Atrial septal chirema (ASD)

Atrial septal defect (ASD) kukanganisa kwemoyo kuripo pakuzvarwa (kuberekwa).

Sezvo mwana anokura mudumbu, madziro (septum) mafomati ayo anopatsanura kamuri yepamusoro kumusoro kuita yekuruboshwe uye kurudyi atrium. Kana madziro aya asina kuumbwa nemazvo, zvinogona kukonzeresa hurema hunosara mushure mekuzvarwa. Izvi zvinodaidzwa kuti atrial septal defect, kana ASD.

Kazhinji, ropa harigone kuyerera pakati pemakamuri maviri epamusoro emoyo. Zvisinei, ASD inobvumira izvi kuti zviitike.

Kana ropa richiyerera pakati pemakamuri maviri emoyo, iyi inonzi shunt. Ropa rinowanzoyerera kubva kuruboshwe kuenda kurudyi. Kana izvi zvikaitika kurudyi kwemoyo kunowedzera. Nekufamba kwenguva kumanikidzwa mumapapu kunogona kuvaka. Kana izvi zvikaitika, ropa rinoyerera kuburikidza nehurema rinobva raenda kubva kurudyi kuenda kuruboshwe. Kana izvi zvikaitika, panenge paine oxygen shoma muropa inoenda kumuviri.

Atrial septal kuremara zvinotsanangurwa seprimum kana secundum.

• Izvo zvikanganiso zvepamberi zvakabatanidzwa kune zvimwe zvinokanganisa moyo zveiyo ventricular septum uye mitral vharafu.
• Secundum zvikanganiso zvinogona kuva rimwe chete, diki kana hombe gomba. Iwo anogona zvakare kuve anopfuura rimwe diki gomba mune septum kana madziro pakati pemakamuri maviri.

Kuremara kudiki kwazvo (asingasvike mamamilimita mashanu kana ¼ inch) kashoma kukonzeresa matambudziko. Zvikanganiso zvidiki zvinowanzoonekwa zvakanyanya gare gare muhupenyu kupfuura zvakakura.

Pamwe pamwe nehukuru hweASD, uko iko kukanganisika kuripo kunotamba chinzvimbo chinokanganisa kuyerera kweropa uye nemazinga eoksijeni. Kuvapo kwehumwe hurema hwemwoyo kwakakoshawo.

ASD haina kujairika.

Munhu asina mumwe moyo urema, kana hurema hushoma (isingasvike mamirimita mashanu) anogona kunge asina zviratidzo, kana zviratidzo zvingasaitika kusvika pazera repakati kana gare gare.

Zviratidzo zvinoitika zvinogona kutanga chero nguva mushure mekuzvarwa kuburikidza nehucheche. Zvinogona kusanganisira:

• Kunetseka kufema (dyspnea)
• Kakawanda kufema kutapukira muvana
• Kunzwa kurova kwemoyo (kurovera) muvanhu vakuru
• Kupfupika kwemweya nekuita

Anopa hutano anoongorora kuti ASD yakakura sei uye yakaoma sei zvinoenderana nezviratidzo, bvunzo dzepanyama, uye zvabuda pakuongororwa kwemoyo.

Iye mupi anogona kunzwa asina kujairika moyo kurira kana achiteerera pachipfuva ne stethoscope. Kugunun'una kunogona kunzwika chete mune dzimwe nzvimbo dzemuviri. Dzimwe nguva, kugunun'una kunogona kusanzwika zvachose. Kugunun'una kunoreva kuti ropa harisi kuyerera kuburikidza nemoyo zvakatsetseka.

Iko kuongorora kwepanyama kunogona zvakare kuratidza zviratidzo zvekutadza kwemoyo kune vamwe vanhu vakuru.

Echocardiogram muyedzo unoshandisa mafungu ezwi kugadzira mufananidzo unofamba wemwoyo. Kazhinji ndiyo bvunzo yekutanga inoitwa. Chidzidzo cheDoppler chakaitwa sechikamu cheiyo echocardiogram inobvumidza mupi wezvehutano kuti aongorore huwandu hweshuwa yeropa pakati pemakamuri emoyo.

