IMitral stenosis

I-Mitral stenosis sisifo apho i-mitral valve ingavuli ngokupheleleyo. Oku kuthintela ukuhamba kwegazi.

Igazi elihamba phakathi kwamagumbi ahlukeneyo entliziyo kufuneka lihambe ngevalve. Ivalve phakathi kwamagumbi ama-2 kwicala lasekhohlo lentliziyo yakho kuthiwa yi-mitral valve. Ivula ngokwaneleyo ukuze igazi liphume kwigumbi eliphezulu lentliziyo yakho (i-atria yasekhohlo) liye kwigumbi elisezantsi (i-ventricle yasekhohlo). Iyavala ke, ukugcina igazi lingaphumi liye ngasemva.

I-Mitral stenosis kuthetha ukuba ivelufa ayinakuvula ngokwaneleyo. Ngenxa yoko, kuncinci igazi elihamba emzimbeni. Igumbi lentliziyo elingaphezulu liyadumba njengoko uxinzelelo lusakha. Igazi kunye nolwelo zinokuqokelela kwizicubu zemiphunga (i-pulmonary edema), yenze kube nzima ukuphefumla.

Kubantu abadala, i-mitral stenosis ixhaphake kakhulu kubantu abane-rheumatic fever. Esi sisifo esinokuphuhla emva kokugula nge-strep throat engakhange inyangwe kakuhle.

Iingxaki zevalvu zikhula kwiminyaka emi-5 ukuya kweli-10 nangaphezulu emva kokuba unerheumatic fever. Iimpawu zisenokungabonakali ixesha elide. I-rheumatic fever iya inqabile e-United States kuba usulelo lwe-strep luhlala lunyangwa. Oku kuye kwenza i-mitral stenosis ingaqhelekanga.

Rhoqo, ezinye izinto zinokubangela i-mitral stenosis kubantu abadala. Oku kubandakanya:

• Iidipozithi zeCalcium ezenza ukujikeleza i-mitral valve
• Ukunyanga ngemitha esifubeni
• Amanye amayeza

Abantwana banokuzalwa nge-mitral stenosis (yokuzalwa) okanye ezinye iziphene zokuzalwa ezibandakanya intliziyo ebangela i-mitral stenosis. Rhoqo, kukho ezinye iziphene zentliziyo ezikhoyo kunye ne-mitral stenosis.

I-Mitral stenosis inokusebenza kwiintsapho.

Abantu abadala banokungabikho mpawu. Nangona kunjalo, iimpawu zinokubonakala okanye ziye zisiba mandundu ngokuzilolonga okanye ngomnye umsebenzi ophakamisa ukubetha kwentliziyo. Iimpawu zihlala zikhula phakathi kweminyaka engama-20 ukuya kuma-50.

Iimpawu zingaqala ngesiqendu se-atrial fibrillation (ngakumbi ukuba ibangela ukubetha kwentliziyo). Iimpawu zisenokubangelwa kukukhulelwa okanye olunye uxinzelelo emzimbeni, njengosulelo entliziyweni okanye emiphungeni, okanye kwezinye iingxaki zentliziyo.

Iimpawu zingabandakanya:

• Ukungonwabi kwesifuba okwandayo ngomsebenzi kwaye kufikelela kwingalo, entanyeni, emhlathini okanye kwezinye iindawo (oku kunqabile)
• Ukukhwehlela, mhlawumbi nge-phlegm enegazi
• Ubunzima bokuphefumla ngexesha nasemva kokuzilolonga (Olu luphawu luqhelekileyo.)
• Ukuvuka ngenxa yeengxaki zokuphefumla okanye xa ulele kwindawo ethe tyaba
• Ukudinwa
• Izifo eziqhelekileyo zokuphefumula, ezifana ne-bronchitis
• Imvakalelo yokubetha kwentliziyo ukubetha (ukubetha kwentliziyo)
• Ukudumba kweenyawo okanye kwamaqatha

