Ka Ho'Emi 'Ana O Ka Aorta

ʻO ka coarctation o ka aorta kahi ho'onui iki ʻana ma kahi hapa o ke kīʻaha nui o ke kino, i kapa ʻia ʻo ka aorta. Pono ka naʻau e pūʻiwa nui aku e hoʻouna i ke koko ma o ka aorta a i nā ʻāpana ʻē aʻe o ke kino.

ʻO ka coarctation o ka aorta (ko-ahrk-TAY-shun) kahi ho'onui iki ʻana o kahi hapa o ke kīʻaha nui o ke kino, i kapa ʻia ʻo ka aorta. Ke koi nei ke kūlana i ka naʻau e hana ikaika e pūʻiwa i ke koko.

Loaʻa pinepine ka coarctation o ka aorta i ka wā hānau. ʻO ia hoʻi, he kīnā hānau ia o ka naʻau. Akā, i kekahi manawa, hiki ke loaʻa ke kūlana ma hope i ke ola.

Loaʻa pinepine ka coarctation o ka aorta me nā kīnā hānau ʻē aʻe o ka naʻau. Hoʻokō pinepine ʻia ka mālama ʻana e hoʻoponopono i ke kūlana. Akā, pono nā nānā olakino maʻamau no ke ola e nānā i nā loli i ke olakino o ka naʻau.

Hōʻailona o ka coarctation o ka aorta e hilinaʻi ana i ka nui o ka aorta i hoʻoemi ʻia. ʻAʻohe hōʻailona o ka hapanui o nā kānaka. ʻAʻole paha he hōʻailona nā mākua a me nā keiki kahiko me ka coarctation iki o ka aorta a ua like paha ko lākou naʻau me ke olakino. Inā hānau ʻia ke pēpē me ka hoʻoemi nui ʻana o ka aorta, hiki ke ʻike ʻia nā hōʻailona ma hope koke o ka hānau ʻana. ʻO nā hōʻailona o ka coarctation o ka aorta i nā pēpē e komo pū ana: Paʻakikī ke hanu. Paʻakikī ke hānai. Ke kaumaha nui nei. Hoʻonāukiuki. Hoʻololi i ke kala o ka ʻili. ʻO nā hōʻailona o ka coarctation o ka aorta ma hope i ke ola e komo pū ana: ʻEha umauma. Ke kiʻekiʻe o ke koko. ʻO ka poʻo ʻeha. Nāwaliwali o nā ʻiʻo. ʻO ka ʻeha o nā wāwae. Nā wāwae anu. Kahe koko i ka ihu. Hoʻomaka pinepine ka coarctation o ka aorta me nā kūlana naʻau ʻē aʻe i loaʻa i ka hānau ʻana. ʻO nā hōʻailona ʻē aʻe e hilinaʻi ana i nā ʻano kikoʻī o nā hemahema naʻau i hānau ʻia. E kiʻi koke i ke kōkua lapaʻau no kekahi ʻeha umauma i koʻikoʻi a ʻaʻole hiki ke wehewehe ʻia. E kiʻi pū i ke kōkua lapaʻau no kēia mau hōʻailona: Ke hiolo ʻana. Ke pokopoko koke ʻana o ka hanu. Ke kiʻekiʻe o ke koko i hiki ʻole ke wehewehe ʻia. Hiki i kēia mau hōʻailona ke hoʻokumu ʻia e nā kūlana olakino like ʻole. Pono ka nānā olakino piha e ʻike i ke kumu.

E hele koke i ke kōkua lapaʻau no kekahi ʻeha umauma ikaika loa a i ʻole hiki ʻole ke wehewehe. E hele pū kekahi i ke kōkua lapaʻau no kēia mau hōʻailona: Hina ʻana. Pōkole koke o ka hanu. Ke koko kiʻekiʻe i hiki ʻole ke wehewehe. Hiki i kēia mau hōʻailona ke hoʻokumu ʻia e nā kūlana olakino like ʻole. Pono ka nānā olakino piha e ʻike i ke kumu.

