Ke manaʻo nei ʻoe i kekahi manawa e kuʻi ana kou puʻuwai, e kuʻi ana, a i ʻole he mea ʻē i loko o kou umauma? ʻO kēia nā mea a mākou e nānā ʻole ai i kekahi manawa, akā hiki ke lilo i mau hōʻailona o kekahi mau maʻi puʻuwai kakaʻikahi. I kēia lā e kamaʻilio mākou e pili ana i kekahi o ia mau maʻi puʻuwai kakaʻikahi, akā he mea koʻikoʻi paha. ʻO kona inoa ʻo Giant Cell Myocarditis, a i ʻole ma ka ʻōlelo Pelekania `(Giant Cell Myocarditis)`.
He aha ka Giant Cell Myocarditis? E hoʻomaopopo maʻalahi kākou.
I ka ʻōlelo maʻalahi, ʻo Giant Cell Myocarditis kahi ʻano laha ʻole o ka mumū o nā ʻiʻo puʻuwai . ʻO ka mumū kahi ʻano pehu. ʻO ka mea e hana ʻia ma kēia maʻi, ʻo ia ka hui pū ʻana o kekahi o nā 'cells mumū' o ko mākou kino a hana i kahi ʻano cell nui i kapa ʻia ʻo 'Giant Cells'. ʻO kēia mau cell nunui, e like me nā ʻenemi, e hoʻouka i kou ʻiʻo puʻuwai a hana i ka ʻeha.
E noʻonoʻo e pili ana i ia mea, ua like ko kākou puʻuwai me ka pamu wai. ʻO ia ka mea e pamu i ke koko ma ke kino holoʻokoʻa. No laila, i ka wā e hōʻino ai kēia mau ʻāpana nui i ka ʻiʻo puʻuwai, ʻaʻole hiki i ka puʻuwai ke hana pono. ʻO ia hoʻi:
- Ke paʻakikī nei ke kaomi ʻana i ke koko .
- Ke kuʻi ka puʻuwai, ʻaʻole e ʻuʻuku nā ʻāpana āpau o ka puʻuwai i ka manawa like .
- Ua hoʻopilikia ʻia nā hōʻailona uila e kaohi ana i ka puʻuwai , a ʻaʻole hele pono kēlā mau hōʻailona ma o ka puʻuwai.
Ma muli o ka hiki ke lilo koke kēia ʻano i mea koʻikoʻi, pono pinepine ka poʻe me kēia maʻi e hana i kahi hoʻoili puʻuwai .
He aha ka ʻokoʻa ma waena o ka Myocarditis a me ka Giant Cell Myocarditis?
ʻO ka myocarditis kekahi mumū o ka ʻiʻo puʻuwai. Eia nō naʻe, ʻo ka myocarditis cell nui he ʻano myocarditis kakaikahi loa a kikoʻī loa . E like me nā ʻano myocarditis ʻē aʻe, hiki iā ia ke hana i nā ʻano ʻē o ka puʻuwai, a i ʻole nā arrhythmias.
ʻO ka maʻi viral ka mea maʻamau ke kumu nui o ka myocarditis. Eia nō naʻe, ke hoʻāʻo nei nā kānaka noiʻi e ʻike i ke kumu o kēia myocarditis cell nui (GCM).
ʻO wai ka mea i hoʻopilikia nui ʻia e kēia maʻi? Pehea ka maʻamau o ia mea?
ʻO ka myocarditis cell nui (GCM) ka mea pinepine e loaʻa i nā poʻe ʻōpio olakino a me nā poʻe waena . Eia nō naʻe, hiki ke loaʻa i nā kānaka o kēlā me kēia makahiki, me ka nānā ʻole i ke kāne.
No ke ʻano o ka maʻamau o kēia, he mea kākaʻikahi loa ia. Hoʻomaopopo nā kauka i kēia maʻi ma lalo o hoʻokahi i loko o 100,000 poʻe i kēlā me kēia makahiki. ʻO ia hoʻi , ua hōʻike ʻia ma kahi o 0.13 no 100,000 poʻe .
He aha nā hōʻailona? Pehea mākou e ʻike ai iā lākou?
ʻO nā hōʻailona mua o ka giant cell myocarditis (GCM) e komo pū paha:
- Nā palpitations o ka puʻuwai (manaʻo e like me ka wikiwiki o kou puʻuwai a i ʻole ke kuʻi nei kou umauma)
- ʻEha umauma
- Paʻakikī ka hanu ʻanaa i ʻole ka pōkole o ka hanu
- Nā kuʻekuʻe wāwae pehu
- Luhi nui
Hoʻomaka koke kēia mau hōʻailona. Ma hope mai, hiki ke ulu aʻe nā ʻano ʻē o ka puʻuwai. ʻOi aku ma mua o ka hapalua o ka poʻe me kēia maʻi e loaʻa i nā ʻano ʻē weliweli o ka puʻuwai ('Ventricular arrhythmias'), e hoʻomaka ana i loko o nā keʻena o ka puʻuwai . Hiki i kēia ke hoʻōki koke i ka puʻuwai.
