Ua loaʻa koke anei iā ʻoe kahi ʻeha nui ma kou umauma? He Acute Aortic Syndrome paha ia? E kamaʻilio kākou e pili ana!

Ua noʻonoʻo paha ʻoe i ka mea e hana ai inā loaʻa koke iā ʻoe ka ʻeha nui o ka umauma? I kekahi manawa he kinoea paha ia, a i ʻole he hōʻeha puʻuwai paha. Eia naʻe, i kēia lā e kamaʻilio mākou e pili ana i kahi ʻano pilikia like, akā ʻokoʻa iki. Ua kapa ʻia kēia ʻo Acute Aortic Syndrome. ʻOiai paha he paʻakikī iki ka inoa, e hoʻomaopopo maʻalahi kākou.

He aha maoli ka Acute Aortic Syndrome?

I ka ʻōlelo maʻalahi, he inoa maʻamau kēia no kekahi mau pilikia pilikia e kū mai ana ma ke kīʻaha koko nui loa i loko o ko kākou kino, ʻo ia hoʻi ka aorta . E noʻonoʻo e like me ka pamu wai. Hoʻolaha kēia pamu i ke koko ma ke kino holoʻokoʻa ma o kahi paipu nui. ʻO kēlā paipu nui ka mea a mākou e kapa nei he aorta. Holo ia ma ka umauma a ma o ka ʻōpū. No laila, ʻo ka "Acute Aortic Syndrome" he pilikia koʻikoʻi e kū mai ana ma ka ʻāpana umauma o kēia aorta, ʻo ia hoʻi ka "Thoracic Aorta" a i ʻole ka "Abdominal Aorta".

ʻO ka mea nui loa, he wikiwiki loa kēia mau kūlana a hiki ke hoʻoweliweli i ke ola . I nā hihia he nui, pono ke ʻoki kino. No laila, he mea nui loa ka makaʻala i kēia.

He aha nā ʻano nui o kēia maʻi?

ʻEkolu mau ʻano nui o ka `(Acute Aortic Syndrome)`. E nānā kākou i ke ʻano o lākou.

1. ʻO ka ʻoki ʻana o ke aortic ʻoi loa: ʻO kēia ka mea koʻikoʻi loa a maʻamau o kēia. ʻO ka mea e hana ʻia ma ʻaneʻi, ʻo ia ka hana ʻana o kahi waimaka liʻiliʻi ma loko o ka paia o ka aorta, e ʻae ana i ke koko e kahe ma waena o nā papa o ka paia. E noʻonoʻo iā ia e like me kahi paipu wai me ʻelua papa, a inā haki kekahi papa, hiki i ka wai ke kahe ma waena o nā papa ʻelua ʻē aʻe. Hiki i kēia ke hoʻonāwaliwali i ka aorta a hiki ke pohā.

2. Hematoma Intramural: ʻO kēia ka wā e pohā ai kahi kīʻaha koko liʻiliʻi i loko o ka paia o ka aorta a hōʻiliʻili kekahi koko i loko o ka paia o ke aʻa. E like me ka wā e loaʻa ai kahi ʻūpā koko i loko o ko mākou kino, paʻa ia. I kekahi manawa hiki i kēia ke ulu aʻe i kahi Aortic Dissection.

3. ʻUlu Atherosclerotic Komo: He ʻeha kēia e ulu ana ma ka paia o ka aorta. He mea maʻamau kēia kūlana i nā poʻe me nā waihona momona i loko o nā kīʻaha koko (atherosclerosis). Hiki i kēia ʻeha ke lilo i hohonu a hoʻonāwaliwali i ka paia o ke aʻa.

Pili nā mea ʻekolu kekahi i kekahi a hiki ke hoʻololi mai kekahi i kekahi. No laila, he mea nui e ʻimi koke i ka lāʻau lapaʻau no kekahi o kēia mau kūlana.

Loaʻa iā ʻoe kēia mau hōʻailona? E nānā...

ʻO ka hōʻailona nui a maʻamau o ka `(Acute Aortic Syndrome)` he ʻeha umauma koke, hiki ʻole ke hoʻomanawanui, a koʻikoʻi . Ua wehewehe ka poʻe he nui iā ia he ʻeha ʻoki a haehae. Hiki i kēia ʻeha ke pālahalaha i lalo i ke kua, i ka ʻōpū, a i ʻole i ka ʻāʻī a me ka ʻāwae.

