Ua lohe paha ʻoe i kekahi kauka e ʻōlelo ana, "Lohe wau i kahi leo haʻalulu liʻiliʻi o ka puʻuwai" ke kau lākou i kahi stethoscope i kou umauma? Ua lohe paha ʻoe iā ia iho. Makaʻu ka poʻe he nui ke lohe lākou i kēia "haʻalulu." He mea maʻamau ka noʻonoʻo ʻana, "Aia kekahi mea hewa i koʻu puʻuwai?" Akā, mai makaʻu. I kēia lā, e kamaʻilio mākou e pili ana i ke ʻano o ka Holosystolic Murmur , no ke aha e hana ʻia ai, a me nā mea hiki ke hana ʻia e pili ana i ia mea.
I ka ʻōlelo maʻalahi, he aha kēia Holosystolic Murmur?
E noʻonoʻo i ka wai e kahe mālie ana ma o kahi paipu wai me ke keʻakeʻa ʻole. A laila, ʻaʻole ʻoe e lohe i kekahi leo. Akā inā he mea keʻakeʻa liʻiliʻi a puka paha ma kekahi wahi o ka paipu, ke kahe ka wai, hana ia i kahi leo ʻē e like me ka 's...'. Pēlā nō ia.
ʻAʻole he maʻi ka Holosystolic Murmur. He hōʻailona ia . Ke hoʻolohe kāu kauka i kou puʻuwai me ka stethoscope, he leo hou ia e lohe ʻia ma waho aʻe o ke kani 'lub-dub' o kou puʻuwai e kuʻi ana, no ka mea, ʻaʻole e kahe mālie ana ke koko. I ka pololei, lohe mau ʻia kēia leo i ka wā o ka ʻūlū ʻana (systole) o ka puʻuwai a no laila ua kapa ʻia ʻo ia he Holosystolic (lohe ʻia ma o ka ʻūlū holoʻokoʻa) Murmur.
ʻO ka mea nui loa, ʻaʻole ia he mea weliweli ke alo o kēia ʻōhumu, akā, ʻo ke kūlana kumu e hoʻoulu ai i ia mea e pono ai mākou e ʻimi a mālama.
E haʻi aku paha kāu kauka iā ʻoe e hāʻawi i kēia kani i kahi helu (mai ka 1 a i ka 6). Hōʻike wale kēia iā ʻoe i ka nui o ke kani. ʻAʻole manaʻo ka helu kiʻekiʻe he ʻoi aku ka weliweli. I kekahi manawa ke kau ke kauka i kona lima ma kou umauma, ua like kēia kani me ka haʻalulu. Ua kapa ʻia hoʻi he 'thrill'.
He aha nā kumu nui o kēia walaʻau?
Ua ʻike ʻoe he ʻehā keʻena o ko kākou puʻuwai. Ma waena o kēia mau keʻena, aia nā mea e like me nā puka e kōkua ana i ke kahe ʻana o ke koko i hoʻokahi ala wale nō. Kāhea mākou iā lākou he 'valves'. Inā ʻaʻole pani pono kēia mau valves, hoʻomaka ke koko e kahe hou. ʻO ia ka manawa e lohe nui ʻia ai kēia rumors.
| Kumu nui | Ua wehewehe maʻalahi ʻia |
|---|---|
| ʻO ka Mitral Regurgitation | ʻO kēia ka manawa e pani pono ʻole ai ka valve mitral ma ka ʻaoʻao hema o ka puʻuwai, e ʻae ana i ke koko e kahe i hope. Hiki ke hōʻino ʻia kēia valve e nā kūlana e like me ka rheumatic fever. |
| ʻO ka hoʻokahe ʻana o Tricuspid | Hana ʻia kēia i ka wā e pani pono ʻole ai ka valve tricuspid ma ka ʻaoʻao ʻākau o ka puʻuwai, e hoʻokahe ana i ke koko i hope. |
| ʻO ke kīnā o ka ventricular Septal (VSD) | He lua kēia ma ka paia ma waena o nā keʻena nui ʻelua (ventricles) ma lalo o ka puʻuwai. He maʻi hānau pinepine kēia. Lohe ʻia kahi hāwanawana i ke kahe ʻana o ke koko ma o kēia lua. |
He aha ka mea e hana ʻia me kēia?
E noʻonoʻo, i loko o ke kanaka me ka Mitral Regurgitation, ʻaʻole pani pono ka valve mitral, e hoʻihoʻi ana i ke koko i ke kuhikuhi i hele mai ai mai nā māmā. Hoʻonui kēia i ke kaomi i loko o nā aa koko e alakaʻi ana i nā māmā, a i nā hihia koʻikoʻi, hiki i nā māmā ke piha i ka wai. I ka hala ʻana o ka manawa, hiki i kēia ke alakaʻi i ka hāʻule ʻana o ka puʻuwai.
Pehea e mālama ʻia ai?
