Uvalo oluneenhlamba ezimbili ze-Aortic? Izimpawu, Izimbangela, kanye Nokwelashwa

Uvalo oluneenhlamba ezimbili ze-aortic yisimo senhliziyo lapho uvalo lwakho lwe-aortic luneenhlamba ezimbili esikhundleni sezintathu ezijwayelekile. Lokhu kwenza kube yisifo senhliziyo esivamile esizalwa naso, esithinta cishe u-1-2% wabantu. Nakuba abantu abaningi bephila impilo evamile ngalesi simo, ngezinye izikhathi singabangela izinkinga njengoba ukhula, kungakho ukuqonda kwakho kubalulekile empilweni yakho.

Iyini i-Uvalo oluneenhlamba ezimbili ze-Aortic?

Uvalo lwakho lwe-aortic lusebenza njengomnyango onendlela eyodwa phakathi kwegumbi elikhulu lokupompa lenhliziyo yakho kanye nomthambo omkhulu womzimba wakho. Ngokuvamile, lo valo unezicucu ezintathu ezinhlangothi ezintathu ezinhlangothi ezintathu eziphuma futhi zivaleke ngaso sonke isithombe senhliziyo. Ngovalo oluneenhlamba ezimbili ze-aortic, uzalwa uneenhlamba ezimbili kuphela esikhundleni sezintathu.

Cabanga ngakho njengokuba nomnyango onamaphaneli amabili esikhundleni sezintathu. Nakuba usengenza umsebenzi wakhe wokulawula ukugeleza kwegazi, isimo asifani nalokho abantu abaningi abanakho. Umehluko olukhulu olukhulu ungathinta ukuthi uvalo lusebenza kangcono kangakanani ngokuhamba kwesikhathi.

Isimo sikhonjwa kusukela ekuzalweni, okusho ukuthi sithuthukiswa ngenkathi usesiswini. Abantu abaningi abazi ukuthi banalo kuze kube yilapho bekuhlola okungokuvamile kwezokwelapha noma lapho izimpawu zivele kamuva ekuphileni.

Ziyini izimpawu ze-Uvalo oluneenhlamba ezimbili ze-Aortic?

Abantu abaningi abane-uvalo oluneenhlamba ezimbili ze-aortic abanawo noma yiziphi izimpawu, ikakhulukazi ngesikhathi sobuntwana nasesikhathini sobukhulu. Uma izimpawu zivele, ngokuvamile zithuthuka kancane njengoba uvalo luya luphunguka ngokuhamba kwesikhathi.

Nazi izimpawu ezivamile ongazibona:

• Ubuhlungu noma ukungakhululeki esifubeni, ikakhulukazi ngesikhathi somsebenzi womzimba
• Ukuphefumula okufushane ngesikhathi somsebenzi womzimba noma lapho ulele phansi
• Ukuzizwa ukhathele noma ubuthakathaka ngokungavamile ngesikhathi semisebenzi evamile
• Ukukhungatheka noma ukuzwa ubuthakathaka, ikakhulukazi ngomzamo
• Ukubetha kwenhliziyo noma ukubetha kwenhliziyo okungavamile
• Ukuvuvukala ezinyaweni, ezinkulwini, noma ezinyaweni

Lezi zimpawu ngokuvamile zivele lapho uvalo luya luvaliwe (luvaliwe) noma luphuma (luphuma). Izindaba ezinhle ukuthi izimpawu zivame ukuthuthuka kancane, zinike wena nodokotela wakho isikhathi sokuqapha nokuhlela ukwelashwa uma kudingeka.

Ziyini izinhlobo ze-Uvalo oluneenhlamba ezimbili ze-Aortic?

Odokotela bahlukanisa ama-uvalo oluneenhlamba ezimbili ze-aortic ngokusekelwe endleleni eenhlamba ezimbili ezihlelekile ngayo nokuthi yiziphi izicucu ezihlanganisiwe ndawonye. Uhlobo oluvamile luhilela ukuhlanganiswa kwezicucu ezifanele nezingezithombe, okwenzeka cishe ku-70-85% yezimo.

