Matenda osokoneza bongo (ASD)

Atrial septal defect (ASD) ndi vuto la mtima lomwe limakhalapo pakubadwa (kobadwa nako).

Mwana akamakula m'mimba, khoma (septum) limagawa chipinda cham'mwamba kukhala chipinda chakumanzere ndi kumanja. Khoma ili likapanda kupanga bwino, limatha kubweretsa vuto lomwe limatsalira pambuyo pobadwa. Izi zimatchedwa vuto la atrial septal, kapena ASD.

Nthawi zambiri, magazi samatha kuyenda pakati pazipinda ziwiri zakumtunda. Komabe, ASD imalola izi kuchitika.

Magazi akamayenda pakati pazipinda ziwiri zamtima, amatchedwa shunt. Magazi nthawi zambiri amayenda kuchokera kumanzere kupita kumanja. Izi zikachitika mbali yakumanja yamtima imakulitsa. Popita nthawi kupanikizika m'mapapu kumatha kukula. Izi zikachitika, magazi omwe amayenda kupyola chilema amapita kuchokera kumanja kupita kumanzere. Izi zikachitika, pamakhala magazi ochepa omwe amapita mthupi.

Zolakwika zam'mimba zam'mimba zimatchedwa Primum kapena secundum.

• Zolakwitsa zapachiyambi zimalumikizidwa ndi zolakwika zina zamtima za ventricular septum ndi mitral valve.
• Zolakwika za Secundum zitha kukhala bowo limodzi, laling'ono kapena lalikulu. Amathanso kukhala bowo limodzi laling'ono mu septum kapena khoma pakati pazipinda ziwiri.

Zolakwika zazing'ono kwambiri (zosakwana mamilimita 5 kapena ¼ ​​inchi) sizimayambitsa mavuto. Zolakwika zazing'ono nthawi zambiri zimapezeka pambuyo pake m'moyo kusiyana ndi zazikulu.

Pamodzi ndi kukula kwa ASD, komwe chilephereko chimagwira chimakhudza kuthamanga kwa magazi ndi kuchuluka kwa mpweya. Kupezeka kwa zopindika zina zamtima ndikofunikanso.

ASD siofala kwambiri.

Munthu wopanda vuto lina la mtima, kapena chilema chochepa (ochepera mamilimita 5) sangakhale ndi zisonyezo, kapena zizindikilo sizingachitike mpaka zaka zapakati kapena mtsogolo.

Zizindikiro zomwe zimachitika zimatha kuyamba nthawi iliyonse atabadwa kuyambira ali mwana. Zitha kuphatikiza:

• Kupuma kovuta (dyspnea)
• Matenda opatsirana pafupipafupi mwa ana
• Kumva kugunda kwa mtima (kugundana) mwa akulu
• Kupuma pang'ono ndi zochitika

Wopereka chithandizo chamankhwala awunika momwe ASD iliri yayikulu komanso yayikulu kutengera zizindikilo, kuyezetsa thupi, komanso zotsatira za kuyesa kwa mtima.

Wothandizirayo amatha kumva mawu osamveka bwino akamamvera pachifuwa ndi stethoscope. Kung'ung'udza kumangomveka m'malo ena thupi. Nthawi zina, kung'ung'udza sikungamveke konse. Kung'ung'udza kumatanthauza kuti magazi samayenda moyenda bwino mumtima.

Kuyezetsa thupi kumatha kuwonetsanso kuti akulu ena akulephera mtima.

Echocardiogram ndiyeso lomwe limagwiritsa ntchito mafunde akumva kuti apange chithunzi chosuntha cha mtima. Nthawi zambiri kumayesedwa koyamba. Kafukufuku wa Doppler wochitidwa ngati gawo la echocardiogram amalola wothandizira zaumoyo kuti awone kuchuluka kwa kusinthana kwa magazi pakati pazipinda zamtima.

Mayesero ena omwe angachitike ndi awa:

• Catheterization yamtima
• Coronary angiography (ya odwala opitilira zaka 35)
• ECG
• Mtima MRI kapena CT
• Transesophageal echocardiography (TEE)

ASD singafunike chithandizo ngati pali zochepa kapena palibe zizindikiro, kapena ngati chilemacho ndi chaching'ono ndipo sichikugwirizana ndi zovuta zina. Kuchita opaleshoni kuti atseke chilembocho kumalimbikitsidwa ngati chilepheretsocho chimayambitsa kusunthira kwakukulu, mtima watupa, kapena zizindikiro zimachitika.

