I-aortic stenosis

I-aorta ingumthambo omkhulu okhipha igazi lisuke enhliziyweni liye kuwo wonke umzimba. Igazi liphuma enhliziyweni lize liye ku-aorta nge-aortic valve. Ku-aortic stenosis, i-aortic valve ayivuli ngokugcwele. Lokhu kunciphisa ukugeleza kwegazi okusuka enhliziyweni.

Njengoba i-aortic valve incipha, i-ventricle engakwesokunxele kufanele isebenze kanzima ukukhipha igazi nge-valve. Ukwenza lo msebenzi owengeziwe, imisipha esezindongeni ze-ventricle iyajiya. Lokhu kungaholela ezinhlungwini zesifuba.

Njengoba ingcindezi iqhubeka ikhuphuka, igazi lingase libuyele emaphashini. I-aortic stenosis enamandla inganciphisa inani legazi elifinyelela ebuchosheni nasemzimbeni wonke.

I-aortic stenosis ingaba khona kusukela ekuzalweni (kokuzalwa), kepha imvamisa iyakhula kamuva empilweni. Izingane ezine-aortic stenosis zingaba nezinye izimo ezikhona kusukela ekuzalweni.

I-aortic stenosis yenzeka kakhulu ngenxa yokwakheka kwamadiphozithi e-calcium anciphisa i-valve. Lokhu kubizwa ngokuthi yi-calcific aortic stenosis. Inkinga ithinta kakhulu abantu asebekhulile.

Ukwakhiwa kwe-calcium kwe-valve kwenzeka ngokushesha kubantu abazalwa benama-aortic angavamile noma ama-bicuspid valves. Ezimweni ezingavamile, i-calcium buildup ingakhula ngokushesha okukhulu lapho umuntu esethole imisebe yesifuba (njengokwelashwa komdlavuza).

Enye imbangela yi-rheumatic fever. Lesi simo singakhula ngemuva kwe-strep throat noma i-scarlet fever. Izinkinga ze-Valve azikhuli iminyaka emi-5 kuya kwengu-10 noma ngaphezulu ngemuva kokuvela komkhuhlane wamathambo. I-rheumatic fever iya ngokuya ixhaphaka e-United States.

I-aortic stenosis ivela kubantu abangaba ngu-2% abaneminyaka engaphezu kwengama-65 ubudala. Kwenzeka kaningi emadodeni kunabesifazane.

Iningi labantu abane-aortic stenosis abazenzi izimpawu kuze kube yilapho lesi sifo sesithuthukile. Ukuxilongwa kungenzeka ukuthi kwenziwa lapho umhlinzeki wezokunakekelwa kwezempilo ezwa ukukhononda kwenhliziyo futhi wenza izivivinyo.

Izimpawu ze-aortic stenosis zifaka:

• Ukungakhululeki kwesifuba: Ubuhlungu besifuba bungaba bukhulu ngomsebenzi futhi bufinyelele engalweni, entanyeni noma emhlathini. Isifuba singazizwa siqinile noma sicindezelwe.
• Ukukhwehlela, mhlawumbe okunegazi.
• Izinkinga zokuphefumula lapho uzivocavoca.
• Ukukhathala kalula.
• Ukuzwa ukushaya kwenhliziyo (ukushaya kwenhliziyo).
• Ukuquleka, ubuthakathaka, noma isiyezi ngomsebenzi.

Ezinganeni nasezinganeni, izimpawu zifaka:

• Ukukhathala kalula ngokuzikhandla (ezimweni ezimnene)
• Ukwehluleka ukuthola isisindo
• Ukudla okungafanele
• Izinkinga zokuphefumula ezinkulu ezikhula kungakapheli izinsuku noma amasonto ezelwe (ezimweni ezinzima)

Izingane ezine-aortic stenosis emnene noma elinganiselayo zingase zibe zimbi kakhulu njengoba zikhula. Basengozini yokutheleleka kwenhliziyo ebizwa nge-bacterial endocarditis.

Ukububula kwenhliziyo, ukuchofoza, noma omunye umsindo ongajwayelekile kuzwakala njalo nge-stethoscope. Umhlinzeki angakwazi ukuzwa ukudlidliza noma ukunyakaza lapho ebeka isandla enhliziyweni. Kungaba nokushaya ngamandla noma ushintsho kwikhwalithi ye-pulse entanyeni.

Umfutho wegazi ungaba phansi.

I-aortic stenosis ivame ukutholakala bese ilandelwa kusetshenziswa uhlolo olubizwa nge-transthoracic echocardiogram (TTE).

Ukuhlolwa okulandelayo kungenziwa futhi:

• ECG
• Vivinya ukuhlolwa kwengcindezi
• I-catheterization yenhliziyo engakwesobunxele
• I-MRI yenhliziyo
• I-Transceophageal echocardiogram (TEE)

Ukuhlolwa njalo ngumhlinzeki kungaba yikho konke okudingekayo uma izimpawu zakho zingezimbi. Umhlinzeki kufanele abuze ngomlando wakho wezempilo, enze ukuhlolwa komzimba, futhi enze i-echocardiogram.

