Overview
Zvinodzvinyirira chirwere chepfungwa chinonyanya kushandiswa pane zvitatu zvakasiyana-siyana zvehupenyu, kana zvirwere zvepfungwa yemwoyo. Mamwe mapoka maviri aya anoderedza mwoyo , uye hypertrophic cardiomyopathy .
Zvinodzvinyirira chirwere chepfungwa chinokosha nokuti kazhinji chinowedzera kukanganisa kwemwoyo , uye zvichienderana nechinokonzera chinokonzera, kukanganisa kwemwoyo kunogona kuva kwakaoma kubata zvakanaka.
Nemhaka yokuti kurapwa kwechirwere ichi kunogona kuva chinonyengera, ani naani anoremekedza chirwere chepfungwa chinofanira kunge chiri pasi pekutarisirwa kwechirwere chemoyo.
Tsanangudzo
Mukugadzirisa kushaya mwoyo, pane chimwe chikonzero kana chimwe chimiro chemwoyo chinowedzera "kusagadzikana" kusina kunaka. Kunyange zvazvo moyo wakaomeswa musumbu uchiri kukwanisa kubvumirana nekusingaperi, uye saka unokwanisa kupompa ropa, haugone kunyatsorodzwa panguva ye diastolic chikamu chekurova kwemwoyo. (Diastole ndiyo "kuzadza" chikamu chemuviri wepfungwa-nguva iri pakati pemhepo inoputika, apo mhepo inobhururuka ichizadza neropa.) Kukundikana kwekuzorodza kunowedzera zvakaoma kuti mhepo inobhururuka izere zvakakwana neropa panguva ye diastole.
Kuregererwa kuzadza mwoyo (izvo zvinopa chiitiko ichi zita racho) kunoita kuti ropa "ritsigire" sezvo richiedza kupinda mumhepo, iyo inogona kuunza kusangana mumapapu uye mune dzimwe nhengo.
Imwe zita rekudzora kuzadza mwoyo mukati me diastole "diastolic kusagadzikana," uye rudzi rwekushaya simba kunobereka runonzi diastolic moyo kusagadzikana.
Chaizvoizvo, kudzivirira kwehutano hwepfungwa ndeimwe yezvikonzero zvakawanda zve diastolic mwoyo kusakundikana, kunyange zvisinganzwisisiki.
Zvinokonzera
Kune mamiriro akawanda maitiro angaita kuti vanhu vasagadzikane. Mune zvimwe zviitiko, hapana chikonzero chaicho chinogona kuzivikanwa, pane izvo zvipi zvinokonzerwa nehutachiona hwemoyo hunonzi "idiopathic." Zvisinei, idiopathic inogadzirisa chirwere chemoyo chinofanirwa kuongororwa chete kana zvimwe zvimwe zvinokonzera zvingave zvichitsvakwa, uye zvakarongwa kunze.
Izvi zvimwe zvinokonzera zvinosanganisira:
- Zvirwere zvinokonzera zvirwere zvakadai seamyloidosis , sarcoidosis , Hurler syndrome , chirwere cheGaucher uye mafuta akapindira.
- Matambudziko akawanda emhuri anowanikwa mazamu, zvakasanganisira pseuoxanthoma elasticum.
- Zvirwere zvekuchengetedza zvinosanganisira chirwere cheMustry, chirwere cheglycogen chirwere, uye hemochromatosis .
- Zvimwe zvinhu zvakasiyana-siyana zvinosanganisira scleroderma , hypereosinophilic syndrome , endomyocardial fibrosis, carcinoid syndrome , kenza metastatic, therapy rayation kana chemotherapy.
Izvozvo zvose zvinokonzera kukanganisa zvinowanzofanana ndezvokuti zvinogadzira imwe nzira inopesana nehutano hwekushanda kwemutsipa wemwoyo, zvakadai sekusava nemafuta ekuputika, kana kuti zvisizvo zvisiri izvo. Izvi zvinowanzosavhiringidza zvakanyanya nekudzikisa kwemitsipa yemwoyo, asi dzinoderedza kuoma kwemitsipa yemwoyo uye nokudaro zvinogadzirisa kuzadza kwevhirigirizi neropa.
Zviratidzo
Zviratidzo izvo vanhu vanowanzoona nekugadzikana kwechirwere chepfungwa zvinofanana nezviratidzo zvinowanikwa nemamwe marudzi ekushaya simba kwemwoyo . Zviratidzo zvinowanzokonzerwa nekukanganiswa kwemapapu, kusangana kwevamwe nhengo, uye kusakwanisa kuwedzera zvakakwana kuwanda kweropa pamapombi pamwoyo panguva yekuedza.
Izvi zvinoita kuti zviratidzo zvakanyanya kuve nekudzivirira kwechirwere chinonzi dyspnea (kupfupika kwemhepo), edema (kuputika kwetsoka uye makumbo), kushaya simba, kuneta, kuderedzwa zvakanyanya kuderera kwekuita muviri, uye palpitations . Nechiremera chakakomba chinokonzera moyo, kusangana kwezviviri zvemuviri kunogona kuitika, kubudisa chiropa chakawedzerwa uye spleen, uye ascites (mvura inowedzera mumakumbo emimba.)
