Kei te turuturu whakamuri te toto mā roto i te takirere o tō ngākau? (Te ruaki o te takirere pūkahukahu) Me kōrero tāua!

He okana whakamiharo tō tātou ngākau, kāore? He wāhanga iti rite ki te tatau kei roto, e kiia nei e tātou he takirere . He mea tino nui ēnei takirere mō te mahi tika o te tuku toto ki tō tātou tinana. I ētahi wā, ki te kore tetahi o ēnei takirere e kati tika, ka turuturu whakamuri ētahi toto. Koinei te āhua ka kōrerohia e tātou i tēnei rā, te ruaki o te takirere pūkahukahu . Kaua e manukanuka, me whakamārama noa iho tēnei.

He aha te Regurgitation o te Takirere Pūkahukahu?

Ki te kī māmā noa, koinei te ingoa i hoatu ki te āhua e kore ai e kati tika te takirere pūkahukahu i roto i tō ngākau, ka turuturu te toto i te huarahi hē, arā, whakamuri, i waenga i ngā pā o te ngakau.

Whakaarohia, e whā ngā rūma o tō tātou ngākau, ā, ko te rere o te toto i waenganui i ēnei rūma e whakahaeretia ana e ngā takirere e whā. Ko te takirere pūkahukahu te tuarua o ngā takirere i roto i tō ngākau e whakahaere ana i te rere o te toto. Koinei te wāhi e wehe atu ai te toto i te ventricle matau . Kātahi ka haere tēnei toto mā roto i ngā uaua pūkahukahu ki ō pūkahukahu, ki reira ka kohia te hāora me te tuku i te hauhā waro.

Nā, ki te pāngia koe e tēnei mate (Pulmonic Regurgitation), kāore te toto katoa e pupuhihia ana mai i te ventricle matau e haere ki ngā pukahukahu. Ka hoki mai ētahi o aua toto ki te ventricle matau. Ka ahatia? Me kaha ake te mahi a te ventricle matau, kia panaia atu ai taua toto tāpiri. I roto i te wā, ka taea e tēnei mahi tāpiri te whakanui i te ventricle matau, te ngoikore, ā, i te mutunga ka arahi ki tētahi mate e kiia nei ko te Right-sided Heart failure .

Ko ētahi atu ingoa mō tēnei ko te Pulmonic Regurgitation, te Pulmonary Valve Regurgitation, te Pulmonary Regurgitation rānei.

He pēhea te noa o tēnei mate? Ko wai te hunga ka nui ake te tūponotanga ka pāngia e tēnei mate?

Ina hoki, he nui ake te kitea o tēnei mate (Pūlmonic Regurgitation) i tō whakaaro. E kiia ana kei waenganui i te 30% me te 75% o te taupori te mate. E ai ki ētahi pūrongo he nui ake te maha. Heoi, i te nuinga o te wā, he iti noa iho tēnei turuturu toto, kāore e whakaatu i ngā tohu . He tokomaha te hunga kāore e mōhio kei a rātou tēnei mate, tae noa ki te kitea mā te tūpono i roto i tētahi whakamātautau.

Heoi anō, ka puta anō hoki te ruaki pūkahukahu i roto i ngā momo take maha. Nā te maha o ngā take, he uaua ki te kī tika i te auau o ēnei mate kino.

Ko wai te mea tino pāngia e tēnei?

• Mō ngā taiohi: Mena ka puta tēnei āhuatanga i roto i ngā taiohi, he maha ngā wā ka puta mai i te pokanga hei whakatika i tētahi mate ngākau whānau i pā ki a rātou i a rātou e tamariki ana.
• Mō ngā kaumātua: Ko ngā pakeke neke atu i te 75 tau te pakeke ka nui ake te tūponotanga ka pāngia e te toto toto tiketike i roto i ngā pukahukahu (te toto toto tiketike o te pūkahukahu) . Ka taea e tēnei āhuatanga te whakararu, te whakararu rānei i te ruaki pūkahukahu.

He aha ngā tohu o tēnei?

