Kei te rongo koe i tētahi oro rerekē mai i tō ngākau? Me ako tātou mō te Murmur Diastolic!

Kua rongo pea koe i tētahi tākuta e kī ana, "Hmm... he haruru iti taku e rongo ana, he ngunguru," ina whakanohoia he stethoscope ki tō uma. He mea noa te mataku ina rongo rātou i tēnā. Engari ehara i te mea he morearea ngā ngunguru katoa. I tēnei rā ka kōrero tātou mō tētahi momo tangi motuhake o te ngākau e kiia nei ko te ngunguru diastolic . Kia kite tātou he aha te mea, he aha te take e puta ai, ā, mēnā he mea hei wehi.

He aha te Murmur Diastolic?

Āe, me titiro tuatahi tātou ki te tikanga o te murmur diastolic. He oro rerekē tēnei e rangona ana i a koe e patupatu ana i tō ngākau, arā, i te wā e okioki ana tō ngākau mō tētahi wā (diastole) . Ina tirohia tō toto toto, ko te tau o raro ko te pēhanga diastolic. Ae, koinei te wā e kī ana tō ngākau i te toto, e whakarite ana hoki mō te patupatu e whai ake nei.

Tērā pea ka rite tēnei ngunguru ki te tangi 'swish' me te 'whoosh' rānei, he rite ki te tangi whiowhio. Nā te pōrearea e puta ana i te rere o te toto i roto i ngā takirere o te ngākau tēnei tangi.

I te nuinga o te wā, kāore he mea morearea te haruru pēnei. Engari i ētahi wā, he tohu pea tēnei mō tētahi mate ngākau. Ki te kī mai tō tākuta he haruru diastolic tōu, tera pea ka tonoa e ia ētahi atu whakamātautau hei whakakore i ētahi atu mate ngākau.

He aha te rerekētanga i waenga i ngā murmur diastolic me ngā murmur systolic?

Tērā pea kei te whakaaro koe, 'E rua ngā mea e tatauhia ana te murmur diastolic me te murmur systolic?' Āe, he pono tēnā.

• Ka rangona he ngunguru diastolic ina whakangā te ngākau i waenga i ngā patu. He uaua ake te tautuhi i tēnei oro i te ngunguru systolic.
• Ka rangona he ngunguru systolic ina kōpiri te uaua o te ngākau, arā, ina pupuhi te ngākau i te toto (i te wā systole).

He whakarapopototanga, ka puta ēnei momo haruru e rua i ngā wā rerekē o te huringa o te ngākau.

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He aha ngā ngunguru 'harakore' me ngā ngunguru 'rerekē'? He morearea katoa ēnei?

Āe, ko tētahi atu mea nui ko te whakarōpūtanga o ēnei māpere.

Ka tapaina e ngā tākuta ētahi ngunguru he 'ngunguru harakore' . Ko te tikanga o tēnei, kāore ngā oro o te ngākau i puta mai i tētahi mate ngākau. He ngunguru noa iho ēnei, kāore he kino. He maha ngā wā ka kitea ēnei i roto i ngā tamariki nohinohi, ā, ka memeha haere i a rātou e pakeke haere ana.

Heoi, ko te tikanga o te 'haumanu rerekē' he mate ngākau kei roto i te ngākau. Koinei te wā ka whakahaerehia e ngā tākuta ētahi atu whakamātautau hei rapu i te tino take.

Kāore e hiahiatia he maimoatanga mō ngā ngunguru harakore. Heoi, he rerekē te maimoatanga o tētahi ngunguru rerekē i runga i te mate ngākau i puta ai.

Kia maumahara: Ehara i te mea he morearea ngā ngunguru katoa. Engari, ki te mea mai te tākuta he ngunguru tōu, he mea nui kia tirohia koe.

He aha ngā take o te murmur diastolic?

Nā, kia tirohia ngā tino take o tēnei murmur diastolic. I te nuinga o te wā, ko ngā raruraru o ngā takirere o te ngākau te take o ēnei.

