Systolic mtima kudandaula

Chodabwitsa systolic mtima musadandaule, kungakhale bwino kwa aliyense. Komabe, pamaso pawo chidwi chifukwa nthawi zambiri iwo m'malembo maziko a matenda aakulu. Ndi mtundu wa chamoyo mbendera zikusonyeza kuti panali mavuto ena ndi mtima.

Kodi zikutanthauzanji madokotala mtima kung'ung'udza

Ntchito mawu monga "phokoso", poyerekezera mtima, cardiologists zikutanthauza chodabwitsa lamayimbidwe kugwirizana ndi kusintha otaya magazi ziwiya ndi mtima. Pakati pa anthu wamba akhoza kukumana ndi maganizo phokoso m'chigawo cha mtima - ndi vuto khalidwe la mwana. Tiyenera kuvomereza - maganizo amenewa ali pafupi ndi choonadi, monga oposa 90% ya zinchito phokoso kudziwika anakonza achinyamata ndi ana. Koma pa yemweyo systolic kudandaula anapezeka ndi achinyamata a zaka kuyambira azaka 20 mpaka 28.

Opinion wa cardiologists ambiri onena mtima anadandaula akulu kugwirizana: mfundo ngati chizindikiro kwa yeniyeni mtima kudwala, limene pamapeto imapereka maziko a maphunziro zonse mtima.

Mawu akuti "systolic" mwachindunji ndi phokoso, amene anamva kusiyana malankhulidwe yoyamba ndi yachiwiri mtima. The zikumveka okha kulenga otaya magazi mtima kapena zingwe zake.

Kodi ndi mitundu iti ya phokoso angathetsedwe

Chilengedwe mankhwala, chinthu monga musadandaule mtima, anawagawa m'magulu angapo. Izi zinchito systolic musadandaule, otchedwa wosalakwa, ndi organic, pamaso amene amasonyeza kudwala yeniyeni.

Siimva osalakwa otchedwa chifukwa iwo mwina chifukwa matenda osiyanasiyana, si ndi mtima. Izi zikutanthauza kuti iwo sali chizindikiro cha chikhalidwe pathological za mtima. Timbre mtundu wa phokoso ndi yofewa, wosakhazikika, music, lalifupi, ndi mokwanira otsika kwambiri. Siimva oterowo wofooka ndi kucheperachepera ntchito thupi koma sanaimbidwe kupitirira mtima. Chikhalidwe cha kusintha awo kugwirizana ndi malankhulidwe a mtima, koma zimatengera pa udindo wa thupi.

Koma phokoso la organic, iwo amayamba chifukwa chakuti ya septal chilema, kapena vavu (ie chilema matenda kapena yamitsempha yamagazi septal). The timbre cha phokoso ndizodabwitsa wosasunthika, molimba, akhakula. Malinga ndi kukula ali akuthwa ndi akulu, ndi nthawi yaikulu. Mtundu uwu wa phokoso anautulutsa ya mtima mu armpit ndi dera interscapular. Pambuyo zolimbitsa phokoso organic nakweza ndi kusungidwa. iwo nawonso, mosiyana ndi kugwira ntchito kukhala ndi malankhulidwe mtima ndipo mofanana bwino amapatutsidwa ndi malo osiyana thupi.

Systolic kudandaula zikuphatikizapo osiyanasiyana zochitika lamayimbidwe m'dera la mtima:

- Early systolic kung'ung'udza;

- pansystolic (holosystolic);

- m'ma mochedwa phokoso;

- srednesistolicheskie phokoso.

N'chifukwa chiyani mumtima muli mitundu yosiyanasiyana ya phokoso

Ngati inu kulabadira phokoso ndithu kuti mumaona ngati kuopseza thanzi, tisaiwale kuti iwo amayamba ndi zifukwa angapo ofunika.

Systolic mtima kudandaula mwina chifukwa stenosis kung'ambika. Mu matenda ayenera kumvetsa kobadwa nako kapena kugula kung'ambika constriction dzenje ndi splicing ndi kutseka kuti uchiwo usatuluke wa valavu yokha. Zimenezi zimapangitsa kovuta yachibadwa magazi mkati mwa mtima.

Kung'ambika stenosis akhoza zimachitika munthu wa kupunduka ambiri mtima kunachitika akulu. Mu matenda kawirikawiri kukhala kung'ambika ndi mitral insufficiency. Chifukwa chakuti chipangizo alipo kung'ambika chizolowezi calcification (pamene patsogolo stenosis), chitukuko cha matenda zikuchulukirachulukira.

