Cyanotic chirwere chemoyo

Cyanotic chirwere chemoyo chinoreva boka rezvakawanda zvakasiyana moyo hurema huripo pakuzvarwa (kuberekwa). Izvo zvinokonzeresa yakaderera ropa oxygen oxygen. Cyanosis inoreva bhuruu yeganda uye mucous membranes.

Kazhinji, ropa rinodzoka kubva mumuviri richiyerera nemumapapu nemapapu.

• Ropa rakaderera muoksijeni (ropa rebhuruu) rinodzoka kubva mumuviri kuenda kurudyi kwemoyo.
• Rutivi rworudyi rwemwoyo runobva rwapomha ropa kumapapu, kwarunotora mweya wakawanda wobva watsvuka.
• Ropa rine okisijeni rakazara rinodzoka kubva mumapapu kuenda kuruboshwe kwemoyo. Kubva ipapo, inopomberwa kune yakasara yemuviri.

Kukanganisa kwemoyo uko vana vanozvarwa vainako kunogona kuchinja nzira inoyerera neropa nepamoyo nemapapu. Urema uhu hunogona kukonzera kushomeka kweropa kuyerera kumapapu. Izvo zvinogona zvakare kukonzera bhuruu uye tsvuku ropa kusanganisa pamwechete. Izvi zvinokonzeresa kuti isina oxygen ine ropa kuputirwa kunze kumuviri. Semagumo:

• Ropa rinoputirwa kumuviri rakadzika muoksijeni.
• Pasina okisijeni yakaunzwa mumuviri inogona kuita kuti ganda riite seblue (cyanosis).

Zvimwe zvezvinhu izvi zvinokanganisa moyo zvinosanganisira mavhavha emoyo. Uku kukanganisa kunomanikidza ropa rebhuruu kuti rivhengane neropa dzvuku kuburikidza nenzira dzisina kujairika dzemwoyo. Mavharuvhu emoyo anowanikwa pakati pemwoyo nemidziyo mikuru yeropa inounza ropa uye nekubva pamoyo. Mavharuvhu aya anovhura zvakakwana kuti ropa riyerere nepakati. Vanobva vavhara, vachichengetedza ropa kuti risayerere richidzokera kumashure.

Kukanganisika kwemagetsi emagetsi anogona kukonzera cyanosis anosanganisira:

• Tricuspid vharafu (iyo vharafu iri pakati pemakamuri maviri kurudyi kwemoyo) inogona kunge isipo kana kutadza kuvhura zvakakwana zvakakwana.
• Pulmonary vharafu (vharuvhu iri pakati pemwoyo nemapapu) inogona kunge isipo kana kutadza kuvhura zvakakwana zvakakwana.
• Aortic vharuvhu (vharuvhu iri pakati pemoyo neropa reropa kune iyo yese muviri) haigone kuvhura zvakakwana zvakakwana.

Zvimwe zvinokanganisa moyo zvinogona kusanganisira kusagadzikana mukuvandudza kwevhavha kana munzvimbo uye nekubatana pakati pemitsipa yeropa. Mimwe mienzaniso inosanganisira:

• Kubatana kana kukanganisa kwakazara kweaorta
• Ebstein anomaly
• Hypoplastic yakasara yemoyo syndrome
• Tetralogy yekunyepedzera
• Yakazara anomalous pulmonary venous kudzoka
• Shanduko yetsinga huru
• Truncus arteriosus

Zvimwe zvehutano mamiriro muna amai zvinogona kuwedzera njodzi yehumwe hutachiona hwemoyo hwecyanotic mumucheche. Mimwe mienzaniso inosanganisira:

• Kemikari kuratidzwa
• Genetic uye chromosomal syndromes, senge Down syndrome, trisomy 13, Turner syndrome, Marfan syndrome, uye Noonan syndrome
• Zvirwere (zvakadai rubella) panguva yekuzvitakura
• Yakashata inodzorwa huwandu hweshuga yeropa mune vakadzi vane chirwere cheshuga panguva yepamuviri
• Mishonga yakatemwa neako mupi wezvehutano kana yakatengwa wega uye yakashandiswa panguva yepamuviri
• Mishonga yemumugwagwa inoshandiswa panguva yekuzvitakura

Humwe hurema hwemwoyo hunokonzera matambudziko makuru mushure mekuzvarwa.

Chiratidzo chikuru cyanosis ibhuruu bhuru remiromo, zvigunwe, uye zvigunwe izvo zvinokonzereswa neakaderera okisijeni iri muropa. Zvinogona kuitika mwana achizorora kana chete kana mwana achinge achishanda.

Vamwe vana vane matambudziko ekufema (dyspnea). Ivo vanogona kupinda munzvimbo yekutsvanzviza mushure mekuita kwemuviri kudzikisira kufema.

Vamwe vane zvitsinga, umo miviri yavo inoerekana yafa nenzara ye oxygen. Pakati peaya mashiripiti, zviratidzo zvinogona kusanganisira:

• Kufunganya
• Kufema nekukurumidza (hyperventilation)
• Kamwe kamwe kuwedzera kweruvara rweblue kune ganda

Vacheche vanogona kuneta kana kudikitira pavanenge vachidya uye vangasawana huremu hwakawanda sezvavanofanira.

Kufenda (syncope) uye kurwadziwa kwepfupa kunogona kuitika.

