Cardiac amyloidosis

Cardiac amyloidosis chirwere chinokonzerwa nekuiswa kweprotein isina kujairika (amyloid) mumoyo tishu. Mari idzi dzinoomesera moyo kuti ushande nemazvo.

Amyloidosis iboka rezvirwere umo mapundu emapuroteni anonzi amyloid anovaka mumatumbu emuviri. Nekufamba kwenguva, mapuroteni aya anotsiva zvakajairika zvinyama, zvichikonzera kukundikana kwenhengo inobatanidzwa. Kune akawanda mafomu amyloidosis.

Cardiac amyloidosis ("stiff heart syndrome") inoitika kana amyloid deposits yatora nzvimbo yemhasuru yemoyo yakajairika. Iyo ndiyo chaiyo mhando yekudzivirira cardiomyopathy. Cardiac amyloidosis inogona kukanganisa mafambiro anoita magetsi nemoyo (conduction system). Izvi zvinogona kutungamira mukurova kwemoyo zvisina kujairika (arrhythmias) uye zvisirizvo zvemasaini emoyo (block block).

Mamiriro acho anogona kugarwa nhaka. Izvi zvinonzi zvemhuri yemoyo amyloidosis. Inogona zvakare kukura semhedzisiro yechimwe chirwere senge rudzi rwefupa uye kenza yeropa, kana semhedzisiro yeimwe dambudziko rekurapa rinokonzera kuzvimba. Cardiac amyloidosis yakajairika mune varume kupfuura vakadzi. Chirwere ichi hachiwanzo kuwanikwa muvanhu vari pasi pemakore makumi mana.

Vamwe vanhu vanogona kunge vasina zviratidzo. Kana zviripo, zviratidzo zvinogona kusanganisira:

• Kunyanyisa kuita weti husiku
• Kuneta, kuderedzwa kugona kurovedza muviri
• Palpitations (kunzwa kwekunzwa kurova kwemoyo)
• Kupfupika kwemweya nekuita
• Kuzvimba kwedumbu, makumbo, makumbo, kana chimwe chikamu chemuviri
• Kunetseka kufema paunenge wakarara pasi

Zviratidzo zvemoyo amyloidosis zvinogona kuve zvinoenderana neakawanda mamiriro akasiyana. Izvi zvinogona kuita kuti dambudziko riome kuongorora.

Zviratidzo zvinogona kusanganisira:

• Mheremhere isina kujairika mumapapu (mapapu anotsemuka) kana kugunun'una kwemoyo
• Ropa reropa rakaderera kana kudonha paunosimuka
• Yakawedzera mitsipa mitsipa
• Chiropa chakazvimba

Iyi bvunzo inotevera inogona kuitwa:

• Chifuva kana dumbu CT scan (inofungidzirwa se "standard yegoridhe" kubatsira kuongorora mamiriro aya)
• Coronary angiography
• Electrocardiogram (ECG)
• Echocardiogram
• Magnetic resonance imaging (MRI)
• Nyukireya mwoyo inoongorora (MUGA, RNV)
• Positron emission tomography (PET)

ECG inogona kuratidza matambudziko nekurova kwemoyo kana chiratidzo chemwoyo. Inogona zvakare kuratidza yakaderera masaini (anonzi "low voltage").

Bhiopsy yemoyo inoshandiswa kusimbisa kuongororwa. Biopsy yeimwe nzvimbo, senge dumbu, itsvo, kana mwongo wemapfupa, inowanzoitwa futi.

Anokuchengetedza hutano anogona kukuudza kuti uchinje zvaunodya, kusanganisira kudzora munyu nemvura.

Ungangoda kutora mapiritsi emvura (diuretics) kubatsira muviri wako kubvisa zvakawandisa mvura. Iye mupi anogona kukuudza kuti uzviyese zuva rega rega. Kurema kuwedzera kwemapirogiramu matatu kana anopfuura (1 kilogiramu kana kupfuura) pamusoro pe1 kusvika kumazuva maviri zvinogona kureva kuti pane zvakawandisa mvura mumuviri.

Mishonga inosanganisira digoxin, calcium-chiteshi blockers, uye beta-blockers inogona kushandiswa muvanhu vane atrial fibrillation. Zvisinei, mishonga inofanira kushandiswa nekuchenjerera, uye muyero unofanirwa kunyatsoongororwa. Vanhu vane cardiac amyloidosis vanogona kuve vakawedzera kunetseka kune mhedzisiro yemishonga iyi.

Mimwe mishonga inogona kusanganisira:

• Chemotherapy
• Inodyara cardioverter-defibrillator (AICD)
• Pacemaker, kana paine matambudziko nezviratidzo zvemwoyo
• Prednisone, mushonga unorwisa-kuzvimba

Kuiswa kwemoyo kunogona kutariswa kune vanhu vane mamwe marudzi eamyloidosis vane moyo wakashata unoshanda. Vanhu vane nhaka amyloidosis vangangoda chiropa chinoiswa.

Munguva yakapfuura, moyo amyloidosis yaifungidzirwa kunge isingarapike uye inokurumidza kuuraya chirwere. Nekudaro, iyo munda irikuchinja nekukurumidza. Mhando dzakasiyana dzeamyloidosis dzinogona kukanganisa moyo nenzira dzakasiyana. Dzimwe mhando dzakanyanya kuomarara kupfuura dzimwe. Vanhu vazhinji vanogona kutarisira kurarama uye kuwana hupenyu hwakanaka hwemakore akati wandei mushure mekuongororwa.

Zvinetso zvinogona kusanganisira:

• Atrial fibrillation kana ventricular arrhythmias
• Kuunganidzwa kwemoyo kukundikana
• Mvura inovaka mudumbu (ascites)
• Kuwedzera kwekunzwa kune digoxin
• Kuderera kweropa uye dzungu kubva mukuwandisa weti (nekuda kwemushonga)
• Kurwara sinus syndrome
• Symptomatic cardiac conduction system chirwere (arrhythmias yakabatana nekusagadzikana kwekufambisa kwemafungiro kuburikidza nemutsipa wemwoyo)

Fonera mupiki wako kana iwe uine dambudziko iri uye nekudziridza zviratidzo zvitsva se:

• Dzungu paunoshandura chinzvimbo
• Kuwedzeredza uremu (fluid) kuwana
• Kuwedzeredza kurasikirwa uremu
• Kufenda zvitsinga
• Matambudziko akakura ekufema

Amyloidosis - mwoyo; Primary cardiac amyloidosis - AL mhando; Sekondari yemoyo amyloidosis - AA mhando; Stiff moyo chirwere; Senile amyloidosis

• Mwoyo - chikamu kuburikidza nepakati
• Dilated cardiomyopathy
• Bheopsy catheter

Falk RH, Hershberger RE. Iyo yakawedzeredzwa, inorambidza, uye infiltrative cardiomyopathies. 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: chits. 77.

McKenna WJ, Elliott PM. Zvirwere zve myocardium uye endocardium. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 54.