Intliziyo ye-Systolic ibubula

Le mba we bambombozela intliziyo iSystolic, inokuba lisaziwa wonke. Kunjalo, ubukho babo Kuyaphawuleka, ngenxa yokuba kwiimeko ezininzi zivela kwi imvelaphi kwezifo. It is a uhlobo ephilayo umqondiso obonisa kwakukho ukuba kubekho ezinye iingxaki ngentliziyo.

Kuthetha ukuthini ngoogqirha luyambombozela intliziyo

Ukusebenzisa ibinzana ezifana "ingxolo", ngokunxulumene entliziyweni, cardiologists kuthetha ngumkhuba ive ezinxulumene notshintsho zibaleke igazi izitya nentliziyo. Phakathi kwabantu abaqhelekileyo nazo uluvo lokuba ingxolo kummandla intliziyo - oko luphawu ingxaki ebuntwaneni. Kufuneka sivume - lo mbono likufutshane enyanisweni, njengoko ngaphezu kwe-90% ye-ubhaqo ezisebenzayo ingxolo olusisigxina abafikisayo nabantwana. Kodwa yambombozela efanayo iSystolic kwafunyaniswa ukuba kunye nabantu abatsha abaneminyaka ukusuka kwiminyaka engama-20 ukuya kuma-28 ubudala.

Uluvo cardiologists ezininzi malunga bambombozela zentliziyo ayavuma: amanqaku uphawu bufana ngezifo ethile kwentliziyo, nto leyo inika isiseko izifundo inhliziyo.

Igama elithi "iSystolic" inxulumene ngqo ingxolo, nto leyo achotshelwa umsantsa phakathi neethowuni intliziyo yokuqala neyesibini. I izandi ngokwabo ukudala igazi kwemali ejikeleza intliziyo mbobo yayo.

Ziziphi iintlobo ingxolo kuhlangatyezwane

Kwimeko-bume lonyango, ikho into ukumbombozela intliziyo, zahlulwe ngokweendidi eziliqela. Le ukukrokra iSystolic ezisebenzayo, ebizwa ngokuba omsulwa, kwaye organic, ubukho ebonisa a ngezifo ethile.

iingxolo abamsulwa kanjalo kuba mhlawumbi ngenxa zizifo ezahlukahlukeneyo, sinxulumana ngentliziyo. Oku kuthetha ukuba akukho iliphawu imeko zophendlo lwezifo intliziyo. Ubume olu hlobo ingxolo ithambe, oguquguqukayo, umculo, elifutshane, ukuba kwelona ephantsi ngokwaneleyo. iingxolo ezinjalo buthathaka kunye ngokunciphisa imisebenzi emzimbeni kwaye azikho zibanjwa ngaphaya intliziyo. Uhlobo utshintsho babo sinxulumana iithowuni zentliziyo, kodwa kuxhomekeke indawo emzimbeni.

Njengoko ngenxa organic ingxolo, zivela ngenxa unesiphako septal, okanye isivalo (okt atrial isiphene okanye ventricular septal). Le besandi yengxolo ingachazwa njengento ezinzileyo, nzima, rough. Ngokutsho ngobunzulu ukuba ezibukhali elikhulu, kunye nexesha ebalulekileyo. Olu hlobo ingxolo lwenziwa ngaphandle kwentliziyo ekhwapheni nommandla interscapular. Emva umthambo iingxolo organic ziyanyuswa kwaye igcinwe. ukuba nabo, ngokuchaseneyo umsebenzi ukunxulunyaniswa aneethowuni ngentliziyo kunye ngokulinganayo yasentabeni ngokucacileyo omzimba ezahlukeneyo.

bambombozela iSystolic iquka iintlobo ezahlukeneyo ngezenzeko ive kummandla we intliziyo;

- luyambombozela Early iSystolic;

- pansystolic (holosystolic);

- yee-ngasekupheleni ingxolo;

- srednesistolicheskie ingxolo.

