ʻO ka mea e pono ai ʻoe e ʻike e pili ana i kahi lua i loko o ka puʻuwai (Atrial Septal Defect - ASD)

Ua makaʻu loa paha ʻoe i ka wā i haʻi aku ai ke kauka iā ʻoe he leo liʻiliʻi ko kāu keiki liʻiliʻi i loko o kona puʻuwai, he 'heart murmur'. A i ʻole, aia ʻoe i kou mau makahiki 40 a ke manaʻo nei ʻoe ua pōkole ka hanu a luhi mau i nā manawa a pau, ʻoiai me ka hoʻoikaika kino iki? Malia paha ke kumu o kēia mau mea ʻelua he lua liʻiliʻi i loko o ka puʻuwai. Ma nā ʻōlelo lapaʻau, kapa mākou i kēia ʻo 'Atrial Septal Defect' a i ʻole ASD. Mai makaʻu ke lohe ʻoe i kēia inoa. He maʻi puʻuwai hānau maʻamau kēia. E kamaʻilio kākou e pili ana i nā mea a pau me ka maʻalahi a me ke ʻano aloha i kēia lā.

I ka ʻōlelo maʻalahi, he aha kēia lua i loko o ka puʻuwai (ASD)?

ʻAe, no ka hoʻomaopopo ʻana i kēia, e noʻonoʻo kākou i ko kākou puʻuwai me he hale lā me ʻehā lumi. ʻElua lumi o kēia hale ma luna a ʻelua lumi ma lalo. I ka lāʻau lapaʻau, kapa mākou i kēia mau lumi ʻelua ma luna ʻo ka atria . ʻO ia hoʻi, ka atrium ʻākau a me ka atrium hema. Aia kahi pā ma waena o kēia mau keʻena ʻelua ma luna. Kapa mākou i kēia pā ʻo ka septum atrial .

ʻO ka mea maʻamau e hana ʻia, ʻo ke koko haumia a nele i ka oxygen o ke kino e komo i ka atrium ʻākau, hele i nā māmā, hoʻomaʻemaʻe ʻia (oxygenated), a hoʻi i ka atrium hema. A laila e pamu ʻia kēia koko maʻemaʻe a waiwai i ka oxygen ma ke kino holoʻokoʻa.

E noʻonoʻo, he aha ka mea e hana ʻia inā he lua liʻiliʻi ma ka paia (septum) e hoʻokaʻawale ana i nā keʻena ʻelua o luna? A laila, e kahe ana kekahi o ke koko maikaʻi a waiwai i ka oxygen mai ke keʻena hema ma o kēia lua i loko o ke keʻena ʻākau. A laila, e hui pū kēia koko maikaʻi me ke koko lepo mai ka ʻākau. ʻO ka hopena, e hōʻiliʻili ka nui o ke koko ma ka ʻaoʻao ʻākau, a pono ka ʻaoʻao ʻākau o ka puʻuwai e hana ikaika e pamu i kēlā koko keu i nā māmā. ʻO ia ke ʻano o ka ASD.

Aia kekahi mau ʻano nui o ka ASD?

ʻAe, ʻehā mau ʻano nui o ka atrial fibrillation, ma muli o kahi o ka paia o ka puʻuwai. He mea nui kēia e ʻike, no ka mea, i kekahi manawa e pili ana nā koho lapaʻau i ke ʻano.

He aha nā hōʻailona o kēia maʻi?

ʻO ka mea kupanaha, ʻoiai he maʻi hānau ʻia ka ASD, ʻaʻole nui ka poʻe e loaʻa i kekahi mau hōʻailona a hiki i nā makahiki ma hope, malia paha i ka makahiki waena. Inā liʻiliʻi loa ka lua (ʻaʻole iʻoi aku ma mua o 5 millimeters), ʻaʻohe ona hopena koʻikoʻi i ka puʻuwai a i ʻole nā ​​māmā, no laila ʻaʻohe paha he mau hōʻailona.

Nā hōʻailona i nā keiki ʻōpio

ʻO ka pinepine, ʻo ka hōʻailona mua e loaʻa ana i kahi keiki ʻōpiopio ka ASD he kani puʻuwai kūpono ʻole (heart murmur) a ke kauka e lohe ai i ka wā o ka nānā ʻana o ka stethoscope. ʻO ia ka hōʻailona maʻamau.

