ʻO ka regurgitation valve valve

ʻO ka mitral regurgitation kahi maʻi kahi i paʻa ʻole ai ka pahu mitral ma ka ʻaoʻao hema o ka puʻuwai.

Regurgitation ʻo ia hoʻi ka kahe ʻana mai kahi kiwikā e pani ʻole i nā ala āpau.

ʻO ka regurgitation Mitral kahi ʻano maʻamau o ka maʻi puʻuwai puʻuwai.

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.

Ke pani ʻole ka ʻōmole mitral i nā ala āpau, kahe hope ke koko i loko o ke keʻena puʻuwai o luna (atrium) mai ke keʻena o lalo e like me ka ʻaelike. ʻO kēia keʻoki i ka nui o ke koko e kahe ana i ke koena o ke kino. A ʻo kahi hopena, hoʻāʻo paha ka puʻuwai e pīpī i ka ikaika. Hiki i kēia ke alakaʻi i ka puʻuwai puʻuwai congestive.

E hoʻomaka koke paha ka regurgitation Mitral. Kū pinepine kēia ma hope o ka puʻuwai puʻuwai. Ke hele ʻole ka regurgitation, lilo ia i wā lōʻihi (mau).

Hiki i nā maʻi a i ʻole nā ​​pilikia ʻē aʻe ke hoʻonāwaliwali a hōʻino paha i ka kiwikā a i ʻole nā ​​puʻuwai puʻuwai e pili ana i ka pā. Aia ʻoe i ka makaʻu no ka regurgitation valve mitral inā loaʻa iā ʻoe:

• ʻO ka maʻi puʻuwai coronary a me ke kahe kiʻekiʻe
• ʻO ka maʻi maʻi o nā puʻupuʻu puʻuwai
• Mitral kiwikā prolaps (MVP)
• ʻO nā kūlana maʻamau, e like me syphilis a i ʻole Marfan Syndrome i hana ʻole ʻia
• Maʻi maʻi Rheumatic. ʻO kēia kahi pilikia o ka puʻu strep untreated e lilo ana i mea liʻiliʻi.
• ʻO ka pehu ʻana o ka lumi haʻahaʻa o ka puʻuwai hema

ʻO kekahi kumu pilikia ʻē aʻe no ka regurgitation mitral ka hoʻohana ʻole ʻia o kahi pillʻai i kapa ʻia ʻo "Fen-Phen" (fenfluramine a me phentermine) a i ʻole dexfenfluramine. Ua lawe ʻia aku ka lāʻau mai ka makeke e ka U.S. Food and Drug Administration (FDA) i ka makahiki 1997 ma muli o nā pilikia palekana.

E hoʻomaka koke paha nā ʻōuli inā:

• Hoʻopōʻino kahi puʻuwai puʻuwai i nā mākala a puni ka pahu mitral.
• ʻO nā kaula e hoʻopili i ka mākala i ka haki haʻihaʻi.
• Luku ʻia kahi maʻi o ka nohona kiwikā e ʻānai ai i ka ʻāpana o ka nohona.

ʻAʻohe pinepine nā hōʻailona. Ke hiki mai nā ʻōuli, ulu pinepine lākou a hoʻopili ʻia:

• Cough
• Ka luhi, luhi, a me ka lightheadedness
• Hanu wikiwiki
• ʻO ka manaʻo o ka puʻuwai ʻana o ka puʻuwai (palpitations) a i ʻole ke kuʻi puʻuwai wikiwiki
• Hōʻemi ka hanu e hoʻonui me ka hana a ke moe ana i lalo
• E ala ana i hoʻokahi hola a ʻoi paha ma hope o ka hiamoe ʻana no ka pilikia o ka hanu ʻana
• Urination, nui loa i ka pō

Ke hoʻolohe nei i kou puʻuwai a me kou mau māmā, ʻike paha ka mea mālama ola:

• ʻO kahi haʻalulu (haʻalulu) ma luna o ka puʻuwai keʻike nei ʻoe i ka umauma
• Kahi kani puʻuwai keu (S4 gallop)
• ʻŌhumu puʻuwai
• Nā māwae i loko o nā akemāmā (inā hoʻi i hope ka wai i nā akemāmā)

Hōʻike paha ka hōʻike kino:

• ʻO ka kuʻekuʻe wāwae a me ka wāwae
• Ake akea
• ʻO nā ʻāʻī o ka ʻāʻū pūhū
• Nā hōʻailona ʻē aʻe o ka holo pono ʻole o ka puʻuwai ʻaoʻao ʻākau

E hana ʻia paha nā hōʻike aʻe e nānā ai i ka hanana o ka puʻuwai puʻuwai a me ka hana.

• CT scan o ka puʻuwai
• ʻO Echocardiogram (kahi hōʻike ultrasound o ka puʻuwai) - transthoracic a i ʻole transesophageal
• Mākēneki resonance kiʻi (MRI)

E hana ʻia paha ka catheterization cardiac inā e ʻoi aku ka maikaʻi o ka hana o ka puʻuwai.

