Ukubuyiswa kwakhona kwevalvevu yeMitral

Ukubuyiselwa kweMitral kukuphazamiseka apho i-mitral valve kwicala lasekhohlo lentliziyo ingavali ngokufanelekileyo.

Ukuphinda kuthethwe kwakhona kuthetha ukuvuza kwivalve engavaliyo yonke indlela.

Ukubuyiselwa kweMitral luhlobo oluqhelekileyo lokuphazamiseka kwentliziyo yevalvu.

Igazi elihamba phakathi kwamagumbi ahlukeneyo entliziyo kufuneka lihambe ngevalve. Ivalve phakathi kwamagumbi ama-2 kwicala lasekhohlo lentliziyo yakho kuthiwa yi-mitral valve.

Xa i-mitral valve ingavali yonke indlela, igazi lihamba liye ngasemva kwigumbi eliphezulu lentliziyo (i-atrium) ukusuka kwigumbi elisezantsi njengoko lisebenza. Oku kunciphisa isixa segazi esiya kuwo wonke umzimba. Ngenxa yoko, intliziyo inokuzama ukupompa ngakumbi. Oku kunokukhokelela kukusilela kwentliziyo yokuxinana.

Ukubuyiselwa kweMitral kunokuqala ngesiquphe. Oku kuhlala kwenzeka emva kokuhlaselwa sisifo sentliziyo. Xa ukuphinda kulungiswe kungahambi, iba lixesha elide (elingapheliyo).

Ezinye izifo okanye iingxaki zinokuyenza buthathaka okanye yonakalise ivalve okanye izicwili zentliziyo ezijikeleze ivalve. Usemngciphekweni wokubuyiswa kwakhona kwe-mitral valve ukuba une:

• Isifo sentliziyo kunye noxinzelelo lwegazi
• Usulelo lweentsimbi zentliziyo
• I-Mitral valve prolapse (MVP)
• Iimeko eziqhelekileyo, ezinje nge-syphilis enganyangekiyo okanye isifo seMarfan
• Rheumatic isifo sentliziyo. Oku kuyinkxalabo yomqala ongaphendulwanga ongaqhelekanga.
• Ukudumba kwegumbi lasekhohlo lentliziyo

Enye into ebalulekileyo emngciphekweni wokuphinda ubuye kwimitral kukusetyenziswa kwepilisi yokutya ekuthiwa yi "Fen-Phen" (fenfluramine kunye ne-phentermine) okanye i-dexfenfluramine. Iyeza lasuswa kwintengiso yi-US Food and Drug Administration (FDA) ngo-1997 ngenxa yenkxalabo yezokhuseleko.

Iimpawu zingaqala ngequbuliso ukuba:

• Ukuhlaselwa kwentliziyo kulimaza izihlunu ezijikeleze i-mitral valve.
• Iintambo ezincamathisela umsipha kwikhefu levalve.
• Usulelo lwevalvu lutshabalalisa inxenye yevalve.

Rhoqo akukho zimpawu. Xa iimpawu zivela, zihlala zikhula ngokuthe ngcembe, kwaye zinokubandakanya:

• Khohlela
• Ukukhathala, ukudinwa kunye nokuqaqanjelwa yintloko
• Ukuphefumla ngokukhawuleza
• Imvakalelo yokuziva ukubetha kwentliziyo (ukubetha kwentliziyo) okanye ukubetha kwentliziyo okukhawulezayo
• Ukuphefumla okufutshane okwandayo ngomsebenzi naxa ulele phantsi
• Ukuvuka iyure okanye ngaphezulu emva kokulala ngenxa yengxaki yokuphefumla
• Ukuchama, ukugqithisa ebusuku

Xa umamele intliziyo kunye nemiphunga, umboneleli wezempilo unokufumana:

• Imincili (ukungcangcazela) ngaphezulu kwentliziyo xa uziva indawo yesifuba
• Isandi esongezelelekileyo sentliziyo (S4 gallop)
• Ukumbombozela kwentliziyo eyahlukileyo
• Ukuqhekeka emiphungeni (ukuba ulwelo lubuyela emiphungeni)

Uvavanyo lomzimba lunokutyhila:

• Ukudumba kweqatha neenyawo
• Ukwandiswa kwesibindi
• Iimvumba zentamo
• Eminye imiqondiso yokusilela kwentliziyo esekunene

Olu vavanyo lulandelayo lunokwenziwa ukujonga ubume bevalvu yentliziyo kunye nomsebenzi:

• Ukuxilongwa kwe-CT kwentliziyo
• Echocardiogram (uxilongo intliziyo intliziyo) - transthoracic okanye transesophageal
• Imagnetic resonance imaging (iMRI)

I-catheterization yentliziyo inokwenziwa ukuba umsebenzi wentliziyo uba mandundu.