Nthawi zambiri pamene atathana kwambiri kung'ambika stenosis, kumanzere ventricle kwambiri opanikizika. Panthawi imeneyi, mtima ndi ubongo anayamba amadwala kupanda kotunga magazi.

Kung'ambika insufficiency akhoza zimachitika zifukwa zimene kukhala systolic kudandaula. Akamanena za matenda ndi kuonetsetsa kuti valavu kung'ambika si kutseka kwathunthu. Iye kung'ambika regurgitation zambiri akufotokozera pa maziko a endocarditis infective. Yosokoneza chitukuko cha matenda ndi enaake ophwanya malungo (oposa theka la milandu), zokhudza zonse lupus erythematosus, chindoko, ndipo atherosclerosis. Pa nthawi yomweyo wafunsira chilema izi kawirikawiri chifukwa kuvulala kapena vuto lobadwa. Systolic anadandaula msempha mwina zimasonyeza pakutchulidwa wachibale insufficiency wa valavu kung'ambika. Chotero chikhalidwe zingadzetse kukula kwambiri kwa mphete fibrous valavu ndi msempha yokha.

Pachimake mitral regurgitation - ndi chinthu china phokoso systolic. Pankhaniyi ndicho gulu mofulumira zakumwa kapena mipweya, lomwe limapezeka mu dzenje akulu limba m'kati kuchepetsa. kayendedwe amenewa popenyana ndi malangizo yachibadwa. Chotero matenda nthawi zambiri chifukwa cha kuvutika m'makoma kugawa.

Systolic anadandaula mtsempha wamagazi ndi m'mapapo mwanga zikusonyeza chitukuko m'dera la stenosis. Ndi matenda amenewa mu m'mapapo mwanga vavu mtsempha wamagazi ndi mwapang'ono thirakiti wa ventricle bwino. Mtundu wa stenosis pafupifupi 8-12% ya zopindika onse obadwa nawo a mtima. phokoso amenewa nthawi zonse limodzi ndi jitter systolic. Makamaka kutchulidwa phokoso walitsa ziwiya khosi.

Worth ponena ndi tricuspid vavu stenosis. Mu matenda pali kuchepetsa wa valavu tricuspid. zosintha zimenezi zili nthawi zambiri chifukwa cha mmene matenda enaake ophwanya m'thupi. Zizindikiro za mtundu uwu wa stenosis monga khungu ozizira, kutopa, kusapeza mu chapamwamba nusu lamanja la pamimba ndi khosi.

Zifukwa systolic anadandaula ana

Zinthu zokhudza ntchito ya mtima ana kwambiri, koma pali zambiri zotsatirazi:

- matenda. Pansi chilema zimatanthauza pakalibe matenda septal minofu, zikubweretsa kumaliseche magazi. Ukulu wa Yambitsaninso zimadalira kugwilizana wa ventricles ndi makulidwe chilema.

- Anomalous m'mapapo mwanga venous kubwerera. Tikuyankhula zokhudza mapangidwe cholakwika kwa mitsempha m'mapapo mwanga. Komanso mwapadera, mitsempha m'mapapo mwanga si lipoti ku atrium lamanja, kugwa nthawi yomweyo mu atrium bwino. Nthawi zambiri moti angakondwere nazo zosakaniza ndi atrium kudzera waukulu mitsempha bwalo (vena bwino kuposa Vienna, Vienna unpaired, kumanzere brachiocephalic thunthu la nkusani inatsekeratu ndi nthenda yotaya venous).

- coarctation kwa msempha. Pansi tanthauzo limeneli amadzibisa ndi obadwa nawo a mtima chilema mmene muli segmental kuchepetsa wa msempha thoracic. Mu mawu ena, segmental kung'ambika lumen amakhala ang'onoang'ono. Vutoli amaliona ndi opaleshoni. Ngati matenda si kanthu, ndi kuchepetsa wa mwana msempha chidzakula akamakula.

- yamitsempha yamagazi septal chilema. Vuto limeneli ndi chimodzi mwa zifukwa zimene atathana systolic kudandaula mu mtima wa mwana. chilema Izi amakhala ndi chakuti chilema akufotokozera pakati pa ventricles awiri a mtima - lamanzere ndi lamanja. chilema izi mtima kawirikawiri olembedwa boma akutali, ngakhale pali milandu imene zinthu chilema ndi mbali ya zopindika ena mtima.