Yini na entliziyweni kukho iintlobo ezahlukeneyo yengxolo

Ukuba uhlawula ingqalelo ingxolo enkulu ukuba ndiyaqonda njengento esisisongelo kwimpilo, kufanele kuphawulwe ukuba zibangelwa ezimbalwa izizathu eziphambili.

bambombozela intliziyo iSystolic inokuba ngenxa stenosis aortic. Phantsi kwale uphethwe kufuneka ziqondwe iziphene okanye lufundiwe aortic constriction umngxuma ngokuthi usifake izinto beziya ka vana ngokwayo. Le nkqubo yenza kube nzima ukuhamba kwegazi yesiqhelo ngaphakathi entliziyweni.

stenosis Aortic kunganxulunyaniswa enye iziphene intliziyo ixhaphakileyo zenzeka abadala. Kule isifo ukuphuhlisa insufficiency aortic kunye mitral. Ngenxa yokuba ukuba icebo utyekelo langoku aortic ukuya calcification (xa phambili stenosis), uphuhliso sifo liyenyuka.

Kwiimeko ezininzi xa esisigxina stenosis ezinzulu aortic, ventricle ekhohlo igcwele kakhulu. Ngeli xesha, intliziyo kunye nobuchopho baqalise behlupheka kukungabi lonikezelo kwegazi.

insufficiency Aortic nazo ingabalelwa izizathu ephuhlisa bayakrokra iSystolic. Undoqo kwesi sifo kukuqinisekisa ukuba ivelufa aortic lingenako ukuvala ngokupheleleyo. Yena regurgitation aortic rhoqo ukuvela imvelaphi endocarditis infective. Ukuphembelela uphuhliso esi sifo samathambo (ngaphezu kwesiqingatha amatyala), systemic lupus zomzimba, negcushuwa, kunye yegazi. Ngelo xesha nye eyabangela esi siphene kubangela azifane ukwenzakala okanye kwasekuzalweni. bambombozela iSystolic kwi aorta kusenokuba kubonisa isenzeko kwesalamane insufficiency lwe ivalve aortic. Loo imeko kunokubangela yokwanda kakhulu le ijikazi ezinezikhondo ye ivalve kunye aorta ngokwayo.

Acute regurgitation mitral - ngomnye unobangela ingxolo iSystolic. Kule meko ke intshukumo okukhawulezayo zokufuma okanye iigesi, nto leyo eyenzeka kwi-organ dystrophy umngxuma inkqubo yokunciphisa. intshukumo okunjalo malunga ulwalathiso yesiqhelo. Loo unesifo kwiimeko ezininzi kubangelwa ezingaqhelekanga ezindongeni hlulo.

bambombozela iSystolic kwi pulmonary ibonisa uphuhliso kwingingqi stenosis. Ekubeni sifo kwi kwemithambo ivalve pulmonary into iingqameko kwisiqwenga ventricle ekunene. Olu hlobo stenosis umalunga 8-12% yazo zonke iziphene ngentliziyo naso. ingxolo enjalo usoloko kunye jitter iSystolic. Ngokukodwa zokukhanya ingxolo kwinqanawa entanyeni.

wabala Worth kunye tricuspid valve stenosis. Kule sifo kukho licuthe ivalve tricuspid. Ezi nguqu kakhulu amaninzi ziziphumo nefuthe samathambo. Iimpawu zesi hlobo stenosis ziquka kwesikhumba, ukudinwa, ubuhlungu xa ikota yesangqa ephezulu ngasekunene esisu kunye nentamo.

Izizathu bambombozela iSystolic ebantwaneni

Izinto ezichaphazela ukusebenza kwentliziyo labantwana, lukhulu, kodwa kukho amaxesha amaninzi oku kulandelayo:

- Atrial septal siphene. Phantsi isiphako kwakuthetha ukungabikho izihlunu atrial septal, ekhokelela wampompoza ukumpompoza kwegazi. Ubukhulu ngocwangcisa ixhomekeke sokuhlangabezana ventricles kunye isiphene nobukhulu.

