Inguva riine dambudziko uye rini?
Overview
Tricuspid regurgitation-a "leaky" tricuspid valve-inonyanya kufanana nehutano hwepfungwa. Vanhu vazhinji vane tricuspid kudzokera vanoshamiswa zvikuru kuziva kuti vane vane mwoyo yevheti yepamwoyo nokuti vanonzwa zvakanaka. Vanachiremba vavo vanowanzoshamiswa sezvavari, uye vangasaziva kuti vangaitei.
Kana iwe uchiudzwa kuti unofunga kudzokerazve, zvinorevei?
Iwe iwe nechiremba wako unofanira kufunga nezvei dambudziko iri uye chii chaunofanira kuita chinotevera?
The Tricuspid Valve uye Tricuspid Kudzokorora
Ivha rinoputika rinoparadzanisa atrium yakarurama kubva kune chinyorwa chakanaka. Kufanana nemagetsi ese emwoyo, chinangwa chevricuspid valve ndechekuti kuve neropa rinoyerera kuburikidza nemwoyo panguva yakakodzera uye nenzira yakarurama. Saka, apo magwaro ekubvumirana zvakanaka, valve yakagadziriswa inomanikidzwa kusununguka, kurega ropa richiyerera mukati me ventricle yakarurama. Kupatsanurwa kwechipiri gare gare, apo chinonzi ventricle ichibvumirana nekudzivisa ropa rayo mumapurmita arteriyumu, vhivhavhavhavha inovhara kuchengetedza ropa kubva pakuyerera kumashure kuenda kune zvakakodzera atrium.
Nenguva isingadzokerizve, valve inonzi tricuspid inokundikana kuvhara zvachose. Izvi zvinobvumira kuti rimwe ropa riyerere kumashure-kureva, kudzokerazve-kupinda muchengeti chaiyo sezvibvumirano zvakanaka zve ventricle.
Njodzi
Nokuti chiremba kungotaurira kune mumwe munhu kuti vane ruzivo rwekudzoka zvakare hahubatsiri, nokuti kukosha kwechirwere ichi chevheji kunogona kusiyanana pakati peiyo uye yakaoma. Kana kuve nekugadzirisa kudzoka kunoonekwa, zvinokosha kuti uone kuti inokosha sei.
Zvimwe zvinyorwa zvekutsvaga zvinotaridzika zvinowanikwa mumapfumbamwe makumi manomwe evanhu vakuru vanogara vane echocardiograms .
Sezvakabvumirana zvakanaka, zvinotora nguva kana maviri kuti chivharo chechivharo chive chichivhara zvachose, uye panguva iyoyo tsanga shoma yeropa inodonha mumvura. Nesayenzi yezuva ranhasi, echocardiogram inowanzove yakanakira kuona kuti "chimiro" chechiropa-uye vanhu ava, avo vane magavheti avo chaiwo chaiwo, vanowanzoudzwa kuti vane tricuspid kudzokerazve, uye naizvozvo, chinetso chevheti yemwoyo. (Sezvakasiyana, chinhu chimwe chete chinoitika kune imwe nzvimbo ne mitral valve, zvichiita kuti vanhu vakawanda vasakanganise "vakaonekwa" ne mitral valve prolapse kana MVP .)
Saka mubvunzo wokutanga unobvunza kana iwe uchiudzwa kuti unofanirwa kudzokera zvakare: Unorema sei? Kana mhinduro yacho iine "unyoro kwazvo," zvichida iwe hauna chinhu chaunotya nazvo.
Kunyange zvakadaro, kana kusununguka kwekutengesa kunotongwa kuti kuenzanisa kana kwakanyanya, dambudziko remoyo rinonyanya kuvepo. Muchiitiko ichi, kuongorora kwepfungwa kunofanirwa kuitwe kuongorora chinokonzera uye chiyero chechirwere chekuita zvekare.
Zvinokonzera
Kukuvadza kwevhavhavha yepamusoro pachayo inogona kuita kuti tricuspid kudzokera zvakare. Mamiriro ezvinhu anogona kukanganisa tricuspid valve dzinosanganisira:
- Kutapukisa endocarditis
- Myocardial infarction inobata ventricle yakarurama
- Myxomatous degeneration of the valve (yakafanana neMVP)
- Kukuvadza kubva pacemaker kana kushandiswa kunogadziriswa
- Marfan syndrome
- Carcinoid syndrome
- Congenital chirwere chemoyo
Zvisinei, chinonyanya kukonzera chikonzero chekugadzirisa zvekare, kure, i "kushandiswa" kwekuvhiringidza kwevhidhiyo inonzi tricuspid valve. Nekushanda kwakanaka kwekugadzirisa zvekare, irovhavha iro pachayo rinowanzoitika. Izvo zvinoputika nepamusoro pevhavha inoitika nokuti chirwere chemwoyo chemarudzi akasiyana chinokanganisa mwoyo-somuenzaniso, apo inoramu yakarurama kana ventricle yakarurama inoputika nenzira iyo inodzivirira vagus valve kubva pakuvhara zvachose.
Zvinetso zvemwoyo izvo zvinowanzokonzera kushanda zvakanaka zvinyorwa zvakare zvinosanganisira:
- Puromonta arteri hypertension
- Heart failure
- Mitral stenosis kana mitral regurgitation
- Pulmonary embolism
- Hyperthyroidism
Vanhu vazhinji vane ruzivo rwakakura rwekudzoka zvakare vachava nehumwe hwezvinetso izvi zvinounza hutano hwakanaka hwekugadzirisa zvakare, uye kuongororwa kwakazara kuchadiwa kuti uzive chinetso chechikonzero.
