USHAURI: Maumivu ya kifua upande wa kulia (Chest side pain)

[Napoleone]

Una TB kiongozi..na usipopata matibab utaugua serious,

Nenda kwenye hospital specila za magonjwa hayo,ukienda tuu hospital haraka haraka hawaez iona hyo TB,sabab hukohoi,na watachek xrays lazma wataona cyst..so fata ushaur wangu,nenda vituo vya tuberculosis ndo watakuelewa vzur

 

[Fedor von Bock]

Ct scan kwa chest pain ambayo hujajua kama ni ya moyo au mapafu...hii ni kutoelewa maana ya CT scan labda!
Kila kipimo kina maeneo yake...hauwezi kuwa na tatizo la moyo ukafanya CT scan wakati kuna ECHO na ECG.

.
ECHO na ECG ni preliminary investigation na sio confirmatory one,that means sensitivity na specificity bado not reliable.
Swali langu kwako ukifanya echo na ku-suspect kuwa ana CHD step inayo fuata ni ipi kama sio Cardiac CT-Angio. or Percutaneous Coronary Interventional. Bahati nzuri huyu jamaa kaisha kwambia kuwa ECHO na ECG vyote normal so kinacho fuata nini kama sio CT Scan (Cardiac CT) or Percutaneous Coronary Intervention.
Ukipata muda soma paper hizi mbili utagundua kuwa Cardiac CTA is more sensitive kuliko echo na ecg

Cardiac CT angiography for evaluation of acute chest pain
The International Journal of Cardiovascular Imaging. January 2016, Volume 32, Issue 1, pp 101–112| Cite as
Cardiac CT angiography for evaluation of acute chest pain

Prognostic value of CT angiography for major adverse cardiac events in patients with acute chest pain from the emergency department: 2-year outcomes of the ROMICAT trial.
JACC Cardiovasc Imaging. 2011 May;4(5):481-91. doi: 10.1016/j.jcmg.2010.12.008. Prognostic value of CT angiography for major adverse cardiac events in patients with acute chest pain from the emergency department: 2-year outcome... - PubMed - NCBI

Usefulness of 64-slice cardiac computed tomographic angiography for diagnosing acute coronary syndromes and predicting clinical outcome in emergency department patients with chest pain of uncertain origin.
Circulation. 2007 Apr 3;115(13):1762-8. Epub 2007 Mar 19.
Usefulness of 64-slice cardiac computed tomographic angiography for diagnosing acute coronary syndromes and predicting clinical outcome in emergenc... - PubMed - NCBI

 

[Jiggy El Jefe]

Safi sana mkuu umejibu vizuri maswali!
kilichonistua ni huyo mtaalamu wa moyo kukupa dawa kama Carbamezapine.
ECHO yake sio standard!

ila kama Xray na ECG zote zinaonesha moyo umetanuka si ajabu kuna kitu kinakusumbua kwenye moyo!

ECG ambayo tulitegemea iondoe mzizi wa fitina kama tatizo lina originate kwenye moyo umeiweka nusu yake.

labda nkuoneshe ECG paper inakua hivi na mawimbi fulani hivi kama hapa chini.

View attachment 832279

vinginevyo ume fall kwenye mikono isiyo sahihi!

Hizi hapa mkuu

 

[Jiggy El Jefe]

Una TB kiongozi..na usipopata matibab utaugua serious,

Nenda kwenye hospital specila za magonjwa hayo,ukienda tuu hospital haraka haraka hawaez iona hyo TB,sabab hukohoi,na watachek xrays lazma wataona cyst..so fata ushaur wangu,nenda vituo vya tuberculosis ndo watakuelewa vzur

Sawa mkuu ntaenda hospital za hayo mambo, ila TB haiwez onekana kww xray?? i mean mapafu yalioathirika hayafahamiki kwa xray? maana nilipiga na haikua na tatizo lolote kuhusiana na hayo.

 

[Njunwa Wamavoko]

Hizi hapa mkuuView attachment 832708View attachment 832709

Hapo sasa umenena.
Hiyo ECG ni abnormal kwa kifupi na naona inaendana na tatizo lako.
nshaona T wave abnormality kwenye lead I na II na ST segment abnormality kwenye Precodial leads ambayo yaweza kuwa sababu ya LVH with repolarization abnormality.
Ntakueleza baada kidogo nkiwa nimetulia

 

[Njunwa Wamavoko]

