Nā ʻōuli maʻi ʻaʻai puʻuwai: He aha ka mea e manaʻo ai

Anter

• Hōʻike Overview
• Nā ʻōuli o ka maʻi ʻaʻai puʻuwai
• 1. Kaohi i ke kahe o ke koko
• 2. ʻO ka maʻi puʻuwai puʻuwai puʻuwai
• 3. Nā pilikia hoʻokele
• 4. ʻO Embolus
• 5. Nā ʻōnaehana ʻōnaehana
• Nā kumu o ka maʻi ʻaʻai puʻuwai
• ʻIke o ka maʻi ʻaʻai puʻuwai
• Nā koho lapaʻau no ka maʻi ʻaʻai puʻuwai
• ʻO nā kūpuna Benign
• Nā kūpale kūpale
• Maʻi ʻaʻai puʻuwai lua
• Outlook no nā puʻuwai puʻuwai
• ʻO ka lawe lawe ʻana

Hōʻike Overview

ʻO nā puʻuwai puʻuwai mua he ulu ulu ʻole i kou puʻuwai. Kākaʻikahi loa lākou. Wahi a ka European Society of Cardiology (ESC), ʻike ʻia lākou ma lalo o 1 o kēlā me kēia 2000 autopsies.

Hiki i nā tumors puʻuwai mua ke noncancerous (benign) a i ʻole cancerous (malignant). Ulu nā puʻupuʻu malignant i nā hale kokoke a i ʻole pāhola i nā ʻāpana ʻē aʻe o ke kino (metastasize), akā ʻaʻole kū nā benign benign. ʻO ka hapa nui o nā puʻuwai puʻuwai mua he benign. ʻO ka hōʻike o ka ESC he 25 wale nō pākēneka e kolohe.

ʻO kekahi mau maʻi ʻinoʻino:

• sarcomas (nā tumors e hoʻomaka ana i nā pūnaewele hoʻopili e like me ka puʻuwai puʻuwai a me ka momona), e like me angiosarcoma a me rhabdomyosarcoma
• lymphoma puʻuwai mua
• pericardial mesothelioma

ʻO kekahi mau tumors maikaʻi:

• myxoma
• fibroma
• rhabdomyoma

Ua metastasized a pāhola paha ka maʻi ʻaʻai lua i ka puʻuwai mai nā mea kokoke e pili ana Wahi a ka ESC, hiki a 40 mau manawa i ʻoi aku ka nui ma mua o nā tumors cardiac mua akā ʻano maʻamau.

ʻO nā maʻi maʻi e hohola a metastasize paha i ka puʻuwai pinepine:

• maʻi ʻaʻai pūpū
• melanoma (maʻi ʻaʻai ʻili)
• maʻi ʻaʻai umauma
• maʻi ʻaʻai kolo
• maʻi leukemia
• lymphoma (ʻokoʻa kēia ma mua o ka lymphoma cardiac mua i ka hoʻomaka ʻana i nā lymph node, spleen, a i ʻole ka iwi iwi ma kahi o ka puʻuwai)

Nā ʻōuli o ka maʻi ʻaʻai puʻuwai

Kūleʻa ka puʻuwai puʻuwai malignant e ulu wikiwiki a komo i nā paia a me nā ʻāpana nui o ka puʻuwai. Hoʻopilikia kēia i ka hanana a me ka hana o ka puʻuwai, kahi e kumu ai nā ʻōuli. ʻOiai ʻo ka puʻuwai puʻuwai benign hiki ke hoʻopilikia i nā pilikia a me nā ʻōuli koʻikoʻi inā kaomi ia i nā hanana koʻikoʻi a i ʻole ke keʻakeʻa ʻana o kona wahi i ka hana a ka puʻuwai.

Hōʻike nā ʻōuli i hana ʻia e nā puʻuwai puʻuwai i ko lākou wahi, ka nui, a me ke ʻano, ʻaʻole kiko tumo kikoʻī. Ma muli o kēia, hoʻohālikelike nā ʻōuli puʻuwai puʻuwai i nā mea ʻē aʻe, ʻoi aku ka maʻamau, nā ʻano puʻuwai e like me ka maikaʻi ʻole o ka puʻuwai a i ʻole arrhythmia. ʻO kahi hōʻike i kapa ʻia he echocardiogram hiki ke ʻokoʻa loa i ka maʻi ʻaʻai mai nā ʻano puʻuwai ʻē aʻe.

