Endocardial pamutsago chakaremara

Endocardial cushion kuremara (ECD) yakasarudzika moyo mamiriro. Iwo madziro anopatsanura ese mana makamuri emoyo haana kusimba kuumbwa kana kusavapo. Zvakare, mavhavha anopatsanura emakamuri ekumusoro neepasi emoyo ane hurema panguva yekuumbwa. ECD chirwere chepfungwa chepamuviri, zvinoreva kuti chiripo kubva pakuberekwa.

ECD inoitika mwana achiri kukura mudumbu. Makushoni endocardial inzvimbo mbiri dzakakora dzinokura kuva madziro (septum) ayo anopatsanura makamuri mana emoyo. Ivo zvakare vanogadzira mitral uye tricuspid mavharuvhu. Aya ndiwo mavharuvhu anoparadzanisa atria (kumusoro kunotora makamuri) kubva kuma ventricles (ezasi ekupomba dzimba).

Kushaikwa kwekuparadzaniswa pakati pemativi maviri emoyo kunokonzeresa matambudziko akati wandei:

• Kuwedzera kweropa kuyerera kumapapu. Izvi zvinoguma nekuwedzera kumanikidzwa mumapapu. MuECD, ropa rinoyerera kuburikidza nekuvhurika zvisina kujairika kubva kuruboshwe kuenda kurudyi kwemoyo, wozoenda kumapapu. Ropa rakawanda richiyerera mumapapu rinoita kuti BP irambe ichisimuka.
• Kutadza kwemoyo. Iko kuwedzera kwekuwedzera kunodiwa kupomba kunoita kuti moyo ushande zvakanyanya kupfuura zvakajairwa. Tsinga yemwoyo inogona kuwedzera uye kushaya simba. Izvi zvinogona kukonzera kuzvimba mumwana, matambudziko mukufema, uye kunetsekana mukudyisa nekukura.
• Cyanosis. Sezvo kuwedzera kweropa kunowedzera mumapapu, ropa rinotanga kuyerera kubva kurudyi kwemoyo kuenda kuruboshwe. Iro oxygen-muropa reropa inosanganiswa neropa-rakapfuma ropa. Nekuda kweizvozvo, ropa rine oxygen shoma kupfuura zvakajairwa rinosvinirwa mumuviri. Izvi zvinokonzera cyanosis, kana bhuruu ganda.

Kune mhando mbiri dzeECD:

• Yakazara ECD. Aya mamiriro anosanganisira atrial septal defect (ASD) uye ne ventricular septal defect (VSD). Vanhu vane ECD yakazara vane rimwe chete hombe moyo vharuvhu (yakajairika AV vharuvhu) panzvimbo pemaviri mavhavha akasarudzika (mitral uye tricuspid).
• Chikamu (kana chisina kukwana) ECD. Mune ino mamiriro, chete ASD, kana ASD neVSD varipo. Kune mavhavha maviri akasarudzika, asi imwe yacho (iyo mitral vharafu) inowanzo kuve isina kujairika nekuvhura ("cleft") mairi. Urema uhwu hunogona kudonhedza ropa kumashure kuburikidza nevhavha.

ECD yakabatana zvakanyanya neDown syndrome. Dzakasiyana geni shanduko dzakabatanawo neECD. Zvisinei, chikonzero chaicho cheECD hachizivikanwi.

ECD inogona kuve yakabatana nehumwe hwakazvarwa nemoyo hurema, senge:

• Kaviri kuburitsa kurudyi ventricle
• Imwe ventricle
• Kuchinja kwemidziyo mikuru
• Tetralogy yekunyepedzera

Zviratidzo zveECD zvinogona kusanganisira:

• Matai evacheche zviri nyore
• Ruvara rweganda reBluish, inozivikanwawo secyanosis (iyo miromo inogona kunge iri yebhuruu)
• Kudyisa matambudziko
• Kukundikana kuwedzera uremu uye kukura
• Kazhinji pneumonia kana hutachiona
• Ganda rakachenuruka (pallor)
• Kukurumidza kufema
• Kukurumidza kurova kwemoyo
• Kudikitira
• Kuzvimba makumbo kana dumbu (zvisingawanzo muvana)
• Kutambudzika kufema, kunyanya panguva yekudya

Munguva yebvunzo, mupi wezvehutano angangowana zviratidzo zveECD, kusanganisira:

• Yakajairika electrocardiogram (ECG)
• Moyo wakakura
• Moyo kugunun'una

Vana vane chidimbu ECD vanogona kunge vasina zviratidzo kana zviratidzo zvechirwere panguva yehucheche.

