Hiki i nā lāʻau lapaʻau maʻi kanesa ke hoʻopilikia i kou puʻuwai? E kamaʻilio kākou e pili ana i ka cardiotoxicity!

Ke mālama ʻia nei ʻoe no ka maʻi kanesa? A i ʻole kekahi āu i ʻike e mālama ʻia nei i ia ʻano mālama? I kekahi manawa hiki i nā mālama ʻana i ka maʻi kanesa ke loaʻa kahi hopena liʻiliʻi i ko mākou puʻuwai. ʻO ia ka mea a mākou e kamaʻilio ai i kēia lā. Kāhea mākou i kēia he cardiotoxicity . Mai hopohopo, e hoʻomaopopo maʻalahi kākou i kēia.

No laila he aha ka cardiotoxicity?

I ka ʻōlelo maʻalahi, ʻo ka cardiotoxicity ka hōʻino ʻana i ko kākou puʻuwai i hana ʻia e kekahi mau lāʻau lapaʻau kanesa a i ʻole nā ​​​​lāʻau lapaʻau kanesa. E hoʻomanaʻo, i kekahi manawa hiki ke loaʻa kēia hopena i nā makahiki ma hope o ka mālama ʻana i ka maʻi kanesa. He kiʻekiʻe loa kēia pilikia no nā pākeke i mālama ʻia no ka maʻi kanesa i ka wā ʻōpiopio, ʻo ia hoʻi, i ko lākou wā kamaliʻi. ʻAʻole nā ​​​​lāʻau lapaʻau kanesa āpau ke kumu o kēia, akā aia kekahi mau lāʻau lapaʻau i ʻoi aku ka nui o ka pilikia o ka hoʻoulu ʻana i ka cardiotoxicity.

Hiki i kēia kūlana ke hoʻoikaika i kou puʻuwai e pamu pono i ke koko ma loko o kou kino. I kekahi mau hihia koʻikoʻi, hiki i kēia ke alakaʻi i kahi maʻi ʻiʻo puʻuwai i kapa ʻia ʻo cardiomyopathy , kahi e paʻakikī ai i kou puʻuwai ke pamu i ke koko.

ʻO wai ka mea i pilikia nui ʻia e ka cardiotoxicity?

ʻO ka ʻoiaʻiʻo, ʻo kēlā me kēia mea i mālama ʻia i ka maʻi kanesa, aia i ka pilikia o ka loaʻa ʻana o ka cardiotoxicity. Eia nō naʻe, ʻoi aku ka kiʻekiʻe o ka pilikia no ka poʻe i hoʻohana i kekahi mau lāʻau lapaʻau a i ʻole i loaʻa i ka radiation therapy i ka ʻāpana umauma.

Eia kekahi, e like me ka mea i ʻōlelo ʻia ma mua, he mea maʻamau kēia ʻano i waena o ka poʻe i mālama ʻia no ka maʻi kanesa i ko lākou wā kamaliʻi, ʻo ia hoʻi, i ka wā makua. He mea paʻakikī ke ʻōlelo pololei i ka nui o kēia maʻamau i waena o ka poʻe i mālama ʻia no ka maʻi kanesa i ka wā makua. Eia nō naʻe, e like me kekahi mau hōʻike, ma kahi o 20% o kēia poʻe e kū paha i ka maʻi puʻuwai, a ma waena o 7% a me 10% e loaʻa paha i ka cardiomyopathy a i ʻole ka hāʻule ʻana o ka puʻuwai. No laila he mea nui loa ka makaʻala i kēia.

Pehea ka hopena o kēia cardiotoxicity i kou kino?

Hiki i ka cardiotoxicity ke hana i nā pilikia puʻuwai like ʻole. E nānā kākou i ke ʻano o lākou:

• Cardiomyopathy: ʻO kēia ka wā e nāwaliwali ai ka ʻiʻo o ka puʻuwai a ʻaʻole hiki i ka puʻuwai ke pamu i ke koko me ke kūpono.
• Nā Infarctions Myocardial a i ʻole nā ​​​​Hoʻouka Puʻuwai: Ua lohe paha ʻoe i kēia. Hiki ke hana ʻia e kahi ālai ʻana i nā aʻa e hoʻolako ana i ke koko i ka puʻuwai.
• Maʻi ʻAʻa Coronary: Ka haiki ʻana a i ʻole ka paʻa ʻana o nā ʻaʻa e lawe ana i ke koko i ka puʻuwai.
• Ka Holo ʻole o ka Puʻuwai: ʻAʻole hiki i ka puʻuwai ke pamu i ke koko e hoʻokō i nā pono o ke kino.
• Ka Maʻi Kiwikā Puʻuwai: ʻAʻole hana pono nā kiwikā puʻuwai.
• Puʻuwai puʻuwai kūpono ʻole (Arrhythmia):Ka puʻuwai kūpono ʻole, ke kuʻi mālie, wikiwiki, a i ʻole me ke ʻano ʻole.
• Hōʻiliʻili ʻana o ka wai a puni ka puʻuwai.
• Ke koko haʻahaʻa a kiʻekiʻe paha.
• Ka wikiwiki o ka puʻuwai lohi.
• ʻO ka Pericarditis Constrictive: Ma kēia ʻano, mānoanoa ka membrane waho o ka puʻuwai, e hoʻemi ana i ka hakahaka no ka puʻuwai e hoʻonui manuahi.

He aha nā hōʻailona o ka cardiotoxicity?

Aia kekahi mau hōʻailona o ka maʻi puʻuwai e pili ana i ka cardiotoxicity. Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau mea, he mea nui e hopohopo:

• ʻŌpū ʻōpū: Puʻe ka ʻōpū i mua, e like me ka puʻupuʻu.
• ʻEha Umauma: Hiki ke paʻa a ʻūmiʻi paha ka umauma.
• Pōʻaiʻī.
• Nā Palpitations o ka Puʻuwai: E noʻonoʻo e like me ka holo ʻana o kou puʻuwai i loko o kou umauma, a i ʻole e kuʻi nui ana.
• Dyspnea a i ʻole ka pōkole o ka hanu: Manaʻo ʻoe i ka pōkole o ka hanu a me ke kani ʻana o ka hanu ʻoiai ma hope o ka hana ʻana i kahi hana liʻiliʻi.
• Ka pehu ʻana o nā wāwae a me ka paʻa ʻana o ka wai (edema): Loaʻa ka pehu ʻana, ʻoiai ma nā wāwae a me nā kuʻekuʻe wāwae.

He aha nā kumu nui o ka cardiotoxicity?

Aia kekahi mau lāʻau lapaʻau no ka maʻi kanesa e hiki ai ke hoʻoulu i ka cardiotoxicity. ʻO nā mea nui loa o kēia mau mea:

• ʻO Anthracyclines: No ka laʻana , ʻo Doxorubicin (Adriamycin®) . He ʻano lāʻau chemotherapy kēia i hoʻohana pinepine ʻia e mālama i nā maʻi kanesa e like me ka leukemia, lymphoma, maʻi kanesa o ka umauma, sarcoma, a i ʻole ka myeloma maha .
• ʻO Trastuzumab (Herceptin®): He lāʻau lapaʻau i hoʻolālā ʻia kēia i hoʻohana ʻia no ka mālama ʻana i ke kanesa o ka umauma, ke kanesa o ka ʻōpū, a i ʻole ke kanesa o ka gastroesophageal junction. Aia kahi pilikia o ka cardiomyopathy, ʻoiai ke hāʻawi ʻia kēia lāʻau me ka anthracycline.
• Lapaʻau Radiation i ka umauma: Hoʻohana ʻia kēia e mālama i nā maʻi e like me ke kanesa o ka umauma a i ʻole ka leukemia .

Pehea e ʻike ai nā kauka i kēia maʻi o ka cardiotoxicity?

Nānā nui nā kauka i ka maikaʻi o ka puʻuwai ʻana o ke koko e hoʻoholo ai inā he cardiotoxicity kou. Ana ʻia kēia e kahi hoʻāʻo i kapa ʻia ʻo Left Ventricular Ejection Fraction (LVEF) . Nānā pū lākou i ka maikaʻi o ka hana ʻana o kāu mau valves puʻuwai. Ana ka LVEF i ka nui o ke koko i puʻu ʻia mai loko mai o ke keʻena haʻahaʻa ma ka ʻaoʻao hema o kou puʻuwai (ka Left Ventricle) i ka manawa hoʻokahi.