Ma waho aʻe o kēlā, aia paha kekahi mau hōʻailona ʻē aʻe:

• ʻEha ʻōpū: ʻOi loa inā pili ka ʻōpū o ka aorta.
• ʻEha kua: Hiki ke hele pū me ka ʻeha o ka umauma.
• Ka nawaliwali a i ʻole ka nalowale o ka ʻike: Ma muli o ka emi ʻana o ke kahe o ke koko i ka lolo.
• Ka nalowale a nāwaliwali loa paha o ka pulse ma nā wāwae a i ʻole nā ​​​​wāwae: Ma muli kēia o ke ālai ʻana o ke kahe koko i nā wāwae.
• Paʻakikī ka hanu ʻana
• Nāwaliwali
• Ka hou ʻana

E hoʻomanaʻo, inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona i ka manawa hoʻokahi, pono ʻoe e hele koke i ka haukapila, me ka hoʻokaʻulua ʻole . He pilikia kēia!

No ke aha e hana ʻia ai kēia? He aha nā kumu?

ʻO ke kumu nui o kēia kūlana weliweli, ʻo ia ke koko kiʻekiʻe i kāohi ʻole ʻia (Hypertension) . Ke kiʻekiʻe ke kaomi no nā makahiki he nui, ua hōʻino ʻia a nāwaliwali nā paia o ko kākou mau aʻa. Hoʻonui kēia i ka pilikia o kēia ʻano haki a me nā haki.

Hiki i nā kumu ʻē aʻe:

• Aortic aneurysm: He puʻupuʻu e like me ka pōpō ma ka aorta. He nāwaliwali kēia puʻupuʻu a hiki ke poha a pahū paha.
• Nā hemahema o ka valve aortic: Hiki i kekahi mau hemahema hānau o ka valve aortic i loko o ka puʻuwai ke hoʻonui i kēia pilikia.
• Nā waihona momona i loko o nā kīʻaha koko (Atherosclerosis): ʻO kēia ke kumu e wili ai, mānoanoa, a nāwaliwali ai nā kīʻaha koko.

ʻO wai ka mea e loaʻa pinepine ai kēia? (Nā kumu pilikia)

ʻOi aku ka nui o ka loaʻa ʻana o kēia `(Acute Aortic Syndrome)` i kekahi poʻe ma mua o kekahi. E nānā kākou iā lākou:

• ʻO nā kānaka i loaʻa mua i ke kūlana "Aortic Aneurysm".
• ʻO nā kānaka me ke ʻano i kapa ʻia ʻo aortic coarctation (ka hoʻohaiki ʻana o ka aorta nui).
• ʻO nā kānaka me ka Bicuspid Aortic Valve Disease (kahi kīnā i loko o ka valve puʻuwai).
• ʻO nā kānaka me kekahi mau maʻi hoʻoilina: No ka laʻana, nā maʻi e like me `(Marfan syndrome)`, `(Turner syndrome)` a i ʻole `(Ehlers-Danlos syndrome).` ʻO kēia nā mea e hoʻonāwaliwali ai i nā ʻiʻo pili o ke kino. ʻOiai ua hana ʻia ka aorta me kēia ʻano ʻiʻo, hiki nō hoʻi iā ia ke hoʻonāwaliwali.
• ʻO nā kānaka me ke koko kiʻekiʻe: ʻO kēia ke kumu nui o ka pilikia.

Ma waho aʻe o kēia mau mea, aia kekahi mau kumu pilikia ʻē aʻe:

• Makahiki: ʻOi aku ke kiʻekiʻe o kēia pilikia no ka poʻe ma luna o 60 mau makahiki.
• Ka hoʻohana ʻana i nā lāʻau lapaʻau: Hiki ke hana ʻia kēia ma nā poʻe e hoʻohana ana i nā lāʻau lapaʻau e like me ka cocaine.
• Ka hāpai kaumaha kiʻekiʻe: ʻO ka poʻe e hāpai i ka nui o ke kaumaha a hana i nā hoʻomaʻamaʻa kūʻē hiki ke loaʻa i kekahi manawa ka nui o ka pilikia.
• Hāpai keiki: He mea kākaʻikahi loa, ua loaʻa pū kēia ʻano i nā makuahine hāpai me ka ʻole o nā kumu pilikia ʻē aʻe.
• Kāne/Wahine:ʻOi aku ka nui o ka loaʻa ʻana o kēia maʻi i nā kāne.

