Ke lawe ʻoe i kāu keiki liʻiliʻi a pēpē hānau hou paha i ke kauka, ʻo ka mea mua a ke kauka e hana ai, ʻo ke kau ʻana i kahi stethoscope ma ka umauma a hoʻolohe i ka puʻuwai. E lohe ʻoe i nā leo puʻuwai maʻamau "lub-dub" e hiki mai ana i ka wā e pani ai nā valves o ka puʻuwai. Akā i kekahi manawa, ma waho aʻe o kēia leo, e lohe ʻoe i kahi leo hou, e like me ka "s...s..." liʻiliʻi, e like me ke kani e like me ka ea e hele ana. E kapa ke kauka i kēia he "mumumu puʻuwai," a i ʻole he mumumu i loko o ka puʻuwai. He mea maʻamau no kekahi makuahine a makuakāne paha ke makaʻu i ka lohe ʻana i kēia mau ʻōlelo. Akā, he mea weliweli maoli anei kēia mau mumumu a pau? E kamaʻilio kākou e pili ana i kēia me nā kikoʻī, maʻalahi.
He aha ka 'Heart Murmur'?
E noʻonoʻo i ko kākou puʻuwai he pamu kupaianaha me nā keʻena ʻehā. ʻO kēia ka mea e pamu ai i ke koko ma ke kino holoʻokoʻa. He ʻehā ona puka (valves) e hana ana e like me ka faucet e hoʻomau i ke kahe ʻana o kēia koko i hoʻokahi ala wale nō. Ke wehe a pani ʻia kēia mau puka i ka manawa kūpono, lohe mākou i ke kani maʻamau "lub-dub" o ka puʻuwai.
No laila pehea e hiki mai ai kēia leo keu i kapa ʻia ʻo 'murmur'? I ka ʻōlelo maʻalahi, hana ʻia kēia leo ke loaʻa kekahi mea keakea a i ʻole ke kahe ʻana o ke koko ma o ka puʻuwai. Ua like ia me ke kahe ʻana o ka wai ma o kahi paipu wai, ʻaʻohe leo, akā inā ua paʻa ka paipu a i ʻole he lua liʻiliʻi, aia kahi leo "s...s...".
Aia paha kekahi mau kumu no kēia:
- Ke kahe wikiwiki nei ke koko ma muli o ka haiki ʻana o ka valve o ka puʻuwai.
- He kiwikā i pani pono ʻole ʻia a kahe ke koko i hope (kiwikā leaky).
- He lua liʻiliʻi ma waena o nā keʻena o ka puʻuwai i loaʻa ʻole maʻamau.
- Nā pilina maʻamau ʻole ma waena o nā kīʻaha koko nui e haʻalele ana i ka puʻuwai.
- Ka mānoanoa maʻamau ʻole o nā paia o ka puʻuwai.
ʻO ka mea nui, ʻaʻole nā mumule a pau he hōʻailona o ka maʻi. ʻO kaʻoiaʻiʻo, ma kahi o ʻelua hapakolu o nā keiki olakino a ma kahi o ʻekolu hapahā o nā pēpē hānau hou e lohe i kahi mumule hala ʻole i kekahi manawa o ko lākou ola.
Nā ʻano murmurs ʻino ʻole (Innocent) a pono e noʻonoʻo ʻia (Pathological)
Ke lohe kāu keiki i ka ʻōhumu puʻuwai, e hoʻāʻo ke kauka e hoʻoholo inā he ʻōhumu hala ʻole a he ʻōhumu pathological paha i hoʻokumu ʻia e kahi maʻi puʻuwai. E nānā i ka papa ma lalo nei e hoʻomaopopo i kēia ʻokoʻa.
