ʻO ka manaʻolana ʻana i kahi pēpē kekahi o nā manawa hauʻoli loa o kou ola. Akā i ka manawa like, ke hele nei kou kino i nā loli he nui. Me kēia mau loli, hiki iā ʻoe ke makaʻu iki i kekahi manawa, ʻoiai i ka wā e pili ana i nā pilikia o ka puʻuwai. Nui ka poʻe e makaʻu pono ʻole no ka mea ʻaʻole lākou i ʻike nui e pili ana i kēia. No laila, i kēia lā e kamaʻilio mākou e pili ana i nā mea āpau e pono ai ʻoe e ʻike e pili ana i ka maʻi puʻuwai i ka wā hāpai, maʻalahi a maopopo.
He aha ke ʻano o ka maʻi cardiac i ka wā hāpai?
I ka ʻōlelo maʻalahi, ʻo kēlā me kēia pilikia e hoʻopilikia i kou puʻuwai i ka wā hāpai e hāʻule i loko o kēia māhele. Hiki ke hana ʻia kēia ma nā ʻano nui ʻelua.
1. Nā maʻi puʻuwai mua: Pili kēia i nā maʻi puʻuwai i loaʻa iā ʻoe ma mua o kou hāpai ʻana. ʻAʻole paha i hōʻeha kēia mau mea iā ʻoe i kekahi mau hōʻailona a i ʻole nā pilikia nui ma mua. Eia nō naʻe, me nā loli e kū mai ana i kou kino i ka wā hāpai, hiki i kēia mau maʻi ke hoʻopilikia iā ʻoe ma ke ʻano ʻokoʻa a hoʻoulu i nā pilikia.
2. Maʻi puʻuwai hou i ka wā hāpai: ʻO kēia nā kūlana i loaʻa ʻole iā ʻoe ma mua o kou hāpai ʻana a ulu aʻe i kēia manawa. ʻOiai ʻaʻole pilikia kekahi o kēia mau mea, hiki i kekahi ke hoʻoweliweli.
ʻO ka mea nui, hiki i ka hapa nui o nā wāhine me ka maʻi puʻuwai ke hāpai palekana a hānau i kahi pēpē olakino, akā pono ia i ke aʻo lapaʻau kūpono a me ka nānā ʻana.
Eia nō naʻe, i kekahi manawa hiki i kēia kūlana ke alakaʻi i nā pilikia koʻikoʻi. ʻO ka ʻoiaʻiʻo, ma nā ʻāina e like me ʻAmelika Hui Pū ʻIa, ʻo ka maʻi cardiovascular ke kumu nui o ka make ʻana o nā makuahine.
- 1 i loko o 3 mau make e pili ana i ka hāpai ʻana ma muli o ka maʻi puʻuwai.
- Hoʻopilikia ka maʻi puʻuwai ma kahi o 4 o 100 mau hāpai keiki.
- ʻO nā mea e like me ke koko kiʻekiʻe, ka momona (ka piʻi ʻana o ke kaumaha o ke kino), a me ka ʻoi aku o 40 mau makahiki e hoʻonui hou aku i kēia pilikia.
Mai makaʻu e aʻo i kēia mau mea. He mau mea kēia e hoʻomaopopo iā ʻoe. Inā hāpai ʻoe a i ʻole e hoʻolālā ana e hāpai, he mea nui loa ia e ʻike i kēia. Ma mua o kēlā, e hoʻomaopopo kākou i ka mea e hana ʻia ana i kou puʻuwai a me nā kīʻaha koko i ka wā hāpai.
He aha ka mea e hana ʻia i kou puʻuwai a me nā kīʻaha koko i ka wā hāpai?
Ke hele nei kou kino i nā loli kupaianaha he nui i kēia manawa. Hoʻokomo kēia mau loli i ke kaomi hou aʻe ma kou kino a pono kou puʻuwai e hana ikaika ma mua o ka maʻamau. He mea maʻamau kēia mau loli. ʻO ia ke hōʻoia i ka loaʻa ʻana o ka nui kūpono o ka oxygen a me nā meaʻai i ka pēpē e ulu ana i loko o ka ʻōpū.
- Hoʻonui ʻia ka nui o ke koko: Hoʻomaka ka nui o ke koko o kou kino e piʻi aʻe mai nā pule mua o ka hāpai ʻana. I ka hopena o ka hāpai ʻana, ua piʻi aʻe ka nui o kou koko ma kahi o 40% - 45%. E hoʻomanaʻo, ʻo kēia no ka mea pono e hoʻonui ʻia kāu lako koko me kāu pēpē.
