Anapeza matenda a mtima: mitral stenosis

Kuchepetsa wa kutsegula pakati kumanzere zipinda za mtima , lotchedwa stenosis mitral nthawi organic. Chifukwa chachikulu chitukuko cha matenda anapeza mtima - enaake ophwanya endocarditis. Kuli zinachitikira stenosis mitral endocarditis chiyambi ena.

Kuchepetsa atrioventricular orifice akufotokozera chifukwa cha maphatikizidwe wa timapepala ta wa valavu mitral ndi mzake, thickening awo ndi kusindikiza. vavu zimatengera mtundu wa zakulera ndi kudula pabwino mu dzenje pakati kapena mawonekedwe a fanulo.

M'dera la orifice mitral bwinobwino 4 - 6 sq. cm. Mitral stenosis kumabweretsa kusintha otaya magazi mu mtima. msokonezo Hemodynamic kuonekera pamene kuchepetsa kutsegula kwa 1.5 sq. cm. Pa diastole, magazi kuchokera atrium kumanzere analibe nthawi kuti athe kupita mu ventricle kumanzere. Choncho, mu atrium kumanzere ndi pang'ono magazi, amene anawonjezera magazi akubwera kuchokera mu mitsempha ya m'mapapo mwanga. Chifukwa, atrium ndi zosawerengeka magazi ndi kumawonjezera kuthamanga m'menemo, amene choyamba akulipira phindu contractions ndi matenda Tambasula. Koma ngati akulu mpanda wa atrium ndi ofooka, posakhalitsa anachepetsa contractility, kuchuluka kwa magalimoto ndi zoipazi Enanso kuzikonzanso. Pa nthawi pali stagnation magazi mu kufalitsa m'mapapo mwanga, kuwonjezera katundu pa ventricle bwino, pali kuchulukana mu dongosolo mtima wa bwalo lalikulu.

chithunzi matenda

Ndi stenosis wofatsa madandaulo a wodwalayo mwina alibe zolimbitsa thupi si zayamba koletsedwa. Amadandaula choyamba, limasonyeza maonekedwe a stagnation ziwiya kufalitsa m'mapapo mwanga, ndi kufupika kwa mpweya ndi chifuwa - youma kapena ndi pang'ono sputum, komanso kutopa ndi palpitations. M'tsogolo, pali hemoptysis ndi matenda kobwereza mphumu mtima. Kupweteka mtima pamaoneka pafupifupi 10% odwala.

Kugunda mwina si chomwecho pa manja onse. Ichi ndi chifukwa zikuluzikulu kumanzere atrium akakufinyani kumanzere subclavian mtsempha wamagazi, ndi kudzaza mtima kwa amachepetsa kumanzere. Nthawi zambiri pali matenda fibrillation.

Palpation ya pamwamba ya mtima anatsimikiza ndi chizindikiro cha purr ndi mphaka a. Nyamayi purring Umaoneka magazi chimadutsa ndi orifice mitral adasandulika.

m'malire Percussion mtima anatsimikiza ndi mtima wonse kuchepetsa upwardly ndi komwe kumachitika chifukwa cha kusintha m'zipinda munthu wa mtima, amene alandira mitral kasinthidwe.

Auscultation za mtima n'kofunika kwambiri mu matenda a wachiwiri monga mitral stenosis ali lililonse auscultatory nyimbo. Pamwamba pachimake pa mtima auscultated sonorous kuomba mmanja kamvekedwe choyamba, diastolic kudandaula ndi matani zina opangidwa pa kutsegula kwa vavu mitral. Zonsezi ndipamene mmene auscultatory nyimbo, wotchedwa quails mungoli. Pa m'munsi mwa mtima ndi auscultated ka ndi kugawikana kapena pogawanikana pamawere II kamvekedwe, maonekedwe omwe akugwirizana ndi stagnation magazi mu mapapo.

magazi ambiri sidzasinthika, nthawi zina penapake yafupika systolic ndi diastolic ukuwonjezeka.

diagnostics

Pa radiograph ndi anatsimikiza ndi kasinthidwe kusinthidwa wa mtima, otchedwa mitral ndi kuchulukana.

The ECG - zizindikiro za kukulitsa mwa zipindazo mtima.

Izi PCG kubwereza zotsatira za auscultation za mtima.

Chofunika kwambiri pa matenda a zopindika echocardiography kuchotsedwa, kulola vavu kudziwa mapindikidwe, thickening ndi calcification kutseka kuti uchiwo usatuluke ake, kusintha buku la m'zipinda mtima, mtima khoma makulidwe.

chithandizo

Chithandizo cha stenosis ya kutanthauzira kulikonse amafuna opaleshoni. Stenoses vavu ntchito tichipeza mu kuchita commissurotomy - kung'ambika kusinthidwa timapepala ta valavu. The mitral ndi kung'ambika stenosis, mankhwala amene anachita opaleshoni, patsogolo ntchito kuti n'kukhala sitepe kulipidwa.