He mea maʻamau ke manaʻo iki i ka makaʻu a me ka hopohopo ke haʻi aku kāu kauka iā ʻoe, "He lua liʻiliʻi kou i loko o kou puʻuwai." Akā, ʻaʻole pono ʻoe e hopohopo no kēia. No ka mea, ʻo kēia kūlana i kapa ʻia ʻo PFO a mākou e kamaʻilio nei i kēia lā e pili ana i hoʻokahi wale nō o ka poʻe ʻehā ma ka honua, a ʻo ka hapa nui o ka manawa he mea ʻino ʻole ia. No laila e ʻike maikaʻi kākou iā ia.
I ka ʻōlelo maʻalahi, he aha kēia PFO?
ʻO ka inoa piha o PFO ʻo Patent Foramen Ovale . I ka ʻōlelo maʻalahi, he lua liʻiliʻi kēia ma waena o nā keʻena ʻelua o luna o ko mākou puʻuwai (ka mea a mākou e kapa nei ʻo atria) e waiho wale ʻia ana ma hope o ka hānau ʻana.
I kēia manawa, ke noʻonoʻo nei paha ʻoe, "Auē, he lua koʻu i loko o koʻu puʻuwai?" Akā ʻo ka ʻoiaʻiʻo: Loaʻa iā kākou āpau kēia lua i loko o ko kākou lolo i ko kākou wā i loko o ka ʻōpū. Kāhea mākou iā ia ʻo 'Foramen Ovale.' He mea nui kēia.
He aha kēia lua i loko o ka ʻōpū?
E noʻonoʻo e pili ana i ia mea, ʻaʻole hanu ka pēpē ma o kona mau māmā i kona wā i loko o ka ʻōpū o kona makuahine. Loaʻa i ka pēpē ke koko waiwai i ka oxygen e pono ai mai ka makuahine ma o ke kaula umbilical. No laila, i ka wā e hiki ai kēia koko waiwai i ka oxygen i ka puʻuwai, ʻaʻole ia e hele i nā māmā, akā, hele pololei ia mai ke keʻena ʻākau o luna o ka puʻuwai a i ke keʻena hema o luna , i kapa ʻia ʻo 'Foramen Ovale'. ʻO ia kahi e hele ai ke koko i ka lolo o ka pēpē a me ke koena o ke kino.
Ke hānau ʻia ke pēpē a hanu mua, hoʻomaka ka hana ʻana o nā māmā. A laila, ʻaʻohe pono no kēlā ala pōkole. No laila, pani pinepine kēia lua ma kāna iho, ma mua o ka piha ʻana o 3 makahiki o ke pēpē.
ʻO ke ʻano o ka huaʻōlelo 'Patent' ʻo ia hoʻi 'wehe'. No laila, ʻo 'Patent Foramen Ovale' (PFO) ʻo ia hoʻi ua wehe ʻia ka lua me ka ʻole o ka pani ʻana.
Pehea ka hopena o ka PFO i koʻu kino?
He nui ka poʻe (ma kahi o 1 i loko o 4 mau kānaka) i loaʻa i kēia PFO, akā ʻaʻole ia e hōʻike i kekahi mau hōʻailona a pilikia paha. Noho lākou i nā ola maʻamau me ka ʻike ʻole ua loaʻa iā lākou.
Eia naʻe, he mea kākaʻikahi loa kēia, hiki ke lilo i pilikia no kekahi poʻe. Ua ʻike anei ʻoe pehea?
I kekahi manawa hiki ke hana ʻia nā ʻōpū koko liʻiliʻi i loko o nā aʻa koko hohonu o ko mākou kino, ʻoi aku hoʻi i ko mākou mau wāwae. Kāhea mākou i kēia he thrombosis aʻa koko hohonu (DVT) . ʻO ka maʻamau, inā haki kahi ʻōpū koko a hele i ka puʻuwai, hoʻouna ʻia ia mai ka puʻuwai a i nā māmā. Hana ko mākou māmā e like me ke kānana , e hopu ana i kēia mau ʻōpū koko a hoʻoheheʻe iā lākou.
Akā i loko o kekahi kanaka me ka lua PFO, hiki i kēia ʻūpā koko ke 'lele' mai ka ʻaoʻao ʻākau o ka puʻuwai a i ka ʻaoʻao hema, ma o kēlā lua. Inā hana ʻia kēlā, hiki i ke ʻūpā koko ke kāpae i ke kānana i loko o nā māmā a hele pololei i ka lolo, nā puʻupaʻa, a i ʻole ma nā wahi ʻē aʻe o ke kino.
Inā hele ia i ka lolo a paʻa i loko o kahi aʻa liʻiliʻi, hiki iā ia ke hana i kahi hahau ischemic.ʻO kēia ka pilikia nui e pili ana me kahi PFO.
ʻO wai ka mea i ʻike nui ʻia me ka PFO?
