Ngo-2007 i-Chicago Chicago Marathon, umgijimi washaywa waza wafa, okwenza iintloko zelizwe. Emva kokwenza i-autopsy, umhloli wezokwelapha waseChicago wachaza ukuba ukufa ngokukhawuleza kokufa kwalowo mntu kwakungekho ngenxa yokufudumala nokushisa okubangele iingxaki ezinkulu phakathi kwabagijimi abaninzi ngaloo mini (kwaye ekugqibeleni kwabangela abaququzeleli ukuba bayeke umncintiswano), kodwa kunokuba "i- mitral valve prolapse " (MVP).
Lo myalelo ngokungathandabuzekiyo wabakhuthaza kakhulu kumagosa asekuhlaleni ukuba aqhubele phambili umncintiswano naphezu kweemeko zezulu eziyingozi, kwaye ngubani (ngokubonga izigqibo ezenziwe nge autopsy) ngoku sele ekhutshwa ngokusemthethweni malunga nokufa kwalowo mntu.
Kucacile, asinakho indlela yokukwazi isizathu esona sizathu sokufa kwalowo mgijimi obulalayo. Nangona kunjalo, isimemezelo esithembekileyo somhloli wezokwelapha saseChicago sakha ubuncinane ubuninzi beentlanzi phakathi kwezigidi ezingama-75 zaseMerika ezize (ngamanqaku athile) zinokuthi zibe ne-MVP. Kwaye emva kweeveki ezimbalwa, ii-cardiologist zaseMelika zazingcoliswa ngeefowuni ezixhalabileyo.
I-Mitral Valve Prolapse kunye nokufa ngokukhawuleza
Ngoko, umbuzo uthwala ukubuza: Ngaba i-MVP ingabangela ukuba iphile ngokukhawuleza?
Impendulo kukuba kukho kubonakala ngathi ukwanda kancinci kwengozi yokufa ngokukhawuleza kwi- tachycardia ye-ventricular okanye i- fibrillation ye-ventricular kubantu abaneMVP ebalulekileyo kodwa kungekhona kwininzi yabantu abaye bafumana ukuxilongwa kwe-MVP.
Uninzi olufumene i-MVP lunomgangatho omnene kakhulu wemeko, engenayo ingozi enokulinganiswa.
Ubungqina bokuqala bokuthi i-MVP inokudibaniswa nokufa ngokukhawuleza kwavela ngokukodwa kwiingqungquthela ze-autopsy. Kwizifundo apho intliziyo ihlolisiswe ngokucophelela kubantu abafa ngokukhawuleza, ubungqina be-MVP bunokufumaneka kwiqela elincinci.
Ngoko ngokwemvelo, i-MVP ithathwa njengokuba yimbangela yokufa ngokukhawuleza.
Kodwa izinto ezimbini azichazwe ngokubanzi kwezi zifundo. Okokuqala, amaninzi amaxhoba okufa ngokungazelelwe awanakho ukungaqhelekanga kwintliziyo. Okwesibini, xa uzimisele ukufumana i-MVP, uya kukwazi ukufumana ubuncinane ubungqina balo kwinxalenye enkulu yabantu.
Kukho ubungqina obuncinane bokuthi abaninzi abantu abafumene i-MVP banomngcipheko onokulinganisela wokufa ngokukhawuleza.
I-Overdiagnosis ye-MVP
Xa wenza i- echocardiography kubantu abakhethiweyo ngokungaqhelekanga, kuxhomekeke kwiinkqubo zokuxilonga, ezisetyenziswayo, i-MVP ingafumaneka kwi-20% -35%. Isixa senyango esona sininzi kwisiphakamiso se-mitra sisigxina esingenasiphelo kwaye asibanga nengozi eyaziwayo. Enyanisweni, njengoko umgangatho wezixhobo ze-echocardiographic uye waphucula ngaphezu kweminyaka, kuye kwaba lula ukufumanisa ukuba ncinane (encinci kwaye ayinakho) inani le-proral valve. Uninzi lweengcali lwamkela ukuba imeko "i-MVP" iye yaxilongwa ngokugqithiseleyo ngabaxhasi be-cardiologists.