- Anomalous pulmonary ukubuya lwemithambo. Sithetha ukuyilwa elingafanelekanga yegazi miphungeni. Ngokucace kakhulu, imithambo pulmonary bangabi ingxelo intendelezo ekunene, ewela kwangoko wakhwela intendelezo ekunene. Amaxesha amaninzi ukuze ukuxuba kunye intendelezo ngenxa yegazi isangqa esikhulu (Vena ekunene kunathi Vienna, Vienna unpaired, ekhohlo brachiocephalic ibhuthi, sinus nemithambo kunye flow lwemithambo).

- coarctation le aorta. Phantsi kwale nkcazo kufihla intliziyo isiphako naso apho kukho exineneyo segmental le aorta thoracic. Ngamanye amazwi, le mithambo segmental aortic iba ezincinane. Le ngxaki iphathwa yi uqhaqho. Ukuba le uphethwe ukuba ukuthatha nawaphi na amanyathelo, licuthe umntwana aorta liya kukhula njengoko bekhula.

- Ventricular septal siphene. Le ngxaki ke sesinye sezizathu esisigxina bayakrokra iSystolic entliziyweni yomntwana. Le isiphako luphawulwa into yokuba isiphene kuphuhliswa phakathi ventricles emibini yentliziyo - asekhohlo nasekunene. Esi siphene intliziyo kubhalwa rhoqo ngokwaseburhulumenteni ekwanti, nangona kukho iimeko xa isiphako enjalo yinxalenye nezinye izifo zentliziyo.

- bambombozela iSystolic emntwaneni ibangela intliziyo esinxulunyaniswa ne emithanjeni siphene evulekileyo. Sithetha njengesitya elifutshane inxulumanisa pulmonary kunye aorta ukwehla. Imfuneko yale shunt komzimba liyalahleka emva impefumlo yokuqala usana, ngoko iintsuku ezimbalwa iza kuvalwa. Kodwa ukuba oku akwenzeki (oko, enyanisweni, Lowo ngumongo unesiphako), igazi iyaqhubeka ukuba shunted ukusuka kwegazi kwi encinane. Ukuba umoya nto incinane, oko kukuthi, e-siseko, kuya kuba nempembelelo embi kwimpilo yomntwana. Kodwa xa kusingethwe enkulu arteriosus lomenzi ductus, kukho umngcipheko omninzi kakhulu inhliziyo. Iimpawu yale meko - ukuba yinxalenye Ukuphelelwa. Ukuba flow likhulu kakhulu (9 mm okanye ngaphezulu), usana inokuba nezibi. Kulo mzekelo, yambombozela iSystolic ebantwaneni ayikho uphawu kuphela - intliziyo ngokwayo iya kwandiswa ubukhulu. umsebenzi Emergency isetyenziselwa Nokwethisa kuyingozi enkulu kangaka.

Ngokwahlukeneyo kuyimfuneko ukuba bachukumise udidi usana. Heart abantwana emva ukuzalwa sivakele esibhedlele. Oku kwenzelwa ukunqanda ezimbi kunokwenzeka. Kodwa ukuba kukho yabhalwa isandi, ngoko musa ukwenza izigqibo ezimbi ngaphambi kwexesha. Isibakala sokuba ngokomlinganiselo, wonke umntwana wesithathu uchonga iingxolo ezithile. Kwaye bonke ubungqina iinkqubo eziyingozi (ukuba kuchaphazela ngokungalunganga uphuhliso usana yaye ezingahambi nokuhamba kwegazi). Kwakuphakathi (flow igazi) lakhe, ulwakhiwo ngokutsha ukuze ingxolo ezisebenzayo umntwana, naye akazange isongela kwimpilo. Kule meko, njengoko X-reyi kwaye electrocardiogram iya kubonisa uphuhliso eqhelekileyo intliziyo losana.

Njengoko ngenxa yomsindo ezendeleyo neentsana, ukuba emiselweyo kwiinyanga ezintathu zokuqala emva kokuzalwa. Esi sifo uthi ngexesha foetal intliziyo lokusekwa usana wayengekho de kube sekupheleni kuphuhliso kwaye, ngenxa yoko, uye iziphene ezithile ekuzalweni. Ukuba iqondo ifuthe ukusilela Wamnyamekela kuphuhliso wosana uya kuba phezulu kakhulu, kunokwenzeka ukuba oogqirha baya isigqibo malunga ukuziphatha kotyando ukuphelisa esi sifo.