Unyango luya kuxhomekeka ekubeni zeziphi iimpawu onazo, yeyiphi imeko ebangele ukuba iphinde ibuye kwakhona i-mitral valve, ukuba isebenza njani intliziyo, kwaye ukuba intliziyo ithe yanda.

Abantu abanoxinzelelo oluphezulu lwegazi okanye izihlunu ezibuthathaka zentliziyo banokunikwa amayeza okunciphisa uxinzelelo entliziyweni kunye nokunciphisa iimpawu.

La machiza alandelayo anokumiselwa xa iimpawu ze-mitral zokuphinda zibuye zisiba mandundu:

• I-Beta-blocker, i-ACE inhibitors, okanye i-calcium block blockers
• Abacoci begazi (ii-anticoagulants) ukunceda ukuthintela amahlwili egazi kubantu abane-atrial fibrillation
• Iziyobisi ezinceda ukulawula ukubetha kwentliziyo okungalinganiyo okanye okungaqhelekanga
• Iipilisi zamanzi (i-diuretics) ukususa ulwelo oluninzi kwimiphunga

Ukutya okune-sodium encinci kunokuba luncedo. Kuya kufuneka uthintele umsebenzi wakho ukuba iimpawu ziyavela.

Nje ukuba kufunyaniswe isifo, kuya kufuneka undwendwele umboneleli wakho rhoqo ukulandelela iimpawu kunye nokusebenza kwentliziyo.

Ungadinga utyando ukulungisa okanye ukubuyisela ivalve endaweni yayo:

• Umsebenzi wentliziyo uhlwempuzekile
• Intliziyo iyandiswa (yande)
• Iimpawu ziba nzima

Iziphumo ziyahluka. Uninzi lwexesha imeko inobulali, ke akukho lonyango okanye kuthintelo luyafuneka. Iimpawu zihlala zilawulwa ngamayeza.

Iingxaki ezinokuphuhlisa zibandakanya:

• Iingqungquthela zentliziyo engaqhelekanga, kubandakanywa i-fibrillation ye-atrial kwaye mhlawumbi iyingozi kakhulu, okanye isongela ubomi iziqhelo ezingavumelekanga
• Amahlwili anokuhamba aye kwezinye iindawo zomzimba, ezinje ngemiphunga okanye kwingqondo
• Usulelo lwe-valve yenhliziyo
• Ukumelwa yintliziyo

Fowunela umnikezeli wakho ukuba iimpawu ziba mandundu okanye aziphuculi ngonyango.

Biza umnikezeli wakho ukuba uphathwa ngale meko kwaye uphuhlise iimpawu zosulelo, ezibandakanya:

• Ukugodola
• Ifiva
• Imvakalelo yokugula ngokubanzi
• Intloko ebuhlungu
• Ubuhlungu bemisipha

Abantu abanezivalo zentliziyo ezingaqhelekanga okanye ezonakalisiweyo basemngciphekweni wosulelo olubizwa ngokuba yi-endocarditis. Nantoni na ebangela ukuba intsholongwane ingene kwigazi lakho inokukhokelela kolu sulelo. Amanyathelo okuphepha le ngxaki abandakanya:

• Kulumkele inaliti ezingahlambulukanga.
• Nyanga izifo ezosulelayo ngokukhawuleza ukuthintela umkhuhlane wamathambo.
• Soloko uxelela umboneleli wakho kunye nodokotela wamazinyo ukuba unembali yesifo sevalveji yentliziyo okanye isifo sentliziyo esizalwe naso ngaphambi konyango. Abanye abantu banokufuna i-antibiotics ngaphambi kweenkqubo zamazinyo okanye utyando.

Ukubuyiswa kwakhona kwevalvethi yeMitral; Ukungoneli kwesivalo seMitral; Ukuphinda ubuye kwimitral yentliziyo; Ukuphinda ubuye kwakhona kwi-mitral

• Icandelo lentliziyo phakathi embindini
• Intliziyo - umbono wangaphambili
• 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.