Ngo-2007 Chicago Marathon, umgijimi wagwa futhi wafa, okwenza isihloko sezwe. Ngemuva kokuba enze i-autopsy, umhloli wezokwelapha waseChicago wamemezela ukuthi ukufa komuntu ngokuzumayo ngokuqinisekile akubangelwa ukushisa nomswakama ocindezelayo owabangela izinkinga ezinkulu phakathi kwabagijimi abaningi ngalolosuku (futhi ekugcineni kwabangela abahleli ukuba bayeke umncintiswano), kodwa esikhundleni kuya " mitral valve prolapse " (MVP).
Lesi siqinisekiso ngokungangabazeki sasizikhulule kakhulu izikhulu zendawo ezibhekene nokuqhubeka nomncintiswano naphezu kwezimo zezulu ezesabekayo, futhi obani (ngenxa yeziphetho ze-autopsy) manje basebenzile ngokusemthethweni ngenkohlakalo ngokufa kwalowo muntu.
Ngokusobala, asinaso indlela yokwazi imbangela yangempela yokufa kwalomgijimi oswele. Kodwa-ke, isimemezelo esiqinisekisiwe sokuhlolwa kwe-medical examiner sikaChicago sakha okungenani isibalo esithile sokwesaba phakathi kwabangamaMelika abangaba yizigidi ezingu-75 (ngezinye izilinganiso) kungenzeka futhi babe ne-MVP. Kwaphela amasonto ambalwa, izazi ze-cardiologists zaseMelika zazigcwele izikhalazo zokushayela ucingo.
I-Mitral Valve Prolapse nokufa okungazelelwe
Ngakho-ke, umbuzo ubhekene nokubuza: Ingabe i-MVP ingabangela ukufa okungazelelwe?
Impendulo yukuthi kubonakala sengathi kunyuke kancane engozini yokufa ngokungazelelwe kusuka e- ventricular tachycardia noma e- ventricular fibrillation kubantu abane-MVP ephawulekayo kodwa hhayi ebantwini abaningi abaye bathola ukuxilongwa kwe-MVP.
Okutholakala kakhulu nge-MVP kunesimo esibucayi kakhulu sesimo, esingenayo ingozi elinganiswayo.
Ubufakazi bokuqala bokuthi i-MVP ingahle ihlotshaniswe nokufa okungazelelwe kwavela ngokuyinhloko kusuka ochungechungeni lwe-autopsy. Ezifundweni lapho inhliziyo iye yahlolisiswa ngokucophelela kubantu abaye bafa ngokuzumayo, ubufakazi be-MVP bungatholakala emncintiswaneni encane.
Ngakho-ke, ngokwemvelo, i-MVP ibilokhu icatshangelwa ukuthi iyimbangela yalokhu kufa okungazelelwe.
Kodwa izinto ezimbili azikhulumi ngokujwayelekile kulezi zifundo. Okokuqala, izisulu eziningi zokufa ngokungazelelwe azikho ukubonakala okungavamile kwenhliziyo. Okwesibili, uma uzimisele ukuthola i-MVP, uzokwazi ukuthola okungenani ubufakazi bayo ngenani elikhulu labantu abaningi.
Kukhona ubufakazi obuncane kakhulu bokuthi iningi labantu ababhekene ne-MVP linomngcipheko owandayo ngokulinganisa wokufa okungazelelwe.
I-Overdiagnosis ye-MVP
Uma wenza i- echocardiography kubantu abakhethwe ngokungahleliwe, kuye ngokuthi kusetshenziswe kanjani izindlela zokuxilonga, i-MVP ingatholakala ukuthi ifika ku-20% - 35%. Inani le-prolapse langempela kule iningi lamagagasi ama-mitral aliyona engokwenyama kakhulu futhi ayifuni nengozi eyaziwayo. Ngempela, njengoba ikhwalithi yezinto zokugcina i-echocardiographic ithuthukile phakathi neminyaka, sekuye kwenzeka ukuthola ukuthi kuncane kangakanani (okuvamile kaningi futhi okungenayo) inani le-valve mitral. Iningi lezazi zamukela iqiniso lokuthi isimo "MVP" sesiphezulu kakhulu-sesitholwe yi-cardiologists.
