Ua luhi paha ʻoe, ka hanu pōkole, a i ʻole nā wāwae pehu? Ua ʻike paha ʻoe i kahi mea i kapa ʻia ʻo "Right Atrial Enlargement" ma kāu hōʻike ECG. He mea maʻamau ke manaʻo iki i ka makaʻu ke lohe ʻoe i kēia inoa. Akā, mai hopohopo. I kēia lā, e kamaʻilio mākou e pili ana i ke ʻano o kēia mea i kapa ʻia ʻo ka hoʻonui ʻana o ka atrial ʻākau, ke kumu o ia mea, a no ke aha e pono ai mākou e makaʻala.
He aha ka hoʻonui ʻana o ka atrial ʻākau?
I ka ʻōlelo maʻalahi, ʻo ia hoʻi, ʻoi aku ka nui o ke keʻena ʻākau o luna o kou puʻuwai, ʻo ia hoʻi ka 'Atrium ʻĀkau' ma mua o ka maʻamau. E noʻonoʻo i kou puʻuwai he hale me ʻehā lumi. ʻO ke keʻena ʻākau o luna ka atrium ʻākau.
ʻO ka atrium ʻākau ke kahua mua no ke koko i hoʻopiha ʻia me ka oxygen (kapa mākou he 'koko haumia') i hoʻopuka ʻia ma ko mākou kino a hoʻi i ka puʻuwai. Ua like ia me ka puka nui o kahi hale. ʻO ke koko e hele mai ana ma ʻaneʻi, ma hope o ka wehe ʻana i ka valve aʻe (Tricuspid Valve), e hele i ka ventricle ʻākau ma lalo. Mai laila mai, hoʻopuka ʻia ke koko i nā māmā e hoʻopiha hou ʻia me ka oxygen.
No laila, inā no kekahi kumu e piʻi aʻe ka nui o ke koko e komo ana i loko o kēia atrium ʻākau, a inā paha e piʻi aʻe ke kaomi i loko o kēlā keʻena, e like me ka pōpō i hoʻopiha ʻia ke puhi nui ʻoe i ka ea i loko, e hoʻomaka pū kēia keʻena e ulu mālie. ʻO ka mea nui, ʻaʻole kēia kūlana e hana ma kāna iho. He hōʻailona ia o kekahi pilikia ʻē aʻe i loko o ke kino, ʻoi aku hoʻi i ka puʻuwai a i ʻole nā māmā.
He kūlana koʻikoʻi anei kēia no nā kānaka a pau?
ʻAʻole i nā manawa a pau. Eia kekahi laʻana, ʻo nā ʻiʻo puʻuwai o nā mea pāʻani e hoʻomaʻamaʻa mau ana, e like me nā ʻiʻo ʻē aʻe, e lilo i mea ikaika a nui aʻe. He mea maʻamau kēlā no lākou.
Eia nō naʻe, inā ua hoʻonui ʻia ka atrium ʻākau i kahi mea pāʻani ʻole, ʻo ia hoʻi he mea ʻē aʻe e pono ai mākou e makaʻala. Eia kekahi laʻana:
- Ke koko kiʻekiʻe o ka puʻuwai: Ke piʻi aʻe ke kaomi i loko o nā māmā , lilo ia i mea paʻakikī no ka ventricle ʻākau ke pamu i ke koko. Hiki i kēia ke hoʻihoʻi i ke koko a hōʻiliʻili i loko o ka atrium ʻākau, e hoʻonui ai.
- Nā Valve Leaky: Inā ʻaʻole pani pono nā valves o ka puʻuwai a kahe ke koko i hope, hiki i ke koko keu ke hōʻiliʻili ma ka atrium ʻākau a hoʻoulu iā ia e pehu.
- ʻO ka hāʻule ʻana o ka ventricle ʻākau: Inā nāwaliwali ka lumi haʻahaʻa (ventricle ʻākau), ʻaʻole hiki iā ia ke pamu i ke koko āpau e komo mai ana. ʻO ke koko i koe ke kumu o ke kaomi e kūkulu ʻia, e hoʻopilikia ana i ka atrium o luna.
ʻO ke koʻikoʻi o kēia ʻano ma muli o ke kumu kumu, kāu mau hōʻailona, a me ka lāʻau lapaʻau āu e loaʻa ai. ʻOi aku ka nui o ka pilikia o ka poʻe me nā hōʻailona ma mua o ka poʻe me ka ʻole o nā hōʻailona.
He aha nā maʻi ʻē aʻe e hiki ke pili pū me kēia ʻano?
Hoʻopili ʻia ka hoʻonui ʻia ʻana o ka atrium ʻākau me nā ʻano maʻi like ʻole. E nānā kākou i ke ʻano o lākou.
| Kūlana olakino | He wehewehe maʻalahi |
|---|---|
| Maʻi puʻuwai hānau | Eia kekahi laʻana, nā kūlana e like me Tetralogy of Fallot a i ʻole Pulmonary Stenosis (ka haiki ʻana o ke kīʻaha koko i nā māmā). |
| Nā maʻi valve puʻuwai | Ka hāiki ʻana o nā kīʻaha ʻākau (Tricuspid Stenosis) a i ʻole ke kahe ʻana o ke koko mai o lākou. |
| Nā maʻi e pili ana i ka māmā | ʻO ka maʻi māmā mau loa (COPD) a i ʻole ke koko kiʻekiʻe i loko o nā māmā (Pulmonary Hypertension) e kau i ke kaumaha hou ma ka ʻaoʻao ʻākau o ka puʻuwai (Cor Pulmonale). |
| Nā ʻano ʻino o ka puʻuwai | Nā kūlana e like me ka puʻuwai puʻuwai kūpono ʻole (Atrial Fibrillation) a i ʻole ka puʻuwai wikiwiki (Atrial Flutter). |
| ʻO ka Hypertrophy Ventricular ʻĀkau | Ka hoʻonui ʻia ʻana o ke keʻena haʻahaʻa ma ka ʻaoʻao ʻākau o ka puʻuwai, e hoʻopilikia pū ana i ke keʻena o luna. |
Pehea e ʻike ai i kēia kūlana?