Uhlobo lwesibili luhilela ukuhlanganiswa kwezicucu ezifanele ze-coronary ngecup engaphansi. Lokhu kwenzeka cishe ku-15-30% yabantu abanesimo. Ngokungavamile, ungaba nokuhlanganiswa kwe-coronary ephansi ne-non-coronary cusps.

Nakuba lezi zindaba zobuchwepheshe zingabonakala zinzima, okubaluleke kakhulu ukuthi uvalo lwakho oluthile lusebenza kangcono kangakanani. I-cardiologist yakho inganquma uhlobo lwakho ngokuhlola izithombe futhi ichaze ukuthi kusho ukuthini isimo sakho esithile.

Yini ebangela i-Uvalo oluneenhlamba ezimbili ze-Aortic?

Uvalo oluneenhlamba ezimbili ze-aortic yisimo esizalwa naso, okusho ukuthi sithuthukiswa ngesikhathi sokuthuthukiswa kwesilwane esiswini. Imbangela eqondile ayiqondakali ngokuphelele, kodwa abacwaningi bakholelwa ukuthi ivela ekuhlanganiseni okunzima phakathi kwezinto zofuzo nezimo ezingqongile.

I-genetics idlala indima ebalulekile kulesi simo. Uma une-uvalo oluneenhlamba ezimbili ze-aortic, kunesilinganiso esingu-10% sokuthi abantu bakho abaseduze (abazali, abafowabo, noma abantwana) bangaba nalo. Lokhu kuphezulu kakhulu kunengozi yabantu abavamile engu-1-2%.

Ezinye izifo zofuzo zihambisana ne-uvalo oluneenhlamba ezimbili ze-aortic, kufaka phakathi i-Turner syndrome, i-Marfan syndrome, kanye nezinye izifo ze-connective tissue. Noma kunjalo, abantu abaningi abane-uvalo oluneenhlamba ezimbili ze-aortic abanazo lezi zimo ezengeziwe.

Izimo ezingqongile ngesikhathi sokukhulelwa zingase futhi zinikeze, nakuba izici ezithile azikaziveliwe ngokucacile. Okubalulekile ukuqonda ukuthi akukho lutho wena noma abazali bakho abalwenzile olubangele lesi simo - kulula nje indlela inhliziyo yakho eyenziwe ngayo ngaphambi kokuzalwa.

Nini okufanele ubona udokotela nge-Uvalo oluneenhlamba ezimbili ze-Aortic?

Kufanele ubona udokotela uma uhlangabezana nanoma yiziphi izimpawu ezingase zikhombe izinkinga zenhliziyo, ngisho noma zibonakala zingenamandla ekuqaleni. Ukutholakala kwangaphambi kwesikhathi nokuqapha kungenza umehluko omkhulu ekulawuleni lesi simo ngokuphumelelayo.

Xhumana nodokotela wakho uma uqaphela ubuhlungu esifubeni, ukuphefumula okufushane, ukukhathala okungavamile, ukukhungatheka, noma ukubetha kwenhliziyo. Lezi zimpawu zidinga ukuhlolwa, ikakhulukazi uma zivele ngesikhathi somsebenzi womzimba noma zibonakala ziba zimbi ngokuhamba kwesikhathi.

Uma unomlando womndeni we-uvalo oluneenhlamba ezimbili ze-aortic noma ezinye izimo zenhliziyo ezikhona ekuzalweni, khuluma lokhu nodokotela wakho ngesikhathi sokuhlola okuvamile. Bangase bacebise ukuhlolwa kokuhlola njenge-echocardiogram ukuhlola isimo nomsebenzi wenhliziyo yakho.

Kwabanjwe kakade nge-uvalo oluneenhlamba ezimbili ze-aortic, ukuvakashela okuqhubekayo kubalulekile. I-cardiologist yakho izonquma ukuthi udinga ukuqapha kangakanani ngokusekelwe ekutheni uvalo lwakho lusebenza kangcono kangakanani.

