He puka liʻiliʻi anei kou i loko o kou puʻuwai? E kamaʻilio kākou e pili ana i ka (Patent Foramen Ovale - PFO)!

Ua lohe paha ʻoe e hiki i kou puʻuwai, a i ʻole ma waena o nā keʻena ʻelua o luna o ka puʻuwai, ke loaʻa kahi puka liʻiliʻi e hiki ke noho ma hope o ka hānau ʻana? Nui ka poʻe i kahaha i ka lohe ʻana i kēia. Akā, he ʻoiaʻiʻo nō ia. Ua kapa ʻia kēia ʻano he `Patent Foramen Ovale` a i ʻole `(PFO)`. Mai hopohopo, e kamaʻilio maʻalahi mākou e pili ana i ia mea, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

He aha ka PFO? E hoʻomaopopo maʻalahi kākou

I ka ʻōlelo maʻalahi, ʻo ka patent foramen ovale (PFO) he puka liʻiliʻi e like me ke poʻi ma waena o nā keʻena ʻelua o luna o kou puʻuwai, ʻo ka atrium ʻākau a me ka atrium hema. I kēia manawa e noʻonoʻo ʻoe i ka wā a mākou a pau i loko o ka ʻōpū o ko mākou makuahine, aia kēia puka, i kapa ʻia ʻo ka foramen ovale. He mea nui ia. Akā, ʻo ka maʻamau, pani ʻia ma hope o ko mākou hānau ʻia ʻana. ʻO ka PFO ka wā ʻaʻole ia e pani ma hope o ka hānau ʻana. ʻO ke ʻano o ka huaʻōlelo "patent" ʻo ia hoʻi "wehe."

ʻO ka hapa nui o ka manawa, ʻaʻohe hōʻailona o ka poʻe me ka PFO a ʻaʻole pono lākou i ka lāʻau lapaʻau. Eia nō naʻe, he mea kakaikahi loa, hiki ke pili pū kekahi mau pilikia, e like me ka hahau ʻana, me ka PFO.

No ke aha he mea nui kēia foramen ovale? He aha ka mea e hana ʻia i ka wā kamaliʻi?

ʻAʻole hoʻohana ka pēpē i loko o ka ʻōpū o ka makuahine, he fetus, i kona mau māmā e loaʻa ai ke koko momona i ka oxygen. Akā, hele mai kēia koko momona i ka oxygen mai ka makuahine ma o ka placenta, ma ke kaula umbilical. ʻO kēia ka hana a ka foramen ovale, e kuhikuhi ana i ke koko momona i ka oxygen mai ke kaula umbilical mai ka atrium ʻākau o ka pēpē pololei i ka atrium hema.

Mai laila mai, hele kēlā koko i ka ʻaoʻao hema o ka puʻuwai o ka pēpē, e hoʻolako ana i ka oxygen i ka lolo o ka pēpē a me nā ʻōpū koʻikoʻi ʻē aʻe. He ʻano hana kupaianaha loa ia, ʻeā?

Ma hope o ka hānau ʻana o ke pēpē, i ka wā e hoʻomaka ai ʻo ia e hanu iā ia iho, hele ke koko i nā māmā e loaʻa ai ka oxygen. ʻO ia ka manawa e pani pinepine ai kēia "foramen ovale". A laila hele ke koko i loaʻa ka oxygen i ka ʻaoʻao hema o ka puʻuwai, a mai laila aku e pamu ʻia i ke kino holoʻokoʻa.

ʻO wai ka mea hiki ke loaʻa i ka PFO? Pehea ka maʻamau?

ʻO kaʻoiaʻiʻo, hiki i ka PFO ke hoʻopilikia i kekahi, me ka nānā ʻole i ke kāne, ka lāhui, a i ʻole ke kala. Eia nō naʻe, ʻoi aku ka maʻamau i waena o kekahi mau hui:

• ʻO nā mea luʻu wai, ʻoiai ka poʻe i loaʻa i ka "Decompression sickness - air embolism", kahi kūlana e ālai ai nā pehu ea i nā kīʻaha koko ma muli o nā loli o ke kaomi.
• I waena o ka poʻe i loaʻa i ka hahau ʻana ʻaʻole hiki ke loaʻa ke kumu pololei (stroke cryptogenic).

Ma ke ao holoʻokoʻa, ma kahi o hoʻokahi o nā kānaka ʻehā (25%) e loaʻa paha i ka PFO. Eia kekahi, ua ʻike ʻia ma waena o 30% a me 40% o ka poʻe i loaʻa i ka hahau me ke kumu ʻole he PFO ko lākou. Eia naʻe, ʻaʻole kēia manaʻo e loaʻa i nā mea āpau me ka PFO ka hahau. He mea nui e hoʻomanaʻo i kēlā.

