Muna 2007 Chicago Marathon, mumhanyi akarwa ndokufa, achiita misoro yenyika. Mushure mokuita chikwata chekutsvaga, chiremba wezvechirongwa cheChicago akazivisa kuti rufu rwomunhu uyu rwakaerekana rwakasimbiswa haruna kukonzerwa nekupisa kunopisa uye hunyoro hwakakonzera matambudziko makuru pakati pevatambi vakawanda zuva iroro (uye izvo zvakaguma zvakaita kuti varongiridzi vamise mhangemutange), asi pane kuti " mitral valve prolapse " (MVP).
Uyu mutongo pasina mubvunzo wakaunza ruzivo rwakanyanya kuvakuru vemunharaunda avo vane mhosva yekuenderera mberi nemakwikwi pasinei nemamiriro okunze anotyisa, uye ndiani (nokuda kwechirevo chechipiri) zvakange zviri zvepamutemo kune hook pamusoro pekufa kwemurume uyu.
Zviri pachena, isu hatigoni nzira yekuziva chikonzero chaicho chekufa kwemhanyi uyu. Zvisinei, mutauriri weChicago weMuongorori wezvokurapa ane chivimbo akaumbwa zvishoma nehuwandu hwekutya pakati pemamiriyoni makumi manomwe evaAmerica avo (nezvimwe zvinofungidzira) vangave vane MVP. Uye kwemavhiki mashomanana, ma cardiologist eAmerica akazara nemafuta nekutya foni.
Mitral Valve Prolapse uye Nokukurumidza Rufu
Saka, mubvunzo unobvunza uchibvunza: Ko MVP inokonzera kufa kamwe kamwe here?
Mhinduro ndeyokuti pane zvinoonekwa sekuwedzera zvishoma muhutano hwekufa kamwe-kamwe kubva kune ventricular tachycardia kana ventricular fibrillation kune vanhu vane MVP inokosha zvikuru asi kwete muchizhinji chevanhu vakagamuchira kurapwa kweMVP.
Nyaya dzakawanda dzinoratidzwa neMVP dzine hunyoro hwakanyanya hwemamiriro ezvinhu, iyo haina kutakura ngozi inogona kuoneka.
Chimwe chekutanga chinoratidza kuti MVP inogona kubatanidzwa nekufa kamwe-kamwe kwakauya kunyanya kubva ku autopsy series. Mukutsvakurudza umo mwoyo wakanyatsoongororwa mukati mevanhu vakafa kamwe kamwe, uchapupu hweMVP hunogona kuwanika mune zvishomanana.
Saka zvakasununguka, MVP yave ichifungidzirwa kuti ndiyo inokonzera kufa kwechimbichimbi.
Asi zvinhu zviviri hazvirevi kutaurwa mune zvidzidzo izvi. Chokutanga, vazhinji vanoerekana vafa vakafa havatombozivikanwe nemoyo. Chechipiri, kana iwe wakatsunga kuwana MVP, uchakwanisa kuwana humwe uchapupu huri mune huwandu hwevanhu vakawanda.
Pane humwe humwe uchapupu hunoratidza kuti huwandu hwevanhu vakaona kuti vane MVP vane chero ngozi inowedzera yakawanda yekufa kamwe kamwe.
The Overdiagnosis of MVP
Paunenge uchiita echocardiography mune vanhu vakasarudzwa vakasarudzwa, zvichienderana nehutano hunoshandiswa hunoshandiswa, MVP inogona kuonekwa mune 20% - 35%. Chiyero chechokwadi chinowedzera muhuwandu hwema mitral valves is physiologically inokosha uye haisi mungozi inozivikanwa. Zvechokwadi, sezvo hutachiona hwehutachiona hwakagadziridzwa pamusoro pemakore aya, zvave zvichikwanisika kuona kuti zviduku zvishoma (kazhinji zvisinganyanyi uye kunyange zvisipo) zviyero zvekupera kwemaster valve. Nyanzvi dzakawanda dzinogamuchira chokwadi chokuti mamiriro ezvinhu "MVP" ave akawandisa kupfuura-akaongororwa ne cardiologists.