Kwiintsana nabantwana, iimpawu zinokubakho kwasekuzalweni (kokuzalwa). Iya kuhlala ihlala ikhula kwiminyaka emibini yokuqala yobomi. Iimpawu zibandakanya:

• Khohlela
• Ukutya okungalunganga, okanye ukubila xa usondla
• Ukukhula kakubi
• Ukuqhawukelwa ngumphefumlo

Umboneleli wezempilo uya kumamela intliziyo kunye nemiphunga nge-stethoscope. Ukumbombozela, i-snap, okanye esinye isandi esingaqhelekanga sinokuvakala. Isimbonono esiqhelekileyo sisandi esidumayo esivakala ngaphezulu kwentliziyo ngexesha lesigaba sokuphumla kwentliziyo. Isandi sihlala sikhwaza ngaphezulu ngaphambi kokuba intliziyo iqale ukusebenza.

Uviwo lunokutyhila ukubetha kwentliziyo okungaqhelekanga okanye ukuxinana kwemiphunga. Uxinzelelo lwegazi luhlala luqhelekileyo.

Ukunciphisa okanye ukuvalwa kwevalve okanye ukudumba kwamagumbi aphezulu entliziyo kunokubonwa ku:

• I-x-ray yesifuba
• Echocardiogram
• I-ECG (i-electrocardiogram)
• I-MRI okanye i-CT yentliziyo
• I-transesophageal echocardiogram (TEE)

Unyango luxhomekeke kwiimpawu kunye nemeko yentliziyo nemiphunga. Abantu abaneempawu ezincinci okanye abanako konke konke abanakudinga unyango. Kwiimpawu ezinzima, unokufuna ukuya esibhedlele ukuze ufumane ukuxilongwa kunye nokunyangwa.

Amayeza anokusetyenziselwa ukunyanga iimpawu zokwehluleka kwentliziyo, uxinzelelo lwegazi oluphezulu kunye nokucothisa okanye ukulawula isingqisho sentliziyo kubandakanya:

• I-diuretics (iipilisi zamanzi)
• IiNitrate, iibhloko ze-beta
• Iibhlokhi zesitayile seCalcium
• I-ACE inhibitors
• I-Angiotensin receptor blockers (ii-ARBs)
• I-Digoxin
• Iziyobisi ukunyanga isingqisho sentliziyo esingaqhelekanga

I-Anticoagulants (igazi elincinci) lisetyenziselwa ukunqanda amahlwili egazi ekubeni enze kwaye ahambele kwamanye amalungu omzimba.

I-antibiotics ingasetyenziselwa kwezinye iimeko ze-mitral stenosis. Abantu abane-rheumatic fever banokufuna unyango lwexesha elide lothintelo nge-antibiotic efana ne-penicillin.

Kwixesha elidlulileyo, uninzi lwabantu abaneengxaki zentliziyo yevalve babenikwa i-antibiotics ngaphambi komsebenzi wamazinyo okanye iinkqubo ezingenayo, ezifana ne-colonoscopy. Amayeza okubulala iintsholongwane anikwa ukuthintela usulelo lwevalvu eyonakalisiweyo yentliziyo. Nangona kunjalo, ii-antibiotics ngoku zisetyenziselwa kakhulu. Buza ugqirha wakho ukuba ufuna ukusebenzisa i-antibiotics.