| ʻAno | ʻŌhumu hala ʻole | Nā Murmurs e hopohopo ai (Pathological Murmur) |
|---|---|---|
| Ke kani āu e lohe ai | He leo palupalu a pōkole. E like me ka makani. | He leo ʻinoʻino, ʻinoʻino, a mau. |
| Hoʻololi me ke kūlana o ke kino | Hoʻololi ka ikaika o ke kani ke noho ke keiki a kū paha i luna. I kekahi manawa lilo ia i mea hiki ʻole ke lohe ʻia. | E lohe mau ʻia ke kani ʻoiai inā e loli ke kūlana o ke kino. |
| Nā hōʻailona ʻē aʻe | ʻAʻohe hōʻailona ʻē aʻe. Ke pāʻani maikaʻi nei ke keiki, ke ʻai nei a me ka inu nei, a ke piʻi nei ke kaumaha. | ʻO nā hōʻailona ʻē aʻe paha e pili ana i ka paʻakikī o ka hanu ʻana, nā lehelehe polū a me nā manamana lima, ka paʻakikī o ka hānai waiū, a me ka hiki ʻole ke piʻi i ke kaumaha. |
| Hopena hope loa | Nalowale kēia leo i ka ulu ʻana o ke keiki. ʻAʻole pono ka lāʻau lapaʻau. | He hōʻailona o kahi maʻi puʻuwai. Pono nā hoʻāʻo hou aʻe a me ka mālama ʻana. |
He aha nā hopohopo o ke kauka?
Ke lohe ke kauka i kahi ʻōhumu, hopohopo nui lākou no kēia mau mea:
- Ka Leo Nui: Pehea ka leo o ka hāwanawana? (Ua helu ʻia kēia mau mea mai 1 a 6).
- Ke kani o ke kani: He leo kiʻekiʻe a he leo haʻahaʻa paha?
- Ma hea i lohe ʻia ai: Ma hea i loko o ka umauma i lohe nui ʻia ai?
- Pāhawewe: Ke pāhawewe nei kēia leo i nā ʻāpana ʻē aʻe o ka umauma a i ʻole ke kua?
- Manawa: I ka manawa hea e lohe ʻia ai kēia leo ma waena o ʻelua mau puʻuwai maʻamau? I ka wā e ʻūlū ai ka puʻuwai (`Systole`) a i ʻole e hoʻomaha ai (`Diastole`)?
Ma hope wale nō o ka nānā pono ʻana i kēia ʻike e hoʻoholo ai ke kauka inā he mea ʻino ʻole kēia a i ʻole e kuhikuhi ʻia ka mea maʻi i kahi cardiologist pediatric.
Nā ʻŌhūhū Puʻuwai i nā Pēpē Hānau Hou
He mea maʻamau loa no nā pēpē hānau hou ke lohe i ka rumors o ka puʻuwai. I kekahi manawa, hiki ke lohe ʻia kēia mau leo i ka wā o ke pani ʻana i kekahi o nā valves o ka puʻuwai i ka wā hānau. No laila, inā ʻōlelo ke kauka he rumors i ka wā o ka nānā mua ʻana, mai hopohopo. Nalo pinepine ia i ka wā o ka nānā hou ʻana, kahi i hana ʻia i loko o kekahi mau pule.
Eia nō naʻe, inā hoʻomau ka ʻōhumu a inā he kānalua iki paha ke kauka no ia mea, e kuhikuhi maoli nō ʻo ia iā ʻoe no nā hoʻokolohua hou aku.
Nā hōʻailona hōʻike e makaʻala ai
Inā ʻike ʻoe he ʻōhumu ko kāu keiki, e makaʻala i nā hōʻailona ma lalo nei. Inā ʻike ʻoe i kekahi o kēia mau mea, e kelepona koke aku i kāu kauka.
- Pōkole o ka hanu: Inā manaʻo ʻoe e pilikia ana ʻoe i ka hanu ʻana, ʻoiai i ka wā e hānai waiū ai a i ʻole e hana ana i nā hana māmā.
- Inā loaʻa iā ʻoe nā maʻi umauma pinepine.
- Paʻakikī i ka inu ʻana a i ʻole ka ʻai ʻana i ka waiū: Manaʻo luhi, hou, a me ka hoʻōki ʻana i ka inu ʻana i ka waiū ma hope o ka inu ʻana i kahi waiū liʻiliʻi.
