Matenda a Wolff-Parkinson-White (WPW)

Matenda a Wolff-Parkinson-White (WPW) ndi momwe mumakhalira njira ina yamagetsi mumtima yomwe imabweretsa nthawi yolimba mtima (tachycardia).

Matenda a WPW ndi chimodzi mwazomwe zimayambitsa mavuto othamanga kwamtima mwa makanda ndi ana.

Nthawi zambiri, zikwangwani zamagetsi zimatsata njira inayake yodutsa pamtima. Izi zimathandiza mtima kugunda nthawi zonse. Izi zimalepheretsa mtima kuti uzigunda mwaphuma kapena kumenyedwa posachedwa.

Mwa anthu omwe ali ndi matenda a WPW, zida zina zamagetsi zamagetsi zimadutsanso njira ina. Izi zitha kupangitsa kugunda kwamtima mwachangu kwambiri kotchedwa supraventricular tachycardia.

Anthu ambiri omwe ali ndi matenda a WPW alibe mavuto ena amtima. Komabe, vutoli lalumikizidwa ndi matenda ena amtima, monga Ebstein anomaly. Mtundu wamtunduwu umayendanso m'mabanja.

Kodi kugunda kwamtima mwachangu kumachitika kangati kumasiyanasiyana kutengera munthu. Anthu ena omwe ali ndi matenda a WPW amakhala ndimagawo ochepa chabe othamanga mtima. Ena amatha kugunda kwamtima kamodzi kapena kawiri pa sabata kapena kupitilira apo. Komanso, sipangakhale zizindikilo nkomwe, kotero kuti vutoli limapezeka ngati kuyesa mtima kumachitika pazifukwa zina.

Munthu amene ali ndi matendawa akhoza kukhala ndi:

• Kupweteka pachifuwa kapena chifuwa
• Chizungulire
• Mitu yopepuka
• Kukomoka
• Kupuma (kumverera kwa mtima wanu ukugunda, nthawi zambiri mwachangu kapena mosasinthasintha)
• Kupuma pang'ono

Kuyezetsa thupi komwe kumachitika panthawi ya tachycardia kukuwonetsa kugunda kwamtima mwachangu kuposa kumenyedwa kwa 100 pamphindi. Kugunda kwamtima ndikumenyedwa kwa 60 mpaka 100 pamphindi mwa akulu, komanso kumenyedwa kochepera 150 pamphindi kwa akhanda, makanda, ndi ana ang'ono. Kuthamanga kwa magazi kumakhala koyenera kapena kotsika nthawi zambiri.

Ngati munthuyo alibe tachycardia panthawi yamayeso, zotsatira zake zimakhala zachilendo. Vutoli limatha kupezeka ndi ECG kapena kuyang'anira ma ECG, monga wowunika wa Holter.

Chiyeso chotchedwa electrophysiologic Study (EPS) chimachitika pogwiritsa ntchito ma catheters omwe amayikidwa mumtima. Mayesowa atha kuthandiza kuzindikira komwe kuli njira yamagetsi yowonjezera.

Mankhwala, makamaka mankhwala osokoneza bongo monga procainamide kapena amiodarone, atha kugwiritsidwa ntchito kuwongolera kapena kupewa kugunda kwamtima.

Ngati kugunda kwa mtima sikubwerera mwakale ndi chithandizo chamankhwala, madokotala amatha kugwiritsa ntchito mtundu wina wamankhwala wotchedwa magetsi wamagetsi (mantha).

Chithandizo chanthawi yayitali cha matenda a WPW nthawi zambiri chimachotsa kabati. Njirayi imaphatikizapo kuyika chubu (catheter) mumtsinje kudzera pocheka pang'ono pafupi ndi kubuula mpaka pamtima. Msonga ukafika pamtima, dera laling'ono lomwe limayambitsa kugunda kwa mtima limawonongeka pogwiritsa ntchito mphamvu yapadera yotchedwa radiofrequency kapena poyiziziritsa (cryoablation). Izi zimachitika ngati gawo la kafukufuku wamagetsi (EPS).

Opaleshoni ya mtima yotseguka kuti iwotche kapena kuimitsa njirayo imaperekanso chithandizo chokhazikika cha matenda a WPW. Nthawi zambiri, njirayi imachitika pokhapokha mukafunika kuchitidwa opaleshoni ya mtima pazifukwa zina.

Kuchotsa paminyezi kumachiritsa vutoli mwa anthu ambiri. Kuchuluka kwa njirayi kumakhala pakati pa 85% mpaka 95%. Mitundu ya kupambana idzasiyana kutengera malo ndi kuchuluka kwa njira zowonjezera.

Zovuta zingaphatikizepo:

• Zovuta za opaleshoni
• Mtima kulephera
• Kuchepetsa kuthamanga kwa magazi (komwe kumachitika chifukwa cha kugunda kwamtima mwachangu)
• Zotsatira zoyipa za mankhwala

Mtundu wowopsa kwambiri wamagundidwe amtima ndimitsempha yamagetsi yamagetsi (VF), yomwe imatha kubweretsa mantha kapena kufa msanga. Nthawi zina zimatha kupezeka mwa anthu omwe ali ndi WPW, makamaka ngati amakhalanso ndi atrial fibrillation (AF), womwe ndi mtundu wina wamtundu wachilendo wamtima. Kugunda kwamtima mwachangu kotere kumafunikira chithandizo chadzidzidzi ndi njira yotchedwa mtima.

Imbani wothandizira zaumoyo wanu ngati:

• Muli ndi zizindikiro za matenda a WPW.
• Muli ndi matendawa ndipo zizindikilo zake zimakulirakulirabe kapena sizikusintha ndi chithandizo chamankhwala.

Lankhulani ndi omwe amakupatsani mwayi ngati achibale anu akuyenera kuwunikidwa ngati ali ndi vuto lobadwa nalo.

Matenda osokoneza bongo; WPW; Tachycardia - matenda a Wolff-Parkinson-White; Arrhythmia - WPW; Nyimbo yachilendo - WPW; Kugunda kwamtima mwachangu - WPW

• Zovuta za Ebstein
• Holter mtima polojekiti
• Kachitidwe kachitidwe ka mtima

Dalal AS, Van Hare GF. Kusokonezeka kwa kugunda ndi kuthamanga kwa mtima. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: mutu 462.

Tomaselli GF, Zipes DP. Njira kwa wodwala ndi mtima arrhythmias. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: mutu 32.

Zimetbaum P. Supraventricular mtima arrhythmias. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 58.