Ke liki iki nei anei kou valve puʻuwai? E aʻo kākou e pili ana i ka Mitral Valve Regurgitation!

Ke paʻakikī koke nei ʻoe i ka hanu ʻana i kekahi manawa? A i ʻole ke manaʻo nei ʻoe i kahi mea ʻē, kaumaha i loko o kou umauma? Ke luhi nei ʻoe i kekahi manawa ma hope o ka hana ʻana i nā hana liʻiliʻi? ʻO kekahi kumu o ia mau mea he pilikia paha me ka puka liʻiliʻi i loko o kou puʻuwai, ʻo ia hoʻi, he valve. I kēia lā e kamaʻilio mākou e pili ana i ka Mitral Valve Regurgitation, ʻo ia hoʻi ke ʻano. Mai hopohopo, e hoʻomaopopo maʻalahi kākou i kēia.

He aha kēia valve mitral i loko o ka puʻuwai? He aha ka mea e hana ai ke hana pono ʻole ia?

I ka ʻōlelo maʻalahi, ʻo ka valve mitral ka puka ma waena o ke keʻena luna (atrium hema) a me ke keʻena haʻahaʻa (ventricle hema) ma ka ʻaoʻao hema o kou puʻuwai. E noʻonoʻo iā ia e like me ka puka i loko o kou hale. Pono kēia puka e wehe a pani pono, e ʻae ana i ke koko e kahe mai ke keʻena luna a i ke keʻena haʻahaʻa. A laila, pono e pani pono ʻia kēia puka e hoʻouna i ke koko mai ke keʻena haʻahaʻa a i ke koena o kou kino. A i ʻole, e hoʻomaka ke koko e kahe hou i loko o ke keʻena luna.

Akā i kekahi manawa, ʻaʻole pani pono kēia puka. E like me nā puka i loko o ko mākou mau hale, ʻaʻole i laka pono kekahi manawa, e waiho ana i kahi liʻiliʻi. Hiki ke kumu o kēia ma muli o kahi pilikia me ka puka ponoʻī, ʻo ia hoʻi, ka ʻiʻo valve. A i ʻole hiki ke kumu o kahi pilikia me nā paia a puni ka puka, ʻo ia hoʻi, nā keʻena hema o ka puʻuwai. Eia naʻe, ke pani pono ʻole kēia puka, kahe kekahi koko i hope, ʻo ia hoʻi, i loko o ke keʻena luna. ʻO kēia ka mea a mākou e kapa nei he mitral valve regurgitation a i ʻole "Mitral Regurgitation - MR".

E noʻonoʻo e like me ka piula wai. Inā ʻaʻole i pani pono ʻia ka piula, e kahe ana ka wai i waho, ʻeā? Pēlā nō kēia me kēia.

Inā liʻiliʻi kēia leaka, ʻo ia hoʻi, ua liʻiliʻi loa ka hakahaka ma ka puka, ʻaʻole paha he pilikia nui. Hiki i kou puʻuwai ke lawelawe iā ia, no laila ʻaʻole paha ʻoe e ʻike i kekahi ʻokoʻa. Eia nō naʻe, inā nui kēia leaka, ʻo ia hoʻi ua hāmama ka puka, manaʻo nui kou puʻuwai i ke kaumaha. No ka mea, pono ka puʻuwai e hana ikaika ma mua o ka maʻamau e pamu i ka nui o ke koko e pono ai e pamu i mua. I ka hala ʻana o ka manawa, ʻaʻole hiki i ka puʻuwai ke lawelawe hou i kēia, a hiki iā ʻoe ke ʻike i nā hōʻailona a me nā pilikia ʻē aʻe.