He tokomaha ngā tāngata e pāngia ana e te ruaki pūkahukahu kāore e pāngia e tetahi tohu nā te mea he iti noa te turuturu toto. He nui ake te tūponotanga ka puta ngā tohu mēnā he paku noa, he kino rānei te turuturu. He rite tonu ēnei ki ngā tohu e kitea ana i te ngoikore o te ngākau. Kei roto i ēnei:

• Te uaua ki te manawa (Dyspnea)
• Ngenge, ngenge
• Pōuriuri, māuiui
• Kia ngaro te māramatanga
• Te tere o te manawa, te koretake rānei o te ngakau (Te tere o te manawa)
• Te pupuhi o te puku, o ngā waewae, o ngā pona rānei

Mena kei a koe te Pūkahukahu Regurgitation (PR) me tētahi atu mate rānei, tera pea ka pā mai ētahi atu tohu. Ka rerekē ēnei tohu i runga i tētahi atu mate.

He aha te take o tēnei āhuatanga?

He maha ngā take pea o te Pūkahukahu. Anei ētahi o aua take:

• Mate Manawa Rūmātiki: Ko te kirika rūmātiki he mate e puta mai ana i te mate huakita kāore i rongoatia, ka taea te kino i ō takirere manawa. He nui ake te kitea i ngā whenua whakawhanake.
• Te Totoke Pūkahukahu: Koinei te wā ka piki ake te pēhanga i roto i ngā oko toto i roto i ō pūkahukahu. Ka pā pea tēnei pēhanga teitei ki te uaua pūkahukahu, te wāhi e wehe atu ai i te ngākau. Ka taea e tēnei pēhanga teitei te totoro o te uaua me te takirere, ka turuturu te toto mā roto i te takirere.
• Ngā Mate Ira: He nui ake te kitea o te ruaki pūkahukahu i roto i te hunga whai mate ira pēnei i te Marfan Syndrome .
• Ngā Pūkahukahu Carcinoid: He momo mate pukupuku puhoi te tipu, he onge hoki. I te nuinga o te wā ka tīmata i roto i te pūnaha nakunaku. Ka taea e tēnei momo mate pukupuku te whakatō i te kiko carcinoid ki roto i te ngākau, ka aukati i te rere o te toto.
• Endocarditis: He mumura tēnei o te arai o roto o te ngākau. Nā te mate pāwera i puta. Ko te hunga e tangohia ana te dialysis , te hunga he pūnga toto tuturu (IV), me te hunga e wero ana i ngā raau taero ture kore, he nui ake te mōrearea.
• Whara: He tino onge, ka taea e te whara o tō uma te pakaru i te takirere pūkahukahu.
• Ngā raruraru whānautanga: Ko te mate whānautanga he raruraru e whānau mai ana me koe. Hei tauira, te whānautanga me te mate e kiia nei ko te Tetralogy of Fallot , te whānautanga kāore he takirere pūkahukahu, te whaiti rānei o te takirere pūkahukahu i whānau mai me koe (Congenital Pulmonic Stenosis) .
• Maimoatanga hauora:Ka puta pea te ruaki pūkahukahu i ngā tau maha i muri i te pokanga, i ētahi atu maimoatanga rānei mō ngā mate ngakau whānau, pērā i te Tetralogy of Fallot, te Pulmonic Stenosis rānei.
• Kāore i te mārama te take: I ētahi wā, kāore e kitea te pūtake.

He mate hopuhopu tēnei?

Kāo, ehara te Pūkahukahu i te mea hopuhopu . Heoi, ka taea te puta mai i te mate e horapa ana ki te ngākau, i te mate rānei e hua ai te mate ngākau rūmātiki.

Me pēhea koe e mōhio ai ki tēnei?

He uaua pea te tautuhi i te mate pūkahukahu (PR). Kei te kaha o te raruraru me ō tohumate. I te nuinga o te wā ka uru mai he whakamātautau tinana me ētahi whakamātautau whakaahua.

Whakamātautau tinana

Ko te tikanga, ko ēnei ngā mahi a te tākuta:

• Āhua: Ka kitea ētahi tohu, pērā i te pupuhi i te puku, i ngā waewae rānei.
• Te Pāpātanga: Ka pā pea te tākuta ki te pupuhi i ō waewae, i tō puku rānei. Ka whakatītaha pea rātou i a koe ki tētahi koki, ka pēhi i tō puku, ka tirotiro hoki mēnā he uaua jugular e pupuhi ana i tō kaki. Ka tupu pea tēnei ina he raruraru pēnei i te toto toto tiketike i roto i ngā pukahukahu, ka pupuhi ai ngā uaua jugular.
• Te Whakarongo: Ka taea e koe te whakarongo ki tō ngākau mā te whakamahi i te stethoscope . Mēnā he regurgitation pūkahukahu ngawari ki te kino, ka rongo pea koe i te ngunguru o te ngākau. He oro rerekē ēnei e puta tahi ana me tō ngākau nā te mea e rere ana te toto i te huarahi hē. He huarahi pai tēnei hei hopu i tēnei āhuatanga i mua i te puta mai o ngā tohu i te wā o te whakamātautau hauora ā-tau.

