Hewa puʻuwai

ʻO ke kū ʻole o ka puʻuwai kahi ʻano i hiki ʻole i ka puʻuwai ke pauma i ke koko waiwai nui i ke koena o ke kino me ka maikaʻi. ʻO kēia ke kumu o ka loaʻa ʻana o nā hōʻailona ma loko o ke kino.

ʻO ka puʻuwai puʻuwai pinepine pinepine kahi kūlana lōʻihi (mau), akā hiki koke mai paha ia. Hiki ke kumu ʻia e nā pilikia puʻuwai like ʻole.

Hoʻopili paha ke ʻano i ka ʻaoʻao ʻākau a i ʻole ka ʻaoʻao hema o ka puʻuwai. Hiki i nā ʻaoʻao ʻelua o ka puʻuwai ke hoʻopili pū.

Aia ka puʻuwai puʻuwai ke:

• ʻAʻole hiki i kāu puʻuwai puʻuwai ke hana maikaʻi maikaʻi. Kāhea ʻia kēia ʻo systolic puʻuwai puʻuwai, ai ʻole puʻuwai puʻuwai me kahi hapa liʻiliʻi e hoʻokuʻu ʻia (HFrEF).
• ʻOʻoleʻa kou puʻuwai puʻuwai a ʻaʻole ia e hoʻopiha i ke koko me ka maʻalahi ʻoiai ʻo ka mana pumping ka mea maʻamau. Kapa ʻia kēia me ka maikaʻi ʻole o ka puʻuwai diastolic, a i ʻole ka puʻuwai puʻuwai me kahi ʻāpana ejection mālama ʻia (HFpEF).

Ke emi a maikaʻi ʻole ka pauma ʻana o ka puʻuwai, e hoʻi paha ke koko i nā wahi ʻē aʻe o ke kino. Kūkulu paha ka wai i loko o nā akemāmā, ate, gastrointestinal tract, a me nā lima a me nā wāwae. Kapa ʻia kēia ʻo ka puʻuwai puʻuwai congestive.

ʻO nā kumu maʻamau o ka hōʻino puʻuwai ka:

• ʻO ka maʻi o ke aʻa aʻa (CAD), kahi ākea a ālai ʻia o nā kīʻaha koko liʻiliʻi e hāʻawi i ke koko a me ka oxygen i ka puʻuwai. Hiki i kēia ke hoʻonāwaliwali i ka puʻuwai puʻuwai ma mua o ka manawa a i ʻole hiki ʻole.
• ʻO ke kahe koko kiʻekiʻe ʻaʻole kaohi maikaʻi ʻia, e alakaʻi ana i nā pilikia me ka ʻoʻoleʻa, a i ʻole ka hopena i ka nāwaliwali ʻana o nā mākala.

ʻO nā pilikia puʻuwai ʻē aʻe i hiki ʻole i ka naʻau ʻole:

• Maʻi maʻi ʻōpū
• ʻO ka puʻuwai puʻuwai (ke loaʻa nā maʻi coronary artery i kahi blockage o ka ʻaʻa puʻuwai)
• ʻO nā kīleo naʻau i kulu a iiki paha
• ʻO ka maʻi e hoʻonāwaliwali ai i ka puʻuwai puʻuwai
• ʻO kekahi ʻano o nā puʻuwai puʻuwai abnormal (arrhythmia)

Nā maʻi ʻē aʻe i hiki ke kumu a hāʻawi paha i ka puʻuwai puʻuwai:

• ʻO Amyloidosis
• Emphysema
• ʻOhana thyroid
• ʻO Sarcoidosis
• Anemia ʻaʻano koʻikoʻi
• Nui loa ka hao i ke kino
• Thyroid underactive

Hoʻomaka mālie nā ʻōuli o ka puʻuwai puʻuwai. I ka wā mua, hana wale paha lākou ke hana nui ʻoe. I ka hala ʻana o ka manawa, ʻike paha ʻoe i nā pilikia hanu a me nā ʻōuli ʻē aʻe ke hoʻomaha ʻoe. Hōʻike koke ʻia nā ʻōuli ma hope o ka hōʻino ʻia o ka puʻuwai mai kahi puʻuwai a i ʻole nā ​​pilikia ʻē aʻe.

