Ciwon Zuciya na Kwayoyin Halitta
Hypertrophic cardiomyopathy (HCM) wani cututtukan kwayoyin halitta ne da ke cikin kwakwalwa (wanda ya shafi kusan 1 cikin mutane 500), wanda zai iya haifar da matsalolin da yawa, ciki har da rashin zuciya da mutuwar kwatsam. Duk da haka, tsananin HCM mai sauƙi ne daga mutum zuwa mutum, kuma mutane da yawa tare da HCM zasu iya haifar da rayuwa ta al'ada.
Dalilin
HCM yana haifar da daya ko daya daga yawan maye gurbin kwayoyin halitta wanda ya haifar da rashin lafiya a ci gaban ƙwayoyin ƙwayoyin tsoka.
HCM an wuce shi a matsayin "tsari ne na gaba", wanda ke nufin cewa idan an samu mahaukacin mahaifa daga iyaye ɗaya, yaron zai kamu da cutar.
Duk da haka, a kusan rabin marasa lafiya tare da HCM, cutar ta kwayar cutar ba a gadonta ba ne, amma yana faruwa ne a matsayin maye gurbin mutuntaka - wanda hakan ya faru, iyaye da 'yan uwa na marasa lafiya ba za su kasance da haɗari ga HCM ba. Duk da haka, wannan maye gurbin "sabon" zai iya wucewa ga tsara na gaba.
Kwayar Cardiac
A HCM, ganuwar muscular ventricles (ƙananan ɗakunan zuciya) ya zama ƙananan ruɓaɓɓu - yanayin da ake kira "hypertrophy." Wannan katako yana haifar da ƙwayar zuciya don yin aiki mai banƙyama, har zuwa wani nau'i. Idan mai tsanani, hypertrophy zai iya haifar da gazawar zuciya da na zuciya arrhythmias .
Bugu da ƙari, idan ya zama matsananciyar hypertrophy zai iya haifar da raguwa a cikin ventricles, wanda zai iya tsangwama tare da aiki na bawul na aortic da valve na gyare-gyare, ya rushe jini daga zuciya.
HCM zai iya haifar da akalla nau'i biyar na matsalolin zuciya na zuciya:
1) HCM zai iya haifar dysfunction diastolic. "Dysfunction Diastolic" yana nufin "hawan" ƙananan ƙwayar mai ƙwayar cuta, wanda ya sa ya fi wahala ga ventricles cika da jini a tsakanin kowace kullun zuciya.
A HCM, hypertrophy kanta kanta ya haifar da ƙananan ƙwayar diastolic. Idan ya isa sosai, wannan lalacewar diastolic zai iya haifar da rashin nasara na zuciya diastolic, da kuma bayyanar cututtuka na dyspnea (shortness na numfashi) da kuma gajiya. Hatta mawuyacin lahani na diastolic ya sa ya fi wahala ga marasa lafiya da HCM don jure jita-jitar zuciya, musamman a fibrillation .
2) HCM zai iya haifar da "haɓakar iska ta ventricular hagu. (LVOT). " A cikin LVOT, akwai tsangwamaccen abu yana sanya wuya ga ventricle na hagu don fitar da jini tare da kullun zuciya. Wannan matsala ma yana faruwa ne tare da ɓacin hanzarin valve , inda kwandon motar ta zama mai karami kuma ta kasa buɗewa akai-akai. Duk da haka, yayinda cututtukan kwayoyin cutar ke haifar da cutar a cikin zuciya ta ba da kanta, LVOT tare da HCM yana haifar da katako daga ƙwayar zuciyar zuciya a karkashin kasafin motar. Wannan yanayin ana kiransa "stenosis." Kamar yadda yake tare da tsutsa jiki, Rigon da HCM ya haifar zai iya haifar da gazawar zuciya.
3) HCM na iya haifar da tsarin regurgitation. A cikin gyaran fuska , bazul din din ya kasa rufewa da kyau lokacin da ventricle na hagu ya yi ƙuru, yana barin jini ya gudana daga baya ("regurgitate") a cikin hagu na hagu.
Tsarin regurgitation da aka gani tare da HCM ba ya haifar da matsala ta hanzarin zuciya, amma maimakon haka, ana haifar da ƙaddamarwa a cikin hanyar kamfanonin ventricle, ta hanyar thickening na muscle ventricular. Mitral regurgitation wani tsari ne wanda mutane da HCM zasu iya haifar da rashin nasara na zuciya.
4) HCM na iya haifar da ischemia daga cikin ƙwayar zuciya. Ischemia - rashawa na oxygen - mafi yawanci ana gani a marasa lafiya da cututtukan cututtuka (CAD) , wanda yaduwa a cikin hadadden cututtukan jini ya sa jini ya kwarara zuwa wani ɓangare na ƙwayar zuciya. Tare da HCM, tsokawar zuciya zai iya zama tsatsar da cewa wasu sashi na tsoka kawai basu karbi isasshen jini, ko da a lokacin da jigilar cututtuka ta jiki ne al'ada.
Lokacin da wannan ya faru, angina zai iya faruwa (musamman tare da aiki), kuma infarction na katsewa (mutuwar ƙwayar zuciya) yana yiwuwa.
