Regurgitation ʻaʻa

ʻO ka regortitation aortic kahi maʻi kīʻaha puʻuwai kahi e pani paʻa ʻole ai ke kō aʻa. ʻAe kēia i ke kahe o ke koko mai ka aorta (ke kīʻaha koko nui) i ka ventricle hema (kahi keʻena o ka puʻuwai).

ʻO kēlā me kēia ʻano pale i ke kiwikā aortic mai ka pani pau ʻana e hiki ke kumu i kēia pilikia. Ke pani ʻole o ka pā i nā ala āpau, hoʻi kekahi koko i kēlā me kēia manawa ke kuʻi ka puʻuwai.

Ke hoʻi mai kahi nui o ke koko, pono ka puʻuwai e hana ʻoi aku ka ikaika e kāpae i ke koko e lawa ai nā pono o ke kino. ʻO ka lumi hema hema o ka puʻuwai e pālahalaha (dilates) a pā ikaika ka puʻuwai (kaomi ʻana i ka lāʻau.) Ma hope o ka holo ʻana o ka manawa, hiki i ka puʻuwai ke lilo i mea hiki ke hāʻawi i ke koko i ke kino.

I ka wā ma mua, ʻo ke kuni rumatika ke kumu nui o ke ola hou ʻana o ke aorta. ʻO ka hoʻohana ʻana i nā lāʻau ʻalopika e mālama ai i nā maʻi o ka maʻi strep ua hoʻoliʻiliʻi pinepine ʻia ka maʻi rumatika. No laila, ʻoi aku ka pinepine o ka regurgitation aortic ma muli o nā kumu ʻē aʻe. Pākuʻi ʻia kēia mau mea:

• Spondylitis Ankylosing
• Dissection ʻaʻano
• Nā pilikia o ke kūpuna (ma ka hānau ʻana), e like me ka nohona bicuspid
• Endocarditis (maʻi o nā puʻuwai puʻuwai)
• Piʻi koko kiʻekiʻe
• Maʻi ʻo Marfan
• ʻO Reiter Syndrome (ʻo ia hoʻi ʻo ka reactive arthritis)
• Syphilis
• ʻO ka lupus erythematosus ʻōnaehana
• Trauma i ka umauma

ʻO ka lawa ʻole o ka maʻi aortic ka mea maʻamau i nā kāne ma waena o nā makahiki 30 a 60.

ʻAʻohe o nā ʻano maʻi i ke ʻano no nā makahiki he nui. Hiki ke hele mālie a hōʻeha paha nā ʻōuli. Pākuʻi ʻia lākou:

• Pākuʻi palena
• ʻO ka ʻeha o ka umauma e like me ka angina (rare)
• Mauleʻa
• Ka luhi
• Palpitations (ka naʻau o ka puʻuwai e kani ana)
• Ka hanu ʻana me ka hana a i ʻole ke moe ʻana i lalo
• Ke ala ala pōkole nei i kekahi manawa ma hope o ka hiamoe ʻana
• ʻO ka pehu ʻana o nā wāwae, nā wāwae, a me nā ʻōpū
• Kūlike ʻole, wikiwiki, heihei, kuʻi, a i ʻole kūleʻa ʻana i ka lāʻau
• Nāwaliwali e hiki ke hana ʻia me ka hana

Pākuʻi ʻia paha nā ʻōuli:

• ʻO ka ʻōhumu o ka naʻau e hiki ke lohe ʻia ma o ka stethoscope
• Pā ikaika loa o ka puʻuwai
• ʻO Bobbing o ke poʻo i ka manawa me ka puʻuwai puʻuwai
• Pākuʻi paʻakikī i nā lima a me nā wāwae
• Ke kahe haʻahaʻa diastolic
• Nā hōʻailona o ka wai i nā akemāmā

ʻIke ʻia ka regurgitation aortic ma nā hōʻike e like me:

• Angiography ʻaʻano
• Echocardiogram - nānā ultrasound o ka puʻuwai
• Catheterization puʻuwai hema
• MRI a i ʻole CT scan o ka puʻuwai
• Transthoracic echocardiogram (TTE) a i ʻole transesophageal echocardiogram (TEE)

Hōʻike ka x-ray umauma i ka pehu o ka lumi haʻahaʻa o ka puʻuwai hema.