Ke hoʻopilikia nei ka loaʻa ʻana o ka PFO i ke kino?

Ke loaʻa iā ʻoe kahi `PFO`, kahe kahi koko liʻiliʻi mai ka atrium ʻākau a i ka atrium hema ma o kēlā mau ʻāpana liʻiliʻi. ʻO ka maʻamau, ʻaʻole kēia e hana no ka mea ua pani ʻia kēia mau ʻāpana.

ʻO ka hapa nui o ka manawa, ʻaʻole pilikia ka PFO. Eia nō naʻe, i kekahi manawa hiki i kahi ʻūpā koko ke hele mai ka ʻaoʻao ʻākau o ka puʻuwai a i ka ʻaoʻao hema o ka puʻuwai ma o kēia PFO. Inā hana ʻia kēlā, hiki i ka puʻuwai ke pamu i kēlā ʻūpā koko i nā ʻāpana ʻē aʻe o ke kino. E noʻonoʻo, inā hele kēlā ʻūpā koko i ka lolo, hiki ke hoʻopilikia ʻia ke kahe koko i ka lolo. ʻO ia ka manawa e hana ʻia ai kahi kūlana i kapa ʻia he ischemic stroke. Eia kekahi, hiki i kēia ʻūpā koko ke hōʻino i nā ʻōpū ʻē aʻe e like me nā puʻupaʻa a me ka puʻuwai.

Aia kekahi kumu kikoʻī no ke kumu e ulu ai ka PFO?

ʻAʻole i ʻike pono nā kānaka noiʻi i ke kumu o ka PFO. ʻO ia hoʻi, ʻaʻole maopopo inā he genetic, he kaiapuni, a i ʻole kekahi mea ʻē aʻe.

He aha nā hōʻailona o ka PFO? E nānā inā loaʻa iā ʻoe kēia mau mea pū kekahi

ʻAʻole hōʻike ka nui o ka poʻe me ka PFO i kekahi mau hōʻailona. He ʻoiaʻiʻo kēlā. Eia naʻe, i kekahi manawa e ʻike paha ʻoe i nā mea e like me kēia:

• Hahau.
• ʻO ka Transient Ischemic Attack (TIA) a i ʻole ka mini-stroke . Hiki i kēia ke hoʻopilikia i ka neʻe ʻana o kahi lālā, a hiki ke hoʻopilikia i nā ʻōpū koʻikoʻi e like me ka lolo, ka ʻōpū liʻiliʻi, ka ʻōpū nui (colon), a i ʻole nā ​​​​puʻupaʻa.

Eia kekahi, ʻo nā kūlana kakaikahi:

• Ka maʻi ʻōpū o ka puʻuwai.
• Hoʻemi ʻia ka nui o ka oxygen i loko o ke koko (Hypoxemia).
• ʻO ka maʻi Platypnea-orthodeoxia (PO syndrome): He ʻano kēia e emi ai ka pae oxygen i loko o ke koko me ka paʻakikī o ka hanu ʻana i ka wā e noho pololei ana.

Pehea ʻoe e ʻike ai inā he PFO kou? He aha nā hoʻokolohua?

E nīnau mua kāu kauka iā ʻoe e pili ana i kāu mau hōʻailona a hana i kahi hoʻokolokolo kino. Inā kānalua ʻia kahi PFO, hiki iā lākou ke ʻōlelo i nā hoʻokolohua e like me:

• ʻO ka echocardiogram Transthoracic : ʻO ka echocardiogram (a i ʻole echo) he hoʻāʻo e hoʻohana ana i nā nalu kani e hana i nā kiʻi o nā keʻena o ka puʻuwai. Hana ʻia ka hoʻāʻo ma ke kau ʻana i kahi mea hana ma luna o ka umauma.
• ʻO ka echocardiogram Transesophageal (TEE) : Ma kēia hoʻokolohua, hoʻokomo kāu kauka i kahi ʻōmole liʻiliʻi i hoʻolako ʻia me ke kāmela i loko o kou esophagus. Hiki i kēia ke hana i kahi kiʻi maopopo o ka PFO ma mua o kahi echo maʻamau.
• ʻO ke ultrasound Transcranial Doppler (TCD) : Hoʻohana ka ultrasound TCD i nā nalu kani e nānā i ke kahe o ke koko i loko a i loko o kou lolo. Hiki iā ia ke kōkua i ka ʻike ʻana i nā hahau i hoʻokumu ʻia e nā ʻōpū koko.

