Kwiminyaka yakutshanje, abaninzi abantu abanama-echocardiograms bayamangalisa ngolwazi lokuba banesifo sengqondo sokuzalwa esibizwa ngokuthi "i-patent foramen ovale," okanye i-PFO.
Iingcebiso ezi balufumanayo emva kokunikezelwa kwezi zifo ziyahlukahluka. Abanye oogqirha baya kufuna ukuwaphatha nge- warfarin okanye i-aspirin ukuzama ukukhusela ama-blood clots.
Abanye baya kuncomeka ngenkqubo yenhliziyo engavumelekanga ukufaka ifowuni ekhethekileyo ukuvala iPOO. Sekunjalo, abanye oogqirha baya kubaxelela ukuba i-PFO ayinanto ebalulekileyo kwaye akukho nonyango efunekayo.
Eli nqaku lisishwankathela into eyaziwayo nge-PFO kunye nokuzama ukubeka ingxabano ekhoyo ngokuphathelele unyango lwayo.
Yintoni i-PFO?
Kwi-developing fetus, i-olamle ye-foramen yindawo evulekileyo ekhoyo kwi-septum yeerriy (isakhiwo esincinci esahlukanisa i-atrium efanelekileyo ukusuka kwi-atrium ekhohlo), evumela igazi ukuba liphume ngokukhululeka ukusuka kwi-atrium elungileyo ngqo kwi-atrium ekhohlo. Ukukhupha kwegazi ukusuka kwi-atrium efanelekileyo ukuya kwi-atrium ekhohlo kuyimfuneko ngexesha lokukhula komntwana, njengoko kuvumela igazi elijikelezayo ukuba lidlulele iipomphu ezikhulayo. (I-fetus ifumana igazi layo lomoya-mpilo kumama wayo, nge-placenta.)
Ekuzalweni, xa umntwana eqala ukuphefumula, uxinzelelo kwi-atrium ekhohlo landa ngokukhawuleza kwaye uxinzelelo kwi-atrium elungileyo linciphisa.
Lo mgca woxinzelelo udala i-flap of tissue ukuzibophelela phezu kwe-olamle ye-foramen, ngokuyivala ngokufanelekileyo. Kule ngongoma, igazi alikwazi ukugeleza ngaphaya kwe-foramen ovale, ukusuka ngakwesokudla ukuya kwi-atrium ekhohlo.
Kwinkoliso yabantu, le ngqungquthela yezicubu zokuvala i-foramen ovale ivalwe, ngoko i-foramen ovale ayikho.
Nangona kunjalo, malunga neyodwa kwabadala abane abaqhelekileyo (ama-25 ekhulwini), i-flap ye-tissue ayifakwanga ngokupheleleyo kwaye ixhomekeke kwingcinezelo ephezulu kwi-atrium yekhohlo ukuze kugcinwe i-oamle ye-foramen. Xa uxinzelelo kwi-atrium elungileyo luba lukhulu kakhulu phakathi kwe-atrium ekhohlo (njengokuba kunokuthi kwenzeke, umzekelo, xa ukhwehlela), ngezikhathi ezimfutshane i-foramen ovale iyakwazi ukuvula, kwaye, ngokukhawuleza, igazi liya kuphinda liphume ukusuka kwi-right torium kwi-atrium ekhohlo. Aba bantu bathi banelungelo lobunikazi be-oam. Ukujonga ngokukhawuleza isakhiwo senhliziyo kunye nendlela esebenza ngayo kunokubonelela ngokucacileyo le ndlela.
I-PFO ichongwa njani?
Oogqirha baxilonga i-PFOs nge-echocardiography. Azikho zonke i-PFOs ezifanayo, kwaye ezinye zilukhuni ngakumbi ukuzibona kunezinye. Kwiimeko ezimbalwa, i-PFO ibonakala ngokucacileyo kwaye iya kuqaphela phantse nayiphi na i-echocardiographer. Ngokuqhelekileyo, ukulungiswa okukhethekileyo kuyimfuneko ukufumanisa i-PFO, kubandakanywa i-echocardiography , i-injection -inophageal echocardiography , injecting material in the bloodstream (" bubble study "), kunye nokufaka uxinzelelo olungileyo kwi-airway ngokusebenzisa izixhobo eziphefumlelweyo. Okubaluleke kakhulu ukuba i-echocardiographer isebenze ukufumanisa i-PFO, mhlawumbi iyakubona enye.
Kwamanye abantu, i-flap of tissue ehlanganisa i-foramen ovale inokuvelisa ibhaluni-njenge-bulge, ebizwa ngokuba yi-annal aneurysm ye-annal (ASA.) Kwiimeko ezininzi i-ASA ihambelana ne-PFO, ngoko ke le mibandela mibili ixhomekeke omnye nomnye. I-ASA kunye ne-PFO zifana noko, kwaye mhlawumbi akunakulungile ukucinga nge-ASA njengokwenyuka kakhulu (kunye mhlawumbi mhlawumbi kakhulu) ye-PFO.
Yintoni ebalulekileyo ye-PFO?
Ulwaphulo lwe-Cryptogenic. Isizathu sokuba oogqirha banenkxalabo malunga ne-PFOs kukuba, ngexesha lezo zihlandlo ezidlulileyo xa uxinzelelo lwe-intanethi luphezulu ngaphezu koxinzelelo lwe-aric left, igazi lingadlulela kwi-atrium efanelekileyo ukuya kwi-atrium yekhohlo.