Ngā raruraru e pā ana ki te takirere ngākau

E whā ngā takirere matua o tō tātou ngākau. He rite ēnei takirere ki ngā tatau, e tuku ana i te toto kia rere i te taha kotahi anake. Mena he raruraru kei roto i ēnei takirere, ka puta te haruru.

• Te Regurgitation o te Aorta: Ka puta tēnei ina kore e kati tika te takirere aorta, e kawe ana i te toto mai i te ngākau ki te aorta. Ka turuturu whakamuri te toto. Whakaarohia he rite ki te puna wai kāore i kati tika, ā, ka turuturu te wai.
• Te Regurgitation o te Pūkahukahu: I roto i tēnei, kāore te takirere pūkahukahu e kawe ana i te toto mai i te ngākau ki ngā pūkahukahu e kati tika ana. Ahakoa i taua wā, ka turuturu whakamuri tonu te toto.
• Te Mitral Stenosis: Koinei te wā ka whaiti te takirere mitral, e kawe ana i te toto mai i te atrium maui ki te ventricle maui. He rite ki te paipa kua āraia. He uaua ki te rere o te toto.
• Te Stenosis Tricuspid: I roto i tēnei, ka whaiti te takirere tricuspid, e kawe ana i te toto mai i te atrium matau ki te ventricle matau o te ngākau.

Ko ēnei momo raruraru takirere ka puta he huringa i roto i te tauira rere o te toto, ā, koinei te take e puta ai te tangi 'whoosh' 'swish', arā, te ngunguru.

Ētahi atu take

Haunga ngā raruraru takirere, ka puta pea ngā murmur diastolic mō ētahi atu take:

• Ko ētahi mate manawa whānau he mate manawa e kitea ana i te whānautanga mai.
• Endocarditis: He mate tēnei o te arai o roto o te ngākau me/ranei ōna takirere.
• Ngā pānga roa o te kirika rūmātiki : Ki te kore e rongoatia tika i te tamarikitanga, ka taea e te kirika rūmātiki te kino i ngā takirere o te ngākau.

He aha ngā tohu o te murmur diastolic?

Ko ngā tohu o te murmur diastolic e whakawhirinaki ana ki te take matua. Arā, ka rerekē pea ngā tohu i runga i te whaiti o te takirere (stenotic) te turuturu rānei (regurgitant). Tērā pea kāore he tohu o ētahi tāngata. Heoi, ko ngā tohu tino kitea ko:

• Te uaua ki te manawa , ina koa kei te ngenge koe, kei te piko rānei.
• Te pupuhi i roto i te puku, i ngā waewae rānei.
• Te tere o te pao o te manawa , te tere rānei o te manawa o te tangata.
• Te ngenge tonu.
• Pōuriuri.
• I ētahi wā ka taea e koe te hemo i te moe .
• Te maremare tonu.

Mena kei a koe tētahi, ētahi rānei o ēnei tohu, he mea tino nui kia toro atu koe ki tētahi tākuta.

Me pēhea te tautuhi a ngā tākuta i te murmur diastolic? (Tautuhinga)

I te nuinga o te wā, ka mōhio tuatahi te tākuta mēnā he ngunguru tōu mā te whakarongo ki tō uma me te stethoscope. I a ia e whakarongo ana, ka whakaarohia e te tākuta ētahi mea:

Ngā mea ka rangona e koe me te stethoscope

• Ka pāngia tēnei oro e te whakarerekētanga o tō tū, e te whakakori tinana rānei?
• Kia pēhea te nui o te tangi?
• He aha te teitei o te oro? He teitei, he iti rānei te reo?
• I tēhea wāhi o te manawa o te ngakau ka rangona te oro, ā, kia pēhea te roa?
• Kei hea i roto i te ngākau e rangona ai tēnei ngunguru?

Mai i ēnei mea, ka taea e te tākuta te mārama ki te āhua o te ngunguru.

He aha ngā whakamātautau e mahia ana?

