I-aortic stenosis

I-aorta yeyona nto ibangela ukuba igazi liphume entliziyweni liye kuwo wonke umzimba. Igazi liphuma entliziyweni lize liye kwi-aorta ngevalvu ye-aortic. Kwi-aortic stenosis, ivelufa ye-aortic ayivuli ngokupheleleyo. Oku kunciphisa ukuphuma kwegazi entliziyweni.

Njengoko ivalve ye-aortic incipha, i-ventricle yasekhohlo kufuneka isebenze nzima ukukhupha igazi ngevalve. Ukwenza lo msebenzi ungaphezulu, izihlunu kwiindonga ze-ventricle ziyajiya. Oku kunokukhokelela kwintlungu yesifuba.

Njengoko uxinzelelo luqhubeka nokunyuka, igazi linokubuya libuyele emiphungeni. Ukuqina kwe-aortic stenosis kunokunciphisa umda wegazi ofikelela kwingqondo nakulo lonke umzimba.

I-aortic stenosis inokubakho kwasekuzalweni (kokuzalwa), kodwa amaxesha amaninzi ikhula kamva ebomini. Abantwana abane-aortic stenosis banokuba nezinye iimeko ezikhoyo kwasekuzalweni.

I-aortic stenosis yenzeka ikakhulu ngenxa yokwanda kweedipozithi zecalcium ezinciphisa ivelufa. Oku kubizwa ngokuba yi-calcific aortic stenosis. Ingxaki ikakhulu ichaphazela abantu abadala.

Ukwakhiwa kweCalcium yevalvevu kwenzeka ngokukhawuleza kubantu abazalwa benemithambo engaqhelekanga ye-aortic okanye ye-bicuspid valves. Kwiimeko ezinqabileyo, ukwakha i-calcium kunokukhula ngokukhawuleza xa umntu efumene imitha yesifuba (njengonyango lomhlaza).

Omnye unobangela sisifo samathambo. Le meko inokukhula emva komqala womqala okanye umkhuhlane obomvu. Iingxaki zeValve azikhuli kangangeminyaka emi-5 ukuya kweli-10 okanye ngaphezulu emva kokuba umkhuhlane wamathambo uvele. I-rheumatic fever iya isiba nqabileyo eUnited States.

I-aortic stenosis yenzeka malunga neepesenti ezi-2 zabantu ngaphezulu kweminyaka engama-65 ubudala. Kwenzeka rhoqo rhoqo emadodeni kunabafazi.

Uninzi lwabantu abane-aortic stenosis aluphuhlisi mpawu de isifo siqhubele phambili. Ukuxilongwa kunokwenzeka ukuba kwenziwa xa umboneleli wezempilo evile ukukrokra kwentliziyo kunye nokwenza uvavanyo.

Iimpawu ze-aortic stenosis zibandakanya:

• Ukungonwabi kwesifuba: Intlungu yesifuba inokuba mandundu ngomsebenzi kunye nokufikelela engalweni, entanyeni, okanye emhlathini. Isifuba sinokuziva siqinile okanye sicudisiwe.
• Khohlela, mhlawumbi unegazi.
• Ukuphefumla iingxaki xa usenza umthambo.
• Ukudinwa ngokulula.
• Ndiva ukubetha kwentliziyo (ukubetha kwentliziyo).
• Ukuphelelwa amandla, ubuthathaka, okanye utyando kunye nomsebenzi.

Kwiintsana nabantwana, iimpawu zibandakanya:

• Ukudinwa ngokulula ngokuzimisela (kwiimeko ezinobulali)
• Ukusilela ukutyeba
• Ukutya okungalunganga
• Iingxaki zokuphefumla ezinzulu ezikhula ngaphakathi kweentsuku okanye iiveki zokuzalwa (kwiimeko ezinzima)

Abantwana abane-aortic stenosis emnene okanye elungeleleneyo banokuba mandundu njengoko bekhula. Basemngciphekweni wosulelo lwentliziyo olubizwa ngokuba yi-bacterial endocarditis.

Ukumbombozela kwentliziyo, ukucofa, okanye esinye isandi esingaqhelekanga siphantse siviwe nge-stethoscope. Umboneleli unokukwazi ukuziva ukungcangcazela okanye intshukumo xa ubeka isandla phezu kwentliziyo. Kunokubakho ukubetha okutyhafileyo okanye utshintsho kumgangatho we-pulse entanyeni.

Uxinzelelo lwegazi lunokuba sezantsi.

I-aortic stenosis ihlala ifunyanwa ize ilandelwe kusetyenziswa uvavanyo olubizwa ngokuba yi-transthoracic echocardiogram (TTE).

Ezi mvavanyo zilandelayo zinokwenziwa:

• ECG
• Zilolonge uvavanyo loxinzelelo
• I-catheterization yentliziyo yasekhohlo
• I-MRI yentliziyo
• I-transesophageal echocardiogram (TEE)

Ukuhlolwa rhoqo ngumboneleli kunokuba yiyo yonke into efunekayo ukuba iimpawu zakho azikho qatha. Umboneleli kufuneka abuze malunga nembali yakho yezempilo, enze uvavanyo lomzimba, kwaye enze i-echocardiogram.