Zviratidzo
Ruzhinji rwevanhu vane tricuspid kudzoka havana zviratidzo zvinogona kuonekwa kune chirwere chevhavha. Chero zviratidzo, kana zviripo, zvinowanzokonzerwa nemamiriro ezvinhu ari kuunza dambudziko rinoshanda revhavha.
Kunyange zvakadaro, kana kubhururuka kunenge kwakanyanya, kunogona kubudisa zviratidzo zvakananga. Izvi zvinogona kusanganisira manzwiro ekudururira zvisingawanzoregi mumutsipa, kana kurwadziwa kwepamuviri uye kuzvimba. Asi kunyange nechisimba chekudzokazve, zviratidzo zvinowanzokonzerwa nehutano hwemwoyo.
Kuziva
Mibvunzo miviri mikuru mushure mokunge tricuspid kudzokera zvakare inoratidzwa kuti inofanira kuva:
- Chii chinokonzera chikonzero?
- Zvakanyanya sei?
Mibvunzo iyi mibvunzo inokosha pakusarudza kuti-uye kunyange-yekurapa dambudziko revhavha.
Muzviitiko zvizhinji, mibvunzo miviri iyi inopindurwa zvakajeka apo chiremba anoita nhoroondo yezvokurapa uye kunyatsoongorora, uye anogamuchira echocardiogram yakakwirira. Panguva iyoyo, chirongwa chekugadzirisa chinogona kugadzirwa.
Management
Nhanho inonyanya kukosha mukugadzirisa tricuspid kudzokera zvakare kuziva uye kugadzirisa chinokonzera chinokonzera. Izvi zvinonyanya kukosha nekushanda kwemaitiro ekugadzirisa, apo inonzi tricuspid valve pachayo inowanzoitika.
Kushanda kwakanaka kunokonzerwa nekudzokorora kunowanzokonzerwa nepermonary arteri hypertension. Kuchengetedza pulmonary hypertension kunogona kuvandudza zvakanyanya kugadziriswa kwechirwere. Saka, zvinokonzerwa zvakare nezvinokonzerwa nehutachiona hwehutachiona-kunyanya kukanganisa kwemwoyo, chirwere chemitral valve, kana chironga chemapummoni-chinofanira kushungurudzwa zvakanyanya.
Kana hutachiona hwekudzorera husiri kushanda-kureva, hunokonzerwa nechinetso chemukati neine tricuspid valve pachayo-kutungamira kunowanzoenderana nekuoma kwekudzoka uye chero zviratidzo zvinosanganiswa.
Vanhu vane zvinyoro zvinyoro zvinyorwa zvekare zvisinganetsi mamwe matambudziko emwoyo zvinowanzotarisa mavheti anowanzoita, uye, kunze kwekuongororwa kwekuongorora nguva nenguva, kusina "kutungamira" zvachose.
Kunyange kana mukati mokunge uchinge uchinge uchinge uchinge uchinge uine huwandu kana hutsinye, chero bedzi pasina mazviratidzo uye echocardiogram inoratidzira hupenyu hwemamiriro ehupenyu uye hukama hwemwoyo hunogara huripo, hapanofanira kuve nekugadziriswa kunoiswa pamabasa epanyama. Iyo chete "kutungamira" kwechokwadi ndeyekuongororazve nguva nenguva nemunhu anonzi cardiologist.
Kurapa
Pane mamiriro mashomanana umo chirwere chekuvhara ropa chinofanirwa kuonekwa kune vanhu vane tricuspid regurgitation.
Kuvhima kunofanirwa kuve sarudzo kana iyo yakagadziriswa ichidzoka inofanirwa ichiita zviratidzo zvikuru.
Kuvhiyiwa kwevhidhiyo kunobatsirawo kune vanhu vane chirwere chakasimba chekudzoka zvakare uye vari kuvhiyiwa kugadzirisa kana kutora mutal valve ane chirwere. Mumamiriro ezvinhu aya magetsi ese anotarisirwa panguva imwe chete. Izvi, nechokure, ndicho chikonzero chinowanzoitika pakuita chirwere chechirve chechirve.
Kazhinji kana kuvhiyiwa kuchidikanwa, pose pazvinenge zvichigadziriswa kugadzirwa kwetricuspid valve inoshandiswa pamusoro pekugadzirisa magetsi.
Summary
Kana iwe uchiudzwa kuti une chirongwa chekudzoka zvakare, chinokosha ndechokuti chiremba wako aone chinokonzera chinokonzera uye kuoma kwematambudziko. Nenzira inofadza, izvi hazviwanzo kuoma kana nguva yekudya.
Ruzhinji rwevanhu rune ruzivo rwekuti tricuspid kudzokera ruchaita kuti ive nechimiro chinyoro chechirwere, kana kuti kwete dambudziko rechokwadi zvachose. Pakati peavo vane tsvina yekudzoka inova yenyaya inokosha, vazhinji vachave nechinetso chevhavhavha chinokonzerwa nemumwe chirwere chemwoyo-uye kurapa kwavo kunoda kuti utsinye kuronga dambudziko iri. Kuvhiya kwechigadziro chekugadziriswa hakuwanzodikanwa.
> Sources:
> Kara I, Koksal C, Erkin A, et al. Migumisiro Yezvinyoro Kusvika Pakati Pakati Kushanda Zvakanaka Kudzokazve Muvarwere Vanosangana neMitral Valve Mashandiro: Meta-Kuongororwa kwevarwere 2 488. Ann Thorac Surg 2015; 100: 2398.
> Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA / ACC Nhungamiro yekutungamira kwevarwere neValvular Heart Disease: Nyaya yeAmerican College of Cardiology / American Heart Association Task Force pamusoro pekuita mazano. J Am Coll Cardiol 2014; 63: e57.