Ziyini izici ezingozi ze-Uvalo oluneenhlamba ezimbili ze-Aortic?

Njengoba i-uvalo oluneenhlamba ezimbili ze-aortic yisimo esizalwa naso, izici ezingozi ezivamile njengokukhetha indlela yokuphila azisebenzi ngendlela efanayo njengoba zenza kwezinye izimo zenhliziyo. Noma kunjalo, izici ezithile zingandisa amathuba akho okuba nalesi simo noma ukuthuthukisa izinkinga.

Isici esinamandla kakhulu sokungozi ukuba nomlando womndeni we-uvalo oluneenhlamba ezimbili ze-aortic noma ezinye izifo zenhliziyo ezikhona ekuzalweni. Amadoda futhi anethuba elikhulu lokuba nalesi simo kunabesifazane, ngesilinganiso esingu-3: 1.

Izimo ezithile zofuzo zikhuphula ingozi yakho, kufaka phakathi i-Turner syndrome, i-Marfan syndrome, ne-Ehlers-Danlos syndrome. Uma unayo noma iyiphi kula ma-condition, udokotela wakho cishe uzohlola i-uvalo oluneenhlamba ezimbili ze-aortic.

Ubudala buya baba yisici sokungozi sezinkinga kunokuba nalesi simo ngokwalo. Njengoba ukhula, isimo esingavamile se-valve singabangela izinkinga ezinjenge-stenosis noma i-regurgitation, ngokuvamile ziya ziveleka eminyakeni engu-40, 50, noma 60.

Ziyini izinkinga ezingase zenzeke nge-Uvalo oluneenhlamba ezimbili ze-Aortic?

Nakuba abantu abaningi abane-uvalo oluneenhlamba ezimbili ze-aortic bephila impilo evamile, isimo singabangela izinkinga ngokuhamba kwesikhathi. Ukuqonda lezi zinto ezingase zenzeke kukusiza uhlale unolwazi futhi usebenze neqembu lakho lokunakekelwa kwezempilo ukuze uzivikele noma uzilawule ngokuphumelelayo.

Izinkinga ezivamile zihlanganisa:

• I-Aortic stenosis - uvalo luya luvaliwe futhi luvimbela ukugeleza kwegazi
• I-Aortic regurgitation - uvalo luya luphuma futhi igazi ligeleza emuva
• I-Aortic root dilation - umthambo omkhulu ovela enhliziyweni yakho uya ukhula
• I-Endocarditis - ukutheleleka kwe-valve yenhliziyo
• Ukwehluleka kwenhliziyo - lapho inhliziyo yakho ingakwazi ukupompa igazi ngokuphumelelayo
• I-Arrhythmias - ukubetha kwenhliziyo okungavamile

I-Aortic root dilation ifuna ukunakekelwa okukhethekile ngoba ingase ibe khona ngisho noma uvalo ngokwalo lusebenza kahle. Ukukhula kwe-aorta kungase kube yingozi ezingeni elikhulu ezingeni elikhulu njenge-aortic dissection, nakuba lokhu kungavamile.

Izindaba ezinhle ukuthi ukuqapha okuvamile kungasiza ukuthola lezi zinkinga ekuqaleni, lapho zitholakala khona kalula. Izinkinga eziningi zithuthuka kancane eminyakeni eminingi noma amashumi eminyaka, zinike wena neqembu lakho lezokwelapha isikhathi sokuhlela izixazululo ezifanele.

I-Uvalo oluneenhlamba ezimbili ze-Aortic ihlonishwa kanjani?

Ukuhlonishwa kwe-uvalo oluneenhlamba ezimbili ze-aortic ngokuvamile kuqala ngodokotela wakho olalele inhliziyo yakho nge-stethoscope. Abantu abaningi abanesimo banomdlandla wenhliziyo - umsindo owengeziwe ovela lapho igazi ligeleza nge-valve engavamile.