ʻAʻole hiki i nā hoʻokolohua Lab ke kuhikuhi i ka lawa ʻole o ke aorta. Eia nō naʻe, kōkua paha lākou i ka pale ʻana i nā kumu ʻē aʻe.

ʻAʻole paha ʻoe e pono ke lapaʻau inā ʻaʻohe ou ʻōuli a i ʻole nā ​​hōʻailona akahai wale nō. Eia nō naʻe, pono ʻoe e ʻike i kahi kahu mālama ola no nā echocardiograms maʻamau.

Inā kiʻekiʻe kou kaomi koko, pono paha ʻoe e lawe i nā lāʻau lapaʻau koko e kōkua i ka hoʻolohi i ka worsening o aortic regurgitation.

Hiki ke kuhikuhi ʻia nā diuretics (nā wai wai) no nā ʻōuli o ka puʻuwai ʻole.

I ka wā ma mua, ʻo ka hapa nui o ka poʻe me nā pilikia o ka puʻuwai puʻuwai i hāʻawi ʻia i nā lāʻau antibiotic ma mua o ka hana niho ʻana a i ʻole kahi hana invasive, e like me ka colonoscopy. Hāʻawi ʻia nā antibiotic i mea e pale aku ai i ka maʻi o ka puʻuwai i hōʻino ʻia. Eia nō naʻe, hoʻohana pinepine ʻia nā lāʻau antibiotic i kēia manawa.

Pono paha ʻoe e kaohi i ka hana e koi ai i nā hana hou aʻe mai kou puʻuwai. E kamaʻilio i kāu mea hāʻawi.

ʻO ke ʻoki kino e hoʻoponopono a hoʻololi paha i ka valve aortic e hoʻoponopono ai i ka regurgitation aortic. ʻO ka hoʻoholo e loaʻa kahi pani pani aortic pili i kāu mau ʻōuli a me ke ʻano a me ka hana o kou puʻuwai.

Pono paha ʻoe i kahi ʻoki e hoʻoponopono hou i ke aorta inā hoʻonui ʻia.

Hiki i ke kīpoki ke hōʻola i ka lawa ʻole o ka aortic a hōʻoluʻolu i nā ʻōuli, ke ʻole ʻoe e hoʻomohala i ka puʻuwai a i ʻole nā ​​pilikia ʻē aʻe. ʻO ka poʻe me ka angina a i ʻole kūleʻa ʻole ka naʻau ma muli o ke regurgitation aortic e hana maikaʻi ʻole me ka ʻole o ka lāʻau.

Komo pū nā pilikia:

• Nā ritme naʻau maʻamau
• Hewa puʻuwai
• ʻO ka maʻi i loko o ka puʻuwai

Kāhea i kāu mea hāʻawi inā:

• Loaʻa iā ʻoe nā ʻōuli o ke regurgitation aortic.
• Loaʻa iā ʻoe ka lawa ʻole aortic a hoʻomāhuahua kāu mau hōʻailona a i ʻole nā ​​ʻōuli hou e hoʻomohala (ʻoi aku ka ʻeha o ka umauma, paʻakikī ka hanu ʻana, a i ʻole ka pehu ʻana).

He mea nui ka kaomi koko inā pilikia ʻoe no ka regurgitation aortic.

Hoʻopiʻi ka valve Aortic; Ka lawa ʻole o ʻAortic; Puʻuwai puʻuwai - regurgitation aortic; Maʻi Valvular - regurgitation aortic; AI - lawa ʻole aorta

• Ka lawa ʻole o ʻAortic

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.

ʻO Lindman BR, Bonow RO, Otto CM. Maʻi maʻi aorta. 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 68.

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 Otto CM. ʻO ka regurgitation valvular. I: Otto CM, hoʻoponopono. Puke puke o ka Clinical Echocardiography. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2018: chap 12.