Hiki ke hoʻokaʻawale ʻia nā ʻōuli o ka maʻi ʻaʻai puʻuwai mua i ʻelima mau mahele.

1. Kaohi i ke kahe o ke koko

Ke ulu aʻe kahi tumo i hoʻokahi o nā keʻena puʻuwai a i ʻole ma o ka pulupuna puʻuwai, hiki iā ia ke pale i ke kahe o ke koko ma o ka puʻuwai. Kūleʻa nā ʻōuli ma muli o ka wahi tumo:

• ʻAtrium. Hiki i kahi tumo i kahi puʻuwai o luna ke ālai i ke kahe o ke koko i loko o nā keʻena o lalo (ventricles), mimicking tricuspid a i ʻole mitral valve stenosis. Hoʻokumu paha kēia iā ʻoe i ka pōkole o ka hanu a luhi, ʻoi loa i ka wā o ka hoʻoikaika ʻana.
• ʻO Ventricle Hiki i kahi tumo i kahi ventricle ke pale i ke kahe o ke koko mai ka puʻuwai, mimicking aortic a i ʻole stenosis pulmonary valve. Hiki i kēia ke kumu i ka ʻeha o ka umauma, ka luhi a me ka nāwaliwali, ka luhi, a me ka hanu liʻiliʻi.

2. ʻO ka maʻi puʻuwai puʻuwai puʻuwai

Ke ulu aʻe kahi tumo i nā paia muscular o ka puʻuwai, hiki iā lākou ke paʻakikī a hiki ʻole ke paipū maikaʻi i ke koko, mimic i ka cardiomyopathy a i ʻole kūleʻa o ka puʻuwai. Pākuʻi ʻia paha nā ʻōuli:

• pokole o ka hanu
• nā wāwae pehu
• ʻeha ka umauma
• nāwaliwali
• luhi

3. Nā pilikia hoʻokele

ʻO nā tumors e ulu ana i loko o ka puʻuwai puʻuwai e pili ana i ka ʻōnaehana conduction o ka puʻuwai hiki ke hoʻopili i ka wikiwiki a me ka pinepine o ka puʻuwai o ka puʻuwai, mimicking arrhythmia. ʻO ka pinepine, pale lākou i ke ala conduction maʻamau ma waena o ka atria a me nā ventricle. Kapa ʻia kēia inoa poloka puʻuwai. ʻO ka manaʻo o ka atria a me nā ventricle i hoʻonohonoho i kā lākou wikiwiki i kahi o ka hana pū ʻana.

Kaukaʻi ʻia i ka maikaʻi ʻole o ia mea, ʻaʻole ʻoe e ʻike iā ia, a i ʻole manaʻo paha ʻoe e lele ana kou puʻuwai i nā paʻi a kuʻi paha me ka lohi. Inā lohi loa ia, maule paha ʻoe a luhi paha. Inā hoʻomaka ka ventricle e paʻi wikiwiki i kā lākou iho, hiki iā ia ke alakaʻi i ka fibrillation ventricular a me ka hopu koke ʻia o ka naʻau.

4. ʻO Embolus

ʻO kahi ʻāpana liʻiliʻi o ka tumo i haki, a i ʻole ke ʻūlū koko e hana ai, hiki ke huakaʻi mai ka puʻuwai a i kekahi ʻāpana o ke kino a moe i kahi aʻa liʻiliʻi. E loli nā ʻōuli ma muli o kahi o ka embolus e pau ai:

• Lung. Hoʻokumu paha kahi embolism pulmonary i ka hanu, ka ʻeha o ka umauma ʻāʻī, a me ke kuʻi puʻuwai ʻole.
• Lolo. Hoʻopuka pinepine kahi hahau embolic i ka nāwaliwali a i ʻole ka lōlō ma kekahi ʻaoʻao o ke kino, kahi helehelena ʻaoʻao hoʻokahi, pilikia i ka ʻōlelo ʻana a i ʻole ka hoʻomaopopo ʻana i nā huaʻōlelo i kākau ʻia a kākau ʻia paha, a huikau.
• Ka lima a wāwae paha. Hiki i kahi embolism arterial ke hopena i kahi lālā anuanu, ʻeha, a pulseless.

