Ua lohe paha ʻoe i ke kauka e ʻōlelo ana, "Hmm... lohe au i kahi walaʻau liʻiliʻi, he rumors," ke kau lākou i kahi stethoscope i kou umauma. He mea maʻamau ke manaʻo iki i ka makaʻu ke lohe lākou i kēlā. Akā, ʻaʻole nā rumors āpau he mea weliweli. I kēia lā e kamaʻilio mākou e pili ana i kahi ʻano kani puʻuwai kūikawā i kapa ʻia he diastolic murmur . E nānā kākou i ke ʻano o ia mea, no ke aha e hana ai, a inā he mea ia e makaʻu ai.
He aha ka Diastolic Murmur?
ʻAe, e nānā mua kākou i ke ʻano o ka murmur diastolic. I ka ʻōlelo maʻalahi, he leo ʻē ia āu e lohe ai i ka wā e kuʻi ana kou puʻuwai, ʻo ia hoʻi, ke hoʻomaha nei kou puʻuwai no kekahi manawa (diastole) . ʻIke ʻoe, ke nānā ʻoe i kou koko, ʻo ka helu lalo ke kaomi diastolic. Pololei kēlā, ʻo ia ka manawa e piha ai kou puʻuwai i ke koko a e hoʻomākaukau ana no ka kuʻi aʻe.
Hiki i kēia ʻōhumu ke kani e like me ke kani 'swish' a i ʻole 'whoosh', e like me ke kani wili. Hoʻokumu ʻia kēia kani e ka haunaele e kū mai ana i ka wā e kahe ai ke koko ma o nā valves o ka puʻuwai.
ʻO ka hapa nui o ka manawa, ʻaʻole weliweli kahi ʻōhumu e like me kēia. Akā i kekahi manawa, hiki ke lilo i hōʻailona o kahi maʻi puʻuwai. Inā ʻōlelo kāu kauka he ʻōhumu diastolic kou, e kauoha paha ʻo ia i kekahi mau hoʻokolohua hou aʻe e kāpae i nā maʻi puʻuwai ʻē aʻe.
He aha ka ʻokoʻa ma waena o nā murmurs systolic a me nā murmurs diastolic?
I kēia manawa ke noʻonoʻo nei paha ʻoe, 'He ʻelua anei ka murmur diastolic a me ka murmur systolic?' ʻAe, he ʻoiaʻiʻo kēlā.
- Lohe ʻia kahi murmur diastolic ke hoʻomaha ka puʻuwai ma waena o nā kuʻi. He ʻoi aku ka paʻakikī o ka ʻike ʻana i kēia leo ma mua o ka murmur systolic.
- Lohe ʻia ka murmur systolic i ka wā e ʻuʻuku ai ka ʻiʻo o ka puʻuwai, ʻo ia hoʻi, i ka wā e pamu ai ka puʻuwai i ke koko (i ka wā systole).
I ka ʻōlelo maʻalahi, ʻike ʻia kēia mau ʻano murmurs ʻelua i nā manawa like ʻole o ke kaʻina hana cardiac.
He aha nā ʻōhumu 'hala ʻole' a me nā ʻōhumu 'kūpono ʻole'? He mea weliweli anei lākou a pau?
ʻAe, ʻo kekahi mea nui ʻē aʻe pehea e hoʻokaʻawale ʻia ai kēia mau kinikini.
Ua kapa nā kauka i kekahi mau ʻōhumu he 'ʻōhumu hala ʻole' . ʻO ke ʻano kēia, ʻaʻole i hoʻokumu ʻia nā leo o ka puʻuwai e kekahi maʻi puʻuwai. He mau ʻōhumu maʻamau wale nō kēia, ʻaʻole pono ʻole. ʻIke pinepine ʻia kēia mau mea i nā keiki ʻōpio, a nalo pinepine lākou i ko lākou wā ʻelemakule.