Ua kapa ʻia hoʻi kēia kūlana:

• ʻO ka lawa ʻole o ka valve mitral (`(Ka lawa ʻole o ka valve mitral)`)
• Ka hemahema o ka valve mitral
• ʻO ka valve mitral leaky (`(Leaky mitral valve)`)

ʻO ka ʻoiaʻiʻo, ʻo ka mitral valve prolapse ke ʻano maʻamau o ka maʻi valve puʻuwai ma nā ʻāina e like me ʻAmelika Hui Pū ʻIa. He mea maʻamau ia i ka poʻe ʻelemakule, ʻoi aku hoʻi ka poʻe ma luna o 65 mau makahiki.

Aia kekahi ʻano leaka o ka valve mitral?

ʻAe, ʻelua mau ʻano nui:

1. Ka hoʻokahe mua ʻana o ka mitral (`(Ka hoʻokahe mua ʻana o ka mitral)`)Ma kēia hihia, aia ka pilikia me ka valve ponoʻī. Hoʻokumu ʻia ia e ka hōʻino ʻana o ke kūkulu ʻana i hoʻokahi a ʻoi aku paha mau ʻāpana o ka valve e pale ai iā ia mai ka pani pono ʻana. No ka laʻana, hiki i nā lau valve ke lilo i palupalu loa a hiki ʻole ke sila pono, a i ʻole e mānoanoa a hiki ʻole ke pani pono.

2. ʻO ka regurgitation mitral lua : Hoʻokumu ʻia kēia e kekahi maʻi puʻuwai ʻē aʻe e hoʻopilikia i nā keʻena o ka puʻuwai (atrium hema a ventricle paha) e kākoʻo ana i ka valve. No ka laʻana, hiki i kahi maʻi ʻiʻo puʻuwai (cardiomyopathy) ke hoʻonui a nāwaliwali i ka puʻuwai. Hiki i kēia mau loli ke hana i ka valve e neʻe a puni a ʻaʻole e pani pono.

ʻOiai ke ʻano o ka leaka, hiki ke koʻikoʻi koke (`(Acute)`), a i ʻole hiki ke ulu mālie i ka hala ʻana o ka manawa (`(Chronic)`).

He aha nā hōʻailona e hiki ke kū mai inā he leaka i loko o ka valve mitral?

Inā liʻiliʻi ka leaka, ʻaʻohe ou hōʻailona. Akā i ka wā e nui ai ka leaka a hoʻomaka e hoʻopilikia i ka hana o ka puʻuwai, ʻo ka hōʻailona maʻamau ka pōkole o ka hanu (dyspnea) . Manaʻo paha ʻoe ʻaʻole hiki iā ʻoe ke loaʻa ka ea lawa i loko o kou mau māmā, a i ʻole e manaʻo paha ʻoe he pōkole ka hanu ke kū wale ʻoe, e moe ana, e hoʻāʻo ana e hiamoe, a i ʻole e hana ana i nā hana maʻalahi.

Hiki paha ke loaʻa nā hōʻailona ʻē aʻe:

• ʻEha umauma ʻano ʻole.
• Kuke.
• Ka pehu ʻana o nā wāwae a i ʻole nā ​​​​wāwae (`(Edema)`).
• Manaʻo luhi loa (`(Fatigue)`).
• Ua like ia me ka hāʻule ʻana, akā, ʻaʻole ia e hana maoli (`(Presyncope)`).
• Ke manaʻo nei e loli ana ka helu o kou puʻuwai, me he mea lā e kuʻi ana kou umauma ("Heart palpitations)").

Hiki i kēia mau hōʻailona ke hele mālie a hoʻomaka koke paha.

He pilikia kēia! Inā ʻike ʻoe i kēia mau hōʻailona, ​​e hele koke i ka haukapila!

Inā hana nui kou puʻuwai, hiki iā ʻoe ke loaʻa nā hōʻailona o ka hāʻule ʻana o ka puʻuwai. Hiki ke hiki koke mai kēia mau mea, no laila e makaʻala i kēia mau hōʻailona:

• Ke hanu nui nei.
• Manaʻo e like me ʻoe e hanu ana.
• Paʻakikī ka hanu ʻana i ka wā e moe ana.
• Manaʻo o ka ʻūmiʻi ma ka umauma.
• Inā hōʻike ka pulse oximeter ma ka home ua haʻahaʻa ka pae oxygen i loko o ke koko.

