Wachidwi anasiya mtsempha wamagazi kuchokera m'mitsempha yam'mapapo

Mitsempha yamitsempha yamanzere yochokera kumitsempha yama pulmonary (ALCAPA) ndi vuto la mtima. Mitsempha yamitsempha yamanzere (LCA), yomwe imanyamula magazi kupita ku minofu yamtima, imayamba kuchokera pamitsempha yam'mapapo m'malo mwa msempha.

ALCAPA imakhalapo pobadwa (kobadwa nayo).

ALCAPA ndimavuto omwe amapezeka mtima wamwana ukukula msanga ali ndi pakati. Mitsempha yamagazi yomwe ikukula kupita kuminyewa yamtima siyilumikizana molondola.

Mumtima wabwinobwino, LCA imachokera ku aorta. Amapereka magazi olemera okosijeni pamitsempha yamtima kumanzere kwa mtima komanso mitral valavu (valavu yamtima pakati pazipinda zakumtunda ndi zapansi zamtima kumanzere). Aorta ndiye chotengera chachikulu chamagazi chomwe chimachotsa magazi olemera okosijeni kuchokera pamtima kupita ku thupi lonse.

Kwa ana omwe ali ndi ALCAPA, LCA imachokera kumtundu wama pulmonary. Mitsempha yama pulmonary ndiye chotengera chachikulu chamagazi chomwe chimatenga magazi osauka okosijeni kuchokera pamtima kupita m'mapapu kuti atenge mpweya.

Vutoli likachitika, magazi omwe alibe oxygen amapita nawo kumtima wamtundu kumanzere kwa mtima. Chifukwa chake, minofu yamtima siyipeza mpweya wokwanira. Minofu imayamba kufa chifukwa chosowa mpweya. Izi zitha kuyambitsa vuto la mtima mwa mwana.

Vuto lotchedwa "coronary steal" limapwetekanso mtima mwa makanda omwe ali ndi ALCAPA. Kuthamanga kwa magazi m'mitsempha yam'mapapo kumapangitsa magazi kuchokera ku LCA yolumikizidwa modabwitsa kuti abwerere kumtunda wama pulmonary m'malo molowera pamtima. Izi zimabweretsa magazi ochepa komanso oxygen pamisempha yamtima. Vutoli litha kubweretsanso vuto la mtima mwa mwana. Coronary amabera pakapita nthawi kwa ana omwe ali ndi ALCAPA ngati vutoli silichiritsidwa msanga.

Zizindikiro za ALCAPA mu khanda ndizo:

• Kulira kapena kuchita thukuta mukamadyetsa
• Kukwiya
• Khungu lotumbululuka
• Kudya moperewera
• Kupuma mofulumira
• Zizindikiro zowawa kapena kupsinjika kwa mwana (nthawi zambiri amalakwitsa chifukwa cha colic)

Zizindikiro zimatha kuoneka mkati mwa miyezi iwiri yoyambirira ya moyo wamwana.

Nthawi zambiri, ALCAPA imapezeka ali wakhanda. Nthawi zambiri, vutoli silipezeka mpaka wina atakhala mwana kapena wamkulu.

Pakuyesa, wothandizira zaumoyo amatha kupeza zizindikilo za ALCAPA, kuphatikiza:

• Nyimbo yachilendo
• Kukulitsidwa mtima
• Kung'ung'uza mtima (kawirikawiri)
• Kutentha mwachangu

Mayeso omwe atha kulamulidwa ndi awa:

• Echocardiogram, yomwe ndi ultrasound yomwe imawona momwe mtima umakhalira komanso magazi amayenda mkati mwa mtima
• Electrocardiogram (ECG), yomwe imayesa zochitika zamagetsi pamtima
• X-ray pachifuwa
• MRI, yomwe imapereka chithunzi chatsatanetsatane cha mtima
• Catheterization yamtima, njira yomwe chubu yocheperako (catheter) imayikidwa mumtima kuti muwone kuthamanga kwa magazi ndikutenga mulingo woyenera wa kuthamanga kwa magazi ndi kuchuluka kwa mpweya

Kuchita opaleshoni kumafunika kukonza ALCAPA. Nthawi zambiri pamafunika opaleshoni imodzi yokha. Komabe, opaleshoniyi idzadalira momwe mwanayo alili komanso kukula kwa mitsempha yamagazi yomwe ikukhudzidwa.