- Hoʻonui ʻia ka helu o ka puʻuwai:He mea maʻamau ka piʻi ʻana o kou puʻuwai ma kahi o 10-20 mau kuʻi i kēlā me kēia minuke i kēia manawa. Piʻi mālie kēia, a hiki i kona kiʻekiʻe i ke kolu o ka trimester.
- Puʻuwai: ʻO kēia ka nui o ke koko e pamu ai kou puʻuwai i kēlā me kēia minuke. Hiki i kēia ke piʻi aʻe ma 30% a 50% ma waena o nā pule 28 a me 34. Inā ʻoe e hāpai ana i nā māhoe, hiki i kēia ke piʻi aʻe a hiki i ka 60%.
Hiki i kēia mau loli ke hoʻomaopopo iā ʻoe i nā mea e like me:
- Manaʻo luhi hiki ʻole ke hoʻomanawanui (Fatigue).
- Manaʻo puni.
- Paʻakikī ka hanu ʻana, me he mea lā e ʻūlū ana ʻoe (Dyspnea).
- Nā palpitations (manaʻo e like me ka wikiwiki o kou puʻuwai).
Eia kahi e lilo ai i mea huikau iki. He mea maʻamau kēia mau hōʻailona i ka wā hāpai. Eia nō naʻe, hiki i kēia mau hōʻailona like ke lilo i mau hōʻailona o ka maʻi puʻuwai . No laila, ʻoiai he mau hōʻailona hōʻailona kou o ka maʻi puʻuwai, e noʻonoʻo paha ʻoe, "ʻĀ, he mea pili kēia i ka hāpai ʻana." ʻO ia ke kumu he mea weliweli loa ka maʻi puʻuwai i ka wā hāpai. Hiki ke paʻakikī ke ʻike inā he mea maʻamau kahi hōʻailona a i ʻole he mea e hopohopo ai.
Inā loaʻa iā ʻoe ka maʻi puʻuwai mua, ʻoi aku ka nui o kou pilikia o nā pilikia i ka wā hāpai. Aia kēia pilikia i ke ʻano o ke kūlana āu e loaʻa ai a me kona koʻikoʻi.
He aha inā he maʻi puʻuwai mua kou?
Pili kekahi mau maʻi puʻuwai me ka hoʻonui ʻia o ka pilikia o nā pilikia i ka wā hāpai. Inā loaʻa iā ʻoe kekahi o nā maʻi i helu ʻia ma lalo nei, he mea nui e kūkākūkā i nā pilikia me kāu kauka ma mua o ka hāpai ʻana.
Maʻi puʻuwai hānau
He mau pilikia kēia me kou puʻuwai i loaʻa iā ʻoe i ka wā hānau. Hiki i kekahi o kēia mau mea ke liʻiliʻi, aʻo kekahi ke koʻikoʻi loa. Hoʻomaʻamaʻa pinepine ʻia nā keiki me nā maʻi koʻikoʻi i ko lākou wā ʻōpiopio. Akā i kekahi manawa hiki i ka puʻuwai ke hana ʻokoʻa ma hope o ke ʻoki ʻana.
No laila, inā he maʻi puʻuwai hānau kou, e kamaʻilio pono me kāu kauka ma mua o ka hāpai ʻana. E kuhikuhi ʻo ia iā ʻoe i kahi kauka puʻuwai. E loiloi lākou i kou pilikia hāpai a hāʻawi iā ʻoe i nā ʻōlelo aʻoaʻo e pono ai.
ʻO nā pilikia maʻamau i nā wahine hāpai me ka maʻi puʻuwai congenital:
- Puʻuwai puʻuwai kūpono ʻole (Arrhythmia)
- Ka hāʻule ʻana o ka puʻuwai
- Ka hemahema o ka fetal a i ʻole ka hānau mua ʻana
Nā kūlana haʻahaʻa pilikia:
- Ka stenosis māmā o ka valve pulmonary.
- Ua mālama pono ʻia nā "lua i loko o ka puʻuwai" - (Atrial Septal Defects - ASDs) a me (Ventricular Septal Defects - VSDs).
- Ua mālama pono ʻia (Patent Ductus Arteriosus - PDA).
Nā kūlana pilikia kiʻekiʻe:
- ʻO ka stenosis o ka valve aortic me ka valve aortic bicuspid.
- ʻO ke kuʻi ʻana o ka aorta.
- Tetralogy o Fallot (i mālama ʻia).
- Ke hoʻololi ʻana o nā aʻa nui (i mālama ʻia).