He pilikia olakino ka hāʻule ʻana o ka puʻuwai koʻikoʻi kahi e pau koke ai ka hana a ka puʻuwai a hiki ke hoʻoweliweli i ke ola. No laila, he mea nui e ʻimi koke i ka lāʻau lapaʻau.

No ke aha i pani pono ʻole ai kēia valve mitral? He aha nā kumu?

E like me kā mākou i kūkākūkā ai ma mua, hiki mai kēia pilikia ke pani pono ʻole ka valve mitral. ʻElua mau ʻāpana (leaflet) o kēia valve. Hāmama a pani lākou e ʻae i ke koko e kahe mai ke keʻena luna a i ke keʻena lalo.

Inā ua hōʻino ʻia kēia mau pepa liʻiliʻi a i ʻole nā ​​​​​​ʻāpana ʻē aʻe o ka valve, a inā he mau maʻi like ʻole ke kumu o ka pani pono ʻole ʻana o ka valve, e kahe ana ke koko liʻiliʻi i hope i kēlā me kēia manawa e pani ai ka valve.

ʻOkoʻa nā kumu no kēia ma muli o ke ʻano o ka MR āu (mua a lua paha).

Hiki ke hana ʻia ka regurgitation mitral mua e:

• ʻO ka Mitral valve prolapse (MVP) : ʻO kēia ke kumu maʻamau i nā ʻāina i hoʻomohala ʻia.
• Maʻi puʻuwai Rheumatic : ʻO kēia ke kumu nui o ka honua holoʻokoʻa.
• Nā maʻi pili pili (`(Nā maʻi pili pili)`).
• ʻO ka valve mitral cleft kahi kīnā puʻuwai hānau.
• ʻO ka maʻi o ka uhi o loko o ka puʻuwai (endocarditis).
• ʻO ka maʻi puʻuwai i hoʻokumu ʻia e ka radiation therapy (`(Radiation heart disease)`).
• Nā ʻeha ulia pōpilikia.

Hiki ke hana ʻia ka regurgitation mitral lua e:

• ʻO ka ischemic cardiomyopathy (ʻo kēia ka mea maʻamau) ke kumu o ka ālai ʻana o nā kīʻaha koko e hoʻolako i ka puʻuwai.
• ʻO ka fibrillation atrial, kahi puʻuwai puʻuwai kūpono ʻole.
• ʻO ka cardiomyopathy dilated (kahi maʻi o ka ʻiʻo puʻuwai e hoʻonui ai i ka puʻuwai no ke kumu ʻike ʻole ʻia)
• He maʻi i hoʻokumu ʻia e ka mānoanoa o ka ʻiʻo o ka puʻuwai (`(Hypertrophic obstructive cardiomyopathy)`).

He aha nā pilikia e hiki ke hana inā lilo kēia ʻano i mea koʻikoʻi?

Inā ʻaʻole mālama ʻia, hiki i ka mitral valve prolapse ke hoʻoweliweli i ke ola. Eia kekahi o nā pilikia e hiki ke hana:

• Hoʻomaka kou puʻuwai e kuʻi kūpono ʻole ("(Atrial fibrillation)`), hiki i kekahi manawa ke alakaʻi i ka hahau ʻana.
• ʻAʻole hiki i kou puʻuwai ke pamu i ke koko kūpono i ke kino (`(Heart failure)`).
• Piʻi ke kaomi i loko o nā aʻa e lawe ana i ke koko mai ka puʻuwai a i nā māmā (`(Pulmonary hypertension)`).
• Hiki ke oki koke ka puʻuwai i ke kuʻi ʻana (`(Sudden cardiac arrest)`).

Pehea e ʻike pololei ai ke kauka i kēia maʻi?

