Ukuvuselelwa kwe-valve ye-Mitral

Ukuvuselelwa kweMitral ukuphazamiseka lapho i-mitral valve ohlangothini lwesobunxele lwenhliziyo ingavali kahle.

Ukuvuselelwa kusho ukuvuza kuvalvu engavali yonke indawo.

Ukubuyiselwa kweMitral uhlobo oluvamile lokuphazamiseka kwe-valve yenhliziyo.

Igazi eligeleza phakathi kwamakamelo ahlukene enhliziyo yakho kufanele ligeleze nge-valve. I-valve ephakathi kwamakamelo ama-2 ohlangothini lwesobunxele lwenhliziyo yakho ibizwa nge-mitral valve.

Lapho i-mitral valve ingavali yonke indlela, igazi ligelezela emuva liye egumbini eliphezulu lenhliziyo (i-atrium) lisuka egumbini eliphansi njengoba lisebenza. Lokhu kwehlisa inani legazi eligelezela kuwo wonke umzimba. Ngenxa yalokho, inhliziyo ingazama ukushaya ngamandla. Lokhu kungaholela ekuhlulekeni kwenhliziyo okucinana.

Ukuvuselelwa kweMitral kungaqala ngokuzumayo. Lokhu kuvame ukwenzeka ngemuva kokuhlaselwa yisifo senhliziyo. Lapho ukubuyiswa kungapheli, kuba isikhathi eside (okungapheli).

Ezinye izifo eziningi noma izinkinga zinganciphisa noma zilimaze i-valve noma izicubu zenhliziyo ezungeze i-valve. Usengozini yokuvuselelwa kwe-mitral valve uma une:

• Isifo senhliziyo kanye nomfutho wegazi ophakeme
• Ukutheleleka kwama-valve enhliziyo
• I-Mitral valve prolapse (MVP)
• Izimo ezingavamile, njenge-syphilis engalashwa noma i-Marfan syndrome
• Isifo senhliziyo i-rheumatic. Lokhu kuyinkinga ye-strep throat engalashwa engasavami kakhulu.
• Ukuvuvukala kwekamelo lenhliziyo elingezansi kwesokunxele

Enye into ebalulekile engcupheni yokuvuselelwa kwe-mitral ukusetshenziswa kwangaphambilini kwepilisi yokudla ebizwa nge- "Fen-Phen" (fenfluramine kanye ne-phentermine) noma i-dexfenfluramine. Lesi sidakamizwa sasuswa emakethe yi-U.S. Food and Drug Administration (FDA) ngo-1997 ngenxa yezinkinga zokuphepha.

Izimpawu zingaqala kungazelelwe uma:

• Ukuhlaselwa yinhliziyo kulimaza imisipha ezungeze i-mitral valve.
• Izintambo ezinamathisela imisipha ekhefini le-valve.
• Ukutheleleka kwe-valve kubhubhisa ingxenye ye-valve.

Ngokuvamile azikho izimpawu. Lapho izimpawu zenzeka, zivame ukukhula kancane kancane, futhi zingafaka:

• Khwehlela
• Ukukhathala, ukukhathala, nekhanda elikhanyayo
• Ukuphefumula ngokushesha
• Ukuzwa kokuzwa ukushaya kwenhliziyo (ukushaya kwenhliziyo) noma ukushaya kwenhliziyo okusheshayo
• Ukuphefumula okwandayo ngomsebenzi nalapho ulele phansi
• Ukuvuka ihora noma ngaphezulu ngemuva kokulala ngenxa yenkinga yokuphefumula
• Ukuchama, ngokweqile ebusuku

Lapho ulalele inhliziyo yakho namaphaphu, umhlinzeki wezokunakekelwa kwempilo angathola:

• Ukuthakazelisa (ukudlidlizela) phezu kwenhliziyo lapho uzizwa indawo yesifuba
• Umsindo wenhliziyo owengeziwe (S4 gallop)
• Inhliziyo ehlukile ibubula
• Ukuqhekeka emaphashini (uma uketshezi lubuyela emaphashini)

Ukuhlolwa komzimba nakho kungaveza:

• Ukuvuvukala kweqakala nemilenze
• Isibindi esandisiwe
• Imithambo yentamo eqhumayo
• Ezinye izimpawu zokwehluleka kwenhliziyo emaceleni angakwesokudla

Ukuhlolwa okulandelayo kungenziwa ukubheka ukwakheka kwenhliziyo ye-valve nokusebenza:

• Ukuhlolwa kwe-CT kwenhliziyo
• I-Echocardiogram (ukuhlolwa kwenhliziyo nge-ultrasound) - i-transthoracic noma i-transesophageal
• Ukucabanga kwe-Magnetic resonance (MRI)

I-catheterization yenhliziyo ingenziwa uma ukusebenza kwenhliziyo kuba kubi kakhulu.