Ikhono lokuthola inani elithile le-MVP uma ulibheke kanzima lingase libe lula kakhulu odokotela (noma ngenxa yalolu daba, kubaphathi bomncintiswano), ngoba kungabenza baphinde babheke ukuthi babhekisise izimpawu noma izimo kunzima noma kungathandeki ukuhlolisisa noma ukuphatha (i- dysautonomia yiyona evelele kunazo zonke).
Ngakho-ke, kuvame ukuba nesisusa esinamandla sokuxilonga ngokweqile i-MVP.
Ukuthola i-MVP ngokufanelekile
Ngonyaka ka-2008, ngokuqaphela ukuthi ukuxilongwa kwe-MVP kuye kwakhula ngendlela engafanele ekuqhakambeni kwesifo, i-American College of Cardiology kanye ne-American Heart Association yashicilela izindlela ezingavamile zokuhlola i-MVP. Ukusebenzisa lezi zindlela ezifanele kakhulu zokwenza ukuxilongwa, kunobunye ubufakazi bokuthi ingozi ekhuphuka kakhulu ye- arrhythmias yenhliziyo nokufa okungazelelwe, nakuba leyo nengozi enkulu kakhulu isesincane kakhulu.
Eqinisweni, ingozi enkulu kulaba bantu akuyona ukufa okungazelelwe, kodwa ukuthuthukiswa kokuphindaphindiwe kwe-mitral nokuhluleka kwenhliziyo .
Kulaba bantu ingozi yokufa okungazelelwe iphakanyiswe ngempela-kodwa isilinganiso esifanayo lapho iphakanyiswa kunoma ubani omunye onamandla okubuyela emuva, kunoma yikuphi isizathu.
Ukusabalalisa kwaloluhlobo lwe-MVP (okungukuthi, langempela, oluphawulekayo lwe-MVP) kubantu abanzi liphela cishe ngo-1-2% hhayi 35%. Futhi phakathi kwalezi zinamba ezincane kakhulu zeziguli ezine-MVP, ngaphansi kuka-1 kuya ku-20 kuzoke zakha izinkinga ezinkulu ze-valral valve.
Izwi elivela
Okubalulekile ukuthi akucaci neze ukuthi i-MVP-okungenani, ifomu eliphansi le-MVP ukuthi iningi labantu ababhekene nalesi simo-liye lihlobene nokufa okungazelelwe, kungabi yimbangela yokufa okungazelelwe.
Ngenxa yokuthi iningi leziguli eziye zatshelwa ukuthi zine-MVP, ingozi yokufa okungazelelwe ayikho ngaphezu kwababantu jikelele, futhi izinhlekelele ezifana ne-Chicago akufanele zibangele ukukhathazeka ngokungadingekile.
Uma utshelwe ukuthi unayo i-MVP, kufanele ufunde kusuka ku-cardiologist yakho noma ngabe ukuxilongwa kwenzelwa ukusebenzisa indlela entsha yokuhlola, noma ukuthi ngabe ukuxilongwa kwenzelwe indlela endala, lapho ungathola khona i-MVP cishe noma ubani uma uyibheka kanzima ngokwanele.
> Imithombo:
> Bonow RO, uCarabello BA, Chatterjee K, et al. Ukubuyekezwa okugxilwe ngo-2008 okuhlanganisiwe ku-Acc / Aha 2006 Imihlahlandlela Yokuphathwa Kwabagulayo Ngezifo Zezinhliziyo Ze-Valvular: Umbiko We-American College of Cardiology / American Heart Association Umsebenzi Wezinkombandlela Zemihlahlandlela (iKomidi Yokubhala Ukubuyekeza Izeluleko Zika-1998 Zokuphathwa Kwezinkinga Iziguli ezine-Valvular Heart Disease): zamukelwa yiNhlangano Yezinhliziyo Zezinhliziyo Ze-Anesthesiologists, i-Society for Cardiovascular Angiography and Interventions, kanye neNhlangano Yezifo Ezihlinzeka Ngama-Thoracic. Ukujikeleza ngo-2008; 118: e523.
> Sriram CS, Syed FF, Ferguson ME, et al. Ibhilifi Ezingcolile I-Mitral Valve I-Prolapse Syndrome Ezigulini Ngaphandle kwalokho Idiopathic Out-Of-Hospital I-Cardiac Ukuboshwa. J Am Coll Cardiol 2013; 62: 222.