Ohumu naʻau

ʻO ke ʻōhumu o ka puʻuwai kahi kani, kani, a kani kani paha i lohe ʻia i ka wā o ka puʻuwai. Hoʻokumu ʻia ke kani e ka piʻipiʻi (kolohe) i ke kahe o ka naʻau a i ʻole kokoke i ka puʻuwai.

He 4 mau keʻena o ka puʻuwai.

• ʻElua keʻena kiʻekiʻe (atria)
• ʻElua keʻena haʻahaʻa (ventricles)

Loaʻa nā valves o ka puʻuwai e pani me kēlā me kēia puʻuwai, e kahe ana ke koko i hoʻokahi wale nō ala. Aia nā nohona ma waena o nā keʻena.

Hiki i nā Murmurs ke hana no nā kumu he nui, e like me:

• Ke pani paʻa ʻole ka pā a paʻa ke koko i hope (regurgitation)
• Ke kahe o ke koko ma waena o ka puʻuwai puʻuwai a paʻakikī paha (stenosis)

Nui a hewahewa nā ala e hiki ai i kāu mea mālama ola ke wehewehe i kahi ʻōhumu.

• Hoʻokaʻawale ʻia nā Murmurs ("graded") ma muli o ke kani o ka ʻōhumu me kahi stethoscope. Aia ka māka ma ka pālākiō. ʻAʻole hiki ke lohe ʻia kaʻu papa. ʻO kahi laʻana o ka wehewehe ʻōhumu he "ʻōhumu papa II / VI." (ʻO kēia ke ʻano o ka namunamu o ka papa 2 ma ka pālākiō o 1 a 6).
• Hoʻohui ʻia, wehewehe ʻia kahi ʻōhumu e ka pae o ka puʻuwai puʻuwai ke lohe ʻia ka ʻōhumu. Hoʻomaopopo ʻia kahi ʻōhumu naʻau me he systolic a i ʻole diastolic. (ʻO Systole ke kaomi ʻana ka puʻuwai i ke koko a ʻo ka diastole ke hoʻopiha ʻia me ke koko.)

Ke ʻike ʻia kahi ʻōhumu, hiki i ka mea hāʻawi ke ʻike iā ia me ka poho o ka lima ma luna o ka puʻuwai. Kāhea ʻia kēia he "thrill".

Nā mea a ka mea hāʻawi e nānā ai i ka hōʻike me:

• Hana ʻia ka ʻōhumu ke hoʻomaha ka puʻuwai a i ʻole ʻaelike paha?
• Kūleʻa paha ia i loko o ka puʻuwai puʻuwai?
• Hiki ke loli ke neʻe ʻoe?
• Hiki ke lohe ʻia i nā ʻāpana ʻē aʻe o ka umauma, ma ke kua, a i ka ʻāʻī?
• Aia i hea ka leo namunamu e lohe ai i ka leo nui?

Nui ʻole nā ​​ʻōhumu puʻuwai he nui ʻole. Kapa ʻia kēia ʻano ʻōhumu he murmurs hewa ʻole. ʻAʻole lākou e hoʻokumu i kekahi hōʻailona a pilikia paha. ʻAʻohe pono nā ʻōhumu hala ʻole i ka lāʻau.

ʻO nā ʻōhumu puʻuwai ʻē aʻe e hōʻike i kahi mea maikaʻi ʻole i ka puʻuwai. Hiki ke hoʻokumu ʻia kēia mau namunamu kūpono ʻole e:

• Nā pilikia o ka aortic valve (aortic regurgitation, aortic stenosis)
• Nā pilikia o ka mitral kiwikā (hoʻomau a mitral regurgitation mitral paha, mitral stenosis)
• Hypertrophic cardiomyopathy
• Pulmonary regurgitation (backflow o ke koko i loko o ka akau ventricle, kena ae la i ka hoʻokō 'ole o ka pulmonary kiwikā e pani pau)
• ʻO ka stenosis valve pulmonary
• Nā pilikia o ka nohona tricuspid (regicitation tricuspid, stenosis tricuspid)

ʻO nā ʻōhumu nui i nā keiki ke kumu ʻia e:

• Hoʻi hoʻi ka venous pulmonary anomalos (kahi hana maʻamau ʻole o nā uaua pulmonary)
• Hewa septal Atrial (ASD)
• Coarctation o ka aorta
• Patent ductus arteriosus (PDA)
• Hewa septal Ventricular (VSD)

ʻO nā ʻōhumu maha he hopena paha mai ka hui pū ʻana o nā pilikia puʻuwai.

He ʻōhumu pinepine nā keiki ma ke ʻano he maʻa mau o ka ulu ʻana. ʻAʻole pono kēia mau ʻōhumu i ka lapaʻau. Pākuʻi ʻia lākou:

• ʻŪhū ke kahe o ka pulmonary
• ʻŌhumu naʻe
• Venous hum

Hiki i kahi mea hoʻolako ke hoʻolohe i nā kani o kou puʻuwai ma ke kau ʻana i kahi stethoscope ma kou umauma. E nīnau ʻia nā nīnau e pili ana i kāu mōʻaukala olakino a me nā ʻōuli, e like me:

• Ua namunamu paha kekahi o nā ʻohana ʻē aʻe a i ʻole nā ​​kani naʻau ʻē aʻe?
• Loaʻa iā ʻoe kahi moʻolelo ʻohana o nā pilikia puʻuwai?
• Loaʻa iā ʻoe ka ʻeha o ka umauma, maule, pōkole o ka hanu, a i ʻole nā ​​pilikia hanu ʻē aʻe?
• Ua loaʻa anei iā ʻoe ka ʻōhū, ka loaʻa ʻana o ke kaumaha, a i ʻole ka huʻi ʻana o nā uaua i ka ʻāʻī?
• He kala bluish kou ʻili?

E noi paha ka mea hāʻawi iā ʻoe e ʻūlū, kū, a paʻa i kou hanu i ka wā e hāpai ana i lalo a i ʻole ʻūlū ʻana i kekahi mea me kou mau lima e hoʻolohe i kou puʻuwai.

E hana ʻia paha kēia mau hoʻāʻo:

• Pākuʻi x-ray
• Electrocardiogram (ECG)
• ʻ .lelo Echocardiography

Kani ka umauma - namunamu; Kani nā puʻuwai - ʻokoʻa; ʻŌhumu - hewa ʻole; ʻŌhumu hala ʻole; ʻŌhumu ka puʻuwai Systolic; ʻŌhumu ka naʻau Diastolic

• Puʻuwai - ʻāpana ma waena o ka waena
• Nā nohona puʻuwai

ʻO Fang JC, O'Gara PT. Mōʻaukala a me ka hoʻokolohua kino: kahi ʻano hōʻike hōʻike. 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 10.

ʻO Goldman L. Ke hoʻokokoke aku i ka mea maʻi me ka maʻi maʻi maʻi maʻi hiki. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 45.

Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA / ACC Kuhi hou 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 ma nā Kumu Alakaʻi. Kaapuni. 2017; 135 (25): e1159-e1195. PMID: 28298458 pubmed.ncbi.nlm.nih.gov/28298458/.

Swartz MH. Ka puʻuwai. I: Swartz MH, ed. Puke aʻo o ʻike kino: Mōʻaukala a me ka hoʻokolokolo. 8th ed. Piladelapia, PA: Elsevier; 2021: chap 14.