- ʻAʻole ulu pono ka ulu ʻana: Inā ʻaʻole kūpono ka piʻi ʻana o ke kaumaha no ka makahiki.
- ʻO ke kala polū o nā lehelehe, ke alelo, a i ʻole ka ʻili (Cyanosis): Inā ʻike ʻia kēia i ka wā e uē ana a hānai waiū paha, he hōʻailona paha ia o ka lawa ʻole o ka oxygen i loko o ke koko e kahe ana mai ka puʻuwai a i ke kino.
ʻO nā hōʻailona e like me kēia ke ʻano e pili ana paha ka ʻōhumu i kekahi ʻano maʻi puʻuwai.
Lapaʻau a me nā hana aʻe
ʻAʻole pono ka ʻōhumu maʻemaʻe i kekahi lāʻau lapaʻau. ʻAʻole pono ka lāʻau lapaʻau, ke ʻoki kino, a i ʻole nā kāohi ʻana i nā hana a ke keiki. E nalo wale ia i kona wā e ulu ai ke keiki. Hiki ke kani nui aʻe kēia leo i ka wā o ke kuni a i ʻole ke kaumaha.
Eia nō naʻe, inā he pathological ka murmur, pono e hoʻoholo ʻia ke kumu. Hiki i ke kauka ke paipai i kekahi mau hoʻokolohua, e like me:
- ʻEchocardiography (Echo): Ua like kēia me ke kiʻi ultrasound o ka puʻuwai. Hiki iā ia ke ʻike maopopo i ka hana o nā keʻena o ka puʻuwai, nā valves, nā paia, a inā he mau lua a i ʻole nā leaka i loko o nā valves.
- ʻO ke kiʻi X-ray o ka umauma: Kōkua kēia i ka loaʻa ʻana o kahi manaʻo o ka nui a me ke ʻano o ka puʻuwai a me nā kīʻaha koko e alakaʻi ana i nā māmā.
Aia ka lāʻau lapaʻau i ke kūlana puʻuwai kumu e hoʻoulu ai i ka murmur. Hoʻopau kekahi mau maʻi puʻuwai hānau ma o lākou iho i ka hala ʻana o ka manawa. Pono paha kekahi i ka lāʻau lapaʻau a i ʻole ke ʻoki ʻana.
ʻO kekahi mea nui e hoʻomaopopo ai, ʻo kekahi mau maʻi puʻuwai e hoʻokomo i kāu keiki i ka pilikia kiʻekiʻe o ka loaʻa ʻana o kahi maʻi puʻuwai (infective endocarditis). I ia mau hihia, hiki i kāu kauka ke ʻōlelo aku i nā lāʻau antibiotic e pale aku i ka maʻi ma mua o ka unuhi ʻana i ka niho a i ʻole ke ʻoki kino ʻē aʻe.
Leka Lawe-Home
- ʻAʻole nā mumu puʻuwai a pau i lohe ʻia i loko o nā keiki he mea weliweli. ʻO ka hapa nui he mea ʻino ʻole.
- ʻAʻole he maʻi ka ʻōhumu, he leo wale nō ia e hiki ke lilo i hōʻailona o kahi maʻi.
- Inā loaʻa i kāu keiki nā hōʻailona e like me ka paʻakikī o ka hanu ʻana, nā lehelehe polū, ka paʻakikī i ka ʻai/inu ʻana i ka waiū, a i ʻole ka hiki ʻole ke piʻi i ke kaumaha, e ʻimi koke i ke kōkua lapaʻau.
- E hahai pono i nā kuhikuhi a ke kauka. Inā noi ʻo ia iā ʻoe e hoʻi mai no ka nānā ʻana, e hōʻoia e hele i ka lā i hoʻonohonoho ʻia.
- He kuleana kou e kūkākūkā ākea i nā hopohopo a makaʻu paha āu e loaʻa nei me kāu kauka.
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