Ukuba i- embolus (i-clot yegazi ehamba kwi-system ye-vascular) iyenzeka ekuhambeni kwi-atrium elungileyo kuloo mzuzu, nayo ingangena kwi-atrium ekhohlo. Ukusuka kwi-atrium engasekhohlo i-clot iyakudlula nge-ventricle engasekhohlo, kwaye ukusuka apho ungene kwinkqubo ye-arterial, kuyo nayiphi na inxalenye yomzimba. Ukuba i-clot iya kwintliziyo, ingabangela ukubetha . Ngaloo ndlela, inkxalabo ephezulu malunga ne-PFO kukuba inokukhokelela ekungciphekweni kwengozi.
Ngoku kukholelwa ukuba i-PFO ingenye yezizathu zokuthi "i- cryptogenic stroke " - oko kukuthi, isifo esiyinto esaziwayo emva kokuvavanywa ngokupheleleyo kwezokwelapha. Nangona kunjalo, ngenxa yokuba ukuxhaphaka kwe-PFOs kuphezulu, ngakumbi xa ubakhangelelana ngokukhawuleza, ukufumana i-PFO kuphela kumntu oye wabetha isithintelo kungekho nto ibonisa ukuba i-PFO yayijongene nesifo.
Ucwaningo lwangoku luye lwaphakamisa ukuba, kubantu abaneminyaka engaphantsi kweminyaka engama-60 abanesifo sokushaya i-cryptogenic, kunye nabani na i-PFO enkulu (okanye i-PFO enxulumene ne-ASA), ukuvala i-PFO kuye kwadibana nomngcipheko omncinci we-stroke . (Ii-PFOs zivaliwe kunye nokufakelwa okukhethekileyo okunokufakwa kwi-catheter.)
Nangona kunjalo, ukuvulwa kwe-PFO akuyiyo ingozi yokungena-mngcipheko, kwaye inzuzo ekwenzeni njalo ibonwe kuphela kwizigulane ezicokisekileyo. Oku kungenxa yokuba imivimbo eninzi ye-cryptogenic ayibangelwa yi-PFOs, nangona i-PFO ichongiwe. Ukuvalwa kwe-PFO kufuneka kuthathelwe ingqalelo kwiintsholongwane zomsindo kuphela emva kokuvavanywa ngokupheleleyo ngumbilini wegazi kunye neurologist.
Migraines. Ezinye izifundo zicebise ukuba i- migraine intloko ixhaphake kubantu abane PFOs. Kodwa ezinye iiphando zabantu zibonise akukho mbutho phakathi kwe-PFOs kunye ne-migraines. Ngoko ke umbutho phakathi kwe-migraines kunye ne-PFO iyayibuza. Ukongezelela, akukho mbono ye-physiologic ebonakalayo echongiwe malunga nendlela iPPO ingabangela ngayo imigraines.
Ukungabi nolu hlobo lweengcamango aluzange kuthintele oogqirha abathile ekucebiseni izixhobo zokuvalwa kwe-PFO kwi-migraine abanezifo. Abanye abenza le nkqubo baxelele ukuba abantu abane-migraine bafumana ukunciphisa iimpawu. Ngenxa yeli bango, ilingo elungelelaniswayo lihlelwe ukuba lihlolisise ukuba ukuvalwa kwe-PFO kusebenza. Olu phofu olulawulwa ngamanyala, olupapashwe ngo-2008, alubonanga nzuzo kuyo yonke ukuvalwa kwe-PFO.
Kule nkcazo akukho nto enesizathu sokukholelwa ukuba i-PFOs yimbangela ye-migraine ikhanda. Ukunikezelwa kwe-PFO kubantu abane-migraine kukuba bangayisebenzisi kakuhle into yokuba nabo bonke-baninzi banqwenela nantoni na into yokuba umntu uthi bangabancedisa. Uninzi lwabantu abane-migraines lunokuphumeza ukulawula okufanelekileyo iimpawu zabo ukuba bangafumana ugqirha onomdla kunye nomsebenzi kunye naye.
I-Platypnea-orthodeoxia syndrome. I-Platypnea-orthodeoxia syndrome yimeko engavumelekanga apho umntu engakwazi ukuphefumula kwaye ahlupheke kwiqondo eliphantsi le-oksijeni yegazi ngelixa efanelekileyo. Le meko ayifuni kuphela i-PFO, kodwa nayo enye imeko yesifo esenza ukuba i-PFO ivule xa umntu ephakame. Ngokuqhelekileyo, le "enye imeko" yinto engavumelekanga yokwakheka kwintliziyo ekhuthaza ukuphuma kwegazi ukusuka kwi-atrium ekunene kwi-atrium ekhohlo. Ukuvala i-PFO ngokuqhelekileyo yinye yezinyathelo ezifunekayo ukuphatha le ntsho.
ILizwi
I-patent foramen ovale yi-"diagnostic" ye-medical diagnostic, eyenziwa kuphela kwiminyaka embalwa edlulileyo kunye nokufika kwe-echocardiography. Nangona i-PFO kucingelwa ukuba yinto ebangela ukuba i-cryptogenic stroke, ininzi yabantu abaninzi bafunyaniswa ukuba babe ne-PFO, akukho ziphumo zezokwelapha eziza kubakho.
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