ʻO ka mea mua a ke kauka e hana ai, ʻo ia ke nānā pono iā ʻoe. Ma laila:

• Nīnau lākou e pili ana i kāu mau hōʻailona a me nā maʻi ʻē aʻe āu e loaʻa nei.
• E nānā lākou i kāu mau hōʻailona koʻikoʻi, e like me kou koko a me ka helu pulse.
• Nānā lākou i ke kino no ka pehu ʻana (edema).
• E hoʻolohe ka stethoscope i kou puʻuwai a me kou mau māmā. Inā lohe ʻoe i kahi kani puʻuwai ʻē aʻe (he "hear murmur"), he hōʻailona paha ia o ka maʻi valve.

A laila e kauoha ke kauka i kekahi mau hoʻokolohua e ʻike i ka ʻike hou aku.

He aha nā hoʻokolohua e hana ʻia e ʻike ai i kēia maʻi?

Hana pinepine nā kauka i kahi hoʻokolohua i kapa ʻia he transthoracic echocardiogram (TTE) e nānā i kahi leaka i loko o kāu valve mitral. He scan ʻeha ʻole kēia, ʻaʻole invasive. Hiki iā ia ke nānā no kahi leaka i loko o kāu valve a no nā pilikia ʻē aʻe me ke ʻano a i ʻole ka hana o kou puʻuwai. Inā makemake kāu kauka e nānā pono i kāu valve, hiki iā lākou ke hana i kahi hoʻokolohua i kapa ʻia he transesophageal echocardiogram (TEE).

Hiki i kāu kauka ke kauoha i nā hoʻokolohua hou aʻe e hoʻoholo ai i ke koʻikoʻi o kou kūlana a hoʻolālā i ka mālama ʻana. Hiki i kēia mau hoʻokolohua ke komo pū me:

• ʻO kahi `(CT scan)` o ka puʻuwai (`(Cardiac CT scan - computed tomography scan)`).
• ʻO kahi `(Echocardiogram)` i hana ʻia i ka wā e hoʻoikaika kino ana (`(Exercise stress echocardiogram)`).
• He hoʻāʻo MRI (magnetic resonance imaging) puʻuwai.
• ʻO ke catheterization cardiac, i ʻike ʻia hoʻi ʻo ka cardiac cath a i ʻole ka angiogram coronary.

He aha nā lāʻau lapaʻau no ka liki ʻana o ka valve mitral?

ʻAʻohe mea e like me ka lāʻau lapaʻau "hoʻokahi-nui-kūpono-āpau". E hoʻopilikino nā kauka i ka lāʻau lapaʻau i kāu mau pono. E noʻonoʻo lākou i kēia mau mea:

• ʻO ke ʻano o ka regurgitation mitral āu i loaʻa (mua a lua paha).
• Ke koʻikoʻi o kou kūlana. Hiki ke wehewehe ʻia he kahua A, B, C, D. ʻO D ke kahua koʻikoʻi loa.
• Ka pilikia o nā pilikia mai ke ʻoki ʻana.

E wehewehe kāu kauka i kāu mau koho lapaʻau, me ko lākou mau pono a me nā pōʻino. E hōʻoia e nīnau i nā nīnau inā he mea āu i maopopo ʻole ai. Ma kēlā ala, hiki iā ʻoe ke hoʻoholo i kahi hoʻoholo naʻauao.

ʻO ka regurgitation mitral ka lua o ke kumu maʻamau no ke ʻoki ʻana i ka valve o ka puʻuwai ma nā ʻāina Komohana (ʻo ka mua ʻo ka stenosis valve aortic).

Aia kekahi mau koho lapaʻau:

Hoʻoponopono ʻana i ka valve mitral (`(Hoʻoponopono valve mitral)`)

Nā koho no kēia:

• ʻO ke ʻoki puʻuwai hāmama.
• ʻO ke ʻoki puʻuwai me ka hoʻohana ʻana i nā ʻoki liʻiliʻi ("(ʻOki puʻuwai minimally invasive)`).
• Hoʻoponopono ʻaoʻao a i ʻole ka Mitral transcatheter (TEER): Ma kēia kaʻina hana, hoʻohana ke kauka i kahi ʻōmole lōʻihi a lahilahi (catheter) e hoʻopili i kahi ʻūpā liʻiliʻi i kāu mau pepa valve. Kōkua kēia ʻūpā i nā pepa e pani pono.

