Yu smɔl pikin in at in men blɔd vesel dɔn blok? Lɛ wi lan bɔt dis (Coarctation of the Aorta)!

Yu dɔn ɛva wɔnda aw wi smɔl at dɛn de wok fayn fayn wan? Bɔt sɔm tɛm, bikɔs ɔf sɔm prɔblɛm dɛn we dɛn kin bɔn wit, di we aw dis at kin wok kin ambɔg smɔl. wan pan dεn kayn at kכ ndyushכn dεm we kin apin pan sכm pikin dεm dεn kכl am `(Coarctation of the Aorta)`. Pan ɔl we di nem kin tan lɛk se i kɔmplikt smɔl, nɔ wɔri. Lɛ wi tɔk bɔt dis simpul wan.

Wetin na `(Coarctation of di Aorta)`? Fɔ put am rili simpul wan...

Fɔ tɔk am simpul wan, Coarctation of the Aorta na we di aorta de smɔl ɔ smɔl, we na di men blɔd vesel we de kɛr blɔd we gɛt ɔksijɛn frɔm yu pikin in at to di ɔda pat dɛn na di bɔdi. Dis na wan at prɔblɛm we dɛn bɔn wit.

Imajin se bɔku motoka dɛn de muf rili fast na big rod. Bɔt wetin go apin if yu smɔl di rod wan tɛm ɛn jɔs alaw wan len fɔ trafik? Trafik jam kin apin, ɛn drayva dɛn kin bigin fɔ muf, nɔto so? Na dat kin apin na dis sityueshɔn bak. i kin at fכ mek b כdi fכ f כlכ fayn fayn wan tru di blכk we de na di aorta.

bכku tεm, dis sכmtεm we de sכmtεm (coarctation) de apin bifo di branch dεm we de kכri bכdi frכm di aorta to di lכw bכdi lεk di lεg dεm, divayd. Wetin kin mek dis apin? di bכdi prεshכn de go כp na di pikin in bכdi in כp pat lεk di an dεm, bכt i de dכn na di lכw pat na di bכdi lεk di leg dεm. Dis big difrɛns pan blɔd prɛshɔn bitwin di ɔp ɛn dɔŋ pat na di bɔdi na wan impɔtant tin we de mek dis sik. Ivin if no ɔda sayn nɔ de, dɔktɔ dɛn kin sɔprayz we dɛn si dis difrɛns pan blɔd prɛshɔn.

Statistikin na Amɛrika sho se na lɛk wan pan ɛvri 1,700 pikin dɛn we dɛn kin bɔn ɛvri ia kin gɛt dis sik (Aortic Coarctation). Sɔm pikin dɛn kin gɛt ɔda at sik dɛn bak we dɛn kin bɔn wit wit dis.

Us sayn dɛm wae pikin dɛm kin sho wae dɛn gɛt dis sik?

dis simptom dεm de dipכnt pan aw di aorta de sכmtεm sכmtεm. Bɔku tɛm, if i smɔl smɔl, di sayn dɛn go bigin fɔ sho insay wan ɔ tu wik afta dɛn bɔn am. Bɔt if di smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl.

Di sayn dɛn we pikin dɛn we dɛn jɔs bɔn kin gɛt

If pikin we dɛn jɔs bɔn gɛt dis sik, dɛn kin gɛt sɔm sayn dɛn lɛk:

• I kin slip ɔltɛm ɛn nɔ kin want fɔ drink milk
• Hat bit kwik kwik wan (fast pulse) .
• We pɔsin de swet pasmak
• Fɔ vɛks ɔltɛm, fɔ kray
• Pale ɔ grey skin
• Fɔ blo kwik kwik wan ɔ we yu de blo tranga wan
• I nɔ izi fɔ drink milk

If di pikin gɛt siriɔs kɔarktashɔn na di aorta , i kin go insay shɔk ɛn i kin mek i day if dɛn nɔ no am ɛn trit am kwik. Bɔt sɔm pikin dɛn nɔ kin sho ɛni sayn bikɔs di blɔk kin smɔl.

Di sayn dɛm fɔ yɔŋ pikin dɛm ɛn yɔŋ pipul dɛm

Big pikin ɛn yɔŋ pipul dɛn we gɛt Aortic Coarctation kin gɛt sɔm sayn dɛn lɛk:

• Yu ed kin at ɔltɛm
• Di ay blɔd prɛshɔn
• Blɔd we de kɔmɔt na yu nos ɔltɛm
• Pen na yu leg we yu de du ɛksɛsayz, rɔn, ɔ jomp

Sɔm pikin dɛn nɔ kin gɛt ɛni sayn atɔl. Bifo dat, dɛn kin no di prɔblɛm fɔs as ay blɔd prɛshɔn we dɛn de chɛk wɛl ɔltɛm.

