Aortic valve: chimiro, nzira yekushanda. Stenosis uye aortic valve insufficiency

Chirwere chemoyo weAortic chinowanzozivikanwa nehutano hunowanikwa uye kuratidzirwa muchipatara chete kune vakwegura. Kuvapo kwavo kunogona kukonzera kukanganiswa kukuru kwehemodynamic. Kuoma kwehutachiona ndechokuti kuchinja kunobata mavhavha hakugoneki.

Chimiro chemoyo: valves

Mwoyo isimbi yakadzika, inosanganisira makamuri mana. Nhindi dzemaseri nechekurudyi dzinoparadzaniswa ne septa, umo pasina maitiro, zvisinei, pakati peatrium uye ventricle kune rumwe rutivi kune chikamu chinopa valve. Iyi miitiro inokubvumira kutarisa kupararira kweropa, kusabvumira kudzoka zvakare, ndiko kuti, kuchinja kushandiswa.

Kuruboshwe ndeye mitral valve, ine mavhavha maviri, uye kurudyi ndeyevhavhavha yegasi, ine zvivharo zvitatu. Mavhavha acho ane masambo emhando, izvo zvinoita kuti vhudzi ravo rive mune imwe nzira. Izvi zvinodzivisa kudzoka kweropa kuAria. Panzvimbo yebato rezasi riri mu-aorta kune valve isingafi. Basa rayo nderekuita kuti unilateral isapfuurire ropa muaorasi. Kurutivi rworudyi kunewo valve yemapurmonary artery. Zvose zviri zviviri zvinonzi "semilunar", dzine matatu mashizha. Chero hutachiona hwehutano, somuenzaniso, calcification yemagetsi e aortic valve, inotungamirira mukuvhiringidzwa kweropa rekufamba. Kukanganiswa kwakakwana kunowanzobatanidzwa nechirwere. Nokudaro, vanhu vane izvo zvinonzi zvipingamupinyi zvinowanzofanira kuongororwa nguva dzose: kunyanya echocardiogram.

Iyo inoshandiswa yekushanda kweaortic valve

Basa rinokosha mukupararira kweropa rinotambidzwa neaortic valve. Mavhareji akaenzaniswa kana kupfupiswa - ichi ndicho chimwe chezvidzidzo zvepamusoro. Icho chinova chinokonzera matambudziko ehemodynamic. Basa rechikamu chino chemuviri ndechekusimbisa kufambira mberi kweropa kubva kuruboshwe kuruboshwe kusvika kumhepo, kudzivirira kudzoka zvakare. Mavhavha anovhurwa panguva yehutachiona hwehutachiona, panguva iyo ropa rinotungamirirwa kuburikidza ne-aortic valve kupinda mu ventricle. Uyezve, zviputi zvinovharwa kudzivirira reverse casting.

Heart defects: classification

Nenguva yezvakaitika zvinokwanisika kusiyanisa congenital moyo kasina maturo (aortic valve uye mamwe maitiro) uye akawana. Kuchinja kunosanganisa kwete chete magetsi, asiwo septa yemwoyo. Congenital pathologies inowanzobatanidzwa, izvo zvinoita kuti kuongororwa uye kurapwa zvive zvakaoma.

Stenosis ye-aortic valve

Kurapa kunosanganisira kuderedza kuchinja kwerutivi rezasi kuruboshwe e-aorta - mavhavha evhavha uye mazamu akakomberedzwa akabatwa. Ichi chirwere, maererano nenhamba dzezviratidzo, inowanzoonekwa kuvanhu. Kusimbiswa kwemasvingo e-aorta uye aortic valve flaps inowanzobatanidzwa ne rheumatic uye degenerative zilonda. Endocarditis, rheumatoid arthritis inogonawo kuita seytiological factor. Zvirwere izvi zvinotungamirira mukukanganiswa kwemagetsi, zvichiita kuti kufamba kwavo kuderedze, uye valve haigoni kuzarura zvizere panguva ye systole yemhepo yakasara. Mukukwegura, chinokonzera chironda ichi kazhinji isrosrosclerosis uye calcification yemagetsi e aortic valve.

Somugumisiro wekutsvaira kwevhenekeri ye aortic, kuchinja kukuru muhemodynamics kunoitika. Zvinonyatsoonekwa apo stenosis ine chirevo chechirevo-kuderera kwekapepa kunopfuura 50%. Izvi zvinotungamirira ku chokwadi chokuti kuipa kwepasitori ye-aortic inopesana - mu aorta, zvinomanikidzwa zvinoramba zvakasununguka, uye mubhokisi rezasi rinowedzera. Kuwedzera kukurudzirwa kumadziro echokupedzisira ye ventricle kunotungamirira kukurudzirwa kwehuwandu hwehupiritsiro, kureva, kusvika pakuwedzera kwayo. Mune zvinotevera, diastolic basa rinoputsika, iyo ndiyo chikonzero chekuwedzera kwekumanikidzwa muruboshwe rwekurima. Hypertrophy inoita kuti kuwedzere kudiwa kwe okisijeni, zvisinei, kuwedzerwa ropa kwemyocardium ndiyo yaimbove yopa ropa, uye pamwe chete nehutachiona huripo kunyange kuderedzwa. Izvi zvinotungamirira kukurudzirwa kwekushaya kwemoyo.

