Aortic stenosis

Msempha ndi mtsempha waukulu womwe umatulutsa magazi kuchokera mumtima kupita ku thupi lonse. Magazi amatuluka kuchokera mumtima ndikupita ku aorta kudzera pa valavu ya aortic. Mu aortic stenosis, valavu ya aortic siyitsegula kwathunthu. Izi zimachepetsa magazi kutuluka mumtima.

Pamene valavu ya aortic imachepa, mpweya wamanzere umayenera kugwira ntchito molimbika kutulutsa magazi kudzera mu valavu. Kuti muchite ntchito yowonjezerayi, minofu pamakoma a ventricle imakulanso. Izi zitha kubweretsa kupweteka pachifuwa.

Pamene kupanikizika kukupitirira, magazi amatha kubwerera m'mapapu. Kuchuluka kwa aortic stenosis kumatha kuchepetsa kuchuluka kwa magazi omwe amafikira kuubongo ndi thupi lonse.

Aortic stenosis imatha kupezeka kuyambira pakubadwa (kobadwa nako), koma nthawi zambiri imayamba pambuyo pake. Ana omwe ali ndi aortic stenosis atha kukhala ndi zikhalidwe zina kuyambira pakubadwa.

Aortic stenosis imachitika makamaka chifukwa cha kuchuluka kwa calcium komwe kumachepetsa valavu. Izi zimatchedwa calcific aortic stenosis. Vutoli limakhudza kwambiri achikulire.

Calcium buildup ya valavu imachitika posachedwa mwa anthu omwe amabadwa ndi ma valavu abortic kapena bicuspid. Nthawi zambiri, calcium buildup imatha kukula msanga munthu akalandira cheza cha chifuwa (monga chithandizo cha khansa).

Choyambitsa china ndi rheumatic fever. Vutoli limatha kuyamba pambuyo pobaya khosi kapena fever. Mavuto a ma valavu samakula kwa zaka 5 mpaka 10 kapena kupitilira apo kuti enaake amveke malungo. Rheumatic fever ikuchulukirachulukira ku United States.

Aortic stenosis imachitika pafupifupi 2% ya anthu azaka zopitilira 65. Zimachitika kawirikawiri mwa amuna kuposa akazi.

Anthu ambiri omwe ali ndi aortic stenosis samakhala ndi zizindikilo mpaka matendawa atakula. Matendawa atha kupezeka pomwe wothandizira zaumoyo atamva kudandaula kwa mtima ndikuchita mayeso.

Zizindikiro za aortic stenosis ndi monga:

• Kusapeza pachifuwa: Kupweteka pachifuwa kumatha kukulirakulira ndikulimbitsa thupi ndikufikira mkono, khosi, kapena nsagwada. Chifuwacho chimamvanso cholimba kapena cholimbidwa.
• Chifuwa, mwina wamagazi.
• Mavuto apuma mukamachita masewera olimbitsa thupi.
• Kukhala otopa mosavuta.
• Kumva kugunda kwa mtima (kugunda kwa mtima).
• Kukomoka, kufooka, kapena chizungulire ndi zochitika.

Kwa makanda ndi ana, zizindikiro zimaphatikizapo:

• Kutopa mosavuta ndikulimbikira (m'malo ofatsa)
• Kulephera kunenepa
• Kudya moperewera
• Mavuto akulu opuma omwe amabwera patatha masiku kapena milungu ingapo kubadwa (zikavuta)

Ana omwe ali ndi aortic stenosis ochepera kapena ochepa amatha kuyipa kwambiri akamakalamba. Ali pachiwopsezo chotenga matenda amtima otchedwa bacterial endocarditis.

Kung'ung'uza mtima, kudina, kapena mawu ena osamveka nthawi zambiri amamvedwa kudzera mu stethoscope. Wothandizirayo amatha kumva kugwedera kapena kusuntha akaika dzanja pamtima. Pakhoza kukhala kukoka kosakomoka kapena kusintha kwa kugunda kwa khosi.

Kuthamanga kwa magazi kumatha kukhala kotsika.

Aortic stenosis imapezeka nthawi zambiri ndikutsatiridwa pogwiritsa ntchito mayeso otchedwa transthoracic echocardiogram (TTE).

Mayesero otsatirawa atha kuchitidwanso:

• ECG
• Yesetsani kuyesa kupanikizika
• Kumanzere kwa catheterization yamtima
• MRI yamtima
• Transesophageal echocardiogram (TEE)

Kupimidwa pafupipafupi ndi wopezera ndalama kumatha kukhala kofunikira pokhapokha ngati matenda anu sali ovuta. Wothandizirayo akuyenera kufunsa za mbiri yaumoyo wanu, kuyesa thupi, ndikuchita echocardiogram.