Features ingxolo kunayo yonke intliziyo

Nale hlobo iimpawu ingxolo lo wokugqibela iyohluka, ngokuxhomekeke unobangela kunye nendawo nasisihlo.

1. Acute valve insufficiency mitral. Kulo mzekelo, ingxolo ingachazwa nje elifutshane. Yena ibonakala ekuqaleni (protosistolichesky). echocardiography Ukusebenzisa bungabonakala zone hypokinesis ukulele msantsa, iimpawu kunye nezinye endocarditis yebhaktiriya.

2. ezingapheliyo valve insufficiency mitral. Ingxolo yale hlobo iya kuhlala ngokupheleleyo ngexesha ucutheko le ventricles (holosystolic kunye pansystolic). Kukho uxhomekeke ngqo unesiphako vana, umthamo wegazi ngokusebenzisa unesiphako kunye umlinganiswa ingxolo ukubuyela. bambombozela iSystolic njengezona intliziyo phantsi kwezi mpawu yasentabeni kakuhle ngokuxwesileyo. Ukuba unesiphako uya inkqubela, kukho lokungcangcazela uvalo eludongeni esifubeni systole.

3. insufficiency Relative mitral. Ukuba uchitha ixesha elide woviwo (X-ray, echocardiography), kunokwenzeka ukuba ukuchonga komlomo le ventricle ekhohlo. bambombozela iSystolic njengezona kulo mzekelo zigcinwe ngalo lonke ixesha ventricular ucutheko, kodwa uya kuba ethule. Ukuba iimpawu nokumfixana ukusilela intliziyo kuyacuthwa, kwaye ziqhutywe unyango olufanelekileyo, lo sonority yengxolo iya kuncitshiswa.

4. Ngendlela kwemisipha papillary. Ngethuba loviwo rhoqo ityhila iimpawu iposi engabalulekanga, okanye (ii) kobuchopho. Loo ukukrokra iSystolic njengezona intliziyo ingachazwa njengento esiguquguqukayo. Ngaphezu koko, le ukubukeka kufuphi ekupheleni systole okanye inxenye eliphakathi.

5. Mitral valve prolapse. Oku kunokwenzeka kunye ukuhlanganiswa ukumbombozela iSystolic emva kwexesha. Bugged olu hlobo kuhle kwindawo tye. ingxolo enjalo ngokuxhomekeke kwimeko yomguli ingahluka kakhulu. Ezo bambombozela iSystolic njengezona luphawulwa nembonakalo inxalenye phakathi systole (ebizwa ngokuba mezosistolichesky click).

Ingxolo kwi ekhohlo kwentamo (point Botkina)

Xa eli lizwi lale hlobo kukho izizathu ezininzi:

- Ventricular septal siphene. Sikubonise enikina esifubeni ngexesha systole ukuya ekhohlo kwentamo. Xa iimpawu ingxolo ubungakanani unesiphako ayinasiphumo. idolo wentliziyo ibanjiwe kwi-100% yamatyala. Fixed ukukrokra rough iSystolic, emi lonke systole neyaziwa kuwo onke amasebe. Ngoncedo lwe X-ray uyakwazi ukuchaza dilatation le arch aortic kunye ingxinano nezengekho miphungeni.

- bekhubazekile stenosis miphungeni. Enye iimpawu eziphambili - iliphawu ngwe purring. Xa kujongwa intliziyo wayo elisemqolo (Buze Isifuba). ithoni yesibini pulmonary abasakwazi kuziphatha.

- Obstructive cardiomyopathy. bambombozela iSystolic e Botkin kule hlobo yi avareji kwaye ayahluka ngamandla ngokuxhomekeke ukuma umzimba xa umntu exabisa - siyenyuka, lulele likarhulumente - etsha.

