Endocarditis

ʻO ka endocarditis he mumū weliweli e hoʻopilikia ana i ka papa komo o loko o nā keʻena a me nā valve o ka naʻau. ʻO kēia papa komo i kapa ʻia ʻo ka endocardium.

ʻO ka endocarditis pinepine ka hopena o ka maʻi. E komo nā bacteria, nā fungi a i ʻole nā germs ʻē aʻe i loko o ke kahe koko a hoʻopili i nā wahi i hōʻino ʻia ma ka naʻau. ʻO nā mea e hoʻonui ai i kou pilikia e loaʻa ai ka endocarditis, ʻo ia nā valve naʻau hana ʻia, nā valve naʻau i hōʻino ʻia a i ʻole nā hemahema naʻau ʻē aʻe.

Inā ʻaʻohe mālama koke ʻana, hiki i ka endocarditis ke hōʻino a luku paha i nā valve naʻau. ʻO nā lāʻau lapaʻau no ka endocarditis, ʻo ia nā lāʻau lapaʻau a me ka ʻoki kino.

Hiki i nā hōʻailona o ka endocarditis ke ʻokoʻa mai ke kanaka a ke kanaka. Hiki i ka endocarditis ke ulu mālie a i ʻole koke. Aia ia ma ke ʻano o nā germs e hoʻoulu ai i ka maʻi a inā paha he mau pilikia puʻuwai ʻē aʻe.

ʻO nā hōʻailona maʻamau o ka endocarditis, ʻo ia hoʻi:

• ʻEha nā hono a me nā ʻiʻo
• ʻEha ka umauma i ka hanu
• Luhi
• Nā hōʻailona like me ka maʻi flu, e like me ka wela a me ka ʻōhule
• Ka luhi i ka pō
• Pōkole o ka hanu
• Pehu i nā wāwae, nā wāwae a i ʻole ka ʻōpū
• Ka leo kani hou a i ʻole i loli i loko o ka puʻuwai (murmur)

Hiki i nā hōʻailona endocarditis liʻiliʻi ke komo pū:

• Pau ke kaupaona me ke kumu ʻole
• Koko i loko o ka mimi
• ʻEha ma lalo o ka iwi ʻaoʻao hema (spleen)
• ʻAʻohe ʻeha, ʻulaʻula, poni a ʻeleʻele paha nā wahi pālahalaha ma ka lalo o nā wāwae a i ʻole nā lima (Janeway lesions)
• ʻEha nā puʻupuʻu ʻulaʻula a poni paha a i ʻole nā ​​​​wahi ʻili ʻeleʻele (hyperpigmented) ma nā piko o nā manamana lima a i ʻole nā ​​manamana wāwae (Osler nodes)
• Nā wahi liʻiliʻi poni, ʻulaʻula a ʻeleʻele paha ma ka ʻili (petechiae), i nā keʻokeʻo o nā maka a i loko paha o ka waha

Inā loaʻa iā ʻoe nā hōʻailona o ka endocarditis, e ʻimi koke i ke kōkua o kāu mea mālama ola - ʻoi aku hoʻi inā loaʻa iā ʻoe kahi hemahema o ka naʻau mai ka hānau ʻana mai a i ʻole ka mōʻaukala o ka endocarditis. Hiki i nā kūlana ʻoi aku ka liʻiliʻi ke hōʻike i nā hōʻailona a me nā ʻōuli like. Pono ka loiloi kūpono e ka mea mālama ola e hana i ka ʻike.