Aia kekahi mau hoʻokolohua a nā kauka e hoʻohana ai e ana i kēia mau mea:

• Echocardiogram: ʻO kēia ka hoʻāʻo kiʻi nui i hoʻohana pinepine ʻia e ʻike i ka cardiotoxicity. Hoʻohana ia i nā electrodes a me nā nalu ultrasound e nānā i kou helu puʻuwai a me ke ʻano o ke kahe ʻana o ke koko ma kou puʻuwai. Ua like ia me ke scan i hana ʻia no nā makuahine hāpai, akā ʻo kēia no ka puʻuwai.
• MRI Puʻuwai: Wahi a kekahi poʻe loea ʻo kēia ka hoʻāʻo maʻamau gula no ka ʻike ʻana i ka cardiotoxicity. Hoʻohana ia i nā magnet, nā nalu lekiō, a me kahi kamepiula kūikawā e kiʻi i nā kiʻi kikoʻī o nā ʻano o kou puʻuwai a loiloi i ke kahe ʻana o ke koko ma o ia mea.
• Hoʻāʻo Hoʻoluhi Puʻuwai: Ke ana kēia hoʻāʻo i ke ʻano o ka pane ʻana o kou puʻuwai i ka hana ikaika. Ke noi ʻia nei ʻoe e hele ma luna o ka treadmill a holo paha i kahi paikikala kūpaʻa. I loko o kēia manawa, ua hoʻopili ʻia ʻoe i kahi mīkini e ana i kou helu puʻuwai a me ke koko.
• Multigated Acquisition Scan (MUGA): Loiloi kēia hoʻāʻo i ka hana o kou mau keʻena puʻuwai (ventricles). Hoʻohana ʻia kahi tracer radioactive palekana no kēia. ʻIke maopopo ʻia ma ke scan. Nānā ke kauka i ke ʻano o ka neʻe ʻana o kēia tracer ma o kou mau kīʻaha koko, a laila helu i kāu ejection fraction.
• ʻO ka CT Scan Cardiac: Lawe ka CT scan i nā kukuna X mai nā kihi like ʻole e hana i kahi kiʻi kikoʻī o ka puʻuwai. Hiki ke lilo i mea pono loa kēia hoʻāʻo, ʻoiai no ka poʻe e kānalua nei i ka cardiotoxicity ma hope o ka radiation therapy i ka umauma.

Pehea e mālama ʻia ai kēia maʻi cardiotoxicity?

Ma muli o nā lāʻau lapaʻau āu e lawe nei, hiki i kāu kauka ke ʻōlelo aku e hoʻōki i kekahi o lākou a hōʻemi paha i kā lākou dosage. Hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau e kōkua i kou puʻuwai e hana maikaʻi. Eia kekahi laʻana:

• Nā mea hoʻopaʻa ACE: No ka laʻana , ʻo Lisinopril (Zestril®) a i ʻole Fosinopril Sodium (Monopril®)ʻAe. ʻO ka hana a kēia mau mea, ʻo ia ka wehe ʻana i kou mau aʻa a e maʻalahi ai ke kahe ʻana o ke koko.
• Nā mea pale Beta: No ka laʻana , metoprolol (Lopressor®) a i ʻole atenolol (Tenormin®) . Hoʻonui kēia i ke kahe koko a hoʻolohi i ka helu o ka puʻuwai.
• ʻO Digoxin, i ʻike ʻia hoʻi ʻo Digitalis (Lanoxin®): Hoʻolohi kēia i ka helu o ka puʻuwai a kōkua i ka paʻi ʻana o ka puʻuwai me ka ʻoi aku ka maikaʻi.
• ʻO nā diuretics (i kapa ʻia hoʻi he mau pila wai): No ka laʻana , ʻo Furosemide (Lasix®) . Hana kēia ma ka wehe ʻana i ka wai keu (wai) mai ke kino ma o ka mimi.
• Nā Vasodilators: No ka laʻana , ʻo Isosorbide Dinitrate (Isordil®) . Hana kēia ma ka hoʻonui ʻana (wehe ʻana) i nā kīʻaha koko, e ʻae ana i ke koko e kahe maʻalahi.

Aia kekahi mea e hiki ai iā mākou ke hana e hōʻemi i ka pilikia o ka cardiotoxicity?

ʻO ka ʻoiaʻiʻo, ʻaʻohe ala e pale loa ai i ka cardiotoxicity. Eia nō naʻe, inā ua ʻike ʻia ʻoe he maʻi kanesa, he mea nui loa ia e kūkākūkā i nā pono a me nā pōʻino o nā koho lapaʻau, ʻo ia hoʻi, nā pilikia olakino a me nā pono, me kāu kauka.

Eia kekahi, ʻo nā hoʻokolohua kiʻi puʻuwai maʻamau i ka wā o ka mālama ʻana i ka maʻi kanesa hiki ke kōkua i ka ʻike ʻana i ka cardiotoxicity i ka wā mua. E noʻonoʻo wale, inā he pilikia, ʻo ka wā mua e ʻike ʻia ai, ʻo ka nui o ka hiki ke mālama pono ʻia.

