ʻO ka puʻuwai (mai ka huaʻōlelo Helene cardia a mai ka Latin cor, "puʻuwai") ke kikowaena o ka ʻōnaehana cardiovascular. ʻO kahi "pump" maoli, hōʻoia ia i ka holo o ke koko i loko o ke kino mahalo i kāna kirimana rhythmic. I ka pilina pili loa me ka ʻōnaehana hanu, ʻae ia i ka oxygenation o ke koko a me ka hoʻopau ʻana o carbon dioxide (CO2).

ʻO ka puʻuwai kahi hollow, muscular organ i loko o ka iwi ʻaoʻao. Aia ma waena o nā māmā ʻelua ma ke kua o ka umauma, aia ia i ke ʻano o kahi pyramid huli. Aia kona piko (a i ʻole ka ʻapex) ma ka mākala diaphragm a kuhikuhi i lalo, i mua, i ka hema.

ʻAʻohe ʻoi aku ka nui ma mua o ka lima kuʻi, kau ʻia ia ma ka awelika 250 a 350 mau gram i nā mākua ma kahi o 12 cm ka lōʻihi.

ʻO ka enopope a me ka paia

Hoʻopuni ʻia ka puʻuwai e kahi enope, ka pericardium. Hana ʻia ia i ʻelua papa: hoʻopili ʻia kekahi i ka puʻuwai puʻuwai, ka myocardium, a ʻo kekahi e hoʻopaʻa paʻa i ka naʻau i nā akemāmā a me ka diaphragm.

 Hana ʻia ka paia o ka puʻuwai i ʻekolu papa, mai waho a i loko.

• ka epicardium
• ka myocardium, ʻo ia ka hapa nui o ka nui o ka puʻuwai
• ka endocardium, nā laina i nā lua

Hoʻopulu ʻia ka naʻau i ka papa e ka ʻōnaehana coronary artery, kahi e hāʻawi ai iā ia me ka oxygen a me nā mea pono e pono ai no kāna hana pono ʻana.

Nā lua o ka puʻuwai

Māhele ʻia ka puʻuwai i ʻehā keʻena: ʻelua atria (a i ʻole atria) a ʻelua ventricle. Hoʻopili pālua ʻia, hana lākou i ka puʻuwai kūpono a me ka puʻuwai hema. Aia ke atria ma ka ʻaoʻao luna o ka puʻuwai, he mau hakahaka lākou no ka loaʻa ʻana o ke koko venous.

Ma ka ʻaoʻao haʻahaʻa o ka puʻuwai, ʻo ka ventricle ka helu hoʻomaka no ka holo o ke koko. Ma ka hana kuʻikahi, hoʻolālā ka ventricle i ke koko ma waho o ka puʻuwai i loko o nā moku like ʻole. ʻO kēia nā pump maoli o ka puʻuwai. ʻOi aku ka mānoanoa o kā lākou mau paia ma mua o ka atria a hōʻike wale i ka nui o ka puʻuwai.

Hoʻokaʻawale ʻia ka atria e kahi pā i kāhea ʻia septum interatrial a me nā ventricle e ka septum interventricular.

Nā nohona puʻuwai

I ka puʻuwai, hāʻawi nā hāpā ʻehā i ke kahe o ke ala hoʻokahi. Kūkākūkā kēlā me kēia atrium me ka ventricle pili ma o ka pahu: ʻo ka paepae tricuspid ma ka ʻākau a me ka pahu mitral ma ka hema. Aia nā kiwikā ʻelua ʻē aʻe ma waena o nā ventricle a me nā aʻa e kū pono ana: a Valve aortic a me ka pulmonary valve. ʻO kahi ʻano o ka "kiwikā", pale lākou i ke kahe o ke koko i ka wā e hele ai ma waena o ʻelua mau lua.

Poma pālua

ʻO ka puʻuwai, mahalo i kāna kuleana o ka omo pālua a me ka pauma paomi, e hōʻoia i ka holo o ke koko i loko o ke kino e hāʻawi i ka oxygen a me nā meaʻai i nā aʻa. Aia he ʻelua ʻano o ka holo ʻana: ka holo ʻana o ka pulmonary a me ka ʻōnaehana ʻōnaehana.

Hoʻolaha pulmonary

ʻO ka hana o ka holo ʻana o ka pulmonary a i ʻole ka holo liʻiliʻi ʻana e lawe i ke koko i nā akemāmā i mea e hōʻoia ai i ka hoʻololi kinoea a laila hoʻihoʻi ia i ka puʻuwai. ʻO kaʻaoʻao'ākau o ka puʻuwai ka pauma no ka holo o ka pulmonary.

Komo ka oxygen-hoʻopau ʻia, CO2 waiwai ke koko i ke kino i ka atrium ʻākau ma o nā vena cava vena o luna a me lalo. A laila iho i lalo i ka ventricle ʻākau e kipaku iā ia i loko o nā ʻāpana pulmonary ʻelua (pahu pulmonary). Hāpai lākou i ke koko i nā akemāmā kahi e hoʻopau ai iā CO2 a komo i ka oxygen. A laila hoʻohuli ʻia i ka puʻuwai, i ka atrium hema, ma o nā uaua pulmonary.

