Matenda a mtima wa Cyanotic

Matenda a mtima wa cyanotic amatanthauza gulu la zofooka zosiyanasiyana zamtima zomwe zimakhalapo pakubadwa (kobadwa nako). Amabweretsa mpweya wochepa wama oxygen. Cyanosis amatanthauza mtundu wabuluu wakhungu ndi ntchofu.

Nthawi zambiri, magazi amabwera kuchokera mthupi ndikuyenda kudutsa mumtima ndi m'mapapu.

• Magazi omwe alibe mpweya wabwino (magazi abuluu) amabwerera kuchokera mthupi kupita kumanja kwamtima.
• Mbali yakumanja yamtima kenako imapopa magazi kupita m'mapapu, komwe imatenga mpweya wambiri ndikukhala wofiira.
• Magazi olemera ndi oxygen amabwerera kuchokera m'mapapu kupita kumanzere kwa mtima. Kuchokera pamenepo, amaponyedwa kuthupi lonse.

Zofooka za mtima zomwe ana amabadwa nazo zimatha kusintha momwe magazi amayendera kudzera mumtima ndi m'mapapu. Zowonongekazi zimatha kupangitsa magazi ochepa kuthamangira m'mapapu. Zitha kupanganso kusakanikirana kwa magazi abuluu ndi ofiira. Izi zimapangitsa magazi operewera mpweya wabwino kupopera thupi. Zotsatira zake:

• Magazi omwe amaponyedwera thupi amakhala ndi mpweya wochepa.
• Mpweya wocheperako ukaperekedwa mthupi umatha kupangitsa khungu kuwoneka labuluu (cyanosis).

Zina mwazolephera zamtima zimaphatikizira ma valve amtima. Zolakwikazi zimakakamiza magazi amtambo kusakanikirana ndi magazi ofiira kudzera mumisewu yachilendo. Mavavu amtima amapezeka pakati pamtima ndi mitsempha yayikulu yamagazi yomwe imabweretsa magazi kuchokera kumtima. Mavavu amenewa amatseguka mokwanira kuti magazi azidutsamo. Kenako amatseka, kuti magazi asatuluke chammbuyo.

Zofooka zamavuto amtima zomwe zingayambitse cyanosis ndi monga:

• Tricuspid valavu (valavu pakati pazipinda ziwiri mbali yakumanja kwa mtima) itha kupezeka kapena singathe kutsegula kokwanira.
• Valavu wamapapo (valavu pakati pa mtima ndi mapapo) atha kusowa kapena sangathe kutsegula mokwanira.
• Aortic valve (valavu pakati pa mtima ndi chotengera magazi mpaka thupi lonse) sichitha kutsegula mokwanira.

Zolakwika zina zamtima zimatha kuphatikizira zovuta pakukula kwa valavu kapena malo ndi kulumikizana pakati pamitsempha yamagazi. Zitsanzo zina ndi izi:

• Kuzungulira kapena kusokoneza kwathunthu kwa aorta
• Zovuta za Ebstein
• Matenda a mtima otsalira
• Zolemba Zachinyengo
• Kubwerera kwathunthu koopsa kwam'mapapo
• Kusintha kwa mitsempha yayikulu
• Truncus arteriosus

Matenda ena mwa mayi amatha kuonjezera chiwopsezo cha matenda amtima wa cyanotic khanda. Zitsanzo zina ndi izi:

• Kutulutsa mankhwala
• Matenda a chibadwa ndi chromosomal, monga Down syndrome, trisomy 13, Turner syndrome, Marfan syndrome, ndi matenda a Noonan
• Matenda (monga rubella) panthawi yoyembekezera
• Mlingo wa shuga wamagazi wosalamulirika mwa amayi omwe ali ndi matenda ashuga ali ndi pakati
• Mankhwala operekedwa ndi omwe amakuthandizani azaumoyo kapena omwe mumagula nokha ndikugwiritsa ntchito nthawi yapakati
• Mankhwala a mumsewu omwe amagwiritsidwa ntchito panthawi yapakati

Zofooka zina zamtima zimayambitsa mavuto akulu atangobadwa.

Chizindikiro chachikulu ndi cyanosis ndi mtundu wa milomo, zala, ndi zala zakumaso zomwe zimayambitsidwa ndi mpweya wochepa m'magazi. Zitha kuchitika mwana akapuma kapena pokhapokha mwanayo atagwira.

Ana ena ali ndi vuto lakupuma (dyspnea). Amatha kulowa m'malo obisalako atachita masewera olimbitsa thupi kuti athetse kupuma.

Ena ali ndi maula, momwe matupi awo amasowa mwadzidzidzi mpweya wa oxygen. Pakati pa izi, zizindikilo zimatha kuphatikiza:

• Nkhawa
• Kupuma mofulumira kwambiri (hyperventilation)
• Mwadzidzidzi kuwonjezeka kwa mtundu wabuluu pakhungu

Makanda amatha kutopa kapena kutuluka thukuta kwinaku akudyetsa ndipo sangakhale olemera kwambiri monga momwe amafunikira.

Kukomoka (syncope) ndi kupweteka pachifuwa kumatha kuchitika.

Zizindikiro zina zimadalira mtundu wa matenda a mtima wosakanikirana, ndipo atha kukhala:

• Mavuto akudya kapena kuchepa kwa njala, zomwe zimabweretsa kukula kosauka
• Khungu lakuda
• Maso kapena nkhope yotupa
• Kutopa nthawi zonse

Kuyesedwa kwakuthupi kumatsimikizira cyanosis. Ana okalamba atha kukhala ndi zala zolimbirana.