He aha ngā momo whakamātautau e mahia ana?

Ko ngā whakamātautau pea me mahi e koe hei tautuhi i tēnei mate ko:

• Te hiko o te manawa (ECG, EKG rānei)
• X-ray o te uma
• Te whakamātautau echocardiogram - Koinei te whakamātautau tino nui. He rite ki te matawai ultrasound o te ngākau.

I roto i ngā take kino, ka taea e tō tākuta te tono i ēnei whakamātautau:

• Te Tātaritanga o te Ngākau Matau
• Whakaahua Āhuatanga Aukume o te Manawa (MRI o te Manawa)

Me pēhea te rongoā? Ka taea te whakaora?

He maha ngā wā ka taea te rongoā i te ruaki pūkahukahu. I runga i te pūtake, ka taea te whakaora katoa i ētahi wā . Heoi, ki te kore e kino, kāore he tohu, e rua rānei, kāore e hiahiatia he maimoatanga. Ahakoa he kino engari kāore he tohu, ko te whāinga o te maimoatanga he aukati i te kino haere o te mate me te ārai i te kino tuturu ki te taha matau o te ngākau.

He aha ngā momo rongoā me ngā maimoatanga e whakamahia ana?

Mena ko te mate (Pūkahukahu Regurgitation) i puta mai i tētahi atu mate,Ko te taahiraa tuatahi ko te rongoā, te whakaora rānei i te mate kē atu. He maha ngā wā ka aukati tēnei i te rere whakamuri o te toto, ka whakaiti rānei i te turuturu, ka whakaiti i ngā raruraru me ngā tohu.

Ki te kore e mutu te toto, ko te mahi e whai ake nei ko te rongoā tika. Ko te rongoā me te whakaora i te ruaki pūkahukahu ko te whakakapi i te takirere tonu. E rua ngā huarahi e taea ai tēnei:

• Pokanga: I tēnei tikanga, ka taea e te taote pokanga te uru tika atu ki tō ngākau me te whakakapi i te takirere. Ka taea te tango i te takirere hou mai i tētahi kaituku tangata, ka taea rānei te hanga mai i te biosynthetic (he mea hanga mai i te huinga o ngā rauemi hangai me ngā kiko ora - i te nuinga o te wā mai i ngā poaka, i ngā kau rānei).
• Te Whakakapinga o te Takirere Pūkahukahu Whakawhiti-Catheter (TPVR): I roto i tēnei tikanga, ka whakamahia he taputapu e kiia nei ko te catheter hei whakakapi i te takirere i roto i te ngākau. Hei mahi i tēnei, ka tapahia e te tākuta he oko toto nui i roto i tō kaki, i tō huha rānei o runga, ka whakauru i te catheter. Kātahi ka arahina te taputapu roa, rite ki te ngongo ki roto i te ngākau, me te pito e tū ana ki runga ake i te takirere o mua. Kātahi ka whakatuwheratia te takirere hou, ā, ka kuruhia te takirere tawhito kua pakaru ki raro. Ko ngā takirere kua whakatakotoria pēnei he mea hanga-koiora. Ka roa pea mō te 15 tau.

I te rongoā i tēnei mate, ka rongoāhia hoki ngā tohu e tino pāwera ana ki a koe. Ko te tikanga, ka mahi ēnei rongoā mā te tango i te wai nui rawa atu i te tinana, te whakangāwari i ngā uaua toto hei whakapai ake i te rere o te toto, te whakahaere, te ārai rānei i ngā pā o te ngakau kāore i te tika (arrhythmias) . Mena kāore e taea te pokanga mō tētahi take, ka taea e ngā rongoā te āwhina i ō tohu, engari kāore e taea e ngā rongoā anake te whakaora i te mate.

He mea nui: Mena he takirere kore-whakapūmau tōu, me tango pea e koe ngā rongoā whakangawari toto mō te toenga o tō oranga. Mā ēnei rongoā ka aukati i te hanganga o ngā toto toto i te taha o te takirere. Ka whakaitihia e tēnei te mōrearea o ngā raruraru pēnei i te whiu, te embolism pūkahukahu rānei.

