Mumakore achangobva kupfuura, vanhu vazhinji vane echocardiograms vari kushamiswa nemashoko avo vane hutano hwepfungwa hunoti "patent foramen ovale," kana PFO.
Mazano aya vanhu ava vanowana mushure mekunge vapiwa izvi zvinoratidzika zvichasiyana zvakasiyana. Vamwe vanachiremba vanoda kuvanetsa ne warfarin kana aspirin kuedza kudzivirira ropa.
Vamwe vachakurudzira nzira inopisa yemwoyo yekuisa chigadzirwa chakakosha chokuvhara PFO. Kunyange zvakadaro, vamwe vanachiremba vachavataurira kuti PFO haina zvazvinokosha zvachose uye kuti hapana kurapwa kunodiwa.
Ichi chinyorwa chinopfupisa izvo zvinozivikanwa nezve PFO uye kuedza kuisa mhirizhonga yezvino maererano nehutano hwayo pakuona.
Chii chinonzi PFO?
Mumumucheche anenge achikura, iyo foramen ovale inguva yekuzarura inowanzovapo mune yeatrial septum (chimiro chakaonda chinoparadzanisa atrium yakarurama kubva kuruboshwe kuruboshwe), iyo inobvumira kuti ropa riyerere zvakasununguka kubva kune imwe nzvimbo yakarurama kusvika kuruboshwe kuruboshwe. Kuyerera kweropa kubva paatrium chaiyo kusvika kuruboshwe rwekurima kunokosha panguva yekukura kwekuberekwa, sezvo inobvumira ropa rinopararira kuti ripfuurire mapapu ari kusimuka. (A fetus inogamuchira ropa rayo oxygenated kubva kuna amai varo, kuburikidza neparcenta.)
Paanenge aberekwa, apo mwana anotanga kufema, kukamanikidzwa kwerutivi rworuboshwe kunowedzera nokukurumidza mukumanikidzwa kwakarurama kunoderera.
Izvi zvinokonzera kukanganisa kunokonzera chidimbu chemuviri kuti chizviise pamusoro peiyo yeenamen ovale, ichivhara zvakajeka. Panguva ino, ropa haichazokwanisi kutenderera kuforamen ovale, kubva kurudyi kusvika kuruboshwe pane.
Muvanhu vazhinji, ichi chidimbu chemiviri inopfigira yeo foramen ovale inoiswa chisimbiso, saka inamen ovale inobudirira haisisipo.
Zvisinei, mune imwechete yevana vakuru vakakura (25 kubva muzana), mavara acho haasati akaiswa chisimbiso zvachose uye anovimba nepamusoro pemhepo iri kuruboshwe kuruboshwe kuti uchengetedze oamen ovale yakavharwa. Kana kukanganiswa kwemukati kwekwenyuka kuchikwira zvakadzama kupfuura kune kuruboshwe kuruboshwe (sezvinogona kuitika, somuenzaniso, kana kukwezva), nokuda kwechidimbu chipfupi iyo foramen ovale inogona kuzaruka, uye, kwenguva pfupi, ropa rinogona zvakare kutenderera richibva kune right right atrium kusvika kuruboshwe rwenyamu. Vanhu ava vanonzi vane patent foramen ovale. Kunyatsoongorora chimiro chemoyo uye kuti chinoshanda sei kunopa kunzwisisa kwakanakisisa kweiyo nzira.
PFO Inowanikwa Sei?
Vanachiremba vanonzvera PFOs ne echocardiography. Haasi ose PFOs akafanana, uye mamwe akaoma zvikuru kuona kune vamwe. Muzviitiko zvishomanana, PFO haina kunyatsojeka uye inogona kuonekwa nechose chero echocardiographer. Kakawanda, kushambadzira kwakakosha kunofanirwa kuziva kuti PFO, kusanganisira kutengesa maitiro ekutsvaga , kuisa zvinhu zvakasiyana-siyana mukati meropa (" bubble study "), uye kunyange kushandisa kumira kwakanaka kune imwe nzira yekufema nenzira yekufema. Izvo zvakanyanyisa echocardiographer inoshanda kuti ione PFO, iyo inowanzoita kuti ione imwe.
Mune vamwe vanhu, chidimbu chemuviri chinosangana neforamen ovale chinogona kukura ibhaluni-yakafanana nebhuruu, iyo inonzi ianeral anealysm inouraya (ASA.) Muzviitiko zvakawanda ASA inofambidzana ne PFO, saka izvi zviri zviviri zvinowanzobatanidzwa pamwe chete. IAA ne PFO ndizvo zvakafanana, uye zvichida hazvina kukodzera kufunga nezveAAA sechinyanya kuwedzererwa (uye zvichida zvimwe zvakakosha) muenzaniso we PFO.
Chii Chinorehwa neFPO?
Cryptogenic stroke. Chikonzero chiremba vanonetseka pamusoro pe PFOs ndechokuti, panguva iyo nguva dzenguva dzenguva apo kukodzera kwepaguru kwepamusoro kwakakwirira kudarika kuruboshwe rwemhirizhonga, ropa rinogona kuyerera kubva paatrium kurudyi kusvika kuruboshwe rwemarerium.
Kana akabatanidzwa (ropa rinoputika rinopfurikidza nemavhututi) rinowanzove richifamba nenzira yakakodzera panguva iyoyo, iyo inogonawo kuisa kuruboshwe rwetrium. Kubva kuruboshwe kuruboshwe iyo inovhara inogona kuyambuka kuburikidza nechokumabvazuva, uye kubva ikoko inopinda urongwa hwehutano, kune chero chikamu chemuviri. Kana chivharo chacho chichienda kuuropi, chinogona kukonzera chirwere . Nokudaro, kunyanya kunetseka pamusoro pe PFO ndechokuti kunogona kutungamirira kune ngozi yakawanda yekurohwa.