Zvimwe zviratidzo zvinoenderana nerudzi rwecyanotic moyo chirwere, uye zvinogona kusanganisira:

• Kudyisa matambudziko kana kudzikisira kudya, zvichikonzera kukura kwakashata
• Ganda rakachena
• Puffy maziso kana kumeso
• Kuneta nguva dzose

Kuongorora kwepanyama kunosimbisa cyanosis. Vana vakura vanogona kunge vaine zvigunwe zveminwe.

Chiremba anoteerera kumoyo nemapapu ane stethoscope. Mwoyo usina kujairika unonzwika, moyo kugunun'una, uye kuputika kwemapapu kunogona kunzwika.

Miedzo ichasiyana zvichienderana nechikonzero, asi inogona kusanganisira:

• Chest x-ray
• Kuongorora okisijeni muropa uchishandisa arterial yeropa gasi bvunzo kana nekuiongorora kuburikidza neganda nekupomba oximeter
• Yakazara kuverenga ropa (CBC)
• ECG (magetsi emagetsi)
• Tichitarisa kuumbwa kwemoyo nemidziyo yeropa uchishandisa echocardiogram kana MRI yemoyo
• Kupfuudza yakatetepa inochinjika chubhu (catheter) kurudyi kana kuruboshwe kwemoyo, kazhinji kubva kugomba (moyo catheterization)
• Transcutaneous okisijeni yekutarisa (kupomba oximeter)
• Echo-Doppler

Vamwe vacheche vangangoda kugara muchipatara mushure mekuberekwa kuitira kuti vagamuchire okisijeni kana kuiswa pamushini unofema. Vanogona kugamuchira mishonga ku:

• Rasa zvimwe zvinwiwa
• Batsira moyo kupomba zvakanyanya
• Chengetedza mimwe mitsipa yeropa yakavhurika
• Bata kurova kwemoyo zvisina kujairika kana mutinhimira

Mushonga wesarudzo yezvakawanda zvekuzvarwa kwemoyo hosha kuvhiya kugadzirisa hurema. Kune mhando dzakawanda dzekuvhiya, zvinoenderana nerudzi rwehurema hwekuzvarwa. Kuvhiya kunogona kudikanwa munguva pfupi mushure mekuzvarwa, kana kunogona kunonoka kwemwedzi kana kunyangwe makore. Kumwe kuvhiya kunogona kuitwa sezvo mwana anokura.

Mwana wako angangoda kutora mapiritsi emvura (diuretics) uye mimwe mishonga yemwoyo pamberi kana mushure mekuvhiyiwa. Ive neshuwa yekutevera chaiyo muyero. Kugara uchitevera-nemupi anopa kwakakosha.

Vana vazhinji vakave nekuvhiyiwa kwemoyo vanofanirwa kutora maantibayoti zvisati zvaitika, uye dzimwe nguva mushure mekuita chero basa remazino kana mamwe marapirwo. Iva nechokwadi chekuti une mirayiridzo yakajeka kubva kumupi wemoyo wemwana wako.

Bvunza mupi wemwana wako usati wawana majekiseni. Vazhinji vana vanogona kutevedzera yakakurudzirwa nhungamiro yekudzivirira majaya.

Iko kutaridzika kunoenderana neicho chakakanganisika uye kuomarara kwayo.

Matambudziko ecyanotic mwoyo chirwere anosanganisira:

• Abnormal moyo mutinhimira uye kamwe kamwe kufa
• Yenguva refu (isingaperi) kukwira kweropa mumidziyo yeropa yemapapu
• Kutadza kwemoyo
• Utachiona mumoyo
• Kurohwa
• Rufu

Fonera mupiki wako kana mwana wako aine:

• Bluish ganda (cyanosis) kana greyish ganda
• Kufema kunetseka
• Kurwadziwa pachifuva kana kumwe kurwadziwa
• Dzungu, kupera simba, kana kurova kwemoyo
• Matambudziko ekudyisa kana kudzikisira kudya
• Fivha, kusvotwa, kana kurutsa
• Puffy maziso kana kumeso
• Kuneta nguva dzose

Vakadzi vane pamuviri vanofanira kuwana rubatsiro rwakanaka rwepabonde.

• Dzivisa kushandisa doro uye zvinodhaka panguva yekuzvitakura.
• Udza chiremba wako kuti une pamuviri usati watora chero mishonga yakatarwa.
• Tora kuongororwa kweropa pakutanga kwepamuviri kuti uone kana iwe usina immune rubella. Kana iwe usinga dzivirirwe, iwe unofanirwa kudzivirira chero kuratidzwa kune rubella uye unofanirwa kuwana jekiseni mushure mekusununguka.
• Vakadzi vane nhumbu vane chirwere cheshuga vanofanirwa kuyedza kudzora huwandu hweshuga yeropa.

Zvimwe zvinhu zvakagarwa nhaka zvinogona kutora chinzvimbo mukuzvarwa kwechirwere chemoyo. Nhengo zhinji dzemhuri dzinogona kukanganiswa. Kana iwe uri kuronga kuita nhumbu, taura nemupi wako nezve kuongorora nezvezvirwere zvemajini.

Kurudyi-kuruboshwe kurwa moyo shunt; Kubva kurudyi-kuruboshwe kutenderera shunt

• Mwoyo - chikamu kuburikidza nepakati
• Catheterization yemwoyo
• Moyo - pamberi pekutarisa
• Tetralogy yekunyepedzera
• Kutamba
• Cyanotic chirwere chemoyo

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Lange RA, Hillis LD. Congenital chirwere chemoyo. Mune: Bope ET, Kellerman RD, eds. Conn Yazvino Therapy 2018. Philadelphia, PA: Elsevier; 2018: 106-111.

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.