Nā mea e pono ai ʻoe e ʻike e pili ana i ka helu o ka puʻuwai o nā wahine!

Ua noʻonoʻo paha ʻoe i ka wikiwiki o ka paʻi ʻana o kou puʻuwai ke kū mālie ʻoe? I kekahi manawa ua like ia me ka wikiwiki loa o ka paʻi ʻana, a i kekahi manawa ua lohi loa. He mea nui loa ia no nā wāhine ke ʻike i ko lākou helu puʻuwai, no ka mea, hiki ke ʻokoʻa iki ko kākou helu puʻuwai ma mua o ke kāne.

He aha ka helu maʻamau o ka puʻuwai no ka wahine?

ʻO ka awelika o ka puʻuwai o ka wahine makua ma waena o 78 a me 82 mau kuʻi i kēlā me kēia minuke. Akā ʻo ka mea a mākou e manaʻo ai he "pae maʻamau" ma waena o 60 a me 100 mau kuʻi i kēlā me kēia minuke. Hiki ke ʻokoʻa kēia waiwai mai kēlā kanaka a kēia kanaka. Nui nā mea e hoʻopilikia i kēia, me kāu mau hormones, ka hoʻoikaika kino āu e hana ai, a me kou nohona .

Ma keʻano laulā, ʻoi aku ka kiʻekiʻe o ka helu o ka puʻuwai o nā wāhine ma mua o nā kāne. ʻO ka awelika o ka helu o ka puʻuwai no ke kāne makua ma waena o 70 a me 72 mau kuʻi i kēlā me kēia minuke.

No ke aha i ʻokoʻa ai nā helu o ka puʻuwai o nā kāne a me nā wahine?

Aia kekahi kumu maʻalahi loa. ʻO ka maʻamau, i ka wā ʻōpio , lilo ka puʻuwai o ke keikikāne i 15% a 30% ka nui ma mua o ka puʻuwai o ke kaikamahine. Hana ʻia kēia hoʻonui ʻana o ka nui o ka puʻuwai i ka ulu ʻana o ke kino.

E noʻonoʻo e pili ana i ia mea, ke kuʻi kou puʻuwai i hoʻokahi manawa, ʻo ia ʻūlū ka mea e hoʻokuʻi i ke koko ma kou kino. ʻOi aku ka liʻiliʻi o nā puʻuwai o nā wāhine ma mua o nā puʻuwai o nā kāne, no laila, no ka hoʻokuʻi ʻana i ka nui like o ke koko ma kou kino, pono kou puʻuwai e kuʻi pinepine. ʻO ia ke kumu i kiʻekiʻe iki ai ko kākou helu puʻuwai. ʻIke ʻoe?

He aha ka helu o ka puʻuwai e weliweli no ka wahine?

Inā ʻoi aku ka nui o kou puʻuwai hoʻomaha ma mua o 100 mau kuʻi i kēlā me kēia minuke, ʻoiai ʻaʻole ʻoe e hoʻoikaika kino, hiki ke lilo i maʻi koʻikoʻi . Pono ʻoe e ʻike koke i ke kauka, ʻoiai inā ʻike pū ʻoe i nā hōʻailona e like me ka poniuniu a me ka māmā o ke poʻo .

Pēlā nō, ʻo ka helu o ka puʻuwai e hāʻule ana ma lalo o 60 mau kuʻi i kēlā me kēia minuke hiki ke lilo i pilikia i kekahi manawa. ʻOi loa aku inā manaʻo ʻoe ua poniuniu, ua māmā ke poʻo, a ua luhi loa paha. Eia nō naʻe, he mea maʻamau no ka poʻe hana, e like me nā mea haʻuki, ke loaʻa ka helu o ka puʻuwai ma waena o 40 a me 50 i kēlā me kēia minuke. ʻAʻohe mea e hopohopo ai.

Pehea e pili ai nā hormones i ka helu o ka puʻuwai?

Ua ʻike ʻia ma ka noiʻi ma mua o ka menopause , ʻo ia hoʻi, ma mua o ka pau ʻana o ka menstruation, ʻoi aku ka maikaʻi o ka hana o ka puʻuwai o nā wahine ma mua o nā kāne o ka makahiki like. Eia naʻe, ma hope o ka menopause, ʻaʻole i ʻike nui ʻia kēia ʻokoʻa. Manaʻo nā kānaka noiʻi he pili paha kēia i ka hormone estrogen a me ke olakino o ka puʻuwai.

