Izifo zeVilve Heart

Ingqwalasela yeSifo seVilve Heart

Injongo yeentsimbi ezine zentliziyo (i-tricuspid, pulmonary, mitral, ne-valor valves) ukuqinisekisa ukuba xa intliziyo ibetha, igazi lihamba ngokukhululeka ngendlela efanelekileyo. Ukuba enye okanye ngaphezulu kwevilveshi zentliziyo zibagula, mhlawumbi ukuphuma kwegazi ngaphandle kwentliziyo kuya kuphazamiseka (stenosis), okanye igazi lingahle livuke ngasemva ngapha kwelovayi ewonakalisiweyo (ukubuyiswa kwakhona) -bini bobabini. Naluphi na uhlobo lweengxaki, ukuba aluhloliswanga rhoqo kwaye luphathwe ngempumelelo, lunokubangela ukuhluleka kwentliziyo , kunye nezinye iingxaki zentliziyo.

Imiphumo yesifo se-valves esisekelwe entliziyweni incike kwiivili ezibandakanyekayo, nokuba ingxaki enkulu yi-stenosis okanye i-regurgity, kunye nomlinganiselo we-valvular. Ukuba une-valvular isifo senhliziyo, kufuneka usebenze ngokusondeleyo kunye ne-cardiologist yakho ukuqinisekisa ukuba imeko yesifo sakho se-valvular, kunye nemfuno yayo yokwelashwa, iphinda ihlaziywe rhoqo.

Iintsimbi ezine zeentliziyo kunye nezinto abazenzayo

> Jonga iine valve zenhliziyo.

Intliziyo inamagumbi amane-i-right and left inria, kunye ne-ventricle efanelekileyo nekhohlo. I-valve nganye ikhona kwindawo yokuvula phakathi kwamagumbi amabini kwaye iqhotyoshelwe ekuvulekeni ngendandatho ekhuni, ebizwa ngokuba yi-annulus. Ifakwe kwi-annulus iileta ezimbini okanye ezintathu (ngamanye amaxesha zibizwa ngokuba yi-cusps) ezisebenza njenge "flaps". zonke iiplavishini zinamaphepha amathathu.

Njengoko intliziyo ibetha, iiflethi zivulekile kwaye zivale. Xa amaqabunga evulekile, igazi lingadlulela kwi-valve. Xa iiflethi zivaliwe, ukuhamba kwegazi kwi-valve kuyama.

I-ventricle efanelekileyo ilondolozwa ngamagatya e- tricuspid and pulmonary valves . I-valve ye-tricuspid iphakathi kwe-atrium efanelekileyo kunye ne-ventricle efanelekileyo. Xa iikontraki ezifanelekileyo, i-valve i-tricuspid ivula kwaye ivumela igazi ukuba lingene kwi-ventricle efanelekileyo. Emva koko, xa i-ventricle yezivumelwano zivaliwe, i-valve i-tricuspid ivala (ukukhusela igazi ekubuyiseleni kwi-atrium elungileyo), kwaye i-valve yamapulmoni ivulela ukuvumela igazi liqhutywe yi-ventricle elungileyo ukuba liqhube kumbhobho we-pulmonary ukuya imiphunga.

I-ventricle ekhohlo iyalindwa yi- mitral valve kunye ne-valor valves . I-mitral valve, ephakathi kwe-atrium ekhohlo kunye ne-left ventricle, ivula xa iikontraki ze-atrium ezisekhohlo zivumela ukuphuma kwegazi kwi-ventricle ekhohlo. Xa i-ventricle ishiya, i-valve valve ivala kunye ne-valor e-aortic iyavula ukuhambisa igazi elipompiweyo kwi-aorta nakwii-tissue zomzimba.

Ziziphi iindidi zeengxaki ezinokuthi zithinte i-Heart Hearts?

