So wo ba ketewa no rete nnyigyei bi a ɛyɛ nwonwa afi wɔn koma mu? Ebetumi ayɛ Still’s Murmur!

Sɛ wode wo ba ketewa no kɔ oduruyɛfo nkyɛn a, ɛyɛ ade a ɛfata sɛ wobɛte nka sɛ wohaw kakra sɛ oduruyɛfo no ka sɛ, "Nwiinwii kakra wɔ wo ba no koma mu." Nanso, ɛnyɛ koma mu nwiinwii nyinaa na asiane wom. Ɛnnɛ yɛbɛka Still's Murmur , koma mu nwiinwii a asiane biara nni ho, anaasɛ "ɛho nni asɛm" a ɛtaa ba mmofra nkumaa mu ho asɛm. Enti, momma yensua ho ade pii a yensuro.

Dɛn ankasa ne Still’s Murmur?

Sɛ yɛbɛka no tiawa a, Still’s Murmur yɛ nnyigyei foforo a koma a ɛte apɔw te a ɛne komayare anaa akwahosan tebea foforo biara nni abusuabɔ. Ɛte sɛ nnwom nnyigyei ketewaa bi a efi koma no mu reba. Ɛtaa ba mmofra nkumaa mu titiriw. Saa nnyigyei yi ba bere a mogya sen fa koma no mu no.

Fa no sɛ, sɛ nsu fa nsu afiri mu a, ɛtɔ mmere bi a wote nnyigyei ketewaa bi, ɛnte saa? Saa na ɛte. Wɔ eyi mu no, sɛ oduruyɛfo de afiri a wɔde tie asɛm di dwuma na otie abofra no koko nkutoo a, wɔte saa nnyigyei yi pefee. Wɔte saa nnyigyei yi titiriw bere a abofra no da fam, kyerɛ sɛ, n’ani kyerɛ soro, wɔ tebea a ɔda fam no mu .

Nea ɛho hia ne sɛ Still’s Murmur no mfa asiane biara mma wo ba no akwahosan, na enhia sɛ wɔsa no yare.

Hena na ɔte saa nnyigyei yi? Ɛtaa ba dɛn?

Nokwarem no, koma nnyigyei a wɔfrɛ no Still’s Murmur yi betumi aba wɔ obiara a wadi mfe biara mu. Nanso, wɔtaa hu no wɔ mmofra a wɔadi fi mfe 3 kosi 6. Asɛmpa no ne sɛ, sɛ abofra no nyin kakra, kyerɛ sɛ , wɔ mmerantebere ne mmabaabere mu a, saa nnyigyei yi taa yera n’ankasa.

Eyi abu so araa ma nhwehwɛmu ahorow ada no adi sɛ mmofra bɛyɛ 72% ate koma a ɛho nni asɛm nwiinwii wɔ wɔn asetra mu bere bi. Eyinom mu no, Still’s Murmur ne koma mu nwiinwii a ɛho nni asɛm a abu so sen biara wɔ mmofra nkumaa mu.

Adɛn nti na mete saa nnyigyei yi? Dɛn ne nea enti a ɛte saa?

Wɔaka akyerɛ yɛn sɛ mogya a ɛsen fa akokoaa no koma mu na ɛde Still’s Murmur ba. Nanso, nnuruyɛfo nnya nhuu nea ɛde nnyigyei yi ba ankasa . Nanso, nneɛma pii wɔ hɔ a nhwehwɛmufo susuw sɛ ebia ɛde ba:

• Nhama (atoro ntini) bi a ɛwɔ benkum ventricle , dan titiriw a ɛwɔ koma no benkum so no mu no betumi ama wosow na ayɛ nnyigyei bere a mogya fa mu no.
• Ɛtɔ da bi a, tebea bi te sɛ mogya a ɛtɔ kɔ nipadua mu (mogya mu nkwammoaa kɔkɔɔ a ɛso tew wɔ nipadua no mu) betumi ama mogya a ɛfa koma no mu no ayɛ kɛse, na ɛno nso betumi ama dede a ɛte sɛɛ aba.
• Valve a ɛyɛ ahinanan a ɛwɔ koma no nifa so (Tricuspid valve) .Saa nnyigyei yi nso betumi afi afã horow bi a ɛyɛ tratraa a ɛyɛ den a ɛte sɛ hama (chordae) a epue fi koma no nifa so ventricle , a ɛne mogya no kwan no wɔ abusuabɔ no mu aba.
• Ebia wɔbɛte saa nnyigyei yi nso esiane wosow a mogya a ɛsen fa koma no mu adan mu sɛnea ɛte daa no de ba nti.

Eyinom ne nneɛma a ebetumi de aba mprempren. Nanso, kae sɛ, ɛmfa ho nea ɛde ba biara no, Still Nwiinwii no nyɛ nea asiane wom.

Dɛn ne Still’s Murmur ho sɛnkyerɛnne ahorow?

