Mitral stenosis

ʻO ka Mitral stenosis kahi maʻi kahi e wehe ʻole ai ka pahu mitral. Hoʻopili kēia i ke kahe o ke koko.

ʻO ke kahe e kahe ana ma waena o nā keʻena like ʻole o kou puʻuwai pono e kahe ma waena o ka nohona. ʻO ke kiwikū ma waena o nā keʻena 2 ma ka ʻaoʻao hema o kou puʻuwai i kapa ʻia ka mitral valve. Wehe ia i lawa i hiki i ke koko ke kahe mai ke keʻena luna o kou puʻuwai (hema atria) i ke keʻena ma lalo (ventricle hema). Pani ia a laila, mālama i ke kahe o ke koko i hope.

ʻO ka stenosis Mitral ʻaʻole hiki i ka valve ke wehe i lawa. ʻO ka hopena, emi ke kahe o ke koko i ke kino. Pehu ka lumi puʻuwai o luna i ke kūkulu ʻana o kaomi. Hiki i ke koko a me ka wai ke hōʻiliʻili i loko o kaʻiʻo māmā (edema pulmonary), e paʻakikī e hanu.

I ka poʻe mākua, pinepine ka mitral stenosis i ka poʻe i loaʻa i ke kuni rumatika. He maʻi kēia e hiki ke ulu ma hope o kahi maʻi me ka ʻāʻī strep ʻaʻole mālama pono ʻia.

Hoʻomohala nā pilikia o ka pahū 5 a 10 mau makahiki a ʻoi paha ma hope o ka loaʻa ʻana i ka maʻi rumatika. ʻAʻole paha e hōʻike ʻia nā ʻōuli no ka mea ʻoi aku ka lōʻihi. Ke hele a lahilahi nei ke kuni Rheumatic ma ʻAmelika Hui Pū ʻIa no ka mea pinepine ka mālama ʻana i nā maʻi strep. Ua hoʻemi kēia i ka mitral stenosis.

Kākaʻikahi, nā kumu ʻē aʻe i hiki i ka mitral stenosis i ka poʻe mākua. Pākuʻi ʻia kēia mau mea:

• ʻO nā waihona Calcium e hana ana a puni ka mitral valve
• Lapaʻau hoʻomālama i ka umauma
• ʻO kekahi mau lāʻau

Hānau ʻia paha nā keiki me ka stenosis mitral (congenital) a i ʻole nā ​​kīnā hānau ʻē aʻe e pili ana i ka puʻuwai e hoʻokumu i ka stenosis mitral. ʻO ka manawa pinepine, aia kekahi mau kīnā o ka naʻau me ka stenosis mitral.

Hiki paha i ka Mitral stenosis ke holo i loko o nā ʻohana.

ʻAʻohe hōʻailona o nā mākua. Eia nō naʻe, ʻike ʻia paha nā ʻōuli a ʻoi aku paha ka maikaʻi me ka hoʻoikaika kino a i ʻole nā ​​hana ʻē aʻe e hāpai ai i ka helu o ka puʻuwai. E ulu pinepine nā ʻōuli ma waena o nā makahiki 20 a 50.

E hoʻomaka paha nā ʻōuli me kahi ʻāpana o ka atrial fibrillation (ʻoi aku ke kumu o ka wikiwiki o ka naʻau). Hoʻokumu pū ʻia nā ʻōuli e ka hāpai ʻana a i ʻole ke koʻikoʻi ʻē aʻe i ke kino, e like me ka maʻi i loko o ka puʻuwai a i ʻole nā ​​mumū, a i ʻole nā ​​maʻi puʻuwai ʻē aʻe.

