Systolic moyo kugunun'una

Chiitiko zviri systolic mwoyo vakan'un'una, ungava avanoziva wose. Kunyange zvakadaro, kuvapo kwavo zvinokosha, nekuti kakawanda vanoonekwa necheseri zvirwere zvakakomba. Zvinokosha Nhengo imwe mhando chiratidzo kunoratidza kuti pakanga mamwe matambudziko nemoyo.

Chii chinorehwa navanachiremba mwoyo ino- tsutsumwa

Kushandisa izwi akadai "ruzha", chokuita mwoyo, cardiologists zvinoreva acoustic chakajairika chokuita nokuchinja ropa riyerere nemidziyo uye mwoyo. Pakati vanhuwo zvavo vanogona nokusangana pfungwa kuti ruzha munzvimbo mwoyo - ndiko dambudziko hunhu vaduku. Tinofanira kubvuma - maonero iri pedyo chokwadi, sezvo vanopfuura 90% of dzichipfekeka ruzha vasabatwa wakaiswa pakati kuyaruka uye vana. Asi panguva imwe chete systolic kutsutsumwa akaonekwa uye vechidiki vane makore kubvira 20 kusvika 28 makore.

Maonero cardiologists zhinji panyaya mwoyo kutsutsumwa mu vakura vanobvuma: akafanana chiratidzo kunongedzera chaiwo cardiac zvokurwara, izvo zvinozoita zvinoita kuti uzere cardiac zvidzidzo.

Shoko rokuti "systolic" kufanana zvakananga ruzha, izvo vakanzwa pakakoromoka pakati wokutanga uye chechipiri mwoyo zvenzwi. The zvinoita pachavo kusika ropa riyerere vakapoteredza mwoyo kana ayo mavharuvhu.

Ndezvipi ruzha zvinogona akasangana

Mune zvokurapa kwezvakatipoteredza, yakadai chinhu sechinhu mwoyo vakan'un'una, vanokamurwa muzvikamu akawanda. Izvi dzichipfekeka systolic vakan'un'una, Yaunoti mhosva, uye makemikari, kuvapo iyo rinoratidza chaicho zvokurwara.

Innocent ruzha vari saka zita nokuti zvingava nokuda zvirwere zvakasiyana-siyana, haruna chokuita nemwoyo. Izvi zvinoreva kuti havana chiratidzo chechimwe pathological mamiriro mumwoyo. Timbre kwakadai ruzha iri nyoro, kusagadzikana, mumhanzi, pfupi, ane zvakakwana pasi zvikuru. ruzha rwakadaro dziri simba pamwe kudzikira mumuviri mabasa uye haana inoitwa mhiri mwoyo. Hunhu Kuchinja dzavo hadzina chokuita pasi nomwoyo, asi zvinoenderana nzvimbo muviri.

Kana Organic ruzha, ivo simuka nokuda septal kuremara, kana vharafu (kureva kuremara atrial kana ventricular septal). The timbre of ruzha zvinogona anozivikanwa akatsiga, zvakaoma, hasha. Maererano kunyatsoita ivo inopinza uye ruzha, pamwe zvaikosha refu. mhando iyi ruzha achaendeswa kunze mwoyo iri hapwa uye interscapular nharaunda. Pashure muviri Organic ruzha vari yakakura uye zvakachengetwa. vari zvakare, mukusiyana kuti mashandiro kuti chokuita mwoyo pasi uye zvakafanana akarova zvakajeka chete zvakasiyana muviri chinzvimbo.

Systolic kutsutsumwa zvinosanganisira marudzi akasiyana acoustic mananara munzvimbo moyo;

- Early systolic ino- tsutsumwa;

- pansystolic (holosystolic);

- makore kunonoka ruzha;

- srednesistolicheskie ruzha.