Ki te whakapae koe he murmur tōu, ka tukuna pea koe e tō tākuta ki tētahi tohunga ngakau mō ētahi atu whakamātautau. Ka taea e ēnei whakamātautau te āwhina ki te whakatau i te manawataki me te hanganga o tō ngakau. Ko ngā whakamātautau tino noa ko:

• Echocardiogram (Echo): Koinei te whakamātautau matua e whakamahia ana hei aromatawai i te ngunguru o te ngākau. Ka whakamahia e te echo ngā ngaru ultrasound hei tango pikitia o te ngākau. Ka taea e ia te whakaatu taipitopito i te uaua o te ngākau me ngā takirere. Kāore he mamae, he rite ki te matawai i te pēpi i roto i te kōpū.
• X-ray o te uma: Ka tangohia ngā whakaahua o te ngākau, ngā wheua, me ngā pukahukahu. Ka taea e ia te whakaatu mēnā kua rahi te ngākau, mēnā rānei he wai kei roto i ngā pukahukahu.
• He tohu hiko-ā-ringa (EKG/ECG): Ka tuhia ngā mahi hiko o te ngākau. Ka taea te tirotiro i ngā hapa o te manawa.

Me ako anō hoki tātou mō te whakatauranga i hoatu ki ēnei māpere?

Ka tātarihia e ngā tākuta te ngunguru o te ngākau i runga i tōna kaha, arā, te nui o te tangi, te koi o te tangi, me te roa o tōna roa.

• Ko ngā Murmur Diastolic e whakatauria ana i runga i te tauine kotahi ki te whā (1 ki te 4) . Kotahi (1) he oro kāore e rangona, ā, ko te whā (4) he oro tino nui.
• Ko ngā Murmur Systolic e whakatauria ana mai i te kotahi ki te ono (1 ki te 6). Kotahi (1) kāore e rangona, ā, e ono (6) te nui o te haruru kia rangona ai mēnā kāore he stethoscope e whakanohoia ana ki te uma.

Ka taea e tēnei tohu te hoatu he whakaaro ki a koe mō te kaha o te ngunguru.

Me pēhea te rongoā i te murmur diastolic?

Ko te maimoatanga e whakawhirinaki ana ki te pūtake o te haruru. Hei tauira, mēnā he raruraru takirere te take o te haruru, ka tūtohu pea tō tākuta i ngā rongoā, i te whakatika takirere, i te whakakapinga rānei i te takirere.

Ngā rongoā

Ko ētahi o ngā rongoā e whakamahia ana mō te maimoatanga ko:

• Ngā aukati whākōkī huri-angiotensin (ACE): Hei tauira, benazepril (Lotensin®) captopril (Capoten® rānei). Ka mahi ēnei mā te whakaheke i tō toto toto.
• Ngā ārai-beta: Pērā i te bisoprolol (Cardicor®) me te metoprolol (Lopressor®). Ka whakahekehia e ēnei te toto toto me te tere o te manawa.
• Ngā rongoā whakaiti toto: ko te warfarin (Coumadin®) me te aspirin (Bayer®, Zorprin®) he rongoā e whakaiti ana i te kaha o te toto ki te totoka.
• Ngā rongoā whakaheke toto (ngā pire wai): Pērā i te furosemide (Lasix®) me te torsemide (Demadex®). Ka āwhina ēnei ki te whakaiti i te nui o te wai tāpiri i roto i te tinana.

He mea nui: He mea tino nui kia tangohia ēnei rongoā kia rite ki ngā tohutohu a tō tākuta, i te horopeta kua whakaritea, me te roanga o te wā kua whakaritea.

Pokanga (Whakatika/Whakakapinga Takirere)

Mena kua pakaru, kua turuturu rānei tētahi o ō takirere ngākau, me mahi pea he pokanga mō te takirere ngākau.