.
ECHO na ECG ni preliminary investigation na sio confirmatory one,that means sensitivity na specificity bado not reliable.
Swali langu kwako ukifanya echo na ku-suspect kuwa ana CHD step inayo fuata ni ipi kama sio Cardiac CT-Angio. or Percutaneous Coronary Interventional. Bahati nzuri huyu jamaa kaisha kwambia kuwa ECHO na ECG vyote normal so kinacho fuata nini kama sio CT Scan (Cardiac CT) or Percutaneous Coronary Intervention.
Ukipata muda soma paper hizi mbili utagundua kuwa Cardiac CTA is more sensitive kuliko echo na ecg

Cardiac CT angiography for evaluation of acute chest pain
The International Journal of Cardiovascular Imaging. January 2016, Volume 32, Issue 1, pp 101–112| Cite as
Cardiac CT angiography for evaluation of acute chest pain

Prognostic value of CT angiography for major adverse cardiac events in patients with acute chest pain from the emergency department: 2-year outcomes of the ROMICAT trial.
JACC Cardiovasc Imaging. 2011 May;4(5):481-91. doi: 10.1016/j.jcmg.2010.12.008. Prognostic value of CT angiography for major adverse cardiac events in patients with acute chest pain from the emergency department: 2-year outcome... - PubMed - NCBI

Usefulness of 64-slice cardiac computed tomographic angiography for diagnosing acute coronary syndromes and predicting clinical outcome in emergency department patients with chest pain of uncertain origin.
Circulation. 2007 Apr 3;115(13):1762-8. Epub 2007 Mar 19.
Usefulness of 64-slice cardiac computed tomographic angiography for diagnosing acute coronary syndromes and predicting clinical outcome in emergenc... - PubMed - NCBI

Uko sawa mkuu ila hauwezi sema History,CXR,ECG na ECHO ni ngojera na si watu wote wanaweza afford hizo gharama za CT angio ambayo last time nimeona mtu kafanyiwa kwa 2M hapo JKCI.

 

[Jiggy El Jefe]

Hapo sasa umenena.
Hiyo ECG ni abnormal kwa kifupi na naona inaendana na tatizo lako.
nshaona T wave abnormality kwenye lead I na II na ST segment abnormality kwenye Precodial leads ambayo yaweza kuwa sababu ya LVH with repolarization abnormality.
Ntakueleza baada kidogo nkiwa nimetulia

Ntashukuru sana mkuu, niko hapa nakusubiri.

 

[Njunwa Wamavoko]

Ntashukuru sana mkuu, niko hapa nakusubiri.

hellow Mkuu nimekaa nikaingalia ECG Yako kwa mda kidogo ambayo naona ulifanya mwezi wa nne mwezi mmoja baada ya maumivu kuanza!
Changamoto kadhaa zipo katika hiyo ECG.
kwanza,ECG hiyo haina vi Box ambavyo vinasaidia kuhesabu kama mawimbi ya moyo yana shida au yapo kawaida.(japo kwa uzoefu unaweza kukadiria)
pili,Kwa kuwa una moyo ulotanuka Left ventricle Hypetrophy(LVH) hizo abnormality zinazoonekana kwenye V1-V6 ni vigumu kujua kama zipo sababu ya moyo kutanuka au zipo kwa sababu ya Pericarditis(nimeileza huko nyuma) au Heart attack au waweza kuita moyo kukosa oxygen(ndo maana mdau akakushauri utumie nitroglycerin hapo awali).
Na kama labda moyo ulishapata injury(Old Heart attack) ndo ukafanya ECG i.e mwezi mmoja mbele... basi changes zake haziendani na hizo kwenye ECG yako.
changes zilizopo kwenye Lead I na II pekee ziko incoclusive ku localize matatizo tunayo ya suspect.

Hivo mpaka hapo hatuwezi jua tatizo linatokea kwenye mapafu au moyo...hivo mimi ningeshauri uende hospitali ambayo iko reliable kidogo walau ya mkoa uweze kuonana na daktari huko umueleze hizo sequences zote ulizopitia ushauri uloupata hapa,huku ukiwa na majibu yako.
Na kama utaweza ufanyiwe extensive workup kwa vipimo vya kuaminika maana ECHO yako I doubt kama ni standard na ECG pamoja na mapungufu yake bado iko incoclusive.
Kuna vipimo vingine kadhaa kama wingi wa cholesterol au Viambatanishi vya heart attck kama troponin ingefaa ufanyiwe.

 

[Sugamadex]

Naona kuna wadau juu wamekupa ushauri na info zaidi especially Njunwa Wamavoko, hivyo basi kwa muonekano wa ECG yako ingawa in reality haiko standard pamoja na history uliyoongezea ninaweza kuwa haya,
DIAGNOSIS
1)Myocardial Infarction(MI)
-Hii ungeweza kuiconfirm au rule out simply with NITROGLYCERIN.
VIPIMO
a)Cardiac Enzymes, ie Tropinins.
b)Better and standard ECG.