Nui nā maʻi puʻuwai hānau ʻē aʻe ʻaʻole ma kēia papa inoa. ʻOiai inā ʻaʻole i helu ʻia kou kūlana ma aneʻi, he mea nui e kamaʻilio me kāu kauka inā ʻoe e noʻonoʻo ana e hāpai.
ʻO ke cardiomyopathy
ʻO ka Cardiomyopathy kekahi kumu nui o nā pilikia koʻikoʻi a me ka make i ka wā hāpai. Aia ka pilikia i ke ʻano āu i loaʻa ai a me kona koʻikoʻi. Inā loaʻa iā ʻoe kēia maʻi, e kamaʻilio e pili ana i nā pilikia ma mua o ka hāpai ʻana.
Maʻi Valve Puʻuwai
Nui nā ʻano maʻi valve puʻuwai e hiki ke loaʻa i kou wā e ola ana. ʻAʻole pili kekahi mau maʻi valve liʻiliʻi i ka hāpai ʻana, ʻoiai kekahi mau kūlana koʻikoʻi e hoʻonui i ka pilikia. Inā he moʻolelo kou no ka maʻi valve, e nīnau i kāu kauka inā palekana ke hāpai.
Loaʻa paha i kekahi mau wahine kahi kiwikā puʻuwai prosthetic. Pono lākou i ka mālama kūikawā i ka wā hāpai. ʻO kēia no ka mea ʻoi aku ka nui o ka pilikia o nā ʻōpū koko i ka wā hāpai. Eia kekahi, ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o kahi kiwikā prosthetic. ʻO kekahi mau lāʻau hoʻokahe koko (anticoagulants) i lawe ʻia no kēia mea hiki ke hōʻino i ka pēpē. No laila, inā loaʻa iā ʻoe kahi kiwikā prosthetic, e ʻike pono i kahi cardiologist ma mua o ka hoʻolālā ʻana e hāpai.
He aha nā maʻi puʻuwai hou e hiki ke kū mai i ka wā hāpai?
ʻOiai inā ʻaʻohe ou maʻi puʻuwai ma mua, hiki iā ʻoe ke loaʻa i nā pilikia puʻuwai a i ʻole nā pilikia koko hou i ka wā hāpai. E nānā kākou i ke ʻano o lākou.
| Kūlana olakino | He wehewehe maʻalahi |
|---|---|
| Ke koko kiʻekiʻe (Hypertension) | Hoʻopilikia ia ma kahi o 1 i loko o 10 mau wahine hāpai. Aia kekahi mau ʻano: - Ke koko kiʻekiʻe o ka wā hāpai: Ke koko kiʻekiʻe e hoʻomaka ana ma hope o 20 mau pule. - Preeclampsia: Ke koko kiʻekiʻe, ka protein i loko o ka mimi, a i ʻole ka hōʻino ʻana i nā ʻōpū ʻē aʻe. Inā hele pū kēia me nā hopu ʻana, ua kapa ʻia ʻo Eclampsia . - Ke koko kiʻekiʻe mau loa:Ke koko kiʻekiʻe i loaʻa mai ka wā ma mua o ka hāpai ʻana. |
| Maʻi diabetes hāpai | ʻO ke kiʻekiʻe o ke kō koko e kū mai ana ma hope o 20 mau pule o ka hāpai ʻana. Inā ʻaʻole mālama ʻia, hiki ke loaʻa nā pilikia no ka makuahine a me ka pēpē. |
| Nā puʻuwai puʻuwai maʻamau ʻole (Arrhythmias) | Nā maʻi ʻōuli o ka puʻuwai. ʻO ka mea maʻamau ka maʻi i kapa ʻia ʻo supraventricular tachycardia (SVT) . |
| ʻO ka ʻoki ʻana i ke aʻa coronary kūlohelohe (SCAD) | He pilikia hoʻoweliweli ola kēia kahi e haehae ai ka paia o ke aʻa e hoʻolako ana i ke koko i ka puʻuwai. Hana pinepine ia i loko o hoʻokahi pule o ka hānau ʻana. |
| ʻO ka Cardiomyopathy Peripartum | He ʻano hāʻule puʻuwai e kū mai ana ma hope o ka hāpai ʻana a i ʻole ma hope koke iho o ka hānau ʻana. Loaʻa ia i nā wahine i loaʻa ʻole ka maʻi puʻuwai ma mua. |
| Nā ʻūpā koko (DVT a me ka Pulmonary Embolism) | I ka wā hāpai, aia ka piʻi ʻana o ka pilikia o nā ʻūpā koko (Deep Vein Thrombosis - DVT) i loko o nā aa koko hohonu o ke kino (maʻamau i nā wāwae). Inā hele kēia ʻūpā koko i nā māmā, ua kapa ʻia ʻo ia he (Pulmonary Embolism - PE) . He kūlana weliweli loa kēia. |
Pehea e ʻike ai i nā hōʻailona o ka maʻi puʻuwai?