- Systolic anadandaula mwana amachititsa mtima likhoza kulumikizidwa ndi lotseguka wolumikizira chilema. Tikuyankhula zokhudza yochepa chotengera zomwe zikugwirizana ndi mtsempha wamagazi m'mapapo mwanga ndi kutsika msempha. Kufunika shunt izi zokhudza thupi Mwamsanga pambuyo mpweya choyamba mwana, kotero kwa masiku angapo izo zidzakhala zitatsekedwa. Koma ngati izi sizikuchitika (kuti zoona, ndicho chilema), magazi akupitirizabe shunted ku zokhudza zonse kufalitsidwa mu yaing'ono. Ngati ritsa zazing'ono, ndi, mfundo, sadzakhala ndi chidwi kungasokoneze thanzi la mwanayo. Koma pochita zinthu ndi lalikulu setifiketi ductus arteriosus, pali chiopsezo zimamuchulukira lalikulu mtima. Zizindikiro za chikhalidwe ichi - ndi gawo la breathlessness. Ngati otaya ioneka (9 mamilimita kapena zambiri), wakhanda akhoza kukhala mu mwakayakaya. Mu nkhani iyi, musadandaule systolic ana si chizindikiro chabe - mtima kudzakudikira zochuluka kukula. ntchito Emergency ntchito n'chongoletsa ngati loopsa kwambiri.

Payokha m'pofunika kukhudza gulu akhanda. ana mtima atabadwa amveka ngakhale mu chipatala. Izi zachitika kupewa pathologies zotheka. Koma ngati palibe chinalembedwa phokoso, ndiye musati kupanga mfundo zoipa asanakalambe. chakuti pafupifupi aliyense mwana wachitatu limatchula phokoso ena. Ndipo si onse amene ali umboni wa njira woopsawo (osati kusokoneza chitukuko cha mwana ndipo si limodzi ndi magazi). Inali nthawi yake (nthenda yotaya magazi), kukonzanso mwina ndi zinchito phokoso mwanayo, amene sanali kusokoneza thanzi. Mmenemonso, monga X-ray ndi electrocardiogram adzakusonyezani chitukuko yachibadwa mtima mwana.

Koma phokoso chibadidwe makanda, iwo anali atathana kwa miyezi itatu pambuyo pa kubadwa. matenda limanena kuti nthawi yoopsa mtima mapangidwe mwanayo sanali mpaka mapeto a chitukuko ndipo chotsatira, ali zopindika ena kubadwa. Ngati digiri amadza chifukwa cha matenda a mtima pa chitukuko cha mwana adzakhala kwambiri, n'zotheka kuti madokotala kusankha pa khalidwe la opaleshoni kuthetsa matenda.

NKHANI phokoso pamwamba pa mtima

Ndi mtundu uwu wa makhalidwe phokoso la yotsirizira zingasiyane malingana chifukwa ndi malo zosayembekezereka.

1. pachimake mitral vavu insufficiency. Pankhaniyi, phokoso akhoza yaifupi anafotokoza. Zikuoneka oyambirira (protosistolichesky). Kugwiritsa echocardiography tingaone hypokinesis zone makodi kusiyana, mbali ndi zina bakiteriya endocarditis.

2. aakulu mitral vavu insufficiency. Siimva mtundu uwu wotanganidwa kwathunthu pa chidule cha ventricles (holosystolic ndi pansystolic). Pali kudalira mwachindunji valavu chilema, buku la magazi kubwerera kudzera chilema ndi khalidwe phokoso. Systolic kudandaula pachimake pa mtima pansi makhalidwe amenewa yabwino amapatutsidwa mu malo yopingasa. Ngati chilema idzapambana, pali kugwedera palpable a linga pachifuwa pa systole.

3. Wachibale mitral insufficiency. Ngati mumathera nthawi yaitali Kupenda (X-ray, echocardiography), n'zotheka kudziwa dilation wa ventricle kumanzere. Systolic kudandaula pa pamwamba Pankhaniyi akhoza kuchita zimenezi pa nthawi ya chidule yamitsempha yamagazi, koma adzakhala ndi chete. Ngati zizindikiro za kuchulukana zoopsa mtima ndi kuchepetsedwa, ndipo anachititsa mankhwala okwanira, sonority phokoso adzakhala yafupika.

4. kukanika kwa minofu papillary. Pamene anali kumupima zambiri limasonyeza zizindikiro za infarction m'mnyewa wamtima, kapena (ii) ischemic. Chotero kudandaula systolic pachimake pa mtima akhoza monga zimasintha anafotokoza. Komanso, maonekedwe khalidwe chakumapeto kwa systole kapena gawo pakati.