Inā ua ʻike ʻia ʻoe me ka endocarditis a loaʻa iā ʻoe kekahi o nā hōʻailona ma lalo nei, e haʻi aku i kāu mea mālama ola. Hiki i kēia mau hōʻailona ke ʻano e ʻoi aku ka ʻino o ka maʻi:

• Anuanu
• Wela
• ʻO ka ʻeha poʻo
• ʻO ka ʻeha o nā hono
• Pōkole o ka hanu

ʻO ka maʻi endocarditis ka mea maʻamau e hoʻokumu ʻia e kahi maʻi bacteria, fungus a i ʻole nā germs ʻē aʻe. Komo nā germs i loko o ke kahe koko a hele i ka naʻau. I loko o ka naʻau, hoʻopili lākou i nā valve naʻau i hōʻino ʻia a i ʻole nā pūnaewele naʻau i hōʻino ʻia.

ʻO ka mea maʻamau, e luku ka ʻōnaehana pale o ke kino i nā bacteria ʻino āpau e komo i loko o ke kahe koko. Eia naʻe, hiki i nā bacteria ma ka ʻili a i ʻole i loko o ka waha, ka ʻāʻī a i ʻole ka ʻōpū (na intestines) ke komo i loko o ke kahe koko a hoʻokumu i ka maʻi endocarditis ma lalo o nā kūlana kūpono.

He nui nā mea like ʻole e hiki ke hoʻokomo i nā germs i loko o ke kahe koko a alakaʻi i ka endocarditis. ʻO ka loaʻa ʻana o kahi valve naʻau hemahema, maʻi a i ʻole i hōʻino ʻia e hoʻonui i ka pilikia o ke kūlana. Eia naʻe, hiki ke loaʻa ka endocarditis i nā poʻe ʻaʻohe pilikia valve naʻau.

Nā kumu pilikia no ka endocarditis:

• Ka makahiki mua. ʻOi aku ka pinepine o ka endocarditis i nā mākua ma mua o 60 mau makahiki.
• Nā valve naʻau hana lima. ʻOi aku ka nui o ka hoʻopili ʻana o nā germs i kahi valve naʻau hana lima (prosthetic) ma mua o kahi valve naʻau maʻamau.
• Nā valve naʻau i hōʻino ʻia. Hiki i kekahi mau kūlana lapaʻau, e like me ka maʻi rheumatic a i ʻole ka maʻi, ke hōʻino a i ʻole ka ʻili o hoʻokahi a ʻoi aku paha o nā valve naʻau, e hoʻonui ana i ka pilikia o ka maʻi. Hoʻonui pū kekahi moʻolelo o ka endocarditis i ka pilikia o ka maʻi.
• Nā hemahema naʻau i hānau ʻia. ʻO ka hānau ʻia ʻana me kekahi mau ʻano o nā hemahema naʻau, e like me ka naʻau kūpono ʻole a i ʻole nā ​​valve naʻau i hōʻino ʻia, e hoʻonui i ka pilikia o nā maʻi naʻau.
• Ka mīkini naʻau i hoʻokomo ʻia. Hiki i nā bacteria ke hoʻopili i kahi mīkini i hoʻokomo ʻia, e like me ka pacemaker, e hoʻokumu ana i ka maʻi o ka laina o ka naʻau.
• Ka hoʻohana ʻana i nā lāʻau lapaʻau intravenous (IV) kūpono ʻole. Hiki i ka hoʻohana ʻana i nā nila IV lepo ke alakaʻi i nā maʻi e like me ka endocarditis. He pilikia nui nā nila a me nā syringes haumia no nā poʻe e hoʻohana ana i nā lāʻau lapaʻau IV kūpono ʻole, e like me ka heroin a i ʻole ka cocaine.
• Ke olakino niho maikaʻi ʻole. He mea nui ka waha olakino a me nā gums olakino no ke olakino maikaʻi. Inā ʻaʻole ʻoe e holoi a floss mau, hiki i nā bacteria ke ulu i loko o kou waha a komo paha i loko o kou kahe koko ma o kahi ʻoki ma kou mau gums. Hiki i kekahi mau kaʻina hana niho e hiki ke ʻoki i nā gums ke ʻae i nā bacteria e komo i loko o ke kahe koko.
• Ka hoʻohana lōʻihi ʻana o ka catheter. He tube lahilahi ka catheter i hoʻohana ʻia no kekahi mau kaʻina hana lapaʻau. ʻO ka loaʻa ʻana o ka catheter i kahi lōʻihi (catheter indwelling) e hoʻonui i ka pilikia o ka endocarditis.

