Matenda odwala sinus

Nthawi zambiri, kugunda kwa mtima kumayambira m'dera lomwe lili m'zipinda zapamwamba za mtima (atria). Dera ili ndi lokonza mtima. Amatchedwa sinoatrial node, sinus node kapena SA node. Udindo wake ndikupangitsa kuti kugunda kwa mtima kukhazikike komanso pafupipafupi.

Sick sinus syndrome ndi gulu lamatenda amtima chifukwa cha mavuto okhala ndi sinus node, monga:

• Kugunda kwa mtima kumakhala kochedwa kwambiri, kotchedwa sinus bradycardia
• Kugunda kwa mtima kumaima kapena kuyima, kotchedwa sinus pause kapena sinus arrest
• Magawo othamanga mtima
• Nyimbo zoyenda pang'onopang'ono zomwe zimasinthasintha ndi nyimbo zachangu, zotchedwa bradycardia-tachycardia kapena "tachy-brady syndrome"

Matenda a sinus odwala nthawi zambiri amapezeka mwa anthu azaka zopitilira 50. Nthawi zambiri zimachitika chifukwa cha kuwonongeka ngati zipsera zamagetsi zamagulu amkati mwamisempha.

Kwa ana, opaleshoni yamtima m'zipinda zam'mwamba ndizomwe zimayambitsa matenda a sinus.

Matenda a mtima, kuthamanga kwa magazi, ndi aortic ndi mitral valve matenda amatha kuchitika ndi matenda a sinus. Komabe, matendawa sangakhale ndi chochita chilichonse ndi matendawa.

Matenda odwala sinus siachilendo, koma si kawirikawiri. Ndicho chifukwa chofala kwambiri chomwe anthu amafunika kupangira pacemaker yochita kupanga. Sinus bradycardia imachitika nthawi zambiri kuposa mitundu ina ya vutoli.

Tachycardias (mothamanga mtima) yomwe imayamba mchipinda chapamwamba cha mtima itha kukhala gawo la matendawa. Izi zimaphatikizapo atril fibrillation, atrial flutter, atrial tachycardia. Nthawi yothamanga mtima nthawi zambiri imatsatiridwa ndi kuchepa kwa mtima. Nthawi zina pamakhala kuchepa komanso kuthamanga kwamtima (mikhalidwe) nthawi zambiri matendawa amatchedwa tachy-brady syndrome.

Mankhwala ena amatha kukulitsa mikhalidwe ya mtima, makamaka pamene mankhwala ali okwera. Izi zikuphatikiza ma digitalis, ma calcium blockers, beta-blockers, ndi antiarrhythmics.

Nthawi zambiri, sipakhala zisonyezo.

Zizindikiro zomwe zimachitika zimatha kufanana ndi zovuta zina.

Zizindikiro zimaphatikizapo:

• Kupweteka pachifuwa kapena angina
• Kusokonezeka kapena kusintha kwina kwamalingaliro
• Kukomoka kapena pafupi-kukomoka
• Kutopa
• Chizungulire kapena kupepuka
• Zomverera zakumva kugunda kwa mtima (kugunda kwa mtima)
• Kupuma pang'ono, mwina pongolimbitsa thupi monga kuyenda

Kugunda kwa mtima kumatha kuchepa kwambiri nthawi iliyonse. Kuthamanga kwa magazi kumatha kukhala kwachilendo kapena kutsika.

Matenda a sinus angayambitse zizindikiro za kulephera kwa mtima kuyamba kapena kukulira. Matenda a sinus odwala amapezeka pamene zizindikirazo zimachitika panthaŵi ya arrhythmia. Komabe, ulalowu nthawi zambiri umakhala wovuta kutsimikizira.

ECG imatha kuwonetsa mikhalidwe yachilendo yokhudzana ndi matendawa.

Ma Holter kapena oyang'anira nyimbo zazitali ndi zida zothandiza pofufuza matenda a sinus. Amatha kutola mtima pang'onopang'ono komanso kupuma kwakanthawi, komanso magawo a atach tachycardias. Mitundu yoyang'anira imaphatikizapo oyang'anira zochitika, zojambulira zojambulira, ndi mafoni a telemetry.

Kafukufuku wa intracardiac electrophysiology (EPS) ndiyeso yeniyeni yamatendawa. Komabe, sikuti nthawi zambiri amafunikira ndipo sangatsimikizire kuti ali ndi vutoli.

Nthawi zina, kugunda kwa mtima kwa munthu kumawonedwa poyenda kapena kuchita masewera olimbitsa thupi kuti awone ngati ukuwonjezeka mokwanira.

Simungafunike chithandizo ngati mulibe zizindikiro zilizonse. Wothandizira zaumoyo wanu adzawunikanso mankhwala omwe mumamwa kuti muwone kuti sakukulitsa vuto lanu. Osasiya kumwa chilichonse cha mankhwala anu pokhapokha wothandizirayo atakuuzani kuti mutero.

Mungafunike pacemaker yokhazikika ngati matenda anu akukhudzana ndi bradycardia (kuchepa kwa mtima).

Kugunda kwa mtima (tachycardia) kumatha kuchiritsidwa ndi mankhwala. Nthawi zina, njira yotchedwa radiofrequency ablation imagwiritsidwa ntchito kuchiritsa tachycardia.

Nthawi zina, mankhwala omwe amagwiritsidwa ntchito poletsa kugunda kwamtima amaphatikizidwa ndikugwiritsa ntchito pacemaker, yomwe imatchinjiriza kuti ichepetse kugunda kwamtima.

Matendawa nthawi zambiri amapita patsogolo. Izi zikutanthauza kuti zimaipiraipira pakapita nthawi nthawi zambiri.

Kuwona kwakanthawi ndikwabwino kwa anthu omwe amakhazikika pacemaker okhazikika.

Zovuta zingaphatikizepo:

• Angina
• Kuchepetsa mphamvu zolimbitsa thupi
• Kukomoka (syncope)
• Kugwa kapena kuvulala komwe kumachitika chifukwa chakomoka
• Mtima kulephera
• Kupopera mtima kosauka

Itanani omwe akukuthandizani ngati muli ndi:

• Mitu yopepuka
• Kukomoka
• Kupindika
• Zizindikiro zina za vutoli

Kusunga mtima wanu wathanzi mwa kudya zakudya zopatsa thanzi komanso kuchita masewera olimbitsa thupi kumatha kupewa mitundu yambiri yamatenda amtima.

Muyenera kupewa mitundu ina ya mankhwala. Nthawi zambiri, vutoli silimalephereka.

Matenda a Bradycardia-tachycardia; Sinus mfundo kulephera; Kugunda kwa mtima pang'ono - sinus yodwala; Matenda a Tachy-brady; Sinus pause - sinus yodwala; Sinus kumangidwa - sinus yodwala

• Mtima pacemaker - kutulutsa

• Wopanga zida

Olgin JE, Zipes DP. Bradyarrhythmias ndi block atrioventricular. 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 40.

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