• Te Whakatikatika i te Takirere: Ka taea e tēnei pokanga te whakawhānui i te takirere whaiti, te whakakī rānei i te takirere turuturu. Mēnā ka taea, ka ngana ngā tākuta ki te whakatika me te tiaki i tō ake takirere.
• Te Whakakapinga o te Takirere: Mena he tino whaiti te takirere (he tino uaua te aukati o te takirere) he tino pakaru rānei, ka tangohia e te tākuta te takirere ka whakakapia ki tētahi takirere ā-ringa, ki tētahi takirere rānei mai i tētahi kaituku.

Ka taea te ārai i te murmur diastolic?

Kāore he huarahi motuhake hei ārai i te murmur diastolic, nā te mea he maha ngā wā e hono ana ki ētahi atu mate hauora. Heoi, ina kitea tō tākuta he murmur diastolic koe, he mea nui kia kite tonu koe i tō tākuta kia kore ai e kitea te pūtake (pēnei i te raruraru takirere) me te whai i ana tohutohu.

Waihoki, mā te whai i ngā tikanga noho hauora hei pupuri i te hauora o tō ngākau ka taea te whakaiti i te mōrearea o ēnei mate ki tētahi taumata.

• Kai i ngā kai e nui ana ngā hua, ngā huawhenua, me ngā witi katoa.
• Me mahi korikori tinana kia 150 meneti pea ia wiki (hei tauira, te hikoi tere, te oma, te kaukau).
• Whakawhāitihia te whakamahinga o te waipiro me te kawheine.
• Ki te mea he kai paipa koe, kati rawa .
• Whakaitihia te ahotea mā roto i ngā mahi pēnei i te whakaaroaro.
• Kia pai te moe mō te whitu ki te waru hāora i ia pō.

He aha te tirohanga mō te tangata he murmur diastolic? (Tirohanga)

Ko te āhua o te mate kei runga i te āhua o te mate. He waimarie, he tino pai ngā maimoatanga mō ngā raruraru takirere. Waihoki, mā te whai i tētahi momo noho hauora ka taea e koe te ora i tētahi oranga pai ake, whai hua ake, ahakoa he ngunguru ngākau. Nō reira kaua e mataku, me whai noa i ngā tohutohu a tō tākuta.

He aha ngā pātai nui hei pātai atu ki te tākuta?

Kia mōhio koe kei a koe te murmur diastolic, he mea pai kia pātai atu koe ki tō tākuta i ēnei pātai:

• He aha te tino take o tēnei murmur diastolic i roto i ahau?
• He aha ngā momo whakamātautau me mahi e au?
• He aha ngā kōwhiringa maimoatanga kei a au?
• He aha ngā mea me mōhio ahau mō te whakahaere i ngā āhuatanga hauora o raro?
• Me kite ahau i tētahi tohunga ?
• Me huri taku āhua noho hei whakapai ake i te hauora o tōku ngākau?

Haunga ēnei pātai, pātai atu ki tō tākuta mō ngā mea katoa kei a koe, ahakoa te iti.

Hei whakamutunga, ngā mea hei maumahara (Karere hei tango ki te kāinga)

Āe, kua kōrerohia e tātou he maha ngā mea mō te Diastolic Heart Murmur i tēnei rā. Anei ētahi mea hei maumahara poto:

• Ko te ngunguru diastolic he oro rerekē e rangona ana i te wā e okioki ana te ngākau (i te wā diastole).
• Ahakoa kāore te nuinga o ngā ngunguru i te mōrearea, i ētahi wā he tohu pea nō te mate ngākau. Nō reira, ki te kī mai te tākuta he ngunguru tōu, he mea tika kia tirohia .
• I runga i te pūtake, ka taea te rongoā mā te rongoā, te pokanga rānei.
• Mā te noho i tētahi momo noho hauora ka āwhina i a koe kia ora pai ahakoa ēnei āhuatanga.
• Mena he pātai, he ruarua rānei āu, kaua e wehi ki te kōrero ki tō tākuta .

Kia maumahara, he mea tino nui te tiaki i tō ngākau. Ko tāku tumanako ka whai hua ēnei mōhiohio ki a koe!