Mimwe bvunzo inogona kuitwa inosanganisira:

• Catheterization yemwoyo
• Coronary angiography (yevarwere vanopfuura makore makumi matatu nemashanu)
• ECG
• Mwoyo MRI kana CT
• Transesophageal echocardiography (TEE)

ASD inogona kusada kurapwa kana paine mashoma kana pasina zviratidzo, kana kana hurema hwacho huri hushoma uye husingaenderane nekumwe kusagadzikana. Kuvhiya kuvhara hurema kunokurudzirwa kana hurema hwacho hukonzera huwandu hwakawanda hwekuzeya, moyo wakazvimba, kana zviratidzo zvikaitika.

Maitiro akagadzirwa kuti avhare hurema (kana pasina zvimwe zvisina kujairika zviripo) pasina kuvhiya kwemoyo kwakashama.

• Maitiro acho anosanganisira kuisa mudziyo wekuvhara ASD mumoyo kuburikidza nemachubhu anonzi macatheters.
• Mutapi wezvehutano anoita akacheka mudiki mukati meiyo groin, uyezve anoisa iyo catheters mumudziyo weropa uye kumusoro mumoyo.
• Chigadzirwa chekuvhara chinozoiswa mhiri kweASD uye hurema hwapfigwa.

Dzimwe nguva, kuvhurika-kwemoyo kuvhiya kunogona kudikanwa kugadzirisa hurema. Rudzi rwekuvhiya runonyanya kudikanwa kana kumwe kukanganisa kwemoyo kuripo.

Vamwe vanhu vane atrial septal kukanganisa vanogona kukwanisa kuita izvi, zvichienderana nehukuru uye nzvimbo yechikanganiso.

Vanhu vane maitiro kana kuvhiyiwa kuvhara ASD vanofanirwa kuwana maantibayotiki vasati vamboitwa mazino panguva yaitevedzwa maitiro. Mishonga inorwisa mabhakitiriya haidiwe gare gare.

Mune vacheche, maASD madiki (asingasviki mashanu mm) haawanzo kukonzera matambudziko, kana kuvhara pasina kurapwa. Makuru maASD (8 kusvika 10 mm), kazhinji haavhare uye anogona kuda maitiro.

Zvinhu zvakakosha zvinosanganisira saizi yekuremara, huwandu hweropa rakawedzera kuyerera kuburikidza nekuvhura, saizi yerutivi rwerudyi rwemoyo, uye kuti munhu wacho ane chero zviratidzo.

Vamwe vanhu vane ASD vanogona kunge vaine zvimwe zvimiro zvemwoyo zvekuzvarwa nazvo. Izvi zvinogona kusanganisira vharuvhu inodonha kana gomba mune imwe nzvimbo yemoyo.

Vanhu vane ASD yakakura kana yakaoma zvikuru vari panjodzi yekuwedzera mamwe matambudziko, kusanganisira:

• Abnormal moyo mutinhimira, kunyanya atrial fibrillation
• Kutadza kwemoyo
• Utachiona hwemwoyo (endocarditis)
• Kuwedzera kweropa mumitsipa yemapapu
• Kurohwa

Fonera mupiki wako kana iwe uine zviratidzo zveatrial septal kuremara.

Iko hakuna inozivikanwa nzira yekudzivirira iyo hurema. Zvimwe zvezvinetso zvinogona kudzivirirwa nekukurumidza kuona.

Congenital moyo hurema - ASD; Chibereko chekuremara moyo - ASD; Primum ASD; Secundum ASD

• Chiremba wemwoyo kuvhiya - kubuda

• Atrial septal kuremara

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Silvestry FE, Cohen MS, Armsby LB, uye al. Nhungamiro yeiyo echocardiographic kuongororwa kweatrial septal defect uye patent foramen ovale: kubva kuAmerican Society yeEchocardiography uye Society yeCardiac Angiography uye Kupindira. J Am Soc Echocardiogr. 2015; 28 (8): 910-958. PMID: 26239900 pubmed.ncbi.nlm.nih.gov/26239900/.

Sodhi N, Zajarias A, Balzer DT, Lasala JM. Kuvharwa kwepercutaneous kwepatent formen ovale uye atrial septal defect. Mune: Topol EJ, Teirstein PS, eds. Chinyorwa cheInopindirana Cardiology. 8th ed. Philadelphia, PA: Elsevier; 2020: chits. 49.

Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital chirwere chemoyo mune mukuru uye wevarwere murwere. Mune: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Chirwere Chemwoyo cheBraunwald: A Chinyorwa cheCardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019: chits. 75.