Amyloidosis Cardiac

ʻO ka Cardiac amyloidosis kahi maʻi i hoʻokumu ʻia e nā waihona o kahi protein kūlohelohe (amyloid) i ka puʻuwai puʻuwai. Hana paʻakikī kēia mau waihona i ka naʻau e hana pono.

ʻO Amyloidosis kahi hui o nā maʻi i loko o nā ʻōpala o nā protein i kapa ʻia ʻo amyloids i loko o nā kino o ke kino. I ka hala ʻana o ka manawa, ua pani kēia mau protein i nā ʻaʻa maʻamau, a hiki i ka holo pono ʻole ʻana o ka mea i pili. Nui nā ʻano o ka amyloidosis.

Hiki i ka amyloidosis Cardiac ("ʻoʻoleʻa ka puʻuwai puʻuwai") ke lawe ʻia nā waihona amyloid ma kahi o nā mākala puʻuwai maʻamau. ʻO ia ka ʻano maʻamau o ka cardiomyopathy kaohi. Hiki i ka amyloidosis cardiac ke hoʻopili i ke ala e neʻe ai nā hōʻailona uila ma o ka puʻuwai (ʻōnaehana conduction). Hiki i kēia ke alakaʻi i nā puʻuwai puʻuwai (arrhythmia) a me nā hōʻailona puʻuwai hewa (poloka puʻuwai).

Hiki ke hoʻoilina ke ʻano. Kāhea ʻia kēia ʻo amyloidosis cardiac ʻohana. Hiki iā ia ke hoʻomohala ma ke ʻano he hopena o kahi maʻi ʻē aʻe e like me ke ʻano o ka iwi a me ka maʻi ʻaʻai koko, a i ʻole he hopena lapaʻau ʻē aʻe e hoʻonā ai i ka mumū. ʻOi aku ka maʻamau o ka Cardiac amyloidosis i nā kāne ma mua o ka wahine. Laha ka maʻi i ka poʻe ma lalo o 40 mau makahiki.

ʻAʻohe o kekahi hōʻailona i kekahi poʻe. Ke loaʻa, hiki ke hoʻopili ʻia nā ʻōuli:

• Urination nui loa i ka pō
• Ka luhi, hoʻemi i ka hiki ke hoʻoikaika kino
• Palpitations (manaʻo o ka puʻuwai puʻuwai)
• Ka hanu ʻana me ka hana
• ʻO ka pehu o ka ʻōpū, nā wāwae, nā kuʻekuʻe wāwae, a i ʻole nā ​​ʻāpana ʻē aʻe o ke kino
• Pilikia ka hanu ʻana i ka wā e moe ana i lalo

Hiki ke pili i nā ʻōuli o ka amyloidosis puʻuwai i kekahi ʻano o nā ʻano like ʻole. Hiki i kēia ke paʻakikī i ka pilikia e kuhikuhi.

Pākuʻi ʻia paha nā ʻōuli:

• ʻO nā kani maʻamau i ka akemāmā (crackles lung) a i ʻole ka ʻōhumu o ka puʻuwai
• ʻO ke kaomi o ke koko e haʻahaʻa a hāʻule paha i kou kū ʻana i luna
• Nā uaua ʻāʻī hoʻonui
• Hū palahalaha

E hana ʻia paha kēia mau hoʻāʻo:

• ʻImi CT a ʻōpū paha CT (manaʻo ʻia ʻo "standard gold" e kōkua ai i ke diagnose i kēia ʻano)
• Angiography Coronary
• Electrocardiogram (ECG)
• ʻEchocardiogram
• Mākēneki resonance kiʻi (MRI)
• Nānā puʻuwai nuklear (MUGA, RNV)
• ʻO ka tomography emission Positron (PET)

Hōʻike paha kahi ECG i nā pilikia me ka puʻuwai a i ʻole nā ​​hōʻailona puʻuwai. Hōʻike paha ia i nā hōʻailona haʻahaʻa (i kapa ʻia ʻo "anakahi uila").

