanele kwenzeke ngaphansi kokuqondiswa kukadokotela.
• Abaphikisi be-angiotensin II abamukelayo - okufana nomphumela wabo ku-ACE inhibitors, kodwa banemiphumela emibi kakhulu;
• i-digoxin - ivame ukungabangela ukuhlukumeza, ngaphezu kwalokho, kuvame ukuthi kunezinkinga ngokukhethwa kwesilinganiso. It isetshenziswa ngokuyinhloko ukumisa isigqi senhliziyo ngama-arrhythmias.
Iziguli eziningi ziboniswa ukwelashwa okuhlangene nezidakamizwa eziningana. Ukuhluleka kwenhliziyo kungathuthuka kunoma yikuphi ubudala, kodwa kubonakala ikakhulukazi asebekhulile. Ukuhluleka kwenhliziyo okungapheli kunesilinganiso esingu-0,4 kuya ku-2% yabantu abadala. Njengoba uneminyaka yobudala, ingozi yokuthuthukisa ukuhluleka kwenhliziyo ikhula kancane kancane. Phakathi kwazo zonke iziguli eziya ezikhungweni zezokwelapha eRussia, ama-38.6% anezibonakaliso zokuhluleka kwenhliziyo engapheli. Naphezu kokuthuthukiswa kwezinqubo zokwelashwa, ukuchazwa kweziguli ezinokuhluleka kwenhliziyo ngokuvamile kuvame ukungalungi. Izinga lokusinda phakathi kwazo zimbi kakhulu kunezinye izinhlobo ezivamile zomdlavuza. Iziguli ezingaba ngu-50% ezinezinhliziyo ezihlulekayo ziyafa zingakapheli iminyaka emibili kusukela ngosuku lokuxilongwa.