\u00c7ocuklarda g\u00f6r\u00fclen kalp hastal\u0131klar\u0131 do\u011fu\u015ftan yahut sonradan geli\u015fen kalp problemlerini kapsamaktad\u0131r. Bu hastal\u0131klar do\u011fumdan itibaren geli\u015febilir yahut ileriki ya\u015flarda ortaya \u00e7\u0131kabilir. \u0130stanbul Okan \u00dcniversitesi Hastanesi \u00c7ocuk Kardiyolojisi k\u0131sm\u0131ndan Uzm. Dr. Hasan Tahsin Tola \u00e7ocuklarda g\u00f6r\u00fclen kalp hastal\u0131klar\u0131n\u0131 sizler i\u00e7in ayr\u0131nt\u0131land\u0131rd\u0131.<\/p>\n
\u00c7ocuk Kalp Hastal\u0131klar\u0131<\/strong><\/p>\n 5 k\u00fcmede incelenir<\/p>\n \u00a0<\/p>\n Do\u011fumsal Kalp Hastal\u0131klar\u0131 (CHD) Nas\u0131l Bir Hastal\u0131kt\u0131r?<\/strong><\/p>\n CHD kal\u0131tsal bir hastal\u0131kt\u0131r. \u0130nsan bedeninin do\u011fu\u015ftan gelen bir kusurdur. Hastalar \u00fcf\u00fcr\u00fcm ve siyanoza e\u015flik eden pek \u00e7ok de\u011fi\u015fik yak\u0131nmadan \u015fik\u00e2yet\u00e7idirler. Bu yak\u0131nmalar ortas\u0131nda; Kilo al\u0131m\u0131 azl\u0131\u011f\u0131, beslenme geli\u015fme gerili\u011fi, motor kilometre ta\u015flar\u0131nda gerilik, \u00a0Morarma (siyanoz-spell-squatting), S\u00fcratli nefes al\u0131p verme (ta\u015fipne dispne), antrenman intolerans\u0131, beslenme intolerans\u0131, Kalpte \u00fcf\u00fcr\u00fcm\u00fc, G\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131, \u00e7arp\u0131nt\u0131 (palpitasyon, \u00a0Bay\u0131lma (senkop), bulunmaktad\u0131r. Kimi hastalar daha \u00f6nemli etkilenir ve bu bireylerde bebeklik devrinde hayat\u0131 tehdit eden morarma ataklar\u0131, geli\u015fme gerili\u011fi, kardiyon\u00f6rolojik hasar\u0131 geli\u015febilir. Pek \u00e7ok hasta bireyde, kalpte \u00fcf\u00fcr\u00fcm ve e\u015flik eden kalpte delikler, kapakta darl\u0131klar vard\u0131r. Bu nedenle bir ba\u015fka ismi \u2018CHD\u201ddir.<\/p>\n Ne S\u0131kl\u0131kla G\u00f6r\u00fcl\u00fcr?<\/strong><\/p>\n Nadir bir hastal\u0131kt\u0131r. 100 canl\u0131 do\u011fumda yakla\u015f\u0131k bir g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131 ile t\u00fcm canl\u0131 do\u011fumlarda en s\u0131k g\u00f6r\u00fclen anomalidir, en s\u0131k g\u00f6r\u00fclen konjenital \u00a0 lezyondur. T\u00fcm \u0131rklarda g\u00f6r\u00fclebilir. CHD her iki cinsde e\u015fit s\u0131kl\u0131kta g\u00f6r\u00fcl\u00fcr.<\/p>\n \u00a0Hastal\u0131\u011f\u0131n Sebepleri Nelerdir?