Pehea ka hopena o ka perimenopause a me ka menopause iā ʻoe?

Ma mua o ka hele ʻana i ka perimenopause a me ka menopause, ʻoi aku ka maikaʻi o nā hopena o nā wahine mai kekahi mau maʻi puʻuwai (hoʻohālikelike ʻia me nā kāne o ka makahiki like). Eia kekahi laʻana:

• ʻO ka stenosis aortic : ʻO kēia ka ʻūlū ʻana o ka valve o ke aʻa nui o ka puʻuwai.
• Ka hāʻule ʻana o ka puʻuwai paʻa : Ka hāʻule ʻana o ka puʻuwai.
• Ke koko kiʻekiʻe (hypertension) .
• ʻO ka cardiomyopathy hypertrophic .

Eia nō naʻe, ʻokoʻa nā hopena o kēia mau kūlana no nā wahine postmenopausal a me nā kāne o ka makahiki like.

Hoʻomaikaʻi anei ka lāʻau hoʻololi hormone (HRT) i ke olakino o ka puʻuwai?

ʻAʻole i ʻike ʻia e nā kānaka noiʻi he lāʻau lapaʻau kūpono ka hormone replacement therapy (HRT) no ka hoʻomaikaʻi ʻana i ka hana o ka puʻuwai i nā wahine postmenopausal. ʻAʻole hoʻi ia e hōʻemi i ka pilikia o nā pilikia cardiovascular. Eia nō naʻe, hiki i ka HRT ke kōkua i ka kaohi ʻana i nā hōʻailona o ka menopause, e like me ka palpitations, nā ʻā wela, a i ʻole ka hou ʻana i ka pō .

Ke hoʻopilikia nei kāu pōʻaiapuni mahina i kou helu puʻuwai?

ʻAe, ʻoiaʻiʻo nō. Hoʻololi kou pae hormone i loko o kou pōʻaiapuni menstrual mahina. ʻO ka maʻamau, piʻi iki ka helu o kou puʻuwai i ka wā o ka ovulation a me ka pule ma hope (luteal phase). E emi iki ana kou helu puʻuwai i nā lā e alakaʻi ana i kou wā a me ka pule ma hope (follicular phase). He mea maʻamau kēia.

He aha ka mea e hana ai i ka helu o ka puʻuwai i ka wā hāpai?

ʻOi aku ke kiʻekiʻe o ka awelika o ka puʻuwai o nā wahine hāpai ma mua o nā wahine hāpai ʻole. Ke hāpai ʻoe, pono kou puʻuwai e hana ikaika e pamu i ke koko i kou ʻōpū . Hoʻonui ʻia ka nui o ke koko a kou puʻuwai e pamu ai ma 30% a 50%. No laila, piʻi ka awelika o kou puʻuwai i kahi o 90 mau kuʻi i kēlā me kēia minuke i ka wā hāpai. Eia kekahi, ke hoʻoikaika kino ʻoe i ka wā hāpai, piʻi aʻe kou puʻuwai ma mua o ka maʻamau.

He mea maʻamau ka loaʻa ʻana o nā arrhythmias puʻuwai liʻiliʻi i ka wā hāpai. No ka laʻana, ma kahi o hoʻokahi i loko o ʻelua mau wahine hāpai e ʻike i kahi kūlana i kapa ʻia ʻo premature atrial contractions . ʻAʻole pinepine kēia mau arrhythmias e hoʻoulu i nā pilikia a hoʻopau pinepine me ka ʻole o ka lāʻau lapaʻau. Eia nō naʻe, ʻo nā arrhythmias koʻikoʻi, e like me nā murmurs puʻuwai diastolic, pono paha e mālama ʻia.

He aha nā pilikia o ka puʻuwai maʻamau (arrhythmias) e hoʻopilikia pinepine ai i nā wahine?

