Ebstein anomaly

Ebstein anomaly ihwo husingawanzo kukanganisika kwemoyo mune izvo zvikamu zveiyo tricuspid vharuvhu zvisina kujairika. Iyo tricuspid vharuvhu inoparadzanisa kurudyi yepazasi yemoyo kamuri (kurudyi ventricle) kubva kurudyi kumusoro kwepamoyo kamuri (kurudyi atrium). MuEbstein anomaly, kuiswa kweiyo tricuspid vharafu uye kuti inoshanda sei kupatsanura makamuri maviri haina kujairika.

Mamiriro acho akaberekwa, zvinoreva kuti aripo pakuzvarwa.

Iyo tricuspid vharafu inowanzo gadzirwa nezvikamu zvitatu, zvinonzi mapepa kana mapundu. Mapepa akavhurika kubvumira ropa kufamba kubva kurudyi atrium (yepamusoro kamuri) kuenda kurudyi ventricle (yepazasi kamuri) moyo uchizorora. Ivo vanovhara kudzivirira ropa kufamba kubva kurudyi ventricle kuenda kurudyi atrium apo moyo unopomba.

Mune vanhu vane Ebstein anomaly, mapepa acho anoiswa zvakadzika mukati meiyo ventricle chaiyo pachinzvimbo chinowanzoitika. Mapepa acho anowanzove makuru pane zvakajairwa. Kuremara kunowanzo kukonzera kuti vharafu isashande zvakanaka, uye ropa rinogona kuenda nenzira isiri iyo. Panzvimbo pekuyerera ichienda kumapapu, ropa rinoyerera richidzokera muatrium chaiyo. Iyo yekuchengetedza yekuyerera kweropa kunogona kutungamira kukuwedzera kwemoyo uye kuwanda kwemvura mumuviri. Panogona zvakare kuve nekudzikira kwevhavha inotungamira kumapapu (pulmonary valve).

Muzviitiko zvakawanda, vanhu zvakare vane gomba pamadziro rinoparadzanisa makamuri maviri epamusoro emoyo (atrial septal defect) uye kuyerera kweropa nepaburi iri kunogona kukonzera oxygen-isina ropa kuenda kumuviri. Izvi zvinogona kukonzera cyanosis, bhuruu tint kune ganda rinokonzerwa neoksijeni-isina ropa.

Ebstein anomaly inoitika sekukura kwemwana mudumbu. Chikonzero chaicho hachizivikanwi. Iko kushandiswa kwemamwe madhiragi (senge lithiamu kana benzodiazepines) panguva yekuzvitakura kunogona kutora chinzvimbo. Mamiriro acho haawanzoitika. Inowanzoitika kune vachena.

Iko kusajairika kunogona kuve kushoma kana kwakanyanya. Naizvozvo, zviratidzo zvinogona zvakare kubva pane zvinyoro kusvika kune zvakanyanya kuomarara. Zviratidzo zvinogona kukura nekukurumidza mushure mekuzvarwa, uye zvinogona kusanganisira miromo yebhuruu-mitsara nezvipikiri nekuda kwekudzikira kweropa reokisijeni. Muzviitiko zvakakomba, mwana anoonekwa achirwara zvakanyanya uye achinetseka kufema. Muzviitiko zvinyoro, munhu akabatwa anogona kunge asina chiratidzo chemakore mazhinji, dzimwe nguva kunyangwe zvachose.

Zviratidzo muvana vakura zvinogona kusanganisira:

• Kukosora
• Kutadza kukura
• Kuneta
• Kukurumidza kufema
• Kufema kwekufema
• Kukurumidza kurova kwemoyo

Vacheche vanozvarwa vane kuvhuvhuta kwakasimba kuyambuka vharuvhu yetricuspid vanozove nezinga rakadzika kwazvo reoksijeni muropa ravo uye nekuwedzera kwekuwedzera kwemoyo. Mutapi wezvehutano anogona kunzwa zvisina kujairika moyo kurira, senge kugunun'una, kana uchiteerera chipfuva ne stethoscope.

Miedzo inogona kubatsira kuongorora iyi mamiriro inosanganisira:

• Chest x-ray
• Magnetic resonance imaging (MRI) yemoyo
• Kuyerwa kwechiitiko chemagetsi chemoyo (ECG)
• Ultrasound yemoyo (echocardiogram)

Kurapa kunoenderana nekurema kwechikanganiso uye nezvakanangana nezviratidzo. Kuchengetwa kwekurapa kunogona kusanganisira:

• Mishonga yekubatsira nekutadza kwemoyo, senge diuretics.
• Oxygen uye imwe rubatsiro rwekufema.
• Kuvhiya kugadzirisa vharuvhu.
• Kutsiva kweiyo tricuspid vharafu. Izvi zvinogona kudikanwa kune vana vanoramba vachiwedzera kana vane matambudziko akakomba.

Kazhinji, zviratidzo zvekutanga zvinokura, chirwere ichi chakanyanya kukura.

Vamwe vanhu vanogona kunge vasina kana zviratidzo kana zvakapusa zviratidzo. Zvimwe zvinogona kuwedzera nekufamba kwenguva, kukudziridza kuchena kwebhuruu (cyanosis), kutadza kwemoyo, moyo block, kana nenjodzi dzemwoyo dzine njodzi.

Kubuda kwakanyanya kunogona kutungamira mukuzvimba kwemoyo nechiropa, uye congestive moyo kutadza.

Zvimwe zvinonetsa zvinogona kusanganisira:

• Abnormal heart rhythms (arrhythmias), kusanganisira zvisizvo zvisina kujairika mutinhimira (tachyarrhythmias) uye zvisina kujairika mutinhimira (bradyarrhythmias uye moyo block)
• Ropa rinovhara kubva pamoyo kuenda kune dzimwe nhengo dzemuviri
• Kuputirwa kwehuropi

Fonera mupiki wako kana mwana wako achivandudza zviratidzo zveichi chiitiko. Tora kurapwa pakarepo kana matambudziko ekufema achiitika.

Iko hakuna kunozivikanwa kudzivirira, kunze kwekutaura nemupi wako usati wabata pamuviri kana iwe uri kutora mishonga iyo inofungidzirwa kuti ine chekuita nekuvandudza chirwere ichi. Iwe unogona kukwanisa kudzivirira zvimwe zvezvinetso zvechirwere. Semuenzaniso, kutora mishonga inorwisa mabhakitiriya usati wavhiyiwa mazino kunogona kubatsira kudzivirira endocarditis.

Anomarara Ebstein; Kushata kwaEbstein; Congenital moyo hurema - Ebstein; Chibereko chekuremara moyo - Ebstein; Cyanotic chirwere chemoyo - Ebstein

• Kusanzwisisika kwaEbstein

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Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Cyanotic congenital moyo maronda: maronda ane hukama nekuderera kweropa remapapu kuyerera. Mune: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chap 457.

Akasimba KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA / ACC nhungamiro yevatungamiriri vevakuru vane chirwere chepfungwa chekuzvarwa: chirevo cheAmerican College yeCardiology / American Heart Association Task Force paKiriniki Yekudzidzira Mazano. Kutenderera. 2019; 139: e698-e800. PMID: 30121239 pubmed.ncbi.nlm.nih.gov/30121239/.

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.