ʻAʻole maopopo ke kumu o ka coarctation o ka aorta. ʻO ka mea maʻamau, he pilikia naʻau ia i loaʻa i ka wā hānau, i kapa ʻia ʻo ka hemahema naʻau congenital. Hana ʻia ka hemahema naʻau congenital i ka wā e ulu ana ke pēpē i loko o ka ʻōpū i ka wā hāpai. ʻO ka mea pinepine, ʻaʻole ʻike ʻia ke kumu.

I nā manawa kakaikahi, hiki i ka coarctation o ka aorta ke hana ma hope i ke ola. ʻO nā kūlana a i ʻole nā hanana e hiki ke hoʻonui i ka aorta a hoʻokumu i kēia kūlana, ʻo ia hoʻi:

• Hōʻeha traumatic.
• Kahi hōʻiliʻili nui o nā kolesterol a me nā momona i nā arteries, i kapa ʻia ʻo atherosclerosis.
• Kahi ʻano kakaikahi o ka pehu a me ka huhū o nā kīʻaha koko i loko o ka naʻau, i kapa ʻia ʻo Takayasu arteritis.

Nā kumu pilikia no ka coarctation o ka aorta:

• Kāne.
• Kekahi mau kūlana genetic, e like me ka Turner syndrome.
• Kekahi mau kūlana naʻau i loaʻa i ka wā hānau, i kapa ʻia he mau hemahema naʻau congenital.

Nā hemahema naʻau congenital e pili ana i ka coarctation o ka aorta:

• Bicuspid aortic valve. ʻO ka aortic valve aia ma waena o ke kīʻaha nui o ke kino a me ka lumi naʻau hema haʻahaʻa. Inā he ʻelua wale nō mau ʻāpana, i kapa ʻia ʻo nā cusps, ma kahi o nā ʻekolu maʻamau, kapa ʻia ʻo ia he bicuspid valve.
• Subaortic stenosis. ʻO kēia kahi kuʻi ʻana o ka wahi ma lalo o ka aortic valve. Ke pale nei ia i ke kahe koko mai ka lumi naʻau hema haʻahaʻa i ka aorta.
• Patent ductus arteriosus. ʻO ka ductus arteriosus kahi kīʻaha koko e hoʻohui ana i ke kīʻaha māmā hema i ka aorta. I ka wā e ulu ana ke pēpē i loko o ka ʻōpū, ʻae kēia kīʻaha i ke koko e hele a puni nā māmā. Ma hope koke o ka hānau ʻana, pani pinepine ʻia ka ductus arteriosus. Inā noho ia i wehe, kapa ʻia ka wehe ʻana he patent ductus arteriosus.
• Nā puka i loko o ka naʻau. Loaʻa pū kekahi poʻe me ka coarctation o ka aorta i hānau ʻia me kahi puka i loko o ka naʻau. Inā aia ka puka ma waena o nā lumi naʻau kiʻekiʻe, kapa ʻia ʻo ia he atrial septal defect. ʻO kahi puka ma waena o nā lumi naʻau haʻahaʻa kapa ʻia he ventricular septal defect.
• Congenital mitral valve stenosis. ʻO kēia ke ʻano o ka maʻi valve naʻau i hānau ʻia kekahi poʻe. Kuʻi ʻia ka valve ma waena o nā lumi naʻau hema kiʻekiʻe a haʻahaʻa. ʻOi aku ka paʻakikī o ke kahe koko ma o ka valve.