Pehea e ʻike ai nā kauka i kēia? (Diagnosis)

Ke hele ʻoe i ka haukapila me nā hōʻailona i ʻōlelo ʻia ma mua, e holo koke nā kauka i kekahi mau hoʻokolohua e ʻike ai inā he "Acute Aortic Syndrome" kēia.

Nā ʻano hoʻokolohua

• CT scan: ʻO kēia ke ala maikaʻi loa a pololei loa e ʻike ai i kēia maʻi (kūlana gula) . Ua like ia me ke kiʻi ʻana i kahi kiʻi 3D o loko o ko mākou kino. Hiki i kēia ke ʻike maopopo i ke ʻano o ka aorta, kāna hana, pehea e kahe ai ke koko, inā he mau māwae, a inā he mau ʻūpā koko.
• ʻO ke kiʻi X-ray o ka umauma: Hiki i kēia ke hāʻawi i kahi manaʻo maʻamau o ke ʻano o ka puʻuwai a me nā ʻōpū a puni. I kekahi manawa, inā ua hoʻonui ʻia ka aorta, hiki ke ʻike ʻia.
• ʻO ka Angiogram Coronary: Nānā kēia i ke kūlana o nā aʻa coronary e hoʻolako koko i ka puʻuwai.
• E.C.G. (Electrocardiogram - EKG): Hoʻāʻo kēia i ka hana uila o ka puʻuwai. Kōkua kēia i ka hoʻokaʻawale ʻana ma waena o ka hōʻeha puʻuwai a me ka hōʻeha puʻuwai.
• ʻO ka Echocardiogram Transthoracic: Ua like kēia me kahi scan ultrasound o ka puʻuwai. Hiki iā ia ke nānā i ke kūlana o nā keʻena o ka puʻuwai, nā valves, a me nā kīʻaha koko.

Me kēia mau hoʻokolohua, hiki i nā kauka ke hōʻoia koke i ka maʻi.

He aha nā lāʻau lapaʻau no kēia? Hiki iā kākou ke hoʻōla ʻia?

ʻO ke ʻano o ka mālama ʻana e pili ana i ka wahi o ka hōʻino ʻana i ka aorta.

• ʻO kahi pilikia me ka aorta piʻi, ka ʻāpana o ka aorta e piʻi ana i ka puʻuwai, pono e hana ʻoki kino koke . Wehe nā kauka ʻoki i ka ʻāpana i hōʻino ʻia o ka aorta a hoʻololi iā ia me kahi graft synthetic . I kekahi mau hihia koʻikoʻi, pono paha e hoʻololi ʻia ka valve aortic.

• Inā he pilikia me ka ʻāpana o ka aorta e iho ana a pili i nā aʻa ʻē aʻe, ʻo ia hoʻi ka descending aorta, hiki ke mālama ʻia kēia me ka lāʻau lapaʻau. Hāʻawi ʻia nā lāʻau lapaʻau e kaohi ana i ke koko, e like me nā beta-blockers a i ʻole nā ​​vasodilators . Hana kēia mau lāʻau lapaʻau ma ka hoʻolohi ʻana i ka puʻuwai, ka hoʻonui ʻana i nā kīʻaha koko, a me ka hoʻēmi ʻana i ke kaomi i loko o ka aorta. Eia nō naʻe, i kekahi manawa pono paha nā pilikia me kēia ʻāpana i ke ʻoki ʻana a i ʻole ke kau ʻana i kahi stent.

ʻO ka mea nui loa, ʻo ka lōʻihi o kou kali ʻana e hoʻomaka i ka lāʻau lapaʻau, ʻoi aku ka weliweli o ke kūlana. No laila, he mea nui ka hele ʻana i ka haukapila a me ka hoʻomaka koke ʻana i ka lāʻau lapaʻau no ka hoʻopakele ʻana i nā ola.

He aha kā mākou e hana ai e pale aku i kēia kūlana weliweli? ( Pehea e hiki ai iā mākou ke hōʻemi i ka pilikia?)

I mea e ola ai i kēlā kūlana paʻakikī, pono mākou e mālama i ko mākou nohona.

