I thinlungah kawngkhar te tak te i nei em? (Patent Foramen Ovale - PFO) chungchang hi han sawi ila!

I thinlung, a nih loh leh thinlung chung lam pindan pahnih inkarah hian pian hnua awm reng thei tur kawngkhar te tak te a nei thei tih i hre ngai em? He thu hi mi tam takin an hriat chuan mak an ti hle. Mahse, a dik a ni. Hetiang dinhmun hi `Patent Foramen Ovale` emaw `(PFO)` emaw an ti a. Lungngai suh, awlsam takin, i hriatthiam theih dan tur angin kan sawi dawn a ni.

PFO chu eng nge ni? A awlsam zawngin i hrethiam ang u

A awlsam zawngin, patent foramen ovale (PFO) hi i thinlung chunglam pindan pahnih, dinglam atrium leh veilam atrium inkar a inhawng te tak te, khuhna ang maia inhawng a ni. Tunah chuan kan nu pum chhunga kan awm vek lai hian he hawnna, foramen ovale an tih hi a awm tih han ngaihtuah teh. A pawimawh hle. Mahse a tlangpuiin, kan pian hnuah a khar thin. PFO chu pian hnua a khar loh chuan a ni. "Patent" tih thumal hi "open" tihna a ni.

A tam zawkah chuan PFO nei te hian symptom an nei lo va, enkawl an ngai lo. Mahse, a tlem hle a, harsatna thenkhat, stroke ang chi hi PFO nen hian a inzawm thei a ni.

Engvangin nge he foramen ovale hi a pawimawh? Nausen lai hian eng nge thleng?

Nausen pum chhunga nausen, nausen chuan a lung chu oxygen tamna thisen lak nan a hmang lo. Chu ai chuan he oxygen tamna thisen hi nu hnen atangin nausen (placenta) kaltlangin, umbilical cord zawhin a lo chhuak zawk a ni. Hei hi foramen ovale hian a ti a, naute dinglam atrium atanga umbilical cord atanga oxygen tamna thisen chu veilam atrium lam pan nghal a ni.

Chuta tang chuan chu thisen chu naute thinlung veilam lamah a kal a, naute thluak leh taksa peng pawimawh dangte hnenah oxygen a pe chhuak a ni. Mechanism mak tak mai a ni lawm ni?

Naute a pian hnuah, a mah chauha thawk a tan chuan thisen chu lungah a kal a, oxygen a la thei a ni. Chutih lai chuan he ``foramen ovale'' hi a khar tlangpui. Tichuan oxygen nei thisen chu thinlung veilam lamah a kal a, chuta tang chuan taksa pum puiah pump chhuah a ni.

Tuin nge PFO siam thei? Engtiang chiahin nge a hluar?

Dik tak chuan PFO hian tu pawh a nghawng thei a, mipa leh hmeichhia, hnam leh vun rawng pawh thliar lovin. Mahse, pawl thenkhatah chuan a tam zawk:

• Diver-te, a bik takin ``Decompression sickness - air embolism`` vei te, pressure inthlak danglam avanga boruak bubble in thisen kalna kawng a tikhawlo thin.
• Stroke nei tawh zingah a chhan dik tak hmuh theih loh (cryptogenic stroke).

Khawvel pumah mi pali zinga pakhat vel (25%) velin PFO an nei thei. Tin, chhan hriat loha stroke nei zinga 30% leh 40% inkar chuan PFO an nei tih hmuhchhuah a ni bawk. Mahse, PFO nei zawng zawngin stroke an nei vek dawn tihna erawh a ni lo. Chu chu hriat reng a pawimawh.

PFO neih hian taksa a nghawng em?

`PFO` i neih chuan chutiang flap te tak te hmang chuan thisen tlemte chu dinglam atrium atang chuan veilam atrium ah a luang chhuak thin. A tlangpuiin heng flap te hi khar a nih avangin hetiang hi a thleng ngai lo.

A tam zawkah chuan PFO hian harsatna a thlen lo. Mahse, a chang chuan thisen zam chu he PFO hmang hian thinlung dinglam atanga thinlung veilam thlengin a kal thei a ni. Chutiang a nih chuan thinlung chuan chu thisen zam chu taksa peng dangah a pump thei a ni. Ngaihtuah teh, chu thisen zam chu thluaka a kal chuan thluaka thisen kalna chu a tibuai thei a ni. Chu chu ischemic stroke an tih condition a lo awm hun a ni. Tin, he thisen zam hian taksa peng dang, kal leh thinlung a tichhe thei bawk.

