Kiyasta lokacin karantawa: 7 minti daya
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(A) ve (B) Misalai biyu na auscultation da rikodi tare da stethoscope na dijital; an gudanar da kuliyoyi a tsaye ko a zaune akan teburin jarrabawa. An gudanar da kuliyoyi a tsaye ko zaune a kan teburin jarrabawa.
(C) Trace phonocardiographic da ECG samu ta DS a cikin wani cat tare da al'ada auscultation kuma babu ciwon zuciya a kan echocardiography.
(D) Trace phonocardiographic da ECG samu ta DS a cikin wani cat tare da systolic gunaguni.
(E) Trace phonocardiographic da ECG samu ta DS a cikin wani cat mai gallop sauti.
Yaya ya kamata a yi auscultation a cikin kuliyoyi?
Don tantance gunaguni na zuciya daidai a cikin kuliyoyi parasternal auscultation, amfani da kayan aiki daidai ve kwarewa A lokuta da aka gano gunaguni, ƙarin cikakken bincike game da lafiyar majiyyaci da aikin zuciya yana da mahimmanci.
Ƙunƙarar zuciya a cikin kuliyoyi sun fi wuya a tantance daidai fiye da karnuka. Wannan shi ne saboda kuliyoyi suna da nau'in jikin kirji daban-daban, kuma gunaguni sau da yawa suna da laushi kuma suna da hankali. Gudun zuciya a cikin kuliyoyi sau da yawa a gefen sternum (parasternal) ana jin karin haske.
Nasihu don Auna Gudun Zuciya a cikin Cats
1. Matsayin Sauraro:
Ana jin sautin gunaguni a kusa da sternum a cikin kuliyoyi, wato, parasternal An fi jin shi daga wurin bawul inda gunaguni ya samo asali. Wannan yana ba da sauƙi don tantance yankin bawul inda gunaguni ya samo asali.
2. Amfani da Stethoscope na Yara:
Lokacin yin auscultation a cikin kuliyoyi stethoscope na yara tare da ƙaramin yanki na kai Yin amfani da stethoscope yana da mahimmanci don jin sautunan zuciya da gunaguni sosai. Daidaitaccen stethoscope na iya yin wahala a saurara a daidaitattun wurare a cikin ƙaramin kejin haƙarƙari.
3. Bukatar Kwarewa:
Ƙayyade daidai wace bawul ɗin zuciya ke haifar da gunaguni yana buƙatar ƙwarewa da ƙwarewa. A cikin kuliyoyi, ƙaddamar da gunaguni zuwa bawul yana yiwuwa tare da sanin wurare na jiki da kuma wurin da ya dace na stethoscope.
Wadanne nau'ikan gunaguni na yau da kullun ne aka gano a lokacin jiyya a cikin kuliyoyi?
Cututtukan zuciya a cikin kuliyoyi (misali, VOD ko PDA), musamman biyu samu systolic gunaguni na zuciya Waɗannan sharuɗɗa guda biyu suna lissafin kusan kashi 98% na gunagunin zuciya da aka gani a cikin kuliyoyi:
1. SAM (Systolic Gaban Motsi)
2. DR VOTO (Harkokin Fitarwa na Dama mai Sauƙi)
SAM (Systolic Gaban Motsi)
• definitionMitral bawul stenosis wani yanayi ne wanda takarda na baya na mitral bawul ɗin yana ɗaukar matsayi mara kyau yayin fitowar jini daga ventricle na hagu, wani ɗan lokaci yana toshe sashin ventricular na hagu (LVOT).
• Makanikai: Haɗe da hypertrophic cardiomyopathy (HCM) kuma yawanci yana haifar da kauri daga bangon ventricular na hagu. SAM na iya haifar da mitral regurgitation (komawar jini ta hanyar mitral valve), yana haifar da gunaguni na systolic tare da kwararar jini.
DR VOTO (Harkokin Fitarwa na Dama mai Sauƙi)
• definition: Yana da ƙwaƙƙwarar ƙunƙunwar ƙwayar jijiyar dama mai fita (RVOT).
