Kube nokudideka okuningi mayelana nalesi sifo esivamile senhliziyo
I-Mitral valve prolapse (MVP) isifo esijwayelekile sokuxilonga inhliziyo. Ngeshwa, kungenye yezinto ezivame ukungaqondi kahle. Ngakho-ke, uma utshelwe ukuthi unayo i-MVP, kubalulekile ukuba uqonde ukuthi iyini, yiziphi izinkinga ezingabangela (futhi kungabangeli), nokuthi yini okufanele uyenze ngakho.
Kuyini i-MVP?
I-MVP yinto engavamile yokuzalwa engavamile eyenza izicubu ezingaphezu kwe-valve ye-mitral (i-valve ehlukanisa i-atrium kwesokunxele ukusuka kwe-ventricle kwesokunxele).
Lokhu okweqile kwezicubu kuvumela i-valve mitral ukuba ibe "i-floppy." Ngenxa yalokho, lapho izinkontileka ze-ventricle ezisele, i-valve ye-mitral ingaphinda ilahleke kancane kancane (noma ibuyele emuva) ku-atrium kwesokunxele. Lokhu kuhogela kuvumela ezinye zegazi kwi-ventricle yangakwesokunxele ukuba zigele phambili (okungukuthi, ukuze zibuyele emuva) endaweni engakwesokunxele. (Ukufunda ngamakamelo nezinhliziyo zamagesi kungakusiza ukuthi uqonde kangcono le nqubo.)
Kuvame ukuthi kube khona ukufakela kwezakhi zofuzo ku-MVP. Uma umuntu ene-MVP yangempela, kungenzeka ukuthi amaphesenti angama-30 wezihlobo zakhe eziseduze angase abe nayo.
I-MVP ikhonjiswe kanjani?
Ngokuvamile, i-MVP iqala ukusola lapho udokotela ezwa umsindo wokuqhafaza "wokuchofoza-murmur" uma ulalela inhliziyo yomuntu. Ukuchofoza kubangelwa umsindo we-snapping owenziwe yi-prolapsing ye-valve valve; ukububula kubangelwa ukuphindaphinda kwegazi emuva emuva kwe-atrium kwesokunxele. Ukuxilongwa kwe-MPV kuqinisekiswa nge- echocardiogram .
Kusobala ukuthi emashumini eminyaka okuqala we-echocardiography, izazi ze-cardiologists zazixhumane kakhulu ekutholeni i-MVP. Okungukuthi, bathola inani elithile lalokho ababekubona njenge-mitral valve ephindaphinda kubantu abasebenzisa amagagasi abo abasebenza empeleni ejwayelekile. Ngenxa yalokho, izinkulungwane zabantu abanhliziyo zabo zivame ukuhlolwa ngokungafanelekile ngaleli fomu lesifo senhliziyo.
Eqinisweni, kwezinye izifundo kuze kube ngamaphesenti angu-35 kubo bonke abantu abavivinywa kuthiwa bane-MVP. Iningi lalaba bantu empeleni lalingenalo, noma inani elincane kakhulu, le-prolapse yangempela.
Eminyakeni yamuva, indlela yokuhlola i-Echocardiographic yokuhlola i-MVP iye yasungulwa ngokuqinile. Ucwaningo oluqhubekayo luye lwabonisa ukuthi umphumela wangempela we-MVP "wangempela" cishe ngamaphesenti amabili kuya ku-3 amaphesenti omphakathi jikelele.
Ngeshwa, kubonakala sengathi abanye odokotela basesimweni esijwayelekile sokuhlola lesi simo.
Kungani i-MVP ibalulekile?
I-MVP ingaveza izinhlobo ezimbili zezinkinga zemitholampilo. Kungabangela izinga lokuphindaphindiwe kwe-mitration , futhi kungenza umuntu akwazi ukuthuthukisa i- endocarditis esithathelwanayo (ukutheleleka kwe-valve senhliziyo).
Ukubaluleka kwe-MVP kuhlobene nhlobo nokuphindaphindiwe kwe-mitral. Ukuphindaphinda okuphawulekayo kwe-mitral (okungukuthi, futhi, i-mitral valve evulekile) ekugcineni kungaholela ekwandiseni amakamelo enhliziyo, ukwehliswa kwemisipha yenhliziyo, futhi ekugcineni, ukuhlukumezeka kwenhliziyo . Ngenhlanhla, iningi labantu abane-MVP abanayo ukuphindaphindiwe kwe-mitral-cishe amaphesenti angu-10 abantu abane-MVP bazoke bahlakulele ngokuphindaphindiwe kwe-mitral esikhathini sokuphila kwabo.
Ngenkathi abantu abane-MVP benengozi encane yokwandisa i-endocarditis esithathelwanayo, leyo ngozi isengaphansi kakhulu. Eqinisweni, ngoba i-endocarditis ingavamile kakhulu, iziqondiso zakamuva zakwa -American Heart Association azisezinconywa ngama-antibiotic we-prophylactic ngeziguli ezine-MVP.
Kuyini Isibikezelo Nge-MVP?
Iningi leziguli ezine-MVP lingalindela ukuhola ukuphila okuvamile, ngaphandle kwempawu ngenxa ye-MVP yazo, futhi ngaphandle kokunciphisa isikhathi sokuphila. Ngokuvamile, ukubikezela kuhlobene eduze nezinga lokubuyiswa kwe-mitral elikhona. Iningi leziguli ezine-MVP ezincane kakhulu zokuphindaphindiwe kwe-mitral zinezizathu ezinhle kakhulu zokubikezelwa .
Yiziphi ezinye izinkinga zemitholampilo eziye zafakwa kuMVP?