Pākuʻi ʻia paha nā ʻōuli:

• Hōʻoluʻolu ka umauma e hoʻonui me ka hana a hoʻonui i ka lima, ka ʻāʻī, ka iwi ā, a i ʻole nā ​​wahi ʻē aʻe (kākaʻikahi kēia)
• Cough, me ka phlegm koko paha
• Ka hanu paʻakikī i ka wā a ma hope paha o ka hoʻoikaika kino (ʻO kēia ka hōʻailona maʻamau.)
• E ala ana ma muli o nā pilikia hanu a i ka wā e moe ana i kahi pālahalaha
• Ka luhi
• ʻO nā maʻi hanu pinepine, e like me ka bronchitis
• ʻO ke kuʻi ʻana o ka naʻau kuʻi (palpitations)
• ʻO ka pehu ʻana o nā wāwae a i ʻole nā ​​kuʻekuʻe wāwae

I nā pēpē a me nā keiki, aia paha nā ʻōuli mai ka hānau ʻana (congenital). ʻAneʻane e ulu mau i loko o nā makahiki 2 mua o ke ola. ʻO nā hōʻailona me:

• Cough
• Hānai hune ʻana, a i ʻole ka hou ʻana o ka hou ma ka hānai ʻana
• Piʻi maikaʻi ʻole
• Pokole o ka hanu

E hoʻolohe ka mea mālama ola i ka puʻuwai a me nā māmā me kahi stethoscope. Hiki ke lohe ʻia kahi ʻōhumu, kuʻi, a i ʻole kani kani naʻau ʻē aʻe. ʻO ke ʻōhumu maʻamau kahi kani kani e lohe ʻia ma luna o ka puʻuwai i ka wā hoʻomaha o ka puʻuwai. Piʻi pinepine ke kani ma mua o ka hoʻomaka ʻana o ka puʻuwai e ʻaelike.

Hōʻike paha ka hoʻokolohua i kahi puʻuwai puʻuwai ʻole a i ʻole kūpikipiki. ʻO ke kaomi koko ke maʻamau maʻamau.

Hiki ke ʻike ʻia ka hali ʻana a i ʻole ka paʻa ʻana o ke kiwikā a i ʻole ka pehu ʻana o nā keʻena puʻuwai luna i:

• Pākuʻi x-ray
• ʻEchocardiogram
• ECG (electrocardiogram)
• MRI a i ʻole CT o ka puʻuwai
• Echocardiogram Transesophageal (TEE)

Pili ka mālama ʻana i nā ʻōuli a me ke ʻano o ka puʻuwai a me nā akemāmā. ʻAʻole pono ka poʻe me nā ʻōuli ʻoluʻolu a ʻaʻole paha i kahi lāʻau. No nā hōʻailona koʻikoʻi, pono paha ʻoe e hele i ka haukapila no ka hōʻoia ʻana a me ka mālama ʻana.

Nā lāʻau i hiki ke hoʻohana ʻia e mālama ai i nā ʻōuli o ka holo pono ʻole o ka puʻuwai, ke koko kiʻekiʻe a hoʻolohi a hoʻomalu i nā mele puʻuwai pū kekahi:

• Diuretics (wai huaale)
• Nā Nitrates, beta-blockers
• Nā poloka ʻauana kalipuna
• Nā mea kāohi ACE
• ʻO nā Angiotensin receptor blockers (ARBs)
• Digoxin
• Nā lāʻau e mālama ai i nā puʻuwai puʻuwai abnormal

Hoʻohana ʻia nā lāʻau anticoagulants (mea lahilahi o ke koko) i mea e pale aku ai ke koko a me ka hele ʻana i nā ʻāpana ʻē aʻe o ke kino.

Hiki ke hoʻohana ʻia nā antibiotic i kekahi mau hihia o ka mitral stenosis. ʻO ka poʻe i loaʻa i ka fiva rumatika pono paha i ka pale pale lōʻihi me kahi lāʻau ʻalopika e like me ka penicillin.

I ka wā i hala, ua hāʻawi ʻia ka hapa nui o ka poʻe me nā pilikia o ka puʻuwai puʻupuʻu i nā lāʻau antibiotic ma mua o ka hana niho ʻana a i ʻole nā ​​hana invasive, e like me ka colonoscopy. Hāʻawi ʻia nā antibiotic i mea e pale aku ai i ka maʻi o ka puʻuwai puʻuwai i hōʻino ʻia. Eia nō naʻe, hoʻohana pinepine ʻia nā lāʻau antibiotic i kēia manawa. E noi i kāu kauka inā pono ʻoe e hoʻohana i nā lāʻau ʻaloʻalo.