He aha ngā raruraru/ngā pānga taha o te maimoatanga?

He tino teitei te angitu o te TPVR ki te rongoā i tēnei mate . E 94% ki te 98% o ngā take ka angitu ngā pokanga TPVR. He tino onge hoki ngā raruraru TPVR, e 3% ki te 6% o ngā take ka puta (ko ngā raruraru tino noa ko te mate uaua coronary, te endocarditis rānei nā te mate).

Ko ētahi atu pānga taha, raruraru rānei ka pā mai:

• Te pā o te manawa kāore i te tika (Arrhythmias)
• Te mate pāwera huri noa i te wāhi i pokangahia
• Te toto e puta mai ana i waho o te takirere
• Me whakakapi anō te takirere kua whakakapia
• Ngā pānga taha, ngā raruraru rānei o ngā rongoā (he tino motuhake ēnei ki te rongoā e tangohia ana e koe, nō reira ko tō tākuta te tangata pai rawa atu hei kōrero atu ki a koe mō tēnei)

Me pēhea taku tiaki i ahau anō/te whakahaere i ngā tohumate?

Ka rite pea tēnei āhua ki ētahi atu āhua o te ngākau e morearea ana ki te ora, nō reira kaua e ngana ki te tātaritanga me te rongoā i a koe anō . Ki te whakaaro koe kei a koe tēnei raruraru, me toro atu ki te tākuta i te wā e taea ai. Ka taea e ia te whakatau mēnā kei a koe te āhua me te tuku tohutohu mō ngā kōwhiringa maimoatanga.

Kia pēhea te roa ka pai ake ai taku āhua i muri i te maimoatanga? Kia pēhea te roa ka ora ai ahau?

Ko te wā whakaora mō tēnei mate e whakawhirinaki ana ki te maimoatanga. Ehara i te mea ko te pokanga te maimoatanga tino noa, ā, ko te wā roa rawa atu hoki ka ora. Ko te hunga kua pokangahia mō te (Pulmonic Regurgitation) ka roa pea he wiki, he marama rānei ki te ora. He poto ake te wā whakaora (TPVR) , ā, ka tīmata koe ki te pai ake i roto i ētahi rā.

Ka taea e au te ārai i tēnei? Me pēhea taku whakaiti i te mōrearea?

Ko te Regurgitation Pūkahukahu (PR) he mate e kore e taea te ārai nā te mea ka puta ohorere mai. Ina koa mēnā i puta mai i ngā mate i whānau mai koe. Ko te mea anake ka taea e koe ko te whakaiti i tō mōrearea mā te karo i ngā āhuatanga, i ngā āhuatanga rānei ka puta ai.

Ko te huarahi anake hei whakaiti i te mōrearea ko te karo i ngā mate ka puta ai tēnei . Ko te tikanga me rongoā wawe tonu tetahi mate, inā koa he korokoro mamae pērā i te korokoro strep. Mā tēnei ka ārai i te whanaketanga o te mate hei mate manawa rūmātiki, i te horapa tika rānei ki te ngākau ka kino ai.

He aha te tirohanga mō tēnei āhuatanga?

He iti noa te toto e turuturu mai ana i te takirere mō te nuinga o te hunga e pāngia ana e te ruaki pūkahukahu. He pai te tirohanga mō rātou, ā, me rite te roanga o ō rātou oranga ki te hunga kāore i te mate.

Ahakoa he iti noa te turuturu, he pai tonu te āhua mēnā ka kitea, ka rongoatia wawe , inā koa mēnā he take kei roto ka taea te whakaora, te whakakore rānei.

Mena he tino turuturu tōu, ko te āhua o te putanga ka whakawhirinaki nui ki te tere o te tautuhi me te rongoā. I te nuinga o te wā, mā te tautuhi me te rongoā wawe ka nui ake te tūponotanga o te whakaora i te mate, ka whakaiti rānei i ōna pānga . Ka taea e tō tākuta te kōrero ki a koe he aha tō āhua me te aha ka taea e koe te mahi hei whakapai ake.

Kia pēhea te roa o tēnei āhuatanga?

Ki te kore e rongoatia, ka noho te ruaki pūkahukahu hei mate mō te wā katoa .