Anthu omwe ali ndi aortic stenosis atha kuuzidwa kuti asamachite masewera ampikisano, ngakhale atakhala kuti alibe zisonyezo. Ngati zizindikiro zikuchitika, ntchito yovuta nthawi zambiri imayenera kuchepetsedwa.

Mankhwala amagwiritsidwa ntchito kuthana ndi zizindikilo za kulephera kwa mtima kapena mayimbidwe amtima (makamaka kufooka kwamatenda). Izi zimaphatikizapo ma diuretics (mapiritsi amadzi), nitrate, ndi beta-blockers. Kuthamanga kwa magazi kuyeneranso kuthandizidwa. Ngati aortic stenosis ndi yayikulu, mankhwalawa ayenera kuchitidwa mosamala kuti kuthamanga kwa magazi kusatsike kwambiri.

M'mbuyomu, anthu ambiri omwe ali ndi vuto la valavu yamtima amapatsidwa maantibayotiki asanayambe ntchito yamano kapena njira monga colonoscopy. Maantibayotiki adapatsidwa kuti ateteze matenda amtima wowonongeka. Komabe, maantibayotiki tsopano sagwiritsidwa ntchito kwambiri asanagwire mano ndi njira zina. Funsani wothandizira zaumoyo wanu kuti mudziwe ngati mukufuna maantibayotiki.

Anthu omwe ali ndi izi komanso zina pamtima ayenera kusiya kusuta ndikuyesedwa cholesterol.

Kuchita opaleshoni yokonzanso valavu nthawi zambiri kumachitika kwa akulu kapena ana omwe amakhala ndi zizindikilo. Ngakhale zizindikiro sizoyipa kwenikweni, adokotala amalimbikitsa kuti achite opaleshoni kutengera zotsatira za mayeso.

Njira yocheperako yotchedwa balloon valvuloplasty itha kuchitidwa m'malo mochita opaleshoni kapena isanachitike.

• Chibaluni chimayikidwa mumtsempha m'mimba, cholumikizidwa mpaka pamtima, kuyikidwa pambali pa valavu, ndikukhala ndi mpweya. Komabe, kuchepa nthawi zambiri kumachitikanso pambuyo pa njirayi.
• Njira yatsopano yochitidwa nthawi imodzimodzi ndi valvuloplasty imatha kuyika valavu yopangira (transcatheter aortic valve m'malo kapena TAVR). Njirayi imachitika nthawi zambiri kwa odwala omwe sangathe kuchitidwa opaleshoni, koma ikuchulukirachulukira.

Ana ena angafunikire kukonza ma valo aortic kapena kuwasintha. Ana omwe ali ndi aortic stenosis wofatsa amatha kutenga nawo mbali pazochitika zambiri.

Zotsatira zimasiyanasiyana. Matendawa atha kukhala ofatsa osatulutsa zizindikiro. Popita nthawi, valavu ya aortic imayamba kuchepa. Izi zitha kubweretsa mavuto amtima kwambiri monga:

• Matenda a Atrial ndi flutter atrial
• Magazi amatundikira kuubongo (sitiroko), matumbo, impso, kapena madera ena
• Kukomoka (syncope)
• Mtima kulephera
• Kuthamanga kwa magazi m'mitsempha ya m'mapapo (pulmonary hypertension)

Zotsatira zakusintha kwa valavu ya aortic nthawi zambiri zimakhala zabwino kwambiri. Kuti mulandire chithandizo chabwino kwambiri, pitani kuchipatala chomwe nthawi zonse chimachita opaleshoni yamtunduwu.

Itanani omwe akukuthandizani ngati inu kapena mwana wanu muli ndi zizindikiro za aortic stenosis.

Komanso funsani dokotala wanu nthawi yomweyo ngati mwapezeka kuti muli ndi vutoli ndipo zizindikilo zanu zikuipiraipira kapena zizindikilo zatsopano zimayamba.

Kung'ambika valavu stenosis; Enaake ophwanya kungʻambika stenosis; Calcific kungʻambika stenosis; Mtima kungʻambika stenosis; Valvular kungʻambika stenosis; Kobadwa nako mtima - kungʻambika stenosis; Rheumatic fever - aortic stenosis

• Aortic stenosis
• Mavavu amtima

Carabello BA. Matenda a mtima wa Valvular. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 66.

Wolemba Hermann HC, Mack MJ. Mankhwala opatsirana pogonana a valvular matenda amtima. 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: chap 72.

Lindman BR, Bonow RO, Otto CM. Matenda a valve aortic. 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 68.

Nishimura RA, Otto CM, Bonow RO, ndi al. Kusintha kwa 2017 AHA / ACC kwaupangiri wa 2014 AHA / ACC wowongolera odwala omwe ali ndi matenda amtima wa valvular: lipoti la American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines. Kuzungulira. Chizindikiro. 2017; 135 (25): e1159-e1195. PMID: 28298458 pubed.ncbi.nlm.nih.gov/28298458/.