ʻOi aku ka maʻamau o kekahi mau maʻi puʻuwai (arrhythmias) a me nā kūlana e hoʻopilikia ai i ka helu o ka puʻuwai i nā wahine. ʻO kekahi o lākou:

• ʻO ka tachycardia atrial : He puʻuwai wikiwiki a kūpono ʻole i loko o nā keʻena o luna o ka puʻuwai (atria).
• ʻO ka atrioventricular nodal reentry tachycardia (AVNRT) : Ka hana hou ʻana o ka puʻuwai wikiwiki loa.
• ʻO ka maʻi QT lōʻihi (LQTS) : ʻO kahi kūlana kahi e lōʻihi ai ka hoʻouna ʻana o kahi hōʻailona uila ma mua o ka maʻamau ma o nā keʻena haʻahaʻa (ventricles) o ka puʻuwai a laila hoʻouka hou ʻia.
• ʻO ka postural orthostatic tachycardia syndrome (POTS) : He kūlana e hoʻoulu ai i ka poniuniu a me ka puʻuwai wikiwiki ke kū ʻoe mai kahi kūlana moe.
• Hoʻopaʻa ʻia ka hana uila pulseless (PEA) : He ʻano hōʻeha puʻuwai kēia. ʻO ka mea e hana ʻia ma ʻaneʻi, ʻoiai aia kahi hōʻailona uila maʻamau mai ka puʻuwai mai, ʻaʻole e kuʻi ana ka puʻuwai, no laila ʻaʻohe pulse.
• ʻO ka ventricular arrhythmias (VAs) o ke ala puka ʻākau o ka ventricle ʻākau (RVOT) : He maʻi ʻōuli o ka puʻuwai kahi e lele ai nā ventricles o ka puʻuwai i kahi kuʻi ma kahi o ka pamu pono ʻana.
• ʻO ka maʻi sinus maʻi : He maʻi puʻuwai puʻuwai e kū mai ana i ka wā e hana pono ʻole ai ka node sinoatrial (SA), ka mea e hoʻouna ana i ka hōʻailona uila e hoʻomaka i kēlā me kēia puʻuwai.

He aha nā pilikia o ka puʻuwai e hoʻopilikia iki ʻole ai i nā wahine?

Eia kekahi, ʻaʻole hiki i nā wahine ke hoʻomohala i kekahi mau maʻi puʻuwai a me nā kūlana e hoʻopilikia ai i ka helu o ka puʻuwai.

• ʻO ka fibrillation atrial (Afib) : He ʻano puʻuwai kūpono ʻole e hoʻomaka ana ma nā keʻena o luna o ka puʻuwai (atria). (ʻIke hou aku e pili ana i kēia ma lalo)
• ʻO ka tachycardia ventricular Fascicular (FVT) : ʻO kahi kūlana e paʻi wikiwiki ai ka puʻuwai, e pili ana i nā pūʻolo o nā fibers (fascicles) e lawe ana i nā hōʻailona uila i loko o ka puʻuwai.
• Make koke ʻana o ka puʻuwai : He pilikia olakino i hoʻokumu ʻia e ka nalowale koke ʻana o ka hana o ka puʻuwai.
• ʻO ka fibrillation ventricular : He ʻano puʻuwai kūpono ʻole e hoʻopilikia ai i nā keʻena haʻahaʻa (ventricles) o ka puʻuwai.
• ʻO ka maʻi Wolff-Parkinson-White (WPW) : He kūlana e kū mai ana i ka wā e loaʻa ai kahi ala keu a ʻano ʻē i loko o ka ʻōnaehana hōʻailona uila o ka puʻuwai. Hiki i kēia ke hoʻoulu i ka puʻuwai e kuʻi wikiwiki loa.

He ʻokoʻa ka hopena o ka atrial fibrillation (Afib) i nā kāne a me nā wahine?

ʻO ka fibrillation atrial (Afib)ʻOi aku ka maʻamau o kēia ʻano puʻuwai kūpono ʻole i nā kāne ma mua o nā wahine. Eia nō naʻe, ke loaʻa i nā wahine kēia ʻano, hiki iā lākou ke ʻike i nā hōʻailona like ʻole . Eia kekahi laʻana:

• Hopohopo pinepine
• Nā palpitations o ka puʻuwai

Eia kekahi, ʻoi aku ka nui o nā wahine e loaʻa i nā kūlana ʻē aʻe me Afib. ʻO kēia mau mea:

• Ka hāʻule ʻana o ka puʻuwai me ka hapa ejection maʻamau.
• Ke koko kiʻekiʻe (hypertension) .
• Maʻi valve .