We big pɔsin gɛt dɛn sik ya, bɔku tɛm i kin bi bikɔs di aorta kin smɔl bak afta dɛn dɔn trit am bifo. I nɔ kin izi fɔ mek dɛn nɔ no bɔt dis sik te i big.

Wetin mek dis tin kin apin? Wetin na di rizin dɛn?

Di masta sabi pipul dɛn stil nɔ no di rayt tin we mek CoA de. Bɔt dɛn biliv se sɔntin de we de mek pɔsin gɛt jɛnɛtiks . dat min se sכm jin chenj dεm we de apin we di pikin de insay di bכdi kin mek di pikin in aorta nכ de divεlכp fayn.

Sɔntɛnde, dɛn kin pas dɛn jɛnɛtik chenj ya tru famili. Risach dɔn sho se if yu gɛt CoA, yu pikin kin gɛt CoA ɔ ɔda at sik pas pɔsin we nɔ gɛt CoA.

כlso, di risk fכ divεlכp CoA de hכy wit sכm jεnεtik kכndishכn dεm. fכ egzampl, di pikin dεm we dεn bכn wit di jεnεtik kכndishכn we dεn kכl Turner syndrome nכ kin gεt כnli Coarctation of the Aorta, bכt dεn kin gεt כda difεkshכn dεm we dεn bכn dεm lεk bicuspid aortic valve, we na difεkt na di at in valv dεm.

Kɔz fɔ `(CoA)` nɔmɔ we nɔ gɛt ɔda at prɔblɛm

di men tin we mek di CoA we dεn ayd na di abnכmal kכloshכn fכ wan sכm sכm bכdi we dεn kכl di daktus arteriosus we di pikin de divεlכp. di daktus atεriכs na sכm sכm bכdi we de kכnεkt di fetal aorta to di pulmonari at. di lכng dεm nכ de wok we di pikin de insay di bεlε, so dis tכb de εp di pikin fכ gεt di bכdi we gεt כksijεn we i nid.

afta dεn bכn di pikin, di lכng dεm kin bigin fכ wok. afta dat, biכs dis `(ductus arteriosus)` nכ nid igen, i de stat fכ klos in wan insay fכ de dεm. כltu, we i kכloz, sכm pan di tisu dεm na da dakt de kin miks wit di tisu na di `(Aorta)`. insay dat, we dεn fכs di `(ductus arteriosus)` fכ klos, di aorta kin sכmtεm bak (coarctation)`.

Us kɔmplikɛshɔn kin apin bikɔs ɔf dis kɔndishɔn?

If dɛn nɔ trit dis sik (Coarctation of the Aorta) fɔ lɔng tɛm, kɔmplikeshɔn dɛn lɛk:

• Di ay blɔd prɛshɔn (haypa prɛshɔn) ɔlsay na di bɔdi.
• di hat mכsul de tik pas nכmal (lεft vεntrikulכr haypatrכfi).
• di plek we de bכku na di korona at dεm, we de gi bכdi to di at, de apin fכs pas nכmal - dεn kכl dis korona at sik.
• wan abnכmal bulge (aneurysm) כ tear (dissection) na di aorta.
• wan bren aneurism (bulging of wan blɔd vesel na di bren).
• Hat fεil na wan sik wae de at nɔr kin ebul fɔ pɔmp blɔd fayn fayn wan.

Dis `(CoA)` kכndyushכn de mכst denja if dεn nכ no am εn trit am. So, i rili impɔtant fɔ no am kwik kwik wan, we yu smɔl, ɛn fɔ du di tritmɛnt we yu nid ɛn chɛk-ap ɔltɛm (monitoring).

Aw dɔktɔ dɛn kin no bɔt dis? (Diagnosis) .

Di dɔktɔ dɛn we de mɛn pikin dɛn kin no dis sik (Coarctation of the Aorta) we dɛn smɔl ɔ we dɛn smɔl. Aw kwik fɔ no am kin dipen pan aw di sik dɛn kin tranga.

Dɛn kin no di pikin dɛn we gɛt smɔl smɔl sik dɛn insay sɔm dez afta dɛn bɔn dɛn. Bɔt dɛn nɔ kin no di pikin dɛn we gɛt smɔl sik, ɔ we nɔ gɛt ɛni sik atɔl, te dɛn big ɛn gɛt ay blɔd prɛshɔn. I nɔ kin izi fɔ mek pipul dɛn no dis we pɔsin big.

Bɔku tɛm dɛn kin no dis sik pan bebi ɛn yɔŋ pikin dɛn bikɔs ɔf sɔm tin dɛn we dɛn kin sɔprayz (rɛd flag) we dɛn kin si we dɛn de chɛk dɛn bɔdi. Dɛn kayn tin dɛn ya na:

• di pikin gεt hכy bכdi prεshכn na in an dεm εn כp bכdi, bכt lכw bכdi prεshכn na in leg εn lכw bכdi.
• difrεns de bitwin di puls rεt na di nεk εn di puls rεt na di groin.
• we di dכkta put di stεtoskop na di pikin in bak εn lisin, dεn de yεri wan difrεnt, harsh sawnd we de kכmכt frכm di at (a ‘harsh heart murmur’) .

