Kuchotsa

Dextrocardia ndi mkhalidwe womwe mtima umaloza mbali yakumanja ya chifuwa. Nthawi zambiri, mtima umaloza kumanzere. Vutoli limakhalapo pakubadwa (kobadwa nako).

Mkati mwa milungu yoyambirira ya mimba, mtima wamwana umakula. Nthawi zina, imatembenuka kotero kuti imaloza mbali yakumanja ya chifuwa m'malo mbali yakumanzere. Zifukwa za izi sizikudziwika bwinobwino.

Pali mitundu ingapo ya dextrocardia. Mitundu yambiri imakhudza zolakwika zina zam'mtima ndi pamimba.

Mumtundu wosavuta wa dextrocardia, mtima ndi chithunzi cha mtima wabwinobwino ndipo palibe zovuta zina. Matendawa ndi osowa. Izi zikachitika, ziwalo zam'mimba ndi m'mapapo nthawi zambiri zimakonzedwanso m'chiwonetsero chagalasi. Mwachitsanzo, chiwindi chimakhala kumanzere m'malo momanja.

Anthu ena omwe ali ndi magalasi okhala ndi dextrocardia ali ndi vuto ndi tsitsi labwino (cilia) lomwe limasefa mpweya wopita m'mphuno ndi mmawu amlengalenga. Matendawa amatchedwa matenda a Kartagener.

Mu mitundu yodziwika bwino ya dextrocardia, zopindika zina zamtima zimapezekanso. Zambiri mwa izi ndi izi:

• Vuto loyenda kawiri lamanja (aorta imalumikiza kolowera kumanja m'malo moyenda kumanzere kumanzere)
• Endocardial khushoni chilema (makoma olekanitsa zipinda zonse 4 za mtima sanapangidwe bwino kapena kulibe)
• Pulmonary stenosis (kuchepa kwa valavu yamapapo) kapena atresia (pulmonary valve siyimapanga bwino)
• Vuto limodzi (m'malo mwa ma ventricle awiri, pali ventricle imodzi)
• Kusintha kwa zotengera zazikulu (aorta ndi pulmonary artery zasinthidwa)
• Ventricular septal defect (dzenje pakhoma lomwe limasiyanitsa ma ventricle akumanja ndi kumanzere a mtima)

Ziwalo zam'mimba ndi pachifuwa mwa makanda omwe ali ndi dextrocardia atha kukhala achilendo ndipo mwina sangathe kugwira bwino ntchito. Matenda owopsa kwambiri omwe amapezeka ndi dextrocardia amatchedwa heterotaxy. Momwemonso, ziwalo zambiri sizili m'malo mwawo ndipo sizingagwire bwino ntchito. Mwachitsanzo, ndulu ikhoza kusowa kwathunthu. Nthendayi ndi gawo lofunikira lachitetezo cha mthupi, chifukwa chake ana obadwa opanda chiwalo ichi ali pachiwopsezo cha matenda opatsirana a bakiteriya ndi kufa. Mu mtundu wina wa heterotaxy, pali tinthu tating'onoting'ono tambirimbiri, koma mwina sangagwire bwino ntchito.

Heterotaxy ingaphatikizepo:

• Ndondomeko yachilendo ya ndulu
• Mavuto ndi mapapo
• Mavuto ndi kapangidwe kapena malo amatumbo
• Zolakwika zazikulu za mtima
• Zovuta zamitsempha yamagazi

Zomwe zingakhale pachiwopsezo cha dextrocardia zikuphatikizapo mbiri ya banja la vutoli.

Palibe zisonyezo za dextrocardia ngati mtima wabwinobwino.

Zinthu zomwe zingaphatikizepo dextrocardia zitha kuyambitsa zizindikiro izi:

• Khungu labuluu
• Kuvuta kupuma
• Kulephera kukula ndikulemera
• Kutopa
• Jaundice (khungu lachikaso ndi maso)
• Khungu loyera (pallor)
• Nthendayi kapena matenda am'mapapo

Wothandizira zaumoyo adzayesa thupi ndikufunsa za zizindikiro.