Eia nō naʻe, ʻo ka 'murmur maʻamau ʻole' ʻo ia hoʻi ua hoʻokumu ʻia ka murmur e kahi maʻi puʻuwai. ʻO kēia ka manawa e hana ai nā kauka i nā hoʻāʻo hou aʻe e hoʻāʻo e ʻimi i ke kumu pololei.
ʻAʻole pono ka lāʻau lapaʻau i nā ʻōhumu hala ʻole. Eia nō naʻe, ʻokoʻa ka lāʻau lapaʻau ʻana i kahi ʻōhumu maʻamau ma muli o ke kūlana puʻuwai i hoʻokumu ai.
E hoʻomanaʻo: ʻAʻole weliweli nā ʻōhumu a pau. Akā inā ʻōlelo ke kauka he ʻōhumu kou, he mea nui e nānā ʻia.
He aha nā kumu o ka murmur diastolic?
I kēia manawa, e nānā kākou i nā kumu nui o kēia murmur diastolic. ʻO ka hapa nui o ka manawa, ua hoʻokumu ʻia kēia mau mea e nā pilikia me nā valves o ka puʻuwai.
Nā pilikia e pili ana i ka valve puʻuwai
ʻEhā mau kiwikā nui o ko kākou puʻuwai. Ua like kēia mau kiwikā me nā puka, e ʻae ana i ke koko e kahe wale ma kekahi ʻaoʻao. Inā he pilikia me kēia mau kiwikā, hiki ke lohe ʻia kēlā leo rumbay.
- ʻO ka Regurgitation Aortic: Hana ʻia kēia i ka wā e pani pono ʻole ai ka valve aortic, ka mea e lawe ana i ke koko mai ka puʻuwai a i ka aorta. ʻO kēia ke kumu o ke kahe ʻana o ke koko i hope. E noʻonoʻo iā ia e like me kahi piula wai i pani pono ʻole ʻia a hoʻokahe i ka wai.
- ʻO ka Regurgitation Pulmonic: Ma kēia, ʻaʻole pani pono ka valve pulmonary e lawe ana i ke koko mai ka puʻuwai a i nā māmā. ʻOiai i kēlā manawa, kahe ke koko i hope.
- ʻO ka Mitral Stenosis: ʻO kēia ka wā e haiki ai ka valve mitral, ka mea e lawe ana i ke koko mai ka atrium hema a i ka ventricle hema. Ua like ia me kahi paipu i paʻa. He paʻakikī ke kahe o ke koko.
- ʻO ka Stenosis Tricuspid: Ma kēia, ua emi ka valve tricuspid, ka mea e lawe ana i ke koko mai ka atrium ʻākau a i ka ventricle ʻākau o ka puʻuwai.
ʻO nā pilikia valve e like me kēia ke kumu o ka loli ʻana o ke ʻano o ke kahe ʻana o ke koko, ʻo ia ke kumu o kēlā kani 'whoosh' 'swish', ʻo ia hoʻi, ka murmur.
Nā kumu ʻē aʻe
Ma waho aʻe o nā pilikia valve, hiki ke loaʻa nā murmurs diastolic no kekahi mau kumu ʻē aʻe:
- ʻO kekahi mau maʻi puʻuwai hānau ʻia he mau maʻi puʻuwai i loaʻa i ka wā hānau.
- Endocarditis: He maʻi kēia o ka uhi o loko o ka puʻuwai a/a i ʻole kona mau valves.
- Nā hopena lōʻihi o ka maʻi rumatika : Inā ʻaʻole mālama pono ʻia i ka wā kamaliʻi, hiki i ka maʻi rumatika ke hōʻino i nā valves o ka puʻuwai.
He aha nā hōʻailona o ka murmur diastolic?