Hiki ke hoʻohuli ʻia kēia kūlana cardiotoxicity, ʻo ia hoʻi, e ho'ōla ʻia?

I kekahi manawa, ʻae. Aia kekahi mau hihia kahi e hiki ai ke hoʻohuli ʻia ka cardiotoxicity. Ua hōʻike ʻia e ka noiʻi hiki ke hoʻohuli ʻia ka cardiotoxicity ma hope o ka hoʻohana ʻana i kahi lāʻau i kapa ʻia ʻo Trastuzumab.

Eia nō naʻe, he mea paʻakikī ke hoʻohuli i ka cardiotoxicity i hoʻokumu ʻia e ka hoʻohana ʻana i nā anthracyclines. Pono ia i ka mālama lōʻihi. Pēlā nō, he mea paʻakikī loa ke hoʻohuli i ka cardiotoxicity e pili ana me ka radiation umauma. I kekahi manawa pono paha ka mālama lōʻihi, a me ke ʻoki ʻana.

Āhea wau e ʻimi koke ai i ke kōkua lapaʻau? He aha kaʻu e hana ai i ka wā pilikia?

Inā loaʻa iā ʻoe kekahi mau hōʻailona o kahi maʻi puʻuwai koʻikoʻi, e kāhea koke i ka 911 no kahi kaʻa kaʻa, a i ʻole e hele i ka lumi pilikia kokoke loa. E makaʻala pono i kēia mau hōʻailona:

• Nā palpitations a i ʻole ka manaʻo o ka puʻuwai wikiwiki e mau ana.
• Pōniuniu, manaʻo māmā ke poʻo, a i ʻole ka nalowale ʻana o ka manaʻo.
• Ka piʻi koke ʻana o ka hanu pōkole a i ʻole ka ʻeha o ka umauma.
• Ka pehu ʻana o ka puʻu a i ʻole nā ​​lehelehe.
• Ka pehu ʻana o nā wāwae a i ʻole nā ​​​​wāwae ma ke ʻano ʻē.
• Piʻi kaumaha ma mua o 1.5 kg (3 paona) i loko o hoʻokahi pule.

Inā loaʻa iā ʻoe kēia mau hōʻailona , ​​​​he mea nui e ʻimi koke i ke aʻo lapaʻau me ka hoʻonele ʻole i ka manawa, no ka mea, he mau hōʻailona kēia o kahi maʻi koʻikoʻi, e like me ka hāʻule ʻana o ka puʻuwai.

ʻO ka mea hope loa, ka leka lawe home koʻikoʻi loa!

ʻAe, ua kamaʻilio nui mākou e pili ana i ka cardiotoxicity. I ka ʻōlelo maʻalahi, ʻo ka cardiotoxicity ka hōʻino ʻana i ka puʻuwai i hana ʻia e nā lāʻau lapaʻau maʻi kanesa. He mea maʻamau ia i ka poʻe i loaʻa i kekahi mau lāʻau chemotherapy, nā lāʻau lapaʻau i kuhikuhi ʻia, a i ʻole ka radiation therapy i ka umauma.

ʻOiai hiki ke hoʻohuli ʻia kekahi mau ʻano cardiotoxicity, pono nā mea ʻē aʻe i ka mālama lōʻihi. ʻO ka mea nui loa, ʻo ia ke kamaʻilio ākea me kāu kauka e pili ana i nā pono a me nā pilikia kūpono o kāu mālama ʻana inā ʻoe e mālama ʻia ana i ka maʻi kanesa. Eia kekahi, ʻo ka loaʻa ʻana o nā hoʻokolohua puʻuwai maʻamau i ka wā o kāu mālama ʻana hiki ke kōkua i ka ʻike ʻana i nā pilikia i ka wā mua a hoʻomaka koke i ka mālama ʻana.

Mai hopohopo, akā e makaʻala. E mālama i kou puʻuwai. Inā ʻike ʻoe i kekahi mau hōʻailona ʻē, mai hoʻowahāwahā iā lākou. E ʻimi koke i ke kōkua lapaʻau.

ʻO ka ʻawahia o ke kino, ka mālama ʻana i ke kanesa, ka maʻi puʻuwai, ka Chemotherapy, ka Radiation Therapy, ke olakino puʻuwai, ka ʻawahia o ke kino