So wote nnyigyei bi a ɛyɛ nwonwa wɔ wo koma mu? So ɛyɛ Koma mu Nwiinwii''? Momma yɛnka eyi ho asɛm!

Sɛ oduruyɛfo bi de afiri a wɔde tie asɛm hyehyɛ wo koma mu na ɔka sɛ, ‘Metumi te nnyigyei kakra wɔ wo koma mu, ɛyɛ nwiinwii’ a, so worensuro kakra? Anaasɛ sɛ wode wo ba ketewa no kyerɛ oduruyɛfo no na wɔka biribi a ɛte saa a? Dɛn ankasa ne saa koma mu nwiinwii yi, anaa ``Koma mu nwiinwii''? Momma yɛnka eyi ho asɛm tiawa.

Dɛn na "anwiinwii" a ɛwɔ koma mu no kyerɛ?

Sɛ yɛn koma bɔ, kyerɛ sɛ, sɛ ɛbɔ mogya a, ntini a ɛwɔ koma no mu no bue na ɛto mu. Te sɛ apon. Sɛ saa valve ahorow yi to mu a, wote nnyigyei abien a wɔfrɛ no ‘lub-dub’ . So woahu oduruyɛfo bi de afiri a wɔde tie asɛm ahyɛ wo moma so na watie pɛn? Ɛno ne nea wote. Nanso, ɛtɔ da bi a, wɔ ‘lub-dub’ nnyigyei yi akyi no, wote nnyigyei te sɛ ‘whoosh’ anaa ‘swish’ te sɛ nea mframa ahyɛ mu ma. Ɛno ne nea yɛfrɛ no `(Heart Murmur)`, wɔ Sinhala kasa mu no, koma mu nwiinwii. Eyi kyerɛ sɛ biribi nketenkete bi a ɛnteɛ wɔ ɔkwan a mogya fa so fa wo koma ntini mu no mu.

So ``Heart Murmur'' yi yɛ biribi a ɛto nnipa pii?

Yiw, nokwarem no, eyi abu so kɛse. Ebia worensusuw ho mpo, yɛn mu dodow no ara anya `(Koma mu Nwiinwii)` a ‘ɛnyɛ asiane biara’ wɔ yɛn mmofraase bere bi, a ɛkyerɛ nwiinwii a ɛba a yare biara nni ase. Enti ɛho nhia sɛ wobɔ hu bere a wote saa din yi no.

So `(Koma mu Nwiinwii)` ahorow bi wɔ hɔ?

Hɔ a. Wɔkyekyɛ eyinom mu sɛnea bere a wɔte saa nnyigyei yi wɔ koma no bɔ kyinhyia mu no.

Sɛ yɛbɛka no tiawa a:

• Systolic murmur: Wɔte eyi bere a wo koma ntini no twetwe, a ɛkyerɛ sɛ ɛpia mogya fi mu no.
• ``Diastolic`` nwiinwii: Wɔte eyi bere a koma ntini no dwo, kyerɛ sɛ, bere a mogya ahyɛ mu ma bio.
• ``Continuous`` Murmur: Eyi te bere a koma no twetwe na ɛho dwo, a ɛkyerɛ sɛ wɔte wɔ kyinhyia no nyinaa mu.

Mpɛn pii no, ``Diastolic`` ne ``Continuous`` nwiinwii taa ne komayare wɔ abusuabɔ. Nanso, ɛho hia yiye sɛ wobɛma oduruyɛfo ahwɛ ``Heart Murmur`` biara.

``Koma mu Nwiinwii'' yɛ den dɛn?

Yɛmfa yɛn aso nte eyi. Ɛyɛ bere a oduruyɛfo de afiri a wɔde tie asɛm tie nkutoo na yebetumi ahu nnyigyei yi pefee. Efisɛ afiri a wɔde tie asɛm no ma nnyigyei yi yɛ kɛse.