Ukukwazi ukufumana inani elithile le-MVP ukuba uyayilindela ngokwaneleyo lunokuba luncedo kakhulu oogqirha (okanye ngenxa yolu hlobo, kubaphathi bobuhlanga), kuba kunokubakhokelela ukuba bajonge phambili ukuba bachaze iimpawu okanye iimeko kunzima okanye kunzima ukuxilonga okanye ukulawula (i- dysautonomia yinto evelele kakhulu kwezi).
Ngenxa yoko, kukho ukukhuthaza ukuba ufumane i-MVP.
Ukuchonga iMVP ngokufanelekileyo
Ngonyaka ka-2008, ekuqapheliseni ukuba ukuxilongwa kwe-MVP kuye kwanda ngokungafanelekanga kwi-epidemic proportions, i-American College yaseCardiology kunye ne-American Heart Association yanyathelisa imigaqo ephezulu yokujonga i-MVP. Ukusebenzisa le ndlela efanelekileyo efanelekileyo yokwenza ukuxilongwa, kukho ubungqina bokuba yingozi enkulu yokwenza i- cardiac arrhythmias kunye nokufa ngokukhawuleza, nangona loo mngcipheko usencinane kakhulu.
Enyanisweni, umngcipheko omkhulu wale bantu awuyikufa ngokukhawuleza, kodwa ukuphuhliswa kwe- mitral regurgation kunye nokuhluleka kwentliziyo .
Kule bantu, umngcipheko wokufa ngokukhawuleza ngokwenene uphakanyisiwe-kodwa kuphela kwizinga elifanayo lokuba liphakanyiswe kunoma ubani omnye onamandla okubuyiswa ngokutsha, kunoma yintoni na isizathu.
Ubuninzi belo hlobo lwe-MVP (okokuthi, okwenene, oluphawulekayo lwe-MVP) kuluntu jikelele luphela malunga ne-1-2% kwaye aluyi-35%. Kwaye phakathi kwale ncinane encinci yezigulane ezine-MVP, ngaphantsi kwe-1 ukuya kwe-20 iya kuphuhlisa iinjongo ezinkulu ze-mitral valve.
ILizwi
Umgca wecala kukuba akucaci ukuba iMVP-ubuncinci, uhlobo oluthile lwe-MVP ukuba uninzi lwabantu abafumene le meko-ludibene nokufa ngokukhawuleza, kungabi yinto ebangela ukufa ngokukhawuleza.
Ngenxa enkulu ininzi yezigulane ezixelelwe ukuba zi-MVP, umngcipheko wokufa ngokukhawuleza awukho mkhulu kunabo bonke abantu, kwaye iintlekele ezifana neChicago akufanele zibangele ukukhathazeka ngokungathí sina.
Ukuba uxelelwe ukuba unayo i-MVP, kufuneka ufumanise kwi-cardiologist yakho ukuba ngaba ukuxilongwa kwenzelwa ukusebenzisa i-newer, imilinganiselo yokuxilonga, okanye ukuba i-diagnostic yenziwe ngendlela endala, apho unokufumana khona i-MVP phantse nabani na ukuba uyayibheka nzima ngokwaneleyo.
> Imithombo:
> Bonow RO, uCarabello BA, Chatterjee K, et al. Ukuhlaziywa okugxininisiweyo ka-2008 kuhlanganiswe kwi-Acc / Aha 2006 Izikhokelo zokuLawula izigulane nge-Valvular Heart Disease: Ingxelo ye-American College of Cardiology / i-American Heart Association Umsebenzi weeKhokelo zoLwazi (iKomiti yokuBhala ukuHlola izikhokelo zoLawulo lwe-1998 Izigulane nge-Valvular Heart Disease): zivunywe nguMbutho wee-Cardiovascular Anesthesiologists, uMbutho wee-Cardiovascular Angiography kunye neNongenelo, kunye noMbutho weeNgcali zeTriracic. Uhambo luka-2008; 118: e523.
> Sriram CS, Syed FF, Ferguson ME, et al. I-Balmaf Malignant I-Mitral Valve I-Prolapse Syndrome Kwizigulane Ngaphandle kwe-Idiopathic Out-of-Hospital I-Cardiac Arrest. J Am Coll Cardiol 2013; 62: 222.