ʻO ke ala nui a maʻalahi hoʻi e ʻike ai i kēia me ka ECG (Electrocardiogram) . Ke nānā aku kāu kauka i kāu ECG, e nānā pono ʻo ia i ka 'nalu P'. Hōʻike kēia nalu P i ka ʻūlū ʻana o kāu atria ʻelua. Inā hoʻonui ʻia ka atrium ʻākau, e ʻoi aku ke kiʻekiʻe o kēia nalu P ma mua o ka maʻamau.
Akā e hoʻomanaʻo, ʻo ka loaʻa ʻana o kēia loli i kāu ECG ʻaʻole ia he manaʻo he pilikia olakino koʻikoʻi kou. No laila, e ʻoluʻolu e kūkākūkā i kou hopohopo e pili ana i kāu mau hōʻike me kāu kauka.
Ma waho aʻe o ka ECG, aia kekahi mau hoʻokolohua ʻē aʻe e hōʻoia i kēia kūlana a ʻike i ke kumu.
- ʻO ka Transthoracic Echocardiogram (TTE): He scan kēia o ka puʻuwai. Hiki iā ia ke ʻike maopopo i nā keʻena o ka puʻuwai, nā valves, a pehea lākou e hana ai.
- ʻO ka Cardiac CT Scan a i ʻole ka Heart MRI: Hiki i kēia ke kiʻi i nā kiʻi ʻekolu-dimensional (3D) o ka puʻuwai a nānā hohonu iā ia.
- ʻEchocardiogram Fetal: He scan kūikawā i hana ʻia e ʻike i nā pilikia puʻuwai ʻoiai ke pēpē i loko o ka ʻōpū.
Hiki ke ho'ōla ʻia kēia me ka lāʻau lapaʻau?
ʻAe. ʻO ka mea nui loa, ʻo ia ka ʻimi ʻana i ke kumu kumu a mālama iā ia. ʻO ka hoʻonui ʻia ʻana o ka atrium ʻākau he hopena wale nō ia. Ma ka mālama ʻana i ke kumu, hiki ke kāohi ʻia kēia kūlana.
- Inā loaʻa iā ʻoe ke koko kiʻekiʻe pulmonary, e hāʻawi ʻia ʻoe i ka lāʻau lapaʻau no ia.
- Inā he pilikia me kahi valve, pono paha ka lāʻau lapaʻau a i ʻole ke ʻoki ʻana.
- Inā he puʻuwai kūpono ʻole, e hāʻawi ʻia ka lāʻau lapaʻau e kaohi ai.
I ka manawa kākaʻikahi loa, hiki ke ʻōlelo ʻia ke ʻoki kino e hoʻemi i ka atrium ʻākau. Ma hope o ke ʻoki kino, pono paha ʻoe e hoʻomau i ka lawe ʻana i nā lāʻau lapaʻau e pale aku i nā ʻūpā koko a kaohi i kou puʻuwai.
ʻOiai ke ʻano o ka lāʻau lapaʻau, e wehewehe pono ana kāu kauka iā ʻoe.
Āhea ʻoe e ʻike ai i ke kauka?
ʻAʻole paha e ʻike kekahi poʻe me kēia maʻi i kekahi mau hōʻailona. Eia nō naʻe, inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, he mea nui e ʻimi i ke aʻo lapaʻau.
| Nā hōʻailona e makaʻala ai |
|---|
| Nā Palpitations o ka Puʻuwai: He manaʻo e kuʻi wikiwiki ana ka puʻuwai a i ʻole ke ʻano ʻē. |
| Paʻakikī ka hanu ʻana: Manaʻo i ka pōkole o ka hanu ʻoiai me nā hana liʻiliʻi. |
| Pehu kino:Ka pehu ʻana, ʻoiai ma nā wāwae, nā kuʻekuʻe wāwae, a me nā kapuwaʻi. |
| Luhi: Manaʻo nui i ka luhi me ke kumu ʻole. |
ʻAʻole loa he mea e hoʻowahāwahā ʻia nā hōʻailona e pili ana i ka puʻuwai. E kamaʻilio me kāu kauka e pili ana i kekahi mea i ʻike ʻia he mea maʻamau. Inā he pilikia, ʻoi aku ka maikaʻi o ka ʻike mua ʻana ma mua o ka lilo ʻana i mea ʻino.
Leka Lawe-Home
- ʻO ka hoʻonui ʻia ʻana o ka atrium ʻākau he hōʻailona ia o kahi maʻi ʻē aʻe, ʻaʻole ia he maʻi ponoʻī.
- ʻO ka mea nui i ka mālama ʻana i kēia, ʻo ia ka ʻike ʻana a me ka mālama ʻana i ke kumu o ka maʻi i hoʻokumu ai.
- Inā loaʻa iā ʻoe nā hōʻailona e like me ka puʻuwai holo wikiwiki, ka paʻakikī o ka hanu ʻana, a i ʻole nā wāwae pehu, mai hoʻowahāwahā iā lākou.
- Inā ʻōlelo ʻia kēia ma kāu hōʻike ECG a i ʻole nā moʻolelo lapaʻau ʻē aʻe, mai makaʻu e kamaʻilio me kāu kauka a wehewehe iā ia. Me ka ʻike mua ʻana a me ka mālama kūpono, hiki iā ʻoe ke ola i kahi ola olakino.
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