Nnuruyɛfo kyekyɛ sɛnea anwiinwii yi mu yɛ den, kyerɛ sɛ, sɛnea nnyigyei no ano yɛ den no. Nsusuwii bi wɔ hɔ a wɔde kyerɛ saa, efi 1 kosi 6.

• Gyinapɛn 1: Ɛkame ayɛ sɛ wɔde afiri a wɔde tie asɛm mpo nte.
• Grade 6: Stethoscope no yɛ den araa ma sɛ wɔanmia honam ani mpo a, wobetumi ate no pefee.

Dɛn na ɛde saa `(Heart Murmur)` yi ba?

Sɛnea madi kan aka no, nwiinwii fi mogya a ɛsen basabasa anaa mogya a ɛsen fa koma no mu a ɛnyɛ ne kwan so.

Ɔkwan bɛn so na innocent, kyerɛ sɛ, apɔwmuden ``Innocent Heart Murmurs'' ba?

Ɛtɔ da bi a, sɛ mogya resen ntɛmntɛm sen sɛnea ɛte daa a, koma mu nwiinwii a ``ɛho nni asɛm'' betumi aba. Wɔsan frɛ eyi sɛ ``normal'' anaa ``physiologic'' nwiinwii. Ɛnyɛ yare biara na ɛde eyinom ba. Wɔtaa ba wɔ nsɛm te sɛ eyinom mu:

• Sɛ́ abofra no: Eyi abu so kɛse wɔ mmofra nkumaa so.
• Sɛ yɛreteɛteɛ yɛn apɔw mu a: Sɛ yetu mmirika na yehuruw a, yɛn koma bɔ ntɛmntɛm, ɛno ne bere.
• Wɔ mmere a mmofra nyin ntɛmntɛm (onyin ntɛmntɛm).
• Wɔ nyinsɛn mu: Eyi nso betumi asi bere a woyɛ ɛna a wobɛyɛ ɛna no.
• Wɔ nna kakraa a edi kan wɔ akokoaa awo akyi no mu.

Ɛtɔ mmere bi a, anwiinwii a ɛho nni asɛm yi betumi aba na akɔ, afei asan aba. Wobetumi ayɛ den nso bere a wo koma rebɔ ntɛmntɛm no. Mpɛn pii no, bere kɔ so no, wɔn ankasa kɔ. Nanso nnipa binom fam no, wobetumi atra hɔ wɔn nkwa nna nyinaa. Adeɛ a ɛho hia ne sɛ saa anwiinwii a ɛho nni asɛm yi nkyerɛ sɛ mfomsoɔ biara wɔ wo koma mu.

Koma mu Nwiinwii, a ebia komayare anaa tebea foforo na ɛde ba

``Koma mu Nwiinwii'' bi betumi afi komayare anaa akwahosan ho haw foforo mu aba. Momma yɛnhwɛ nea wɔyɛ:

• Monemia: Eyi kyerɛ sɛ mogya mu nkwammoaa kɔkɔɔ dodow a ɛwɔ mogya no mu no so tew. Eyi ka mogya no mu ntini a ɛyɛ den, na ebetumi ama koma no nwiinwii. Nsɛnkyerɛnne no bi ne sɛ ɔte nka sɛ wayɛ mmerɛw na wabrɛ. Fa no sɛ, Nimali brɛ bere nyinaa na ontumi nyɛ hwee. Bere a ɔkɔ oduruyɛfo nkyɛn nkutoo na ohu sɛ ne mogya so atew. Ná ɔwɔ koma mu nwiinwii nso.

• Carcinoid syndrome anaa carcinoid komayare: Eyi yɛ kokoram a enyin nkakrankakra. Ɛfiri nkwaadɔm a ɛdɔɔso dodo, na ɛno nso tumi ka koma no. Ebia wubehu nso sɛ wo mu duru so tew, yafunu mu yaw, akisikuru, ne mogya mmoroso a ɛba fam.

• Koma mu dɛmdi a wofi awo mu: Ɔhaw bi a ɛfa sɛnea wo koma no te, anaa ɔkwan a wɔfa so hyehyɛ no ho a wɔde wo wo. Sɛ nhwɛso no, tokuru a ɛwɔ koma no mu (a `septal defect`) anaa tebea horow te sɛ `Tetralogy of Fallot`.