Iko zvino yave ichitenda kuti PFO ndeimwe chikonzero che " cryptogenic stroke " - kureva, chirwere chisingazivikanwi chikonzero chisingazivikanwi mushure mekuongororwa kwakazara kwechiremba. Zvisinei, nokuti kupararira kwe PFOs kwakanyanya kwazvo, kunyanya kana iwe ukavatarisira zvakaoma zvakakwana, kungowana PFO mumunhu anenge aine chirwere chisina kuratidza kuti PFO ndiyo yakakonzera chirwere chacho.
Zvidzidzo zvenguva pfupi zvakaratidza kuti, kune vanhu vari pasi pemakore makumi matanhatu avo vane chirwere checryptogenic, uye vanewo PFO (kana PFO inobatanidza neAAA), kupfigira PFO yakabatanidzwa nehuwandu huripo hwekudzoka kwechirwere . (PFOs inogona kuvharwa nekumanikidzwa kwakakosha kunogona kuiswa ne catheter.)
Zvisinei, kugadziriswa kwePFO haisi mungozi isingabhadhari, uye kubatsirwa kubva pakuita izvi kwakaratidzwa chete nevarwere vakanyatsoongorora. Izvi ndezvokuti vazhinji vakachema maitiro havakonzerwi ne PFOs, kunyange apo PFO inoratidzwa. PFO yekuvhara inofanirwa kutaridzirwa muvakasara vasara chete mushure mekuongororwa kwakazara nea cardiologist uye neurologist.
Migraines. Dzimwe dzidzo dzakaratidza kuti migraine misoro yakanyanya kune vanhu vane PFOs. Asi dzimwe dzidzo dzevanhu dzisina kuratidza kushamwaridzana pakati pe PFOs uye migraines. Saka kunyange kushamwaridzana pakati pemigraines ne PFO inopokana. Uyezve, hapana chirevo chinonzi physiologic theory chakaonekwa sekuti PFO inogona sei kukonzera migraines.
Kushayikwa kwedzidziso yakadaro hakuna kudzivirira vamwe vanachiremba kubva kurumbidza maPOvha ekuvhara mafaira muvanosangana nemagraine. Vamwe vakagadzira nzira iyi vakataura kuti vanhu vane migraine vakawana kuderedza zviratidzo. Nemhaka yezvakataurwa izvi, kuedza kwakasarudzwa kwakarongeka kuongorora kana PFO yekuvhara yaive yakabudirira. Iyi yekudzidzisa kushorwa, yakabudiswa muna 2008, haina kuratidza kubatsirwa zvachose neFPO yekuvhara.
Panguva ino pane chikonzero chiduku chekutenda kuti PFOs inokonzera kusuruvara kwemusoro. Kupa PFO kugadziriswa nevarwere vane migraine ndekushandisa zvisina kunaka kuti ivo vose-uyewo-kazhinji vanoda chimwe chinhu icho munhu anoti vanogona kuvabatsira. Vanhu vazhinji vane migraines vanogona kugadzirisa kutarisira zviratidzo zvavo kana vakwanisa kuwana chiremba ane hanya uye vanoshanda pamwe naye.
Platypnea-orthodeoxia syndrome. Platypnea-orthodeoxia syndrome haisi inowanikwa mumunhu umo munhu anononoka kufema uye anotambura nechepasi yeopa oxygen levels apo ari panzvimbo yakarurama. Izvi hazvirevi kungova PFO chete, asiwo chimwe chimiro chepfungwa chinokonzera PFO kuzarura apo munhu akasimuka. Kazhinji, iyi "imwe mamiriro ezvinhu" ndeyezvimwe zvisingaoneki mumoyo zvinokurudzira ropa richiyerera kubva paatrium chaiyo kusvika kuruboshwe rwemanzi. Kuvhara PFO inowanzova imwe yenhanho dzinotarisirwa kubata chirwere ichi chisingawanzoitiki.
Shoko Rinobva
Patent foramen ovale i "mazuva ano" kurapwa kwehutano, yakapararira chete mumakumi mashoma emakore akapfuura nehuyo hwekuongorora kwechikoro. Kunyange zvazvo PFO inofungidzirwa kuti ndiyo inowanzokonzera chirwere che cryptogenic, muhuzhinji hwevanhu vanoonekwa kuti vane PFO, hapana zvinetso zvezvehutano zvingangodaro zvichibva kune iyo.
> Sources:
> Dowson A, Mullen MJ, Peatfield R, et al. Migraine Kupindirana ne Starflex Technology (Mist) Kuedza: Muchidimbu, Multicenter, Double-Blind, Sham-Controled Trial Kuongorora Kubudirira kwePentent Foramen Ovhale Kuvhara ne Starflex Septal Kugadzirisa Kugadzirisa Kugadzirisa Kuramba Migraine Headache. Circulation 2008; 117: 1397.
> Mas JL, Derumeaux G, Guillon B, et al. Patent Foramen Ovale Kuvhara kana Anticoagulation vs. Antiplatelets mushure meStroke. N Engl J Med 2017; 377: 1011.
> Saver JL, Carroll JD, Thaler DE, et al. Migumisiro Yenguva Yakareba yePentendiri Kufuridzirwa Kwekuvhara Chivharo kana Kurapa Utachiona mushure mekurohwa. N Engl J Med 2017; 377: 1022.
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