Mtsinga huru yeropa yemwana wako yakavharwa here? Ngatidzidzei nezveizvi (Kubatana kweAorta)!

Wakambozvibvunza here kuti mwoyo yedu midiki inoshanda zvinoshamisa sei? Asi dzimwe nguva, nekuda kwemamwe matambudziko ekuzvarwa nawo, kushanda kwemoyo uyu kunogona kukanganiswa zvishoma. Chimwe chezvirwere zvemoyo zvakadaro chinogona kuitika mune vamwe vacheche chinonzi `(Coarctation of the Aorta)`. Kunyangwe zita racho ringanzwika serakaoma, usazvidya moyo. Ngatitaurei nezvazvo zviri nyore.

Chii chinonzi `(Coarctation of the Aorta)`? Zvichitaurwa zviri nyore...

Zvichitaurwa zviri nyore, kubatana kweAorta kupfupika kana kuti kupfupika kweaorta, tsinga huru yeropa inotakura ropa rine oxygen kubva pamwoyo wemwana wako kuenda kumuviri wese. Uku ndiko kusakwana kwemoyo kwakaberekwa nako.

Fungidzira, mota zhinji dziri kufamba nekukurumidza mumugwagwa mukuru. Asi chii chinoitika kana ukamanikana mugwagwa pane imwe nzvimbo wobvumira nzira imwe chete yemotokari? Kuzara kwemotokari kunoitika, uye vatyairi vanotanga kufamba, handiti? Ndizvo zvinoitikawo mumamiriro ezvinhu aya. Zvinova zvakaoma kuti ropa riyerere zvakanaka kuburikidza nekuvharika kweaorta.

Kazhinji, kutetepa uku (coarctation) kunoitika matavi anotakura ropa kubva kuaorta kuenda kumuviri wepasi, senge makumbo, asati apatsanurana. Chii chinokonzera izvi? Kumanikidzwa kweropa kunowedzera muchikamu chepamusoro chemuviri wemwana, senge maoko, asi kunoderera muchikamu chezasi chemuviri, senge makumbo. Musiyano mukuru uyu muBP pakati pechikamu chepamusoro nechepasi chemuviri chinhu chikuru chechirwere ichi. Kunyangwe pasina zvimwe zviratidzo, vanachiremba vanogona kunge vachifungidzira pavanoona musiyano uyu weBP.

Zvichienderana nehuwandu hwevana muUnited States, mwana mumwe chete pavana 1,700 vanoberekwa gore rega rega anogona kunge aine chirwere ichi (Aortic Coarctation). Vamwe vacheche vanogona kunge vaine zvimwe zvirwere zvemwoyo zvekuzvarwa nazvo pamwe chete neizvi.

Ndezvipi zviratidzo zvinoratidzwa nevana pavanotanga chirwere ichi?

Zviratidzo izvi zvinoenderana nekuti aorta yakatetepa zvakadii. Kazhinji, kana paine kutetepa kudiki, zviratidzo zvinotanga kuoneka mukati mevhiki imwe kana maviri mushure mekuzvarwa. Zvisinei, kana kutetepa kusiri kwakanyanya, zviratidzo zvinogona kusaonekwa kusvika mwana akura, kana kuti zvingasazomboonekwa zvachose.

Zviratidzo zvevacheche vachangoberekwa

Kana mwana achangoberekwa aine chirwere ichi, anogona kuona zviratidzo zvakaita se:

• Kugara uchirara uye kusada kunwa mukaka
• Kurova kwemoyo nekukurumidza (kurova kwemoyo nekukurumidza)
• Kudikitira zvakanyanya
• Kugumbuka nguva dzose, kuchema
• Ganda rakachenuruka kana kuti grey
• Kufema nekukurumidza kana kwakaoma
• Kuomerwa nekunwa mukaka

Kana mwana akavharika zvakanyanya mutsinga yeropa , anogona kuvhunduka uye kuva nengozi yehupenyu kana akasaonekwa uye akarapwa nekukurumidza. Zvisinei, vamwe vacheche vangasaratidza zviratidzo nekuti kuvharika kwacho kudiki.

Zviratidzo muvana vadiki nevakuru vechidiki

Vana vakwegura nevechidiki vane Aortic Coarctation vanogona kuona zviratidzo zvakaita se:

• Musoro unowanzo rwadza
• Kukwira kweropa
• Kubuda ropa mumhino kakawanda
• Marwadzo mumakumbo kana uchirovedza muviri, uchimhanya, kana kusvetuka

Vamwe vana vanogona kusaona zviratidzo zvachose. Pane kudaro, dambudziko rinotanga kuonekwa seBP yakakwira panguva yekuongororwa kwechiremba nguva dzose.