Abantu abane-aortic stenosis enzima banokuxelelwa ukuba bangadlali imidlalo yokhuphiswano, nokuba abanazimpawu. Ukuba iimpawu ziyenzeka, umsebenzi onzima kufuneka usikelwe umda.

Amayeza asetyenziselwa ukunyanga iimpawu zokungaphumeleli kwentliziyo okanye isingqisho esingaqhelekanga sentliziyo (esona siqhelo sifrillation atrial). Oku kubandakanya i-diuretics (iipilisi zamanzi), ii-nitrate, kunye ne-beta-blockers. Uxinzelelo lwegazi oluphezulu kufuneka lunyangwe. Ukuba i-aortic stenosis inzima, olu nyango kufuneka lwenziwe ngononophelo ukuze uxinzelelo lwegazi lungawi kude kakhulu.

Kwixesha elidlulileyo, uninzi lwabantu abaneengxaki ze-valve zentliziyo babenikwa i-antibiotics ngaphambi komsebenzi wamazinyo okanye inkqubo efana ne-colonoscopy. Amayeza okubulala iintsholongwane anikwe ukuthintela usulelo lwentliziyo eyonakeleyo. Nangona kunjalo, amayeza okubulala iintsholongwane ngoku asetyenziswa kakhulu ngaphambi kokusebenza kwamazinyo kunye nezinye iinkqubo. Hlola nomboneleli wakho wezempilo ukuba ufumanise ukuba ngaba ufuna i-antibiotics.

Abantu abanolu hlobo kunye nezinye iimeko zentliziyo kufuneka bayeke ukutshaya kwaye bavavanyelwe i-cholesterol ephezulu.

Utyando lokulungisa okanye lokutshintsha i-valve luhlala lusenziwa kubantu abadala okanye abantwana abaphuhlisa iimpawu. Nokuba iimpawu azizimbi kakhulu, ugqirha unokucebisa ukuba utyando lusekwe kwiziphumo zovavanyo.

Inkqubo encinci yokuhlasela ebizwa ngokuba yi-balloon valvuloplasty inokwenziwa endaweni okanye ngaphambi kotyando.

• Ibhaluni ibekwe emthanjeni kwi-groin, efakwe entliziyweni, ibekwe ngapha kwevalve, kwaye inyuswe. Nangona kunjalo, ukunciphisa kuya kuhlala kwenzeka kwakhona emva kwale nkqubo.
• Inkqubo entsha eyenziwayo ngaxeshanye ne-valvuloplasty inokufaka ivalve yokufakelwa (i-transcatheter aortic valve replacement okanye i-TAVR). Le nkqubo ihlala isenziwa kwizigulana ezingenakho ukwenza utyando, kodwa iya isiba yinto eqhelekileyo.

Abanye abantwana banokufuna ukulungiswa kwe-aortic valve okanye ukutshintshwa. Abantwana abane-aortic stenosis encinci banakho ukuthatha inxaxheba kwimisebenzi emininzi.

Iziphumo ziyahluka. Ukuphazamiseka kunokuba buthathaka kwaye kungazivezi iimpawu. Ixesha elingaphezulu, ivelufa ye-aortic inokuba ncinci. Oku kunokubangela iingxaki zentliziyo ezinje ngezi:

• I-Atrial fibrillation kunye ne-atrial flutter
• Amahlwili egazi kwingqondo (ukubetha), amathumbu, izintso, okanye ezinye iindawo
• Ukuphelelwa ngamandla (syncope)
• Ukumelwa yintliziyo
• Uxinzelelo lwegazi oluphezulu kwimithambo yemiphunga (uxinzelelo lwegazi)

Iziphumo zokutshintshwa kwevalvu ye-aortic zihlala zibalaseleyo. Ukufumana olona nyango luphambili, yiya kwiziko elenza olu hlobo lotyando rhoqo.

Biza umnikezeli wakho ukuba wena okanye umntwana wakho uneempawu ze-aortic stenosis.

Nxibelelana nogqirha wakho kwangoko ukuba ufumene ukuba unale meko kwaye iimpawu zakho ziya zisiba mbi okanye ukukhula kweempawu ezintsha.

IAvalic valve stenosis; I-rheumatic aortic stenosis; Calcific aortic stenosis; Intliziyo ye-aortic stenosis; IValvular aortic stenosis; Intliziyo yengqondo - i-aortic stenosis; Umkhuhlane we-rheumatic fever - aortic stenosis

• I-aortic stenosis
• Ivaluva zentliziyo

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UHermann HC, uMack MJ. Unyango lweTranscatheter yesifo sentliziyo se-valvular. 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 72.

ILindman BR, iBonow RO, i-Otto CM. Isifo sevalve seAortic. 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 68.

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/.