Cardiac tamponade ndiyo mamiriro ezvinhu anotyisa mune imwe iyo iyo inowanzoonekwa yepicardial effusion (kureva, kuunganidzwa kwechirwere chisingawanzogadziriswa muvharasi ye pericardial) kana kubuda mukati me sache pericardial, kunokanganisa kushanda kwemoyo. Cardiac tamponade inogona kuoneka zvakanaka kana inogona kukura zvishoma nezvishoma. Chero zvazvingaitika, zviratidzo zvinowanzonyanya kushamisa, uye kugadziriswa kwezviratidzo kunoda kubvisa nokukurumidza kushandiswa kwemvura yakanyanya kubva pa pericardial sac.
Ko Cardiac Tamponade Yakagadzirwa Sei?
Cardiac tamponade inowanikwa apo kuwedzerwa kwemukati mukati me pericardial sac, inokonzerwa nehuwandu hwemvura, inokwana kuvhara mwoyo mukati me diastole . Sezvo mwoyo usingakwanise kuzadza zvachose, ropa shoma rinodzingwa nemoyo umwe neumwe, uye mwoyo unoshanda zvakaoma zvikuru kupa zvido zvemuviri. Uyezve, ropa riri kuedza kupinda mumoyo rinotenderera zvakare, rinoita kusanganisa mumapapu nemaspini.
Nhamba ye pericardial fluid iyo inofanirwa kubudisa tamponade inotaridzika kusvika pamwero mukuru wekukurumidza kwechirwere ichi. Kana kuonekwa kwemvura kunowedzera nokukurumidza, iyo pericardium haina nguva yeku "kutambanudza," uye kuwedzera mukati me pericardial space kunogona kuwedzera zvikuru-kunyange nehuwandu hwemvura. Kune rumwe rutivi, kana chirwere chepicardial chinowedzera zvishoma nezvishoma (taura, kwemazuva emazuva kana masvondo), pericardium ine nguva yokutambanudza kuti igare pane imwe mvura inowedzera.
Muchiitiko ichi, kushungurudzika mukati mezvimbo ye pericardial hakukwanisi kuwedzera zvakanyanya kusvika iyo inonzi pericardial effusion yave yakakura kwazvo, kusvika pakatarisa iyo pericardium isingakwanise kutambanudza zvimwe.
Ndezvipi Zvinokonzerwa neCaracac Tamponade?
Cardiac tamponade inogona kukonzerwa nemhando ipi zvayo inobereka pericardial effusion.
Izvi zvinosanganisira:
- Pericarditis
- Dressler's syndrome
- Zvirwere (viral, bhakitiriya, kana fungal)
- Kurwisa zvirwere zvakadai se lupus
- Chifukidzo chechipfuva nemhaka yengozi kana kushungurudzika
- Cancer
- Radiation therapy kumapfupa
- Hypothyroidism
- Aortic dissection
- Zvinodhaka (zvikurukuru hydralazine, isoniazid, uye procainamide)
Ndezvipi zviratidzo zveCardiac Tamponade?
Chimiro uye kuoma kwezviratidzo zvinoenderana nokuti kana tamponade yakagadzirwa zvakanaka kana zvishoma nezvishoma. Nzira yakasimba inonyanya kubudiswa nechifukidzo chepfuva, chirwere chepfungwa kana zvimwe zvirwere zvepfungwa zvinoparadza, zvakadai sechirwere chemwoyo , kana neaortic dissection . Mumamiriro ose aya, ropa rinogona kuzadza sac pericardial munyaya yemaminitsi kana maminitsi, ichikurumidza kukurumidza uye yakaoma mwoyo. Nemhaka yekuti mvura yakanyanya kudarika (kureva, ropa) muvharasi ye pericardial inowedzera nokukurumidza mumamiriro ezvinhu aya, kuputika kunogona kukura kunyange nechinguva chiduku chepicardial fluid. Zviratidzo zviri kukurumidza uye zvakanyanya. Kuchipa kwepfupa, kupera kwakanyanya kwemhepo, uye tachycardia uye palpitations zvakajairika. Kunyanya kuderedzwa kweropa kunogona kuitika, pamwe chete nekwakaputika kweganda, bluish skin discoloration, uye kuderedzwa kwomuviri.