ʻO nā hōʻailona o ka murmur diastolic e pili ana i ke kumu kumu. ʻO ia hoʻi, hiki ke ʻokoʻa nā hōʻailona ma muli o ka haiki ʻana o ka valve (stenotic) a i ʻole ka leaka ʻana (regurgitant). ʻAʻole paha i loaʻa i kekahi poʻe kekahi mau hōʻailona. Eia naʻe, ʻo nā hōʻailona maʻamau:
- Paʻakikī ka hanu ʻana , ʻoiai ke luhi ʻoe a kūlou paha.
- Ka pehu ʻana i loko o ka ʻōpū a i ʻole nā wāwae.
- Nā palpitations , a i ʻole ka manaʻo o ka puʻuwai wikiwiki.
- Ka luhi mau.
- Pōʻaiʻī.
- I kekahi manawa hiki iā ʻoe ke hemo i waho .
- ʻŪhū mau.
Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, he mea nui loa e ʻike i ke kauka.
Pehea e ʻike ai nā kauka i ka murmur diastolic? (Diagnosis)
ʻO ka maʻamau, e ʻike mua ke kauka inā he murmur kou ma ka hoʻolohe ʻana i kou umauma me kahi stethoscope. I ka hoʻolohe ʻana, e noʻonoʻo ke kauka i kekahi mau mea:
Nā mea āu e lohe ai me ka stethoscope
- Ke hoʻololi nei anei kou kūlana a i ʻole kou hoʻoikaika kino ʻana i kēia kani?
- Pehea ka leo nui o ke kani?
- He aha ke kiʻekiʻe o ke kani? He leo kiʻekiʻe a he leo haʻahaʻa paha?
- Ma ka manawa hea o ka puʻuwai e lohe ʻia ai ke kani, a pehea ka lōʻihi o kona mau ʻana?
- Ma hea i loko o ka puʻuwai e lohe ʻia ai kēia ʻōhumu?
Mai nā mea e like me kēia, hiki i ke kauka ke loaʻa i kahi manaʻo o ke ʻano o ka ʻōhumu.
He aha nā hoʻokolohua e hana ʻia?
Inā kānalua ʻoe he murmur kou, hiki i kāu kauka ke kuhikuhi iā ʻoe i kahi cardiologist no nā hoʻokolohua hou aku. Hiki i kēia mau hoʻokolohua ke kōkua i ka hoʻoholo ʻana i ka rhythm a me ke ʻano o kou puʻuwai. ʻO nā hoʻokolohua maʻamau:
- Echocardiogram (Echo): ʻO kēia ka hoʻāʻo nui i hoʻohana ʻia e loiloi i ka murmur puʻuwai. Hoʻohana ka echo i nā nalu ultrasound e kiʻi i nā kiʻi o ka puʻuwai. Hiki iā ia ke hōʻike i nā ʻiʻo puʻuwai a me nā valves me nā kikoʻī. ʻAʻohe ʻeha, e like me ke scan o kahi pēpē i loko o ka ʻōpū.
- X-ray umauma: Lawe kēia i nā kiʻi o ka puʻuwai, nā iwi, a me nā māmā. Hiki iā ia ke hōʻike inā ua hoʻonui ʻia ka puʻuwai a inā he wai i loko o nā māmā.
- Electrocardiogram (EKG/ECG): Hoʻopaʻa kēia i ka hana uila o ka puʻuwai. Hiki iā ia ke nānā i nā hewa i loko o ka puʻuwai.
E aʻo pū anei kākou e pili ana i ke ʻano o ka māka ʻana i hāʻawi ʻia i kēia mau kinikini?
Hoʻopāpā nā kauka i ka ʻōhumu puʻuwai ma muli o kona ikaika, ʻo ia hoʻi ke kani nui, ke ʻoi o ke kani, a me ka lōʻihi o kona mau.
- Ua helu ʻia nā Diastolic Murmurs ma kahi pālākiō mai hoʻokahi a ʻehā (1 a 4) . ʻO hoʻokahi (1) he leo paʻakikī ke lohe ʻia, a ʻo ʻehā (4) he leo nui loa.