Āhea ahau ka taea te hoki ki te mahi/kura?

E whā ki te rima noa ngā rā e noho ai te nuinga o te tangata ki te hōhipera kia whiwhi ai i te TPVR, ā, he tokomaha ka taea te hoki tonu ki te mahi i muri iho. Mena ka pokangahia koe hei utu mō te TPVR, ka roa pea ngā wiki, tae noa ki ngā marama, hei whakaora i a koe me te hoki ki ō mahi noa. Ka taea e tō tākuta te kī atu ki a koe āhea koe ka taea te hoki ki te mahi, ki te kura, ki ō mahi noa rānei.

He mate whakamate tēnei āhuatanga?

Ehara i te mea whakamate te ruaki pūkahukahu i a ia anō . Engari, ka taea e ia te arahi atu ki ētahi atu mate e morearea ana ki te ora i roto i te wā. Koia te mea nui kia tere te tautuhi me te rongoā.

Me pēhea taku tiaki i ahau anō?

Ka taea e tō tākuta te kōrero tika atu ki a koe he aha ngā mea me mahi e koe, me ngā mea ka taea e koe te mahi hei whakahaere i ō tohu me te tiaki i a koe anō. I te nuinga o te wā, me mahi e koe ēnei mea:

• Tangohia tika tō rongoā: Tangohia tō rongoā kia rite ki te mea i whakaritea. Tangohia ina mahara koe, kaua hoki e waiho kia kore e whakamahia nā te mea he watea.
• Tirohia tō tākuta: Ahakoa kāore koe e whiwhi maimoatanga, ka whakaritea pea e tō tākuta he wā tirotiro hei aroturuki i tō āhua. Mā te tirotiro i a ia e ai ki ngā taunakitanga ka āwhina i te kite wawe i ngā tohu o ngā raruraru, ngā raruraru rānei.
• Kaua e tino whakakaha i a koe anō: Tērā pea ka kī atu tō tākuta kia whakawhāitihia ō mahi. Mā tēnei ka āwhina i a koe kia kaua e nui rawa te taumahatanga ki tō ngākau, ka kino ake pea ō tohumate, tō āhua rānei.
• Kia tūpato ki ō kare ā-roto: Mā te aro ki tō tinana me ngā tohumate ka āwhina i a koe ki te kite i ngā tohu wawe o te raruraru me te rapu maimoatanga i mua i te puta mai o ngā raruraru tuturu.

Āhea ahau me waea atu, me kite rānei i taku tākuta?

Ki te puta anō ō tohumate, ki te rerekē rānei i te wā e kore e tūmanakohia, me kōrero koe ki tō tākuta. He mea nui tēnei mēnā he ohorere ngā huringa, mēnā rānei ka tīmata ngā tohumate ki te whakararuraru i ō mahi o ia rā .

Āhea ahau me haere ki te Tari Whawhati Tata (ETU) ?

Me haere koe ki te hōhipera mēnā kei a koe ētahi o ngā tohu e whai ake nei. He tohu ēnei mō te ngoikore o te ngākau, ngā whakaeke ngākau, ētahi atu mate ngākau kino rānei:

• Te uaua ki te manawa (Dyspnea)
• Te whanoke tonu, te ngaro ohorere rānei o te māramatanga
• Te tere o te manawa, te koretake rānei o te ngakau (Te tere o te manawa)
• Pupuhi hou i roto i te puku, i ngā waewae me ngā pona rānei

Hei whakamutunga, he karere hei kawe ki te kāinga:

He mate noa te ruaki pūkahukahu, ā, mō te nuinga o te tangata, kāore e waiho hei take e manukanuka ai. Heoi, ki te kaha rawa, ka puta he tohu ka whakararuraru i tō oranga. Ki te kore e rongoatia, ka taea e ia te arahi ki ngā raruraru nui, tae atu ki te mate.

He waimarie, he maha ngā wā ka taea te rongoā i tēnei mate - ā, i ētahi wā ka taea te whakaora . Ā, he tino teitei te angitu o ngā maimoatanga tino noa. Nō reira, ki te mea he ruarua āu mō tēnei, kaua e whakaroa ki te rapu tohutohu hauora.

Te ruaki o te takirere pūkahukahu, te mate takirere ngākau, te rere o te toto, te ventricle matau, te ngoikore o te ngākau, te toto toto tiketike pūkahukahu, te poto o te manawa