Pakati pa zofooka za mtima, aortic stenosis ndi imodzi mwazofala kwambiri: matendawa amakhazikika mwa munthu aliyense wa khumi wa zaka 60 mpaka 65, ndipo amuna amavutika nthawi zambiri.
Kawirikawiri, stenosis ndi kupopera kwa valve ya aortic, chifukwa chake, panthawi ya kuvomereza (systole) ya kumapeto kwa ventricle, kuyenderera kwa magazi kuchokera ku iyo mpaka kukwera kwa aorta kumakhala kovuta kwambiri.
Mitundu ndi zifukwa za aortic stenosis
Ndizozoloŵera kusiyanitsa pakati pa congenital malformation ndi kulandira imodzi. Pachiyambi choyamba, aorta ili ndi valve ziwiri kapena imodzi (yachibadwa - zitatu), zomwe zimayambitsa malo a aortic kuti apsere, ndipo kumbuyo kwa ventricle kumagwira ntchito ndi katundu wambiri.
Mavuto omwe amapezeka amachititsa kuti matendawa asokonezeke (mpaka 10%), zomwe nthawi zambiri zimakhala ndi kusakwanira kapena kupweteka kwa mitsempha ya mitral. Achinyamata amatenga aortic stenosis chifukwa cha chifuwa chachikulu .
Zizindikiro za stenosis za valve aortic zingathenso kuonekera kumbuyo kwa endocarditis, momwe ma valve amathandizira ndi kukhala okhwima, kupyolera mu lumen.
Anthu okalamba, matenda a atherosclerosis kapena kutulutsa calcium salt (calcinosis) kaŵirikaŵiri amawonedwa pamagetsi a valavu, omwe amachititsanso kuti phokoso likhale lochepa.
Zizindikiro za aortic stenosis
Pazigawo zoyamba za kukula kwa matenda, zizindikiro za stenosis siziwonekera, ndipo nthawi zambiri zimawoneka mwadzidzidzi panthawi yokonzekera mtima. Ngakhale mutatha kuchipatala, zizindikiro zingakuchititseni kuti mudikire zaka zingapo.
Wodwalayo amalembedwa ndi katswiri wa zamoyo ndipo amamuwona panthawi ya matendawa. Pakapita nthawi, kupyapyala kwa aortic valve lumen kumapangitsa kuti mpweya ukhale wochepa komanso kuwonjezeka kutopa, komwe kumawoneka makamaka panthawi ya masewera olimbitsa thupi. Izi zimatchedwa stenosis yosavuta ya valve ya aortic - dera la lumen limachepetsa 1.6-1.2 cm2, pamene munthu wathanzi ndilo 2.5-3.5 cm2.
Pa gawo lachiwiri la kukula kwa matenda (kufotokozera stenosis), kukula kwa lumen kumadziwika kuti sikuposa 0.7-1.2 cm2. Panthawi yogwira thupi, odwala otere amadandaula za chizungulire ndi stenocardia (ululu pambuyo pa sternum).
Miyendo yotsatirayi ndi yowopsya komanso yowopsya yotchedwa aortic stenosis, yomwe imadziwika ndi zizindikiro monga choking, mtima wa mphumu komanso mphumu ya edema. Kuwala kumachepetsa mpaka 0,5-0.7 cm2.
Ngati stenosis imabadwa, zizindikiro zake zimayamba kuonekera m'zaka khumi kapena zitatu za moyo, ndipo matendawa amakula mofulumira kwambiri.
Kuchiza kwa aortic stenosis
Pakadali pano, palibe mankhwala enieni a matendawa, ndipo kumayambiriro koyambako amangoyang'ana chitukuko chake.
M'madera otsiriza, pamene kuwala kwa aortic valve kumapatsa munthu chisokonezo monga momwe tafotokozera pamwambapa, ntchito yowonjezeretsa valve ili yoyenera. Ndizovuta komanso zovuta, makamaka kwa achinyamata komanso achikulire. Panthawi imodzimodziyo, zizindikiro zowonjezera zimawopsyeza moyo wa wodwalayo kwambiri - ndi aortic stenosis amakhala ndi moyo zaka 3 mpaka 6.
Njira ina yowonjezera opaleshoni ya valve ndi valvuloplasty. Ndondomekoyi imaphatikizapo kuika mu valavu kutsegula buluni yapadera, yomwe mpweya umaperekedwa. Motero, n'zotheka kukulitsa chilolezo cha valve, komabe valvuloplasty ndi yovuta kwambiri kuposa ma prosthetics omwe amagwiritsidwa ntchito.
Moyo
Odwala ndi aortic stenosis amatsutsana pazinthu zazikulu. Kulephera kwa mtima, kumayambitsa vuto la matenda, kumatengedwa mwachizolowezi, komabe, kukonzekera gulu la vasodilators, monga lamulo, sizimapangitsa. Kuchokera ku zida za angina kumathandiza nitroglycerin, yomwe iyenera kuvala nawo.