PFO a lo awm chhan bik a awm em?

Researcher-te chuan PFO thlentu hi eng nge ni tih chiang takin an la hre chiang lo. Chu chu, genetic nge environmental nge thil dang tih erawh a la chiang lo tihna a ni.

PFO natna lan chhuah dan chu engte nge ni? Hengte pawh hi i nei em tih en rawh

PFO nei tam tak chuan symptom an nei lo. Chu chu a dik a ni. Mahse, a châng chuan hetiang hi i hmu mai thei:

• Thai.
• Transient Ischemic Attack (TIA) emaw, mini-stroke emaw hmanga tihdam theih a ni. Hei hian kut leh ke pakhat tihchak harsatna a thlen thei a, taksa peng pawimawh tak tak, thluak, small intestine, large intestine (colon), emaw kidney te pawh a nghawng thei bawk.

Chu bakah, natna hlauhawm tak takte chu:

• Myocardial infarction a awm thin.
• Thisenah oxygen level a tlahniam (Hypoxemia).
• Platypnea-orthodeoxia syndrome (PO syndrome): Hei hi ding chunga thut laia thawk harsat avanga thisena oxygen level tlahniam thin a ni.

Engtin nge PFO i neih leh neih loh i hriat theih ang? Test te chu engte nge ni?

I doctor chuan i symptoms te a zawt hmasa ang che a, physical exam a ti ang che. PFO rinhlelh a nih chuan test an rawt thei a, chungte chu:

• Transthoracic echocardiogram : Echocardiogram (or echo) chu sound wave hmanga thinlung pindan thlalak siamna test a ni. Test hi a rilruah instrument dahin tih a ni.
• Transesophageal echocardiogram (TEE) : He test-ah hian i doctor chuan i chaw kawng chhungah camera dahna tube te tak te a dah lut a. Hei hian echo pangngai aiin PFO thlalak chiang zawk a siam thei a ni.
• Transcranial Doppler (TCD) ultrasound : TCD ultrasound hian sound wave hmangin i thluak chhunga thisen kal dan leh a chhunga thisen kal dan a en thin. Thisen zam vanga stroke awmte hriatchhuahna kawngah pawh a pui thei bawk.

Heng test te bakah hian i doctor chuan ``bubble test'' tih a rawt thei bawk a ni.Hei hian i vein-ah saline solution inject a ngai a ni. Heng bubble te hi lungphun filter chhuak lovin i thinlung veilam sir hawnna atanga luang lut a nih chuan ``PFO'' i nei thei em tih an hre thei ang.

PFO enkawlna tur a awm em? Mi zawng zawngin kan mamawh em?

PFO nei tam zawk chuan enkawl an ngai lo. Mahse, stroke emaw thisen zam emaw i neih tawh a nih chuan, emaw, chutiang hlauhawmna sang tak i neih chuan doctor chuan enkawl a rawt thei ang. PFO enkawl dan tur hrang hrangte chu:

• Thisen zam vengtu damdawi : Entirnan, aspirin emaw warfarin emaw.
• Catheterization : Hetiang tih danah hian interventional cardiologist chuan tube sei tak, te tak te (catheter) hmangin valve chu a khar thin. He catheter hi groin chhunga vein lian tak kaltlangin thinlung chhungah a lut a, valve khar nan special device (closure device) hman a ni. Zirna hrang hrangah chuan he catheter hi kum 60 hnuai lam PFO enkawlnaah hian operation aiin operation aiin a hlawk zawk tih hmuhchhuah a ni.
• Heart surgery : Surgeon chuan incision a siam a, flap chu a stitch khar a. Hei hi catheter hman dan a hlawhtlin loh chuan tih theih a ni. Hei hi open-heart surgery hmangin emaw, rilru chhunga incision tenau tlemte hmangin emaw tih theih a ni a, chu chu minimally invasive robotically assisted patent foramen ovale repair an ti a ni.

Tun hnaia zirchianna atanga a lan dan chuan PFO nei, sawifiah theih loh stroke nei te tan chuan PFO khar hian nakin lawka stroke lo awm tur venna kawngah a pui thei a ni. I doctor nen eng treatment option nge i tan a tha tih sawipui a tha ber.

Enkawlna hian side effect a thlen thei em?