Clinic

Mune matanho ekutanga, iyo inopinda aortic valve ingasati izviratidze. Kuchinja kwechipatara kunowanikwa apo iyo yepamusoro inoderedzwa ne 2/3 yezvigadzirwa. Nokushanda kwakasimba mumuviri, varwere vanotanga kunetseka pamusoro pekutambudzika kunowanikwa mukati me sternum. Pain syndrome muzviitiko zvisingaiti zvinogona kusanganiswa nekurasikirwa kwekuziva nekuda kwe systemic vasodilation. Kuumbwa kwepulmonary hypertension kunotungamirira ku dyspnea, iyo inotanga kushungurudza chete kana yakatakurwa, asi inozoonekwa uye yorora. Nzira yakareba yechirwere ichi inokonzera kusingaperi kwemoyo kusakatika. Utano hunoda kurapwa, sezvo pane ngozi yekuderera uye kufa kamwe kamwe kwemoyo.

Diagnostics

Kana kuongororwa nevarwere, unhu hunopera hunobatanidzwa nehutachiwana hwehutano hunoonekwa hunoonekwa. Iko kusvibiswa pamarara e-radial kunogadzikana nekutambudzika - hazvisi nyore uye hauna simba. Pakusarudzwa kune kuora kwezwi kana kuparadzaniswa. ECG haina kudzidzisa zvakakwana - zviratidzo zvehutachiona zvinongorongedzerwa chete nechirwere chakasimba che stenosis. Chinonyanya kuratidza ndechekuongorora zvinyorwa, izvo zvinoita kuti zvibvirire kuongorora aortic valve. Mavhavha acho akaiswa chisimbiso uye akaoma, bhu rakaderedzwa - aya ndiwo maitiro makuru ekuongororwa anobatsira kuona chidzidzo ichi. Degree ye stenosis uye chidimbu chekumanikidzika zvinobudirira kunobvumira kutsvaga catheterization yemagetsi.

Kurapa

Nekanyoro uye ine mwero ye stenosis, kungogadziriswa kwemararamiro anodiwa - kusazvidzivirira kwekunyanyisa muviri, kurapwa kwekugadzikana kwemaitiro. Nenguva yakawanda yezvipembenene, adrenoblockers inorayirwa, uye kana mwoyo wekushaya mahara diuretics, glycosides yemwoyo inoshanda . Iko kunonzi compaction yemasvingo e-aorta uye mabheji e-aortic valve inoda kurapwa. Sezvo mutemo, hutachiona kana bhaluni kuputika kunoitwa.

Aortic valve insufficiency

Zita rakadaro rakagamuchirwa nehutachiona, hwakaratidzwa nemapapiro asina kubhururuka. Izvi zvinokonzera kuchinja kushandura kweropa mumhepo yakasara ye ventricle, iyo inowanikwa panguva ye diastole. Izvo zvinowanzova kusagadzikana kwehutachiona endocarditis uye rheumatic kukuvara. Zvisiri zvishoma zvakajairika zvirwere, sora aneurysm, aortitis, arterial hypertension, Marfan syndrome, systemic lupus erythematosus.

The valor valve ine basa rinokosha mukupararira. Kuvharwa kusina kukwana kwemagetsi ayo kunova chikonzero chekudzoka zvakare, ndiko kuti, kuchinja kudengenyeka kweropa kusvika kuruboshwe rweseriki. Somugumisiro, pane kuwedzerwa kwehuwandu kweropa mumakumbo ayo, izvo zvinotungamirira kuwandisa uye kutambanudza. Iyo systolic basa inoputsika, uye kukwidziridzwa kunokonzera kukura kwehutachiona. Dzorerazve kudzvinyirira mumuduku mutsva inokwira - pulmonary hypertension inoumbwa.

Clinic

Sezvo ne stenosis, hutachiona hunozviita hunoita chete nechirevo chechimiro chekusakwanira. Nekushingaira kwepanyama, kupfupika kwefema kunowanikwa, kunobatanidza ne pulmonary hypertension. Nhamo inongoda 20% yemhosva. Panguva imwechete yakaratidza auscultative uye kunze kwezviratidzo zvehutano:

1. Kuputika kwetirotid arteriyo.
2. Symptom Durozier kana kuti kuitika kwechirosi murunyunyu pachikadzi chechikadzi. Izvo zvinoitika kana ichinyorwa pedyo nechinzvimbo chekuterera.
3. Symptom Quincke inoshanduka mumuchere wemiromo nemisumari maererano nekuputika kwe arterioles.
4. Traube ane maitiro maviri, izwi guru, "cannon", rinomuka pamusoro pemharo yevakadzi.
5. Symptom de Musset, kuratidza wiggle wemusoro wake.
6. Diastolic kugunun'una shure kwemashoko maviri anowanzoitika nechisimba chemoyo, pamwe nekuderera kwet 1 inzwi.

Diagnostics

Nzira dzinodzidzisa ndezvenyanzvi echocardiography uye catheterization yemagetsi. Vanokubvumira kuti uongorore aortic valve, uyewo kuti uone kuwandisa kwehuwandu hweropa. Kubva pane zvidzidzo izvi, chiyero chekuremara kwechiremera chakagadziriswa uye mubvunzo wekudikanwa kwekupindira kwakagadziriswa.

Kurapa

Izvo zvinoratidzika kusagadzikana nehuwandu hwekudzokazve, zviratidzo zvakasimba zvekuchirapa zvinoda kurapwa pakushandiswa. Zvakanakisisa zvakabuda - maitiro aortic valves, izvo zvinobvumira kudzorerwa kwemoyo. Kana zvichidikanwa, chirwere chinorapa chirwere chinorapwa chinorayirwa.

Stenosis uye kusagadzikana kweaortic valve ndiyo yakanyanya kukanganisika yemwoyo, iyo, sekutonga, iyo inoguma chero ipi zvayo yeropa kana chirongwa. Pathology inofambira mberi zvishoma nezvishoma zvokuti inobvumira kuidzidzira panguva. Nzira dzemazuva ano dzokurapa dzinobatsira kugadzirisa valve uye kuvandudza mamiriro emurwere.