5) HCM na iya haifar da mutuwar kwatsam. Mutuwar mutuwa a HCM yawanci shine saboda tachycardia ventricular ko fibrillation ventricular , kuma yana da alaka da matsanancin aiki. Wataƙila ƙwaƙwalwar ƙwayar zuciya ta tsohuwar zuciya ta haifar da yawa idan ba yawancin arrhythmias ba wanda ke haifar da mutuwar mara lafiya a marasa lafiya tare da HCM. Saboda haka, yawancin marasa lafiya tare da HCM suna buƙatar ƙuntata aikin su.
Cutar cututtuka
Kwayoyin cututtuka da mutanen da ke HCM suka samu suna da yawa. An yi amfani da marasa lafiya tare da cutar mai tsanani ba tare da samun alamun bayyanar ba. Duk da haka, idan duk wani matsalolin zuciya da aka ambata sun kasance, a kalla akwai alamun bayyanar. Mafi yawan bayyanar cututtuka da marasa lafiya da HCM ke fama da ita shine dyspnea tare da motsa jiki, orthopnea , dyspnea na nocturnal nuclei , kwantar da hankula , farfadowa na walƙiya , zafi ciwo, gajiya ko kumburi. Mahimmanci (asarar sani) a cikin kowa da HCM, musamman ma idan an haɗa shi da motsa jiki, abu ne mai tsanani, kuma zai iya nuna mummunan haɗarin mutuwa ta mutuwa. Duk wani ɓangare na syncope yana buƙatar gwadawa ya kamata a kimanta shi nan da nan.
Sanin asali
Bugu da ƙari, ƙwaƙwalwar echocardiogram shine hanya mafi kyau na bincikar HCM. Kullin echocardiogram yana ba da cikakkiyar auna game da kauri daga ganuwar ventricular, kuma zai iya gano LVOT da kuma tsarin gyaran fuska.
Electrocardiogram (ECG) zai iya bayyana hawan hypertrophy na hagu, kuma an yi amfani dashi azaman kayan aiki don neman HCM a matasan 'yan wasa.
Dukkanin ECG da echocardiogram ya kamata a yi a dangin dangi na duk wanda aka gano tare da HCM, kuma an yi amfani da echocardiogram a kowane mutumin da ECG ko jarrabawa na jiki ya nuna magungunan jini.
Jiyya
HCM ba za'a iya warkewa ba, amma a mafi yawancin lokuta kulawar kiwon lafiya zai iya sarrafa bayyanar cututtuka kuma ya inganta sakamakon asibiti. Duk da haka, gudanarwa na HCM zai iya zama mai wuya, kuma duk wanda ke da alamar bayyanar cututtuka saboda HCM ya kamata ya biyo bayan mai kwakwalwa.
Beta blockers da kuma calcium blockers zai iya taimakawa rage rage "stiffness" a cikin thickened zuciya tsoka. Yin guje wa nakasawa yana da mahimmanci ga marasa lafiya da HCM a rage cututtuka da suka shafi LVOT. A cikin wasu tiyata marasa lafiya don cire wani ɓangare na tsoka tsohuwar ƙwayar zuciya dole ne don taimakawa LVOT.
Idan har ya auku, idan ana faruwa ne, yakan haifar da bayyanar cututtuka kuma ya kamata a gudanar da shi a cikin marasa lafiya tare da HCM fiye da yawan jama'a.
Rigakafin Rushewar Mutuwa
HCM shine mafi yawan dalilin mutuwar kwatsam a matasa 'yan wasa. Duk da yake mutuwa ta kwatsam ita ce matsala mai lalacewa, musamman ma lokacin da yake faruwa a matasa. Saboda wannan dalili, ya kamata a taƙaita matsanancin aiki da wasan motsa jiki a marasa lafiya tare da HCM.
Anyi amfani da hanyoyi da yawa don rage haɗarin mutuwa ta mutuwa a marasa lafiya tare da HCM - ciki har da yin amfani da beta blockers da calcium blockers, da kuma kwayoyin antiarrhythmic . Duk da haka, waɗannan hanyoyi basu tabbatar da isasshen tasiri ba. Yanzu dai a bayyane yake cewa, a cikin marasa lafiya da HCM wanda hadarin mutuwa na mutuwa ya bayyana, ya kamata a yi la'akari sosai da defibrillator .
Sources:
Massie, BM "Zuciyar Zuciya" a: Goldman L da Ausiello D (Eds). Cecil littafi na likita, WB Saunders, 2003.
Nishimura RA, Holmes DR Jr. Ayyukan asibiti. Hypertrophic obstructive cardiomyopathy. N Engl J Med 2004; 350: 1320.
Gersh BJ, Maron BJ, Bonow RO, et al. 2011 ACCF / Manufar AHA don ganewar asali da kuma maganin cututtuka na hypertrophic: zane-zane: Rahoton Cibiyar Harkokin Kasuwancin Ƙungiyar Amirka ta Ƙungiyar Harkokin Kasuwancin Amirka da Ƙungiyar Ayyuka ta Ƙungiyar Amirka game da Sharuɗɗan Ɗaukaka. Yanayin 2011; 124: 2761.