Hōʻino o ka coarctation o ka aorta e kū mai ana no ka mea, pono ka keʻena naʻau hema haʻahaʻa e hana ikaika e pūpū i ke koko ma o ke kīʻaha koko haiki. ʻO kēia ka mea e piʻi ai ke kaomi koko i loko o ke keʻena naʻau hema haʻahaʻa. Eia kekahi, hiki i ka paia o ke keʻena ke mānoanoa. Ua kapa ʻia kēia kūlana he ventricular hypertrophy. ʻO nā hōʻino o ka coarctation o ka aorta e komo pū ana: Ke kaomi koko kiʻekiʻe lōʻihi. Maʻamau ka emi ʻana o ke kaomi koko ma hope o ka ʻoki kino e hoʻoponopono i ka aorta. Akā, hiki ke kiʻekiʻe ma mua o ka maʻamau. ʻO ka kīʻaha koko nāwaliwali a i ʻole puʻupuʻu i loko o ka lolo, i ʻike ʻia hoʻi he aneurysm lolo. Ke koko koko i loko o ka lolo. ʻO ka haki a i ʻole ka haehae i loko o ke kīʻaha nui o ke kino, i kapa ʻia ʻo ka aortic dissection. ʻO ka puʻupuʻu i loko o ka paia o ke kīʻaha nui o ke kino, i kapa ʻia ʻo ka aortic aneurysm. ʻO ka maʻi kīʻaha coronary. Stroke. Pono ka mālama koke e kōkua i ka pale ʻana i nā hōʻino. Me ka ʻole o ka mālama ʻana, hiki i ka coarctation o ka aorta ke alakaʻi i: ka hōʻino ʻana o ka puʻupaʻa. Ka hōʻino ʻana o ka naʻau. Make. Loaʻa i kekahi poʻe nā hōʻino ma hope o ka mālama ʻana no ka coarctation o ka aorta. ʻO kēia mau hōʻino e komo pū ana: Ke hoʻohaiki hou ʻana o ka aorta, i kapa ʻia ʻo re-coarctation. Aortic aneurysm a i ʻole rupture. No ka pale ʻana i nā hōʻino, pono nā poʻe me ka coarctation o ka aorta i nā nānā olakino maʻamau no ke ola.

ʻAʻohe ala i ʻike ʻia e pale aku ai i ka coarctation o ka aorta. E haʻi aku i kāu kime mālama ola inā he mōʻaukala ʻohana kāu o nā kūlana naʻau i loaʻa i ka wā hānau.

Hiki ke hilinaʻi ka ʻike ʻana o ka coarctation aortic i ka nui o ka pilikia o ka naʻau. Hoʻomaopopo pinepine ʻia ka coarctation aortic koʻikoʻi ma hope koke o ka hānau ʻana. Hiki ke ʻike ʻia ke kūlana ma nā kiʻi ultrasound i lawe ʻia i ka wā hāpai.

Inā māmā ke kūlana, ʻaʻole paha e ʻike ʻia a hiki i ka wā ma hope.

Hiki ke lohe ʻia kahi kani ʻūlū i kapa ʻia he murmur naʻau i ka hoʻolohe ʻana i ka naʻau.

Hana ʻia nā hoʻokolohua e ʻike i ka coarctation o ka aorta.