Sei mumwoyo pane zvakasiyana-siyana ruzha

Kana kuteerera wandei ruzha kuti kuona sezvo kukanganisa utano, zvinofanira kucherechedzwa kuti zvinokonzerwa mashomanana anokosha zvikonzero.

Systolic mwoyo kutsutsumwa ungava nokuda kutsemuka stenosis. Under chirwere ichi anofanira kunzwisiswa vachiberekwa kana vakatodzidza kutsemuka constriction buri kuburikidza splicing ari ichibhabhamisa pakati vharuvhu pachayo. Izvi zvinoita zvakaoma dzose ropa riyerere mukati mumwoyo.

Kutsemuka stenosis anogona kunzi mumwe inonyanya mwoyo zvikanganiso kuitika nedzevakuru. In chirwere ichi kazhinji kuva kutsemuka uye mitral insufficiency. Nokuti kuti mudziyo aripo kutsemuka tsika calcification (kana mberi stenosis), kukura maperembudzi kuwedzera.

Kazhinji kana wakaiswa chakakomba kutsemuka stenosis, kuruboshwe ventricle yekudyidzana migweje. Panguva ino, mwoyo uye uropi vanotanga kutambura nokushayiwa ropa rakawanda.

Kutsemuka insufficiency inogona kunzi zvikonzero zvinokura systolic kutsutsumwa. Musimboti chirwere ichi kuitira kuti kutsemuka vharuvhu haasi kukwanisa kuvhara zvachose. Iye kutsemuka regurgitation kazhinji anova pamusoro pakanyorwa infective endocarditis. Kufurira kukura chirwere ichi rheumatic fivha (kupfuura hafu nyaya), chinonzi systemic lupus erythematosus, njovhera, uye atherosclerosis. Panguva nayo chamuita kuti kuremara ino nguva kashoma kukonzera kukuvara kana pakupona. Systolic kutsutsumwa mu yeropa angava anoratidza panowanikwa hama insufficiency pamusoro kutsemuka vharuvhu. ezvinhu akadaro kungaita kunoshamisa rokuwedzera fibrous chindori vharuvhu uye yeropa pacharo.

Chenjera mitral regurgitation - nderimwe kukonzera systolic ruzha. Panyaya iyi ndicho nokukurumidza kufamba mvura kana magasi, kunoitika muchanza tsandanyama nhengo mu nedanho rutapudzo. sangano kwakadaro chakatarisana chakaipa negwara. chirwere akadaro kakawanda kunokonzerwa abnormalities vari partition masvingo.

Systolic kutsutsumwa ari pulmonary tsinga chinoratidza kukura munzvimbo stenosis. Nechirwere chakadaro pulmonary tsinga vharuvhu kujekesa chomunda rworudyi ventricle. Izvi mhando stenosis iri anenge 8-12% moyo vose vakaremara. ruzha kwakadaro nguva dzose pamwe chete systolic jitter. Kunyanya iziviswe ruzha irradiation pamutsipa midziyo.

Worth nezvenyu uye tricuspid vharafu stenosis. In chirwere ichi pane aienda pamusoro tricuspid vharuvhu. kuchinja izvi vanowanzobatwa mugumisiro matambudziko rheumatic nefivhiri. Zviratidzo izvi mhando stenosis zvinosanganisira ganda chando, kurukutika, kusagadzikana mune chokumusoro rworudyi quadrant pakati mudumbu nemutsipa.

Zvikonzero systolic kutsutsumwa muvana

Zvinhu zvine chokuita nokushanda vana mwoyo, mumwe mujenya, asi pane kazhinji zvinotevera:

- Atrial septal kuremara. Under kuremara kwaireva kusavapo atrial septal zvinyama, zvoita kuti kubuda ropa. Kwakakura Reset kunoenderana zvaidiwa pamusoro ventricles uye kuremara hukuru.