Me kēia mau hoʻokolohua, hiki i kāu kauka ke kuhikuhi pū i kahi "hoʻāʻo pehu." ʻO kēia ke komo ʻana i kahi hopena saline i loko o kou aʻa. Inā kahe kēia mau pehu ma ka puka i loko o ka ʻaoʻao hema o kou puʻuwai me ka ʻole o ka kānana ʻana i nā māmā, hiki iā lākou ke ʻike inā he "PFO" paha kāu.

Aia kekahi lāʻau lapaʻau no ka PFO? Pono anei nā kānaka a pau?

ʻAʻole pono ka hapa nui o ka poʻe me ka PFO i ka lāʻau lapaʻau. Eia nō naʻe, inā he moʻolelo kou o ka hahau ʻana a i ʻole nā ​​ʻūpā koko, a i ʻole he pilikia nui kou no lākou, hiki i kāu kauka ke ʻōlelo i ka lāʻau lapaʻau. ʻO nā koho lapaʻau no ka PFO:

• Nā lāʻau lapaʻau e pale ai i ke kāpili ʻana o ke koko : No ka laʻana, aspirin a warfarin paha.
• Ka Hoʻokomo ʻana i ka Catheter : Ma kēia kaʻina hana, hoʻohana kahi kauka cardiologist interventional i kahi ʻōmole lōʻihi a lahilahi (catheter) e pani i ka valve. Hoʻokomo ʻia kēia catheter ma o kahi aa nui ma ka ʻūhā i loko o ka puʻuwai a hoʻohana ʻia kahi mea kūikawā (mea pani) e pani i ka valve. Ua ʻike ʻia nā noiʻi he ʻoi aku ka maikaʻi o kēia kaʻina hana catheter ma mua o ke ʻoki ʻana i ka mālama ʻana i nā PFO i nā poʻe ma lalo o 60 mau makahiki.
• ʻO ke ʻoki puʻuwai : Hana ke kauka lapaʻau i kahi ʻoki a humuhumu i ka ʻaoʻao i pani ʻia. Hiki ke hana ʻia kēia inā ʻaʻole holomua ke ʻano catheter. Hiki ke hana ʻia kēia ma o ke ʻoki puʻuwai hāmama a i ʻole ma o kekahi mau ʻoki liʻiliʻi ma ka umauma i kapa ʻia ʻo ka hoʻoponopono ʻana i ka patent foramen ovale i kōkua ʻia e ka robotically.

Ua hōʻike ʻia nā noiʻi hou i nā poʻe me ka PFO i loaʻa i kahi hahau i wehewehe ʻole ʻia, ʻo ka pani ʻana i ka PFO e kōkua paha i ka pale ʻana i nā hahau i ka wā e hiki mai ana. ʻOi aku ka maikaʻi o ke kamaʻilio ʻana me kāu kauka e pili ana i ke koho lapaʻau kūpono iā ʻoe.

Hiki i nā lāʻau lapaʻau ke hana i nā hopena ʻaoʻao?

Hiki i kekahi poʻe ke loaʻa nā pilikia mai ka mālama ʻana no ka PFO. ʻOkoʻa kēia mau pilikia ma muli o ke ʻano o ka mālama ʻana:

Nā mea e hiki ke hana me ka lāʻau lapaʻau

Ke lawe nei i nā lāʻau lapaʻau e like me Aspirin a i ʻole Warfarin, hiki i kēia mau mea ke hana:

• Ke kahe ʻana o ke koko.
• Ke kahe ʻana o ke koko i loko o ka lolo (Intracranial hemorrhage).

He aha ka mea e hiki ke hana i ka wā o ka mālama ʻana i ka catheter?

Nā pilikia maʻamau o ka catheterization:

• Nā ʻūpā koko.
• Ka hōʻino ʻana i nā kīʻaha koko.
• Ua wehe ʻia ka mea pani.
• ʻO ka maʻi puʻuwai a i ʻole 'endocarditis'.
• ʻAʻole pani pono ka `PFO`.
• ʻO ke koko paʻa i loko o nā māmā (Pulmonary embolism)

Nā pilikia kakaikahi:

• Ka embolism ea.
• Nā ʻano like ʻole o ka puʻuwai (Arrhythmia).
• ʻO ka fibrillation atrial (Afib)
• ʻO ka tamponade puʻuwai (hōʻiliʻili ʻana o ka wai a puni ka puʻuwai).