Hoʻohana ʻia kahi biopsy cardiac e hōʻoia i ka ʻike. ʻO kahi biopsy o kahi ʻē aʻe, e like me ka ʻōpū, hakuʻala, a i ʻole ka iwi iwi, hana pinepine ʻia hoʻi.

E haʻi paha kāu mea mālama ola iā ʻoe e hoʻololi i kāu papaʻai, me ka kaupalena ʻana i ka paʻakai a me nā wai.

Pono ʻoe e lawe i nā wai wai (diuretics) e kōkua i kou kino e hoʻolei i ka nui o ka wai. E haʻi paha ka mea hāʻawi iā ʻoe e kaupaona iā ʻoe iho i kēlā me kēia lā. ʻO ke kaupaona ʻana o 3 a ʻoi paona (1 kilogram a ʻoi paha) ma mua o 1 a 2 mau lā hiki ke manaʻo he nui loa ka wai i loko o ke kino.

Hiki ke hoʻohana ʻia nā lāʻau e like me digoxin, blockers calcium-channel, a me beta-blockers i nā poʻe me ka fibrillation atrial. Eia nō naʻe, pono e hoʻohana i nā lāʻau me ke akahele, a pono e nānā pono ʻia nā ana. ʻO ka poʻe me ka amyloidosis cardiac hiki ke makaʻala i nā hopena ʻaoʻao o kēia mau lāʻau.

Hiki i nā mālama ʻē aʻe ke:

• ʻO Chemotherapy
• Imi i ka cardioverter-defibrillator (AICD)
• Pacemaker, inā he mau pilikia me nā hōʻailona puʻuwai
• ʻO Prednisone, kahi lāʻau anti-inflammatory

E noʻonoʻo ʻia kahi transplant puʻuwai no ka poʻe me kekahi ʻano amyloidosis i maikaʻi ʻole ka hana puʻuwai. Pono paha ka poʻe me ka amyloidosis hoʻoilina i kahi transplant ake.

I ka wā ma mua, ua manaʻo ʻia ka amyloidosis puʻuwai he maʻi hiki ʻole ke mālama ʻia a make koke hoʻi. Eia naʻe, ke hoʻololi wikiwiki nei ka kahua. Hiki i nā ʻano amyloidosis ke hoʻopili i ka puʻuwai ma nā ʻano like ʻole. ʻOi aku ke koʻikoʻi o kekahi mau ʻano ma mua o nā mea ʻē aʻe. Hiki i nā poʻe he nui ke manaʻo e ola a ʻike i kahi kūlana maikaʻi o ke ola no nā makahiki he nui ma hope o ka hōʻailona.

Komo pū nā pilikia:

• Aibrial fibrillation a i ʻole ventricular arrhythmias
• Hoka puʻuwai Congestive
• Kūkulu wai i ka ʻōpū (ascites)
• Hoʻonui i ka ʻike i ka digoxin
• Ke koko haʻahaʻa a me ka dizziness mai ka nui urination (ma muli o ka lāʻau)
• Maʻi maʻi sinus
• ʻO ka maʻi maʻi condiment system maʻi (arrhythmia e pili ana i ka lawe maʻamau o nā impulses ma o ka puʻuwai puʻuwai)

Kāhea i kāu mea hāʻawi inā loaʻa kēia maʻi iā ʻoe a hoʻomohala i nā hōʻailona hou e like me:

• Pōpō ke hoʻololi ʻoe i kou kūlana
• Ka waiwai nui loa (wai) loaʻa
• Ka pohō kaumaha nui loa
• Mākala hōʻeha
• Nā pilikia hanu nui

ʻO Amyloidosis - puʻuwai; Amyloidosis cardiac mua - ʻano AL; Amyloidosis cardiac lua - ʻano ʻAno; ʻOʻoleʻa puʻuwai puʻuwai; Amyloidosis Senile

• Puʻuwai - ʻāpana ma waena o ka waena
• Hoʻoiho i ka cardiomyopathy
• Pahu lope biopsy

Falk RH, Hershberger RE. ʻO nā cardiomyopathies i hoʻonui ʻia, kaohi ʻia, a me nā infiltrative. 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 77.

McKenna WJ, Elliott PM. Nā maʻi o ka myocardium a me ka endocardium. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 54.