- Anomalous pulmonary venous kudzoka. Tiri kutaura zvakaipa paumbwe pulmonary mutsinga. More zvakananga, asi pulmonary mutsinga havasi vakaudza kurudyi atrium, akawira pakarepo kupinda zvakanaka atrium. Kazhinji kuitira kuti kubatanidza pamwe atrium kuburikidza guru denderedzwa mutsinga (kurudyi mukuru vena Vienna, Vienna unpaired, kuruboshwe brachiocephalic hunde, ari coronary sinus uye venous chokubuda).

- coarctation of yeropa. Under tsanangudzo iyi inovanza munhu vachiberekwa mwoyo urema umo mune segmental aienda pamusoro thoracal yeropa. Nemamwe mashoko, segmental kutsemuka lumen kunova duku. dambudziko iri kubatwa kuvhiyiwa. Kana chirwere ichi haisi kutora chero chinhu, kuti aienda pamusoro yeropa mwana pachamera sezvavanokura.

- Ventricular septal kuremara. dambudziko iri zvakare mumwe zvikonzero kuti ngadzirambe systolic kutsutsumwa mumwoyo womwana. kuremara ichi kunoratidzwa ndechokuti kuremara hwapedyo pakati ventricles mbiri mwoyo - kuruboshwe uye zvakarurama. Izvi chakaremara mwoyo kakawanda yakanyorwa yoga mamiriro, kunyange pane zviitiko kana chakaremara akadaro mamwe mwoyo kuremara.

- Systolic kutsutsumwa mune mwana kunokonzera mwoyo vawadzane rakavhurika arterial kuremara. Tiri kutaura mudziyo pfupi iyo rinobatanidza pulmonary tsinga uye kurova kworuoko yeropa. Kudiwa ichi vasiri shunt haazombotaurwi mushure mwana wokutanga mweya, saka mazuva mashoma zvicharangarirwa kuvharwa. Asi kana izvi zvikasaitika (kuti, chaizvoizvo, ndiwo ari kuremara), ropa kuramba shunted kubva systemic kuparadzirwa munzvimbo duku. Kana mutsinga dzinofamba nemukaka iri duku, iwo musimboti, haangavi kuchikosha inokanganisa hutano mwana. Asi kana kubata huru bvumidzwa ductus arteriosus, pane mukana chakakomba cardiac zadzisa. Zviratidzo izvi ezvinhu - zviri chikamu breathlessness. Kana kuerera riri guru kwazvo (9 mm kana kupfuura), achangoberekwa ungava yakaoma ezvinhu. Panyaya iyi, iyo systolic kutsutsumwa mune vana hakusi chete chiratidzo - mwoyo ichatambanudzirwa yakawedzera kukura. Emergency oparesheni rinoshandiswa neutralize nengozi yakadaro.

Yoga zvakafanira kuti kubata muchikwata achangoberekwa. Moyo vana azvarwa kunonzwika kunyange muchipatara. Izvi zvinoitwa kuti tidzivise pathologies. Asi kana pane hwakanyorwa ruzha, usade kuti kunaka mhedziso nguva isati yakwana. Chokwadi kuti paavhareji, mwana ose wechitatu rinozivisa zvimwe ruzha. Uye kwete vose vari uchapupu ngozi pezvakaitwa (kwete kukanganisa kukura mwana uye havasi pamwe neropa kutenderera). Zvaive munguva yake (ropa aibuda), kuti kugadzirisa angave dzichipfekeka ruzha mwana, iyewo haana vangangokukuvadza utano. In mamiriro ichi, sezvo X-ray uye unonzi, electrocardiograph tigokuzivisai chakaipa kukura mumwoyo vomwana.

Kana ruzha kuri mumashoko vacheche, vakanga wakaiswa nokuda yokutanga mitatu pashure pokuberekwa. chirwere ichi inoti munguva fetus mwoyo paumbwe mwana haana kusvikira pamugumo kukura uye, somugumisiro, rine zvimwe pakupona. Kana mwero matambudziko mwoyo kukundikana kukura mwana achava kukwirira, zvinokwanisika kuti vanachiremba Uchasarudza mufambiro kuvhiyiwa kubvisa chirwere.