Hiki i kekahi ke loaʻa i ka PFO, akā ʻike pinepine ʻia ia i ka wā o ka hoʻāʻo ʻana no kekahi kumu ʻē aʻe. ʻOi aku ka nui o ka poʻe o kēia mau hui e ʻike ʻia me ka PFO:
- ʻO nā kānaka me nā hahau cryptogenic: Inā loaʻa kahi hahau i kekahi ma lalo o 60 mau makahiki a ʻaʻohe kumu maopopo e loaʻa, e nānā nā kauka no kahi PFO, no ka mea, hoʻokahi i loko o ʻelua mau kānaka me kēia maʻi e loaʻa paha i hoʻokahi.
- Nā mea luʻu: Ke piʻi wikiwiki nā mea luʻu, hiki i nā loli o ke kaomi ke hana i nā pehu ea i loko o ke koko. Hiki i kēia mau pehu ke hele ma o ka PFO i loko o ka lolo, e hana ana i nā pilikia.
- Nā mea piʻi mauna: Ua manaʻoʻiʻo ʻia he hiki i ka loaʻa ʻana o ka PFO ke kōkua i kekahi o nā kūlana e kū nei ma nā wahi kiʻekiʻe.
He aha nā hōʻailona o ka PFO?
E like me ka mea i ʻōlelo ʻia ma mua, ʻaʻohe hōʻailona o ka maʻi i ka hapa nui o nā kānaka.
Akā, he mea kākaʻikahi loa ia, inā he nui iki ka lua a inā paha i hui pū ʻia me nā maʻi puʻuwai ʻē aʻe, e ʻike ʻia paha kekahi mau hōʻailona.
- Ua emi nā pae oxygen i loko o ke koko.
- ʻO nā ʻeha poʻo e like me ka migraine.
- Paʻakikī ka hanu ʻana i ka wā e noho ana a kū ana paha (platypnea-orthodeoxia syndrome).
- Nā hōʻailona o ka emi ʻana o ke kahe o ke koko i nā lālā o ke kino a i ʻole nā ʻōkana e like me nā puʻupaʻa.
Akā e hoʻomanaʻo, ʻike pinepine ʻia kahi PFO ma hope o ka loaʻa ʻana o kahi hahau , ka transient ischemic attack (TIA) , a i ʻole ka hōʻeha puʻuwai , ʻoiai e hoʻāʻo nei e hoʻoholo i ke kumu.
Pehea e ʻike ai nā kauka i kahi PFO?
Aia kekahi mau hoʻokolohua e hoʻoholo pono ai inā loaʻa kahi PFO.
1. Ke hoʻolohe ʻana me ka stethoscope: I kekahi manawa, ke hoʻolohe ke kauka i kou puʻuwai, lohe paha lākou i kahi leo ʻē (murmur) i ke kahe ʻana o ke koko ma o ka PFO. Akā, ʻaʻole kēia he mea maʻamau.
2. Echocardiogram: ʻO kēia ke ala nui a maikaʻi loa e ʻike ai i kahi PFO. Ua like ia me ke scan o ka puʻuwai. ʻElua ʻano nui.
- ʻO ka echocardiogram Transthoracic (TTE): Pili kēia i ka hoʻopili ʻana i kahi gel i ka ʻili o kou umauma a kau i kahi mea like me ka probe ma luna e kiʻi i nā kiʻi o kou puʻuwai.
- ʻO ke kaʻina hana echocardiogram Transesophageal (TEE):ʻAe kēia i nā kiʻi maopopo o ka puʻuwai. Hoʻokomo ʻia kahi probe liʻiliʻi i hoʻopili ʻia i kahi ʻōmole lahilahi ma o ka waha, i lalo o ka esophagus, a kau ʻia ma hope pono o ka puʻuwai. E hāʻawi ʻia ʻoe i kahi anesthetic māmā ma mua o kēia kaʻina hana, no laila ʻaʻole ʻoe e ʻike i kekahi ʻeha.
3. Hoʻāʻo ʻana i ka pehu: Hiki ke hana ʻia kēia i ka manawa like me ke kani ʻana o ka leo. Pili kēia i ka lūlū ʻana i kahi liʻiliʻi o ka wai saline a hiki i ka pehu ʻana a laila e hoʻokomo iā ia i loko o kou aa koko. Inā loaʻa iā ʻoe kahi PFO, e ʻike maopopo ʻia ka pehu saline ma ka scan echo i kona hele ʻana ma waena o ka lua i kēlā ʻaoʻao o ka puʻuwai.
Pono anei ka PFO i ka mālama ʻana?
ʻO kēia ka mea nui loa. ʻAʻole pono ka hapa nui o ka poʻe i kekahi lāʻau lapaʻau. ʻOiai inā he PFO ko lākou, inā ʻaʻole ia e hoʻopilikia ana i kekahi pilikia, e haʻi aku ke kauka iā lākou ʻaʻole e noʻonoʻo iki i ia mea.