ʻO nā ʻōuli maʻamau ka:

• Cough
• Ka luhi, nāwaliwali, maʻule
• Loaʻa ka ʻai ʻole
• Pono e mimi i ka pō
• Pulse e manaʻo wikiwiki a hewa ʻole paha, a i ʻole ke ʻano o ka naʻau o ka naʻau (palpitations)
• Ka hanu ʻana o ka hanu ke hana ʻoe a ma hope paha o kou moe ʻana i lalo
• Pehu (hoʻonui) ke ake a i ʻole ka ʻōpū
• Nā wāwae wāwae a me nā kuʻekuʻe wāwae
• E ala ana mai ka hiamoe ma hope o kekahi mau hola ma muli o ka pōkole o ka hanu
• Kaumaha hoʻonui

E nānā ana kāu mea mālama ola iā ʻoe no nā hōʻailona o ka puʻuwai puʻuwai.

• Hanu wikiwiki a paʻakikī paha
• Pahu ka wāwae (edema)
• Nā ʻāʻī o ka ʻāʻī e pili ana (distanc)
• Kani (crackles) mai ka hoʻoulu wai i kāu mau māmā, i lohe ʻia ma o kahi stethoscope
• ʻO ka pehu ʻana o ke ake a i ʻole ka ʻōpū
• Pālehu ʻole a wikiwiki paha ke kani ʻana o ka naʻau a me nā kani naʻau ʻole

Hoʻohana ʻia nā hoʻokolohua he nui e hōʻoia a nānā i ka holo pono ʻole o ka puʻuwai.

ʻO kahi echocardiogram (echo) ka mea ʻoi loa ka hoʻāʻo mua maikaʻi loa loa no ka poʻe ke loiloi ʻia ka puʻuwai puʻuwai. E hoʻohana kāu mea hāʻawi iā ia e alakaʻi i kāu mālama ʻana.

Hiki i nā hoʻokolohua kiʻi ʻē aʻe ke nānā i ka hiki i kou puʻuwai ke pauma i ke koko, a me ka nui o ka ʻeha o ka puʻuwai i hōʻino ʻia.

Hiki ke hoʻohana ʻia i nā hoʻokolohua koko he nui i:

• Kōkua e hōʻoia a nānā i ka holo pono ʻole o ka naʻau
• E ʻike i nā pilikia no nā ʻano maʻi maʻi puʻuwai
• E nānā no nā kumu kūpono o ka puʻuwai puʻuwai, a i ʻole nā ​​pilikia e hōʻeha paha i kou puʻuwai
• Nānā i nā hopena o nā lāʻau e lawe nei iā ʻoe

KA MALAMA ANA I KA LOMI ANA

Inā loaʻa ʻole ka puʻuwai, e nānā pono kāu mea lawelawe iā ʻoe. He mau kipa ukali kāu ma ka liʻiliʻi i kēlā me kēia 3 a 6 mau mahina, akā i kekahi manawa ʻoi aku ka pinepine. E loaʻa iā ʻoe kekahi mau hoʻokolohua e nānā i kāu hana puʻuwai.

ʻO ka ʻike ʻana i kou kino a me nā ʻōuli e hōʻino nui ana kou puʻuwai e kōkua iā ʻoe e noho olakino a ma waho o ka haukapila. Ma ka home, e nānā i nā loli i ka helu o kou puʻuwai, ka lāʻau, ka pehu, a me ke kaupaona.

ʻO ka loaʻa ʻana o ka paona, ʻoi aku ma kahi o hoʻokahi lā a ʻelua paha, hiki ke lilo i hōʻailona no ka paʻa ʻana o kou kino i ka wai keu a ʻoi aku ka ʻino o kou puʻuwai. E kamaʻilio i kāu mea hoʻolako e pili ana i ka mea āu e hana ai inā piʻi aʻe kou kaumaha a hoʻonui paha ʻoe i mau hōʻailona.

Palena i ka nui o ka paʻakai āu e ʻai ai. E noi paha kāu mea hāʻawi iā ʻoe e kaohi i ka nui o ka wai e inu ai i ka lā.

Nā hoʻololi hou e hana i kou nohona:

• E noi i kāu mea nāna e hoʻolako i ka nui o ka waiʻona e inu ai ʻoe.
• MAI Puhi.
• Noho mau. Hele wāwae a holo kaʻa paikikala paha. Hiki i kāu mea hoʻolako ke hoʻolako i kahi hoʻolālā hoʻoikaika palekana a maikaʻi iā ʻoe. Mai hoʻoikaika i nā lā ke piʻi aʻe kou kaumaha mai ka wai a i ʻole ʻaʻole maikaʻi ʻoe.
• Lilo i ke kaupaona inā ʻoi nui ʻoe.
• E hoʻohaʻahaʻa i kāu cholesterol ma ka hoʻololi ʻana i kou nohona.
• E hoʻomaha nui, e like me ma hope o ka hoʻoikaika kino, ʻai ʻana, a i ʻole nā ​​hana ʻē aʻe. ʻAe kēia i kou puʻuwai e hoʻomaha pū.