Kuyesa kuti mupeze dextrocardia ndi monga:

• X-ray pachifuwa
• Kujambula kwa CT pamtima
• Electrocardiogram
• MRI yamtima
• Zojambulajambula

Galasi yathunthu ya dextrocardia yopanda zopindika pamtima sifunikira chithandizo. Ndikofunika, komabe, kudziwitsa wothandizira zaumoyo wamwana kudziwa kuti mtima uli kumanja kwa chifuwa. Izi zitha kukhala zofunikira pamayeso ena ndi mayeso.

Mtundu wa chithandizo chofunikira chimadalira mtima kapena mavuto amthupi omwe khanda limakhala nawo kuphatikiza pa dextrocardia.

Ngati zofooka za mtima zilipo ndi dextrocardia, mwanayo adzafunika kuchitidwa opaleshoni. Ana omwe akudwala kwambiri angafunike kumwa mankhwala asanayambe opaleshoni. Mankhwalawa amathandiza kuti mwana akule kwambiri kotero kuti opaleshoni imavuta.

Mankhwala ndi awa:

• Mapiritsi amadzi (okodzetsa)
• Mankhwala omwe amathandiza kupopera kwa minofu yamtima mwamphamvu kwambiri (inotropic agents)
• Mankhwala omwe amachepetsa kuthamanga kwa magazi ndikuchepetsa ntchito pamtima (ACE inhibitors)

Mwanayo angafunikenso kuchitidwa opaleshoni kuti athetse mavuto m'mimba.

Ana omwe ali ndi matenda a Kartagener adzafunika kuthandizidwa mobwerezabwereza ndi maantibayotiki a matenda a sinus.

Ana omwe ali ndi ndulu yosowa kapena yachilendo amafunikira maantibayotiki a nthawi yayitali.

Ana onse omwe ali ndi vuto la mtima angafunike kumwa maantibayotiki asanachitike maopaleshoni kapena mano.

Ana omwe ali ndi dextrocardia yosavuta amakhala ndi chiyembekezo chokhala ndi moyo ndipo sayenera kukhala ndi mavuto okhudzana ndi komwe kuli mtima.

Pamene dextrocardia imawoneka ndi zolakwika zina mumtima komanso kwina kulikonse mthupi, momwe mwanayo amathandizira zimadalira kukula kwa mavuto enawo.

Ana ndi ana opanda ndulu amatha kutenga matenda pafupipafupi. Izi ndizotheka kupewa pang'ono ndi maantibayotiki a tsiku ndi tsiku.

Zovuta zimadalira ngati dextrocardia ndi gawo la matenda akulu, komanso ngati mavuto ena amapezeka mthupi. Zovuta zimaphatikizapo:

• Matumbo oletsedwa (chifukwa cha vuto lotchedwa kutsekula m'matumbo)
• Mtima kulephera
• Matenda (heterotaxy opanda ndulu)
• Kusabereka kwa amuna (Kartagener syndrome)
• Chibayo chobwerezabwereza
• Matenda abwerezabwereza a sinus (Kartagener syndrome)
• Imfa

Itanani omwe akukuthandizani ngati mwana wanu:

• Zikuwoneka kuti zimadwala pafupipafupi
• Zikuwoneka kuti sizikulemera
• Matayala mosavuta

Funani chisamaliro chadzidzidzi ngati mwana wanu ali:

• Mtundu wabuluu pakhungu
• Kuvuta kupuma
• Khungu lachikaso (jaundice)

Ma syndromes ena omwe amaphatikizapo dextrocardia amatha kuyenda m'mabanja. Ngati muli ndi mbiri ya banja ya heterotaxy, lankhulani ndi omwe amakupatsani musanakhale ndi pakati.

Palibe njira zodziwika zoletsera dextrocardia.Komabe, kupewa kugwiritsa ntchito mankhwala osokoneza bongo (makamaka cocaine) musanachitike komanso mukakhala ndi pakati kumachepetsa chiopsezo cha vutoli.

Lankhulani ndi omwe amakupatsani ngati muli ndi matenda ashuga. Izi zitha kukupangitsani kukhala pachiwopsezo chokhala ndi mwana wamtundu wina wa dextrocardia.

Cyanotic mtima chilema - dextrocardia; Kobadwa nako mtima chilema - dextrocardia; Chilema - dextrocardia

• Kuchotsa

Park MK, Salamat M. Chamber kutanthauzira komanso kuwonongeka kwa mtima. Mu: Park MK, Salamat M, ma eds. Park's Pediatric Cardiology ya Ogwira Ntchito. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2021: mutu 17.

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.