Njira yapangidwa kuti atseke vutoli (ngati palibe zovuta zina zomwe zilipo) popanda opaleshoni yamtima yotseguka.

• Njirayi imaphatikizapo kuyika chida chotseka cha ASD mumtima kudzera mumachubu wotchedwa catheters.
• Wopereka chithandizo chamankhwala amacheka pang'ono pang'onopang'ono, kenako amalowetsa ma catheters mumtsuko wamagazi ndikufika mumtima.
• Chida chotsekeracho chimayikidwa kudutsa ASD ndipo chilema chatsekedwa.

Nthawi zina, pamafunika opaleshoni ya mtima wonse kuti athetse vutoli. Mtundu wa opaleshoni umafunika kwambiri pakakhala zovuta zina zamtima.

Anthu ena omwe ali ndi zofooka zamatenda amatha kukhala ndi njirayi, kutengera kukula ndi malo olakwikawo.

Anthu omwe ali ndi njira kapena opareshoni yotseka ASD ayenera kulandira maantibayotiki asanalandire mano aliwonse munthawi yotsatira. Maantibayotiki safunika pambuyo pake.

Kwa makanda, ma ASD ang'onoang'ono (osakwana 5 mm) nthawi zambiri samabweretsa mavuto, kapena amatseka popanda chithandizo. Ma ASD okulirapo (8 mpaka 10 mm), nthawi zambiri samatseka ndipo angafunike njira.

Zinthu zofunika ndizophatikizira kukula kwa chilema, kuchuluka kwa magazi omwe akuyenda potsegula, kukula kwa mbali yakumanja ya mtima, komanso ngati munthuyo ali ndi zizindikiro zilizonse.

Anthu ena omwe ali ndi ASD amatha kukhala ndi matenda ena obadwa nawo. Izi zitha kuphatikizira valavu yotayikira kapena bowo mdera lina lamtima.

Anthu omwe ali ndi ASD yokulirapo kapena yovuta kwambiri ali pachiwopsezo chowonjezeka chokhala ndi mavuto ena, kuphatikiza:

• Nyimbo zosadziwika bwino, makamaka kutsekeka kwamatenda
• Mtima kulephera
• Matenda a mtima (endocarditis)
• Kuthamanga kwa magazi m'mitsempha ya m'mapapo
• Sitiroko

Itanani omwe akukuthandizani ngati muli ndi zizindikilo za vuto la atrial septal.

Palibe njira yodziwika yotetezera chilema. Zina mwazovuta zimatha kupewedwa ndikazindikira msanga.

Kobadwa nako mtima chilema - ASD; Mtima wobadwa ndi vuto - ASD; Primus ASD; Masewera a AS

• Kuchita opaleshoni yamtima wa ana - kutulutsa

• Matenda osokoneza bongo

Liegeois JR, Rigby ML. (Adasankhidwa) Matenda a atrial septal (kulumikizana kwamatenda). Mu: Gatzoulis MA, Webb GD, Daubeney PEF, olemba. Kuzindikira ndi Kuwongolera Matenda Aakulu Obadwa Ndi Mtima. Wachitatu ed. Philadelphia, PA: Elsevier; 2018: mutu 29.

Silvestry FE, Cohen MS, Armsby LB, ndi al. Maupangiri owunikira a echocardiographic of atrial septal defect and patent foramen ovale: ochokera ku American Society of Echocardiography ndi Society for Cardiac Angiography and Intervention. J Am Soc Echocardiogr. 2015; 28 (8): 910-958. (Adasankhidwa) PMID: 26239900 adatulutsidwa.ncbi.nlm.nih.gov/26239900/.

Sodhi N, Zajarias A, Balzer DT, Lasala JM. Kutsekedwa kwa patent patent formen ovale ndi atrial septal defect. Mu: Topol EJ, Teirstein PS, olemba. Buku Lophunzitsira la Cardiology. 8th ed. Philadelphia, PA: Elsevier; 2020: chap 49.

Webb GD, Smallhorn JF, Therrien J, Redington AN. Matenda obadwa nawo mumtima mwa wamkulu komanso wodwala. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: mutu 75.