5. Nā ʻōnaehana ʻōnaehana

Hiki i kekahi mau puʻuwai puʻuwai mua ke kumu i nā hōʻailona nonspecific, mimicking i kahi maʻi. Pākuʻi ʻia paha kēia mau ʻōuli:

• ke kuni a me ka haʻalulu
• luhi
• puhū pō
• Kaumaha emi
• ʻeha pū

Hoʻopilikia nā leki metastatic o ka maʻi ʻaʻa puʻuwai lua i ka pale a puni ka waho o ka puʻuwai (pericardium). Ke alakaʻi pinepine nei kēia i kahi buildup o ka wai a puni ka puʻuwai, e hana ana i kahi effic pericardial malignant.

Ke piʻi ka nui o ka wai, pahu i ka puʻuwai, e hoʻemi ana i ka nui o ke koko e hiki ke pauma. Pākuʻi ʻia nā ʻōuli me ka ʻeha o ka umauma ʻoi i kou hanu ʻana a me ka hanu ʻana o ka hanu, keu hoʻi ke moe ʻoe i lalo.

Hiki i ke kaomi o ka puʻuwai ke kiʻekiʻe loa i ka pauma liʻiliʻi ʻia o ke koko. Kapa ʻia kēia kūlana hoʻoweliweli i ke ola tamponade. Hiki iā ia ke alakaʻi i nā arrhythmia, haʻalulu, a me ka hopu ʻana o ka naʻau.

Nā kumu o ka maʻi ʻaʻai puʻuwai

ʻAʻole maopopo nā kauka no ke aha e loaʻa ai i kekahi poʻe ka maʻi ʻaʻa puʻuwai a ʻaʻole ʻike nā poʻe ʻē aʻe. Aia wale kekahi mau mea ʻike pilikia no kekahi ʻano o nā puʻuwai puʻuwai.

• Makahiki. Kū pinepine pinepine kekahi mau tumors i nā mākua, a ʻo nā mea ʻē aʻe pinepine i nā pēpē a me nā keiki.
• Hoʻoilina. Hiki i kekahi ke holo i loko o nā ʻohana.
• Nā maʻi maʻi ʻaʻai genetic. ʻO ka hapa nui o nā keiki me ka rhabdomyoma i loaʻa ka tubler sclerosis, kahi maʻi maʻi i hoʻokumu ʻia e kahi hoʻololi (mutation) i ka DNA.
• ʻŌnaehana pale ʻinoʻino. ʻO ka lymphoma cardiac mua ka mea pinepine i ka poʻe me ka ʻōnaehana pale maikaʻi ʻole.

ʻAʻole like me ka mesothelioma pleura i kū i ka uhi (mesothelium) o ka māmā, ʻaʻole i hoʻokumu ʻia kahi pilina ma waena o ka asbestos a me ka mesothelioma pericardial.

ʻIke o ka maʻi ʻaʻai puʻuwai

No ka mea liʻiliʻi loa lākou a ʻano like nā ʻōuli me nā kūlana puʻuwai maʻamau, hiki i nā puʻuwai puʻuwai ke paʻakikī e kuhikuhi.

Hoʻohana mau ʻia nā hoʻokolohua e ʻike pono i ka maʻi ʻaʻai puʻuwai.

• ʻEchocardiogram. Hoʻohana kēia hoʻokolohua i ke kani e hana i kahi kiʻi neʻe e hōʻike ana i ke ʻano a me ka hana o ka puʻuwai. ʻO ia ka hoʻāʻo e hoʻohana pinepine ʻia no ka hōʻailona, ​​ka hoʻolālā hoʻomaʻamaʻa ʻana, a me ka ukali makahiki.
• CT scan. Hiki i kēia mau kiʻi ke kōkua i ka hoʻokaʻawale ʻana i nā puʻupuʻu puʻupuʻu maikaʻi a maikaʻi ʻole.
• MRI. Hāʻawi kēia scanna i nā kiʻi kikoʻī o ka tumo, i hiki ke kōkua i kāu kauka e hoʻoholo i ke ʻano.

