Pericarditis

ʻO Pericarditis kahi kūlana e wela ai ka ʻeke e like me ka uhi ʻana o ka puʻuwai (pericardium).

ʻO ke kumu o ka pericarditis ʻike ʻole a hōʻoia ʻole ʻia i nā manawa he nui. Hoʻololi ka hapa nui i nā kāne 20 a 50 mau makahiki.

ʻO Pericarditis ka hopena pinepine o kahi maʻi e like me:

• Nā maʻi virus i kumu e anu ai ka umauma a i ʻole pneumonia
• Nā maʻi āpau me nā koʻohune (emi iki)
• Kekahi fungal nā mea palahēhē (kakaikahi)

ʻIke ʻia ke ʻano me nā maʻi e like me:

• Kanesa (me leukemia)
• Nā maʻi i hōʻeha ʻia e ka ʻōnaehana pale kino i ke kino olakino ma ke kuhihewa
• ʻO ka maʻi HIV a me ka maʻi AIDS
• Pahu thyroid paʻa ʻole
• Hewa ʻole nā ​​hakuʻala
• Mū Rumatika
• Tuberculosis (TB)

Nā kumu ʻē aʻe e:

• Maʻi hohola
• ʻO ke kīʻaha puʻuwai a i ʻole trauma i ka umauma, esophagus, a i ʻole puʻuwai
• ʻO kekahi mau lāʻau, e like me procainamide, hydralazine, phenytoin, isoniazid, a me kekahi mau lāʻau i hoʻohana ʻia e mālama ai i ka maʻi ʻaʻai a i ʻole kaomi ʻana i ka ʻōnaehana pale
• ʻO ka pehu a me ka mumū o ka mākala puʻuwai
• ʻO ka radiation radiation i ka umauma

ʻAneʻane mau ka ʻeha o ka umauma. ʻO kaʻeha:

• ʻIke ʻia paha i ka ʻāʻī, poʻohiwi, kua, a i ʻole ʻōpū
• Hoʻonui pinepine me ka hanu hohonu a me ka moe pālahalaha, a hoʻonui paha me ka ʻū a me ka ale ʻana
• Hiki iā ia ke noʻonoʻo a koi hou
• Hoʻomaha pinepine ʻia e ka noho ʻana a hilinaʻi a i ʻole ke kūlou ʻana i mua

Loaʻa paha ʻoe i ke kuni, ka haʻalulu, a me ka sweating inā hopena ʻia ke ʻano e kahi maʻi.

Hiki i nā ʻōuli ʻē aʻe ke:

• ʻO ka kuʻekuʻe wāwae, nā wāwae, a me ka pehu ʻana o ka wāwae
• Hopohopo
• Ka pilikia o ka hanu ke moe i lalo
• Mū maloo
• Ka luhi

Ke hoʻolohe nei i ka puʻuwai me kahi stethoscope, hiki i ka mea mālama ola ke lohe i kahi kani i kapa ʻia he rubic pericardial. Hiki paha ke muffled a lōʻihi paha ka leo o ka puʻuwai. Aia paha he mau hōʻailona ʻē aʻe o ka nui o ka wai i ka pericardium (pericardial effusion).

Inā koʻikoʻi ka maʻi, aia paha:

• Nā māwae i nā māmā
• Kani ka hanu hōʻemi
• Nā hōʻailona ʻē aʻe o ka wai i ke ākea a puni nā māmā

E hana ʻia paha nā hoʻokolohua kiʻi ʻana e nānā i ka puʻuwai a me ka ʻili a puni iā ​​(pericardium):

• Scanner MRI pahu
• Pākuʻi x-ray
• ʻEchocardiogram
• Uila uila
• Heart MRI a i ʻole CT scan puʻuwai
• ʻO ka nānā ʻana ʻo Radionuclide

E nānā ai no ka hōʻino ʻana o ka puʻuwai puʻuwai, e kauoha ka mea hāʻawi i kahi troponin I e hoʻāʻo. Hiki i nā hoʻokolohua keʻena hoʻokolohua ʻē aʻe ke:

• Antinuclear antibody (ANA)
• Moʻomeheu Koko
• CBC
• Pūmua C-reactive
• Ka helu sedimentation ʻErythrocyte (ESR)
• Hōʻike HIV
• ʻLelo Rheumatoid
• Hōʻike ʻili tuberculin

Pono e ʻike ʻia ke kumu o ka pericarditis, inā hiki.