Ukuphinda, iigraves zentliziyo zifezekisa izinto ezimbini ezibalulekileyo: Ziqinisekisa ukuba xa intliziyo ibetha, igazi lihamba ngentliziyo ngokukhululekile kwaye lihamba kuphela ngendlela efanelekileyo.

Ngoko kuyaqondakala ukuba ukuba iipilves zentliziyo zibagula, iintlobo ezimbini zeengxaki zibangelwa.

Okokuqala, iingxaki zentliziyo ye-valve zingenza ukuba i-valve ikhutshwe ngokukodwa, ukuze igazi lingaphumi ngokukhululeka kulo lonke. Le meko ibizwa ngokuba yi- valvular stenosis . Xa i-valve yenhliziyo iba yinto ye-stenotic, igumbi le-cardiac elimele litshintshe igazi kwi-valve elincinci kufuneka lisebenze nzima ngakumbi ukuxosha igazi. Oku kubangela ukuba uxinzelelo lwaloo gumbi lwandise, ekugqibeleni lenza ukuba imisipha yenhliziyo iqhube (ukuba ibe "yi-hypertrophic"), kwaye ekugqibeleni ingabangela ukuba i-muscle ingaphumeleli.

Okwesibini, isifo se-valve senhliziyo singenza i-valve ibe yinto engenakulungele; oko kukuthi, i-valve ihluleka ukuvala ngokupheleleyo kwaye igazi liyakwazi ukugeleza ngasemva kwi-valve xa kufuneka ivalwe. Le meko ibizwa ngokuba yi- valvular regurgation . Ukuphindaphinda kubangela ukuba i-ventricle echaphazelekayo iqhube umthamo omkhulu wegazi ngaphezu kwesigqirha, esinokukhokelela ekunciphiseni amagumbi ezinhliziyo, ukutyhafaza kwintliziyo yesisu, kwaye ekugqibeleni, ukuhluleka kwentliziyo.

Ngoko, zombini i-valvular stenosis kunye ne-valvular regurgity kunokukhokelela ekuphelelweni kwentliziyo. Ukongezelela, isifo se-valve senhliziyo sinxulumene kakhulu nomngcipheko wokwakheka kwe- cardiac arrhythmias , ngakumbi i-fibrillation ye -rial .

Naliphi na iinevini zomoya ezinokuba yi-stenotic okanye i-regurgitant, kwaye ezinye iigraves zentliziyo zigula zingabonisa zombini ezi ngxaki ngexesha elifanayo. Ukuqina kwesifo se-valve senhliziyo kuxhomekeke kwisixa se-stenosis okanye ukubuyiswa kwakhona okuveliswayo. Ngeentlobo ezininzi ze-valvular isifo senhliziyo, ubunzima beemeko-kunye nempembelelo yalo kwimisebenzi yentliziyo-unokunyuka kakhulu njengoko ixesha lihamba. Nesifo "intliziyo" yesifo se-valves kufuneka sithathwe ngokungathí sina kwaye silandelwe ngamaxesha ngamagqirha anekhono.

Ziziphi iimeko ezibangela izifo zentliziyo ye-Valve?

Isifo senhliziyo saseValvular sinokubangelwa kwiimeko ezahlukeneyo zonyango. Izizathu eziqhelekileyo zezifo zentliziyo ye-valves zibandakanya:

Izibonakaliso zezifo zentliziyo ye-Valve

Kwiimeko ezininzi, isifo se-valve senhliziyo asinakubonakalisa zonke iimpawu kuze kube yintliziyo yomzimba eyonakaliswe ngokwaneleyo ukuqala ukusilela. Xa kuvela iimpawu, zivame ukuba zifana neempawu zesifo senhliziyo . Ezi ziquka i- dyspnea (ukuphefumula okufutshane); buthathaka; u bunzima ; okanye i-edema (ukuvuvukala) emaqotsheni, iinyawo okanye isisu.