• Echocardiogram. Hoʻohana ʻia nā hawewe leo e hana i nā kiʻi o ka naʻau e kuʻi ana. Hōʻike ka echocardiogram i ke ʻano o ke kahe ʻana o ke koko ma o ka naʻau. Hiki pinepine i ka hoʻokolohua ke haʻi i kahi ʻāpana a me ka nui o ka aorta i hoʻonui ʻia. Kūkulu pū ka echocardiogram i nā limahana mālama ola e hoʻolālā i ka mālama ʻana no ka coarctation o ka aorta.
• Electrocardiogram (ECG a EKG). Hoʻokolohua wikiwiki a ʻoluʻolu ʻole kēia e nānā i ka kuʻi ʻana o ka naʻau. Hoʻopili ʻia nā mea ʻike i kapa ʻia he electrodes i ka umauma a i kekahi manawa i nā lima a i nā wāwae. Hoʻohui nā uwea i nā mea ʻike i ka mīkini, kahi e hōʻike ai a i ʻole paha e paʻi i nā hopena. Inā hoʻonui loa ʻia ka aorta, hiki i ka ECG ke hōʻike i ka mānoanoa ʻana o nā paia o nā keʻena naʻau haʻahaʻa.
• X-ray umauma. Hōʻike ka X-ray umauma i ke kūlana o ka naʻau a me nā māmā. Hiki i ka X-ray umauma ke hōʻike i ka hoʻonui ʻia ʻana i ka aorta ma ka wahi o ka coarctation.
• Cardiac magnetic resonance imaging (MRI). Hoʻohana kēia hoʻokolohua i nā kahua magnetic a me nā hawewe radio e hana i nā kiʻi kikoʻī o ka naʻau a me nā kīʻaha koko. Hiki iā ia ke hōʻike i kahi ʻāpana a me ka nui o ka aorta i hoʻonui ʻia. Hiki i kahi limahana mālama ola ke hoʻohana i nā hopena MRI e alakaʻi i ka mālama ʻana.
• Computerized tomography (CT) scan. Hoʻohana ka CT scan i kahi moʻo o nā X-rays e hana i nā kiʻi cross-sectional kikoʻī o ke kino.
• Coronary angiogram me ka cardiac catheterization. Hoʻohana ka coronary angiogram i nā X-rays e nānā i nā kīʻaha koko o ka naʻau, i kapa ʻia he coronary arteries. Hana pinepine ʻia ia e ʻike inā hoʻonui ʻia a i ʻole paha i pani ʻia kahi kīʻaha koko. ʻO ka coronary angiogram kahi ʻāpana o kahi hui nui o nā hoʻokolohua naʻau a me nā mālama i kapa ʻia ʻo cardiac catheterization.

I ka wā o ka cardiac catheterization, waiho ʻia kahi tube māmā a palupalu i kapa ʻia he catheter i loko o kahi kīʻaha koko, maʻamau ma ka ʻūhā a i ʻole ka lima, a alakaʻi ʻia i ka naʻau. Kahe ke kala ma o ka catheter i nā arteries i loko o ka naʻau. Hana maʻalahi ka kala i nā arteries i ka ʻike ʻana ma nā kiʻi X-ray a me nā wikiō. Hiki i ka cardiac catheterization ke kōkua i ka hoʻoholo ʻana i ka nui o ka aorta i hoʻonui ʻia.

• CT angiogram. Nānā kēia hoʻokolohua i nā arteries e hoʻolako i ke koko i ka naʻau. Hoʻohana ia i kahi mīkini X-ray ikaika e hana i nā kiʻi o ka naʻau a me nā kīʻaha koko. Hoʻohana ka CT angiogram i kahi kala a me nā X-rays kūikawā e hōʻike i ke ʻano o ke kahe ʻana o ke koko ma o nā veins a me nā arteries. Hiki i ka hoʻokolohua ke hōʻike i kahi a me ka nui o ka coarctation o ka aorta. Hiki nō hoʻi ke haʻi inā pilikia nā kīʻaha koko ʻē aʻe. Hiki ke hoʻohana ʻia ka CT angiogram e alakaʻi i ka mālama ʻana.

Coronary angiogram me ka cardiac catheterization. Hoʻohana ka coronary angiogram i nā X-rays e nānā i nā kīʻaha koko o ka naʻau, i kapa ʻia he coronary arteries. Hana pinepine ʻia ia e ʻike inā hoʻonui ʻia a i ʻole paha i pani ʻia kahi kīʻaha koko. ʻO ka coronary angiogram kahi ʻāpana o kahi hui nui o nā hoʻokolohua naʻau a me nā mālama i kapa ʻia ʻo cardiac catheterization.

I ka wā o ka cardiac catheterization, waiho ʻia kahi tube māmā a palupalu i kapa ʻia he catheter i loko o kahi kīʻaha koko, maʻamau ma ka ʻūhā a i ʻole ka lima, a alakaʻi ʻia i ka naʻau. Kahe ke kala ma o ka catheter i nā arteries i loko o ka naʻau. Hana maʻalahi ka kala i nā arteries i ka ʻike ʻana ma nā kiʻi X-ray a me nā wikiō. Hiki i ka cardiac catheterization ke kōkua i ka hoʻoholo ʻana i ka nui o ka aorta i hoʻonui ʻia.