5. Mitral vavu prolapse. N'zotheka ndi osakaniza ndi mochedwa kudandaula systolic. Bugged mtundu uwu ndi bwino mu malo woongoka. Chotero phokoso malingana ndi mmene wodwalayo zingasiyane kwambiri. Chotero systolic kudandaula pa pamwamba pa amakhala ndi chiwonetsero cha gawo pakati systole (otchedwa mezosistolichesky pitani).

Siimva kumanzere kwa sternum ndi (mfundo Botkina)

Pa phokoso la mtundu uwu pali zifukwa zingapo:

- yamitsempha yamagazi septal chilema. Mowonekera kugwedeza pachifuwa pa systole kumanzere kwa sternum lapansi. Mu makhalidwe phokoso la kukula chilema alibe chochita. Mtima hump ndi wapezeka 100% ya milandu. Atathana akhakula systolic kudandaula, amene ali lonse la systole ndipo unachitikira ku mabungwe onse. Mothandizidwa ndi X-ray angaulule dilatation wa Chipilala kung'ambika ndi kuchulukana m'mapapo mwanga.

- kobadwa nako m'mapapo mwanga stenosis. Chimodzi mwa zinthu zazikulu - chizindikiro cha nyamayi purring. Kuwaona noticeable mtima hump (protrusion thorax). Chachiwiri kamvekedwe ka mtsempha wamagazi ndi m'mapapo mwanga lafooka.

- Obstructive Cardiomyopathy. Systolic kudandaula pa Botkin wa mtundu uwu ndi avareji ndi siyana mu mwamphamvu malingana ndi udindo kwa thupi pamene munthu ofunika - auka, atagona mu chikhalidwe - zinaleka.

- Tetarda halyard. Siimva izi kusiyana ndi kuwaphatikiza shunt la kumanzere zipinda za mtima chifukwa chilema mu septum pakati pa ventricles ndi m'mapapo mwanga mtsempha wamagazi kuchepetsa. Phokoso ndi zamwano, ndi fixation wa jitter systolic. Siimva zimamveka bwino pa mfundo wotsikitsitsa sternum lapansi. Ndi thandizo la ECG akhoza atathana zizindikiro za ventricle bwino kusintha hypertrophic. Koma mothandizidwa ndi X-ray kuwulula kudwala sizigwira ntchito. Pamene katundu aliyense akuwonekera cyanosis.

Phokoso kudzanja lamanja la sternum ndi

Pa nthawi imeneyi (II intercostal danga) auscultated zopindika kung'ambika. Phokoso mu luso zikusonyeza anapeza constriction kapena kobadwa nako chiyambi.

Chotero kudandaula systolic ali ndi makhalidwe ena:

- kwambiri zaphindu malo kudziwika kwake - 4 ndi 5 intercostal malo kumanzere kwa sternum ya;

- pensistolichesky mwamphamvu akhakula ndipo nthawi zambiri kuchipala phokoso;

- ikuchitika kumbali yakumanzere ya chifuwa, nufikira kumbuyo;

- mu malo atakhala kumawonjezera phokoso;

- X-ray Kupenda detects kuwonjezeka kung'ambika calcification vavu ake zida ndi kuwonjezeka mu ventricle kumanzere;

- zimachitika ali okhutira osauka ndi osowa;

Kupitilira chilema kumabweretsa kukula kwa anachoka yamitsempha yamagazi arterio-mabowo. Imeneyi, pali kuthekera kumvetsera phokoso awiri osiyana. Ngati systolic kudandaula anali amayamba ndi stenosis kobadwa nako, kuti azipereka ndi athamangitsidwe zina kamvekedwe, ndilo chifukwa concomitant kung'ambika rugurgitatsiey.

Mtima kudandaula pa mimba

Pa kubala kumachitika sistalicheskih phokoso. Nthawi zambiri, iwo ndi zinchito mu chikhalidwe ndi chifukwa zikuchepa kuchuluka katundu pa mtima za mkazi wa pakati. Chotero boma kwambiri khalidwe la trimester lachitatu. Ngati phokoso anali mapulani ichi ndi chizindikiro kuti atenge boma pakati (impso, katundu dosing, kuthamanga kwa magazi) lolamulidwa mosamala.

Ngati amafuna zonsezi molondola anakumana, ndiye pali mwayi uliwonse kuti mimba komanso pobereka, adzakhala zabwino, palibe mavuto obwera pa mtima.

matenda a phokoso

Choyamba, momwe ayambe Kupeza Vuto matenda a mtima - tanthauzo la pakalibe kapena pamaso pa musadandaule mtima. Pankhaniyi, auscultation za mtima ikuchitika mu malo yopingasa kapena umodzi, pambuyo thupi, kumanzere komanso kutalika kwa inhalation ndi mpweya. miyeso zimenezi n'zofunika kuti systolic mtima musadandaule, zimayambitsa omwe mwina chosiyana, izo molondola kumene.