Eia kekahi, hiki i kekahi mau keiki ke hōʻike i nā hōʻailona e like me:

• ʻO ka pohō kaumaha kūpono i ka makahiki a me ka lohi o ka ulu ʻana.
• Nā maʻi hanu pinepine (e like me ke anu, ka maʻi pneumonia).
• Ka luhi koke ʻana i ka wā e pāʻani ana.
• Paʻakikī ka hanu ʻana.
• ʻO nā ʻano hewa o ka puʻuwai (arrhythmias) - akā he mea kakaikahi kēia i nā keiki.

Nā hōʻailona i nā pākeke

Inā he lua nui kou i ʻike ʻole ʻia i ka wā kamaliʻi, e hoʻomaka paha nā hōʻailona e ʻike ʻia ma kahi o 40 mau makahiki. ʻO kēia no ka mea ua hana nui ka ʻaoʻao ʻākau o ka puʻuwai a me nā māmā no nā makahiki he nui a ua luhi.

Hiki i nā pākeke ke loaʻa nā hōʻailona e like me:

• Ka luhi nui me ke kumu ʻole.
• Ka paʻakikī o ka hanu ʻana, e like me ka hele wāwae ʻana i kahi mamao pōkole a i ʻole ke piʻi ʻana i nā alapiʻi.
• Ke manaʻo nei i kahi puʻuwai puʻuwai kūpono ʻole (palpitations).
• Ka wikiwiki o ka puʻuwai (tachycardia).
• Ka pehu ʻana (edema) o nā wāwae, nā kuʻekuʻe wāwae, a me nā lima.
• I kekahi manawa, polū nā lehelehe a me ka ʻili (cyanosis).

No ke aha lā e kū mai ai kēia kūlana?

ʻAʻole ʻike ʻia ke kumu kikoʻī o kēia. Eia nō naʻe, ʻo ka hapa nui o kēia mau kīnā hānau i hana ʻia e nā loli genetic e kū mai ana i ka wā o ka ulu ʻana o ka pēpē i loko o ka ʻōpū. Ua ʻike ʻia nā loli i nā genes e like me NKX2.5/CSX, GATA4, a me TBX5 e pili ana me ASD.

Eia kekahi, i kekahi manawa hiki i nā pēpē me ka ASD ke loaʻa i nā kīnā puʻuwai ʻē aʻe a i ʻole nā ​​​​kūlana genetic ʻē aʻe, e like me Down syndrome.

Nā mea e hoʻonui ai i ka pilikia i ka wā hāpai

Inā loaʻa i ka makuahine hāpai kekahi mau maʻi, hiki i ka pēpē ke hoʻonui iki i ka pilikia o ka loaʻa ʻana o ka maʻi puʻuwai hānau.

• Ua loaʻa i ka makuahine ka maʻi diabetes ma mua o ka hāpai ʻana.
• Ke hoʻomohala nei i nā maʻi viral e like me ka maʻi flu i ka wā hāpai.
• Ka hoʻohana ʻana i ka waiʻona a me ka paka.
• Ka hoʻohana ʻana i kekahi mau lāʻau lapaʻau me ka ʻole o ka ʻōlelo aʻoaʻo a ke kauka.
• Ka hoʻohana ʻana i nā lāʻau lapaʻau e like me ka cocaine.

He aha nā pilikia e hiki mai ana inā ʻaʻole mālama ʻia?

ʻAʻole e nui ka pōʻino o kahi lua liʻiliʻi. Eia nō naʻe, inā waiho ʻole ʻia kahi lua nui no ka manawa lōʻihi, hiki iā ia ke hoʻoulu i nā pilikia olakino koʻikoʻi. ʻO kēia no ka mea ke hana mau nei ka ʻaoʻao ʻākau o ka puʻuwai a me nā māmā, kahi e hōʻino ai iā lākou.

• Hoʻonui ʻia ka puʻuwai ʻākau: Inā hoʻomau kēia, hiki iā ia ke alakaʻi i ka hāʻule ʻana o ka puʻuwai.
• Nā maʻi ʻāʻī puʻuwai (Arrhythmia): Ma kahi o ka hapalua o ka poʻe me ASD ma luna o 40 mau makahiki e loaʻa i nā maʻi ʻāʻī puʻuwai (e like me ka atrial fibrillation).
• Hahau: I kekahi manawa, hiki i nā ʻūpā koko liʻiliʻi e hana ʻia i loko o ka puʻuwai ke hele ma o kēia lua a i loko o ka lolo, e hana ana i ka hahau.
• Ke koko kiʻekiʻe o ka puʻuwai: Ke koko kiʻekiʻe i loko o nā kīʻaha koko e lawe ana i ke koko i nā māmā. He kūlana weliweli kēia.
• ʻO ka maʻi Eisenmenger:He pilikia koʻikoʻi e kū mai ana ke loaʻa kahi ASD me ka hypertension pulmonary koʻikoʻi.