Features ruzha chakaderedzwa mutengo mwoyo

With kwakadai ruzha zvechadenga yokupedzisira dzingasiyana zvichienderana chikonzero uye nzvimbo chiitiko.

1. yakakomba ingabatanidza mitral vharafu insufficiency. Panyaya iyi, ruzha anganzi pfupi. Agozviratidza mangwanani (protosistolichesky). Kushandisa echocardiography vangazivikanwa hypokinesis mapazi chords or the gwanza, zvinhu uye zvimwe kwemabhakitiriya endocarditis.

2. chisingaperi mitral vharafu insufficiency. Ruzha urwu mhando zvizere kubatikana panguva marwadzo ari ventricles (holosystolic uye pansystolic). Pane rakananga kutsamira pane vharuvhu kuremara, bhuku ropa kudzoka kuburikidza kuremara uye mheremhere hunhu. Systolic kutsutsumwa panguva chakaderedzwa mutengo mwoyo pasi maitiro aya zvakanakisisa akarova mune chinjikira chinzvimbo. Kana chakaremara kuchaita mberi, pane palpable vibration pechipfuva rusvingo munguva systole.

3. rushomanana mitral insufficiency. Kana iwe Unopedza nguva refu kunzvera (X-ray, echocardiography), zvinokwanisika kuziva dilation kuti ventricle kuruboshwe. Systolic kutsutsumwa panguva chakaderedzwa mutengo mune iyi inogona ainawo nguva ventricular marwadzo, asi achava nekaupenyu akanyarara. Kana zviratidzo kuzara mumwoyo kukundikana vari akaderedzwa, uye zvidzidzo zvakakwana kurapa, ari sonority ari ruzha uchaderedzwa.

4. Dysfunction of papillary netsandanyama. Panguva yokuongorora kazhinji rinozivisa zviratidzo myocardial infarction, kana (ii) ischemic. Akadaro systolic kutsutsumwa panguva chakaderedzwa mutengo mwoyo anganzi unochinja. Uyezve, ndiko maitiro chitarisiko pedyo kuguma systole kana mugove pakati.

5. Mitral vharafu prolapse. Zvinokwanisika chete wemishonga kunonoka systolic kutsutsumwa. Bugged ichi mhando zvakanaka mune akarurama chinzvimbo. ruzha kwakadaro zvichienderana ezvinhu omurwere anogona zvakasiyana-siyana. Kwakadaro systolic kutsutsumwa panguva chakaderedzwa mutengo kunoratidzwa nekuratidza pakati chikamu systole (anonzi mezosistolichesky watinya).

Ruzha kuruboshwe pamusoro sternum (pfungwa Botkina)

At nomubvumo ichi mhando pane zvikonzero zvinoverengeka:

- Ventricular septal kuremara. Zvinooneka vachidzungudza bhokisi panguva systole kuruboshwe yacho sternum. In nomubvumo zvechadenga kuremadza saizi haana maturo. Cardiac ano ari kuona muna 100% nyaya. Fixed ine systolic vakan'un'una, izvo inoremekedzwa yose systole uye rakaitirwa mumadhipatimendi ose. Achibatsirwa X-ray anogona kuzivisa dilatation pamusoro kutsemuka chematenga uye pulmonary kuzara.

- vachiberekwa pulmonary stenosis. Mumwe mukuru zvinhu - munhu chiratidzo feline purring. Kana kuonekwa kuoneka mwoyo ano (protrusion thorax). mataurire pulmonary tsinga Second simba.

- Obstructive Cardiomyopathy. Systolic kumugunun'unira Botkin ino mhando ndiyo Paavhareji uye anogona siyana kuchinyanya zvichienderana nzvimbo muviri kana munhu aikosha - rinobuda, akarara mamiriro - kwakaderera.