Ngati ife kulankhula za zoipa za valavu mitral, malo mulingo woyenera kumvetsera phokoso mu nkhani iyi ndi nsonga za mtima. Pankhani ya zopindika wa valavu kung'ambika ayenera kulabadira wachitatu intercostal danga otsala a sternum kapena wachiwiri kumanja. Ngati muyenera kuthana ndi zoipa za valavu tricuspid, ndi kudandaula systolic kumvetsera bwino thupi la sternum pansi m'mphepete.

Ponena za makhalidwe a phokoso, ndi Dziwani chakuti akhale ndi fezi osiyana (systolic ndi diastolic), nthawi, osakhalitsa ndi madutsidwe. Limodzi mwa mavuto chifungulo pa siteji iyi ndi tanthauzo lenileni la chimodzi kapena zingapo mwa epicenters wa phokosolo. M'pofunikanso kuganizira phokoso kamvekedwe, popeza chinthu ichi chikusonyeza njira yeniyeni. Ngati zosavuta systolic kudandaula portends mavuto aakulu, zamwano, kumaliza, kuchipala limasonyeza stenosis wa kung'ambika kapena m'mapapo mwanga kung'ambika. Nawonso phokoso kuwomba chili mu endocarditis infective ndi mitral insufficiency. N'komwe buku ndi mmene m'munsi ndi nsonga za mtima.

Nkofunika pa miyeso koyamba matenda kuti achotse phokoso extracardiac, ndiyo gwero la yomwe inali kunja kwa mtima. Nthawi zambiri, mapokoso amenewa anamva pamene pericarditis. Koma anatsimikiza ndi chodabwitsa ngati lamayimbidwe lokha pa systole. Monga zosiyana, iwo angamvetsere pa diastole.

Kwa matenda a mtima wa ntchito njira zamakono osiyana. ntchito yawo ndi zofunika popeza mfundo kukopedwa pa maziko a analandira anapezazo thupi, mutu ndi chitsimikiziro. Pofuna kukwaniritsa cholinga ichi Akatswiri ntchito PCG, ECG, X-ray za mtima miyeso itatu, echocardiography, kuphatikizapo transesophageal.

Monga zosiyana ndi njira olanda matenda ntchito zinthu okhwima (cholinga, ndi njira zina mosiyana.).

Kuyeza mphamvu ya mtima zikumveka ntchito zitsanzo zina:

- katundu thupi (isometric, isotonic ndi carpal dynamometry);

- kupuma (kuwonjezeka phokoso ku lamanzere ndi lamanja mtima kutulutsa)

- matenda fibrillation ndi matenda kumenyedwa msanga;

- Pamalo kusintha (kukweza miyendo pamalo chiliri, kusintha kwa thupi wodwalayo malo ndi kukhala akuluakulu);

- Valsalva kuzemba (clamping kupuma ndi chatsekedwa pakamwa ndi mphuno) ndi ena.

Zina mwa mfundo zikuluzikulu

Choyamba ndikofunika kumvetsetsa kufunika kwa diagnostics masiku ano pamaso pa musadandaule mtima. kufunikira kwake anafotokoza chifukwa chakuti systolic kudandaula mwina zikukhudza mavuto chogwirika thanzi, koma pa nthawi yomweyo amatha kukhala chiwonetsero cha matenda.

Choncho, phokoso uliwonse umene wapezeka mu mtima, ayenera anafotokoza madokotala oyenerera (m'pofunika kudziwa chifukwa mwaluso molondola). Ndipotu, nthawi zonse mtima kudandaula munthu makhalidwe kugwirizana ndi nthawi obwera ndi ukalamba. phokoso aliyense mu mtima dokotala woyenera. Nthawi ya kung'ung'udza mtima mkazi wapakati n'chifukwa chokwanira kukhazikitsa ulamuliro okhazikika pa chikhalidwe chake.

Ngakhale sitili mavuto alionse ndi mtima kapena zizindikiro za kuvutika kulikonse, ayenera nthawi kuti ndisanabadwe. Nthawi kuwulula systolic phokoso limapezeka mosintha. Choncho, matenda nthawi amatha kudziwa kumene kudwala pa siteji pamene mwina ogwira mankhwala.