• Endocarditis: Eyi yɛ ɔyare a ɛba koma no mu. Mmoawa anaa mmoawa afoforo betumi akɔ mogya no mu na wɔatow ahyɛ koma no mu ntini ahorow no so. Eyi betumi de sɛnkyerɛnne afoforo te sɛ atiridiinini, atiridiinini, honam ani akisikuru, ne menewam a ɛyɛ yaw aba.

• `Koma mu ntini mu yare`: .Eyi kyerɛ sɛ koma no mu ntini biako anaa nea ɛboro saa nyɛ adwuma yiye. Afei mogya no nkɔ yiye. Sɛ nhwɛso no, valve bi betumi ayɛ den (`valve stenosis`). Anaasɛ ebia ɛremmue na ɛrento mu yiye. Mogya betumi atu akɔ ɔkwan a ɛnteɛ so (`valve regurgitation`). Wɔ mmere a ɛte sɛɛ mu no, nneɛma te sɛ nansoaa ne nan a ɛho ahonhon, koma no a wɔte nka sɛ ɛrebɔ ntɛmntɛm (`palpitations`), ahome a ɛyɛ den, ne koko a ɛyɛ den betumi aba.

• Hyperthyroidism: Eyi ne bere a thyroid ntini no ma thyroid hormone pii ba. Saa tebea yi betumi ama obi ho atɔ no, aduan ho akɔnnɔ ayɛ kɛse, ne koma abɔ ntɛmntɛm, na ne mu duru so atew.

• Hypertrophic cardiomyopathy: Eyi yɛ komayare bi a ɛma koma ntini no yɛ kɛse, ɛyɛ den, anaa ɛyɛ den. Ebetumi afi awo mu, anaasɛ ebetumi ayɛ kɛse bere a obi nyin anaa esiane mogya mmoroso nti. Nsɛnkyerɛnne afoforo betumi ayɛ obi a ɔtotɔ piti (syncope), ne koko mu yaw, ne koma a ɛbɔ, ɔbrɛ, ne ahome a ɛyɛ tiaa.

Dɛn ne `(Heart Murmur)` ho sɛnkyerɛnne?

``Heart Murmurs'' binom nkyerɛ sɛnkyerɛnne biara. Wohu wɔn bere a wɔreyɛ aduruyɛ mu nhwehwɛmu a wɔyɛ no daa no.

Nanso, egyina nea ɛde nwiinwii no ba so no, wubetumi anya yare no ho sɛnkyerɛnne te sɛ:

• Wora a ɛyɛ bruu (titiriw anofafa ne nsateaa ano) .
• Ɔfe a ɛkɔ so daa
• Sɛ wote nka sɛ wo koma rebɔ ntɛmntɛm (pulpitations) .
• Koko mu yaw anaasɛ ɛyɛ den
• Ɔhome a ɛyɛ den
• Nhumu a ɛyera mpofirim (syncope) anaasɛ ɔte nka sɛ obi ayɛ mmerɛw

Ɔkwan bɛn so na oduruyɛfo hu ``Koma Nwiinwii''?

Oduruyɛfo bi betie wo koma ahwɛ sɛ ``Heart Murmur'' bi wɔ hɔ anaa. Sɛ nwiinwii bi ba a, wobɛte nnyigyei bi a ɛyɛ soronko, te sɛ ‘whoosh’ anaa ‘swish’ a mekaa ho asɛm no.

Oduruyɛfo no de afiri a wɔde tie asɛm no bɛto wo moma so ne w’akyi afã horow de atie wo koma bɔ. Wɔbɛma wɔn ani aku saa nneɛma yi ho titiriw:

• So wote nnyigyei foforo biara ka ‘lub-dub’ nnyigyei no ho?
• Nnyigyei no te dɛn? (`Akasakasa`) .
• Koma a ɛbɔ denneennen (`Rhythm`) .
• Bere bɛn na wɔte nnyigyei no wɔ koma no mu? (`Bere a wɔde yɛ adwuma`)
• Nnyigyei no mu yɛ den dɛn? (`Volume`) .