E like me kaʻu i ʻōlelo ai ma mua, ʻaʻole mākou e mālama i ka murmur, akā ke kūlana kumu e hoʻoulu ai . E hana mua kāu kauka i nā hoʻokolohua (no ka laʻana, kahi echocardiogram , ʻo ia hoʻi kahi scan o ka puʻuwai) e ʻike i ke kumu o ia mea.
- Inā kahe ke koko mai nā valves (Regurgitation):
- Nā lāʻau lapaʻau: Hiki ke hāʻawi ʻia nā lāʻau lapaʻau e like me nā anticoagulants a i ʻole diuretics .
- ʻOki kino: Inā ʻaʻole lawa ka lāʻau lapaʻau wale nō, pono paha ke ʻoki kino e hoʻoponopono i ka valve i hōʻino ʻia a i ʻole e pani iā ia me kahi valve hou loa.
- Inā he lua i loko o ka puʻuwai (VSD):
- Hiki ke hāʻawi ʻia ka lāʻau lapaʻau e kāohi i nā hōʻailona.
- I ka manawa pinepine, hana ʻia ke ʻoki kino e pani ai i kēia lua.
- Inā ua ʻūmiʻi ka valve (Stenosis):
- I kekahi manawa, hiki ke hana ʻia kahi murmur e ka haiki ʻana o ka valve. I ia mau hihia, hoʻohana ʻia kahi kaʻina hana i kapa ʻia ʻo Balloon Valvuloplasty . Hoʻokomo ʻia kahi balloon ma o kahi vein ma o kahi kaʻina hana i kapa ʻia ʻo cardiac catheterization a hoʻopiha ʻia i loko o ka valve i haiki ʻia, e hoʻonui ana i ka valve.
He aha inā ua hoʻokomo ʻia kahi kiwikā puʻuwai hou?
ʻElua ʻano o nā kiwikā hou.
| ʻAno kiwikā | He aha e ʻike ai |
|---|---|
| Mekanika | Hana ʻia kēia mau mea i ka metala a me ka palakiko. He lōʻihi ko lākou ola. Akā, pono ʻoe e lawe i nā lāʻau anticoagulant no ke koena o kou ola. |
| Bioprosthetic (olaola) | Hana ʻia kēia mau mea mai ka ʻiʻo puʻuwai puaʻa a bipi paha. He 10-15 mau makahiki ko lākou mau lā. Akā, ʻaʻole pono ʻoe e lawe i nā lāʻau anticoagulant no ke koena o kou ola. |
| Nā mea e hoʻomanaʻo ai i ka wā e hoʻokomo ai i kekahi o kēia mau ʻano valves ʻelua: | |
| |
He aha nā hōʻailona e pono ai ke ʻike ʻana i ke kauka?
Loaʻa i kekahi poʻe ka ʻōhumu akā ʻaʻohe hōʻailona. ʻAʻole paha lākou i ʻike he ʻōhumu ko lākou. Akā no kekahi poʻe, hiki i ke kumu kumu ke hoʻoulu i nā hōʻailona hoʻopilikia. Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, e ʻike koke i ke kauka.
- Paʻakikī ka hanu ʻana
- ʻEha ka umauma a i ʻole ka manaʻo o ka paʻa
- Manaʻo e like me ka wikiwiki o kou puʻuwai (palpitations)
- Pōkole o ka hanu (dyspnea)
- ʻO ka pehu ʻana, ʻoiai ma nā wāwae, nā kuʻekuʻe wāwae, a me nā wāwae
Inā ʻoe e hele no nā nānā lapaʻau maʻamau, hiki i kāu kauka ke ʻike i kēia maʻi i ka wā mua. ʻOi aku ka maikaʻi o ka ʻike ʻana i kekahi maʻi ma mua o ka lilo ʻana i mea ʻino.
Leka Lawe-Home
- ʻAʻole he maʻi ka Holosystolic Murmur, he hōʻailona wale nō ia aia kekahi mea hewa me kou puʻuwai.
- ʻO nā kumu nui o kēia, ʻo ia ke kahe ʻana o ke koko i hope mai nā valves o ka puʻuwai (regurgitation) a i ʻole kahi lua i loko o ka paia o ka puʻuwai (VSD).
- ʻAʻole no ka ʻōhumu ka lāʻau lapaʻau, akā, no ke kūlana olakino kumu e hoʻoulu ai ia.
- Inā loaʻa iā ʻoe nā hōʻailona e like me ka paʻakikī o ka hanu ʻana, ka ʻeha o ka umauma, a i ʻole ka pehu ʻana i kou mau wāwae, mai hoʻowahāwahā iā lākou a e ʻike koke i kāu kauka .
- Ma ka nānā ʻana i nā hoʻokolohua lapaʻau i ka manawa kūpono, hiki ke ʻike mua ʻia nā kūlana e like me kēia a hiki ke hoʻomaka ʻia ka lāʻau lapaʻau ma mua o ko lākou lilo ʻana i mea koʻikoʻi.
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