Nā mea e hiki ke hana me ke ʻoki kino

ʻO ke ʻoki ʻana e pani i kahi PFO hiki ke hana i nā pilikia e like me:

• ʻO ka fibrillation atrial (Afib)
• Ke kahe ʻana o ke koko.
• Nā maʻi.
• Hahau.

Aia kekahi ala e hōʻemi ai i ka pilikia o ka hoʻokumu ʻia ʻana o PFO?

ʻAʻohe mea hiki iā ʻoe ke hana e hōʻemi i ka pilikia o ka loaʻa ʻana o kahi PFO. ʻAʻole ia he mea hiki iā mākou ke kaohi. Eia nō naʻe, inā loaʻa iā ʻoe kahi hahau i wehewehe ʻole ʻia (stroke cryptogenic), he mea nui e hoʻāʻo ʻia no kēia ʻano. A laila, inā pono, hiki iā ʻoe ke loaʻa koke ka lāʻau lapaʻau.

He aha ke kūlana olakino o kekahi me ka PFO? He mea anei ia e hopohopo ai?

I ka hapanui o nā hihia, pani loa ke poʻi o kahi keiki me ka PFO i loko o nā makahiki ʻekolu mua o ke ola. He nui ka poʻe me ka PFO e ola piha a olakino me ka ʻole o nā pilikia i ka wā makua. No laila , mai hopohopo no ia mea me ke kumu ʻole .

Inā he PFO koʻu, pehea e hiki ai iaʻu ke mālama i koʻu olakino?

Hiki iā ʻoe ke mālama i kou puʻuwai olakino a hōʻemi i kou pilikia o ka hahau ʻana ma o ka hahai ʻana i kēia mau hana:

• E hōʻalo i ka hoʻohana ʻana i ka waiʻona a i ʻole nā ​​​​lāʻau lapaʻau ʻē aʻe.
• E ʻai i ka meaʻai olakino no ka puʻuwai.
• E kāohi i ke koko kiʻekiʻe (Hypertension) a i ʻole nā ​​​​pae cholesterol kiʻekiʻe.
• E mālama i ke kaumaha olakino.
• E ho'ōki i ka puhi paka a me ka hoʻohana ʻana i nā huahana paka.
• E kiʻi i ka lāʻau kūpono no nā kūlana olakino ʻē aʻe e hoʻonui ai i kou pilikia o ka hahau ʻana, e like me ka atrial fibrillation (Afib).

Eia kekahi, ʻo ka noho ʻole ʻana ma ke kūlana hoʻokahi no ka lōʻihi loa hiki ke hōʻemi i ka pilikia o nā ʻūpā koko.

He aha nā manawa kūpono loa e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe kekahi o nā hōʻailona o ka hahau ʻana , e ʻike koke i ke kauka a kāhea aku paha i ka 911 (a i ʻole kāu helu pilikia kūloko). Hiki i kēia mau hōʻailona ke komo pū me:

• Ka paʻakikī i ka ʻōlelo ʻana a i ʻole ka hoʻomaopopo ʻana.
• Ka poniuniu a i ʻole ka nalowale o ke kaulike.
• Ka maneʻo a nāwaliwali paha ma ka maka, ka lima, a i ʻole ka wāwae.
• Ka paʻakikī o ka ʻike ʻana i kekahi a i ʻole nā ​​maka ʻelua.
• ʻEha poʻo koʻikoʻi koke.

Leka Lawe-Home

ʻO ka patent foramen ovale (PFO) he puka liʻiliʻi i loko o ka puʻuwai ma waena o nā keʻena ʻākau a me ka hema o ka puʻuwai. Hoʻopilikia ia i hoʻokahi o ka poʻe ʻehā (25%) . ʻO ka hapa nui o ka manawa, ʻaʻole hana ka PFO i kekahi mau hōʻailona a ʻaʻole pono ka mālama ʻana. Eia nō naʻe, i kekahi manawa hiki ke lilo i hōʻailona o ka hahau ʻana a i ʻole ka hahau liʻiliʻi. Inā loaʻa iā ʻoe kahi mōʻaukala o nā hahau ʻana a i ʻole nā ​​​​​​ʻōpū koko, hiki i kāu kauka ke ʻōlelo i ka mālama ʻana. ʻO nā koho lapaʻau e pili ana i ka lāʻau lapaʻau, ka catheterization, a me ke ʻoki ʻana. ʻO ka mea nui, hiki i ka hapa nui o ka poʻe me ka PFO ke ola piha a olakino. Inā he mau hopohopo kāu, mai kānalua e kamaʻilio me kāu kauka.

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