Still’s Murmur no su titiriw ne nnyigyei a ɛyɛ brɛoo a ɛwosow a ɛte sɛ nnwom . Nnipa binom ka sɛ ɛte sɛ Aeolian sanku nnyigyei . Ebia worentumi nte saa nnyigyei yi denam tie a wubetie ara kwa so. Nanso, oduruyɛfo a ɔde afiri a wɔde tie asɛm di dwuma nkutoo na obetumi ahu.

Sɛnea yɛadi kan aka no, saa nnyigyei yi yɛ den bere a akokoaa no da n’akyi , na ɛyɛ komm bere a ɔte hɔ anaa ogyina hɔ no. Afei nso, ɛnyɛ bere nyinaa na saa nnyigyei yi kɔ so. Ɛtɔ da bi a, ebetumi aba na akɔ. Saa nnyigyei yi betumi ayɛ den kɛse bere a akokoaa no yare anaasɛ n'ani agye kɛse anaasɛ n'ani agye no .

Nea ɛho hia sen biara ne sɛ Still’s Murmur mfa nipadua mu sɛnkyerɛnne foforo biara anaa akwahosan ho haw afoforo mma.

Oduruyɛfo, wobɛyɛ dɛn ahu no yiye sɛ eyi yɛ Still’s Murmur?

Sɛ wode wo ba kɔ oduruyɛfo nkyɛn a, wobedi kan abisa wo ba no aduruyɛ ho abakɔsɛm na wɔayɛ ne nipadua mu nhwehwɛmu a edi mũ . Saa sɔhwɛ yi bɛhwehwɛ nea edidi so yi pɔtee:

• Wɔde nsa ka yafunu mu de hwɛ sɛ mmerɛbo no ayɛ kɛse ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ koma no ayɛ adwuma yiye anaa.
• Wɔresusuw mogya mmoroso.
• Wɔde wɔn nsa ka koko de hwɛ sɛ koma no ayɛ kɛse (cardiomegaly).
• Wɔhwɛ mogya mu mframa pa dodow (Pulse oximetry).
• Wɔhwɛ abofra no nan mu sɛ ebia ne koma bɔ (distal pulse palpation) hwɛ sɛ mogya no kɔ yiye anaa.

Afei, oduruyɛfo no de afiri a wɔde tie asɛm di dwuma de tie nnyigyei a efi abofra no nipadua mu ba. Saa bere no:

• Dede a ɛyɛ soronko
• Nnyigyei a wɔde klik
• Koma mu nnyigyei a ɛboro so (nwiinwii) .

Nneɛma a ɛtete saa a wɔde wɔn adwene besi so.

Sɛ oduruyɛfo no te koma nnyigyei foforo a, wɔbɛhwɛ nea edidi so yi yiye ahwɛ sɛ ɛyɛ Still’s Murmur anaa :

• So nnyigyei no sesa bere a akokoaa no di akɔneaba no? Nnyigyei no mu yɛ den kɛse bere a akokoaa no da n’akyi no.
• So wɔte nnyigyei no bere a koma no twetwe (Systolic murmur), bere a koma no agye n’ahome (Diastolic murmur), anaasɛ bere nyinaa? Wɔte Still no nwiinwii bere a koma no ayɛ mmerɛw akyi, kyerɛ sɛ, wɔ mfinimfini (Mid-systolic).
• So wɔte nnyigyei no fi beae biako pɛ, anaasɛ ɛtrɛw kɔ koko no afã horow (mframa)? Ntrɛwmu biara nni hɔ a ɛte saa wɔ stills murmurs mu.
• Beae a nnyigyei no wɔ. Wɔte Still nwiinwii no titiriw wɔ koko no ase, wɔ sternum , dompe a ɛwɔ koko no mfinimfini no benkum so.
• Nnyigyei no mu yɛ den/ɛyɛ mmerɛw dɛn? `(Ahoɔden)`? Still nwiinwii no ma nnyigyei a ɛyɛ brɛoo.
• Nnyigyei no su ne ɛnne nnyigyei (a ɛkorɔn, mfinimfini, ɛba fam). Still murmur yɛ nnyigyei a ɛyɛ nnwom, ɛbɔ, ɛnne nnyigyei a ɛba fam.

Sɛ oduruyɛfo no hwɛ eyinom nyinaa na osi gyinae sɛ ɛyɛ Still’s Murmur , a, ɛho renhia sɛ wɔyɛ wo ba no nhwehwɛmu foforo biara.

Nanso, sɛ oduruyɛfo no adwenem yɛ no naa wɔ nnyigyei no ho, anaasɛ osusuw sɛ ebetumi ayɛ koma mu nwiinwii a ɛnyɛ nea ɛho nni asɛm a, wobetumi de abofra no akɔma komayare ho oduruyɛfo a ebia ɔbɛyɛ nhwehwɛmu foforo bi. Saa sɔhwɛ ahorow yi bi ne:

• Electrocardiogram (EKG): Eyi kyerɛw anyinam ahoɔden dwumadi a ɛwɔ koma no mu.
• Echocardiogram (echo): Eyi de asorɔkye a ano yɛ den di dwuma de twa koma no mu adan ne ntini ahorow no mfonini.