Pehea e ʻike ai nā kauka i kēia?

E nīnau lākou e pili ana i kāu mau hōʻailona, ​​​​hana i kahi hoʻokolokolo kino, a laila hana i kekahi mau hoʻokolohua e nānā i ka hana a me ke ʻano o kou puʻuwai.

I kekahi mau hihia, pono paha ke hoʻohana ʻia ka MRI a i ʻole ka CT cardiac.

He aha nā lāʻau lapaʻau no kēia?

ʻOiai hiki ke hāʻawi ʻia nā lāʻau lapaʻau e kāohi i kekahi o nā hōʻailona o ka ASD, ʻaʻole hiki iā lākou ke pani i ka lua. ʻElua mau ala e pani ai i ka lua: ʻoki kino a i ʻole ka pani ʻana o ka lua me ka ʻoki ʻole (percutaneous repair).

• Nā ASD liʻiliʻi:ʻO nā lua liʻiliʻi loa, ʻoi aku hoʻi i nā keiki, e pani wale ʻia paha. Inā ʻaʻole, a inā ʻaʻole lākou e hōʻeha nei, e ʻōlelo ke kauka "kali makaʻala," ʻo ia hoʻi ka hana ʻole ʻana i kekahi mea akā nānā pinepine.

• Nā ASD Nui: Inā nui ka lua, ʻoi aku ka maikaʻi o ka pani ʻana, ʻoiai inā ʻaʻohe hōʻailona. Hiki i kēia ke pale i nā pilikia koʻikoʻi e hiki mai ana i ka wā e hiki mai ana. ʻO ka maʻamau, inā ua hoʻonui ʻia ka ʻaoʻao ʻākau o ka puʻuwai, a inā paha he nui ke koko e kahe ana ma ka lua, ua ʻōlelo ʻia ka lāʻau lapaʻau.

Nā ʻano lapaʻau

1. Pani ʻana i ka Mea Hana Percutaneous: ʻO kēia ke ʻano hana i hoʻohana nui ʻia i kēia manawa. Hoʻokomo ʻia kahi paipu liʻiliʻi (catheter) ma o kahi aʻa nui ma ka wāwae, alakaʻi ʻia i ka puʻuwai, a hoʻokomo ʻia kahi mea hana liʻiliʻi (mea hana) e like me ka umbrella e pani i ka lua. ʻAʻole pono kēia i kahi ʻoki nui. Hoʻokahi a ʻelua paha lā ka noho ʻana ma ka haukapila. ʻAʻole loaʻa kēia ʻano hana no nā ʻano ASD āpau.

2. ʻO ke ʻoki puʻuwai hāmama: Hana ʻia kēia ʻoki no nā lua i hiki ʻole ke pani ʻia e nā ʻano hana i luna a i ʻole no nā lua e pili ana me nā kīnā puʻuwai ʻē aʻe. Maanei, ua wehe ʻia ka umauma a ua pani ʻia ka lua o ka puʻuwai me nā humuhumu a i ʻole kahi ʻāpana. He ʻoki palekana a holomua loa kēia i kēia manawa.

Ma hope o ka lāʻau lapaʻau, e haʻi aku kāu kauka iā ʻoe e lawe i nā lāʻau hoʻokahe koko a me nā lāʻau antibiotic e pale aku i nā maʻi puʻuwai no kahi o 6 mau mahina.

Pehea ke ʻano o ke ola me ka ASD?

He mea maʻamau ka makaʻu ke ʻike ʻoe a i ʻole kāu keiki he ASD ko lākou. Akā ʻo ka nūhou maikaʻi, me ka ʻepekema lapaʻau holomua o kēia wā, hiki ke mālama pono ʻia kēia maʻi a hiki i nā kānaka ke ola olakino a maʻamau .

ʻO ke keiki i pani ʻia kahi lua e hiki iā ia ke pāʻani, holo, a pāʻani haʻuki e like me nā keiki ʻē aʻe ma hope o ka ho'ōla ʻana. ʻOiai he kanaka makua, hiki iā lākou ke hoʻomau i kā lākou mau hana maʻamau ma hope o ka mālama ʻana.

ʻO ka mea nui loa, ʻo ia ka hahai pono ʻana i nā kuhikuhi a kāu kauka a hele i nā keʻena lapaʻau no nā nānā ʻana i ka manawa kūpono. ʻOi aku hoʻi, ʻo ka noho ʻana ma lalo o ka nānā ʻana a kahi loea maʻi puʻuwai hānau e like me kēia he mea nui loa ia no kou olakino.