ʻAʻole loaʻa kahi laʻana kikoʻī (biopsy) no ka mea hiki i ke kiʻi ke hoʻoholo pinepine i ke ʻano tumo, a hiki i ke kaʻina biopsy ke hoʻolaha i nā hunaola maʻi ʻaʻai.

Nā koho lapaʻau no ka maʻi ʻaʻai puʻuwai

Ke hiki, ʻo ka ʻoki ʻana ʻo ia ka lāʻau o ke koho no nā puʻuwai puʻuwai mua āpau.

ʻO nā kūpuna Benign

• Hiki ke hoʻōla ʻia ka hapa nui o kēia inā hiki ke hemo loa ka tumo.
• Ke nui loa ka tumo a nui paha nā tumors, ʻo ka hemo ʻana i kahi ʻāpana ʻaʻole ia i loko o nā paia o ka puʻuwai hiki ke hoʻomaikaʻi a hoʻopau paha i nā ʻōuli.
• Hiki ke ukali ʻia kekahi ʻano me nā echocardiograms o ka makahiki ma kahi o ke kahakaha inā ʻaʻole lākou e hoʻokumu i nā hōʻailona.

Nā kūpale kūpale

• Ma muli o ka ulu wikiwiki a hoʻouka i nā hanana puʻuwai nui, hiki iā lākou ke paʻakikī loa e mālama.
• Minamina, ʻaʻole i loaʻa ka hapa nui a hiki i ka hoʻoneʻe ʻia ʻana o ka ʻoki.
• Hoʻohana ʻia ʻo Chemotherapy a me radiation therapy i kekahi manawa e hoʻāʻo e lohi i ka ulu ʻana o ka tumo a hoʻomaikaʻi i nā hōʻailona (mālama palliative), akā pinepine ʻole lākou e pono ʻole no ka maʻi ʻaʻai nui.

Maʻi ʻaʻai puʻuwai lua

• I ka manawa e loaʻa ai nā metastases puʻuwai, ua pālahalaha pinepine ka maʻi ʻaʻai i nā meaola ʻē aʻe a ʻaʻole hiki ke mālama ʻia.
• ʻAʻole hiki ke wehe i ka maʻi Metastatic i ka puʻuwai me ke kaʻe
• ʻO ka mālama Palliative me chemotherapy a me radiation therapy ka koho pinepine wale.
• Inā ulu kahi effic pericardial, hiki ke hoʻoneʻe ʻia e ke kau ʻana i kahi nila a i ʻole ka wai liʻiliʻi i loko o ka hōʻiliʻili wai (pericardiocentesis).

Outlook no nā puʻuwai puʻuwai

Maikaʻi ʻole ka maka no nā puʻuwai puʻuwai malignant mua. Ua hōʻike ʻia kahi noiʻi i kēia mau helu ola (ka pākēneka o ka poʻe e ola ana ma hope o ka manawa i hāʻawi ʻia):

• hoʻokahi makahiki: 46 pakeneka
• ʻekolu makahiki: 22 pakeneka
• ʻelima mau makahiki: 17 pakeneka

ʻOi aku ka maikaʻi o ka nānā aku no nā tumors benign. Ua ʻike kekahi i ka helu awelika o ke ola ʻana:

• 187.2 mau mahina no nā maʻi maʻi maʻi benign
• 26.2 mau mahina no nā hikoko malignant

ʻO ka lawe lawe ʻana

Hiki i ke kanulau puʻuwai mua ke lilo i maʻi maʻi maʻi benign a malignant paha a i ʻole ka tumo metastatic lua. Pili nā ʻōuli i ka nui a me kahi o ka tumo a mimic i nā ʻano puʻuwai maʻamau.

He maikaʻi ʻole ka nānā ʻana o ka maʻi ʻaʻai maʻi maʻi ʻōpio malignant akā ʻano laha ʻole loa ia. ʻOi aku ka maʻamau o nā tumele benign a hiki ke hoʻōla ʻia me ke ʻoki.