NA LAAU LAPAAU, NA OIHANA, A ME NA LAKO

Pono ʻoe e lawe i nā lāʻau e mālama pono ʻole ai i kou puʻuwai. Mālama nā lāʻau i nā ʻōuli, pale i ka hōʻeha o kou puʻuwai mai ka ʻino ʻana, a kōkua iā ʻoe e ola lōʻihi. He mea nui ia e lawe i kāu lāʻau e like me ke kuhikuhi a kāu hui mālama ola.

ʻO kēia mau lāʻau:

• Kōkua maikaʻi i ka puʻuwai puʻuwai puʻuwai
• E mālama i kou koko mai ka hoʻopili ʻana
• E hoʻohaʻahaʻa i kāu mau pae kolesterol
• E wehe i nā kīʻaha koko a hoʻōlohi paha i ka helu o kou puʻuwai i ʻole e hana paʻakikī kou puʻuwai
• E hōʻemi i ka hōʻino o ka puʻuwai
• E hoʻemi i ka makaʻikaʻi no nā mele puʻuwai maʻamau
• Hoʻololi i ka potassium
• E hoʻokuʻu i kou kino i ka nui o ka wai a me ka paʻakai (sodium)

He mea nui ia e lawe i kāu lāʻau e like me ke kuhikuhi. Mai lawe i nā lāʻau ʻē aʻe a i ʻole nā ​​mea kanu me ka nīnau mua ʻole i kāu mea lawelawe e pili ana iā lākou. ʻO nā lāʻau e hōʻino paha i kou puʻuwai me ka:

• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve, Naprosyn)

ʻO nā ʻōkuhi a me nā hāmeʻa aʻe e koi ʻia no kekahi poʻe me ka puʻuwai puʻuwai.

• ʻO ke kahakaha ʻana o Coronary (CABG) a i ʻole angioplasty me a i ʻole me ka stenting ke kōkua i ka hoʻomaikaʻi ʻana i ke kahe o ke koko i nā puʻuwai puʻuwai nāwaliwali a nāwaliwali paha.
• Hiki ke hana i ke kīpoki puʻuwai inā hoʻololi ʻia ka valve puʻuwai e hoʻonāukiuki i kou puʻuwai.
• Hiki i kahi mea hana pacemaker ke kōkua i ka mālama ʻana i nā helu puʻuwai a i ʻole kōkua i nā ʻaoʻao ʻelua o kāu puʻuwai i ka manawa like.
• Hoʻouna kahi defibrillator i kahi pulse uila e hoʻōki i nā mele puʻuwai ʻole e hoʻoweliweli nei i ke ola.

HOLO KE KUMU O KA PUU HALE

Hana ʻia ka puʻuwai puʻuwai koʻikoʻi ke hana ʻole nā ​​lapaʻau. Hiki ke hoʻohana ʻia kekahi mau ʻano lapaʻau ke kali nei ke kanaka (a i ʻole ma kahi) kahi kuʻi puʻuwai:

• Pahu balloon intra-aortic (IABP)
• ʻO ka hāmeʻa kōkua kōkua hema hema a ʻākau paha (LVAD)
• Huina puʻuwai puʻuwai

I kekahi manawa, e hoʻoholo ka mea hāʻawi inā ʻoi aku ka maikaʻi o ka mālama ʻana me ka ikaika ʻole o ka naʻau. Makemake paha ke kanaka, me ko lākou ʻohana a me nā kauka, e kūkākūkā i ka mālama palliative a hōʻoluʻolu paha i kēia manawa.

I ka manawa pinepine, hiki iā ʻoe ke kaohi i ka hōʻeha o ka puʻuwai ma o ka lawe ʻana i ka lāʻau, hoʻololi i kou ʻano nohona, a me ka mālama ʻana i ke ʻano o ke kumu.