- Tetarda halyard. ruzha aya kusiyaniswa shunt wemishonga kuruboshwe Makamuri mwoyo nokuda akaremara iri septum pakati ventricles uye pulmonary tsinga aienda. Kurira riri ine, pamwe Kuda kutamba ose systolic jitter. Ruzha zviri vakanzwa zvakanakisisa panguva yakaderera pfungwa sternum. Tichibatsirwa ari ECG zvinogona pazvinhu zviratidzo rworudyi ventricle hypertrophic kuchinja. Asi tichibatsirwa maekisirei dzinoratidza zvokurwara hakushandi. Kana chero mutoro kunoratidzwa cyanosis.

Ruzha kuti kurudyi sternum

Panguva iyi (II intercostal nzvimbo) auscultated kutsemuka kuremara. Ruzha iri mifananidzo hunoratidza vawana constriction kana ane vachiberekwa Genesisi.

kutsutsumwa systolic kwakadaro unhu:

- zvinobetsera nzvimbo yaro Detective - 4 uye 5 intercostal dzezvimwe kuruboshwe pamusoro sternum;

- pensistolichesky, zvikuru, dzemakwiringwindi uye kazhinji tichibvisa ruzha;

- rinoitwa parutivi pechipfuva rworuboshwe, uye inosvika shure;

- panzvimbo vagere panzvimbo anowedzera ruzha;

- X-ray Kuongorora anoona kuwedzera kutsemuka calcification wayo vharafu midziyo uye kuwedzera ventricle kuruboshwe;

- kupomba ane murombo kugutsikana uyewo zvisingawanzoitiki;

Kunoita urema inotungamirira rokuwedzera akasiya ventricular arterio-makomba. Pakadaro, pane mukana kuteerera zviviri zvakasiyana ruzha. Kana systolic kutsutsumwa akanga kukonzerwa vachiberekwa stenosis, zvichaita kuuya wokuwedzera makatodzinga matauriro, riri kukonzerwa concomitant kutsemuka rugurgitatsiey.

Heart kutsutsumwa panguva pamuviri

Panguva vana zvingaitika sistalicheskih ruzha. Kakawanda, vari kushanda zvakasikwa uye nokuda zvikuru kwakawedzera mutoro pamusoro mwoyo womukadzi pamuviri. mamiriro akadaro chinonyanya yo wechitatu trimester. Kana ruzha vakanga wakaiswa, ichi ndicho chiratidzo kuna kutora pamuviri ezvinhu (itsvo, mutoro dosing, BP) pasi nokungwarira kuzvidzora.

Kana zvose zvinodiwa izvi zvakarurama asangana, ipapo mukana wose kuti pamuviri uyewo kusununguka, achava akanaka, hapana Migumisiro pamwoyo.

kuongorora chirwere mheremhere

Chokutanga, sei kutanga muitiro diagnosing mwoyo chirwere - tsanangudzo asipo kana kuvapo mwoyo kutsutsumwa. Muchiitiko chino, auscultation mwoyo rinoitwa munyika chinjikira kana wehunyambiri chinzvimbo, pashure muviri, kurutivi rworuboshwe uyewo kukwirira inhalation uye nedzinovengwa. matanho akadaro anodiwa kuti systolic mwoyo kutsutsumwa, zvinokonzera izvo zvingave zvakasiyana zvachose, rakanga zvakarurama kuzivikanwa.

Kana isu kutaura uipi mitral vharuvhu, kupfuura Zvakanyanya Kunaka Panguva Yepamuviri nzvimbo kuteerera Mheremhere iyi ndiyo muromo mwoyo. Kana urema ari kutsemuka vharuvhu vanofanira kuteerera wechitatu intercostal nzvimbo wakasiya sternum kana wechipiri kurutivi rworudyi. Kana kugadzirisa uipi tricuspid vharuvhu, ari systolic kutsutsumwa kuteerera nani muviri sternum pasi mucheto.