IArrhythmias inokubangelwa nesifo senhliziyo; njengoko kuphawulwe, umngcipheko we-fibrillation we-atrial ukwanda ngokukodwa. Iimpawu zeemeyimu zomzimba zingabandakanywa iziqulatho zezibilini , ukunyaniseka, ubuthathaka, okanye ukunyamezela ukunyamezela.

Kubantu abaninzi, iimpawu zentliziyo yesifo se-valvular zivame ukubonakaliswa kokukhawuleza kwesi sifo. Ngokufanelekileyo, umntu onesifo se-valve senhliziyo uya kufunyaniswa kakuhle phambi kokuba iimpawu ziphuhlise, ukwenzela ukuba unyango lubekwe phambi kokuba umonakalo we-muscle ungenakwenzeka.

Ngamanye amaxesha, nangona kunjalo, isifo se-valve senhliziyo sinokuba yingxaki enzima kwaye asiyiyo enye inkqubela. Ngokomzekelo, isifo senhliziyo se-valvular sinokuthi, ngenxa yesifo senhliziyo esisuka kwisifo senhliziyo, okanye kumonakalo omkhulu kwiimvenge zentliziyo ezivela kwi-endocarditis okanye i-rheumatic disease disease.

Kodwa ngokuphindaphindiweyo, isifo se-valve senhliziyo sisifo esingapheliyo, esiqhubekayo esingasifumana kakuhle phambi kokuba iimpawu ziphuhlise. Ukuxilongwa kwangaphambili, ngokuqinisekileyo, kukubalulekileyo.

Ukuchonga i-Valvular Heart Disease

Ukuxilongwa kwangaphambili kwesifo se-valve senhliziyo kubaluleke kakhulu ekulawuleni kwayo. Eyona ndlela, unyango luya kuqaliswa ngaphambi kokuba intliziyo iqala ukusilela kwaye umonakalo wentliziyo ungapheliyo. Kodwa ukwenzela ukwenza njalo, kubalulekile ukuba ukwazi ukuba isifo se-valve silapha kakuhle phambi kokuba kukho naziphi iimpawu eziye zaphuhliswa.

Izifo zentliziyo ye-valves yokuqala yinto enye yezo ngxaki zezokwelapha ezingaqhelekanga ezinokuthi zifunyanwe kusenjenjalo ngokuvandlakanywa kovavanyo lwezonyango-kwaye esinye sezizathu sonke sikhuthazwa ukuba sihlolwe rhoqo.

Inkcazo yokuqala yeengxaki zentliziyo ye-valve ngokuqhelekileyo ukufumanisa intliziyo igungquthela ngexesha lokuhlolwa komzimba. Ngaba i-valvular stenosis okanye i-valvular regurgitation ivelisa inani elithile lokuqhuma kwegazi ngaphakathi kwentliziyo. Le ngxabano idala isandi ukuba ugqirha unokuva nge stethoscope (intliziyo igungqungquthela). Akuyiyo yonke intliziyo yokukhononda kubonisa ingxaki yentliziyo, nangona kunjalo; abaninzi banokuthiwa "abangenacala" ukukhonona, oko kukuthi, babangelwa yintlanzi yintlanzi enokuthi ikhona phantse nayiphi na intliziyo eqhelekileyo.

Ukuba ugqirha wakho ufumanisa izandi ezingabonisa isifo senhliziyo, i- echocardiogram ibonakala kakuhle kakhulu phakathi kweengxaki zentliziyo kunye nekratshi. Nge-echocardiogram, ukuxilongwa ngokucacileyo kunokwenziwa malunga naluphi na uhlobo lweengxaki ze-valve yenhliziyo.

Ukuba isifo se-valvular silapha, i-echocardiogram ingakwazi ukulinganisa umlinganiselo wengxaki. Amanani athile athile angenziwa ngamaphetheni wegazi kunye nobukhulu begumbi lesifo senhliziyo, kwaye le milinganiselo ingafaniswa naleyo evela kwiimvavanyo ze-echo ezilandelayo ukwenzela ukuba ichane ukuba ingxaki ye-valve iyingozi kangakanani na ukuba ikhona.

