Endocarditis

Endocarditis iko kuzvimba kwemukati memukati memakamuri emoyo uye mavharuvhu emwoyo (endocardium). Iyo inokonzerwa nehutachiona kana, kashoma hutachiona hwefungal.

Endocarditis inogona kusanganisira yemwoyo mhasuru, yemagetsi mavharuvhu, kana lining yemoyo. Vamwe vanhu vanoita endocarditis vane:

• Kuremara kwekuzvarwa kwemoyo
• Yakakuvara kana isina kujairika moyo vharuvhu
• Nhoroondo ye endocarditis
• New moyo vharafu mushure mekuvhiyiwa
• Parenteral (intravenous) kupindwa muropa nezvinodhaka

Endocarditis inotanga apo hutachiona hunopinda muropa uye hwofamba kuenda pamoyo.

• Hutachiona hutachiona ndicho chinonyanya kukonzera endocarditis.
• Endocarditis inogona zvakare kukonzerwa nefungi, senge Candida.
• Mune zvimwe zviitiko, hapana chikonzero chinogona kuwanikwa.

Utachiona hunonyanya kupinda muropa panguva:

• Central venous yekuwana mitsara
• Jekiseni kushandisa zvinodhaka, kubva pakushandisa isina kuchena (isina kusimba) tsono
• Kuvhiya kwemazino kuchangobva kuitika
• Kumwe kuvhiya kana madiki maitiro kune yekufema turakiti, weti turakiti, hutachiona ganda, kana mapfupa uye mhasuru

Zviratidzo zve endocarditis zvinogona kukura zvishoma nezvishoma kana kamwe kamwe.

Fivha, kutonhora, uye kudikitira ndizvo zvinowanzoitika zviratidzo. Izvi dzimwe nguva zvinogona:

• Kuvapo kwemazuva pasati paonekwa zvimwe zviratidzo
• Huya uende, kana kuve unonyanya kuoneka panguva yehusiku

Iwe unogona zvakare kuve nekuneta, kushaya simba, uye kurwadziwa uye kurwadziwa mumhasuru kana majoini.

Zvimwe zviratidzo zvinogona kusanganisira:

• Nzvimbo diki dzekubuda ropa pasi pezvipikiri (splinter hemorrhages)
• Tsvuku, isina kurwadziwa ganda mavara pane zvanza nemakumbo (Janeway maronda)
• Dzvuku, mapundu anorwadza mumapedhi eminwe nezvigunwe (Osler node)
• Kupfupika kwemweya nekuita
• Kuzvimba kwetsoka, makumbo, dumbu

Anopa hutano anogona kuona kutsutsumwa kwemoyo mutsva, kana shanduko mune yekupedzisira moyo kugunun'una.

Kuongororwa kweziso kunogona kuratidza kubuda ropa muiyo retina uye nzvimbo yepakati yekuchenesa. Uku kutsvaga kunozivikanwa seRoth mavara. Panogona kunge paine zvidiki, zvinonongedza nzvimbo dzekubuda ropa pamusoro peziso kana maziso.

Miedzo inogona kuitwa inosanganisira:

• Ropa tsika yekubatsira kuona hutachiona kana chakuvhe chiri kukonzera hutachiona
• Yakazara kuverenga ropa (CBC), C-inoshanda mapuroteni (CRP), kana erythrocyte sedimentation mwero (ESR)
• Echocardiogram yekutarisa mavharuvhu emwoyo

Iwe ungangoda kuve muchipatara kuti utore maantibayoti kuburikidza nemutsinga (IV kana intravenously). Tsika dzeropa uye bvunzo zvichabatsira mupi wako kusarudza yakanakisa mishonga inorwisa mabhakitiriya.

Iwe unozobva wada kwenguva refu-refu antibiotic kurapa.

• Vanhu vanowanzoda kurapwa kwemasvondo mana kusvika matanhatu kuti vauraye mabhakitiriya ese kubva kumakamuri emoyo nemavharuvhu.
• Mishonga inorwisa mabhakitiriya inotangwa muchipatara inoda kuenderera mberi kumba.

Kuvhiya kutsiva vharuvhu yemoyo inowanzo kudikanwa kana:

• Hutachiona huri kupaza kuita zvidimbu zvidiki, zvichikonzera sitiroko.
• Munhu anokudziridza kutadza kwemoyo semhedzisiro yemagetsi mavharuvhu emoyo.
• Pane humbowo hwekuwedzera kukuvara kwemuviri.

Kuwana kurapwa kwe endocarditis ipapo ipapo kunovandudza mikana yemhedzisiro yakanaka.

Mamwe matambudziko akakomba anogona kukura anosanganisira:

• Kuputirwa kwehuropi
• Kumwe kukuvara kwemavharuvhu emoyo, zvichikonzera kutadza kwemoyo
• Kupararira kwehutachiona kune zvimwe zvikamu zvemuviri
• Sitiroko, inokonzerwa nemakunduru madiki kana zvidimbu zvehutachiona zvinotsemuka uye kuenda kuuropi

Fonera waunopa kana iwe ukaona zvinotevera zviratidzo panguva kana mushure mekurapwa:

• Ropa mune weti
• Kurwadziwa pachifuva
• Kuneta
• Fivhiri iyo isingaendi
• Kupindwa nechando
• Unhu
• Kushaya simba
• Kurera huremu pasina shanduko mukudya

IAmerican Heart Association inokurudzira kudzivirira mishonga inorwisa mabhakitiriya kune vanhu vari panjodzi yehutachiona hwe endocarditis, senge iine:

• Humwe hurema hwekuzvarwa kwemoyo
• Moyo kupinza uye mavhavha matambudziko
• Prosthetic moyo mavharuvhu (mwoyo mavharuvhu akaiswa nachiremba anovhiya)
• Nhoroondo yakapfuura ye endocarditis

Vanhu ava vanofanirwa kugamuchira maantibiotic kana vaine:

• Maitiro emazino ayo anogona kukonzera kubuda ropa
• Maitiro anosanganisira kufema turakiti
• Maitiro anosanganisira iyo weti turakiti system
• Maitiro anosanganisira ekugaya nzira
• Maitiro pazvirwere zveganda uye zvakapfava hutachiona hutachiona

Valve hutachiona; Staphylococcus aureus - endocarditis; Enterococcus - endocarditis; Streptococcus viridans - endocarditis; Candida - endocarditis

• Kuvhiya kwevhavha yemoyo - kubuda

• Mwoyo - chikamu kuburikidza nepakati
• Moyo - pamberi pekutarisa
• Janeway lesion - pedyo-kumusoro
• Janeway lesion pachigunwe
• Mavharuvhu emwoyo

Baddour LM, Freeman WK, Suri RM, Wilson WR. Utachiona hwemwoyo. 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. 73.

Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis muvakuru: kuongororwa, antimicrobial therapy, uye manejimendi ezvinetso: chirevo chesainzi chevashandi vezvehutano kubva kuAmerican Heart Association. Kutenderera. 2015; 132 (15): 1435-1486. PMID: 26373316 www.ncbi.nlm.nih.gov/pubmed/26373316.

Fowler VG, Bayer AS, Baddour LM. Inotapukira endocarditis. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits. 76.

Fowler VG, Scheld WM, Bayer AS. Endocarditis uye intravascular hutachiona. Mune: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, uye Bennett's Maitiro uye Maitiro Ezvirwere zvinotapukira. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015: chits. 82.