Hoʻololi i ka valve mitral (`(Hoʻololi i ka valve mitral)`)

Nā koho no kēia:

• E hāʻawi ʻia ʻoe i kahi ʻoki puʻuwai hāmama (`(Open-heart surgery)`) a e hoʻokomo ʻia kahi valve mitral hou. Hiki ke hana ʻia kēia valve me ka metala (`(mechanical)`) a i ʻole hana ʻia me ka ʻiʻo holoholona (`(bioprosthetic)`).
• ʻO ka hoʻololi ʻana o ka valve mitral Transcatheter (TMVR) kahi hana invasive iki wale nō.

Lapaʻau no ka hāʻule ʻana o ka puʻuwai

Hiki i kēia ke komo pū me:

• Nā lāʻau lapaʻau e like me ka diuretics .
• Ke hoʻokomo ʻana o kahi mea kōkua ventricular hema (LVAD).
• Mālama hoʻomanawanui.

Lapaʻau no ka fibrillation atrial

Hiki i kēia ke komo pū me:

• Nā lāʻau lapaʻau.
• Nā Kaʻina Hana.
• ʻOki kino.

Pehea lā koʻu olakino inā loaʻa iaʻu kēia maʻi?

He nui nā kumu e hoʻopilikia i ke ʻano o kou olakino. Eia kekahi laʻana:

• kou mau makahiki.
• Loaʻa iā ʻoe nā hōʻailona a pehea ke koʻikoʻi o lākou?
• Ke koʻikoʻi o ka leaka.
• Hiki ke hoʻoponopono ʻia kāu valve?
• ʻO ka nui o ka pōʻino i kou puʻuwai.

Ma muli o kēia mau mea a pau e pili ana i kou kūlana, ʻokoʻa paha kou kūlana mai nā mea ʻē aʻe. ʻO kāu kauka ke kanaka maikaʻi loa e ʻike pono i ke ʻano o ka holomua ʻana o kou kūlana. Ua ʻike ʻo ia iā ʻoe, kou mōʻaukala olakino, a me nā koho lapaʻau e hiki ke kōkua iā ʻoe.

Pehea ka wikiwiki o ka piʻi ʻana o kēia leaka mitral valve?

No kekahi poʻe, holomua mālie kēia. No kekahi poʻe, hiki ke holomua wikiwiki. E haʻi aku kāu kauka iā ʻoe pehea kou kūlana, pehea ka pinepine e pono ai ʻoe e ʻike i ke kauka no ka nānā ʻana, a pehea e pili ai kēia kūlana i kou ola.

Aia kekahi mau ala e pale aku ai i kēia maʻi?

ʻAʻole paha hiki iā ʻoe ke pale aku i kēia i nā manawa a pau. Eia nō naʻe, hiki iā ʻoe ke hana pū me kāu kauka e hōʻemi i kou pilikia o ka loaʻa ʻana o nā maʻi puʻuwai like ʻole. E nānā kāu kauka i kāu mōʻaukala olakino a me nā kumu pilikia a hāʻawi iā ʻoe i ka ʻōlelo aʻoaʻo kūpono iā ʻoe. Ma keʻano laulā, hiki iā ʻoe ke hana i kēia mau mea:

• E hoʻōki loa i ka hoʻohana ʻana i nā huahana paka (e like me nā cigarettes, beedis).
• E hoʻoikaika kino i nā manawa a pau.
• E ʻai i nā meaʻai olakino no ka puʻuwai.
• E mālama i ke kaumaha olakino nou.
• E ʻike i ke kauka ma ka liʻiliʻi hoʻokahi manawa i ka makahiki no ka nānā ʻana a ʻike koke i nā pilikia.
• Inā loaʻa pinepine iā ʻoe ka ʻeha puʻu me ke kuni, a inā paha ua loaʻa iā ʻoe ka maʻi rumatika ma mua, e ʻike i ke kauka.

