Peripartum Kardiyomiyopati Tanısında Hemşirelik Bakımı

Year 2024, Volume: 7 Issue: 3, 258 - 264, 27.09.2024

Filiz Selen

https://doi.org/10.53493/avrasyasbd.1441478

Abstract

Kardiyomiyopati, gözlenen miyokard anormalliğine neden olabilecek başka hastalıkların yokluğunda kalp kasının yapısal ve işlevsel olarak anormal olduğu bir patolojik durumdur. Peripartum kardiyomiyopati (PPKM) ise bilinen kalp hastalığı olmayan kadınlarda hamileliğin sonlarına doğru veya doğum sonrası ilk aylarda gelişen sol ventrikül ejeksiyon fraksiyonunun (LVEF) <45% olması ile karakterize idiyopatik bir kardiyomiyopatidir. Seyrek görülmekle birlikte gebelikteki kardiyovasküler komplikasyonların ağır seyreden nedenlerini oluşturmaktadır. Presipitan faktörler arasında çoğul gebelik, çoğul doğum, genetik yatkınlık, etnik köken, sigara/alkol kullanımı, hipertansif ve metabolik bozukluklar, ileri maternal yaş gebeliği ve uzun süreli beta bloker kullanımı olduğu bildirilmektedir. Olgular nefes darlığı, çarpıntı hissi, baş dönmesi, ortopne, paroksismal noktürnal dispne ve ödem dahil olmak üzere kalp yetmezliği semptomları ile kliniğe başvurmaktadır. Bu semptomlar birçok yönden son trimestır veya peripartum dönemin normal bulgularına benzemesi nedeniyle tanıda gecikmeler görülmektedir. Fetal ve maternal etkileri nedeniyle erken tanı, tedavi ve bakım sürecinin başlatılması önerilmektedir. Gebelik sonrasında ya da ardıl gebeliklerde de olası komplikasyon olasılığın yüksek olması nedeniyle bireylerin öz bakım becerilerinin artırılması ve yaşam biçimi düzenlemelerine ilişkin hemşireler tarafından profesyonel bir danışmanlık desteği alması gerekmektedir. Alanyazında, olası komplikasyon riski yüksek olan peripartum kardiyomiyopati tanısı olan bireylere yönelik kanıta dayalı hemşirelik girişimlerinin incelendiği kaynakların kısıtlılığı nedeniyle bu çalışmada, sistematik ve profesyonel bir hemşirelik bakım planı aktarılması amaçlanmıştır.

Keywords

Kardiyomiyopati, peripartum, hemşirelik

Nursing Care in the Diagnosis of Peripartum Cardiomyopathy

Abstract

Cardiomyopathy is a pathological condition in which the heart muscle is structurally and functionally abnormal in the absence of other diseases that could cause the observed myocardial abnormality. Peripartum cardiomyopathy (PCPC) is an idiopathic cardiomyopathy characterized by a left ventricular ejection fraction (LVEF) <45% that develops late in pregnancy or in the first months postpartum in women without known heart disease. Although it is rare, it is the leading cause of severe cardiovascular complications in pregnancy. Precipitating factors include multiple pregnancy, multiple births, genetic predisposition, ethnicity, smoking/alcohol use, hypertensive and metabolic disorders, advanced maternal age pregnancy and long-term beta blocker use. Pregnant women present to the clinic with symptoms of heart failure, including dyspnea, palpitations, dizziness, orthopnea, paroxysmal nocturnal dyspnea and edema. Because these symptoms resemble in many ways the normal findings of the last trimester or peripartum period, there is a delay in diagnosis. Because of the fetal and maternal effects, early diagnosis, treatment and initiation of care are recommended. Due to the high likelihood of possible complications after pregnancy or in subsequent pregnancies, individuals should receive professional counseling support by nurses to increase their self-care skills and lifestyle arrangements. Due to the limited literature on evidence-based nursing interventions for individuals diagnosed with peripartum cardiomyopathy with a high risk of possible complications, this study aimed to provide a systematic and professional nursing care plan.

Keywords

Cardiomyopathy, peripartum, nursing

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