Eminyakeni yamuva, abantu abaningi abanama- echocardiograms bayamangala ngolwazi lokuthi banesimo senhliziyo sokuzalwa esibizwa ngokuthi "i-patent foramen ovale," noma i-PFO.
Iseluleko laba bantu abasithola ngemuva kokunikezwa lokhu kuhlolisiswa kuzohlukahluka. Abanye odokotela bazofuna ukuwaphatha nge- warfarin noma i-aspirin ukuzama ukuvimbela ama-blood clots.
Abanye bayotusa inqubo yenhliziyo engavamile ukufaka idivayisi ekhethekile ukuvala i-PFO. Noma kunjalo, abanye odokotela bazokutshela ukuthi i-PFO ayikho into ebaluleke kakhulu futhi ayikho ikwelashwa edingekayo.
Lesi sihloko sifingqa ukuthi yini eyaziwayo nge PFO kanye nokuzama ukubeka ingxabano yamanje mayelana nokuphathwa kwayo ngendlela efanele.
Yini i-PFO?
Emvuleni okhulayo, i-foramen ovale yimibukiso evame ukuba khona kule-septum ye-atrial (isakhiwo esincane esahlukanisa i-atrium elungile ukusuka ku-atrium kwesobunxele), okuvumela igazi ukuba ligijime ngokukhululekile kusuka ku-atrium elungile ngqo kwi-atrium kwesokunxele. Lokhu kugeleza kwegazi kusuka ku-atrium kwesokudla kuya kwe-atrium kwesokunxele kuyadingeka ngesikhathi sokuthuthukiswa komntwana, njengoba kuvumela igazi elijikelezayo ukuba lidlule amaphaphu athuthukayo. (I-fetus ithola igazi layo e-oksijeni kumama wayo, ngokusebenzisa i-placenta.)
Lapho uzalwa, lapho ingane iqala ukuphefumula, ukucindezela ngakwesokunxele kwe-atrium kwanda ngokushesha futhi ukucindezela ku-atrium kwesokudla kunciphisa.
Lesi sici sokucindezela senza i-flap of tissue izibophezele phezu kwe-foramen ovale, ngokuyivala ngokuphumelelayo. Kuleli phuzu, igazi alisakwazi ukugeleza ngaphesheya kwe-foramen ovale, kusukela ngakwesokudla kuya ku-atrium kwesokunxele.
Kubantu abaningi, leli phuzu lezincuba ezivala i-foramen ovale livalwe, ngakho-ke i-foramen ovale ayisekho kahle.
Kodwa-ke, kumuntu oyedwa kwabadala abane abavamile (amaphesenti angu-25), i-flap ye-tissue ayihlanganisiwe ngokuphelele futhi ixhomeke ekucindezelweni okuphezulu kwesitoreji sokungakwesokunxele ukugcina i-olamle ye-foramen ivaliwe. Uma ingcindezi e-atrium efanele iphakama ngokweqile kune-atrium engakwesokunxele (njengoba kungenzeka, ngokwesibonelo, uma ukhwehlela), ngenxa yalezi zikhathi ezimfushane i-foramen ovale ingavula, futhi, okwesikhashana igazi liphinde ligele kusukela ku-atrium elungile kuya kwe-atrium kwesokunxele. Laba bantu kuthiwa babe ne-patent foramen ovale. Ukubheka ngokucophelela isakhiwo senhliziyo nendlela esebenza ngayo kunganikeza ukuqonda okungcono kwale ndlela.
I-PFO ihlolwe kanjani?
Odokotela baxilonga i-PFOs nge-echocardiography. Akuzona zonke i-PFOs ezifanayo, kanti ezinye zilukhuni kakhulu ukuthola kunabanye. Ezimweni ezimbalwa, i-PFO ibonakala ngokucacile futhi ingabonwa yi-echocardiographer. Ngokuvamile, kudingekile ukuthi kusetshenziswe okukhethekile ukukhomba i-PFO, kuhlanganise ne -echocardiography e-trans-esophageal , injecting material material egazini (" ukutadisha "), futhi ngisho nokusebenzisa ukucindezela okuhle emoyeni ngokusebenzisa idivayisi ekhethekile yokuphefumula. Okubaluleke nakakhulu ukuthi i-echocardiographer isebenza ukukhomba i-PFO, okungenzeka ukuthi uzobona eyodwa.
Kwamanye abantu, i-flap of tishu ehlanganisa i-foramen ovale ingahlakulela i-balge-like bulge, ebizwa ngokuthi i-aneal aneurysm ye-atrial (ASA.) Ezimweni eziningi i-ASA ihambisana ne-PFO, ngakho-ke lezi zimo ezimbili zivame ukuhambisana nomunye nomunye. Ngakho-ke i-ASA ne-PFO zifana kakhulu, futhi cishe akuyona into engalungile ukucabanga nge-ASA njengesibonelo esithile esiphezulu (futhi mhlawumbe esicacile kakhulu) se-PFO.
Kuyini Ukubaluleka Kwe-PFO?
I-cryptogenic stroke. Isizathu sokuthi odokotela bakhathazeke nge-PFOs yilokho, ngalezi ziqephu zesikhashana lapho ukucindezeleka kwesifo se-atrial kuphakeme kunokucindezela kwe-atrial kwesokunxele, igazi lingadlulela ukusuka ku-atrium elungile kuya kwe-atrium kwesokunxele.