<\/strong><\/p>\n CHD kal\u0131tsal bir hastal\u0131kt\u0131r. Sorumlu olan farkl\u0131 genler vard\u0131r. Bu gen defektleri CHD\u2019a yol a\u00e7ar. Hastal\u0131\u011f\u0131n bir\u00e7ok nedeni vard\u0131r. Bunlar ortas\u0131nda premat\u00fcritelik gebelik 37 GH dan evvel do\u011fum hikayesi, \u00e7oklu gebelik,\u00a0rahim i\u00e7i enfeksiyon<\/strong>; annenin grip yahut grip gibisi hastal\u0131\u011f\u0131, k\u0131zam\u0131k\u00e7\u0131k enfeksiyonu,\u00a0anneye ili\u015fkin fakt\u00f6rler;<\/strong>\u00a0premat\u00fcrite, hipertansiyon, diyabetes mellitus, fenilketon\u00fcri, tiroid bozukluklar\u0131, sistemik ba\u011f dokusu hastal\u0131klar\u0131 anne ya\u015f\u0131 >40 ya\u015f, epilepsi ve sendromlar\u0131 ve annenin birinci trimestirda sigara i\u00e7imi, hamilelik s\u0131ras\u0131nda annenin kulland\u0131\u011f\u0131 ila\u00e7lar (retinoik asit, fenitoin, ACE inhibit\u00f6r\u00fc, talidomid, lityum, NSA\u0130D\u2019lar),\u00a0yard\u0131mc\u0131 \u00fcreme tetkiklerinin kullan\u0131m\u0131<\/strong>, KKH hikayesi, 1. Derece akrabalarda, 2 derece akrabalarda, heterotaksi sendromlar\u0131, RVOTO lezyonlar\u0131, koonotrunkal lezyonlar, izole ASD, izole VSD.\u00a0<\/p>\n \u00a0<\/p>\n Hastal\u0131k Kal\u0131tsal M\u0131d\u0131r?<\/strong><\/p>\n \u00a0<\/p>\n CHD poligenik multifakt\u00f6ryel kal\u0131t\u0131lmaktad\u0131r. Sorumlu tek gen yoktur. \u00a0Buna nazaran bir \u015fah\u0131sta CHD olmas\u0131 i\u00e7in annede ve babada olmas\u0131 d\u0131\u015f\u0131nda hi\u00e7 kimse de olmadan da bu hastal\u0131k olu\u015fabilmektedir. \u00a0Sendromik olmayan izole KKH’si olan birinci derece akrabalar\u0131 (yani ebeveynleri yahut karde\u015fleri) olan bebeklerde KKH riskinin genel pop\u00fclasyondan \u00fc\u00e7 ila d\u00f6rt kat daha y\u00fcksek oldu\u011fu varsay\u0131m edilmektedir. Risk, KKH tipine ve anne, baba, karde\u015f yahut birden fazla aile \u00fcyesinin etkilenip etkilenmedi\u011fine ba\u011fl\u0131 olarak de\u011ferli \u00f6l\u00e7\u00fcde de\u011fi\u015fir. Sol kalp obstr\u00fcktif lezyonlar\u0131 daha y\u00fcksek n\u00fcks riski ta\u015f\u0131r; b\u00fcy\u00fck arterlerin D-transpozisyonu d\u00fc\u015f\u00fck bir n\u00fcks riski ta\u015f\u0131r.<\/p>\n \u00a0\u2018Ba\u015fl\u0131ca Bulgusu, Yenido\u011fan Devrinde; \u00dcf\u00fcr\u00fcm Ve Siyanozdur\u2019<\/strong><\/p>\n \u00a0<\/p>\n Hastal\u0131\u011f\u0131n en \u00f6nemli bulgusu, yenido\u011fan periyodunda; \u00fcf\u00fcr\u00fcm ve siyanozdur. Birtak\u0131m bebeklerde yenido\u011fan devrinde rastgele bir \u015fikayet olmaz bunlara nab\u0131z oksimetri taramas\u0131 yap\u0131larak \u00f6nemli CHD lezonlar\u0131na te\u015fhis konabilir. Bu metot ABD zaruridir. T\u00fcrkiyede de birtak\u0131m hekimler uygulamaktad\u0131r. Sa\u011f el ve sa\u011f aya\u011fa pulse oksimetri tak\u0131larak yap\u0131l\u0131r. Ortas\u0131ndaki fark % 3 \u00fcn \u00fczerinde ise manal\u0131 kabul edilir. Kimi bireyler daha \u00f6nemli