• Makanikai: Sau da yawa ana danganta shi da damuwa, ƙara yawan bugun zuciya, ko hauhawar jini na ventricular dama. Wannan yana haifar da tashin hankali yayin da jini ke gudana daga ventricle na dama zuwa jijiya na huhu, yana haifar da gunaguni na systolic.
Matsalolin Ƙirar Gida da Buƙatar Bincike
Abin takaici, SAM da DR VOTO sun yi gunaguni ba za a iya bambanta a fili cikin sharuddan gidaDukansu yanayi yawanci ana jin su a wurare iri ɗaya kuma ba za a iya tabbatar da ganewar asali ta hanyar jiyya kaɗai ba.
Saboda haka, Ultrasonography na zuciya (echocardiography) a cikin duk kuliyoyi tare da gunaguni na zuciya Echocardiography yana da mahimmanci don tantance tushen gunaguni, bincikar cututtukan da ke ciki kamar HCM, da haɓaka tsarin kulawa.
sakamakon
• Sam ve DR VOTO, lissafin yawancin (98%) na gunaguni na systolic a cikin kuliyoyi.
Ba za a iya bambanta waɗannan gunaguni daidai ta hanyar auscultation kadai ba.
• A cikin kuliyoyi waɗanda aka gano gunaguni na zuciya, echocardiography wajibi ne don ganewar asali da magani.
Tunda waɗannan yanayi yawanci alama ce ta cututtukan cututtukan zuciya mai tsanani, ganewar farko da bin diddigin suna da mahimmanci.
Menene Systolic Gaban Motsi (SAM) a cikin Cats?
Sam (Systolic Anterior Motion) yana faruwa ne lokacin da takaddar mitral bawul ɗin septal ta motsa zuwa gefen hagu na ventricular outflow (LVOT) yayin systole. Wannan shi ne musamman hypertrophic cardiomyopathy (HCM) Ana ganin shi a cikin mahallin kuma yana haifar da mummunan kauri na musculature na ventricular na hagu.
Makanikai
1. Canje-canje na Matsayi a cikin tsokoki na Papillary da Mitral Valve
• Kauri na tsokar ventricular na hagu, canji a matsayi na tsokoki na papillary kai zuwa.
• Leaflets na mitral bawul, Chordae Tendinae An haɗa shi da tsokoki na papillary ta hanyar tsokoki na papillary. Yayin da tsokoki na papillary suka canza matsayi, takardun mitral bawul kuma suna canza matsayi.
2. Motsi na Mitral Valve Leaflets zuwa cikin Hagu na Fitowa Fitowa
• Leaflets na mitral bawul yayin systole Wurin fita na ventricular na hagu (LVOT) Musamman, leaflet ɗin mitral septal (na gaba) yana hana ɓarna a ɓangaren hagu na hagu.
3. Dynamism-Dangatakar Subaortic Stenosis da Mitral Regurgitation
• Wannan canjin matsayi yana faruwa a lokacin systole. mai tsauri na subaortic stenosis halitta.
• A lokaci guda, zubar jini yana faruwa daga mitral valve zuwa hagu na atrium, wanda mitral regurgitation (wanda aka bayyana a matsayin rashin isasshen mitral).
Binciken Clinical da Murmur Maɗaukaki
• SAM, yawanci hauhawar zuciya (tachycardia) ya bayyana.
• Lokacin da aka rage yawan bugun zuciya (misali, ta hanyar kwantar da hankali), gunaguni mai ƙarfi na iya ɓacewa ko raguwa cikin ƙarfi.
• Gunaguni yawanci a cikin hagu parasternal yankin an fi jin sa.
Muhimmancin asibiti
• SAM, hypertrophic cardiomyopathy (HCM) Yana da alaƙa ta kut-da-kut da kuma bincike ne na kowa a cikin kuliyoyi masu HCM.