• Ka mālama ʻana i ke kaumaha olakino:E mālama i ke kaumaha olakino no kou kiʻekiʻe, kou makahiki, a me kou kāne.
• Ke kāohi ʻana i ke koko: ʻO kēia ka mea nui loa . Inā loaʻa iā ʻoe ke koko, e lawe i ka lāʻau lapaʻau a kāu kauka i kuhikuhi ai i ka manawa kūpono. E nānā mau i kou koko.
• Ka hoʻokele ʻana i nā kūlana olakino ʻē aʻe: Inā loaʻa iā ʻoe nā pilikia e like me ka maʻi diabetes a i ʻole ka cholesterol, e hoʻokele pono iā lākou e like me nā kuhikuhi a kāu kauka.
• E hoʻōki loa i ka puhipaka: He mea ʻino loa ka puhipaka i nā kīʻaha koko.

Ma ka hahai ʻana i kēia mau ʻanuʻu maʻalahi, hiki iā ʻoe ke hōʻemi nui i ka pilikia o ka hoʻomohala ʻana i nā kūlana weliweli e like me ka "Acute Aortic Syndrome".

He aha ka mea e hana ʻia inā hana ʻia kēia? Pehea ka lōʻihi e ola ai? (Nānā i ka maʻi)

He pilikia weliweli ke ʻano o ka Acute Aortic Syndrome. Pono pinepine ia i ke ʻoki kino pilikia. Aia kou ho'ōla ʻana i ka wikiwiki o ka loaʻa ʻana o ka lāʻau lapaʻau.

ʻOi aku ka kiʻekiʻe o ka ola ʻana o nā maʻi ʻelua `(Intramural Hematoma)` a me `(Penetrating Atherosclerotic Ulcer)` ma mua o `(Acute Aortic Dissection)`.

Ma hope o ka lāʻau lapaʻau, pono ʻoe e hoʻomau ma lalo o ka nānā ʻana o ke kauka. Pono ʻoe e loaʻa nā hoʻokolohua maʻamau e nānā i kekahi kahe koko i loko o ka aorta a i ʻole ke kūkulu ʻia ʻana o nā aneurysms hou. He mea nui loa hoʻi e mālama pono i kou koko i kou ola a pau.

Mai poina e nīnau i kāu kauka e pili ana i kēia mau mea.

Inā ua ʻike ʻia ʻoe me, a i ʻole ke manaʻo nei ʻoe he Acute Aortic Syndrome kou, hiki iā ʻoe ke nīnau i kāu kauka i kēia mau nīnau:

• He aha ke kumu kūpono loa o koʻu mau hōʻailona?
• He maʻi puʻuwai koʻu. He aha koʻu pilikia o ka loaʻa ʻana o ka `(Acute Aortic Syndrome)`?
• He aha nā hōʻailona o ka `(Acute Aortic Syndrome)` aʻu e pono ai e makaʻala?
• He aha nā koho lapaʻau no kēia? ʻO wai ka mea maikaʻi loa iaʻu?
• He aha nā lāʻau lapaʻau e pono iaʻu e hana ma hope o ka lāʻau lapaʻau?

I ka hōʻuluʻulu manaʻo (Leka Lawe-Home)

ʻAe, no laila hiki iā ʻoe ke hoʻomanaʻo i kekahi o nā mea nui loa mai nā mea a mākou i kamaʻilio ai.

ʻO ka Acute Aortic Syndrome kahi maʻi koke a hoʻoweliweli i ke ola e kū mai ana i loko o ka aorta.

ʻO ka hōʻailona nui, ʻo ia ka ʻeha umauma koke a koʻikoʻi . Hiki i kēia ʻeha ke pālahalaha i ke kua a me ka ʻōpū.

ʻO ke koko kiʻekiʻe ke kumu nui o kēia.

Inā ʻike ʻoe i kēia mau hōʻailona , ​​e hele koke i ka haukapila. Hiki i ka lāʻau lapaʻau wikiwiki ke hoʻopakele i kou ola.

Hiki ke hoʻēmi ʻia kēia pilikia ma o ke ola ʻana i kahi nohona olakino a me ke kaohi ʻana i ke koko.

Inā he mau nīnau hou aku kāu e pili ana i kēia, mai kānalua e kamaʻilio me kāu kauka ʻohana. E noho olakino!

`ʻO ka maʻi ʻeha o ka ʻōpū, ʻeha ʻōpū, ʻeha umauma, koko kiʻekiʻe, maʻi puʻuwai, ʻoki kino pilikia