- Ua helu ʻia nā Murmurs Systolic mai hoʻokahi a ʻeono (1 a 6). ʻAʻole hiki ke lohe ʻia kekahi (1), a ʻeono (6) ka leo nui e lohe ʻia me ka ʻole o kahi stethoscope i kau ʻia ma ka umauma.
Hiki i kēia māka ke hāʻawi iā ʻoe i kekahi manaʻo no ke koʻikoʻi o ka ʻōhumu.
Pehea e mālama ʻia ai ka murmur diastolic?
Aia ka lāʻau lapaʻau i ke kumu nui o ka murmur. No ka laʻana, inā ua hana ʻia ka murmur e kahi pilikia valve, hiki i kāu kauka ke ʻōlelo i nā lāʻau lapaʻau, ka hoʻoponopono ʻana i ka valve, a i ʻole ke pani ʻana i ka valve.
Nā lāʻau lapaʻau
ʻO kekahi o nā lāʻau lapaʻau i hoʻohana ʻia no ka mālama ʻana:
- Nā mea hoʻopaʻa i ka enzyme hoʻololi-angiotensin (ACE): No ka laʻana, benazepril (Lotensin®) a i ʻole captopril (Capoten®). Hana kēia mau mea ma ka hoʻohaʻahaʻa ʻana i kou koko.
- Nā mea pale Beta: E like me bisoprolol (Cardicor®) a i ʻole metoprolol (Lopressor®). Hoʻohaʻahaʻa kēia i ke koko a me ka helu o ka puʻuwai.
- Nā lāʻau hoʻokahe koko: ʻo warfarin (Coumadin®) a i ʻole aspirin (Bayer®, Zorprin®) he mau lāʻau lapaʻau e hōʻemi ana i ka hiki ke koko ke kāpili.
- Nā lāʻau diuretic (nā pila wai): E like me ka furosemide (Lasix®) a i ʻole torsemide (Demadex®). Kōkua kēia i ka hōʻemi ʻana i ka nui o ka wai keu i loko o ke kino.
Mea nui: He mea nui loa e lawe i kēia mau lāʻau lapaʻau e like me ke kuhikuhi a kāu kauka, ma ke ʻano i kuhikuhi ʻia a no ka manawa i kuhikuhi ʻia.
ʻOki kino (Hoʻoponopono/Hoʻololi Valve)
Inā ua hōʻino ʻia a liki paha kekahi o kou mau kiwikā puʻuwai, pono paha ʻoe e hana i ke ʻoki kiwikā puʻuwai.
- Hoʻoponopono Valve: Hiki i kēia ʻoki kino ke hoʻonui i kahi valve i haiki a hoʻopaʻa paha i kahi valve e leaka ana. I nā manawa hiki, hoʻāʻo nā kauka e hoʻoponopono a mālama i kāu valve ponoʻī.
- Hoʻololi Valve: Inā he haiki loa ka valve (stenosis valve koʻikoʻi) a i ʻole ua hōʻino nui ʻia, e wehe ke kauka i ka valve a hoʻololi iā ia me kahi valve mechanical a i ʻole kahi valve mai kahi mea hāʻawi.
Hiki ke pale ʻia ka murmur diastolic?
ʻAʻohe ala kikoʻī e pale aku ai i ka murmur diastolic, no ka mea, pili pinepine ia me nā kūlana olakino ʻē aʻe. Eia nō naʻe, i ka wā i ʻike ai kāu kauka iā ʻoe me ka murmur diastolic, he mea nui e ʻike pinepine i kāu kauka e kāpae i ke kumu kumu (e like me ka pilikia valve) a hahai i kāna mau kuhikuhi.
Eia kekahi, ʻo ka hahai ʻana i nā ʻano nohona olakino e hiki ai ke mālama i kou puʻuwai i ke olakino hiki ke hōʻemi i ka pilikia o kēia mau kūlana i kekahi ʻano.