etkilenir ve bunlarda bebeklikte hayat\u0131 tehdit eden kardiyojenik \u015fok, kardiao n\u00f6rolojik hasar geli\u015febilir. Bu b\u00fcsb\u00fct\u00fcn CHD tipiyle ilgilidir. Do\u011fumdan sonra birinci y\u0131l i\u00e7erisinde kateter yahut cerrahi bazl\u0131 m\u00fcdahale yap\u0131lmas\u0131 gereken CHD\u2019na kritik CHD denmektedir. Bunlarda duktal ba\u011f\u0131ml\u0131 ve siyanotik olarak 2 k\u00fcmeye ayr\u0131lmaktad\u0131r.\u00a0<\/p>\n Her \u00c7ocukta T\u0131pk\u0131 M\u0131d\u0131r?<\/strong><\/p>\n Hastal\u0131k her \u00e7ocukta birebir de\u011fildir. Mevcut olan kalp delikli\u011fin yahut kapak darl\u0131\u011f\u0131n\u0131n tipine nazaran yahut olu\u015fmayan kalp yap\u0131s\u0131na nazaran hastal\u0131k seyri \u00f6ld\u00fcr\u00fcc\u00fc olabilir yahut hi\u00e7 m\u00fcdahale gerektirmeyen ve ya\u015fla d\u00fczelen yahut kapanan bir ASD-VSD-PD \u00fczere lezyonlar olabilir.\u00a0<\/p>\n \u00c7ocuklarda ve Eri\u015fkinlerde Farkl\u0131 M\u0131d\u0131r?<\/strong><\/p>\n Hasta b\u00fcy\u00fcd\u00fck\u00e7e b\u015fr k\u0131s\u0131m CHD d\u00fczg\u00fcnle\u015fme e\u011filimi g\u00f6sterirken kimilerine ise yenido\u011fan devrinde m\u00fcdahale yap\u0131lmad\u0131ktan sonra hastay\u0131 kaybetmekteyiz. Birtak\u0131m CHD ise ard\u0131\u015f\u0131k s\u00fcre\u00e7ler gerekmektedir. Yeti\u015fkin hastalarda CHD ise ba\u015fka bir uzmanl\u0131k istemektedir. Onlar takibi \u00f6b\u00fcr CHD ve eri\u015fkin kalp hastal\u0131klar\u0131ndan farkl\u0131 seyir g\u00f6stermektedir.<\/p>\n Nas\u0131l Te\u015fhis Edilir?<\/strong><\/p>\n Ekokardiyografik tahlille kesin te\u015fhis koyulur. \u00d6b\u00fcr testler ise EKG, pulse oksimetri nab\u0131z oksimetri taramas\u0131 \u00fczere testler CHD olan bireyleri ortaya \u00e7\u0131karmakta ve EKO yap\u0131lmas\u0131n\u0131 sa\u011flayarak te\u015fhis konmas\u0131na neden olmaktad\u0131r. Genetik tahlili ile kimi hastal\u0131klarda y\u00f6nlendirme yap\u0131labilmektedir.\u00a0<\/p>\n Di\u011fer De\u011ferli Testler Nedir?<\/strong><\/p>\n \u00a0<\/p>\n Kardiyak tan\u0131sal ve tedavi gayeli anjiyo ve kardiyak g\u00f6r\u00fcnt\u00fcleme tetkiklerinden kardiyak CT ve kardiyak MR \u00fc\u00e7 boyutlu EKO, TEE tekrar te\u015fhis s\u0131ras\u0131nda bize yard\u0131mc\u0131 olabilir.\u00a0<\/p>\n \u00a0<\/p>\n Hastal\u0131\u011f\u0131n Tedavisi yahut Tam \u015eifayla Uygunla\u015fmas\u0131 M\u00fcmk\u00fcn M\u00fcd\u00fcr?<\/strong><\/p>\n \u00a0<\/p>\n CHD lar\u0131n\u0131n bir k\u0131sm\u0131 spontan bizatihi d\u00fczg\u00fcnle\u015fir. Bir k\u0131sm\u0131 ise medikal tedavilerle bir k\u0131sm\u0131 ise kateter yahut cerrahi bazl\u0131 s\u00fcrece muhta\u00e7l\u0131k duyar. Hastal\u0131\u011f\u0131n kesin tedavisi CHD tipine nazaran de\u011fi\u015fim g\u00f6stermektedir.