Hiki ke lilo i mea ʻole nā ​​puʻuwai ma muli o ka:

• Ischemia (ka nele o ke kahe o ke koko i ka puʻuwai puʻuwai)
• Ke ʻai nei i nā meaʻai paʻakai kiʻekiʻe
• Maʻi hohola
• Nā maʻi maʻi a i ʻole nā ​​maʻi ʻē aʻe
• ʻAʻole lawe pololei i nā lāʻau
• Hou, nā puʻuwai puʻuwai maikaʻi ʻole

ʻO ka hapa nui o ka manawa, maʻi ʻole ka naʻau ʻole. Hoʻolālā kekahi poʻe i ka maikaʻi ʻole o ka puʻuwai. I kēia wā, ʻaʻole kōkua nā lāʻau lapaʻau, nā lāʻau lapaʻau ʻē aʻe, a me ke kaha ʻana i ke ʻano.

Hiki paha i ka poʻe me ka puʻuwai puʻuwai ke makaʻu no nā mele puʻuwai weliweli. Loaʻa pinepine i kēia poʻe i kahi defibrillator i hoʻokomo ʻia.

Kāhea i kāu mea hāʻawi inā hoʻomohala ʻoe:

• Hoʻonui i ka ʻū a me ka phlegm
• Loaʻa kaumaha a pehu paha
• Nawaliwali
• Nā hōʻailona hou a wehewehe ʻole ʻia paha

E hele i ka lumi pilikia a kāhea paha i ka helu pilikia kūloko (e like me 911) inā:

• Maule ʻoe
• Loaʻa iā ʻoe ka puʻuwai puʻuwai wikiwiki a kaulike ʻole (ʻoi loa inā loaʻa iā ʻoe kekahi mau ʻōuli ʻē aʻe)
• ʻIke ʻoe i ka ʻehaʻeha o ka umauma ʻeha

ʻO ka hapa nui o nā hanana puʻuwai hiki ke pale ʻia e ka noho ʻana i kahi nohona olakino a me ka hana ʻana i nā ʻanuʻu e hoʻoliʻiliʻi i kou makaʻi no ka maʻi puʻuwai.

CHF; Hoka puʻuwai Congestive; Hewa puʻuwai ʻaoʻao hema; Hoka puʻuwai ʻaoʻao ʻākau - cor pulmonale; Cardiomyopathy - puʻuwai puʻuwai; HF

• Nā mea kāohi ACE
• Nā lāʻau Antiplatelet - nā mea kūpaka P2Y12
• Ke hana nei inā loaʻa ka maʻi puʻuwai
• ʻOki kino bypass - hoʻokuʻu
• Hewa ka puʻuwai - hoʻokuʻu
• Hewa ka puʻuwai - nā wai a me nā diuretics
• Ka maikaʻi ʻole o ka naʻau - ka nānā ʻana i ka home
• Hewa ka puʻuwai - he aha e nīnau aku ai i kāu kauka
• Hoʻomaʻamaʻa i ka puʻuwai - hoʻokuʻu
• Imibrable cardioverter defibrillator - hoʻokuʻu

• Puʻuwai - ʻāpana ma waena o ka waena
• Puʻuwai - ʻike mua
• Ke kaapuni ʻana o ke koko ma o ka puʻuwai
• Huʻi wāwae

Allen LA, Stevenson LW. Ka mālama ʻana i nā mea maʻi me ka maʻi maʻi ʻōpū i kokoke i ka hopena o ke ola. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 31.

ʻO Felker GM, ʻo Teerlink JR. ʻIke a me ka hoʻokele o ka hōʻeha puʻuwai koʻikoʻi. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 24.

Forman DE, Sanderson BK, Josephson RA, Raikhelkar J, Bittner V; Ke KulanuiʻAmelika o kā Cardiology Kāohiʻana i ka Maʻi Maʻi Maʻi. ʻO ke kū ʻole o ka puʻuwai ma ke ʻano he hōʻoia hou no ka hoʻoponopono hou ʻana o ka maʻi ʻO J Am Coll Cardiol. 2015; 65 (24): 2652-2659. PMID: 26088305 pubmed.ncbi.nlm.nih.gov/26088305/.

ʻO Mann DL. Ka mālama ʻana i nā mea maʻi puʻuwai me ka hapa liʻiliʻi o ka eject. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 25.

ʻO Yancy CW, Jessup M, Bozkurt B, et al. 2017 ACC / AHA / HFSA hoʻomōlele hou i ka 2013 ACCF / AHA alakaʻi no ka mālama ʻana i ka puʻuwai puʻuwai: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force e pili ana i nā Clinical Practice Guide a me ka Heart Failure Society of America. Kaapuni. 2017; 136 (6): e137-e161. PMID: 28455343 pubmed.ncbi.nlm.nih.gov/28455343/.

Zile MR, Litwin SE. Hema ka puʻuwai me kahi ʻāpana eject i mālama ʻia. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 26.