Wannan yanayin duka biyu ne Haguwar fitowar fili ta hagu har da mitral insufficiency Idan ba a kula da shi ba, zai iya haifar da rikice-rikice na zuciya da jijiyoyin jini.
• Ƙarfin gunaguni na zuciya na iya bambanta dangane da bugun zuciya. Saboda haka, echocardiography ya zama dole don tantance canje-canje masu ƙarfi a cikin kuliyoyi waɗanda ake zargi da SAM.
SamHCM wani muhimmin yanayin zuciya ne wanda ke shafar sashin fitowar huhu na hagu kuma yana da alaƙa da HCM. A lokuta na SAM da aka gano a cikin kuliyoyi, yana da mahimmanci don kafa ingantaccen ganewar asali da tsarin kulawa. cardiac Ultrasonography (echocardiography) Wannan ya kamata a yi. Gudun gunaguni na iya ƙara bayyanawa a yawan hauhawar zuciya kuma ya ɓace a ƙananan ƙima, don haka saka idanu don canje-canje masu ƙarfi yana da mahimmanci. Ana yin amfani da magani don sarrafa HCM da ke ƙasa da kuma rage alamun.
DR VOTO, menene toshewar hanyar fita ta hannun dama?
DR VOTOyanayi ne na zuciya wanda ya samo asali daga tsantsar kunkuntar fili mai fita na dama. Wannan yanayin yawanci m ana ɗaukar gunaguni kuma sau da yawa kawai hauhawar zuciya (tachycardia) m.
Makanikai
1. Matsananciyar Motsi na Katangar Kyauta ta Dama
DR VOTO yana faruwa ne sakamakon matsananciyar matsananciyar motsin bangon ventricle na dama.
• Wannan matsananciyar motsi yana haifar da matsewar fili mai fita na ventricular dama da ƙunci na ɗan lokaci.
2. Gudun Jini Mai Tashin hankali
• Jinin da ke fitowa daga ventricle na dama zuwa jijiya na huhu yana haifar da tashin hankali a cikin kunkuntar hanyar fita, wanda gunaguni na systolic ana jin kamar.
Muhimmancin asibiti
• A Benign Murmur: DR VOTO, a mafi yawan lokuta marasa alaƙa da cututtukan zuciya Wani gunaguni ne.
• Dangantaka da HCM: A lokuta da ba kasafai ba hypertrophic cardiomyopathy (HCM) Yana iya haɗawa da cututtukan zuciya kamar. Koyaya, wannan ƙungiyar gabaɗaya tana da wuya.
• Dangantaka da Cututtukan Tsari: DR VOTO, a wasu lokuta karancin jini ko kuma ana iya gani tare da wasu cututtuka na tsarin. Sabili da haka, yana da mahimmanci don kimanta yanayin tsarin da ke ciki.
Murmura mai ƙarfi da ganewa
• Mahimman Kiwon Zuciya Mai Girma: DR VOTO gunaguni yawanci yakan zama bayyananne a yawan bugun zuciya kuma yana iya ɓacewa lokacin da bugun zuciyar ya dawo daidai.
• EchocardiographyDon tabbatar da raguwar fitowar huhu na dama da motsin bangon da ya wuce kima echocardiography ya kamata a yi amfani da shi.
DR VOTOGabaɗaya yanayi ne mara kyau kuma baya haifar da wata babbar matsala ta asibiti a yawancin kuliyoyi. Duk da haka, hypertrophic cardiomyopathy, karancin jini Yana da mahimmanci don kimanta dalilin da ya sa a cikin kuliyoyi tare da gunaguni saboda, ko da yake yana da wuya, ana iya danganta shi da wasu cututtuka na tsarin. A matsayin gunaguni mai ƙarfi, ƙarfin DR VOTO na iya bambanta dangane da ƙimar zuciya kuma yana iya buƙatar cikakken kimantawar echocardiographic.
Wasu Labarun Kuna iya Sha'awarsu
"Abin da ba a cikin hankali ba zai iya zama a cikin hankali."
John Locke