Kana munhu mukuru akasangana nezviratidzo izvi, zvinowanzokonzerwa nekudzokororwa kwetsinga yeropa mushure mekurapwa kare. Kashoma kuti chirwere ichi chisaonekwe kusvika munhu akura.

Sei izvi zvichiitika? Ndezvipi zvikonzero?

Nyanzvi hadzisati dzaziva chikonzero chaicho cheCoA. Zvisinei, zvinofungidzirwa kuti pane chikamu chemajini . Kureva kuti, shanduko dzemajini dzinoitika mwana ari mudumbu dzinogona kukonzera kuti aorta yemwana isakure zvakanaka.

Dzimwe nguva shanduko idzi dzemajini dzinogona kupfuudzwa kuburikidza nemhuri. Tsvagiridzo yakaratidza kuti kana uine CoA, mwana wako ane mukana wekuwana CoA kana chimwe chirwere chemwoyo kupfuura munhu asina CoA.

Uyewo, njodzi yekubatwa neCoA yakawanda kana paine mamwe mamiriro ezvinhu emajini. Semuenzaniso, vana vanozvarwa vane chirwere chemajini cheTurner syndrome vanowanzova neCoarctation yeAorta chete, asiwo zvimwe zvirema zvekuzvarwa nazvo zvakaita sebicuspid aortic valve, chikanganiso mumavharuvhu emwoyo.

Chikonzero che `(CoA)` chega chisina zvimwe zvikanganiso zvemoyo

Chikonzero chikuru cheCoA yakaparadzaniswa kuvharika kusingawanzoitika kwetsinga diki yeropa inonzi ductus arteriosus panguva yekukura kwemwana ari mudumbu. Ductus arteriosus itsinga diki yeropa inobatanidza fetal aorta netsinga yemapapu. Mapapu haasi kushanda mwana ari mudumbu, saka chubhu iyi inobatsira mwana kuwana ropa rakawanda reokisijeni raanoda.

Mushure mekunge mwana azvarwa, mapapu anotanga kushanda. Zvadaro, sezvo iyi `(ductus arteriosus)` isingachadiwi, inotanga kuvhara yoga mukati memazuva mashoma. Zvisinei, painovhara, mamwe matishu ari mumugero iwoyo anogona kusangana netishu ye`(Aorta)`. Muchiitiko ichocho, kana `(ductus arteriosus)` ikamanikidzwa kuvhara, aorta inogonawo kutetepa (coarctation)`.

Ndezvipi zvinetso zvinogona kuitika nekuda kwechirwere ichi?

Kana chirwere ichi (Coarctation of the Aorta) chikasarapwa kwenguva yakareba, matambudziko akadai se:

• Kukwira kweropa (BP) mumuviri wese.
• Tsandanyama dzemwoyo dzinova dzakakora kupfuura zvakajairika (left ventricular hypertrophy).
• Kuunganidzwa kweplaque mutsinga dzemwoyo, dzinopa ropa kumoyo, kunoitika nguva isati yakwana - izvi zvinonzi chirwere chetsinga dzemwoyo.
• Kuzvimba kusina kujairika (aneurysm) kana kubvaruka (kubvaruka) mu aorta.
• Kubuda kwetsinga yeropa muuropi (aneurysm).
• Kukundikana kwemoyo chirwere chinokonzerwa nekuti moyo haugone kupomba ropa nemazvo.

Dambudziko iri re `(CoA)` rine njodzi huru kana rikasaonekwa uye rikasarapwa. Saka, zvakakosha zvikuru kuriziva nekukurumidza sezvinobvira, uchiri mudiki, uye kupiwa kurapwa kwakakodzera uye kuongororwa nguva dzose (kutarisa).

Vanachiremba vanoongorora sei izvi? (Kuongororwa)

Vanachiremba vemwoyo vevana vanowanzo ongorora chirwere ichi (Coarctation of the Aorta) vachiri vacheche kana kuti vachiri vadiki. Kuti chirwere ichi chinokurumidza sei kucherechedzwa zvinoenderana nekuti zviratidzo zvacho zvakakura sei.

Vacheche vane zviratidzo zvisina kunyanya kuipa vanoonekwa mukati memazuva mashoma ekuzvarwa. Zvisinei, vacheche vane zviratidzo zvisina kunyanya kuipa, kana kuti vasina zvachose, vanogona kusaonekwa kusvika vakura uye vatanga kukwira kweropa. Hazviwanzoitiki kuti izvi zvizivikanwe pakukura.

