Hewa ka puʻuwai - nā hoʻāʻo

ʻO ka hōʻailona o ka puʻuwai puʻuwai e hana nui ʻia ma nā ʻōuli o ke kanaka a me kahi hoʻokolohua kino. Eia nō naʻe, nui nā hoʻokolohua i hiki ke kōkua i ka hāʻawi ʻana i ka ʻike hou aku e pili ana i ke ʻano.

ʻO kahi echocardiogram (echo) kahi hōʻike e hoʻohana ai i nā nalu kani e hana i kahi kiʻi neʻe o ka puʻuwai. ʻOi aku ka kikoʻī o ke kiʻi ma mua o kahi kiʻi x-ray maʻamau.

Kōkua kēia hōʻoia i kāu mea mālama ola e aʻo hou e pili ana i ka maikaʻi o ka hoʻopaʻa a me ka hoʻomaha ʻana o kou puʻuwai. Hāʻawi pū ia i ka ʻike e pili ana i ka nui o kou puʻuwai a pehea ka maikaʻi o ka hana ʻana o nā puʻuwai puʻuwai.

ʻO kahi echocardiogram ka hōʻoia maikaʻi loa i:

• E ʻike i ke ʻano o ke kīnā ʻole o ka puʻuwai (systolic, diastolic, valvular)
• Nānā i kou puʻuwai ʻole a alakaʻi i kāu lāʻau

Hiki ke hōʻoia ʻia ka puʻuwai puʻuwai inā e hōʻike ana ka echocardiogram i ka haʻahaʻa loa o ka hana pauma ʻana o ka puʻuwai. Kapa ʻia kēia he ʻāpana eject. ʻO kahi ʻāpana puʻupuʻu maʻamau ma kahi o 55% a 65%.

Inā ʻaʻole kekahi o nā ʻāpana o ka puʻuwai e hana pono, ʻo ia paha ka mea i paʻa i ke aʻa o ka puʻuwai e lawe i ke koko i kēlā wahi.

Hoʻohana ʻia nā hoʻokolohua kiʻi ʻē aʻe e nānā i ka hiki i kou puʻuwai ke pauma i ke koko a me ka nui o ka hōʻino ʻana o ka puʻuwai puʻuwai.

Hiki paha iā ʻoe ke hana i ka x-ray umauma i ke keʻena o kāu mea hāʻawi inā ʻoi aku ka hewa o kāu mau hōʻailona. Eia nō naʻe, ʻaʻole hiki i ka x-ray ke hōʻike i ka maikaʻi ʻole o ka puʻuwai.

ʻO Ventriculography kahi hōʻike ʻē aʻe e ana i ka ikaika o ka ʻomi ʻana o ka puʻuwai (ʻāpana ʻākeʻe). E like me ka echocardiogram, hiki iā ia ke hōʻike i nā ʻāpana o ka puʻuwai puʻuwai e holo maikaʻi ʻole. Hoʻohana kēia ho'āʻo i ka x-ray ʻokoʻa wai e hoʻopiha i ka lumi pumping o ka puʻuwai a loiloi i kāna hana. Hana pinepine ʻia ia i ka manawa like me nā hoʻokolohua ʻē aʻe, e like me ka coronary angiography.

MRI, CT, a i ʻole PET scans o ka puʻuwai e hana ʻia e nānā i ka nui o ka nā puʻuwai puʻuwai i loaʻa. Hiki iā ia ke kōkua i ke ʻike ʻana i ke kumu no ka holo pono ʻole o ka naʻau o ka mea maʻi.

Hana ʻia nā hoʻāʻo koʻikoʻi e ʻike inā lawa ka kahe o ka puʻuwai i ke kahe o ke koko a me ka oxygen ke hana nui nei (ma lalo o ke koʻikoʻi). Nā ʻano o ka hoʻāʻo koʻikoʻi e komo pū ana:

• Hōʻike hoʻāʻo nuklear
• Hōʻike hoʻohaʻahaʻa hoʻoikaika kino
• Strocch echocardiogram

E kauoha paha kāu mea hāʻawi i ka catheterization puʻuwai inā hōʻike ʻia nā hoʻokolohua kiʻi ua hōʻemi ʻoe i kekahi o kou mau aʻa, a inā ʻoe e ʻehaʻeha ana i ka umauma (angina) a i ʻole kahi makemake hou e makemake ʻia.