Uma udokotela wakho ekrotha ngenkinga ye-valve yenhliziyo, cishe uzoyala i-echocardiogram. Lolu hlolo lwe-ultrasound olungenakuthi luveze izithombe eziningi zenhliziyo yakho futhi lubonise ukuthi uvalo lwakho lubukeka kanjani futhi lusebenza kanjani. Yilona hlolo elibaluleke kakhulu lokuhlonishwa kwe-uvalo oluneenhlamba ezimbili ze-aortic.

Ukuhlolwa okwengeziwe kungase kuhlanganise i-electrocardiogram (ECG) ukuhlola umsebenzi wama-elekthronikhi wenhliziyo yakho, noma i-X-ray yesifuba ukubona usayizi nesimo senhliziyo yakho. Kwezinye izimo, udokotela wakho angase acebise izithombe eziphambili njenge-cardiac MRI noma i-CT scans.

Uma une-uvalo oluneenhlamba ezimbili ze-aortic, udokotela wakho uzofuna futhi ukuhlola i-aortic dilation. Lokhu ngokuvamile kuhilela ukubuka i-aorta yonke ukuhlola noma yikuphi ukukhula okungase kudinge ukuqapha noma ukwelashwa.

Iyini ukwelashwa kwe-Uvalo oluneenhlamba ezimbili ze-Aortic?

Ukwelashwa kwe-uvalo oluneenhlamba ezimbili ze-aortic kuncike ekutheni uvalo lwakho lusebenza kangcono kangakanani nokuthi uhlangabezana yini nezimpawu. Abantu abaningi abane-valves ezisebenza kahle badinga nje ukuqapha okuvamile ngaphandle kokwelashwa okusheshayo.

Kwabanesinkinga elincane le-valve futhi abangenazo izimpawu, udokotela wakho cishe uzokhuthaza indlela "yokulinda nokulinda". Lokhu kusho ukuvakashela okuvamile kanye ne-echocardiograms ukuqapha ukuthi uvalo lwakho lusebenza kanjani ngokuhamba kwesikhathi.

Uma izimpawu zivele noma umsebenzi we-valve uya uba mbi kakhulu, izinketho zokwelashwa zihlanganisa:

• Imithi yokulawula izimpawu nokuvikela inhliziyo yakho
• I-Balloon valvuloplasty - inqubo yokuvula uvalo oluvaliwe
• Ukulungiswa kwe-valve yokucutshungulwa uma kungenzeka
• Ukuhlukaniswa kwe-valve nge-mechanical noma i-biological valves
• I-Transcatheter aortic valve replacement (TAVR) kwezinye izimo

I-cardiologist yakho izosebenza nawe ukuze unqume indlela yokwelashwa engcono kakhulu ngokusekelwe esimweni sakho esithile, ubudala, impilo yonke, kanye nezifiso zakho siqu. Umgomo uhlala ukukusiza ugcine ikhwalithi yempilo engcono kakhulu.

Ungazinakekela kanjani nge-Uvalo oluneenhlamba ezimbili ze-Aortic?

Ukuphila kahle nge-uvalo oluneenhlamba ezimbili ze-aortic kuhilela ukuhlala unolwazi ngesimo sakho nokulandela iziphakamiso zedokotela wakho. Abantu abaningi bangagcina impilo esebenzayo, enempilo ngokunakekelwa okuhle nokuqapha.

Gcina uqhubeke nokuvakashela okuvamile kwe-cardiology, ngisho noma uzizwa kahle. Lezi zivivinyo zisiza udokotela wakho ukuthi alandelele noma yikuphi ukushintsha emsebenzini we-valve yakho futhi abambe izinkinga ezingase zenzeke ekuqaleni. Ungawashiyi ama-aphoyintimenti ngoba uzizwa kahle.