Uma i- embolus (i-clot yegazi ehamba ngesistimu yemisipha) kwenzeka ukuba ihambe nge-atrium efanele ngaleso sikhathi, nayo ingangena ku-atrium kwesokunxele. Kusukela kwesokunxele i-clot ingakwazi ukugeleza ngaphakathi kwe-ventricle engakwesokunxele, futhi ukusuka lapho ungene ohlelweni lokuguqula, kunoma iyiphi ingxenye yomzimba. Uma i-clot iya ebuchosheni, ingabangela isifo . Ngakho-ke, ukukhathazeka okuyinhloko mayelana ne-PFO ukuthi kungabangela ingozi yokwanda kwesifo.
Manje sekukholelwa ukuthi i-PFO iyisisodwa sezizathu zokuthi "i- cryptogenic stroke " - okungukuthi, isifo esiyingozi esingabonakali ngemuva kokuhlolwa okuphelele kwezokwelapha. Kodwa-ke, ngoba ukusakazeka kwama PFOs kuphakame kakhulu, ikakhulukazi uma ubhekelela kanzima, uthola nje i-PFO kumuntu obhekene nesifo sokushaywa yindlala ngaphandle kokufakazela ukuthi i-PFO ibhekene nesifo sohlangothi.
Ucwaningo lwamuva luye lwaphakamisa ukuthi, kubantu abangaphansi kweminyaka engama-60 abaye babhekana nesifo sokushaya i-cryptogenic, futhi abane-PFO enkulu (noma i-PFO ehlobene ne-ASA), ukuvala i-PFO kuye kwahlanganiswa nengozi enciphise yokushaya kwesisu . (I-PFOs ingavalwa ngesiphakamiso esikhethekile esingasetshenziswa nge-catheter.)
Kodwa-ke, ukuvalwa kwe-PFO akuyona inqubo yokungena engozini, kanti inzuzo yokwenza kanjalo ibonwe kuphela kwiziguli ezihlolwe ngokucophelela. Lokhu kungenxa yokuthi izigameko eziningi ze-cryptogenic azibangelwa yi-PFOs, ngisho nalapho i-PFO ibonakala. Ukuvalwa kwe-PFO kufanele kubhekwe ngabasindile abahlukunyezwa kuphela emva kokuhlolwa okuphelele yi-cardiologist kanye neurologist.
I-Migraines. Ucwaningo oluthile luye lwasikisela ukuthi i- migraine ikhanda livame kakhulu kubantu abane PFOs. Kodwa ezinye izifundo zabantu azibonisi ukuhlangana phakathi kwe-PFOs kanye ne-migraines. Ngakho-ke ngisho nokuhlangana phakathi kwe-migraines ne-PFO kungabaza imibuzo. Ngaphezu kwalokho, azikho izingqinamba eziphathekayo ze-physiologic eziye zaboniswa ukuthi iPOO ingabangela kanjani imithanguzo.
Ukungabi nalolu daba akuzange kuvimbele odokotela abathile ekunconyeni amadivaysi okuvalwa kwe-PFO kulabo abagulayo. Abanye abenza le nqubo babike ukuthi abantu abane-migraines babhekana nokunciphisa izimpawu. Ngenxa yalesi simangalo, kwahlolwa ukuhlolwa okungahleliwe ukuze kuhlolwe ukuthi ukuvalwa kwe-PFO kuphumelele yini. Lolu cwaningo olulawulwa ngokuhlukunyezwa, olushicilelwe ngo-2008, alubonanga nhlobo inzuzo ngokuvalwa kwe-PFO.
Kuleli qophelo kunesizathu esincane sokukholelwa ukuthi i-PFOs iyimbangela yokuphathwa ikhanda. Ukunikeza i-PFO ukuvalwa kwabahlukumezekile yikusebenzisa ngokunembile ukuthi bonke-futhi-bavame ukulangazelela noma yini okuthiwa umuntu angabasiza. Iningi labantu abane-migraine lingakwazi ukuthola ukulawula okunengqondo kwezimpawu zabo uma bengathola udokotela okhathalelayo futhi basebenze eduze naye.
I-Platypnea-orthodeoxia syndrome. I-Platypnea-orthodeoxia syndrome yisimo esingavamile lapho umuntu engakwazi ukuphefumula futhi ehlushwa amazinga aphansi e-oxygen okwamanje. Lesi simo asidingi kuphela i-PFO, kodwa futhi nesinye isimo senhliziyo esenza iPOO ivule lapho umuntu ephakama. Ngokuvamile, lesi "esinye isimo" siyinto engavamile yokwakhiwa kwegazi enhliziyweni ekhuthaza ukugeleza kwegazi kusukela ku-atrium kwesokudla kuya kwe-atrium kwesokunxele. Ukuvala i-PFO ngokuvamile kuyinye yezinyathelo ezidingekayo ukuphatha le syndrome engavamile.
Izwi elivela
I-patent foramen ovale iyisifo se-"yesimanje" sokuxilongwa kwezokwelapha, esasakazeke kuphela emashumini ambalwa eminyaka edlule ngokufika kwe-echocardiography. Ngenkathi i-PFO icatshangwa ukuthi iyimbangela engavamile ye-cryptogenic stroke, iningi labantu abatholwa ukuthi bane-PFO, akukho zinkinga zezokwelapha ezizovela kulo.
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