Chirwere ichi chinowanzoonekwa muvacheche nevana vadiki nekuda kwezvimwe zvinhu zvinofungidzirwa (zviratidzo zvitsvuku) zvinoonekwa panguva yekuongororwa kwemuviri. Zvinhu zvakadaro zvinosanganisira:

• Mwana ane BP yakakwira mumaoko nemumuviri wepamusoro, asi BP yakaderera mumakumbo nemumuviri wepazasi.
• Pane musiyano pakati pekurova kwemoyo mumutsipa nekurova kwemoyo mudumbu.
• Chiremba paanoisa stethoscope kumusana kwemwana oteerera, inzwi rakasiyana, rakasimba rinobva pamwoyo ('kugunun'una kwemwoyo kwakasimba') rinonzwika.

Vamwe vacheche vanoonekwa vaine chirwere ichi vasati vatomboratidza zviratidzo. Unozviziva sei? Kuongororwa kunonzi ``pulse oximetry`` kunoyera huwandu hweokisijeni muropa ravo kunoratidza kuti huwandu hweokisijeni hwakaderera. Hushoma hweokisijeni hunogona kuva chiratidzo chechirwere chemwoyo chakakomba chekuzvarwa nacho, saka vacheche ava vanoongororwa kuti vaone kuti chii chaizvo chiri kunetsa.

Kuti vasimbise chirwere ichi che `(CoA)`, vanachiremba vanowanzo shandisa `(Echocardiogram)`, heart scan, kana `(echo)`. Vanogonawo kuita bvunzo dzakadai se `(CT scan)` kana `(MRI scan)` kuti vadzidze zvakawanda nezve chimiro uye chimiro che aorta yemwana.

Pane zvimwe zvirwere zvemwoyo zvine chekuita ne "Coarctation of the Aorta" here?

Ehe, vacheche vane CoA vanogona kuonekwa vaine mamwe matambudziko emwoyo. Semuenzaniso, pakati pe45% ne75% yevanhu vane CoA vanewo chirwere chinonzi bicuspid aortic valve. Izvi zvinoreva kuti vharuvhu inotakura ropa kubva pamoyo kuenda kuaorta ine mapepa maviri chete panzvimbo pematatu ayo inofanira kunge iine.

Kwete izvozvo chete, asi `(CoA)` inogonawo kuperekedzwa nemamiriro ezvinhu anotevera:

• Kuva neburi mumoyo - izvo zvinonzi `(atrial septal defect)` kana `(ventricular septal defect)`.
• Tsinga yeropa yaivepo panguva yehupenyu hwemwana ari mudumbu (`ductus arteriosus`) inoramba yakavhurika kwenguva yakareba kupfuura zvaitarisirwa - izvi zvinonzi ``patent ductus arteriosus``.
• Aortic arch hypoplasia kana hypoplastic left heart syndrome.
• Kuoma kwevharuvhu yemoyo - kureva, aortic valve stenosis kana mitral valve stenosis.

Vanachiremba vemwoyo vanotarisa zvinhu izvi zvose mumoyo wemwana wenyu vogadzira hurongwa hwekurapa hwakanangana navo. Izvi zvinoreva kuti kurapa mwana ane matambudziko emwoyo akawanda kunogona kuoma zvishoma pane kurapa mwana ane CoA imwe chete.

Ndezvipi zvinorapwa izvi?

Nzira dzekurapa dzinoenderana nezera remwana wako, kutetepa kweaorta, uye kana aine zvimwe zvirwere zvemwoyo. Kuvhiyiwa ndiyo nzira yakanakisisa yekurapa coagulopathy muvacheche nevana vadiki. Kune vana vakuru, kana kutetepa kwacho kusina kunyanya kuoma, cardiac catheterization, nzira isinganyanyi kupindira pane kuvhiyiwa, inogona kunge yakakodzera. Inoshandiswawo kuvana nevakuru vakambodzokorora kutetepa mushure mekurapwa kare.

Kuvhiya

Kune mhando dzakasiyana-siyana dzekuvhiya dzinoitwa kugadzirisa dambudziko iri re `(CoA)`:

• Kuvhiyiwa kwekubvisa tsinga nekubvisa tsinga kubva pamuromo kusvika pamuromo: Kana tsinga yacho iri diki, chiremba anogona kubvisa tsinga yeropa yemwana yakavharika obatanidza mativi asara.
• Kubviswa kweganda nekubvisa ganda kubva paganda kusvika paganda kwenguva refu:Kana aorta arch yemwana yakavharikawo, chiremba anogona kucheka chikamu chakavharika cheaorta obatanidza chikamu chezasi cheaorta inoburuka nekucheka kwenguva refu muaorta arch. Iyi ndiyo sarudzo yakanakisa kana mwana aine transverse aortic arch hypoplasia uye aortic coarctation.