I ka endocarditis, ulu mai nā mea ulu ʻole i hana ʻia i nā germs a me nā ʻāpana o ka cell i kahi puʻupuʻu ma ka naʻau. Ua kapa ʻia kēia mau clumps he vegetations. Hiki iā lākou ke haki a hele i ka lolo, nā māmā, nā puʻupaʻa a me nā ʻōnaehana ʻē aʻe. Hiki nō hoʻi iā lākou ke hele i nā lima a me nā wāwae.

ʻO nā pilikia o ka endocarditis e komo pū ai:

• Hāʻule o ka naʻau
• Hōʻino o ka valve naʻau
• Stroke
• Nā ʻeke o ka pus i hōʻiliʻili ʻia (abscesses) e ulu ana i ka naʻau, lolo, māmā a me nā ʻōnaehana ʻē aʻe
• Blood clot i loko o ka artery māmā (pulmonary embolism)
• Hōʻino o ka puʻupaʻa
• Nā nui o ka spleen

Hiki iā ʻoe ke lawe i kēia mau ʻanuʻu e kōkua ai i ka pale ʻana i ka endocarditis:

• E ʻike i nā hōʻailona a me nā hōʻailona o ka endocarditis. E ʻike koke i kāu mea lawelawe ola inā loaʻa iā ʻoe kekahi mau hōʻailona o ka maʻi - ʻoiai kahi kuni ʻaʻole e hele, ka luhi wehe ʻole ʻia, kekahi ʻano o ka maʻi ʻili, a i ʻole nā ​​ʻoki a i ʻole nā ​​ʻeha wehe ʻole e ho'ōla pono.
• E mālama pono i kou mau niho a me kou mau gums. E pulu a floss i kou mau niho a me kou mau gums pinepine. E kiʻi i nā nānā niho maʻamau. He ʻāpana nui ka mālama niho maikaʻi i ka mālama ʻana i kou olakino holoʻokoʻa.
• Mai hoʻohana i nā lāʻau lapaʻau IV kū kānāwai ʻole. Hiki i nā nila lepo ke hoʻouna i nā bacteria i loko o ke kahe koko, e hoʻonui ana i ka pilikia o ka endocarditis.

No ka hōʻoiaʻana i ka endocarditis, e hana kekahi mea mālama ola i kahi hōʻoia kino a nīnau i nā nīnau e pili ana i kou mōʻaukala lapaʻau a me nā hōʻailona. Hana ʻia nā hoʻokolohua e kōkua i ka hōʻoia ʻana a i ʻole ke kāpae ʻana i ka endocarditis.

Nā hoʻokolohua i hoʻohana ʻia e kōkua i ka hōʻoia ʻana i ka endocarditis:

Echocardiogram. Hoʻohana ʻia nā leo leo e hana i nā kiʻi o ka naʻau e kuʻi ana. Hōʻike kēia hoʻokolohua i ka maikaʻi o ka hoʻopuka ʻana o nā keʻena a me nā valve o ka naʻau i ke koko. Hiki nō hoʻi ke hōʻike i ke ʻano o ka naʻau. Hiki i kāu mea hoʻolako ke hoʻohana i ʻelua ʻano echocardiograms like ʻole e kōkua i ka hōʻoia ʻana i ka endocarditis.

Ma kahi echocardiogram maʻamau (transthoracic), hoʻoneʻe ʻia kahi mea hana e like me ka lāʻau (transducer) ma luna o ka ʻāpana umauma. Ke kuhikuhi nei ka mea hana i nā leo leo i ka naʻau a hoʻopaʻa iā lākou i ka wā e hoʻi mai ai.