Ukwelashwa kuzoya ngokuthi unaziphi izimpawu, yisiphi isimo esidale ukuthi i-mitral valve ibuye, ukuthi inhliziyo isebenza kahle kangakanani, futhi uma inhliziyo ikhulisiwe.

Abantu abanomfutho wegazi ophakeme noma imisipha yenhliziyo ebuthakathaka banganikezwa imithi yokwehlisa ubunzima enhliziyweni nokunciphisa izimpawu.

Izidakamizwa ezilandelayo zingabekwa lapho izimpawu zokuvuselelwa kwe-mitral ziba zimbi kakhulu:

• Ama-beta-blocker, ama-ACE inhibitors, noma ama-blocker wesiteshi se-calcium
• Ama-thinner egazi (ama-anticoagulants) okusiza ukuvimbela amahlule egazi kubantu abane-atrial fibrillation
• Izidakamizwa ezisiza ukulawula ukushaya kwenhliziyo okungalingani noma okungavamile
• Amaphilisi wamanzi (isisu) ukususa uketshezi oluningi emaphashini

Ukudla okunesodium ephansi kungasiza. Ungadinga ukukhawulela umsebenzi wakho uma kuvela izimpawu.

Lapho kutholakala ukuxilongwa, kufanele uvakashele umhlinzeki wakho njalo ukulandelela izimpawu zakho nokusebenza kwenhliziyo.

Ungadinga ukuhlinzwa ukulungisa noma ukufaka enye i-valve uma:

• Ukusebenza kwenhliziyo kubi
• Inhliziyo iyakhuliswa (ihlanjululwe)
• Izimpawu ziba zimbi kakhulu

Umphumela uyehluka. Isikhathi esiningi isimo simnene, ngakho-ke aludingi ukwelashwa noma ukuvinjelwa. Izimpawu zivame ukulawulwa ngemithi.

Izinkinga ezingakhula zibandakanya:

• Isigqi senhliziyo esingajwayelekile, kufaka phakathi i-atrial fibrillation futhi okungenzeka kube sibi ngokwengeziwe, noma isigqi esingajwayelekile esisongela impilo
• Amahlule angahambela kwezinye izindawo zomzimba, njengamaphaphu noma ubuchopho
• Ukutheleleka kwe-valve yenhliziyo
• Ukwehluleka kwenhliziyo

Shayela umhlinzeki wakho uma izimpawu ziba zimbi kakhulu noma zingathuthuki ngokwelashwa.

Shayela nomhlinzeki wakho uma welashwa ngalesi simo futhi uthuthukise izimpawu zokutheleleka, okubandakanya:

• Amakhaza
• Imfiva
• Ukuzizwa okuvamile
• Ubuhlungu bekhanda
• Ubuhlungu bemisipha

Abantu abanezivalo zenhliziyo ezingajwayelekile noma ezilimele basengozini yokutheleleka okubizwa nge-endocarditis. Noma yini ebangela ukuthi amabhaktheriya angene egazini lakho kungaholela kulokhu kutheleleka. Izinyathelo zokugwema le nkinga zifaka:

• Gwema imijovo engahlanzekile.
• Phatha izifo ezithathelwanayo ngokushesha ukuvimbela imfiva ye-rheumatic.
• Tshela njalo umhlinzeki wakho nodokotela wamazinyo uma unomlando wesifo se-valve senhliziyo noma isifo senhliziyo esizalwe ngaphambi kokulashwa. Abanye abantu bangadinga ama-antibiotic ngaphambi kwezinqubo zamazinyo noma ukuhlinzwa.

Ukuvuselelwa kwe-valve ye-Mitral; Ukungakwazi ukusebenza kahle kwe-Mitral valve; Ukuvuselelwa kwe-mitral yenhliziyo; Ukuvuselelwa kabusha kwe-Valvular mitral

• Inhliziyo - isigaba phakathi nendawo
• Inhliziyo - ukubuka kwangaphambili
• Ukuhlinzwa kwe-valve yenhliziyo - uchungechunge

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UNishimura RA, Otto CM, uBonow RO, et al. Ukubuyekezwa okugxile kwe-2017 AHA / ACC komhlahlandlela we-2014 AHA / ACC wokuphathwa kweziguli ezinesifo senhliziyo se-valvular: umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice Guidelines. Ukujikeleza. 2017; 135 (25): e1159-e1195. I-PMID: 28298458 pubmed.ncbi.nlm.nih.gov/28298458/.

UThomas JD, uBonow RO. Isifo seMitral valve. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 69.