Sɔm pikin dɛn we dɛn jɔs bɔn, dɛn kin no se dɛn gɛt dis sik bifo dɛn ivin sho di sik. Aw yu no? wan tεst we dεn kכl ``pulse oximetry`` we de mכsu di כksijεn lεvεl dεm na dεn bכdi sho se di כksijεn lεvεl dεm lכw. If di ɔksijɛn nɔ bɔku, dat kin bi sayn fɔ se pɔsin gɛt siriɔs at sik we dɛn bɔn wit, so dɛn kin tɛst dɛn pikin ya fɔ no di rayt tin we nɔ rayt.

Fɔ kɔnfɔm dis `(CoA)` kɔndishɔn, dɔktɔ dɛn kin yuz `(Echocardiogram)`, at skan, ɔ `(echo)`. dεn kin du tεst dεm bak lεk `(CT scan)` כ `(MRI scan)` fכ lan mכr bכt di shep εn strכkchכ fכ di pikin in aorta.

Ɔda at sik dɛn de we gɛt fɔ du wit ``Coarctation of the Aorta''?

Yes, dεn kin no se pikin dεm we gεt CoA gεt כda hat kכndyushכn dεm. fכ egzampl, bitwin 45% εn 75% pan di pipul dεm we gεt CoA gεt wan kכndyushכn bak we dεn kכl bicuspid aortic valve. dis min se di valv we de kכri bכdi frכm di at to di aorta gεt tu lif dεm nכmכ insted fכ di tri we i fכ gεt nכmal.

Nɔto dat nɔmɔ, bɔt `(CoA)` kin kam wit dɛn sityueshɔn ya bak:

• fכ gεt ol na di at - dat dεn kכl am `(atrial septal defect)` כ `(ventricular septal defect)`.
• wan bכdi we bin de insay di pikin in layf (`ductus arteriosus`) de opin fכ lכng pas aw dεn bin epk - dεn kכl dis ``patent ductus arteriosus``.
• Aortic arch hypoplasia ɔ haypoplastik lɛft at sindrom.
• stiffness fכ wan hat valv - dat na, aorta valv stεnosis כ mitral valv stεnosis.

Di dɔktɔ dɛn we de du ɔpreshɔn pan yu at kin luk ɔl dɛn tin ya na yu pikin in at ɛn mek wan tritmɛnt plan we spɛshal fɔ dɛn. Dis min se fɔ trit pikin we gɛt bɔku bɔku at prɔblɛm dɛn kin kɔmplikt smɔl pas fɔ trit pikin we gɛt jɔs wan CoA.

Wetin na di tritmɛnt dɛm fɔ dis?

Di tritmɛnt we yu kin pik kin dipen pan di ej we yu pikin ol, aw di aorta dɔn smɔl, ɛn if i gɛt ɔda at prɔblɛm dɛn. Ɔpreshɔn na di bɛst we fɔ trit kɔagulopathy pan bebi ɛn yɔŋ pikin dɛn. Fɔ big pikin dɛn, if di smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl. Dɛn kin yuse am bak pan pikin ɛn big pipul dɛm we dɔn gɛt di narrowing bak afta dɛn dɔn trit am bifo.

Ɔpreshɔn

difrεn men kayn כpεrayshכn dεm de we dεn kin du fכ k כrekt dis `(CoA)` kכndishכn:

• rεsεkshכn wit εnd-to-εnd anastomosis: if di kכarktashכn sכm, di sכjaman kin rεsεkt di pat we dεn blכk pan di pikin in aorta εn jכyn bak di rεst εnd dεm.
• Rεsεkshכn wit εkstend εnd-to-εnd anastomosis:if di pikin in aorta arch dεm blכk bak, di sכjaman kin kכt di pat we blכk na di aorta εn kכnekt di lכw pat pan di aorta we de dכn to wan lכng insishכn na di aorta arch. dis na di bεst opshכn we di pikin gεt transvas aorta arch haypoplasia εn aorta kכarktashכn.

di pikin dεm we sho se dεn kin sho se dεn gεt bad bad sik afta dεn bכn dεn kin nid fכ gi dεm mεdikeshכn bak bifo dεn du dεn כpεrayshכn. Fɔ ɛgzampul:

• dεn kin gi wan mεdisin we dεn kכl `(Prostaglandin (PGE-1))` fכ kip di pikin in `(ductus arteriosus)` opin. dis go mek di pikin gεt di כksijεn we i nid εn i go mek i stebul te i rεdi fכ כpεrayshכn.
• Yu kin gi di pikin mɛrɛsin bak fɔ ɛp in at fɔ pɔmp blɔd.