Eia kekahi, hiki i ka wikiwiki loa o ka puʻuwai a lohi loa paha. Hiki iā ʻoe ke manaʻo i ka poniuniu a i ʻole ka nāwaliwali . Hiki i kekahi poʻe ke loaʻa i kahi maʻi koʻikoʻi i kapa ʻia ʻo "cardiogenic shock," kahi e hiki ʻole ai i ka puʻuwai ke pamu i ke koko me ka pono.
No ke aha e hana ʻia ai kēia? He aha nā kumu?
ʻAʻole maopopo loa i nā kānaka noiʻi ke kumu o ka giant cell myocarditis (GCM). Ke nānā nei lākou i nā ʻano mea like ʻole. No ka laʻana, ke nānā nei lākou inā paha kekahi mau maʻi, nā ʻano ʻē i loko o kāu ʻōnaehana pale, a i ʻole kekahi mea i loko o kāu mau genes e hoʻonui ai i ka maʻi.
ʻO kekahi mea ʻē aʻe, ma kahi o 20% o ka poʻe i loaʻa i kēia maʻi ua ʻike ʻia he mau maʻi autoimmune . ʻO nā maʻi Autoimmune ka wā e hoʻouka ai ka ʻōnaehana pale o ko mākou kino, ʻo ia hoʻi, ka ʻōnaehana pale, i nā cell o ko mākou kino ponoʻī. No laila, hiki i kēia ʻano maʻi ke lilo i kumu a i ʻole kumu pilikia no ka hoʻomohala ʻana i ka GCM.
Pehea ʻoe e ʻike pololei ai i kēia maʻi?
I mea e hōʻoia ai i ka maʻi o ka giant cell myocarditis (GCM), pono kāu kauka e lawe i kahi laʻana liʻiliʻi o kou ʻiʻo puʻuwai . Ua kapa ʻia kēia he biopsy puʻuwai. Hoʻouna ʻia ka laʻana i kahi keʻena hoʻokolohua a nānā ʻia e kahi pathologist cardiac.
He mea nui e nānā ʻia ka hāpana e kekahi loea e like me kēia no ka mea hiki i nā hopena o kahi biopsy o ka myocarditis cell nui ke like me nā hopena o nā maʻi ʻē aʻe e hoʻoulu ai i ka mumū o ka ʻiʻo puʻuwai, e like me ka sarcoidosis cardiac. No laila, he mea nui ka ʻike pololei no kahi hoʻolālā lapaʻau.
He mea weliweli kēia hoʻāʻo `(Biopsy)`, akā ʻo ia wale nō ke ala e ʻike pono ai inā loaʻa iā ʻoe kēia maʻi. ʻO kekahi o nā pilikia e hiki ke hana me ka ʻiʻo puʻuwai `(Biopsy)` penei:
- ʻO ka effusion pericardial (hōʻiliʻili wai i loko o ka membrane a puni ka puʻuwai)
- Tamponade puʻuwai
- Ka puka ʻana o ka paia o kahi keʻena puʻuwai (paia ventricular)
I ka lawe ʻana i kēia hāpana, hoʻokomo ke kauka i kahi ʻōmole lahilahi loa, i kapa ʻia he catheter, i loko o kou puʻuwai ma o kahi kīʻaha koko nui ma kou ʻāʻī a i ʻole ka ʻūhā. Alakaʻi ʻia kēia catheter i loko o ka puʻuwai me ka hoʻohana ʻana i kahi mea kūikawā (`Imaging`). A laila, lawe kahi mea hana kūikawā i loko o ka catheter i kahi ʻāpana liʻiliʻi o ka ʻiʻo puʻuwai.
I kekahi manawa, pono paha ma mua o hoʻokahi `(Biopsy)`. ʻO kēia no ka mea ʻaʻole paha e hoʻopili like ka `(GCM)` i nā ʻāpana āpau o ka puʻuwai. ʻO ka hana ʻana i kahi mea e like me ka scan `(MRI)` o ka puʻuwai e kōkua i ke kauka e hoʻoholo pono i kahi e lawe ai i ka `(Biopsy)`.
He aha nā hoʻokolohua ʻē aʻe āu e hana ai?