E like me kā mākou i kūkākūkā ai ma mua, ua like loa kekahi mau hōʻailona o ka maʻi puʻuwai me nā hōʻailona hāpai maʻamau, no laila he mea nui e hoʻokaʻawale ma waena o nā mea ʻelua.
| Nā hōʻailona maʻamau i ka wā hāpai | Nā hōʻailona hōʻike e hōʻike paha i ka hōʻeha puʻuwai |
|---|---|
| - Luhi nui loa - Mimi pinepine - Ka pōkole iki o ka hanu - Ka pehu ʻana o nā wāwae a me nā kuʻekuʻe wāwae (Edema) | - Paʻakikī ka hanu ʻana i ka wā hoʻomaha - Paʻakikī ka hanu ʻana e hoʻāla iā ʻoe i ka pō - Nā palpitations e mau ana ma mua o 30 kekona - Ka hiolo ʻana - ʻEha a ʻeha paha ka umauma - ʻIke pōwehiwehi |
He mea nui loa: Inā ʻeha kou umauma a ʻoluʻolu ʻole paha , mai hoʻowahāwahā iā ia. E kelepona koke i ka 911 a i ʻole e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa. ʻO ka hana wikiwiki i ka manawa e like me kēia hiki ke hoʻopakele i ke ola.
E haʻi i kāu kauka e pili ana i nā hōʻailona āpau āu e ʻike nei. He mea maikaʻi inā hiki iā ʻoe ke kākau i kēia mau mea i loko o kahi puke.
- ʻO ka hōʻailona āu e ʻike nei.
- Lā a me ka manawa.
- Kona koʻikoʻi (ma kahi pālākiō o 1-10).
- Nā mea āu e hana nei i kēlā manawa (e.g., hoʻoikaika kino, hana i ka hana home, hoʻomaha).
Pehea e mālama ai i nā maʻi puʻuwai i ka wā hāpai?
Hiki ke mālama ʻia ka maʻi puʻuwai i ka wā hāpai me ka mālama pono ʻana iā ʻoe iho. Eia kekahi mau mea hiki iā ʻoe ke hana:
- Mai poina i nā hālāwai lapaʻau: Pono ʻoe e nānā ʻia e ke kauka hānau keiki a me ke kauka puʻuwai. Mai poina i nā hālāwai. Pono ʻoe e loaʻa i nā hoʻokolohua maʻamau (echocardiograms) e nānā i ke ʻano o ka hana ʻana o kou puʻuwai.
- E pale i ka piʻi nui ʻana o ke kaumaha: E nīnau i kāu kauka e pili ana i ka nui o ke kaumaha hiki iā ʻoe ke loaʻa me ka palekana i ka wā hāpai.
- E pale i ke kaumaha: E noho mamao aku mai nā mea e hoʻopilikia iā ʻoe i ka hiki. E ʻimi i nā ala e hōʻoluʻolu ai i kou manaʻo. Inā ʻae kāu kauka, hiki i nā mea e like me ka yoga prenatal ke kōkua.
- E ʻai i ka meaʻai olakino no ka puʻuwai: E kūkākūkā me kāu kauka e pili ana i nā meaʻai e ʻai ai a me nā mea ʻaʻole e ʻai. Ma keʻano laulā, e hōʻemi i ka paʻakai, ke kō, ka momona momona, a me ka momona trans.
- E hoʻoikaika kino me ka palekana: E nīnau i kāu kauka e pili ana i nā ʻano hoʻoikaika kino kūpono iā ʻoe a me ka pinepine o kāu hana ʻana iā lākou. Pono ʻoe e pale i nā hana e hoʻokaumaha nui ai i kou puʻuwai.
Nā lāʻau lapaʻau i ka wā hāpai
ʻO ka lawe ʻana i kāu mau lāʻau lapaʻau i kuhikuhi ʻia e like me ke kauoha he ʻāpana koʻikoʻi ia o kāu hoʻolālā hoʻokele. ʻAʻole palekana kekahi mau lāʻau lapaʻau puʻuwai i ka wā hāpai, no laila e hoʻololi paha kāu kauka i kāu mau lāʻau lapaʻau.