Eia nō naʻe, inā ua loaʻa iā ʻoe kahi hahau mua a manaʻo ʻoe ʻo ke kumu ka PFO, a inā paha ʻoe i ka pilikia nui o ka hoʻomohala ʻana i nā ʻūpā koko, hiki i kāu kauka ke ʻōlelo i ka lāʻau lapaʻau.
Hiki ke hoʻokaʻawale ʻia nā ʻano lapaʻau i kekahi mau ʻāpana nui.
| ʻAno lapaʻau | He wehewehe maʻalahi |
|---|---|
| Nā lāʻau lapaʻau | ʻO kēia ka hāʻawi ʻana i nā lāʻau hoʻomāmā koko (anticoagulants). ʻO nā laʻana e like me ka aspirin , clopidogrel , a i ʻole warfarin . Hoʻemi kēia i ka pilikia o nā ʻūpā koko. |
| ʻO ke ʻoki kino endovascular | ʻO kēia ke ala maʻamau e pani ai i ka lua. ʻAʻole pono ke ʻoki kino nui. Hoʻokomo ʻia kahi paipu lahilahi (catheter) ma o kahi aʻa nui ma ka wāwae a i ʻole ka lima a alakaʻi ʻia a hiki i ka puʻuwai. A laila, hoʻokomo ʻia kahi mea liʻiliʻi ma o ka paipu a pani ʻia ka lua PFO ma nā ʻaoʻao ʻelua. Ua like kēia me ka pani ʻana i ka lua me ʻelua mau umbrellas. |
| ʻO ke ʻoki puʻuwai | Hiki ke hoʻohana ʻia kēia kaʻina hana ke hiki ʻole nā hana i luna, a i ʻole i ka wā o nā ʻoki puʻuwai ʻē aʻe. Hiki ke lilo i ʻoki puʻuwai hāmama a i ʻole kahi ʻoki liʻiliʻi. Eia nō naʻe, he mea kakaikahi loa ka hana ʻana i kēlā ʻoki nui e pani wale i kahi PFO. |
E nānā kāu kauka i kou kūlana a hoʻoholo i ke ʻano lapaʻau kūpono loa iā ʻoe.
Aia kekahi mau pilikia i ka mālama ʻana?
E like me nā lāʻau lapaʻau āpau, aia kekahi mau pilikia liʻiliʻi loa e pili ana i kēia mau lāʻau. Eia nō naʻe, he mea kākaʻikahi loa lākou. Hiki ke loaʻa ke kahe koko, nā ʻano puʻuwai ʻē (atrial fibrillation), a me nā maʻi. Eia nō naʻe, he liʻiliʻi loa kēia mau pilikia i hoʻohālikelike ʻia me nā pono o ka lāʻau.
Pehea lā koʻu wā e hiki mai ana me kahi PFO?
He maʻalahi loa ka pane i kēia a he mea hōʻoluʻolu hoʻi: maikaʻi loa!
He nui ka poʻe e ola maʻamau a olakino me ka ʻike ʻole he PFO ko lākou. ʻOiai inā pono ka lāʻau lapaʻau, ʻoiai ma hope o ke ʻoki ʻana e pani i ka lua, ua holomua loa nā hopena. Hoʻōla piha ka nui o ka poʻe, hele i ko lākou ola o kēlā me kēia lā me ka ʻole o nā pilikia, a ola i nā ola piha.
Inā haʻi ʻia i kahi pēpē hānau hou he PFO ko lākou, mai hopohopo no ia mea. ʻO ka hapa nui o ka manawa, e pani ia ma kona iho i ko lākou wā ʻelemakule.
Leka Lawe-Home
- He lua liʻiliʻi ka PFO (Patent Foramen Ovale) ma waena o nā keʻena ʻelua o luna o ka puʻuwai ʻaʻole e pani ʻia ma hope o ka hānau ʻana. He kūlana maʻamau loa kēia.
- Loaʻa iā kākou a pau kēia lua i ko kākou wā i loko o ka ʻōpū. He mea nui ia no ke kahe ʻana o ke koko o ka pēpē.
- ʻAʻole ʻike ka hapa nui o ka poʻe i nā hōʻailona a i ʻole nā pilikia olakino ma muli o ka PFO.
- ʻO ka pilikia nui, ʻo ia ka hiki i kahi ʻūpā koko e hana ʻia i loko o ke kino ke hele ma o kēia lua i ka lolo a hiki i ka hahau ʻana. Akā, he mea kākaʻikahi kēia.
- ʻAʻole pono ka hapa nui o ka poʻe i kekahi lāʻau lapaʻau. Pono wale ka lāʻau lapaʻau no ka poʻe i pilikia nui i ka hahau ʻana.
- Inā ua ʻike ʻia ʻoe me ka PFO, mai hopohopo a kamaʻilio ākea me kāu kauka. E hāʻawi ʻo ia iā ʻoe i ka ʻike a me ke alakaʻi āpau āu e pono ai.
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