Achitaura pamusoro hunhu ruzha, zvinokosha kuziva kuti vave dzakasiyana Pasika (systolic uye diastolic), kwenguva refu, volatility uye conductivity. Mumwe kiyi matambudziko Panguva iyi chaiwo tsanangudzo imwe kana kupfuura epicenters ari ruzha. Zvinokoshawo kuti kufungawo ruzha matauriro, sezvo chinhu ichi kunoratidza chaizvo kwendangariro. Kana nyore systolic kutsutsumwa portends nezvinetso zvakakomba, mafungu, sawing, tichibvisa inoratidza stenosis pamusoro kutsemuka kana pulmonary kutsemuka. Uyewo ichivhuvhuta ruzha ndee mu infective endocarditis uye mitral insufficiency. Kufungwa vhoriyamu uye mataurire nechigadziko uye muromo mwoyo.

Zvakakosha chaizvo panguva kutanga chirwere matanho asava extracardiac ruzha, ndiro tsime riri kunze mwoyo. Kazhinji, ruzha izvi zvinogona kunzwika kana pericarditis. Asi ndezvipi acoustic chinoshamisa zvakadaro chete panguva systole. Sezvo zvagara, vanogona kuteerera panguva diastole.

Nokuti nechirwere kwemoyo mamiriro kushandisa michina yakasiyana. Chikumbiro chavo zvakakodzera, sezvo mhedziso rakavhomorwa riri achishandisa vakawana utano zvakawanikwa, pasi inosimbisa. Kuti vawane chinangwa ichi nyanzvi vanoshandisa PCG, ECG, X-ray komoyo kukura matatu, echocardiography, kusanganisira transesophageal.

Somunhu anosiiwa invasive chirwere unyanzvi zvinoshandiswa enderana ezvinhu (vachifunga, uye dzimwe musiyano nzira.).

Kuyera kusimba mwoyo rinonzwika kushandisa zvimwe ivhu:

- panyama mutoro (Isometric, isotonic uye carpal dynamometry);

- kufema (vachiwedzera ruzha kubva kuruboshwe uye kurudyi mwoyo exhale)

- atrial fibrillation uye atrial rokusamhanyira anorova;

- positional kuchinja (nokusimudza makumbo ari akamiswa, shanduko murwere muviri chinzvimbo uye ugare kupota);

- Valsalva rinoshamisa (clamping kufema nezvinhu yakavharwa muromo uye mhuno) uye vamwe.

Key zvakawanikwa

Chekutanga zvose zvakakosha kunzwisisa chakakoshera Diagnostics ano pamberi mwoyo kutsutsumwa. faniro Its rinotsanagurwa ndechokuti systolic kutsutsumwa arege chinorevei matambudziko chaihwo zvoutano, asi panguva imwe chete anokwanisa kuva nokuratidzwa chirwere chakakomba.

Saka, chero ruzha rakanga dzakaonekwa mumwoyo, anofanira akatsanangura Vanachiremba vanokwanisa (zvinokosha kuona chikonzero nounyanzvi uye zvakarurama). Kutaura zvazviri, nguva dzose vane mwoyo kutsutsumwa nomumwe maitiro chokuita zera-ukama nguva. Chero Mheremhere chiremba moyo akakodzera. The panowanikwa mwoyo ino- tsutsumwa ari mukadzi pamuviri chikonzero zvakakwana kukusimbisai zvachose vadzore wake ezvinhu.

Kunyange pasina zvinetso nomoyo kana zviratidzo chero abnormalities, vanofanira nguva nenguva firimu. Chinowanzoonekwa yokuzivisa systolic ruzha kunoitika randomly. Saka, kwenguva nenguva chirwere anokwanisa kubata zvokurwara iri mudariro apo zvichida kunobudirira kurapwa.