DIFFERENTIAL DIAGNOSIS
1)Angina Pectoris
2)Pleurisy pain ambayo inaweza kusababishwa na infection yoyote ile kwenye mapafu(Ingawa maumivu ya upande mmoja ni nadra sana kama sababu ni systemic infection, unless iwe ni local infection especially from something like Abscess, etc due to TB).
3) Full TB work out. Kwa TB hata kama huna makohozi watachukua hata mate na kufanya Gene X-pert.

NB :Usiende vichochoroni, jaribu kwenda hospital inayoeleweka, CARBAMAZEPINE si dawa ya ugonjwa wa moyo, nachelea kusema uliyekutana naye si Daktari wa magonjwa ya moyo(ie Cardiologist).

All the best.

 

[Mukson]

Habari za Muda huu ndugu zangu.

Tusaidiane kidogo kwa mawazo au ushauri kwa yoyote mwenye ufahamu au uelewa wa jambo hili.

Kwenye kipindi cha mwezi ww tatu mwishoni nlikua najiskia maumivu upande wa kulia ww kifua yaliopanda mpaka shingoni, begani na kichwani kidogo upande huo uko wa kulia. Yalikua nayasikia nikivuta hewa kawaida (kupumua), kukohoa au muda mwingi nikiwa nimelala.

Nilienda hospital ya private, wakasema wanipime pneumonia, ila hakukua na dalili halisi, hivyo doctor akanishauri nitumie antibiotics za pneumonia, week moja baaae tatizo halikuisha, nikarud hospital nyingine, nikamuelezea daktari akanipa dawa za pink- ethromycin (Sina hakika na spelling). na sindano ya maumivu...wakat natumia maumiv yanaenda kama yanapungua ila dose ikiisha yapo palepale. Mara ya tatu nikaenda kupima H.pylori wakasema iko positive, hivyo nikapewa Heligo kit ya siku 7...wakat natumia tatizo linapotea ila ikiisha linarudi

Mara ya nne nikaenda hospital tena nikapigwa xray ya kifua, doctor akasema anaona kama moyo umetanuka kidogo, so niende kwa daktari maalum wa magonjwa ya moyo pengine hilo ndo tatizo.

Nilionana na daktar wa magonjwa ya moyo katika clinic yake, akanipima vipimo viwili, ECHO na ECG. na alinambia kua haoni tatizo linalohusiana na moyo, na pia nlimueleza kuhusu Hpylori kuwa positive last time nilivyopia, akaniuliza kama nna dalili za vidonda, nikamwambia sina...since sijawah sumbuliwa na tumbo ama hata nikila vyakula ambayo haviendani na vidonda sijawah kuumwa. Daktar akasema Kua positive haimaanishi una ulcers ila ye alisema anaona kama kifua kinabana upande mmoja, alinipa dawa nikatumia, tatizo likaisha kwa muda....ila sasa limerud tena kuna maumiv sana upande wa kulia wa kifua kama vile kuna kidonfa ndani au kama mtu aliegongwa na chuma eneo hilo...hasa nikiwa nimejilaza au kukohoa ama ata kupiga chafya.

Naombeni ushauri kwa yoyote mwenye ufahamu ama hata uelewa juu ya hili, tafadhali.

Mkuu samahan namie pia nasumbuliwa na tatizo kma Hili nimezunguka hospital lakin bado sijapta suluhisho vip ulipata mwenzangu ulifanikiwa kupata tiba?

 

[chisluk]

Mkuu samahan namie pia nasumbuliwa na tatizo kma Hili nimezunguka hospital lakin bado sijapta suluhisho vip ulipata mwenzangu ulifanikiwa kupata tiba?

Mkuu samahan namie pia nasumbuliwa na tatizo kma Hili nimezunguka hospital lakin bado sijapta suluhisho vip ulipata mwenzangu ulifanikiwa kupata tiba?

na mimi nasubiri jibu lake

 

[airwing]

