Rashin zuciya na zuciya

Mutuwar cututtukan zuciya yana faruwa lokacin da zuciya ta lalace sosai ta yadda ba ta iya samar da isasshen jini ga gabobin jiki.

Dalilin da ya fi dacewa shine yanayin zuciya mai tsanani. Yawancin waɗannan suna faruwa a lokacin ko bayan bugun zuciya (infarction myocardial). Wadannan rikitarwa sun haɗa da:

• Babban sashi na tsokar zuciya wanda baya motsi da kyau ko baya motsi kwata-kwata
• Karya budewa (fashewa) na tsokar zuciya saboda lalacewa daga bugun zuciya
• Bugun zuciya mai hadari, kamar su tachycardia na zuciya, fibrillation na ventricular, ko supraventricular tachycardia
• Matsi akan zuciya saboda tarin ruwa a kusa da ita (pericardial tamponade)
• Hawaye ko fashewar tsokoki ko jijiyoyi waɗanda ke tallafawa bawul na zuciya, musamman maɓallin mitral
• Hawaye ko fashewar bango (septum) tsakanin hagu da dama (ƙananan ɗakunan zuciya)
• Mai saurin jinkirin zuciya (bradycardia) ko matsala tare da tsarin lantarki na zuciya (ciwon zuciya)

Mutuwar cututtukan zuciya yana faruwa lokacin da zuciya ta kasa fitar da jini kamar yadda jiki ke buƙata. Zai iya faruwa koda kuwa ba'a samu bugun zuciya ba idan daya daga cikin wadannan matsalolin ya faru kuma aikin zuciyar ka ya fadi kwatsam.

Kwayar cutar sun hada da:

• Jin zafi ko matsin lamba
• Coma
• Rage fitsari
• Saurin numfashi
• Saurin bugun jini
• Gumi mai nauyi, fata mai laushi
• Haskewar kai
• Rashin faɗakarwa da ikon maida hankali
• Rashin natsuwa, tashin hankali, rikicewa
• Rashin numfashi
• Fata mai jin sanyi ga tabawa
• Launi mai launi ko fata mai laushi
• Rashin ƙarfi (tuni)

Wani jarrabawa zai nuna:

• Pressureananan jini (mafi sau da yawa ƙasa da 90 systolic)
• Ruwan jini wanda ya fadi sama da maki 10 idan ka tashi tsaye bayan ka kwanta (orthostatic hypotension)
• Rashin ƙarfi (tuni)
• Fata mai sanyi da clammy

Don bincika cututtukan zuciya, ana iya sanya catheter (bututu) cikin jijiyar huhu (ƙwayar zuciya ta dama). Gwaje-gwaje na iya nuna cewa jini yana dawowa cikin huhu kuma zuciya ba ta yin famfo da kyau.

Gwajin sun hada da:

• Cardiac catheterization
• Kirjin x-ray
• Magungunan jijiyoyin zuciya
• Echocardiogram
• Kayan lantarki
• Binciken nukiliya na zuciya

Sauran karatun ana iya yin su don gano dalilin da yasa zuciya bata aiki yadda yakamata.

Gwajin gwaje-gwaje sun haɗa da:

• Gas na jini na jini
• Kimiyyar jini (chem-7, chem-20, electrolytes)
• Cardiac enzymes (troponin, CKMB)
• Kammala ƙididdigar jini (CBC)
• Hormone mai motsa motsa jiki (TSH)

Rashin zuciya na Cardiogenic shine gaggawa na likita. Kuna buƙatar zama a asibiti, galibi a cikin Careungiyar Kulawa Mai ensivearfi (ICU). Manufar magani ita ce ganowa da magance matsalar girgiza don ceton ranka.

Kuna iya buƙatar magunguna don haɓaka hawan jini da inganta aikin zuciya, gami da:

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

Wadannan magunguna na iya taimakawa cikin gajeren lokaci. Ba a yawan amfani da su na dogon lokaci.

Lokacin da rikicewar rikicewar zuciya (dysrhythmia) ke da tsanani, ana iya buƙatar magani na gaggawa don dawo da hawan zuciya na yau da kullun. Wannan na iya haɗawa da:

• Wutar lantarki "girgiza" (defibrillation ko cardioversion)
• Dasa kayan bugun zuciya na ɗan lokaci
• Magungunan da ake bayarwa ta jijiya (IV)

Hakanan zaka iya karɓar:

• Maganin ciwo
• Oxygen
• Ruwa, jini, da kayan jini ta jijiya (IV)

Sauran jiyya don damuwa na iya haɗawa da:

• Cardiac catheterization tare da jijiyoyin jini angioplasty da stenting
• Kulawa da zuciya don jagorantar magani
• Yin aikin tiyata na zuciya (tiyatar zuciya ta jijiyoyin zuciya, maye gurbin bawul na zuciya, na'urar taimaka wajan hagu)
• Balaramar balan-balan na cikin-aortic (IABP) don taimakawa zuciya aiki da kyau
• Mai daukar ciki
• Na'urar taimaka na Ventricular ko wani tallafi na inji

A baya, yawan mutuwa daga bugun zuciya ya fara daga 80% zuwa 90%. A cikin karatun da aka yi kwanan nan, wannan ƙimar ya ragu zuwa 50% zuwa 75%.

Lokacin da ba a kula da girgizar zuciya ba, hangen nesa ba shi da kyau.

Matsaloli na iya haɗawa da:

• Lalacewar kwakwalwa
• Lalacewar koda
• Lalacewar hanta

Je zuwa dakin gaggawa ko kira lambar gaggawa ta gida (kamar 911) idan kuna da alamun cututtukan zuciya. Rashin zuciya na Cardiogenic shine gaggawa na likita.

Kuna iya rage haɗarin haɓakar zuciya ta zuciya ta:

• Da sauri magance dalilinsa (kamar ciwon zuciya ko matsalar bawul na zuciya)
• Hanawa da magance matsalolin haɗarin cututtukan zuciya, kamar ciwon suga, hawan jini, hauhawar cholesterol da triglycerides, ko amfani da taba

Shock - cardiogenic

• Zuciya - sashi ta tsakiya

Felker GM, Teerlink JR. Bincike da kuma kula da rashin saurin zuciya. A cikin: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald na Ciwon Zuciya: Littafin rubutu na Magungunan zuciya da jijiyoyin jini. 11th ed. Philadelphia, PA: Elsevier; 2019: sura 24.

Hollenberg SM. Rashin zuciya na zuciya. A cikin: Goldman L, Schafer AI, eds. Magungunan Goldman-Cecil. 26th ed. Philadelphia, PA: Elsevier; 2020: babi na 99.