So aduru bi wɔ hɔ a wɔde yɛ eyi? Ɛbɛka akokoaa no dɛn?

Ade a ɛho hia sen biara ni. Abofra a ɔwɔ Still’s Murmur no nhia ayaresa biara . Ɛbɛkɔ n’ankasa so bere a bere kɔ so no.

Wo ba no Still’s Murmur no rensiw wɔn da biara da dwumadi ahorow, agodie, anaa sukuu dwumadi ahorow kwan ɔkwan biara so. Wobetumi atra ase a ɛfata koraa na apɔwmuden wom .

So ɔkwan bi wɔ hɔ a wɔbɛfa so asiw Still’s Murmur ano?

Dabi, biribiara nni hɔ a yebetumi ayɛ de asiw Still’s Murmur ano. Efisɛ ɛnyɛ yare.

Sɛ yɛn ba no wɔ Still’s Murmur a, dɛn na ɛsɛ sɛ yɛn a yɛyɛ awofo hu?

Sɛ wuhu sɛ wo ba no wɔ Still’s Murmur , ma nneɛma yi ntra w’adwenem:

• Mpɛn pii no eyi ankasa fi hɔ ansa na abofra no adu ne mpanyin afe so .
• Ebia mpanyimfo binom nso benya saa nnyigyei yi, nanso ebia wɔrenna yare no ho sɛnkyerɛnne biara adi.
• Still’s Murmur nyɛ komayare anaa akwahosan tebea foforo biara ho sɛnkyerɛnne .
• Abofra no tumi di agoru, teɛteɛ n’apɔw mu, kɔ sukuu, na ɔde ne ho hyɛ nneɛma afoforo nyinaa mu sɛnea ɔtaa yɛ no.
• Ade a ɛho hia sen biara ne sɛ wobɛkɔ akɔhwɛ wo ba daa wɔ bere ano.Afei oduruyɛfo no betumi ahwɛ abofra no akwahosan nyinaa.

Bere bɛn na ɛsɛ sɛ yɛkɔ oduruyɛfo nkyɛn?

Ɛwom sɛ Still’s Murmur no nhia ayaresa de, nanso sɛ wo ba nya sɛnkyerɛnne foforo yi bi a, ɛho hia sɛ wokɔ oduruyɛfo nkyɛn ntɛm ara:

• Sɛ wote nka sɛ wo koko yɛ wo yaw, wo ho yɛ wo yaw, anaasɛ wo ho ayɛ wo den a .
• Sɛ wote nka sɛ woabrɛ kɛse (ɔbrɛ kɛse).
• Sɛ biribi te sɛ ɔtopae ba a.
• Sɛ ɛyɛ den ma wo sɛ wobɛhome (Dyspnea) anaasɛ wote nka sɛ wo ho ayɛ wo hyew a.

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi a, ɛbɛyɛ papa sɛ wobɛhwehwɛ aduruyɛfo afotu ntɛm ara sɛnea wubetumi, efisɛ ebia ɛne Still’s Murmur nni abusuabɔ.

Enti, nkrasɛm a etwa to a wɔde bɛkɔ fie ne sɛ:

Okay, enti yɛaka Still’s Murmur ho asɛm pii. Nea etwa to no, nneɛma a ɛho hia sen biara a ɛsɛ sɛ wokae ni:

• Still’s Murmur yɛ koma nnyigyei a ɛho nni asɛm a abu so kɛse wɔ mmofra nkumaa mu (titiriw wɔn a wɔadi mfe 3-6).
• Eyi ne komayare anaa akwahosan ho haw afoforo biara nni abusuabɔ .
• Eyi nhia ayaresa biara , na mpɛn pii no ɛno ara kɔ bere a abofra no nyin no.
• Nnuruyɛfo nam nipadua mu nhwehwɛmu ne koma no a wɔde afiri a wɔde tie asɛm di dwuma so hu eyi.
• Ɛwom sɛ koma mu nwiinwii te sɛ eyi a wobɛte no betumi ayɛ hu kakra de, nanso Still’s Murmur nsɛe akokoaa no akwahosan biara .
• Sɛ wo ba no wɔ saa tebea yi mpo a, obetumi atra ase a ɔyɛ nnam koraa na ɔwɔ apɔwmuden .

Enti, sɛ wo ba no duruyɛfo ka biribi te sɛ eyi kyerɛ wo a, mma wo ho nnpopo a ɛho nhia, wo ne oduruyɛfo no nkasa yiye na hwehwɛ nsɛm no mu nsɛm nyinaa. Kae bere nyinaa sɛ ɛho hia sen biara sɛ wugyina aduruyɛ mu afotu so si gyinae wɔ wo ba no akwahosan ho.

` Still's Murmur, Koma Nnyigyei, Innocent Murmur, Mmofra Ayaresa, Koma Akwahosan, Innocent Murmur, Still's Murmur