Vacheche vanoratidza zviratidzo zvakakomba mushure mekuzvarwa vangangodawo kupihwa mushonga vasati vavhiyiwa. Semuenzaniso:

• Mushonga unonzi `(Prostaglandin (PGE-1))` unogona kupihwa kuti `(ductus arteriosus)` yemwana igare yakavhurika. Izvi zvinobvumira mwana kuwana oxygen yaanoda uye kumuchengetedza akasimba kusvika agadzirira kuvhiyiwa.
• Unogonawo kupa mwana mushonga wekubatsira mwoyo wake kupomba ropa.

Kuisa katheta mumoyo

Kana mwana wako adzikira kutetepa kwetsinga yeropa, kana kuti kutetepa kwadzokororwa mushure mekuvhiyiwa, chiremba anogona kukurudzira kurapwa kwakadai se:

• Kuvhiyiwa kwebharumu angioplasty: Chiremba anoshandisa bharumu diki kuti awedzere chikamu chakamanikana chetsinga yeropa yemwana.
• Kuvhiyiwa kwebharumu nekuisa stent: Chiremba wevana pavanenge vachiwedzera aorta yemwana, anoisawo chubhu diki, inonzi stent, kuti isavharike zvakare.

Ndinofanira kuenda nemwana wangu kuna chiremba riini? (Kuongororwazve)

Chikwata chevanachiremba vemwana wenyu chichakuudzai kuti muuye nemwana wenyu riini. Muhupenyu hwemwana wenyu, vachafanira kuteverwa nachiremba wezvirwere zvemwoyo. Nyanzvi iyi icha:

• Gara uchitarisa BP yemwana.
• Kuita scans (miedzo yemifananidzo) nguva nenguva kuti vaone mashandiro emwoyo wemwana uye zviratidzo zvematambudziko.
• Kupa mazano ekudya zvine hutano uye kurovedza muviri.
• Kunyora mishonga uye kuchinja mwero wayo sezvinodiwa.

Munhu ane chirwere ichi anogona kurarama kwenguva yakareba sei?

Nekushandisa nzira dzepamusoro dzekuongorora nekurapa, vanhu vane Coarctation of the Aorta vanogona kurarama kusvika makore makumi matanhatu. Kare, avhareji yehupenyu hwevanhu vane chirwere ichi yaive makore angangoita makumi matatu nemashanu. Saka aya mashoko akanaka kwazvo.

Kana mwana wako aine Coarctation yeAorta, ungangove uchishamisika kuti sei zvakaitika. Hatigone kugara tichiziva chikonzero chaicho chechirwere chemwoyo chaakaberekwa nacho. Asi tinoziva kuti kuongororwa nekurapwa nekukurumidza kunogona kuderedza zvakanyanya kukanganisa kwechirwere ichi pahupenyu hwemwana.

Chikwata chevanachiremba chiripo nguva dzose kuti chibatsire mwana wako. Vakagadzirira kupindura chero mibvunzo yaungave nayo uye kukubatsira kunzwisisa kuti kuongororwa uku (CoA) kuchakanganisa sei mwana wako. Ungawanawo zvichibatsira kutaura nevamwe vabereki vane vana vane chirwere chemwoyo chakadai.

Zvinhu zvakakosha zvekurangarira (Mharidzo Yekuenda Kumba)

Ndinovimba kuti wava kunzwisisa mamiriro atave tichikurukura anonzi "Coarctation of the Aorta". Heano mamwe ematambudziko akakosha ekurangarira:

• Uku ndiko kukanganiswa kwemoyo kwakaberekwa nako ; kuvharika kwetsinga huru inotakura ropa kubva pamoyo kuenda kumuviri.
• Zviratidzo zvinogona kuonekwa panguva yehucheche kana kuti zvinogona kuzoitika gare gare. Kana ukaona hope dzakawandisa, kufema zvakaoma, kana kusada kuyamwisa mwana wako, tsvaga rubatsiro rwechiremba nekukasika.
• Kuongororwa kwechirwere ichi nekukurumidza uye kurapwa kwacho kunopa mwana mukana wakakura wekurarama hupenyu hwakanaka uye hwakajairika.
• Dambudziko iri rinogona kurapwa zvinobudirira nekuvhiyiwa uye mamwe marapirwo.
• Kutarisirwa kwechiremba kwehupenyu hwese kwakakosha kunyangwe mushure mekurapwa.

Musatya. Sainzi yezvekurapa yafambira mberi zvikuru nhasi. Kune vanachiremba vane hunyanzvi vanogona kupa kurapa kwakanakisisa kumwana wenyu. Chinhu chakakosha ndechekuti muzive izvi, teererai shanduko dzemwana wenyu, uye tsvagai mazano echiremba nenguva.

Kubatanidzwa kweAorta, Chirwere cheMwoyo, Vana, Chirwere cheMwoyo cheCongenital, Aortic Stenosis, Hutano hweVana, Kumanikidzwa kweRopa