- Tetarda halyard. Ezi iingxolo ahluka yi intlanganisela shunt of ekhohlo ukuya ekunene ezingontsini zentliziyo ngenxa unesiphene ekudibaneni phakathi ventricles kunye kwemithambo ukuvala miphungeni. Isandi isonka, kunye nitrogen of jitter iSystolic. Iingxolo ziphulaphulwa zamawonga kwindawo ezisezantsi kwentamo. Ngoncedo lwe ECG ingalungiswa Imiqondiso ventricle ekunene utshintsho hypertrophic. Kodwa ngoncedo-X reyi zibonisa ngezifo akusayi kusebenza. Xa nawuphi na umthwalo kubonakala cyanosis.

Ingxolo ekunene kwentamo

Kweli nqanaba (II isithuba intercostal) auscultated iziphene aortic. Ingxolo kwimizobo bacebisa ukuba ufumene constriction okanye genesis naso.

Ezo bambombozela iSystolic uneempawu ezithile:

- ndawo nenzuzo ukuba ubhaqo lwalo - na izithuba intercostal-4 no-5 ukuya ekhohlo kwentamo;

- pensistolichesky, olunzulu, yayimbi kwaye kaninzi sisusa ingxolo;

- lwenziwa kwicala lasekhohlo esifubeni, yaye ifikelela ngasemva;

- kwindawo ehleli kwandisa ingxolo;

- iimviwo X-ray ibhaqa ukwanda aortic calcification nezixhobo ezihamba nokufakelwa ukwanda ventricle ekhohlo;

- ukubetha na isiqulatho amahlwempu nabo inqabile;

Ukuqhubela phambili isiphene ikhokelela ekubeni ukwanda kwale ventricular arterio-imingxuma ekhohlo. Kule meko, kukho amathuba ukuphulaphula ababini ingxolo ezahlukeneyo. Ukuba bambombozela iSystolic kwaba senziwa stenosis enaso, uya kunikela ukugxothwa eyongezelweleyo ithoni, apho kungenxa rugurgitatsiey ezihamba aortic.

bambombozela Heart ngexesha lokukhulelwa

Ngexesha nabantwana zingenzeka ingxolo sistalicheskih. Amaninzi, zikwazi ukusebenza ngokwendalo ngenxa okwanda umthwalo njengentliziyo yomfazi okhulelweyo. Loo urhulumente kakhulu uphawu leenyanga ezintathu lesithathu. Ukuba ingxolo onakele, lo umqondiso ukuba ukuthatha karhulumente okhulelweyo (nezintso, umthamo umthwalo, uxinzelelo lwegazi) phantsi kolawulo ngenyameko.

Ukuba zonke ezi mfuno ngokuchanekileyo wadibana, ngoko kukho wonke amathuba ukuba ukukhulelwa kwakunye ekubelekeni, kuya kuba HIV, akukho ezingalunganga entliziyweni.

ukuxilongwa ingxolo

Okokuqala, ukuqalisa indlela inkqubo zokufumanis isifo sentliziyo - kwinkcazelo ukungabikho okanye ubukho ukumbombozela kwentliziyo. Kulo mzekelo, auscultation entliziyweni lwenziwa kwindawo oxwesileyo okanye nkqo, emva umthambo, kwicala lasekhohlo kwakunye kwi ukuphakama inhalation kunye nomphunga. amanyathelo ayimfuneko ukuze bambombozela intliziyo iSystolic, oonobangela apho inokuba nomahluko ngokupheleleyo, ukuba ngokuchanileyo ezichongiweyo.

Ukuba sithethe ngayo izinto ezimbi ivalve mitral, eyona ndawo kangangoko belungiselelwa ukuphulaphula ingxolo kule meko ke kwincam kwentliziyo. Kwimeko iintsilelo ivalve aortic kufuneka sinikele ingqalelo isithuba intercostal wesithathu abasindileyo kwentamo okanye yesibini kwicala lasekunene. Ukuba une ukujongana ububi ka vana tricuspid, yambombozela iSystolic baphulaphule bhetele umzimba kwentamo edge ezantsi.