Kuziva
Sezvo nemhando dzakawanda dzekushaya simba kwemoyo, kuongororwa kwekuregererwa kwechirwere chepfungwa kunotanga kutanga kune chiremba achive akangwarira kuti zvingave zvichiitika kuti chiitiko ichi chinogona kuvapo paanoita nhoroondo yezvokurapa uye kuongorora kwepanyama.
Vanhu vane chiremera chikuru chekushaya mwoyo kunogona kunge vane hama inonzi tachycardia (kukurumidza kwemoyo yemhepo) pakuzorora, uye kuparadzana kwemaketani mumutsipa. Izvi zviwanikwa zvenyama, pamwe chete nezviratidzo, zvinowanzove zvakafanana kune izvo zvinowanikwa nechinokonzera pericarditis . Kutaura zvazviri, kusiyanisa kusagadzikana kwechirwere chepfungwa kubva kumagadzirirwo emapirisiditis ndechimwe chinetso chinonzi cardiologists chinotarisana nepamabhodhi avo ekupikiridza. (Pamuedzo, mhinduro yacho ine chokuita neshoko reoteric rinonzwika nemamiriro maviri aya - "s3 gallop" nechinokonzera kushaya mwoyo cardiomyopathy vs. "pericardial knock" nechinokonzera pericarditis.)
Kuongororwa kwekuregererwa kwechirwere chepfungwa kunowanzosimbiswa kuburikidza nekuita echocardiography , iyo inoratidza diastolic kusagadzikana uye uchapupu hwekuregeredza kuzadza kwevhirikiri. Kana chikonzero chinokonzera chirwere chinokonzera chirwere chakadai seamyloidosis, kuongorora kwechikwata kunogonawo kuratidza uchapupu hwemajaya asina kukodzera mumhepo yemhepo. Cardiac MRI kupikisa kunogona kubatsirawo kuti kuongororwa, uye mune dzimwe nguva, kunogona kubatsira kuziva chimwe chinokonzera. Mwoyo wemisvo yemazino inogonawo kubatsira zvikuru mukuita kuti chirwere chacho chionekwe kana chirwere chinopinza kana chekuchengetedza chiripo.
Kurapa
Kana chinokonzera chikonzero chekudzivirira chirwere chepfungwa chinenge chichionekwa, kushungurudza nechisimba ichocho chinokonzera chikonzero chinogona kubatsira kuchinja kana kumisa kufambira mberi kwekuregererwa kwemwoyo. Zvinosuruvarisa, hakuna chirwere chinonyatsodzokorora zvakananga chekudzivirira chirwere chemoyo.
Kutarisira kugadziriswa kwechirwere chepfungwa kunotungamirirwa kurongedza mapapu kukanganisa uye edema kuitira kuti kuderedza zviratidzo. Izvi zvinoitwa kuburikidza nekushandisa mishonga yakafanana iyo inoshandiswa pamwoyo kusakonzerwa nekuda kwechirwere chemoyo .
Diuretics , yakadai seLasix (furosemide), anowanzopa rubatsiro rwakanyatsojeka mukurapa vanhu vane chiremera chekushaya mwoyo. Zvisinei, zvinobvira kuita vanhu vane chirwere ichi "chakanyanya kuoma" nehutachiona, zvichiwedzera kuderedza kuzadzwa kwevhirikiri panguva ye diastole. Saka kunyatsotarisa kwemuviri wavo kunokosha, kuyera uremu zvishoma zuva nezuva uye nguva nenguva kuongorora kuongororwa kweropa kuti utsvake uchapupu hwekusingaperi kwemvura. Izvo zvakakosha mibare ye diuretics inogona kuchinja munguva, saka kusvinurira uku ndeyekugara kwenguva refu.
Kushandiswa kwe calcium channel blockers kunogona kubatsira kuburikidza nekuvandudza zvakananga diastolic basa, uye nekudzikisa kutengesa kwemoyo kubvumira nguva yakawanda yekuzadza ivhu rinoputika pakati pemoyo. Nezvikonzero zvakafanana, beta-blockers inogonawo kubatsira.
Pane humwe humwe uchapupu hwekuti ACE inhibitors inogona kubatsira kune vamwe vanhu vane chiremera chekushaya mwoyo, zvichida nekuderedza mwoyo musimba kuoma.
Kana chirwere chinonzi atrial fibrillation chiripo, zvakakosha kudzora kutengesa kwemoyo kubvumira nguva yakakwana yekuzadza ivhu. Kushandiswa kwe calcium channel blockers uye beta blockers kunowanzoita izvi.
Kana kurapwa kwechiremba kusingagoni kudzora zviratidzo zvekudzivirira chirwere chepfungwa, kushanduka kwemwoyo kunogona kuva sarudzo inofanira kuonekwa.
Kutaura kwekuregererwa kwechirwere chemoyo kunowedzera kuipa pakati pevarume, kune vanhu vanopfuura makore makumi manomwe, uye kune vanhu vane chirwere chepfungwa chinokonzerwa nemamiriro ezvinhu ane chirwere chisina kunaka, chakadai seamyloidosis.
Summary
Chiremera chekushaya mwoyo chimiro chisingawanzwi chekushaya mwoyo. Munhu wose ane chirwere ichi anoda basa rekurapa rakazara-kutarisa zvinokonzera zvinokonzera, uye anodawo nekuchenjerera nekurapa kurapwa kwechiremba kuti kuderedza zviratidzo uye kugadzirisa migumisiro yenguva refu.
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