Kukwanisa kuona humwe huwandu hweMVP kana ukatsvaga zvakaoma zvakakwana kunogona kuva yakanakisisa kune vanachiremba (kana nokuda kweiyo nyaya, kune vehutungamiri vehutungamiri), nokuti inogona kuvasunungura kuti vatarise zvimwe zvekutsanangura zviratidzo kana mamiriro zvakaoma kana zvisinganzwisisiki kuongorora kana kutarisira ( dysautonomia ichive yakakurumbira kune iyi).
Nokudaro, pane kazhinji kacho chinokurudzira zvakasimba kunyanya kufungidzira MVP.
Kuongorora MVP Zvakakodzera
Muna 2008, achiziva kuti kuongororwa kweMVP kwave kuchikura zvisina kufanira kuhuwandu hwemhirizhonga, American College of Cardiology neAmerican Heart Association yakabudisa zvinetso zvakasimba zvekuongorora MVP. Uchishandisa zvirevo izvi zvakakodzera kuti uongororwe, kune uchapupu hwehumwe huwandu hunowedzera hutachiona hwemwoyo uye kufa kamwe kamwe, kunyange zvazvo kuwedzerwa kwehuwandu kuchiri kuduku.
Kutaura zvazviri, dambudziko guru revanhu ava harisi kufa kamwe kamwe, asi kukurudzirwa kwemashure ekudzokorora uye kukanganisa kwemwoyo .
Muvanhu ava njodzi yekufa kamwe-kamwe inokwidziridzwa-asi kune imwechete iyo iyo inova yakakwirira kune ani zvake anenge ane mitral regurgitation yakaoma, kubva pane chero chikonzero.
Kuwanda kwechirudzi urwu rweMVP (kureva, chaiyo, inokosha MVP) muhuwandu hwevanhu inenge iine 1-2% uye kwete 35%. Uye kunyange pakati pezvikamu zviduku zvakakura zvevarwere vane MVP, vashoma kupfuura 1 mu20 vachazombova nehukuru hwematral valve.
Shoko Rinobva
Chinonyanya kukosha ndechekuti hazvisi pachena kuti MVP-zvishoma, maitiro akaita unyoro hweMVP iyo huwandu hwevanhu vakaona kuti vane chirwere ichi-hunosanganiswa nekufa kamwe-kamwe, kusava nechikonzero chekufa kamwe kamwe.
Nokuda kwechizhinji chevarwere vakamboudzwa kuti vane MVP, njodzi yekufa kamwe kamwe haisi yepamusoro kune vanhu vazhinji, uye njodzi dzakafanana neyekuChicago hazvifaniri kuvanganisa kushushikana zvisina kukodzera.
Kana iwe wakamboudzwa kuti une MVP, unofanira kuwana kubva kune chikwata chako chemapurisa kana hutachiona hwaive huchishandiswa uchishandisa hutsva, humwe hutano hwakanyanya hwekuongorora, kana kuti kuongororwa kwakaitwa nenzira yekare, kwaunogona kuwana MVP kunenge chero ani zvake kana iwe uchizvitsvaga zvakaoma zvakakwana.
> Sources:
> Bonow RO, Carabello BA, Chatterjee K, et al. 2008 Inotarisa Kuvandudzwa Kunopindirwa MuAka / Aha 2006 Nhungamiro Yekutungamira Kwevarwere NeValvular Heart Disease: Nyaya YaAmerican College yeCardiology / American Heart Association Basa reMakoronike Emitungamiri Yedzidzo (Komiti Yokunyora Kudzokorora Nhungamiro Yekutungamira kwa2008 Varwere Vane Valvular Heart Disease): vanobvumirwa neSosaiti yeCrodiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, uye Society of Thoracic Surgeons. Circulation 2008; 118: e523.
> Sriram CS, Syed FF, Ferguson ME, et al. Malignant Bileaflet Mitral Valve Prolapse Syndrome Muvarwere Pasina kudaro Idiopathic kunze kwechipatara Cardiac Inosungwa. J Am Coll Cardiol 2013; 62: 222.