Ngenxa yokuthi i-MVP ivame ukutholakala (ngisho noma ingase ingabi khona), ihlotshaniswa nemibandela eminingi okungenzeka ayinayo ngempela i-MVP ngokwayo. Lokhu kudideka kwavela ezinsukwini zokuqala ze-echocardiography, ngenkathi i-MVP ixilongwa kakhulu. Noma nini lapho isiguli sikhala ngezibonakaliso ezithile noma izinkinga ezithile, odokotela babeyoyala i-echocardiogram-futhi cishe ngamaphesenti angu-35 ngaleso sikhathi, babeyothola "i-MVP." Izinkinga eziningi zemitholampilo ziye zatshelwe i-MVP kule minyaka embalwa edlule, lapho imitholampilo yangempela inhlangano ingase ibe khona nhlobo.
Nazi izimo ezivame kakhulu eziye zahlotshaniswa ne-MVP, kodwa ubuhlobo babo boqobo ku-MVP bubuhlungu kakhulu:
Ukukhathazeka, ubuhlungu besifuba , ukuphawula . Nakuba kuvame ukukholelwa ukuthi i-MVP ibangele lezi zimpawu, abantu abaningi abane-MVP abazitholi, futhi abantu abaningi abanezinkathazo, ubuhlungu besifuba, ne-palpitations abanalo i-MVP. Ukuhlangana kweqiniso ne-MVP akukaze kuboniswe.
Ukushaywa yisisu noma ukufa okungazelelwe. Akukaze kuboniswe ukuthi i-MVP ngokwayo ibangela ukushaywa noma ukufa okungazelelwe, noma ukuthi izigameko ze-MVP ziphakeme kunezinye iziguli ezibhekana nalezi zinkinga. Ngenkathi iziguli ezinomthelela omkhulu wokubuyiswa kwezidakamizwa zisuka kunoma yikuphi imbangela zinengozini enkulu yokwehla kwesifo sohlangothi kanye nokufa okungazelelwe, labo abaneMVP emincane cishe banengozi efanayo nomphakathi jikelele. Funda kabanzi mayelana ne-MVP nokufa okungazelelwe .
Ama- syndromes e-dysautonomia . Ama-syndromes e-dysautonomia, afaka phakathi izinto ezinjengokugula okungapheli syndrome , i- vasovagal (noma i-neurocardiogenic) syncope , ukuhlaselwa kwe-panic , i- fibromyalgia , ne- syndrome eyathukuthela , ngokuvamile ivame ukubizwa nge-MVP. Akucaci ukuthi abantu abane-MVP empeleni banengozi enkulu yokuthuthukisa izimpawu ezihlobene nama-dysautonomias (njengama-palpitations, ukukhathazeka, ukukhathala, ama-aches, nezinhlungu). Kodwa ekukhulekeleni kwabo ukuthola ukuxilongwa kweziguli ezikhononda ngalezi zimpawu, futhi ngaleyo ndlela ziyala zonke izivivinyo ezaziwayo kumuntu, odokotela bathole (ngokwemvelo) ukuthi ingxenye yalezi ziguli ezinzima zinesi-MVP. Ngakho odokotela baye bahlanganisa le nkulumo ethi "Mitral Valve Prolapse Syndrome" ukuyichaza. Kungakhathaliseki ukuthi i-MVP ngokwayo ihlangene yini nalezi zimpawu akungabazeki kakhulu.
Izwi elivela
Uma utshelwe ukuthi unayo i-MVP, kufanele uqiniseke ukuthi uyaqonda kusuka kudokotela wakho izinga lokuphindaphindiwe kwe-mitral, nokuthi udokotela wakho ubeke isimiso sokuhlola okulandelwayo. Uma ungenakho ukuphindaphindiwe kwe-mitral, kuzomele udingeke uhlolwe ngokomzimba njalo eminyakeni emihlanu noma ngaphezulu. Uma kunesilinganiso esithile sokuphindaphinda kwe-mitral, ama-echocardiograms anyaka ngamunye kufanele acatshangelwe.
Uma unezibonakaliso ezifana nobuhlungu besifuba noma ama-palpitations, lezi zimpawu kufanele zihlolwe njengezinkinga ezihlukene. Uma udokotela wakho ebhala nje lezi zimpawu njengoba ngenxa ye-MVP, engakaze ahlole ngokugcwele, cabanga ngokufuna olunye umbono.
Uma ucabanga ukuthi ungaba nesinye sezidakamizwa ze-dysautonomia, qiniseka ukuthi udokotela wakho uyazi kahle ekulawuleni le mibandela. Musa ukuchitha isikhathi nodokotela obonakala ethanda futhi ukubhala izimpawu zakho "njengengxenye nje ye-MVP." I-dysautonomiy yizifo ezingokoqobo, ezithembekile-ubuhle zemizimba ye-physiologic, ezihlukile kwe-MVP, futhi ezifanelwe ukuphathwa futhi zingasuswa.
> Imithombo:
> Avierinos, JF, Gersh, BJ, Melton LJ 3rd, et al. Umlando Wemvelo Wokungaqondakali I-Mitral Valve Ibuyela Emphakathini. Ukujikeleza kuka-2002; 106: 1355.
> Kim, S, Kuroda, T, Nishinaga, M, et al. Ubuhlobo Phakathi Kokucindezeleka Kwe-Mitral Ukuphindaphinda Nokuguqulwa Kwe-Mitral Valve Prolapse: Ukufunda Okulandelwayo kwe-Echocardiographic. Am Heart J 1996; 132: 348.
> Nishimura RA, Otto CM, Bonow RO, et al. 2014 I-Aha / Acc Guideline Yokuphathwa Kwabagulayo abane-Valvular Heart Disease: Umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice. J Am Coll Cardiol 2014; 63: e57.