Vawana mwoyo chirwere: mitral stenosis

Kuderedza hwomukova pakati rworuboshwe Makamuri mwoyo , rinozivikanwa mitral stenosis nguva Organic. Chikonzero chikuru kuti kukura vawana mwoyo chirwere - rheumatic endocarditis. Ndoda zvakaitika mitral stenosis endocarditis mamwe mavambo.

Kuderedza atrioventricular orifice kukura somugumisiro Fusion pakati mapepa ari mitral vharuvhu nemumwe, thickening dzavo uye chisimbiso. The vharafu anotora chimiro diaphragm ine mutswe akaiswa pakati gomba kana fanera chimiro.

Nharaunda mitral orifice anowanzoitwa 4 - 6 ba. cm. Mitral stenosis kunotungamirira kuchinja ropa riyerere mumwoyo. Hemodynamic vachivavhiringidza kuonekwa kana kuderedza hwomukova kusvika 1,5 ba. cm. Panguva diastole, ropa kubva kuruboshwe atrium haana nguva zvakazara kupinda ventricle kuruboshwe. Saka, muna atrium kuruboshwe riri shoma ropa, kuti icho akawedzera ropa ichibva pulmonary mutsinga. Somugumisiro, mashoko atrium iri yakafukidzwa ropa uye inowedzera kufurirwa mairi, iyo kutanga compensating pfuma sunga uye atrial Stretch. Asi sezvo tsandanyama rusvingo atrium simba, akanga nokukurumidza wakaderedzwa contractility, ikawanda kuzara uye kumanikidza yakanga hunowedzerwazve. Over nguva pane kurega kunotanga ropa iri pakati pulmonary riparadzirwe, kuwedzera mutoro kurudyi ventricle, pane kuzara ari vascular hurongwa huru denderedzwa.

zvekuchipatara mufananidzo

With munyoro stenosis ari kunyunyuta murwere angasava muviri basa iri haina kunyanya kuoma. Wokutanga Kunyunyuta, inoratidza pakuonekwa kurega kunotanga iri nhumbi pulmonary riparadzirwe, muri kupfupika mweya uye chikosoro - yakaoma kana shoma sputum, uyewo kuneta uye palpitations. Mune ramangwana, hapana hemoptysis uye idzokororo kurwisa kuti cardiac asima. Kurwadziwa mwoyo iri vanenge 10% wevarwere.

Pulse kungava kwete zvakafanana zvose maoko. Izvi nokuti wakakurisa rworuboshwe atrium akakudzvinya kuruboshwe subclavian tsinga, uye achizadza mwoyo kuruboshwe kunodzikira yacho. Kazhinji hapana atrial fibrillation.

Palpation of chakaderedzwa mutengo kwomwoyo vagara vandifungira chiratidzo katsi wacho purr. Feline purring anooneka apo ropa ichipfuura ari mitral orifice akachinjwa.

Percussion mwoyo miganhu akatara zvaizopedza upwardly uye kurudyi, kunoitika somugumisiro kuchinja nomumwe Makamuri mwoyo, izvo anogamuchira mitral configuration.

Auscultation kwomwoyo kwakakosha munyika nechirwere dzezvakaipa sezvo mitral stenosis ane kwese auscultatory rokuimba. Pamusoro chakaderedzwa mutengo mwoyo auscultated sonorous kuombera inzwi rokutanga, diastolic kutsutsumwa uye mamwe matani anobudiswa panguva pakuvhurwa mitral vharuvhu. izvi zvose unoumba hwokufananidzira auscultatory mutinhimira, inonzi zvihuta mutinhimira. On mujinga mwoyo auscultated madudziro emazwi uye kutsemura kana cleavage II inzwi, pakuonekwa uko chokuita kurega kunotanga ropa mumapapu.

BP kazhinji handishanduki, dzimwe nguva zvishoma akaderedza systolic uye diastolic inowedzerawo.

Diagnostics

On the radiograph kunotemwa ne dzakachinja configuration mwoyo, yainzi mitral uye kuzara.

The ECG - Zviratidzo akawedzera mwoyo makamuri.

PCG izvi vanodzokorora migumisiro auscultation mwoyo.

Zvikuru muna nechirwere urema echocardiography akabvisa, vachibvumira vharuvhu kuziva deformation, thickening uye calcification ichibhabhamisa ayo, vhoriyamu kuchinja mwoyo pamakamuri, cardiac rusvingo ukobvu.

mabatiro

Mabatirwo stenosis upi localization kunoda kuvhiyiwa. Stenoses vharafu kuvhiyiwa kuri kuita commissurotomy - kwetsinga dzakachinjwa vharafu mapepa. The mitral uye kutsemuka stenosis, kurapwa iyo rinoitwa surgically, pamberi oparesheni kutendeukira kuva ndanyarara hangu danho.