So wokae sɛnea ɛtɔ mmere bi a oduruyɛfo no ka kyerɛ wo sɛ yɛ nneɛma bere a wode afiri a wɔde tie asɛm retie no? Ɛno ne nea ɛyɛ ma. Nhwɛsoɔ:

• Wɔse sɛ wɔbɛkyere wɔn nsa.
• Ɔka kyerɛ me sɛ mentena ase.
• Ɔka kyerɛ me sɛ mensɔre mfi ase ntra ase.
• Ɔka kyerɛ me sɛ menda fam.

Sɛ ɔte ``Koma Nwiinwii'' a, nhwehwɛmu bɛn na oduruyɛfo no bɛyɛ?

Sɛ wo duruyɛfo te anwiinwii bi a, ebehia sɛ wɔyɛ nhwehwɛmu pii de hu sɛ ebia akwahosan ho haw bi na ɛde ba anaa. Ebia wɔde wo bɛkɔ komayare ho oduruyɛfo nkyɛn.

Wobetumi ayɛ sɔhwɛ ahorow a edidi so yi de ahu nea ɛde ``Koma mu Nwiinwii`` ba:

• Koko so X-ray: .Eyi twa koko no mu mfonini de hwɛ sɛ ebia nhyehyɛe mu ɔhaw ahorow bi wɔ koma anaa ahurututu no mu anaa.
• Echocardiogram (anaasɛ echo): Eyi te sɛ koma no mu ultrasound scan. Ɛde nnyigyei asorɔkye yɛ koma no ntini ne ne dan ho mfonini. Ɛboa nso ma wɔhwɛ sɛnea koma no rebɔ mogya yiye. Eyi betumi ayɛ scan a wɔde fa honam ani, anaasɛ transesophageal echocardiogram, a wɔde adwinnade titiriw bi fa ano ne menewa mu di dwuma. Eyi betumi ama wɔanya koma no ho mfonini a emu da hɔ.
• Electrocardiogram (ECG anaa EKG): Eyi yɛ sɔhwɛ a ɛyaw nnim a ɛkyerɛ sɛnea wo koma no anyinam ahoɔden yɛ adwuma. Ebetumi ahu ɔhaw ahorow a ɛwɔ wo koma a ɛbɔ no mu ne komayare ho sɛnkyerɛnne ahorow.

Sɛnea wɔsa `(Koma mu Nwiinwii)`?

`(Heart Murmur)` dodow no ara nhia ayaresa biara. Na biribiara nni hɔ a ɛsɛ sɛ ɛhaw wɔn ho. Titiriw saa anwiinwii a `ho nni asɛm' no.

Nanso, sɛ tebea bi a emu yɛ den na ɛde nwiinwii ba a, ebia wubehia ayaresa te sɛ eyi:

• Nnuru: Sɛ nhwɛso no, nnuru a wɔde dade ayɛ a wɔde sa mogya a ɛtɔ kɔ nipadua mu, anaa nnuru a wɔde ma thyroid dwumadi so tew.
• Oprehyɛn: Ɛtɔ mmere bi a, ehia sɛ wɔyɛ oprehyɛn de siesie koma mu ntini bi anaasɛ wɔde foforo si ananmu.

Nea ɛho hia sen biara ne sɛ oduruyɛfo no bɛhwehwɛ ɔyarefo no mu yiye na wahu nea ɛde nwiinwii no ba ne sɛ ebia ɛho hia sɛ wɔsa no yare anaasɛ ɛnsɛ sɛ ɔyɛ saa.

So wobetumi asiw Koma mu Anwiinwii ano?

Nokwarem no, ɔkwan biara nni hɔ a wɔbɛfa so asiw ``Koma mu Nwiinwii'' ano. Efisɛ ebinom fi awo mu, na afoforo nso fi nyarewa afoforo.