Ngati minofu ya mtima yothandizira mitral valve yawonongeka kwambiri chifukwa cha kuchepa kwa mpweya, mwanayo angafunikenso kuchitidwa opaleshoni kuti akonze kapena kusintha valavu. Valavu ya mitral imayang'anira magazi pakati pa zipinda kumanzere kwa mtima.

Kuika mtima kumatha kuchitika kuti mtima wa mwana uwonongeke kwambiri chifukwa chosowa mpweya.

Mankhwala omwe amagwiritsidwa ntchito ndi awa:

• Mapiritsi amadzi (okodzetsa)
• Mankhwala osokoneza bongo omwe amachititsa kuti minofu ya mtima igwire kwambiri (inotropic agents)
• Mankhwala osokoneza bongo omwe amachepetsa ntchito pamtima (beta-blockers, ACE inhibitors)

Popanda chithandizo, ana ambiri samakwanitsa chaka choyamba. Ana omwe amapulumuka popanda kulandira chithandizo atha kukhala ndi mavuto amtima. Ana omwe ali ndi vutoli omwe samalandira chithandizo amatha kufa mwadzidzidzi mzaka zotsatirazi.

Ndi chithandizo choyambirira monga opaleshoni, makanda ambiri amachita bwino ndipo amatha kuyembekezera moyo wabwinobwino. Kutsata pafupipafupi ndi katswiri wamtima (cardiologist) kudzafunika.

Mavuto a ALCAPA ndi awa:

• Matenda amtima
• Mtima kulephera
• Mavuto amtundu wamtima
• Kuwonongeka kwamuyaya pamtima

Itanani omwe akukuthandizani ngati mwana wanu:

• Akupuma mofulumira
• Zikuwoneka zotuwa kwambiri
• Zikuwoneka ngati zapanikizika ndikulira nthawi zambiri

Chiyambi chosasunthika cha mtsempha wamagazi wamanzere wotuluka m'mitsempha yama pulmonary; ALCAPA; Matenda a ALCAPA; Bland-White-Garland matenda; Kobadwa nako mtima chilema - ALCAPA; Chilema - ALCAPA

• Wachidwi anasiya mtsempha wamagazi

Abale JA, Frommelt MA, Jaquiss RDB, Myerburg RJ, Fraser CD Jr, Tweddell JS. Malangizo a akatswiri: zoyipa zamtundu wa aortic zamitsempha yama coronary. J Thorac Cardiovasc Opaleshoni. 2017; 153 (6): 1440-1457. PMID: 28274557 pubed.ncbi.nlm.nih.gov/28274557/.

Abale JA, Gaynor JW. Kuchita opaleshoni yokhudzana ndi kubadwa kwa mitsempha yamitsempha. Mu: Sellke FW, del Nido PJ, Swanson SJ, olemba. Opaleshoni ya Sabiston ndi Spencer pachifuwa. 9th ed. Philadelphia, PA: Elsevier; 2016: chap 124.

Johnson JT, Harris M, Anderson RH, Spicer DE, Jacobs M, Tweddll JS, ndi al. Zobadwa ndi matenda am'thupi. Mayi: Wernovsky G, Anderson RH, Kumar K, et al. Matenda a Ana a Anderson. Wolemba 4. Philadelphia, PA: Elsevier; 2020: mutu 46.

Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Matenda ena obadwa nawo a mitima ndi mitima. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: chap 459.