- E ʻai i ka meaʻai momona i nā huaʻai, nā mea kanu, a me nā palaoa holoʻokoʻa.
- E hana ma ka liʻiliʻi he 150 mau minuke o ka hoʻoikaika kino aerobic i kēlā me kēia pule (e.g., hele wikiwiki, holo, ʻauʻau).
- E hōʻemi i ka hoʻohana ʻana i ka waiʻona a me ka caffeine.
- Inā ʻoe e puhipaka, e hoʻōki pono .
- E hōʻemi i ke kaumaha ma o nā hana e like me ka noʻonoʻo ʻana.
- E hiamoe maikaʻi ma ka liʻiliʻi he ʻehiku a ʻewalu hola i kēlā me kēia pō.
He aha ka manaʻo no kekahi me ka murmur diastolic? (Outlook)
ʻO ka nānā ʻana ma muli o ke kūlana kumu. ʻO ka mea pōmaikaʻi, aia nā lāʻau lapaʻau maikaʻi loa no nā pilikia valve. Eia kekahi, ʻo ka hahai ʻana i kahi nohona olakino hiki ke kōkua iā ʻoe e ola i kahi ola maikaʻi a piha, me ka puʻuwai murmur. No laila, mai makaʻu, e hahai wale i nā ʻōlelo a kāu kauka.
He aha nā nīnau koʻikoʻi e nīnau aku ai i ke kauka?
Ke ʻike ʻoe he murmur diastolic kou, he mea maikaʻi ke nīnau i kāu kauka i nā nīnau e like me kēia:
- He aha ke kumu kūpono loa o kēia ʻōhumu diastolic i loko oʻu?
- He aha nā ʻano hoʻokolohua e pono iaʻu e hana?
- He aha nā koho lapaʻau e loaʻa iaʻu?
- He aha kaʻu e pono ai e ʻike e pili ana i ka mālama ʻana i nā kūlana olakino maʻamau?
- Pono anei au e ʻike i kahi loea ?
- Pono anei iaʻu e hoʻololi i koʻu nohona e hoʻomaikaʻi ai i ke olakino o koʻu puʻuwai?
Ma waho aʻe o kēia mau nīnau, e nīnau i kāu kauka e pili ana i nā mea āu i loaʻa ai, ʻaʻohe mea liʻiliʻi.
ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)
ʻAe, ua kamaʻilio nui mākou e pili ana i ka Diastolic Heart Murmur i kēia lā. Eia kekahi mau mea e hoʻomanaʻo ai i ka pōkole:
- ʻO ka murmur diastolic he leo ʻē i lohe ʻia i ka wā e hoʻomaha ai ka puʻuwai (i ka wā diastole).
- ʻOiai ʻaʻole weliweli ka hapa nui o nā murmurs, i kekahi manawa hiki iā lākou ke lilo i hōʻailona o kahi maʻi puʻuwai. No laila, inā haʻi aku ke kauka iā ʻoe he murmur kou, he mea pono ke nānā ʻia .
- Ma muli o ke kumu, hiki ke mālama ʻia me ka lāʻau lapaʻau a i ʻole ke ʻoki kino.
- ʻO ke ola ʻana i kahi nohona olakino e kōkua iā ʻoe e ola maikaʻi me nā kūlana e like me kēia.
- Inā he mau nīnau a kānalua paha kāu, mai makaʻu e kamaʻilio me kāu kauka .
E hoʻomanaʻo, he mea nui loa ka mālama ʻana i kou puʻuwai. Lana koʻu manaʻo he mea pono kēia ʻike iā ʻoe!
ʻO ka Murmur Diastolic, Maʻi Puʻuwai, Nā Kiwikā Puʻuwai, Pōkole o ka Hanu, Puʻuwai, Echocardiogram, ECG, Leo Puʻuwai, Puʻuwai
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