Iingxaki zeNhliziyo zeVilve kunye neNyango yabo

I-Mitral Stenosis: Kwi- mitral stenosis , ukuvinjelwa kwe-valve ye-mitral kunciphisa ukuhamba kwegazi ukusuka kwi-atrium ekhohlo ukuya kwi-ventricle engasekhohlo. Ngexesha elide, uxinzelelo luyakha kwi-atrium ekhohlo, ekugqibeleni kubangela umthambo we-pulmonary umfutho wokunyuka kwengqondo kunye nokuhluleka kwentliziyo okubandakanya kakhulu kwicala lokunene lentliziyo. Unyango luyilungiselwano okanye ukutshintshwa kwe-valve mitral, kwaye ixesha lokuhlinzwa libalulekileyo. Xa isidingo sokuhlinzwa sisungulwe, uhlobo olufanelekileyo lwe-mitral stenosis lugqirha ludinga ukuba lubekelwe umntu ngamnye.

Ukubuyiswa kweMitral: Ukubuyiswa kwe-Mitral , okuvelisa ukuhamba kwegazi ukusuka kwi-ventricle engasekhohlo ukuya kwi-atrium engasekhohlo, uhlobo oluqhelekileyo lwesifo se-valve senhliziyo kuba unobangela obuninzi. Ngokomzekelo, ukubaluleka okubalulekileyo kwe- mitral valve prolapse (i-MVP) kukuba ngamanye amaxesha kunokuvelisa ukuphindaphinda okukhulu kwe-mitral. Ukubuyiswa kwe-Mitral kungabangela ukwandiswa kwingozi kwintsimbi ekhohlo kunye ne-left ventricle, kwaye ngaphandle kokuba iphathwa ngayo ingakhokelela ekuphelelweni kwentliziyo engapheliyo. Ixesha elifanelekileyo lokonyango lonyango lixhomekeke kwisigaba sokubuyiswa kwakhona . Izindlela ezininzi zokuhlinzwa zifumaneka ukuze uphathwe ngokuphindaphindiweyo.

I-Aortic Stenosis: Kwi- aortic stenosis , i-valor i-aortic iyanqandwa ngokukodwa, okwenza kube nzima ukuba i-ventricle yekhohlo ixoshe igazi kumathambo omzimba. Ikhokelela ekuxhaseni i-hypertrophy ye-muscle ye-ventricle engasekhohlo, kwaye ekugqibeleni yenze intliziyo ingaphumeleli. Ukongezelela, ukuba inani legazi intliziyo inokupompa liyancipha kakhulu ngenxa yokhuselo, i- syncope okanye nokufa ngokukhawuleza. Enyanisweni, i-syncope ngenxa ye-aortic stenosis ifanele iphathwe njengongxamiseko lwezonyango, kuba ibonisa ukuba i-valor i-aortic igxininise kakhulu. Njengoko naluphi na uhlobo lwesifo senhliziyo, i-aortic stenosis kufuneka ihlolwe ngokukhawuleza ngexesha elide. Ukuba imeko iya kuba yanele ngokwaneleyo, utyando lwe-aortic luya kufuneka.

Ukuhlaziywa kwe-Aortic: Nge- aortic kwakhona , i-aortic valve iyaba yinto ephosakeleyo ukuze igazi lihlambuluke ngasemva ukusuka kwi-aorta ukuya kwi-ventricle engasekhohlo. Ukuhamba kwamanzi okugqithisa kakhulu kwandisa umsebenzi we-ventricle ekhohlo. Ukuba ukuhlaziywa kubalulekile, i-ventricle ekugqibeleni igxininiswa kakhulu kwaye i-heart failure failure. Unyango lwe-aortic yokuvuselela ngokutsha lufuna ukutshintshwa ngokugqithisileyo kwe-valve ye-aortic.

