ضخیم شدن عضلات قلب


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هیپرتروفی مادرزادی قلب (ضخیم شدن عضلات قلب) یک بیماری ژنتیکی نسبتاً شایع است (۱% افراد جامعه). اختلال ژنتیکی در مبتلایان به این ‏بیماری منجر به افزایش ضخامت عضلات قلب می شود که مشخصه آن بوده و در ‏اکوکاردیوگرافی تشخیص داده می شود؛ افزایش ضخامت عضلات قلب منجر به کوچک ‏شدن فضای حفره بطن چپ ودر نتیجه اختلال در عملکرد پمپ آن می شود. بنابراین یکی ‏از مهمترین علائم بیماری افزایش ضخامت عضلات قلب به صورت نشانه های نارسایی قلب شامل خستگی پذیری، تنگی ‏نفس و ... ظاهر می شود. ‏

علل ضخیم شدن عضلات قلبی

ضخیم شدن عضلات قلب یعنی همان نوع اول بزرگی قلب در اثر فشار زیادی که به قلب وارد می‌شود، ایجاد می‌شود. این حالت معمولا دیواره حفره‌های اصلی قلب به اسم بطن‌ها را درگیر می‌کند. بیشترین علت ضخیم شدن عضلات قلبی، افزایش فشارخون است. با افزایش فشارخون، قلب مجبور است برای مقابله با این فشارخون بالا قدرت پمپ‌کردن خون را بالا ببرد و این کار اضافی موجب ضخیم شدن عضلات قلب می‌شود.
دقیقا مثل اینکه شما وزنه می‌زنید تا عضلات دست و پای خود را حجیم کنید. قلب هم انگار در مقابله با فشارخون می‌خواهد وزنه بزند. همان‌طور که گفتیم از مهم‌ترین علل افزایش ضخامت عضلات قلب، افزایش فشارخون است اما علل دیگری هم وجود دارند، مثل تنگی دریچه آئورت. حتی گاهی به‌صورت ژنتیک و بدون علت خاصی ممکن است این بیماری بروز کند.

در هیپرتروفی مادرزادی قلب، عضلات قلب فرد به‌صورت ژنتیکی ضعیف هستند و برای پمپ‌کردن خون نیاز به فعالیت بیشتر دارند. این حالت به مرور زمان سبب ضخیم‌شدن عضلات می‌شود. میزان ابتلا‌ به بیماری نسبتا نادر است. همان‌طور که می‌دانید قلب ما از دو بطن چپ و راست تشکیل شده است و عللی که ذکر شد مربوط به افزایش ضخامت دیواره بطن چپ قلب بود. اما بعضی از علل هم موجب افزایش ضخامت بطن راست می‌شوند. این بیماری‌ها شامل بیماری‌های ریوی مثل آمفیزم و برونشیت مزمن هستند.

تشخیص ضخیم شدن عضلات قلب

مهم ترین عارضه افزایش ضخامت عضلات قلب، آریتمی های وخیم بطنی به علت اختلال در ‏سیستم هدایتی می باشد. ممکن است فرد مبتلا به بیماری های عضله قلب بدون سایر تظاهرات قلبی به ‏عنوان اولین تظاهر دچار مرگ ناگهانی شود. بنابراین تشخیص سریع ضخیم شدن عضلات قلب و تعیین میزان ‏خطر و درمان مناسب براساس آن اهمیت فراوانی دارد. در صورتی که پزشک متخصص بیماری های عضله قلب و کاردیومیوپاتی ها با توجه به ‏معاینات فیزیکی شرح حال و تغییرات الکتروگرام قلبی مشکوک به ضخیم شدن عضلات قلب باشد ‏اکوکاردیوگرافی قلب انجام می شود که در این روش تشخیص دقیق به عمل می آید. البته ‏در برخی موارد نیاز به آزمایشات ژنتیک است که فعلاً در کشور ما موجود نمی باشد.‏

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