Myxoma Atrial

ʻO kahi myxoma atrial kahi tumo noncancerous ma ka ʻaoʻao hema a ʻākau paha o ka puʻuwai. Hoʻonui pinepine ia ma ka paia e hoʻokaʻawale i nā ʻaoʻao ʻelua o ka puʻuwai. Kapa ʻia kēia pā i ka septial atrial.

ʻO ka myxoma kahi puʻuwai mua (puʻuwai). ʻO kēia ke kumu i hoʻomaka ai ka tumo i loko o ka puʻuwai. Hoʻomaka ka hapa nui o nā puʻuwai puʻuwai ma kahi ʻē aʻe.

Kākaʻikahi nā ʻōpū puʻuwai mua e like me myxomas. Ma kahi o 75% o nā myxomas e hana i ka atrium hema o ka puʻuwai. Hoʻomaka pinepine lākou i ka paia e hoʻokaʻawale i nā keʻena kiʻekiʻe ʻelua o ka puʻuwai. Hiki iā lākou ke hana i nā pūnaewele intra-cardiac pū kekahi. Hoʻohui ʻia nā myxomas Atrial i kekahi manawa me ka stenosis aʻa a me ka fibrillation atrial.

ʻOi aku ka nui o ka myxomas i nā wahine. Ma kahi o 1 ma 10 myxomas i hoʻoili ʻia e nā ʻohana (hoʻoilina). Kapa ʻia kēia mau tumors ʻo myxomas ʻohana. Kū pinepine lākou i nā mea ʻoi aku ma mua o hoʻokahi o ka puʻuwai i ka manawa, a ke kumu pinepine nei i nā ʻōuli i ka wā ʻōpio.

ʻAʻole nui nā myxomas i nā ʻōuli. ʻIke pinepine ʻia kēia mau mea ke hana ʻia kahi noiʻi kiʻi (echocardiogram, MRI, CT) no kekahi kumu ʻē aʻe.

Hiki ke loaʻa nā ʻōuli i kēlā me kēia manawa, akā hele pinepine lākou me ka loli i ke kūlana o ke kino.

Pākuʻi ʻia paha nā ʻōuli o ka myxoma:

• Ka paʻakikī o ka hanu ʻana ke moe palahalaha a i ʻole kekahi ʻaoʻao a i ʻole kekahi
• Ka pilikia o ka hanu ke hiamoe
• ʻO ka ʻeha o ka umauma a i ʻole ke kūiki
• Puʻupuʻu
• Mauleʻa
• ʻO ka manaʻo o ka puʻuwai ʻana o kou puʻuwai (palpitations)
• Ka hanu ʻana me ka hana
• Nā ʻōuli ma muli o ka embolism o nā mea tumo
  

Hoʻohālikelike nā ʻōuli a me nā hōʻailona o myxomas atrial hema i ka stenosis mitral (hoʻoliʻiliʻi o ka kiwikā ma waena o ka atrium hema a me ka ventricle hema). ʻAʻole hana iki nā myxomas atrial pono i nā ʻōuli a hiki i ko lākou ulu ʻana a nui (5 ʻīniha ākea, a 13 cm paha).

Hiki i nā ʻōuli ʻē aʻe ke:

• ʻO kaʻili Bluish, keu hoʻi ma nā manamana lima (Raynaud hanana)
• Cough
• ʻO ka curvature o nā kui i hele pū ʻia me ka pehu o nā mea palupalu (clubbing) o nā manamana lima
• Fiva
• Hiki i nā manamana lima ke hoʻololi i ke kala ma ke kaomi a me ke anuanu a koʻikoʻi paha
• General discomfort (malaise)
• ʻEha hui
• ʻO ka pehu i kēlā me kēia ʻāpana o ke kino
• Ka hoʻemi kaumaha me ka hoʻāʻo ʻole

E hana ka mea mālama ola i kahi hoʻokolohua kino a hoʻolohe i kou puʻuwai ma o kahi stethoscope. Lohe paha ka naʻau maʻamau a i ʻole ka namunamu. E loli paha kēia mau kani ke hoʻololi ʻoe i ke kūlana o ke kino.

Hoʻokomo ʻia paha nā hoʻokolohua kiʻi:

• Pākuʻi x-ray
• CT scan o ka umauma
• ECG
• ʻEchocardiogram
• Hoʻopaʻa haʻawina Doppler
• Puʻuwai MRI
• Haulelau puʻuwai hema
• Angiography naʻau pono

Pono paha ʻoe i nā hoʻokolohua koko e like me:

• Helu piha ke koko (CBC) - hōʻike paha i ka anemia a hoʻonui ʻia i nā hunaola keokeo
• ʻO ka helu sedimentation ʻErythrocyte (ESR) - hiki ke hoʻonui ʻia

Pono ke ʻoki e wehe i ka tumo, ʻoiaʻiʻo inā ke kumu ia o nā hōʻailona puʻuwai puʻuwai a i ʻole embolism.

Hoʻomaʻamaʻa ʻole ʻia, hiki i kahi myxoma ke alakaʻi i kahi embolism (nā hunaola tumora a i ʻole kahi pūpū e haki a hele i ke kahe o ke koko). Hiki i kēia ke alakaʻi i kahi paʻa o ke kahe o ke koko. Hiki i nā ʻāpana o ka tumo ke neʻe i ka lolo, ka maka, a i ʻole nā ​​lālā.

Inā ulu ka tumo i loko o ka puʻuwai, hiki iā ia ke pale i ke kahe o ke koko, e hana ana i nā ʻōuli o ka ālai.

Komo pū nā pilikia:

• ʻO Arrhythmias
• Edema pulmonary
• Emboli peripheral
• Ka pale o nā valves naʻau

Tumo Cardiac - myxoma; Tumo puʻuwai - myxoma

• Myxoma atrial hema
• Myxoma atrial pono

Lenihan DJ, Yusuf SW, Shah A. Tumors e hoʻopili ana i ka ʻōnaehana cardiovascular. 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 95.

ʻO Tazelaar HD, ʻo Maleszewski JJ. Nā tumors o ka puʻuwai a me ka pericardium. I: Fletcher CDM, hoʻoponopono. Diagnostic Histopathology o nā Tumors. 5th lā. Piladelapia, PA: Elsevier; 2021: chap 2.