Dokotala amamvetsera pamtima ndi m'mapapu ndi stethoscope. Mtima wosazolowereka umamveka, kung'ung'uza mtima, ndi mabowo am'mapapo amveka.

Mayeso amasiyana kutengera chifukwa, koma atha kukhala:

• X-ray pachifuwa
• Kuyang'ana kuchuluka kwa mpweya wamagazi m'magazi pogwiritsa ntchito magazi ochepa magazi kapena kuwunika kudzera pakhungu ndi oximeter
• Kuwerengera kwathunthu kwa magazi (CBC)
• ECG (electrocardiogram)
• Kuyang'ana kapangidwe ka mtima ndi mitsempha yamagazi pogwiritsa ntchito echocardiogram kapena MRI yamtima
• Kupititsa chubu chofewa (catheter) kumanja kapena kumanzere kwa mtima, nthawi zambiri kuchokera kubuula (catheterization yamtima)
• Pulogalamu ya okosijeni yopitilira muyeso (pulse oximeter)
• Echo-Doppler

Ana ena amafunikira kuti azikhala mchipatala akabadwa kuti alandire mpweya kapena kuti aziyikidwa pamakina opumira. Amatha kulandira mankhwala ku:

• Chotsani madzi ena owonjezera
• Thandizani kupopera mtima mwamphamvu
• Sungani mitsempha ina yamagazi
• Chitani kugunda kwamtima kosazolowereka kapena nyimbo

Chithandizo chomwe amasankha pamatenda amtima obadwa nawo ndi opaleshoni yokonza chilema. Pali mitundu yambiri ya opareshoni, kutengera mtundu wa chilema chobadwa. Kuchita opaleshoni kungafunike atangobereka kumene, kapena kungachedwetseke miyezi kapena ngakhale zaka. Opaleshoni ina imatha kuchitika mwana akamakula.

Mwana wanu angafunike kumwa mapiritsi a madzi (okodzetsa) ndi mankhwala ena amtima musanachite opaleshoni kapena pambuyo pake. Onetsetsani kutsatira mlingo woyenera. Kutsata pafupipafupi ndi wopezayo ndikofunikira.

Ana ambiri omwe achita opaleshoni ya mtima ayenera kumwa maantibayotiki kale, ndipo nthawi zina atagwirapo ntchito kapena njira zina zamankhwala. Onetsetsani kuti muli ndi malangizo omveka bwino ochokera kwa omwe amapereka mtima wa mwana wanu.

Funsani wothandizira mwana wanu musanalandire katemera aliyense. Ana ambiri amatha kutsatira malangizo olimbikitsira katemera wa ana.

Maganizo amatengera vuto linalake komanso kuopsa kwake.

Zovuta za matenda amtima wamtundu wa cyanotic ndi awa:

• Nyimbo zosadziwika bwino ndi imfa yadzidzidzi
• Kutalika kwa nthawi yayitali (kuthamanga) kuthamanga kwa magazi m'mitsempha yamagazi yamapapo
• Mtima kulephera
• Matenda mumtima
• Sitiroko
• Imfa

Itanani omwe akukuthandizani ngati mwana wanu ali:

• Khungu labuluu (cyanosis) kapena khungu loyera
• Kupuma kovuta
• Kupweteka pachifuwa kapena kupweteka kwina
• Chizungulire, kukomoka, kapena kugunda kwa mtima
• Mavuto akudya kapena kuchepa kwa njala
• Malungo, mseru, kapena kusanza
• Maso kapena nkhope yotupa
• Kutopa nthawi zonse

Amayi omwe ali ndi pakati ayenera kulandira chithandizo chamankhwala asanabadwe.

• Pewani kumwa mowa ndi mankhwala osokoneza bongo mukakhala ndi pakati.
• Uzani dokotala wanu kuti muli ndi pakati musanamwe mankhwala alionse omwe akupatsani.
• Pezani magazi koyambirira kwa mimba kuti muwone ngati mulibe rubella. Ngati mulibe chitetezo chamthupi, muyenera kupewa kupezeka kwa rubella ndipo muyenera kulandira katemera mukangobereka kumene.
• Amayi oyembekezera omwe ali ndi matenda ashuga ayenera kuyesetsa kuti azitha kuyang'anira shuga wawo wamagazi.

Zina mwazotengera zomwe timakhala nazo zimatha kutenga matenda obadwa nawo amtima. Ambiri mwa abale awo akhoza kukhudzidwa. Ngati mukukonzekera kutenga pakati, lankhulani ndi omwe amakupatsani mwayi wokhudza kuwunika matenda amtundu.

Shunt yamanzere kuchokera kumanzere; Shunt kuchokera kumanja kupita kumanzere

• Mtima - gawo kupyola pakati
• Catheterization yamtima
• Mtima - kuwonera kutsogolo
• Zolemba Zachinyengo
• Kalabu
• Matenda a mtima wa Cyanotic

Bernstein D. Cyanotic wobadwa ndi matenda amtima: kuwunika odwala kwambiri omwe ali ndi cyanosis komanso kupuma kwamatenda. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, MBBS, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2019: mutu 456.

Lange RA, Hillis LD. Matenda amtima obadwa nawo. Mu: Bope ET, Kellerman RD, eds. Chithandizo Chamakono cha Conn 2018. Philadelphia, PA: Elsevier; 2018: 106-111.

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.