ʻO kekahi mau ʻano lāʻau lapaʻau i palekana ʻole i ka wā hāpai:
- (Nā mea hoʻopaʻa ACE)
- (Nā mea pale i ka mea loaʻa Angiotensin - ARBs)
- (Nā mea kū'ē iā Aldosterone)
- ʻO kekahi mau lāʻau hoʻokahe koko, e like me Warfarin
ʻO ka mea nui loa, mai hoʻōki a hoʻomaka paha i kekahi lāʻau lapaʻau me ka ʻole o ke kamaʻilio ʻana me kāu kauka. Inā ʻike ʻoe ua hāpai ʻoe i ka wā e lawe ana i kekahi o kēia mau lāʻau lapaʻau, e kāhea koke aku i kāu kauka.
E noʻonoʻo i kou olakino ma hope o ka hānau ʻana o kahi pēpē a me kou olakino i ka wā e hiki mai ana.
Hiki ke loaʻa kekahi mau pilikia a hiki i ʻeono mahina ma hope o ka hānau ʻana o ke pēpē. No laila, he mea nui loa ka nānā ʻana o ke kauka ma hope o ka hānau ʻana. ʻOiai inā paʻahana loa ʻoe a luhi paha i kēia manawa, mai poina i nā lā e pono ai ʻoe e ʻike i ke kauka.
ʻO ka loaʻa ʻana o ka maʻi puʻuwai a i ʻole kahi maʻi pili e like me ka preeclampsia a i ʻole ka maʻi diabetes gestational i ka wā hāpai e hoʻonui ai i kou pilikia o ka hoʻomohala ʻana i nā maʻi cardiovascular i ka wā e hiki mai ana.
- Hoʻonui ka maʻi diabetes gestational i ka pilikia o ka maʻi puʻuwai i ka wā e hiki mai ana ma 68%.
- Hoʻonui ka hypertension gestational i ka pilikia o ka maʻi puʻuwai i ka wā e hiki mai ana ma 67%.
- Hoʻonui ka preeclampsia i ka pilikia o ka make ʻana mai ka maʻi puʻuwai i ka wā e hiki mai ana ma 75%.
Mai hopohopo i kēia mau helu. E noʻonoʻo iā lākou he hōʻailona hōʻike. E hoʻohana i kēia ʻike e hana i nā hana e pale aku iā ʻoe iho mai ka maʻi puʻuwai i ka wā e hiki mai ana. Inā loaʻa iā ʻoe kahi kūlana like, e kamaʻilio me kāu kauka ma hope o kou hānau ʻana i kāu pēpē a e nānā ʻia no ka maʻi puʻuwai. Ma ka hoʻololi ʻana i ke ʻano o ka nohona a, inā pono, e hoʻomau i ka ʻike ʻana i kahi kauka puʻuwai, hiki iā ʻoe ke noho olakino i ka wā lōʻihi.
Inā loaʻa iā ʻoe ka maʻi puʻuwai a ke hoʻolālā nei e hāpai, e kamaʻilio me kāu kauka i kēia manawa. E aʻo e pili ana i nā pilikia a pehea e hoʻokele ai i kou kūlana i ka wā hāpai. ʻOiai inā ʻaʻohe ou maʻi puʻuwai, he mea nui e makaʻala i nā pilikia puʻuwai i manaʻo ʻole ʻia. Ma ke kamaʻilio ʻana me kāu kauka, ka hōʻemi ʻana i kāu mau kumu pilikia, a me ka loaʻa ʻana o kahi hāpai palekana a olakino, hiki iā ʻoe ke kōkua i ka pale ʻana i ka maʻi puʻuwai.
Leka Lawe-Home
- ʻO ka hāpai ʻana he manawa ia e kaumaha nui ai kou puʻuwai. He mea maʻamau kēlā.
- ʻO nā hōʻailona e like me ka luhi a me ka nausea i maʻamau i ka wā hāpai hiki ke lilo i mau hōʻailona o ka maʻi puʻuwai. E makaʻala i kēia.
- Inā loaʻa iā ʻoe ka maʻi puʻuwai mua, ma mua o ka hāpai ʻanaE ʻike pono i kahi cardiologist a e noi i ka ʻōlelo aʻoaʻo.
- E mālama i ka ʻeha o ka umauma, ka nalowale o ka ʻike, a me ka pōkole o ka hanu ʻoiai i ka wā e hoʻomaha ai e like me nā pilikia . E hele koke i ka ʻOihana Pilikia o ka haukapila (ETU).
- Mai hoʻomaka a hoʻōki paha i kekahi lāʻau lapaʻau me ka ʻole o ke aʻo a kāu kauka.
- ʻOiai ma hope o ka hānau ʻana o kahi pēpē, e noʻonoʻo i kou olakino. Mai poina i nā hoʻokolohua lapaʻau i hoʻonohonoho ʻia.
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