Hiki ke hoʻohana ʻia i nā hoʻokolohua koko ʻokoʻa e aʻo hou aʻe e pili ana i kāu ʻano. Hana ʻia nā hōʻike iā:

• Kōkua e hōʻoia i ke kumu no ka nānā ʻana i ka maikaʻi ʻole o ka puʻuwai.
• E ʻike i nā mea pilikia no ka maʻi puʻuwai.
• E nānā no nā kumu kūpono o ka puʻuwai ʻole a i ʻole nā ​​pilikia e hōʻeha paha i kou puʻuwai.
• E nānā i nā hopena o nā lāʻau e lawe nei iā ʻoe.

ʻO ka nitrogen urea nitrogen (BUN) a me nā hoʻokolohua creatinine serum e kōkua i ka nānā ʻana pehea ka maikaʻi o ka hana o kāu mau puʻupaʻa. Pono ʻoe i kēia mau hōʻoia inā mau:

• Ke lawe nei ʻoe i nā lāʻau i kapa ʻia nā mea kāohi ACE a i ʻole nā ​​ARBs (angiotensin receptor blockers)
• Hoʻololi kāu mea hāʻawi i nā lāʻau o kāu lāʻau
• Loaʻa iā ʻoe ka maikaʻi ʻole o ka puʻuwai

Pono e ana ʻia nā pae sodium a me nā potassium i kou koko i kahi manawa maʻamau ke hoʻololi ʻia no kekahi mau lāʻau e like me:

• Nā mea kāohi ACE, ARB, a i ʻole kekahi ʻano o nā pila wai (amiloride, spironolactone, a me triamterene) a me nā lāʻau e hiki ai ke kiʻekiʻe loa i kāu mau potassium.
• ʻO ka hapanui o nā ʻano pila wai ʻē aʻe, hiki ke hoʻohaʻahaʻa i kāu sodium a i ʻole kiʻekiʻe loa kāu potassium

ʻO ka anemia, a i ʻole ka helu ʻulaʻula o ke koko ulaula, hiki ke hōʻeha i kou naʻau. E hōʻoia kāu mea hāʻawi i kāu CBC a i ʻole ka helu o ke koko ma kahi manawa maʻamau a i ʻole ke wā e ʻoi aku ai kou mau hōʻailona.

CHF - nā hoʻāʻo; Hoka puʻuwai Congestive - nā hoʻāʻo; Cardiomyopathy - nā hoʻāʻo; HF - nā hoʻāʻo

Greenberg B, Kim PJ, Kahn AM. ʻO ka loiloi Clinical o ka maikaʻi ʻole o ka naʻau. I: Felker GM, Mann DL, hoʻoponopono. Hewa Ka Puʻuwai: He Hoa i ka Maʻi Puʻuwai ʻo Braunwald. ʻEhā ed. Piladelapia, PA: Elsevier, 2020: chap 31.

ʻO Mann DL. Ka mālama ʻana i nā mea maʻi me ka puʻuwai puʻuwai me ka hapa liʻiliʻi o ka eject. 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 Saunders; 2019: chap 25.

ʻO Yancy CW, Jessup M, Bozkurt B, et al. 2017 ACC / AHA / HFSA hoʻomōlele hou i ka 2013 ACCF / AHA alakaʻi no ka mālama ʻana i ka puʻuwai puʻuwai: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force on Clinical Practice Guide and the Heart Failure Society of America. J Hanakila ole. 2017; 23 (8): 628-651. PMID: 28461259 www.ncbi.nlm.nih.gov/pubmed/28461259.

ʻO Yancy CW, Jessup M, Bozkurt B, et al.2013 ACCF / AHA alakaʻi no ka mālama ʻana i ka puʻuwai puʻuwai: kahi hōʻike o ka American College of Cardiology Foundation / American Heart Association Task Force e pili ana i nā kulekele hana. Kaapuni. 2013; 128 (16): e240-e327. PMID: 23741058 www.ncbi.nlm.nih.gov/pubmed/23741058.

• Hoka Puʻuwai