Cardiogenic kuvhunduka

Cardiogenic kuvhunduka kunoitika kana moyo wakakuvadzwa zvakanyanya zvekuti haugone kupa ropa rakakwana kunhengo dzemuviri.

Izvo zvinowanzoitika zvikonzero zvakakomba mamiriro emoyo. Zvizhinji zveizvi zvinoitika panguva kana mushure mekurwadziwa kwemoyo (myocardial infarction). Aya matambudziko anosanganisira:

• Chikamu chakakura chetsandanyama yemoyo chisingachafambi zvakanaka kana kusatombofamba zvachose
• Kutsemuka (kuputika) kwemhasuru yemoyo nekuda kwekukuvara kubva pakurwara kwemoyo
• Njodzi dzemwoyo dzinotyisa, senge ventricular tachycardia, ventricular fibrillation, kana supraventricular tachycardia
• Kushushikana pamwoyo nekuda kwekuvakwa kwemvura inoitenderedza (pericardial tamponade)
• Kubvarura kana kuputika kwemhasuru kana tendon inotsigira mavharuvhu emwoyo, kunyanya iyo mitral vharafu
• Kubvarura kana kutsemuka kwemadziro (septum) pakati pekurudyi uye kurudyi ventricles (yakadzika moyo makamuri)
• Inononoka kwazvo moyo rhythm (bradycardia) kana dambudziko nemagetsi system yemoyo (moyo block)

Cardiogenic kuvhunduka kunoitika kana moyo usingakwanise kupomba ropa rakawanda senge rinodiwa nemuviri. Zvinogona kuitika kunyangwe pasina kuve nekurwadziwa kwemoyo kana rimwe rematambudziko aya rikaitika uye moyo wako uchidonha kamwe kamwe.

Zviratidzo zvinosanganisira:

• Kurwadziwa pachifuva kana kumanikidzwa
• Coma
• Kuderedza weti
• Kukurumidza kufema
• Kukurumidza kupisa
• Ziya rinodikitira, ganda nyoro
• Musoro wakareruka
• Kurasikirwa kwekusvinura uye kugona kuisa pfungwa
• Kusazorora, kusagadzikana, kusagadzikana
• Kufema kwekufema
• Ganda rinonzwa kutonhorera pakubata
• Ruvara rweganda rakachenuruka kana ganda rakatsvuka
• Kushaya simba (thready) kupisa

Bvunzo icharatidza:

• Kuderera kweropa (kazhinji kazhinji pasi pe90 systolic)
• Ropa kumanikidza iro rinodonha anopfuura gumi mapoinzi kana iwe uchisimuka mushure mekurara (orthostatic hypotension)
• Kushaya simba (thready) kupisa
• Icho chinotonhora uye chine ganda ganda

Kuti uongorore kuvhunduka kwemoyo, catheter (chubhu) inogona kuiswa mumapapu arteri (kurudyi moyo catheterization). Bvunzo dzinogona kuratidza kuti ropa riri kutsigira kumusoro mumapapu uye moyo hausi kupomba mushe.

Miedzo inosanganisira:

• Catheterization yemwoyo
• Chest x-ray
• Coronary angiography
• Echocardiogram
• Electrocardiogram
• Nyukireya scan yemoyo

Zvimwe zvidzidzo zvinogona kuitwa kuti uone kuti nei moyo usiri kushanda nemazvo.

Miedzo yeLab inosanganisira:

• Arterial ropa gasi
• Ropa kemisitiri (chem-7, chem-20, electrolyte)
• Makemikari emwoyo (troponin, CKMB)
• Yakazara kuverenga ropa (CBC)
• Utachiona hunokurudzira hormone (TSH)

Cardiogenic kuvhunduka ndeyekurapwa kwekukurumidzira. Iwe unozofanirwa kugara muchipatara, kazhinji kazhinji muIntensive Care Unit (ICU). Chinangwa chekurapa ndechekutsvaga uye kubata chinokonzeresa chekuvhundutsa hupenyu hwako.

Iwe ungangoda mishonga yekuwedzera BP uye kugadzirisa moyo basa, kusanganisira:

• Dobutamine
• Dopamine
• Epinephrine
• Levosimendan
• Milrinone
• Norepinephrine
• Vasopressin

Iyi mishonga inogona kubatsira munguva pfupi. Izvo hazviwanzo kushandiswa kwenguva yakareba.

Kana kukanganiswa kwemoyo mutinhimira (dysrhythmia) kwakakomba, kurapwa nekukurumidza kungangodikanwa kudzoreredza yakajairika moyo mutinhimira. Izvi zvinogona kusanganisira:

• Magetsi "kuvhunduka" kurapa (defibrillation kana cardioversion)
• Kuisa pacemaker kwenguva pfupi
• Mishonga inopihwa kuburikidza netsinga (IV)

Iwe unogona zvakare kugamuchira:

• Mushonga wemarwadzo
• Okisijeni
• Mvura, ropa, uye zvigadzirwa zveropa kuburikidza netsinga (IV)

Mamwe marapirwo ekutyisidzira anogona kusanganisira:

• Catheterization yemoyo ine coronary angioplasty uye kunhuwa
• Kuongorora kwemoyo kutungamira kurapwa
• Kuvhiya kwemoyo (coronary artery bypass surge, kutsiva kwevhavha yemoyo, chishandiso chekuruboshwe chemhepo
• Intra-aortic balloon kupokana (IABP) kubatsira moyo kushanda zvirinani
• Pacemaker
• Ventricular anobatsira chishandiso kana imwe michina tsigiro

Munguva yakapfuura, iyo yekufa chiyero kubva ku cardiogenic kushamiswa kwakatangira kubva ku80% kusvika 90%. Muongororo dzichangoburwa, chiyero ichi chadzikira kusvika pa50% kusvika pa75%.

Kana cardiogenic kuvhunduka ikasarapwa, iwo maonero akashata kwazvo.

Zvinetso zvinogona kusanganisira:

• Kukuvara kwehuropi
• Itsvo kukuvara
• Kukuvara kwechiropa

Enda kuimba yekukurumidzira kana kufonera iyo yemuno emergency emergency (se911) kana uine zviratidzo zvekushushikana kwemoyo. Cardiogenic kuvhunduka ndeyekurapwa kwekukurumidzira.

Iwe unogona kudzikisa njodzi yekukudziridza cardiogenic kuvhunduka ne:

• Nekukurumidza kurapa chikonzero chayo (senge chirwere chemwoyo kana dambudziko remagetsi revhavha)
• Kudzivirira uye kurapa zvinokuvadza zvehosha yemoyo, senge chirwere cheshuga, kuwedzerwa kweropa, cholesterol yakawanda uye triglycerides, kana kushandisa fodya

Shock - cardiogenic

• Mwoyo - chikamu kuburikidza nepakati

Felker GM, Teerlink JR. Kuongororwa uye manejimendi yeakanyanya moyo kutadza. Mune: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Chirwere Chemwoyo cheBraunwald: A Chinyorwa cheCardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019: chitsiko 24.

Hollenberg SM. Cardiogenic kuvhunduka. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chits. 99.