Mi thenkhat chuan PFO enkawlna atang hian harsatna an tawk thei. Heng harsatnate hi enkawl dan azirin a inang lo:

Damdawi hmanga thil thleng thei

Damdawi Aspirin emaw Warfarin emaw ei hian a hnuaia mite hi a thleng thei a ni:

• Thisen chhuak.
• Thluak chhunga thisen chhuak (Intracranial hemorrhage).

Catheter hmanga enkawl chhung hian eng nge thleng thei?

Catheterization avanga harsatna awm tlangpui:

• Thisen a chhuak thin.
• Thisen kalna kawng a chhiat.
• Closure device chu a lo chhuak ta.
• Lung natna emaw `endocarditis` emaw a awm thei.
• `PFO` hi a khar tha lo.
• `Thupah thisen zam (Pulmonary embolism)`.

Harsatna awm lo tak tak:

• Air embolism a awm thin.
• Thinlung thawk mumal lo (Arrhythmia).
• `Atrial fibrillation (Afib) a awm avangin a chhuak thei lo.
• Cardiac tamponade (thinlung chhehvela tui awmkhawm).

Surgery hmanga thil thleng thei te

PFO khar tura operation neih hian harsatna a thlen thei a, chungte chu:

• `Atrial fibrillation (Afib) a awm avangin a chhuak thei lo.
• Thisen chhuak.
• Infection awm thei te.
• Thai.

PFO siam theihna tur tihziaawm theih dan a awm em?

PFO vei theihna tur tihziaawmna tur hian engmah tih theih a awm lo tak zet a ni. Kan thunun theih thil a ni lo. Mahse, sawifiah theih loh stroke (cryptogenic stroke) i neih chuan he natna hi test neih a pawimawh hle. Tichuan, a tul chuan enkawlna i dawng vat thei ang.

PFO nei mi pakhat hriselna dinhmun chu eng nge ni? Thil ngaihtuahawm tak a ni em?

A tam zawkah chuan PFO nei naupang khuhna chu a dam kum thum chhungin a khar vek thin. PFO nei tam tak chu puitling an nih chuan harsatna nei lovin nun famkim, hrisel takin an hmang thin. Chuvangin a tul lovah ngaihtuah buai suh .

PFO ka neih chuan engtin nge ka hriselna ka enkawl ang?

I thinlung hi i hrisel thei a, stroke i neih theihna pawh i tihziaawm thei a, hengte hi i zawm hian:

• Zu leh ruihhlo dang hman loh tur.
• Thinlung hrisel ei tur ei rawh.
• Thisen sang (Hypertension) emaw cholesterol sang emaw control.
• I taksa rihna hrisel tak vawng reng rawh.
• Meizial zu leh zuk leh hmuam thil hman kha bansan rawh.
• Stroke vei theihna tipungtu hriselna lama harsatna dang, atrial fibrillation (Afib) te tan enkawlna tha tak dawng rawh.

Tin, hmun khata rei tak awm loh chuan thisen zam a ti tlem thei bawk.

Doctor hmuh hun tha ber berte chu engte nge ni?

Stroke symptoms i neih chuan doctor hmu nghal la, emaw 911 (or i local emergency number) call rawh. Heng symptoms te hi a hnuaia mi ang hian a ni thei:

• Thusawi emaw hriatthiam harsat.
• Luak chhuak emaw, balance hloh emaw.
• Hmai, kut leh kea natna emaw, chak lohna emaw.
• Mit pakhat emaw, mit pahnih emawa hmuh harsa.
• Lu na na tak a lo awm nghal.

Take-Home Thuchah a ni

Patent foramen ovale (PFO) hi thinlung chhunga inhawng te tak te, thinlung dinglam leh veilam chamber inkar a ni. Mi pali zinga pakhat vel (25%) a vei . A tam zawkah chuan PFO hian symptom a nei lo va, enkawl a ngai lo. Mahse, a chang chuan stroke emaw mini-stroke emaw chhinchhiahna a ni thei. Stroke emaw thisen zam emaw i neih tawh chuan doctor chuan enkawl a rawt thei ang. Enkawlna tur hrang hrang chu damdawi, catheterization, leh surgery te a ni. A pawimawh ber chu PFO nei tam zawk hi nun famkim, hrisel takin an nung thei a ni. Thil ngaihtuah tur i neih chuan doctor nen inbiakna neih hreh suh.

`PFO, patent foramen ovale, thinlunga khur, stroke, thisen zam, thinlung natna, foramen ovale