I mea e hōʻoia ai ʻaʻole ʻoe he maʻi puʻuwai ʻē aʻe, e kauoha paha kāu kauka i nā hoʻokolohua ʻē aʻe. ʻO kekahi o kēia mau mea:
- ʻElectrocardiogram (EKG)
- ʻEchocardiogram
- Ka hoʻopili ʻana o ka puʻuwai
He aha nā lāʻau lapaʻau?
Hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau like ʻole e mālama ai i kēia maʻi. ʻO kēia mau lāʻau lapaʻau:
- Hiki ke hoʻēmi i ka mumū .
- Kōkua ia i ka pale ʻana i ka hanana ʻana o nā ʻano puʻuwai kūpono ʻole a i ʻole ka hāʻule ʻana o ka puʻuwai.
- Hiki ke hāʻawi ʻia aku iā ʻoe ka manawa hou aʻe a hiki i kou wā e pono ai i kahi hoʻoili puʻuwai.
- Kōkua i ka hoʻolōʻihi i ke ola .
ʻO nā lāʻau lapaʻau ʻē aʻe no ka giant cell myocarditis (GCM) e kōkua i ka kaohi ʻana i ka hāʻule ʻana o ka puʻuwai a me nā ʻano puʻuwai maʻamau ʻole. Hiki i kēia mau lāʻau lapaʻau ke komo pū me:
- Nā lāʻau lapaʻau
- Ka hoʻopau ʻana o ka catheter
- He mea hoʻokele pace
- ʻO kahi implantable cardioverter defibrillator (ICD) kahi hāmeʻa i hoʻokomo ʻia i loko o ke kino e hoʻoponopono a hoʻopūhoihoi i ka helu o ka puʻuwai.
- He hoʻoili puʻuwai
ʻOiai e kali ana no kahi hoʻoili puʻuwai, pono paha ʻoe i kahi mea kōkua ventricular hema (LVAD). Inā makemake ʻoe i kahi hoʻoili puʻuwai, pono ʻoe e loaʻa i nā hoʻokolohua a me ka mālama ʻana ma kahi haukapila i loaʻa nā pono no ia mea.
He aha ke ʻano o nā lāʻau lapaʻau i hoʻohana ʻia?
ʻO ka lāʻau lapaʻau no ka giant cell myocarditis (GCM) e komo pū me nā lāʻau lapaʻau e kāohi ana i kāu ʻōnaehana pale (immunosuppressants). ʻO ia hoʻi, nā lāʻau lapaʻau e hōʻemi ana i ka pale ʻana. ʻO kekahi o kēia mau mea:
- Cyclosporine (e.g. Gengraf®, Neoral®)
- ʻO nā Corticosteroids e like me prednisone (e like me Sterapred®, Rayos®)
- Azathioprine (e.g. Imuran®, Azasan®)
He mea nui loa ka hoʻomaka ʻana i kēia mau lāʻau lapaʻau i ka wā hikiwawe loa. Me ka ʻole o kēia mau lāʻau lapaʻau, hiki ke koi ʻia kahi hoʻoili puʻuwai i loko o ʻekolu mahina o ka hoʻomaka ʻana o nā hōʻailona, a i ʻole hiki ke make ke kūlana. Eia nō naʻe, ʻo ka poʻe e lawe ana i nā lāʻau lapaʻau e kaohi ana i ka ʻōnaehana pale maʻamau e ola no kahi o 12 mau mahina.
Aia kekahi mau hopena ʻaoʻao o ka lāʻau lapaʻau?
Hiki ke ʻokoʻa nā hopena ʻaoʻao ma muli o ke ʻano o ka lāʻau lapaʻau āu e lawe ai. ʻO kekahi o nā hopena ʻaoʻao maʻamau:
- ʻEha a nāwaliwali paha nā ʻiʻo
- ʻEha poʻo
- Ke kō koko kiʻekiʻe
- Ka maʻi pākī
- ʻAʻole hiki ke hiamoe
Inā manaʻo ʻoe i kekahi mea e like me kēia, mai poina e haʻi i kāu kauka.
Pehea lā ke ʻano o ke ola me kēia maʻi?
Inā loaʻa iā ʻoe ka giant cell myocarditis (GCM), hiki iā ia ke alakaʻi i ka hāʻule ʻana o ka puʻuwai a i ʻole ka poloka puʻuwai . Ke lilo kēia mau kūlana i mea koʻikoʻi (maʻamau i loko o ʻelima mau mahina), pono paha ʻoe i kahi hoʻoili puʻuwai, inā kūpono ʻoe. He nui ka poʻe e lilo i mea ʻole o nā hōʻailona ma hope o ka loaʻa ʻana o kahi puʻuwai hou, akā pono lākou e lawe i nā lāʻau lapaʻau hou e kākoʻo i ka puʻuwai hou.
Hiki ke pale ʻia ka giant cell myocarditis?