Chirwere chakasimba ndechekukurumidzira kwechiremba, uye kufa nokukurumidza kunogona kunge kusingarapwa nekukurumidza.
Cardiac tamponade iyo inoguma nemamiriro ezvinhu kunze kwekutambudzika, kurapwa, kana kuti aortic dissection inotanga kukura zvishoma nezvishoma zvishoma nezvishoma, kazhinji kupfuura mazuva kana vhiki. Izvo zvinodzvinyirira zvinoshandiswa muzviitiko zve "sub-acute" zvinowanzove zvakakura kudarika mumatambudziko akakomba kubva pa pericardium kazhinji kacho ine nguva yekutambanudza kuti igare yakanyanya kuwedzerwa mvura yakawanda. Zviratidzo zvisingashamisi. Varwere vane tamponade yakaoma inowanzova nekuzara kwechifuva kana kusagadzikana, nyore kuneta-kukwanisa, kuperevedza kwepfufu nemabasa mashoma, uye edema mumakumbo netsoka. Asi apo zviratidzo zvinogona kuwedzera zvisingashamisi kudarika nekugadziriswa kwepachipfuva, ivo vanogona kuguma vakaoma zvikuru.
Izvi zvishoma nezvishoma zvishoma nezvishoma zvinokonzerwa nemoyo zvinogonawo kuurayisa, uye kurapa kwakakurumidza kuchiri kudiwa.
Ko Cardiac Tamponade Inozivikanwa Sei?
Chiremba achawanzofungira kuti mwoyo unopikisa nekuteerera zviratidzo zvevarwere, nechechipatara mamiriro ezvinhu (zvakadai sekuvapo kwekufungidzirwa kwechimwe chezvoutano zvinokonzerwa kukonzera tamponade), uye nekuongorora kwepanyama. Zvimwe zvinyorwa zvinogona kuwanikwa nebhokisi x-ray uye electrocardiogram . Kana chiitiko ichi chikafungidzirwa, chirwere ichi chinogona kugadziriswa zvakananga ne echocardiogram .
Ko Cardiac Tamponade Inoitwa Sei?
Kurapa kwechigunha chemwoyo ndiko kubvisa zvakanyanyisa pericardial fluid kubva pa pericardial sac. Kubviswa kwemvura kunobvisa kukonzera mukati me pericardial sac uye kunobvumira mwoyo kudzoka zvakare.
Kubviswa kwe pericardial fluid inowanzoitwa nenzira ye pericardiocentesis -kureva, kubudisa mvura inoyerera kuburikidza nekanyoro inogadziriswa inowanikwa munzvimbo ye pericardial. Zvimwe, kushandiswa kwemvura kunogona kuitwa kuburikidza nekugadzira chirongwa chemvura. Kutsvaga mvura kunowanzoitwa kana, kunze kwekuchenesa mvura, biopsy ye pericardium inodiwa kuti zviongorore zvikonzero. Kana iyo pericardial effusion inodzoka mushure mokunge yanyura, a pericardiectomy (kubviswa kushandiswa kwe pericardium) inogona kuva yakakosha kuitira kudzivirirazve kudzokorora.
Chero bedzi iyo inowanikwa kuti yakakurumidza uye inotaurirwa nokukurumidzika, kukanganisa kwemwoyo kunogona nguva dzose kunogona kurapwa zvinobudirira, uye mugumisiro wenguva refu inowanzoenderana nehupenyu uye kuoma kwechikonzero chinokonzerwa neutano.
Sources:
Maisch B, Seferovic PM, Ristic AD, et al. Nhungamiro pamusoro pekuona nekugadzirisa kwePericardial Diseases Executive Summary; Basa Rinoona Kuongororwa uye Kutungamirirwa kwePericardial Diseases yeEuropean Society of Cardiology. Eur Moyo J 2004; 25: 587.
Spodick DH. Acute Cardiac Tamponade. N Engl J Med 2003; 349: 684.