Abantu abane-aortic stenosis enamandla bangatshelwa ukuthi bangadlali imidlalo yokuncintisana, noma ngabe abanazo izimpawu. Uma kwenzeka izimpawu, umsebenzi okhandlayo kumele uvinjelwe.

Imithi isetshenziselwa ukwelapha izimpawu zokwehluleka kwenhliziyo noma isigqi senhliziyo esingajwayelekile (imvamisa i-atrial fibrillation). Lokhu kufaka phakathi isisu (amaphilisi amanzi), ama-nitrate, nama-beta-blocker. Umfutho wegazi ophakeme nawo kufanele welashwe. Uma i-aortic stenosis inzima, le ndlela yokwelashwa kufanele yenziwe ngokucophelela ukuze umfutho wegazi ungehli kakhulu.

Esikhathini esedlule, abantu abaningi abanezinkinga ze-valve yenhliziyo babenikezwa ama-antibiotic ngaphambi komsebenzi wamazinyo noma inqubo efana ne-colonoscopy. Imithi elwa namagciwane yanikezwa ukuvimbela ukutheleleka kwenhliziyo eyonakele. Kodwa-ke, ama-antibiotic manje asasetshenziswa kaningi kakhulu ngaphambi kokusebenza kwamazinyo nezinye izinqubo. Buza kumhlinzeki wakho wezempilo ukuthola ukuthi uyawadinga yini ama-antibiotic.

Abantu abanalokhu nezinye izimo zenhliziyo kufanele bayeke ukubhema futhi bahlolelwe i-cholesterol ephezulu.

Ukuhlinzwa ukulungisa noma ukufaka esikhundleni i-valve kuvame ukwenziwa kubantu abadala noma ezinganeni eziba nezimpawu. Noma izimpawu zingabi zimbi kakhulu, udokotela angancoma ukuhlinzwa ngokuya ngemiphumela yokuhlolwa.

Inqubo encane engahlaseli ebizwa nge-balloon valvuloplasty ingenziwa esikhundleni sokuhlinzwa noma ngaphambi kokuhlinzwa.

• Ibhaluni lifakwa emthanjeni osemgodini, lixhunywe enhliziyweni, libekwe ngaphesheya kwe-valve, futhi ligcwale umoya. Noma kunjalo, ukunciphisa kuvame ukuvela futhi ngemuva kwale nqubo.
• Inqubo entsha eyenziwe ngasikhathi sinye ne-valvuloplasty ingafaka i-valve yokufakelwa (i-transcatheter aortic valve replacement noma i-TAVR). Le nqubo ivame ukwenziwa ezigulini ezingakwazi ukuhlinzwa, kepha kuya ngokuya kujwayelekile.

Ezinye izingane zingadinga ukulungiswa kwe-aortic valve noma ukushintshwa. Izingane ezine-aortic stenosis emnene zingakwazi ukubamba iqhaza emisebenzini eminingi.

Umphumela uyehluka. Lesi sifo singahle sibe mnene futhi singakhiphi izimpawu. Ngokuhamba kwesikhathi, i-aortic valve ingancipha. Lokhu kungaholela ezinkingeni zenhliziyo ezinzima njenge:

• I-Atrial fibrillation ne-atrial flutter
• Amahlule egazi ebuchosheni (isifo sohlangothi), amathumbu, izinso, noma ezinye izindawo
• Ukuphela kweziphonso (i-syncope)
• Ukwehluleka kwenhliziyo
• Umfutho wegazi ophakeme emithanjeni yamaphaphu (umfutho wegazi ophakeme wamaphaphu)

Imiphumela yokushintshwa kwe-aortic valve ivame ukuba mihle kakhulu. Ukuze uthole ukwelashwa okungcono kakhulu, iya esikhungweni esenza lolu hlobo lokuhlinzwa njalo.

Shayela umhlinzeki wakho uma wena noma ingane yakho unezimpawu ze-aortic stenosis.

Futhi xhumana nodokotela wakho khona manjalo uma utholwe unalesi sifo futhi izimpawu zakho ziba zimbi kakhulu noma kuvela izimpawu ezintsha.

I-aortic valve stenosis; I-rheumatic aortic stenosis; I-calcific aortic stenosis; I-aortic stenosis yenhliziyo; I-Valvular aortic stenosis; Inhliziyo ezelwe - i-aortic stenosis; I-rheumatic fever - i-aortic stenosis

• I-aortic stenosis
• Ama-valve enhliziyo

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UHermann HC, uMack MJ. Izindlela zokwelapha zeTranscatheter zesifo senhliziyo se-valvular. 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 72.

ILindman BR, iBonow RO, i-Otto CM. Isifo se-aortic 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 68.

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