Pehea e ʻike ʻia ai nā maʻi o ka puʻuwai (Arrhythmias)?

Inā kānalua ʻoe he maʻi puʻuwai kou, hiki iā ʻoe ke kuhikuhi ʻia i kahi electrophysiologist , he cardiologist i loea i nā maʻi puʻuwai.

Hiki i kāu kauka ke hoʻohana i kekahi mau hoʻokolohua a me nā mea hana e ʻike ai i kahi maʻi puʻuwai. ʻO kekahi o lākou:

• Mea nānā Ambulatory : He mau mea hana kēia e kau ʻia ma ke kino. Hoʻopaʻa lākou i kou helu puʻuwai ma luna o kekahi mau lā a i ʻole nā ​​pule. Hiki i kēia ke kōkua i ka ʻike ʻana i nā ʻano puʻuwai kūpono ʻole i manaʻo ʻole ʻia. E noʻonoʻo e pili ana i ia mea, i kekahi manawa ua maikaʻi ʻoe ma ke keʻena o ke kauka, akā ke manaʻo nei ʻoe e kuʻi ana kou puʻuwai ma ka home. He mea pono loa kēia i nā manawa e like me kēia.
• Hoʻāʻo hoʻoikaika kino : He hoʻāʻo e ana i ke ʻano o ka pane ʻana o kou puʻuwai ke hoʻonui ʻoe i kāu hana. ʻO ka maʻamau, ua noi ʻia ʻoe e hele ma luna o ka treadmill a holo paha i kahi paikikala hoʻoikaika kino i ka wā e pili ana i kahi mīkini e hoʻopaʻa ana i ka hana uila o kou puʻuwai.
• Electrocardiogram (EKG/ECG) : Hiki i ke kauka ke kauoha i kahi EKG e hoʻopaʻa i ka hana uila o kou puʻuwai. Ma kēia, ua kau ʻia kekahi mau ʻāpana liʻiliʻi a pipili (electrodes) ma kou umauma. Hōʻike ka mīkini EKG i nā hōʻailona uila o kou puʻuwai ma ke ʻano he kiʻi.
• Haʻawina Electrophysiology (EP) : Inā makemake kāu kauka i ka ʻike hou aku ma hope o kahi EKG a i ʻole ka hoʻāʻo koʻikoʻi, pono paha ʻoe e loaʻa i kahi haʻawina EP. Ma kēia, hoʻokomo ʻia nā ʻōmole liʻiliʻi, hakahaka (catheters) ma o kahi kīʻaha koko i loko o kou ʻūhā. Me ka hoʻohana ʻana i kēia mau catheters, hiki i nā kauka ke nānā i ka hana o kou puʻuwai.
• Hoʻāʻo papa hoʻokiʻekiʻeHōʻike kēia hāmeʻa pehea e hoʻopilikia ai nā kūlana kino like ʻole i kou helu puʻuwai, ke koko, a me ke ʻano o ka puʻuwai. Moe ʻoe ma luna o kahi papa hoʻokiʻekiʻe mīkini a ua pili ʻia i kahi mīkini EKG. Ke neʻe nei ka papa ma nā kūlana like ʻole, hoʻopaʻa ka EKG i ka hana uila o kou puʻuwai.

Pehea e mālama ʻia ai nā maʻi o ka puʻuwai?

ʻO ka maʻamau, ʻo ka mālama ʻana no ka maʻi rhythm heart e komo pū me:

• Nā lāʻau lapaʻau : Hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau e kāohi i kou puʻuwai puʻuwai a hōʻemi paha i kou pilikia o nā ʻōpū koko a me ka hahau ʻana . No ka mea, ʻoi aku ka lōʻihi o ka manawa QT o nā wahine ma mua o nā kāne, ʻaʻole kūpono mau kekahi mau lāʻau lapaʻau e hoʻolōʻihi i ka manawa QT (e.g., sotalol, dofetilide, amiodarone ).
• Nā loli o ke ʻano o ka nohona : Hiki ke hoʻemi ʻia kekahi mau maʻi e nā loli o ke ʻano o ka nohona, e like me ka hoʻēmi ʻana i ka caffeine a i ʻole ka waiʻona . Hiki i ka haʻalele ʻana i ka puhipaka ke kōkua i ka hoʻokele ʻana i nā maʻi.
• ʻO ke cardioversion uila : ʻOiai ʻoe e hiamoe ana, hoʻouna ʻia kahi haʻalulu uila i kou paia umauma. Hiki i kēia ke hoʻihoʻi i kahi ʻano puʻuwai maʻamau. Hiki ke lilo i mea pono no nā poʻe maʻi i hiki ʻole ke hoʻokō i kahi helu puʻuwai maʻamau me ka lāʻau lapaʻau wale nō. Hoʻohana ʻia hoʻi ia ma ke ʻano he kaʻina hana hoʻōla ola no nā poʻe maʻi me nā arrhythmias ventricular e hiki ai ke alakaʻi i ka hopu koke ʻana o ka puʻuwai.
• ʻO ka hoʻopau ʻana i ka catheter : Hoʻokomo ke kauka i kahi catheter i loko o kou puʻuwai a hoʻouna i ka ikehu wela a anu paha ma o ia mea. Hoʻokumu kēia i nā ʻeha liʻiliʻi i loko o ka ʻiʻo puʻuwai e hoʻoulu ai i ka ʻano ʻē, a laila e ālai ana i nā impulses uila ʻano ʻē.
• Nā mea uila : Hiki iā ʻoe ke pōmaikaʻi mai kahi mea liʻiliʻi i hoʻokomo ʻia ma lalo o kou ʻili. Hiki i kēia mau mea ke ʻike a mālama paha i nā ʻano puʻuwai maʻamau ʻole. Loaʻa i kekahi poʻe nā pacemakers . Hoʻouna kēia mau mea i nā impulses uila liʻiliʻi e kaohi i ka helu o ka puʻuwai. Loaʻa i kekahi poʻe ka pōmaikaʻi mai nā implantable cardioverter-defibrillators (ICDs) . ʻIke kēia i nā ʻano puʻuwai maʻamau ʻole a hoʻouna i ka ikehu i ka puʻuwai e hoʻihoʻi i ka puʻuwai maʻamau.
• ʻOki kino : Inā ʻaʻohe lāʻau ʻē aʻe e hiki ke kaohi i kou helu puʻuwai, hiki i kāu kauka ke ʻōlelo aku i ke ʻoki kino. ʻO ke koho maʻamau ka hana maze . Ma kēia kaʻina hana, hana ke kauka puʻuwai i kahi maze o nā ʻoki i loko o kou ʻiʻo puʻuwai e ālai i nā hōʻailona uila maʻamau ʻole.

No laila, he aha ka leka a mākou e makemake ai e lawe i ka home mai kēia moʻolelo?

Inā ʻike koke ʻoe i ka wikiwiki o ka paʻi ʻana o kou puʻuwai i kou wā e hoʻomaha ana ma hope o ka hana, makaʻu iki paha ʻoe, ʻeā? A i ʻole ua ʻike paha ʻoe he haʻahaʻa mau ka helu o ka puʻuwai hoʻomaha o kekahi o kāu mau hoaaloha kāne ma mua o kou.

E hoʻomanaʻo, he mea maʻamau no nā wāhine ke loaʻa i kahi puʻuwai kiʻekiʻe iki aʻe ma mua o nā kāne. Me he mea lā ua hoʻopilikia ʻia kēia e nā hormones.

Eia nō naʻe, inā ʻoi aku ka nui o kou puʻuwai hoʻomaha ma mua o 100 mau kuʻi i kēlā me kēia minuke , pono ʻoe e ʻike i ke kauka. Eia kekahi, inā ʻoi aku ka nui o kou puʻuwai ma lalo o 60 mau kuʻi i kēlā me kēia minuke, ʻoiai inā ʻaʻole ʻoe e hana nui i nā haʻuki a i ʻole ka hoʻoikaika kino, e haʻi i kāu kauka e pili ana i ia mea. He mea nui loa ka mālama ʻana i kou puʻuwai!

ʻO ka helu o ka puʻuwai, ke olakino wahine, ka puʻuwai, nā hormones, ka menopause, ka hāpai ʻana, ka arrhythmia