ʻŌnaehana ʻōnaehana

Mālama ka ʻōnaehana ʻōnaehana i ka hoʻokaʻawale maʻamau o ke koko i nā aʻa i loko o ke kino a hoʻi i ka puʻuwai. Eia, ʻo ka puʻuwai hema ia e hana ma ke ʻano he pauma.

Hiki ke koko reo oxygenated i ka atrium hema a laila hele i ka ventricle hema, e kipaku iā ia ma ke kuʻi ʻana i loko o ke aʻa aorta. Mai laila mai, ua māhele ʻia i nā ʻoka a me nā ʻano like ʻole o ke kino. A laila hoʻihoʻi ʻia i ka puʻuwai kūpono e ka pūnaewele venous.

Kuʻi ka puʻuwai a me ka hōʻemi kūlohelohe

Hāʻawi ʻia ke kaapuni e ke kuʻi o ka puʻuwai. Kūlike kēlā me kēia pā i ka hōʻemi o ka puʻuwai puʻuwai, ka myocardium, i hana ʻia i nā ʻāpana nui o nā hunaola mākala. E like me nā mākala āpau, ʻaelike ia ma lalo o ka mana o nā hopena uila. Akā loaʻa ka puʻuwai i ka puʻuwai o ka hana kuʻikahi ma kahi ʻano kuʻikuʻi ʻole, rhythmic a kūʻokoʻa hoʻi i kahi hana uila o loko.

Hoʻopiʻi ka naʻau maʻamau i 3 biliona mau manawa i kahi ola 75-makahiki.

ʻO ka maʻi Cardiovascular ke kumu nui o ka make i ka honua. I ka 2012, ua helu ʻia ka nui o nā make ma 17,5 miliona, a i ʻole 31% o ka nui o ka make honua (4).

Hahau (hahau)

Kūlike i ka ālai a haki paha o kahi moku e hāpai ana i ke koko i ka lolo (5).

Myocardial infarction (ai ʻole puʻuwai puʻuwai)

ʻO ka hōʻeha puʻuwai kahi luku hapa o ka mākala puʻuwai. ʻAʻole hiki i ka puʻuwai ke pāʻani i kāna kuleana o ka pauma a kū i ka pā ʻana (6).

Angina pectoris (a i ʻole angina)

Hoʻohālikelike ʻia e ka ʻeha hoʻokaumaha e hiki ke loaʻa i ka umauma, ka lima hema a me ka iwi ā.

Kuhi o ka naʻau

ʻAʻole hiki i ka puʻuwai ke paipū i lawa e lawa ai ke kahe o ke koko e kū i nā pono o ke kino.

Nā haunaele o ka naʻau (a i ʻole arrhythmia naʻau)

Kūleʻa ka puʻuwai puʻuwai, lohi a wikiwiki paha, me ka ʻole o kēia mau hoʻololi ʻana i ke mele e hoʻopili ʻia i kahi kumu i kapa ʻia ʻo "physiological" (hoʻoikaika kino, e laʻa me (7).

Nā Valvulopathies 

Ka hōʻino ʻia o ka hana o nā kiwikā o ka puʻuwai e nā ʻano maʻi like ʻole e hiki ai ke hoʻololi i ka hana o ka puʻuwai (8).

Nā kīnā o ka puʻuwai

Congregational malformations o ka puʻuwai, i kēia manawa i ka wā hānau.

ʻO Cardiomyopathies 

Nā maʻi e alakaʻi i ka hana ʻole o ka puʻuwai puʻuwai, myocardium. Hoʻemi i ka hiki ke pauma i ke koko a kipaku iā ia i ka holo.

ʻO ka maʻi maʻi maʻi

ʻO ka hoʻohaunaele o ka pericardium ma muli o nā maʻi: viral, bacterial a parasite paha. Hiki ke hana i ka mumū ma hope o ka hōʻeha ʻana o ka trauma a ʻoi paha.

Venous thrombosis (aiʻole phlebitis)

ʻO ke kūkulu ʻia ʻana o nā clots i nā aa hohonu o ka wāwae. Piʻi ka piʻi ʻana o ka ʻōpū mai loko mai o ka vena cava inferior a laila i nā aʻa pulmonary ke hoʻi ke koko i ka puʻuwai.

Emperor pulmonary

ʻO ka neʻe ʻana o nā clots i nā aʻa pulmonary kahi e paʻa ai lākou.

Nā mea pilikino

ʻO ka puhipaka, kaʻai maikaʻi ʻole, ka momona, ka hana ʻole o ke kino a me ka inu ʻana i ka waiʻona, ke koko kiʻekiʻe, diabetes a me hyperlipidemia e hoʻonui ai i ka makaʻi o ka puʻuwai a me nā hahau.