I-Tricuspid Stenosis: I-stenosis ye-tricuspid, isithintelo esincinci se-tricuspid valve, iyona eqhelekileyo yezifo ezinkulu ze-valvular. Ngokuqhelekileyo kubonakala kubantu abaye bafumana isifo senhliziyo yesifo, kwaye, kwiimeko ezininzi, zihamba nezifo kwezinye iipavini zentliziyo. Ukuba i-stenosis, i-tricuspid stenosis yenza kube lula ukunyameka nokunciphisa ukunyamezela. Nangona kunjalo, iimpawu ezibangelwa zizifo kwenye yezinye iiguvane zidla kakuhle ngaphambi kokuba i-tricuspid stenosis iqale ukuvelisa iimpawu. Ngenxa yoko, unyango oluphambili lwe-tricuspid stenosis (oluqukethe ukulungiswa kwe-valvular esikhundleni sokutshintshwa) ngokuqhelekileyo lwenzeka ngokuqhubekayo njengenkqubo "yokongezwa", xa utyando luyimfuneko yokuphatha i-valve emoyeni echaphazelekayo.

Ukuhlaziywa kwe-Tricuspid: Kwi- tricuspid regurgation , ukuvuza kwegazi kwi-valve ye-tricuspid ukusuka kwi-ventricle efanelekileyo ukuya kwi-atrium efanelekileyo. Ukuphindaphinda kwezinto eziqhelekileyo kubangelwa ukuhluthwa kwe-tricuspid annulus eyenzeka njengomphumo we-pulmonary artery hypertension, ukungaphumeleli kwintliziyo okanye i- pulmonary embolus . Ukuphindaphinda kwezinto eziqhelekileyo ngokuqhelekileyo kunomdla kwaye kaninzi akufuneki unyango. Ukuhlola ngokucophelela ukujonga ingxaki yezokwelapha kubalulekile, ekubeni ukuphathwa kwengxaki esezantsi kubangela ukuba uphuculo oluphezulu kwi-tricuspid regurgitation.

I-Pulmonary Stenosis: I-stenosis ye-pulmonary, isithintelo se-valve ye-pulmonary, ngokuqhelekileyo i-disordination disorder edla ngokuxhamla ne-tetralogy ye-Fallot, i-Noonan syndrome (i-genetic disorder ene-cardiac, i-short stature, i-chest deformity, neengxaki zokufunda), okanye i-congenital rubella. I-stenosis ye-pulmonary isifo sikwimeko yokuzalwa okanye kungekudala emva koko. Ukuba kunzima, kunokuvelisa ukungaphumeleli kwinqanaba elifanelekileyo lentliziyo. I-stenosis epholileyo iyimeko enobungozi ngokupheleleyo engadingi unyango. Ukuba le meko ibaluleke kakhulu, iyakwazi ukuphathwa ngebhaloon valvuloplasty, inkqubo encinterization encinterization encinci.

Ukuphindaphinda kwe-Pulmonary: Kwi-pulmonary regurgation, ukuvuza kwegazi kwi-valve ye-pulmonary evaliweyo esuka kumbhobho we-pulmonary kwi-ventricle efanelekileyo. Isizathu esiqhelekileyo sokuvuselela i-pulmonary is arterary artery hypertension, esingavelisa ukuhluthwa kwe-pulmonary valvular annulus ukuya kwinqanaba lokuba i-valve ye-pulmonary ayikwazi ukusondela ngokupheleleyo. Ukuba kunzima, ukuvuselelwa kwepulmori kungenza ukuba intliziyo efanelekileyo ihluthe, kwaye ukungaphumeleli kwintliziyo kunokuqinisekisa. Ngokuqhelekileyo, unyango lwe-pulmonary regurgation kuthatha amanyathelo okunciphisa uxinzelelo lwe-pulmonary artery . Ukuvuthwa akusoloko kufuneka.

Ngaba Kukhona Unyango Ongafakwanga Ngonyango Ngezifo Zengqungquthela?