Pono paha kekahi poʻe i ke kīʻaha puʻuwai a i ʻole nā ​​kaʻina hana e mālama ai i ka stenosis mitral. Pākuʻi ʻia kēia mau mea:

• Percutaneous balloon mitral valvotomy (i kapa ʻia hoʻi ʻo valvuloplasty). I loko o kēia kaʻina hana, hoʻokomo ʻia kahi paipu (catheter) i loko o kahi aa koko, ma ka maʻamau ka wāwae. Ua wili ʻia i ka puʻuwai. Hoʻonui ʻia kahi pāluna ma ka piko o ka catheter, e hoʻonui ana i ka kiwikā o mitral a hoʻomaikaʻi i ke kahe o ke koko. Hiki ke hoʻāʻo ʻia kēia kaʻina hana ma kahi o ka ʻoki ʻana i ka poʻe me kahi pahu mitral liʻiliʻi i hōʻino ʻia (keu hoʻi inā ʻaʻole kahe nui ka pahu). ʻOiai ke kūleʻa, pono e hana hou i ke kaʻina hana i mau mahina a i ʻole mau makahiki ma hope.
• ʻO ke keʻoki e hoʻoponopono a hoʻololi paha i ka pahu mitral. Hiki ke hana i nā valves hoʻololi mai nā mea like ʻole. He mau makahiki paha ka lōʻihi o kekahi, a hiki i nā poʻe ʻē aʻe ke luhi a pono e hoʻololi.

Pono nā keiki i ke kahakaha e hoʻoponopono a hoʻololi paha i ka nohona mitral.

Hoʻololi ka hopena. Māmā paha ka maʻi, me ka ʻole o nā ʻōuli, a i ʻole ʻoi aku ke koʻikoʻi a lilo i ka hana ʻole i ka holo ʻana o ka manawa. Kūpilikiʻi a pilikia paha ke ola. I ka hapanui o nā hihia, hiki ke kāohi ʻia ka stenosis mitral me ka mālama ʻana a hoʻomaikaʻi ʻia me ka valvuloplasty a i ʻole ke ʻoki kino.

Komo pū nā pilikia:

• Aibrial fibrillation a me atrial flutter
• Hoʻopili ke koko i ka lolo (hahau), ʻōpū, nā puʻupaʻa, a i ʻole nā ​​wahi ʻē aʻe
• Hoka puʻuwai Congestive
• Edema pulmonary
• Hypertension pulmonary

Kāhea i kāu mea hāʻawi inā:

• Loaʻa iā ʻoe nā ʻōuli o ka mitral stenosis.
• Loaʻa iā ʻoe ka stenosis mitral a ʻaʻole hoʻomaikaʻi nā hōʻailona me ka mālama ʻana, a i ʻole ʻike ʻia nā hōʻailona hou.

E hāhai i nā ʻōlelo aʻoaʻo a kāu mea hāʻawi aku no ka mālama ʻana i nā kūlana e hiki ai ke hōʻeha i ka maʻi valve. E mālama koke i nā maʻi o ka maʻi strep e pale aku ai i ka fiva rumatika. E haʻi i kāu mea hāʻawi inā loaʻa iā ʻoe ka moʻolelo ʻohana o nā maʻi puʻuwai hānau.

ʻO nā mea ʻē aʻe ma mua o ka mālama ʻana i nā maʻi strep, ʻaʻole hiki ke pale pinepine ʻia ka mitral stenosis iho, akā hiki ke pale ʻia nā pilikia mai ke ʻano. E haʻi i kāu mea hāʻawi e pili ana i ka maʻi puʻuwai o kou puʻuwai ma mua o kou loaʻa ʻana i kahi lāʻau lapaʻau. Kūkākūkā inā pono ʻoe i nā lāʻau ʻaloʻalo pale.

ʻO ka pale Mitral valve; ʻO ka stenosis mitral puʻuwai; Valvular mitral stenosis

• Mitral stenosis
• Nā nohona puʻuwai
• ʻO ke kīpoki puʻuwai puʻuwai - series

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