Kāohi

Paipai ʻo WHO (4) ma ka liʻiliʻi he 30 mau minuke o ka hoʻoikaika kino i kēlā me kēia lā. ʻO ka ʻai ʻana i ʻelima mau huaʻai a me nā mea kanu i ka lā a me ka kaupalena ʻana i ka lawe ʻana i ka paʻakai kekahi mea kōkua ia e pale i ka puʻuwai a i ʻole ka hahau.

ʻO nā lāʻau anti-inflammatory (NSAIDs) a me nā pōpilikia cardiovascular

Ua hōʻike ʻia nā haʻawina (9-11) i ka hoʻolōʻihi ʻia ʻana o nā NSAID nui loa (Advil, Iboprene, Voltarene, a me nā mea ʻē aʻe) i nā pilikia o ka maʻi puʻuwai.

Mediator a me ka maʻi kiwikā

Kauoha ʻia e mālama pono i ka hypertriglyceridemia (pae o kekahi momona i kiʻekiʻe i ke koko) a i ʻole hyperglycemia (kiʻekiʻe kiʻekiʻe o ke kō), ua kuhikuhi ʻia hoʻi i nā diabetic i kaumaha nui. ʻO kāna waiwai "suppressant gana" ka hopena i hoʻopau nui ʻia ma waho o kēia mau hōʻike e kōkua ai i ka poʻe me ka ʻole diabetes e lilo i ka kaumaha. A laila pili pū ʻia me ka maʻi puʻuwai puʻuwai a me kahi maʻi maʻi maʻi ʻaʻai liʻiliʻi i kapa ʻia ʻo Pulmonary Arterial Hypertension (PAH) (12).

Kūlana hōʻike lāʻau

E hana mua kāu kauka i kahi hoʻokolokolo maʻamau: ka heluhelu ʻana i ke kahe o ke koko, ka hoʻolohe ʻana i ka kuʻi ʻana o ka puʻuwai, ka lawe ʻana i ka lāʻau, me ka nānā ʻana i ka hanu ʻana, ka nānā ʻana i ka ʻōpū (13), etc.

ʻO ultrasound Doppler

ʻO kahi ʻano kiʻi olakino e nānā ai i ke kahe a me nā kaʻauwai o ka naʻau a me nā kīʻaha koko e nānā ai no ka paʻa o nā aʻa a me ke ʻano o nā kiwikā.

Ka hoʻopaʻa ʻana

ʻO ke kaʻina hana kiʻi olakino e hiki ai i ka ʻike ʻana i nā aʻa coronary.

Ultrasound o ka puʻuwai (a i ʻole echocardiography)

ʻO nā ʻenehana kiʻi lāʻau lapaʻau e hiki ai i ka ʻike ʻana i nā hanana kūloko o ka puʻuwai (nā lua a me nā kiwikā).

EKG i ka maha a i ʻole i ka hoʻoikaika kino

ʻO kahi hōʻike e hoʻopaʻa i ka hana uila o ka puʻuwai i mea e ʻike ai i nā mea kūpono ʻole.

Manaʻo scintigraphy

Nānā kiʻi e hiki ai ke nānā i ka maikaʻi o ka wai o ka naʻau e nā aʻa korona.

ʻO ka angioscanner

ʻO ka hoʻokolokolo ʻana e ʻae iā ʻoe e ʻimi i nā kīʻaha koko e ʻike i ka embolism pulmonary, no ka laʻana.

ʻOki kino Bypass

Hana ʻia ke ʻoki ʻana ke keʻakeʻa ʻia nā aʻa ākea i mea e hoʻihoʻi ai i ka holo.

Nānā Lapaʻau

Lipid profile:

• Ka hoʻoholo ʻana i nā triglycerides: kiʻekiʻe loa i ke koko, hiki iā lākou ke kōkua i ka paʻa ʻana o nā aʻa.
• Ka hoʻoholo ʻana i ke kolamu: ʻo ka LDL kolesterol, i wehewehe ʻia ma ke ʻano he "ʻino" kolesterol, pili ia me ka hoʻonui ʻia o ka maʻi puʻuwai puʻuwai ke loaʻa ia i kahi nui i loko o ke koko.
• Ka hoʻoholo ʻana i ka fibrinogen : he mea pono ia no ka nānā ʻana i ka hopena o kahi lapaʻau i kapa ʻia ” fibrinolytic", Hoʻolālā e hoʻonā i kahi kīʻaha koko i ka hihia o thrombosis.

ʻO ka naʻau ka mea hōʻailona nui o ke kino o ke kanaka. I ka wā o ka wā kahiko, ua ʻike ʻia ia ma ke kikowaena o ka ʻike. A laila, ua ʻike ʻia ma nā moʻomeheu he nui kahi noho o ka naʻau a me nā ʻano, no ka mea paha e pili ka naʻau i kahi naʻau a kumu pū kekahi ia. I ka wā waena i ʻike ʻia ai ke kinona o ka puʻuwai. Ma ka honua a puni, hōʻike ia i ke kuko a me ke aloha.