Abanye abantu banokufuna utyando lwentliziyo okanye iinkqubo zonyango lwe-mitral stenosis. Oku kubandakanya:

• Ibhaluni ye-mitral yebhaluni ye-valvotomy (ekwabizwa ngokuba yi-valvuloplasty). Ngexesha lale nkqubo, kufakwa ityhubhu (i-catheter) emthanjeni, ngesiqhelo emlenzeni. Ifakwe ngaphakathi entliziyweni. Ibhaluni kwincam ye-catheter iyaphuphuma, iyenza nkulu ivalve ye-mitral kunye nokuphucula ukuhamba kwegazi. Le nkqubo inokuzama endaweni yoqhaqho kubantu abane-mitral valve eyonakalisiweyo (ngakumbi ukuba ivelufa ayivuzi kakhulu). Nokuba uphumelele, inkqubo inokufuna ukuphindwaphindwa kwiinyanga okanye kwiminyaka kamva.
• Ugqirha ukulungisa okanye ukubuyisela i-mitral valve. Ivaluva zokutshintsha zingenziwa ngezinto ezahlukeneyo. Ezinye zinokuhlala amashumi eminyaka, kwaye ezinye zinokuphelelwa ngamandla kwaye kufuneka zitshintshwe.

Abantwana bahlala befuna utyando ukuze balungise okanye batshintshe i-mitral valve.

Iziphumo ziyahluka. Ukuphazamiseka kunokuba buthathaka, ngaphandle kwempawu, okanye kunokuba nzima kakhulu kwaye kukhubaze ixesha. Iingxaki zinokuba nzima okanye zisongele ubomi. Kwiimeko ezininzi, i-mitral stenosis inokulawulwa ngonyango kwaye iphuculwe nge-valvuloplasty okanye ngoqhaqho.

Iingxaki zinokubandakanya:

• I-Atrial fibrillation kunye ne-atrial flutter
• Amahlwili egazi kwingqondo (ukubetha), amathumbu, izintso, okanye ezinye iindawo
• Ukusilela kwentliziyo
• Ukudumba kwemiphunga
• Uxinzelelo lwegazi

Fowunela umnikezeli wakho ukuba:

• Unempawu ze-mitral stenosis.
• Unayo i-mitral stenosis kwaye iimpawu aziphuculanga kunyango, okanye iimpawu ezintsha ziyavela.

Landela iingcebiso zomboneleli wakho ngokunyanga iimeko ezinokubangela isifo sevalve. Nyanga izifo ezosulelayo ngokukhawuleza ukuthintela umkhuhlane wamathambo. Xelela umboneleli wakho ukuba unembali yosapho yezifo zentliziyo yokuzalwa.

Ngaphandle kokunyanga usulelo lwe-strep, i-mitral stenosis ngokwayo ayinakuthintelwa, kodwa iingxaki ezivela kwimeko zinokuthintelwa. Xelela umboneleli wakho malunga nesifo sentliziyo sakho se-valve ngaphambi kokuba ufumane naluphi na unyango. Xoxa malunga nokuba uyafuna na ukuthintela amayeza.

Ukuthintela ivalve yeMitral; Intliziyo ye-mitral stenosis; IValvular mitral stenosis

• IMitral stenosis
• Ivaluva zentliziyo
• Utyando lwevalvu yentliziyo-uthotho

ICarabello BA. Isifo sentliziyo seValvular. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 66.

UNishimura RA, Otto CM, uBonow RO, et al. Uhlaziyo lwe-2017 AHA / ACC olujolise kwisikhokelo se-AHA / ACC sika-2014 kulawulo lwezigulana ezinesifo sentliziyo se-valvular: ingxelo yeAmerican College of Cardiology / American Heart Association Task Force kwizikhokelo zeKlinikhi yokuziQhelanisa. Ukujikeleza. Ngo-2017; 135 (25): e1159-e1195. IINKCUKACHA: 28298458 pubmed.ncbi.nlm.nih.gov/28298458/.

UThomas JD, uBonow RO. Isifo seMitral valve. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 69.

UWilson W, Taubert KA, uGewitz M, et al. Uthintelo lwe-endocarditis esulelayo , kunye noMgangatho woKhathalelo kunye neZiphumo zoPhando kwiQela lokuSebenza eliDibeneyo. Ukujikeleza. Ngo-2007; 116 (15): 1736-1754. IINKCUKACHA: I-17446442 ipapashwe.ncbi.nlm.nih.gov/17446442/.