Kadiak kateshɔn

If yu pikin dɔn ridyus di aortic narrowing, ɔ if di narrowing dɔn kam bak afta di ɔpreshɔn, di dɔktɔ kin tɛl yu fɔ du tritmɛnt dɛn lɛk:

• Balɔn angioplasty: Di dɔktɔ we de du ɔpreshɔn kin yuz smɔl balyɔn fɔ mek di pat we dɔn smɔl na di pikin in aorta big.
• Balɔn angioplasty wit stent ples: We di dɔktɔ de mek di pikin in aorta big, i kin put wan smɔl tiub bak we dɛn kɔl stent fɔ mek i nɔ blok igen.

Ustɛm a fɔ kɛr mi pikin go to dɔktɔ? (Ri-ɛgzamin dɛn)

Yu pikin in mɛdikal tim go tɛl yu ustɛm fɔ briŋ yu pikin kam. Dis spɛshal pɔsin go:

• Monitor di pikin in blɔd prɛshɔn ɔltɛm.
• Fɔ du skan (imajin tɛst) ɔltɛm fɔ chɛk aw di pikin in at de wok ɛn fɔ si sayn dɛn we de sho se i gɛt prɔblɛm.
• Fɔ gi advays bɔt aw fɔ it tin dɛn we go ɛp yu at ɛn aw fɔ du ɛksɛsayz.
• Fɔ gi yu mɛrɛsin ɛn chenj dɛn doz as nid de.

Aw lɔŋ pɔrsin wae gɛt dis sik kin liv?

Wit advans diagnostik ɛn tritmɛnt mɛtɔd, pipul dɛm wae gɛt Coarctation of the Aorta kin liv naw fɔ at le 60 ia. Trade, di avrej layf we pipul dɛn we gɛt dis sik kin liv na lɛk 35 ia. So dis na rili gud nyus.

If yu pikin gɛt Coarctation of the Aorta, yu kin de wɔnda wetin mek i apin. Wi nɔ kin ebul fɔ no ɔltɛm di rayt tin we kin mek pɔsin gɛt at sik we pɔsin kin bɔn wit. Bɔt wi no se if dɛn no am kwik kwik wan ɛn trit am, dat kin rili ridyus di impak we dis sik kin gɛt pan pikin in layf.

Di mɛdikal tim de ɔltɛm fɔ ɛp yu pikin. Dɛn rɛdi fɔ ansa ɛni kwɛstyɔn we yu gɛt ɛn fɔ ɛp yu fɔ ɔndastand aw dis `(CoA)` diagnosis go afɛkt yu pikin. Yu kin si bak se i fayn fɔ tɔk to ɔda mama ɛn papa dɛn we gɛt pikin dɛn we gɛt dis kayn at sik.

Impɔtant tin dɛn fɔ mɛmba (Take-Home Message) .

a op se naw yu geht sכm כndastandin fכ di kכndishכn we wi bin de tכk bכt we dεn kכl ``Coarctation of the Aorta''. Na sɔm pan di impɔtant tin dɛn we yu fɔ mɛmba:

• Dis na wan at prɔblɛm we dɛn bɔn wit ; wan blɔk we de na di men at we de kɛr blɔd kɔmɔt na di at to di bɔdi.
• Di sayn dɛm kin de we i smɔl ɔ i kin kam leta. If yu notis se yu pikin de slip pasmak, i nɔ izi fɔ blo, ɔ yu nɔ want fɔ gi yu pikin in bɛlɛ, go to dɔktɔ wantɛm wantɛm.
• If dɛn no di sik kwik kwik wan ɛn trit di pikin, dat kin mek i gɛt mɔ chans fɔ liv nɔmal, wɛlbɔdi layf.
• Dɛn kin ebul fɔ mɛn dis sik fayn fayn wan wit ɔpreshɔn ɛn ɔda tritmɛnt dɛn.
• Di spɛshal mɛdikal sɔpɔtishɔn fɔ ɔl yu layf impɔtant ivin afta dɛn dɔn trit am.

Nɔ fred. Mɛdikal sayɛns dɔn rili go bifo tide. Dɔktɔ dɛn de we gɛt sɛns ɛn we go ebul fɔ gi yu pikin di bɛst tritmɛnt. Di tin we impɔtant pas ɔl na fɔ no dis, pe atɛnshɔn to di chenj dɛn we yu pikin de chenj, ɛn go to dɔktɔ di rayt tɛm.

` Koarktashכn fכ di Aorta, Hat Disiz, Pikin dεm, Kכnεjital At Sik, Aorta Stenosis, Pikin Wεlth, Blכd Prεshכn