Chirwere cheMwoyo muImbwa neKatsi

"Imbwa yangu ine chimwe chinhu pamwoyo wayo" chimwe chinhu chaunowanzonzwa, kunyanya kana mhuka yacho yati kurei. Asi zvese nezvei? chiremba wemhuka dr Sebastian Goßmann-Jonigkeit anopa nzwisiso yezviratidzo zvehosha yemwoyo mumbwa nekatsi uye inoratidza kurapa kungangoitwa.

Chirwere cheMwoyo… Izvi Zvinomborevei?

Heino kushanyira kubhururuka kune cardiology - sainzi yemoyo.
Mwoyo une basa rakafanana mumhuka dzose: unopomba ropa kuburikidza nemuviri. Izvi zvinovimbisa kuti mweya weokisijeni wakasungwa kumasero matsvuku eropa unowanikwa kusero rega rega remumuviri muhuwandu hwakakwana. Chinodiwa chinogona kusiyanisa kubva pasi kusvika kumusoro panguva yekurovedza muviri pakuzorora - kubhadharira izvi kunowirawo mukati menzvimbo yemoyo yemutoro.

Mamiriro Emwoyo

Kunze kwezvishoma mumhuka, mwoyo wakaumbwa zvakafanana nenhengo inoshanda isina maburi. Kumativi ose kune ventricle hombe pazasi peatrium diki, yakanyatsoparadzaniswa kubva kune imwe neimwe nevharuvhu yemoyo inoshanda sevharuvhu yenzira imwe chete saka ropa rinoyerera richienda kune imwe nzira. Ropa rinochengetwa mukutenderera nguva dzose panguva yekupomba nehurongwa hwakaoma hwekushushikana kwemhasuru uye kufamba kwevharuvhu.
Yakaderera muokisijeni, inoyerera ichipinda mukati menhengo kuburikidza neafferent posterior vena cava. Inopinda mu ventricle yakarurama kubva paatrium yakarurama kuburikidza neinonzi tricuspid valve. Kubva ipapo kuburikidza nepulmonary artery kupinda muvascular system yemapapu, uko masero matsvuku eropa anotakurwa neokisijeni nyowani. The pulmonary tsinga inotungamirira ropa kuruboshwe atrium, kuburikidza inonzi bicuspid vharafu kupinda kuruboshwe ventricle, uye inobudiswa kubva ipapo kuburikidza aorta kupinda systemic kutenderera, akapfuma muokisijeni.

The Stimulation Line

Kuti kuyerera kweropa kushande sezvizvi, kudhonzwa kwemhasuru yemwoyo kunofanira kunyatsodzorwa. Iyo inonzi sinus node inogadzirisa kufamba kweizvi - inotumira simba remagetsi rinosvika kune mamwe masero emwoyo yemhasuru nenzira kwayo kuitira kuti vabvumirane chaizvo maererano nebasa rekupomba. Uku kutorwa kwemagetsi kunogona kuratidzwa pachishandiswa electrocardiogram (ECG) uye inoratidza kufambisa kwekusimudzira mumhasuru yemoyo. Inoshandiswa kuona zvinogona kuitika arrhythmias (semuenzaniso nguva isina kururama kana kufambisa kusina kunaka) iyo, isingaonekwi, inogona kukonzera kusakwana kwekuyerera kweropa. Ichi ndicho chikonzero kutarisa mwoyo panguva yeanesthesia kwakakosha zvikuru.

Zviratidzo zveChirwere cheMwoyo muImbwa neKatsi

Zviratidzo zvese zvekutadza kushanda kwemoyo zvinogona kutsanangurwa nekusashanda zvakanaka kwemoyo. Chimwe chezvikonzero zvikuru zvekugadzwa panguva yekubvunzurudza kudonha kunooneka kwekuita - izvi zvinowanzotanga kuoneka kana tembiricha yekunze yakakwira mukutanga kwezhizha. Sezvo mwoyo une chirema chine zera remoyo vharafu uchingogona kungovhara izvo zvinodikanwa zveokisijeni kumuviri, murwere anowanzo fambisa zvishoma kana kuti zvishoma pane zvakajairika. Nekuwedzera kwekushisa kwekunze, iyo yemwoyo system inosimbiswa zvakanyanya, sezvo chikamu chikuru chesimba remuviri chinoyerera mukutonga kwekushisa uye zvishoma zvishoma zveokisijeni munhengo dzose (kunyanya kukosha muuropi) hazvibvumirwi nguva dzose. Mamiriro ezvinhu aya anokonzeresa kudonha kwemunhu asingazivikanwe kana kubatwa zvisina kufanira murwere wemoyo mumazuva anopisa ezhizha.

Chimwe chiratidzo chinogona kuva bluish (cyanotic) disccolored mucous membranes (eg conjunctiva muziso kana unpigmented gums), izvo zvinokonzerwa nokushayikwa kweokisijeni muropa.
Muchikamu chepamusoro, icho chinonzi 'chikosoro chemoyo' chinowanzoitika - uku ndiko pulmonary edema, iyo murwere anoedza kukosora kana kudzipwa pasina. Zvinoitika apo ropa rinobva kuruboshwe rworuboshwe richidzokera mumapapu uye mvura iri muropa ichidzvanywa ichibuda muvascular system ichienda munzvimbo dziri pakati pebronchi - kana ikasarapwa, mhuka dzinogona 'kunyura' kana 'kudzipwa'.

kuongorora chirwere

Pane nzira dzakawanda dzokuongorora mwoyo. Izvo zviri nyore kuteerera ne stethoscope - iyo inonzi auscultation. Muchiitiko ichi, ruzha rwechipiri rwemwoyo (kuridza mhere, kurira, nezvimwewo) zvinogona kutariswa nemavharuvhu emwoyo asina kukwana. Panguva imwecheteyo, munhu anogona kuverenga kurova kwemwoyo uye zvichida kunzwa arrhythmia.