Ethetha iimpawu ingxolo, kubalulekile ukukhumbula ukuba babe Phase ezahlukeneyo (iSystolic kunye ukuzala), ubude, hexa kunye conductivity. Enye yemingeni engundoqo ngeli thuba nkcazelo ngqo omnye okanye ngaphezulu epicenters yengxolo. Kwakhona kubalulekile ukuba uthathe ingqalelo ithowuni ingxolo, ekubeni lo mba ibonisa iinkqubo ezithile. Ukuba bambombozela iSystolic lula yesi iingxaki ezinkulu, rough, namarhela, kokuphalwa ibonisa stenosis le aortic aortic okanye miphungeni. Ngenxa yoko, ingxolo uthule busisigxina kwi endocarditis infective kunye insufficiency mitral. Ithathelwe ingqalelo umthamo kunye nethoni isiseko kunye incam yentliziyo.

Kubaluleke kakhulu ngexesha amanyathelo sokuqala yoxilongo ukwahlula extracardiac ingxolo, oko kukuthi, umthombo apho ibekwe ngaphandle kwentliziyo. Kwiimeko ezininzi, ezi iingxolo nga kuviwa xa pericarditis. Kodwa kuthatha isigqibo eso simanga ive kuphela ngexesha systole. Njengomntu ngaphandle, ukuba uphulaphule ngexesha diastole.

Kuba lokufunyaniswa imeko intliziyo ngokusebenzisa ubuchwepheshe ezahlukeneyo. isicelo yabo kuyimfuneko, ekubeni izigqibo ezotywe ngokwesiseko iziphumo ezifunyenweyo emzimbeni, kuxhomekeke ekubeni isiqinisekiso. Ukuze kufikelelwe kule njongo basebenzisa PCG, ECG, X-ray wentliziyo imilinganiso emithathu, echocardiography, kuquka transesophageal.

Njengoko Kwimeko ongasetyenziswayo iindlela zokuxilonga invasive asetyenziswa kwiimeko engqongqo (Ukuzibona, kunye nezinye iindlela umahluko.).

Ukulinganisa ngentliziyo izandi usebenzisa iisampuli ezithile:

- umthwalo ngokomzimba (ulwandiso, isotonic kunye carpal dynamometry);

- uphefumla (ukunyuka ingxolo ukusuka ekhohlo nasekunene intliziyo uwukhuphe)

- fibrillation atrial kunye ibetha atrial yokuya;

- utshintsho ngokokuma (imilenze ephakamisa kwi babemile, ukutshintsha indawo emzimbeni wakhe uhlale-ups);

- Valsalva zenzeke (nokubotshwa ukuphefumla ngomlomo evaliweyo kunye nempumlo) abanye.

ezifunyanisiweyo key

Okokuqala kubalulekile ukuqonda ukubaluleka kuxilongo mihla phambi ukumbombozela kwentliziyo. isidingo sayo sichazwe yinyaniso ukuba nimkrokrele iSystolic ukuze zinto zingumqondiso iingxaki zempilo ebambekayo, kodwa kwangaxeshanye liyakwazi ukuba sisibonakaliso isifo esimandundu.

Ngoko ke, nayiphi na ingxolo oko kubonakele ku entliziyweni, kufuneka kuchazwe ngoogqirha abaqeqeshiweyo (kuyimfuneko ukumisela unobangela ngobuchule nangokuchanekileyo). Eneneni, kusoloko kukho yambombozela intliziyo iimpawu ngamnye ezinxulumene ngamaxesha ezinxulumene-ubudala. Nayiphi ingxolo entliziyweni ugqirha befanelekile. Kukuvela luyambombozela nhliziyo komithiyo sinesizathu ngokwaneleyo ukuseka ulawulo esisigxina phezu imeko yakhe.

Naxa kungekho naziphi na iingxaki ngentliziyo okanye iimpawu nantoni na engaqhelekanga, kufuneka athile kuhlolwa. Kudla utyhila iSystolic ingxolo kwenzeka ngokuzenzekelayo. Ngoko ke, kukho uxilongo ngamaxesha uyakwazi ukubona i ngezifo kwinqanaba xa unyango mhlawumbi olusebenzayo.