Gcina ukuhlanzeka okuhle kwamazinyo futhi uqondise udenti yakho ngesimo senhliziyo yakho. Nakuba izinqubo ezivamile zokwelapha amazinyo zivame ukuphepha, udokotela wakho angase akhuthaze ama-antibiotics ngaphambi kokwelashwa okuthile kwamazinyo ukuvimbela ukutheleleka.

Hlala usebenza ngokomzimba ngaphakathi kwemingcele i-cardiologist yakho eyiqondisa. Ukusebenza komzimba okuvamile kusiza impilo yenhliziyo, kodwa ungase udinge ukugwema imisebenzi enzima kakhulu noma imidlalo yokuncintisana ngokusekelwe emsebenzini we-valve yakho.

Phila impilo enempilo yenhliziyo ngokudla ukudla okunomsoco, ugcine isisindo esinempilo, ungabhemi, futhi ulawule ukucindezeleka. Lezi zindlela ziyazuza wonke umuntu kodwa kubaluleke kakhulu lapho unesimo senhliziyo.

Kufanele uzilungiselele kanjani i-aphoyintimenti yakho yedokotela?

Ukulungiselela i-aphoyintimenti yakho ye-cardiology kusiza uqinisekise ukuthi uthola okuningi ekuhambeni kwakho. Qala ngokubhala phansi noma yiziphi izimpawu ozibonile, ngisho noma zibonakala zingenamandla noma azinhlobene nenhliziyo yakho.

Letha uhlu lwemithi yonke oyithathayo, kufaka phakathi imithi yokuthengwa ngaphandle komthetho kanye nezinhlanganisela. Futhi, buthana nanoma yimaphi imiphumela yokuhlolwa yangaphambili noma amarekhodi ezempilo ahlobene nesimo senhliziyo yakho uma ubona udokotela omusha.

Lungiselela imibuzo mayelana nesimo sakho, izinketho zokwelashwa, ukulinganiselwa kwemisebenzi, nokuthi yini okulindelekile esikhathini esizayo. Unganqikazi ukubuza nganoma yini ekukhathazayo - udokotela wakho ufuna ukukusiza uqonde isimo sakho.

Cabanga ngokuletha ilungu lomndeni noma umngani emihlanganweni ebalulekile. Bangakusiza ukuba ukhumbule ulwazi futhi banikeze ukwesekwa ngesikhathi sokuqondana ngezinketho zokwelashwa.

Iyini into ebaluleke kakhulu mayelana ne-Uvalo oluneenhlamba ezimbili ze-Aortic?

Uvalo oluneenhlamba ezimbili ze-aortic yisimo esilawuleka abantu abaningi abaphila ngaso ngempumelelo ekuphileni kwabo konke. Nakuba kudinga ukunakekelwa okuqhubekayo kwezokwelapha, abantu abaningi abanesimo bangajabulela impilo evamile, esebenzayo ngokunakekelwa okuhle nokuqapha.

Into ebaluleke kakhulu ongayenza ukugcina ukuvakashela okuqhubekayo ne-cardiologist eqonda isimo sakho. Ukutholakala kwangaphambi kwesikhathi kwanoma yikuphi ukushintsha emsebenzini we-valve kuvumela ukusebenza ngesikhathi uma kudingeka.

Khumbula ukuthi ukuba ne-uvalo oluneenhlamba ezimbili ze-aortic akuchazi impilo yakho noma akulinganiselwe amaphupho akho. Ngokuqhubeka kwezokwelapha namuhla kanye nezinketho zokwelashwa, abantu abanesimo bangalindela imiphumela emihle kanye nekhalithi yempilo lapho basebenza eduze neqembu labo lokunakekelwa kwezempilo.

Imibuzo Evamile Ebuzwayo Mayelana ne-Uvalo oluneenhlamba ezimbili ze-Aortic

Ngingasebenza yini nge-uvalo oluneenhlamba ezimbili ze-aortic?