Muchiitiko chemoyo X-ray (kazhinji inogoneka pasina sedation), iyo yakatwasuka uye yakatwasuka dimensions yenhengo inoiswa maererano nehukuru hwe thoracic vertebrae kuti ione kana yakawedzera. Kana ikayera zvinopfuura 10.5 vertebral miviri mumbwa, izvi zvinonzi kuwedzera kwemoyo kunoda kurapwa - iyi nzira yekuverenga inonzi VHS X-rays (Vertebral Heart Score).

Kuti ukwanise kuongorora kushanda kwemavharuvhu pasina kupokana, iyo Doppler ultrasound yakazviratidza pachayo. Pamusoro pehukuru hwemavharuvhu emoyo, chero kudzoka kweropa nekuda kwekuremara kunogona kuratidzwa muvara.

DCM vs HCM

Kana kukanganisa kwemoyo kunoitika mukukwegura, muviri wembwa nekatsi zvinowanzoita zvakasiyana. Sezvo kuyerera kweropa kunovhiringidzwa nemavharuvhu emwoyo asina kukwana uye anogona kutoderedzwa mune dzimwe nzvimbo, mwoyo senzvimbo yepakati yekupomba inofanirwa kuvakwazve uye kugadziridzwa zvinoenderana.

Imbwa dzinowanzoita izvo zvinonzi dilated cardiomyopathy (DCM). Uku ndiko kuwedzera kwenhengo iyo inogona kuoneka zviri nyore paX-rays. Huwandu hwemakamuri ese ari maviri hunoratidzika kunge hwakawedzera zvakanyanya zvekuti huwandu hwakakura hweropa hunogona kutamiswa pakurova kwemoyo. Dambudziko nekuchinja uku nderekuti tsandanyama yemoyo inova yakamanikana kwazvo munzvimbo yemakamuri - inoshaya simba rekushandira nhengo yakawedzera zvakanyanya.

Katsi, kune rumwe rutivi, inogadzira hypertrophic cardiomyopathy (HCM) inenge yakangochembera chete kana paine mavharuvhu anoenderana. Nerudzi urwu rwemuripo, tsandanyama yemoyo yakakora zvakanyanya nekudzikira kwakakosha muhukuru hwemakamuri emoyo. Naizvozvo, chitsama chidiki cheropa chinogona kupomba pakurova kwemoyo uye moyo unofanirwa kurova kakawanda kuitira kutakura huwandu hweropa.

kurapa

Munguva pfupi yapfuura apo zviratidzo zvehosha yemwoyo zvinorondedzerwa pamusoro apa zvinooneka mumbwa nekatsi, chiremba wemhuka anofanira kubvunzurudzwa nokukurumidza sezvinobvira nokuda kwokuongorora mwoyo.

Sezvo mavharuvhu emwoyo achipera zvishoma nezvishoma nezera, ruzhinji rweimbwa dzese nekatsi zvichakurumidza kana gare gare kuita zviratidzo zvinoenderana uye zvinoda kurapwa. Kuti vatsivise kukundikana kwemoyo kunoguma, mushonga wemazuva ano wemhuka unoshandisa mbiru ina dzemoyo (mushonga wemoyo):

1. Kudzikisa mushure mekutakura neACE inhibitors (nekuwedzera tsinga dzeropa, zvinova nyore kuti mwoyo upombe kupesana neropa riripo)
2. Kunonoka kana kudzoreredza maitiro ekugadzirisa anoitika mu dilated kana hypertrophic cardiomyopathy
3. Kusimbiswa kwesimba remuscular heart kuburikidza neiyo inoshanda chinhu 'pimobendan' mumbwa.
4. Kuyerera kwemapapu nekuita kuti itsvo ishande pamwe neanoshanda zvinosanganisa 'Furosemide' kana kuti 'Torasemide' pamberi pepulmonary edema.

Uye zvakare, kutenderera kweropa-kukurudzira vamiririri vakaita sepropentofylline vanogona kushandiswa munzvimbo yeterminal kuyerera nzira.

Ndeupi chinhu chinoshanda chinoshandiswa umo murwere anofanirwa kusarudzwa pahwaro hwezviwanikwa zviripo uye zviratidzo. A generalization haigoneki.

mhedziso

Makore mashomanana apfuura, chirwere chemwoyo mumbwa nekatsi, kunyanya nyaya dzine chokuita nezera, yainzi yakaoma zvikuru. Kune rimwe divi, nekuti sarudzo dzemushonga dzaive shoma uye, kune rumwe rutivi, mushonga waive wakaoma kudhaka (semuchetura wefoxglove dzvuku) waivepo.

Kunyanya, kusimbaradza kwepimobendan kwakaunza kufambira mberi kukuru mukurapa kwembwa dzine chirwere chemoyo mumakore achangopfuura.
Nhasi, tarisiro yehupenyu yemurwere wemoyo akagadziridzwa uye akatariswa zvakanaka anogona kunge akakwira semurwere ane hutano - chero matanho ekutanga atorwa.