E hilinaʻi ka mālama ʻana i nā hōʻailona āu, ke ʻano o ke ʻano o ka mitral valve regurgitation, pehea ka maikaʻi o ka hana ʻana o ka puʻuwai, a inā ua hoʻonui ʻia ka puʻuwai.

ʻO ka poʻe me ke koko kiʻekiʻe a i ʻole ka nāwaliwali o ka puʻuwai nāwaliwali e hāʻawi ʻia i nā lāʻau e hōʻemi i ke kanana ma ka puʻuwai a hoʻomāmā i nā ʻōuli.

Hiki ke kuhikuhi ʻia nā lāʻau aʻe i ka wā e ʻino ai nā hōʻailona regurgitation mitral:

• ʻO nā beta-blockers, nā mea kāohi ACE, a i ʻole nā ​​mea kahakaha kōlepa
• ʻO nā mea lahilahi o ke koko (anticoagulants) e kōkua i ke pale ʻana i ke koko i nā kānaka me ka fibrillation atrial
• Nā lāʻau i kōkua i ke kaohi i nā puʻuwai puʻuwai a kaulike ʻole paha
• Pila wai (diuretics) e hoʻoneʻe i ka nui o ka wai i nā akemāmā

Kōkua paha kahi papaʻai sodium haʻahaʻa. Pono paha ʻoe e kaohi i kāu hana inā ulu nā ʻōuli.

Ke hana ʻia ke kuhi, pono ʻoe e kipa pinepine i kāu mea lawelawe e nānā i kāu mau hōʻailona a me ka hana o ka puʻuwai.

Pono ʻoe i kahi ʻoki e hoʻoponopono a hoʻololi paha i ka kiwikā inā:

• Hune ka hana naʻau
• Hoʻonui ʻia ka puʻuwai (dilated)
• ʻOi aku ka maikaʻi o nā ʻōuli

Hoʻololi ka hopena. ʻO ka hapanui o ka manawa he akahai ke kūlana, no laila ʻaʻole pono kahi lāʻau a me nā kapu. Hiki ke kāohi pinepine ʻia nā ʻōuli me ka lāʻau.

ʻO nā pilikia e ulu ana paha:

• Nā ritme puʻuwai maʻamau, e laʻa me ka fibrillation atrial a ʻoi aku paha ke koʻikoʻi, a i ʻole nā ​​rhythm abnormal e hoʻoweliweli nei i ke ola
• Hiki i nā lole ke hele aku i nā wahi ʻē aʻe o ke kino, e like me nā akemāmā a i ʻole ka lolo
• ʻO ka maʻi o ka nohona puʻuwai
• Hewa puʻuwai

Kāhea i kāu mea hāʻawi inā hele a maikaʻi ʻole nā ​​hōʻailona a hoʻomaikaʻi ʻole paha me ka lāʻau.

Kāhea pū i kāu mea hāʻawi inā mālama ʻia ʻoe no kēia ʻano a hoʻomohala i nā hōʻailona o ka maʻi, i hoʻopili ʻia:

• ʻO Chills
• Fiva
• Manaʻo maʻi laulā
• ʻEha poʻo
• ʻEha ka ʻili

ʻO ka poʻe me nā kīleʻa puʻuwai a i ʻole pohō paha e makaʻu no ka maʻi i kapa ʻia endocarditis. ʻO nā mea āpau e komo i nā bacteria i loko o kou kahe koko hiki ke alakaʻi i kēia maʻi. Nā ʻanuʻu e hōʻalo ai i kēia pilikia me:

• Hōʻalo i nā inikia haumia.
• E mālama koke i nā maʻi o ka maʻi strep e pale aku ai i ka fiva rumatika.
• E haʻi mau i kāu mea hoʻolako a me kāu kauka niho inā loaʻa iā ʻoe ka mōʻaukala o ka maʻi puʻuwai puʻuwai a i ʻole ka maʻi puʻuwai congenital ma mua o ka mālama. Pono paha kekahi poʻe i nā antibiotic ma mua o nā kaʻina hana niho a ʻokiʻoki paha.

ʻO ka regurgitation kiwikā o Mitral; Ka lawa ʻole o ka nohona kiwikā; Regurgitation mitral puʻuwai; ʻO ka regurgitation mitral valvular

• Puʻuwai - ʻāpana ma waena o ka waena
• Puʻuwai - ʻike mua
• ʻO ke kīpoki puʻuwai puʻuwai - series

ʻO Carabello BA. Maʻi maʻi valvular. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 66.

Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA / ACC nānā i ka hoʻohou o ka 2014 AHA / ACC alakaʻi no ka mālama ʻana i nā mea maʻi me ka maʻi puʻuwai valvular: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines. Kaapuni. 2017; 135 (25): e1159-e1195. PMID: 28298458 pubmed.ncbi.nlm.nih.gov/28298458/.

ʻO Thomas JD, Bonow RO. Maʻi maʻi mitral. 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 69.