Hāʻawi pinepine ʻia nā lāʻau kiʻekiʻe o nā lāʻau anti-inflammatory nonsteroidal (NSAIDs) e like me ibuprofen me kahi lāʻau i kapa ʻia colchicine. E hoʻēmi kēia mau lāʻau i kou ʻeha a hoʻemi i ka pehu a me ka mumuna o ka ʻeke a puni kou puʻuwai. E noi ʻia ʻoe e lawe iā lākou i mau lā i mau pule a ʻoi aku paha i kekahi mau hihia.

Inā ke kumu o ka pericarditis kahi maʻi:

• E hoʻohana ʻia nā lāʻau antibiotic no nā maʻi bacteria
• E hoʻohana ʻia nā lāʻau Antifungal no ka pericarditis fungal

ʻO nā lāʻau ʻē aʻe i hoʻohana ʻia paha:

• ʻO Corticosteroids e like me prednisone (i kekahi poʻe)
• "Pila wai" (diuretics) e hemo i ka nui o ka wai

Inā hana maikaʻi ʻole ka puʻuwai i ka hana ʻana o ka wai, hoʻopili pū ʻia ka mālama ʻana:

• Ke hoʻokahe nei i ka wai mai ka ʻeke. ʻO kēia kaʻina hana, i kapa ʻia he pericardiocentesis, hiki ke hana ʻia me ka nila, i alakaʻi ʻia e ultrasound (echocardiography) i ka nui o nā hihia.
• Ke ʻoki ʻana i kahi puka liʻiliʻi (window) i ka pericardium (subxiphoid pericardiotomy) e ʻae i ka wai i loaʻa i ka maʻi i loko o ka lua o ka ʻōpū. Hana ʻia kēia e kahi kauka.

Pono paha ke ʻoki lāʻau i kapa ʻia he pericardiectomy inā lōʻihi ka lōʻihi o ka pericarditis, hoʻi mai ma hope o ka hoʻomaʻamaʻa ʻana, a i ʻole ke kumu o ka ʻūlū ʻana a i ʻole ke ʻākī ʻana o nā mea a puni ka puʻuwai. Hoʻopili ka hana i ka ʻoki a wehe ʻana paha i kahi o ka pericardium.

Hiki ke kau ʻia ka Pericarditis mai nā maʻi palupalu e ʻoi aku ka maikaʻi ma ona iho, a i kahi kūlana hoʻoweliweli ola. ʻO ka hana ʻana o ka wai a puni ka puʻuwai a me ka hana puʻuwai maikaʻi ʻole hiki ke hoʻopilikia i ka maʻi.

Maikaʻi ka hopena inā mālama koke ʻia ka pericarditis. Ola ka hapa nui o ka poʻe i 2 mau pule a 3 mau mahina. Eia nō naʻe, hoʻi paha ka pericarditis. Kapa ʻia kēia mea he recurrent, a mau paha, inā hoʻomau mau nā ʻōuli a i ʻole nā ​​ʻāpana.

ʻO ka scarring a me ka mānoanoa o ka uhi e like me ka sac a me ka puʻuwai o ka puʻuwai ke hana ʻia inā nui ka pilikia. Kapa ʻia kēia ʻo pericarditis constrictive. Hiki iā ia ke kumu i nā pilikia lōʻihi e like me nā naʻau ʻole.

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe nā ʻōuli o pericarditis. ʻAʻole hoʻoweliweli kēia maʻi i ka hapa nui o ka manawa. Eia naʻe, hiki ke lilo i mea weliweli ke mālama ʻole ʻia.

ʻAʻole hiki ke pale ʻia nā hihia he nui.

• Pericardium
• Pericarditis

Chabrando JG, Bonaventura A, Vecchie A, et al. Ka mālama ʻana i ka pericarditis huehue a pinepine hoʻi: ʻO ka loiloi ʻo JACC State-of-the-art. ʻO J Am Coll Cardiol. 2020; 75 (1): 76-92. PMID: 31918837 pubmed.ncbi.nlm.nih.gov/31918837/.

Knowlton KU, Savoia MC, Oxman MN. Myocarditis a me pericarditis. I: Bennett JE, Dolin R, Blaser MJ, hua pā. ʻO Mandell, Douglas, a me Bennett's Principle a me ka hoʻomaʻamaʻa ʻana i nā maʻi kūpilikiʻi. 9th ed. Piladelapia, PA: Elsevier; 2020: chap 80.

LeWinter MM, Imazio M. Nā maʻi Pericardial. 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 83.