Nanso, wubetumi ahwɛ wo koma akwahosan so. Sɛ wobɛkɔ akɔhwɛ wo daa na woabɔ bra pa (adidi pa, apɔw-mu-teɛteɛ, ne sigaret a wonnom) betumi aboa kɛse ma ɔhaw a emu yɛ den a komayare de ba no so atew.

Obi a ɔwɔ `(Heart Murmur)` akwahosan tebea te dɛn?

Eyi gyina nea ɛde nwiinwii no ba no so koraa. Mpɛn pii no, anwiinwii a ‘ɛho nni asɛm’ wɔ mmofra nkumaa mu no fi hɔ bere a wɔrenyin no. Anwiinwii a ɛba bere a wɔyem no taa kɔ bere a wɔawo awie no.

Nanso, akyinnye biara nni ho sɛ anwiinwii a ɛfa komayare ho no hwehwɛ sɛ wɔkɔ ayaresabea. Ɛno nti sɛ oduruyɛfo bi ka kyerɛ wo sɛ wowɔ anwiinwii bi a, ɛsɛ sɛ wohwehwɛ mu yiye.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi bi a wususuw sɛ ebia ɛne komayare wɔ abusuabɔ a, ɛsɛ sɛ wohwehwɛ aduruyɛfo afotu ntɛm ara :

• Sɛ honam ani yɛ bruu (titiriw wɔ anofafa ne nnadewa ho) .
• Sɛ wote nka sɛ wo koko yɛ wo yaw anaasɛ wohyɛ wo so a
• Sɛ wote nka sɛ wo koma rebɔ wɔ ɔkwan a ɛnteɛ so (a ɛyɛ wo yaw) .
• Sɛ ɛyɛ den ma wo sɛ wobɛhome a
• Sɛ wototɔ piti mpofirim (syncope) anaasɛ wote nka sɛ wo ti ayɛ hare a

Sɛ wowɔ saa sɛnkyerɛnne yi bi a, mmu w’ani ngu so. Ɛyɛ papa sɛ wobɛkɔ oduruyɛfo nkyɛn ntɛm ara na woakɔhwɛ.

Momma yɛnkae saa nsɛntitiriw yi (Take-Home Message) .

Okay, enti, sɛ yɛbɛbɔ nea yɛaka ho asɛm no mua a, koma mu nwiinwii yɛ ‘whoosh’ anaa ‘swish’ nnyigyei a wote bere a mogya sen fa wo koma no ntini mu wɔ ɔkwan a ɛnteɛ so no.

Mpɛn pii no, eyinom yɛ anwiinwii a ‘ɛho nni asɛm’, a ɛkyerɛ sɛ ɛnyɛ yare biara na ɛde ba na ɛnyɛ biribiara a ɛsɛ sɛ wosuro. Wɔtaa ba mmofra nkumaa mu paa.

Nanso, anwiinwii bi betumi afi komayare anaa akwahosan ho haw foforo bi mu aba. Enti, ɛho hia yiye sɛ wɔma oduruyɛfo hwehwɛ ``Koma mu Nwiinwii`` biara mu na ama wɔahu nea ɛde ba ankasa.

Sɛ oduruyɛfo ka kyerɛ wo anaa wo ba sɛ wɔwɔ ``Koma mu Nwiinwii,'' a, mma wo ho nnyɛ wo hu, na mmom tie nea wɔka no yiye. Ɛdenam nhwehwɛmu a ɛho hia a wobɛyɛ na woanya ayaresa a ɛfata ama nea ɛde ba no (sɛ ɛho hia a) so no, wubetumi akɔ so anya apɔwmuden.

Kae sɛ wo koma yɛ w’agyapade! Ɛyɛ w’asɛyɛde sɛ wobɛhwɛ so yiye.

` Koma mu nwiinwii, koma mu nwiinwii, koma nnyigyei, nwiinwii a ɛho nni asɛm, komayare, koma ntini, mogya a ɛkɔ nipadua no mu