Kuyedza kuongorora ECD kunosanganisira:

• Echocardiogram, inova iyo ultrasound inotarisisa mamiriro emoyo uye kuyerera kweropa mukati memwoyo
• ECG, inoyera mashandiro emagetsi emoyo
• Chest x-ray
• MRI, iyo inopa yakajeka mufananidzo wemoyo
• Catheterization yemoyo, maitiro ayo akaonda chubhu (catheter) inoiswa mukati memwoyo kuti uone kuyerera kweropa uye kutora zviyero chaizvo zvekumanikidza kweropa uye nemazinga eoksijeni

Kuvhiya kunodiwa kuvhara maburi pakati pemakamuri emoyo, uye kugadzira akasiyana tricuspid uye mitral mavharuvhu. Nguva yekuvhiyiwa inoenderana nemamiriro emwana uye kuomarara kweECD. Inogona kazhinji kuitwa kana mwana aine mwedzi mitatu kusvika kumwedzi mitanhatu. Kugadzirisa ECD kungangoda kuvhiyiwa kunopfuura kamwe chete.

Chiremba wemwana wako anogona kupa mushonga:

• Kurapa zviratidzo zvekutadza kwemoyo
• Usati wavhiyiwa kana ECD yaita kuti mwana wako arware zvakanyanya

Iyo mishonga inobatsira mwana wako kuti awedzere uremu uye simba asati avhiyiwa. Mishonga inowanzo shandiswa inosanganisira:

• Diuretics (mapiritsi emvura)
• Zvinodhaka zvinoita kuti moyo ubvumirane zvine simba, senge digoxin

Kuvhiya kweECD yakakwana kunofanirwa kuitwa mugore rekutanga remwana. Zvikasadaro, kukuvara kwemapapu kunogona kusakwanisa kudzoserwa kunogona kuitika. Vacheche vane Down syndrome vanowanzo kukura chirwere chemapapu pakutanga. Naizvozvo, kuvhiyiwa kwekutanga kwakakosha kwazvo kune vacheche ava.

Kunyatsoita mwana wako zvinoenderana ne:

• Kuomarara kweECD
• Hutano hwemwana hwese
• Kunyangwe hosha yemapapu yakatokura kare

Vana vazhinji vanorarama zvakajairika, zvinoshingaira hupenyu mushure mekugadziriswa kweECD.

Matambudziko kubva kuECD anogona kusanganisira:

• Kuunganidzwa kwemoyo kukundikana
• Rufu
• Eisenmenger chirwere
• Kuwedzera kweropa mumapapu
• Kukuvara kusingadzorerwe kumapapu

Kumwe kunetseka kwekuvhiyiwa kweECD hakugone kuoneka kusvikira mwana akura. Izvi zvinosanganisira moyo mutinhimira matambudziko uye inodonha mitral vharafu.

Vana vane ECD vanogona kunge vari panjodzi yekutapukirwa nemoyo (endocarditis) usati uye mushure mekuvhiyiwa. Bvunza chiremba wemwana wako kana mwana wako achida kutora maantibayotiki pasati paitwa mamwe mazino maitiro.

Fonera mupi wemwana wako kana mwana wako:

• Matai nyore
• Anonetseka kufema
• Ine ganda rebhuruu kana miromo

Uyezve taura nemupi kana mwana wako asiri kukura kana kuwedzera uremu.

ECD inosanganisirwa neakawanda akajairika maitiro. Vaviri vane nhoroondo yemhuri yeECD vangangoda kutsvaga zvemajini vasati vaita nhumbu.

Atrioventricular (AV) mugero kukanganisika; Atrioventricular septal kuremara; AVSD; Yakajairika AV orifice; Ostium primum atrial septal kukanganisa; Congenital moyo hurema - ECD; Kuremara kwekuzvarwa - ECD; Chirwere cheCyanotic - ECD

• Ventricular septal kuremara
• Atrial septal kuremara
• Atrioventricular canal (endocardial cushion kuremara)

Basu SK, Dobrolet NC. Kuberekwa kwakakanganiswa kwehutano hwemwoyo. Mune: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff naMartin's Neonatal-Perinatal Mushonga. 11th ed. Philadelphia, PA: Elsevier; 2020: chits. 75.

Ebels T, Tretter JT, Spicer DE, Anderson RH. Antroventricular septal kukanganisa. Muna: Wernovsky G, Anderson RH, Kumar K, et al. Anderson's Pediatric Cardiology. 4th ed. Philadelphia, PA: Elsevier; 2020: chits. 31.

Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Acyanotic congenital chirwere chemoyo: kuruboshwe-kurudyi shunt maronda. Mune: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chitsamba 453.