Ma kahi transesophageal echocardiogram, alakaʻi ʻia kahi paipu palupalu e loaʻa ana i kahi transducer i lalo o ka ʻāʻī a komo i loko o ka paipu e hoʻohui ana i ka waha i ka ʻōpū (esophagus). Hāʻawi ka transesophageal echocardiogram i nā kiʻi kikoʻī loa o ka naʻau ma mua o ka hiki ʻana me kahi echocardiogram maʻamau.

• Hoʻokolohua moʻomeheu koko. Kōkua kēia hoʻokolohua e ʻike i nā germs i loko o ke kahe koko. Kōkua nā hopena mai kēia hoʻokolohua e hoʻoholo i ka antibiotic a i ʻole ka hui o nā antibiotics e hoʻohana ai no ka mālama ʻana.

• Helu koko piha. Hiki i kēia hoʻokolohua ke hoʻoholo inā nui nā keʻena keʻokeʻo, hiki ke hōʻailona o ka maʻi. Hiki i ka helu koko piha ke kōkua i ka hōʻoia ʻana i nā pae haʻahaʻa o nā keʻena ʻulaʻula olakino (anemia), hiki ke hōʻailona o ka endocarditis. Hiki nō hoʻi ke hana ʻia nā hoʻokolohua koko ʻē aʻe.

• Echocardiogram. Hoʻohana ʻia nā leo leo e hana i nā kiʻi o ka naʻau e kuʻi ana. Hōʻike kēia hoʻokolohua i ka maikaʻi o ka hoʻopuka ʻana o nā keʻena a me nā valve o ka naʻau i ke koko. Hiki nō hoʻi ke hōʻike i ke ʻano o ka naʻau. Hiki i kāu mea hoʻolako ke hoʻohana i ʻelua ʻano echocardiograms like ʻole e kōkua i ka hōʻoia ʻana i ka endocarditis.

  Ma kahi echocardiogram maʻamau (transthoracic), hoʻoneʻe ʻia kahi mea hana e like me ka lāʻau (transducer) ma luna o ka ʻāpana umauma. Ke kuhikuhi nei ka mea hana i nā leo leo i ka naʻau a hoʻopaʻa iā lākou i ka wā e hoʻi mai ai.

  Ma kahi transesophageal echocardiogram, alakaʻi ʻia kahi paipu palupalu e loaʻa ana i kahi transducer i lalo o ka ʻāʻī a komo i loko o ka paipu e hoʻohui ana i ka waha i ka ʻōpū (esophagus). Hāʻawi ka transesophageal echocardiogram i nā kiʻi kikoʻī loa o ka naʻau ma mua o ka hiki ʻana me kahi echocardiogram maʻamau.

• Electrocardiogram (ECG a i ʻole EKG). Ke ana nei kēia hoʻokolohua wikiwiki a ʻoluʻolu ʻole i ka hana uila o ka naʻau. I ka wā o ka electrocardiogram (ECG), hoʻopili ʻia nā mea ʻike (electrodes) i ka umauma a i kekahi manawa i nā lima a i nā wāwae. ʻAʻole ia i hoʻohana kūikawā ʻia e hōʻoia i ka endocarditis, akā hiki ke hōʻike inā he mea e hoʻopilikia ana i ka hana uila o ka naʻau.

• X-ray umauma. Hōʻike ka X-ray umauma i ke kūlana o nā māmā a me ka naʻau. Hiki ke kōkua e hoʻoholo inā ua hoʻokumu ka endocarditis i ka pehu o ka naʻau a i ʻole inā ua pālahalaha kekahi maʻi i nā māmā.

• Computerized tomography (CT) scan a i ʻole magnetic resonance imaging (MRI). Pono paha ʻoe i nā scan o kou lolo, umauma a i ʻole nā ​​ʻāpana ʻē aʻe o kou kino inā manaʻo kāu mea hoʻolako ua pālahalaha ka maʻi i kēia mau wahi.