Isifo se-valves senhliziyo sisisiseko sengxaki. Ukujongana nengcinezelo, ukuhlinzwa ngokuqhelekileyo kuyona ndlela kuphela.

Nangona kunjalo, kumaxesha amaninzi unyango lwezonyango lunokufumaneka lunokukunceda. Ngamanye amaxesha, amayeza anokunceda ukuzinzisa intliziyo nokunyusa ukunyuka kwesifo se-valve. Oku kubaluleke kakhulu ngeentlobo ezininzi ze-valvular regurgation, apho i-valve ingxaki ibangelwa ukuhluthwa kwegumbi le-cardiac. Unonyango olunonyango olubhekiselele ekuphatheni i- hypertension okanye i-cardiomyopathy , okanye ukukhusela i-ventricular remodeling emva kokuhlaselwa kwintliziyo, okanye ukulawula izinga lentliziyo kwi-fibrillation ye-atrial , umzekelo, lunokunciphisa kakhulu amathuba okuphuhlisa i-mitral okanye i-tricuspid regurgity.

Ngenxa yeso sizathu, ngokuqhelekileyo yinto efanelekileyo yokuba abantu abanesifo senhliziyo yesifo se-valvular bahlale bebonwa nguthambo lwezinto ezinokwenyama, ngubani ongakwazi ukujongana nantoni nayiphi na ingxaki echaphazelekayo ye-cardiovascular.

Ukuphila Ngeentliziyo Zengqondo

Ukuba unesifo se-valve senhliziyo, kukho ezinye izinto oza kuzenza ukuze ukwandise amathuba akho okuphila ubomi obude kunye nobomi. Kufuneka ufunde yonke into onokuyenza malunga nohlobo lwesifo se-valvular onayo, kunye nobukhulu beengxaki ze-valve yakho. Ukuba unamayeza ukuze uncede intliziyo yakho isebenze ngokufanelekileyo, kufuneka uwathathe rhoqo kwaye ubhengeze inkathazo kubo ugqirha wakho.

Ngaloo nto, kufuneka uhlale uqeshwe rhoqo kunye nogqirha wakho. Nangona oku kubalulekile kunoma ubani, kubaluleke kakhulu kumntu onenkinga yesifo senhliziyo, ekubeni isifo senhliziyo sevvular siqhubela phambili kwixesha. Umele uthethe ugqirha wakho malunga nokuba ufuna ukuthatha i- antibiotic prophylaxis ye-endocarditis .

Ekugqibeleni, ekubeni sele unesifo sengqondo, kufuneka wenze konke onokukwenza ukunciphisa iimeko zakho zokuphuhlisa ezinye iintlobo zesifo senhliziyo: Musa ukutshaya; kugcina ukutya okunempilo kunye nobunzima obuphilileyo; fumana umthambo omkhulu; kwaye, ukuba unesifo soxinzelelo okanye isifo sikashukela , qiniseka ukuba unemiqathango phantsi kolawulo olufanelekileyo.

ILizwi

Isifo senhliziyo saseValvular sinokuba yingxaki enkulu. Kodwa ngokufumanisa kwangaphambili, ukulandelelwa rhoqo kwezokwelapha, kunye nokufumaneka koononophelo lwangonyango kunye nophando, namhlanje abaninzi abantu abanesifo se-valves senhliziyo bangalindela ukuhlala ubomi obude kunye nobomi.

Imithombo:

> IQela eliSebenzi eliManyeneyo kwi-Valvular Heart Disease ye-European Society of Cardiology (ESC), i-European Association yeCrodio-Thoracic Surgery (EACTS), iVahanian A, et al. Izikhokelo zolawulo lwe-valvular isifo senhliziyo (ingqungquthela ka-2012). I-Eur Heart J 2012; 33: 2451.

Nishimura RA, Otto CM, Bonow RO, et al. 2014 Isikhokelo se-AHA / ACC sokulawulwa kwezigulane ezine-valvular isifo senhliziyo: ingxelo ye-American College of Cardiology / American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014; 63: e57.