Wakuu habarini za asbh Na Mimi Ni muhanga wa tatizo Kama ndg yangu, hapo Ni ndio sababu ya kufuatilia tatizo hili ili kupata suluhisho.
Week Sasa nasumbuliwa na tatizo la kifua kuuma upande mmj wa kulia hasa wakati wa kulala usiku. Nilijarb kuenda hospital nikaonana na Daktari nikafanyiwa vipimo ikiwemo ECG na vidonda vya tumbo, Majibu yakaja kwamba Nina vidonda vya tumbo Ila ECG ilionesha kwamba moyo wangu unapiga Kasi kidogo 133/76 Ila Daktari akasema sio shida sana... Week Sana natimiza natumia dawa hizo lakn nafuu Hakuna, by professional Mimi Ni dereva na ninafanya Kazi kwenye NGO na kila siku naendesha Gari kubwa asbh mpk usiku ninaporudi..
Mwanzoni nilihisi Ni tatizo la misuli tu nikatenga mda wa kupumzika Ila naona ttz linaendelea mpk kufikia kwenda hospital..
Jamani kifua kinauma unapofika wakati wa kulala, Kuhema kwa nguvu, kukohoa au kwikwi labda au kupiga muayo, Ila maumivu hata Ni ya ndani kabisa shughuli zingine unaweza nikafanya Kama kubeba kitu kizito, kuendesha Gari lakini Sasa kwenye upande wa kulala au kulalia huo upande Ni maumivu makali Sana....
Msaada wanandugu

 

[Luvako1991]

Ct scan kwa chest pain ambayo hujajua kama ni ya moyo au mapafu...hii ni kutoelewa maana ya CT scan labda!
Kila kipimo kina maeneo yake...hauwezi kuwa na tatizo la moyo ukafanya CT scan wakati kuna ECHO na ECG.

Jaman hata Mimi naombeni ushauri ninatatzo la kifua kubana , iko hivo kifua kilinibana ghafla tangu mwaka Jana , lakin hospital nimeenda kuanzia bugando hata mhimbili , kila nikipim naambiwa sina tatzo ila navyoumwa ni hivi

Nikiamuka asubhi najisikia vzr kabisa kma sina tazo ila kadili muda utakavyokuwa unaenda ndo kifua kinazid bana na kuchoka sana , vipmo ambavyo nimepima ni ,echo , ecg , inhale air and exhale air capacity, dam , cholesterol na mengine mengi lakin tatzo halionekan kwa hivyo vipimo vyote nifanye nin maana changamoto ni kifua tu kubana na kuchoka muda mwingine had kichwa kinauma

 

[The Sunk Cost Fallacy 2]

Wataalamu mbona mimepotea?

 

[Lotus 123]

Nenda kwa wamasai utatibika kirahisi

 

[Must1]

1. Maumivu yapo chini ya titi (infra mammary) la upande wa kulia, kias kwamba hata nikibonyeza panauma.
2.Kukohoa sio ugonjwa yaan nikijaribu tu kujikoholesha ili nipime maumiv...ila sikuwah kukohoa kama ugonjwa, nlikua nafanya kama nakohoa ndo nikawa naskia maumiv pia.
3.x-ray nilifanya, na doctor alisema moyo unaonekana kama umetanuka kidogo sana, ila baada ya ECG na ECHO, doctor wa moyo alisema moyo kwa size uliotanuka sio tatizo kubwa la kufanya kuwe na maumiv, na alishaur tu nikifanya mazoez litaisha hilo, ila yeye alisema anaona kama kifua kinabana upande huo, kama mtu alietumia sigara ama kufanya kazi kwenye mavumbi sana.
4.Dawa za pneumonia nazokumbuka walinipa tu Ethromycin kama skosei jina...na zingine zilikua antibiotic za rangi mbili(kijani na nyeupe) sizikumbuk jina.
5.Dawa za Heligokit nlitumia kabla ya kuonana na mtaalam wa moyo, ila nlivomaliza maumiv yalipogoma kutoka, ndio nkaonana na huyo mtaalam akaniuliza kama nna dalili za vidonda, nikamwambia hapana...akasema tatizo haliwez kua ni vidonda.
6. Dawa za daktar wa moyo zilikua dose tatu, naikumbuka moja iliitwa "carbamazepina" na ingine ilikua ya rangi mbili mfumo wa antibiotics zile kama amoxlyn
7. Nliwah kutumia sigara kipindi flani ila nilishaamua kuacha., maana sikufikia pia stage ya kutokushindwa kuacha.
8. Sifanyi kazi mazingira hayo wala ya mavumbi.
9.Sijawah kupata ajali wala kuumia upande huu mmoja...yalianzaga tu kiutan kama shingoni nkajua nimelala vibaya...nikawa nachua na dawa ila yanarudi ndo yakashuka ad kifuani... mpaka so sasa ni kifuani tu chini ya titi...Sio sehem nyingine tena.

Vipimo vya ECG na ECHO ni hivi:
View attachment 831976View attachment 831979

Kiongozi samahani na mimi nina shda kama hii naomba nsaidie ulitumia nn had ukapona?..

 

[Must1]

Kiongozi samahani na mimi nina shda kama hii naomba nsaidie ulitumia nn had ukapona?..