ʻOiai hiki i nā kānaka ke ola lōʻihi me ka giant cell myocarditis (GCM) ma mua o ka wā ma mua, he maʻi make nō ia me ka ʻole o ka hoʻoili puʻuwai . No ka hapa nui o nā makahiki 1900, ua ola ka poʻe me GCM no ka liʻiliʻi ma mua o ʻekolu mahina. Akā i kēia lā, inā ʻike mua ʻia ka maʻi a mālama ʻia me nā lāʻau lapaʻau e kaohi ana i ka ʻōnaehana pale, 90% o ka poʻe me GCM e ola ana no ka liʻiliʻi o hoʻokahi makahiki. Hiki i kēia mau lāʻau ke kūʻai iā ʻoe i nā mahina a i ʻole nā makahiki a hiki i kou pono ʻana i kahi hoʻoili puʻuwai.
He aha ka wānana o ka maʻi?
Ma hope o ka hoʻoili puʻuwai, ma kahi o 71% o ka poʻe me ka giant cell myocarditis (GCM) e ola no ʻelima mau makahiki (82% ma kekahi noiʻi ʻē aʻe) . He ʻumi makahiki ma hope o ka hoʻoili puʻuwai, ʻo ka nui o ke ola ma kahi o 68%.
Eia nō naʻe, hiki i nā hunaola nunui ke ʻike hou ʻia ma waena o 10% a me 50% o ka poʻe i loaʻa i kahi puʻuwai hou. Hiki ke hana ʻia kēia ma nā wahi āpau mai kekahi mau pule a i ʻeiwa mau makahiki ma hope o ke kāpili ʻana. Inā hana ʻia kēia, pono ʻoe e lawe i nā steroids no kekahi mau mahina.
Pehea wau e mālama ai iaʻu iho?
Inā loaʻa iā ʻoe ka giant cell myocarditis (GCM), pono ʻoe e pale i nā haʻuki hoʻokūkū no ka liʻiliʻi o ʻekolu a ʻeono mahina . Ke paʻa kāu GCM, e nīnau i kāu kauka inā palekana ke hoʻi mālie i ka hoʻoikaika kino.
Āhea ʻoe e pono ai e ʻike i ke kauka?
Inā loaʻa iā ʻoe nā hopena ʻino mai kāu lāʻau lapaʻau, a inā paha e ʻoi aku ka ʻino o kāu mau hōʻailona, e ʻike koke i kāu kauka . He mea nui hoʻi e ʻike mau i kāu kauka e nānā i kou kūlana.
I ka manawa hea ʻoe e pono ai e hele i ka Emergency Treatment Unit (ETU) ?
Inā loaʻa iā ʻoe ka ʻeha nui o ka umauma a i ʻole ka paʻakikī o ka hanu ʻana, e kāhea koke i ka 911 a i ʻole e hele i kahi lumi pilikia. He mea nui loa kēia, no ka mea, he mau hōʻailona kēia o kahi maʻi koʻikoʻi.
He aha nā nīnau e pono iaʻu e nīnau aku i ke kauka?
Mai poina e nīnau i kēia mau nīnau ke ʻike ʻoe i kāu kauka:
- ʻEhia pinepine e pono ai iaʻu e hele mai no nā hālāwai hoʻomaʻamaʻa?
- Aia kekahi hui kākoʻo e hiki ai i ka poʻe me kēia maʻi ke hui pū?
- Manaʻo ʻoe e pono iaʻu kahi hoʻoili puʻuwai?
ʻO ka mea hope loa, ʻo ka mea nui e hoʻomanaʻo
No laila, i kēia manawa ua maopopo paha iā ʻoe he maʻi puʻuwai kakaʻikahi loa ka Giant Cell Myocarditis, akā he maʻi puʻuwai koʻikoʻi loa. ʻO ka mea nui loa, ʻo ia ka ʻike mua ʻana i nā hōʻailona, e ʻimi i ke aʻo lapaʻau, a hoʻomaka i ka mālama kūpono. Mai hopohopo, no ka mea, aia nā lāʻau lapaʻau no kēia maʻi i kēia manawa, a hiki ke hoʻolōʻihi ʻia ke ola. No laila, inā manaʻo ʻoe i kahi mea ʻē e pili ana i kou puʻuwai, mai hoʻowahāwahā iā ia a ʻike i ke kauka. E mālama i kou puʻuwai!
ʻO ka Myocarditis Kelepona Nui, Myocarditis Kelepona Nui, Maʻi Puʻuwai, Hoʻoili Puʻuwai, Nā Kelepona Nui, Nā Maʻi ʻŌnaehana Puʻuwai, ʻŌnaehana Palekana, Hoʻouka Puʻuwai, Maʻi Puʻuwai
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