Abantu abaningi abane-uvalo oluneenhlamba ezimbili ze-aortic bangasebenza ngokuphepha, kodwa ubukhulu nohlobo lomsebenzi kuncike ekutheni uvalo lwakho lusebenza kangcono kangakanani. Uma uvalo lwakho lusebenza kahle futhi awunawo noma yiziphi izimpawu, cishe ungasebenzisa imisebenzi eminingi. Noma kunjalo, uma unezinkinga ezinkulu ze-valve, udokotela wakho angase akhuthaze ukugwema imidlalo enkulu noma yokuncintisana. Hlala uxoxa ngezinhlelo zakho zokusebenza nomzimba ne-cardiologist yakho ukuze uthole iziphakamiso eziqondene nesimo sakho esithile.

Ingabe ngizodinga ukuhlinzwa nge-uvalo oluneenhlamba ezimbili ze-aortic?

Akuwona wonke umuntu one-uvalo oluneenhlamba ezimbili ze-aortic odinga ukuhlinzwa. Abantu abaningi baphila impilo yabo yonke ngokuqapha kuphela. Ukuhlinzwa kuba yadingeka lapho uvalo lubangela izimpawu ezinkulu, luvimbela ukugeleza kwegazi kakhulu, noma luvumela igazi eliningi ukuba ligeleze emuva. Udokotela wakho uzohlola ngokucophelela umsebenzi we-valve yakho, izimpawu, nempilo yonke ukuze anqume ukuthi nini ukuhlinzwa kungaba usizo. Isinqumo sihlala siqondene nesimo sakho esithile.

Ingabe i-uvalo oluneenhlamba ezimbili ze-aortic lingadluliselwa kubantwana bami?

Yebo, i-uvalo oluneenhlamba ezimbili ze-aortic lingasebenza emindenini. Uma unalesi simo, ngamunye wabantwana bakho unesilinganiso esingu-10% sokuthi naye abe nalo, okuphezulu kakhulu kunengozi yabantu abavamile. Noma kunjalo, lokhu futhi kusho ukuthi kunesilinganiso esingu-90% sokuthi ngeke babe nalo. Udokotela wakho angase akhuthaze ukuthi abantu bakho abaseduze (abantwana, abafowabo, abazali) babe ne-echocardiograms yokuhlola ukuhlola lesi simo, ikakhulukazi uma bethuthukisa noma yiziphi izimpawu ezihlobene nenhliziyo.

Uyini umehluko phakathi kwe-uvalo oluneenhlamba ezimbili ze-aortic nezinye izinkinga ze-valve yenhliziyo?

Uvalo oluneenhlamba ezimbili ze-aortic yumehluko wesakhiwo ozalwa nawo, kuyilapho ezinye izinkinga ze-valve zivame ukuthuthuka ngokuhamba kwesikhathi ngenxa yokuguga, ukutheleleka, noma ezinye izimbangela. Uvalo oluneenhlamba ezimbili luneenhlamba ezimbili esikhundleni sezintathu, okwenza lube lula kakhulu izinkinga njengoba ukhula. Ezinye izimo ze-valve zingase zihilele ama-valves amathathu aneenhlamba ezivamile ezilimele noma ezigulayo. Izindlela zokwelapha zingafana, kodwa imbangela yokuqala nokuqhubeka kungase kuhluke.

Ndingakanani ukuvakashela okuqhubekayo okudingayo?

Ukuvamile kokuvakashela okuqhubekayo kuncike ekutheni uvalo lwakho lusebenza kangcono kangakanani. Uma uvalo lwakho oluneenhlamba ezimbili ze-aortic lusebenza kahle, ungase udinge ukuvakashela eminyakeni engu-2-3. Uma kunesibonakaliso sezinkinga ze-valve ezithuthukayo, udokotela wakho angase afune ukukubona minyaka yonke noma ngisho ngokuvamile. Labo abanezinkinga ezinkulu ze-valve bangase badinge ukuqapha izinyanga eziyisithupha. I-cardiologist yakho izokwakha isimiso sokuvakashela okuqhubekayo esiqondene nomsebenzi wakho we-valve kanye nanoma yiziphi izinkinga ezihambisana nayo njenge-aortic dilation.