\u00a0<\/p>\n Hastal\u0131\u011f\u0131n Tedavisi Nas\u0131ld\u0131r?<\/strong><\/p>\n CHD tedavisinde medikal hastan\u0131n kalp yetersizli\u011fine ve kalp i\u015flevlerine ba\u011fl\u0131 de\u011fi\u015fim g\u00f6stermektedir. Bu ila\u00e7lardan hi\u00e7biri kesin tesirli de\u011fildir hastal\u0131\u011f\u0131n kalpte yapt\u0131\u011f\u0131 hasar\u0131 azaltma yahut mevcut hasar\u0131 tedbire yahut g\u00fczelle\u015ftirme istikametinde tesir g\u00f6sterir. \u0130la\u00e7lar\u0131n tipine nazaran yan tesir profilleri de\u011fi\u015fmekle birlikte kullan\u0131lan ila\u00e7lar yan tesir a\u00e7\u0131s\u0131ndan g\u00fcvenilirdir.<\/p>\n Kaynak: (BYZHA) Beyaz Haber Ajans\u0131<\/p>\n","protected":false},"excerpt":{"rendered":" \u00c7ocuklarda g\u00f6r\u00fclen kalp hastal\u0131klar\u0131 do\u011fu\u015ftan yahut sonradan geli\u015fen kalp s\u0131k\u0131nt\u0131lar\u0131n\u0131 kapsamaktad\u0131r. Bu hastal\u0131klar do\u011fumdan itibaren geli\u015febilir yahut ileriki ya\u015flarda ortaya \u00e7\u0131kabilir.<\/p>\n","protected":false},"author":1,"featured_media":6687,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[569,2673,1550,678,2488],"class_list":["post-6686","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-saglik","tag-anne","tag-chd","tag-etki","tag-hasta","tag-kalp"],"_links":{"self":[{"href":"https:\/\/yalovasondakika.com.tr\/index.php\/wp-json\/wp\/v2\/posts\/6686"}],"collection":[{"href":"https:\/\/yalovasondakika.com.tr\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/yalovasondakika.com.tr\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/yalovasondakika.com.tr\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/yalovasondakika.com.tr\/index.php\/wp-json\/wp\/v2\/comments?post=6686"}],"version-history":[{"count":1,"href":"https:\/\/yalovasondakika.com.tr\/index.php\/wp-json\/wp\/v2\/posts\/6686\/revisions"}],"predecessor-version":[{"id":6688,"href":"https:\/\/yalovasondakika.com.tr\/index.php\/wp-json\/wp\/v2\/posts\/6686\/revisions\/6688"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/yalovasondakika.com.tr\/index.php\/wp-json\/wp\/v2\/media\/6687"}],"wp:attachment":[{"href":"https:\/\/yalovasondakika.com.tr\/index.php\/wp-json\/wp\/v2\/media?parent=6686"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/yalovasondakika.com.tr\/index.php\/wp-json\/wp\/v2\/categories?post=6686"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/yalovasondakika.com.tr\/index.php\/wp-json\/wp\/v2\/tags?post=6686"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n