Patent foramen ovale

Patent foramen ovale (PFO) he lua ma waena o ka atria hema a me ka akau (keena kiʻekiʻe) o ka puʻuwai. Aia kēia lua i nā mea āpau ma mua o ka hānau ʻana, akā pani pinepine ka manawa ma hope koke o ka hānau ʻana. ʻO PFO ka mea i kapa ʻia ai ka lua ke hiki ʻole ke pani kūlohelohe ma hope o ka hānau ʻana o kahi pēpē.

Hāʻawi kahi foramen ovale i ke koko e hele a puni nā māmā. ʻAʻole hoʻohana ʻia nā māmā o ke pēpē ke ulu ia i loko o ka ʻōpū, no laila ʻaʻole pilikia ka lua i kahi pēpē i hānau ʻole ʻia.

Manaʻo ʻia ʻo ka wehe e pani koke ma hope o ka hānau ʻana, akā ʻaʻole i kekahi manawa. Ma kahi o 1 o 4 mau kānaka, ʻaʻole pani ka wehe. Inā ʻaʻole ia e pani, ua kapa ʻia ʻo PFO.

ʻAʻole ʻike ʻia ke kumu o ka PFO. ʻAʻohe mea ʻike pilikia e ʻike ʻia. Hiki ke loaʻa me nā ʻano maʻi puʻuwai ʻē aʻe e like me atrial septal aneurysms a i ʻole Chiari network.

ʻO nā pēpē me ka PFO a ʻaʻohe kīnā o ka puʻuwai i loaʻa ʻole nā ​​ʻōuli. ʻO kekahi mau mākua me ka PFO ʻeha pū kekahi i ka maʻi migraine.

Hiki ke hana i kahi echocardiogram e hōʻoia i kahi PFO. Inā ʻaʻole ʻike maʻalahi ʻia ka PFO, hiki i ka mea maʻi maʻi maʻi ke hana i kahi "bubble test." Hoʻokomo ʻia ka wai paʻakai (wai paʻakai) i loko o ke kino e like me ka nānā ʻana o ka cardiologist i ka puʻuwai ma kahi monitor ultrasound (echocardiogram). Inā he PFO, e ʻike ʻia nā huʻihuʻi liʻiliʻi e neʻe ana mai ka ʻākau a ka ʻaoʻao hema o ka puʻuwai.

ʻAʻole mālama ʻia kēia ʻano ke ʻole nā ​​pilikia puʻuwai ʻē aʻe, nā ʻōuli, a i ʻole inā ua loaʻa ka maʻi kīnā i ka maʻi o ke koko i ka lolo.

Pono ka hoʻomaʻamaʻa pinepine i ke kaʻina hana i kapa ʻia he catheterization cardiac, i hana ʻia e ka mea hoʻomaʻamaʻa puʻuwai hoʻomaʻamaʻa e sila mau loa i ka PFO. ʻAʻole hoʻohana hou ʻia ke ʻoki puʻuwai puʻuwai e mālama i kēia ʻano ke ʻole ke hoʻokō ʻia kahi ʻoki ʻē aʻe.

ʻO ke pēpē ʻaʻohe ona kīnā puʻuwai e loaʻa ke olakino a me ke ola maʻamau.

Inā ʻaʻole he mau kīnā ʻē aʻe, ʻaʻohe pilikia mai kahi PFO i ka nui o nā hihia.

Loaʻa paha i kekahi poʻe ka pōkole o ka hanu a me nā pae o ka oxygen arterial haʻahaʻa ke noho a kū paha. Kapa ʻia kēia platypnea-orthodeoxia. Kākaʻikahi kēia.

Kākaʻikahi wale nō, hiki i nā poʻe me nā PFO ke kiʻekiʻe o ke ʻano o ka hahau (i kapa ʻia he paradoxical thromboembolic stroke). I loko o kahi kuʻi like ʻole, haki ke kōkō koko e hoʻomohala i ke aa (pinepine nā uaua o ka wāwae) e hūnā a hele i ka ʻaoʻao ʻākau o ka puʻuwai. ʻO ka maʻamau, e hoʻomau kēia ʻōpala i nā akemāmā, akā i kekahi me kahi PFO, hiki i ka ʻōpelu ke hele ma waena o ka lua i ka ʻaoʻao hema o ka puʻuwai. A laila e hoʻokuʻu ʻia i ke kino, hele i ka lolo a paʻa i laila, pale i ke kahe o ke koko i kēlā ʻāpana o ka lolo (hahau).

Lawe paha kekahi poʻe i nā lāʻau e pale aku ai i ke koko koko.

Kāhea i kāu mea mālama ola inā uliuli kāu pēpē i ka wā e uē ana a i ʻole ke neʻe ʻana o ka ʻōpū, paʻakikī e hānai, a hōʻike i ka ulu maikaʻi ʻole.

PFO; Hewa naʻau congenital - PFO

• Puʻuwai - ʻāpana ma waena o ka waena

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ʻO Therrien J, Marelli AJ. ʻO ka maʻi puʻuwai Congenital i nā mākua. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 61.

Webb GD, Smallhorn JF, Therrien J, Redington AN. ʻO ka maʻi puʻuwai Congenital i ke kanaka makua a me ka mea maʻi pediatric. 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 75.