Pehea wau e mālama ai iaʻu iho?

He mea maikaʻi mau ke kāohi i kou koko a ʻai i ka nui o nā huaʻai a me nā mea kanu.

ʻO ke komo ʻana i kahi papahana hoʻoponopono puʻuwai ("(Cardiac rehab)`) ma hope o ke ʻoki ʻana i ka valve puʻuwai hiki ke kōkua iā ʻoe e hoʻomaka hou i ka hoʻoikaika kino.

Inā loaʻa iā ʻoe kahi valve prosthetic hou, pono ʻoe e lawe i ka lāʻau lapaʻau ma hope. Pono ʻoe e lawe i nā anticoagulants (nā mea hoʻokahe koko) no ke koena o kou ola e pale aku i nā ʻōpū koko. Pono nō hoʻi ʻoe e lawe i nā antibiotics e pale aku i ka endocarditis (ka maʻi o ka ʻili o ka puʻuwai) ma mua o nā kaʻina hana niho a me kekahi mau hoʻokolohua hanu kiʻekiʻe.

Āhea wau e ʻike ai i ke kauka? He aha nā nīnau e pono ai iaʻu e nīnau?

E haʻi aku kāu kauka iā ʻoe i ka pinepine o kou pono e ʻike i kāu kauka no nā nānā ʻana. ʻO ka ʻoi aku o ke koʻikoʻi o kou kūlana, ʻo ka pinepine o kou pono e ʻike i kāu kauka a loaʻa nā hoʻokolohua kiʻi (e like me nā scans). He mea nui e mālama i kāu mau manawa a pau.A laila hiki i ke kauka ke nānā i kou kūlana a hāʻawi i ka lāʻau lapaʻau i ka manawa kūpono.

Eia kekahi mau nīnau hiki iā ʻoe ke nīnau i kāu kauka e aʻo hou e pili ana i kou kūlana:

• Pehea ka nui o ka liki o koʻu valve mitral?
• He aha nā koho lapaʻau āu e paipai mai nei noʻu?
• He aha nā pōmaikaʻi a me nā pōʻino o nā lāʻau lapaʻau?
• He aha nā hoʻololi o ke ʻano o ka nohona e pono iaʻu e hana?
• ʻEhia pinepine e pono ai iaʻu e ʻike i ke kauka a i ʻole e hana i nā hoʻokolohua kiʻi?
• Pehea lā koʻu olakino i ka wā e hiki mai ana?

He mea e noʻonoʻo ai

He mea maʻamau ke kaumaha ke lohe ʻoe he maʻi puʻuwai kou. Akā i kou aʻo ʻana i nā mea hou aʻe e pili ana i kou kūlana a loaʻa ka lāʻau lapaʻau, hiki iā ʻoe ke neʻe hou i mua koke.

Hoʻopilikia ka mitral valve prolapse i kēlā me kēia kanaka i nā ʻano like ʻole, no laila e hoʻopili kāu kauka i kāu lāʻau lapaʻau i kāu mau pono. Mai kānalua e kaʻana like i kāu mau nīnau a me nā hopohopo me kāu kauka. E kōkua ʻo ia iā ʻoe e hoʻomaopopo hou aʻe e pili ana i ka hana ʻana o kou puʻuwai. E paipai pū ʻo ia i nā lāʻau lapaʻau a me nā hoʻololi ʻana i ke ʻano o ka nohona e kōkua iā ʻoe e noho olakino a ola i ke ʻano maikaʻi loa o ke ola.

ʻO ka valve mitral, ka maʻi valve puʻuwai, ka pōkole o ka hanu, ka hōʻeha puʻuwai, ke ʻoki puʻuwai, echocardiogram, ka regurgitation o ka valve mitral