Matenda a Atrial kapena flutter

Matenda a Atrial kapena flutter ndimtundu wofala wa kugunda kwamtima. Nyimbo yamtima imathamanga ndipo nthawi zambiri imasinthasintha.

Pogwira ntchito bwino, zipinda zinayi za mgwirizano wamtima (Finyani) mwadongosolo.

Zizindikiro zamagetsi zimawongolera mtima wanu kuti mupope magazi okwanira pazosowa za thupi lanu. Zizindikiro zimayambira mdera lotchedwa sinoatrial node (yomwe imadziwikanso kuti sinus node kapena SA node).

Mu fibrillation ya atrial, chikoka chamagetsi chamtima sichichitika pafupipafupi. Izi ndichifukwa choti mfundo za sinoatrial sizikulamuliranso kuthamanga kwamtima.

• Zigawo za mtima sizingagwirizane mwadongosolo.
• Zotsatira zake, mtima sungapope magazi okwanira kukwaniritsa zosowa za thupi.

Mu flutter ya atrial, ma ventricles (zipinda zam'munsi zamtima) atha kumenya mwachangu kwambiri, koma munthawi zonse.

Mavutowa amatha amuna ndi akazi. Amakhala ofala ndikukula.

Zomwe zimayambitsa kuperewera kwamatenda ndi monga:

• Kumwa mowa (makamaka kumwa mowa mwauchidakwa)
• Mitsempha ya Coronary
• Matenda a mtima kapena opaleshoni ya mtima
• Kulephera kwa mtima kapena kukulitsidwa kwa mtima
• Matenda a mtima wamavuto (nthawi zambiri ma mitral valve)
• Matenda oopsa
• Mankhwala
• Chithokomiro chopitilira muyeso (hyperthyroidism)
• Matenda a m'mapapo
• Matenda odwala sinus

Mwina simukudziwa kuti mtima wanu sukugunda mofananira.

Zizindikiro zimatha kuyamba kapena kuyima mwadzidzidzi. Izi ndichifukwa choti matenda a atrial amatha kuyima kapena kuyamba pawokha.

Zizindikiro zimaphatikizapo:

• Kugunda komwe kumamveka mwachangu, kuthamanga, kuthamanga, kukwapula, kusasinthasintha, kapena kutsika kwambiri
• Zomverera zakumva kugunda kwa mtima (kugunda kwa mtima)
• Kusokonezeka
• Chizungulire, kupepuka mutu
• Kukomoka
• Kutopa
• Kulephera kuchita masewera olimbitsa thupi
• Kupuma pang'ono

Wopereka chithandizo chamankhwala amatha kumva kugunda kwamtima kwinaku akumvetsera mtima wanu ndi stethoscope. Kutentha kwanu kumatha kumva mwachangu, kusagwirizana, kapena zonse ziwiri.

Kugunda kwamtima ndikumenyedwa kwa 60 mpaka 100 pamphindi. Mu atrial fibrillation kapena flutter, kugunda kwa mtima kumatha kukhala 100 mpaka 175 kumenya pamphindi. Kuthamanga kwa magazi kumatha kukhala kwachilendo kapena kutsika.

ECG (mayeso omwe amalemba zamagetsi pamtima) atha kuwonetsa atril fibrillation kapena atrial flutter.

Ngati mungakhale ndi vuto la mtima wosazolowereka, mungafunike kuvala chowunikira chapadera kuti mupeze vutoli. Wowunikirayo amalemba malankhulidwe amtima kwakanthawi.

• Kuwunika zochitika (masabata 3 mpaka 4)
• Holter polojekiti (mayeso a maola 24)
• Chojambula chojambulidwa chozungulira (kuwunika kowonjezera)

Kuyesa kopeza matenda amtima kungaphatikizepo:

• Echocardiogram (kujambula kwa ultrasound ya mtima)
• Kuyesera kuti muwone momwe magazi amapezera minofu yamtima
• Kuyesa kuphunzira zamagetsi zamagetsi pamtima

Chithandizo chamatenda amtima chimagwiritsidwa ntchito kuti mtima ubwerere m'chiyimbidwe nthawi yomweyo. Pali njira ziwiri zochiritsira:

• Zovuta zamagetsi pamtima panu
• Mankhwala operekedwa kudzera mumitsempha

Mankhwalawa atha kuchitidwa ngati njira zadzidzidzi, kapena kukonzekera pasadakhale.

Mankhwala omwe amatengedwa pakamwa amagwiritsidwa ntchito:

• Wosachedwa kugunda pamtima mosachedwa - Mankhwalawa atha kuphatikizira beta-blockers, calcium channel blockers, ndi digoxin.
• Pewani ma fibrillation atrial kuti asabwerere -- Mankhwalawa amagwira ntchito bwino mwa anthu ambiri, koma amatha kukhala ndi zovuta zina. Matenda a Atrial amabwereranso mwa anthu ambiri, ngakhale akumwa mankhwalawa.

Njira yotchedwa radiofrequency ablation itha kugwiritsidwa ntchito kuwononga malo mumtima mwanu momwe mavuto amtundu wamtima amayamba. Izi zitha kuteteza zilembo zamagetsi zomwe zimayambitsa matenda a atrial kapena flutter kuti zisadutse pamtima panu. Mungafunike wopanga pamtima pambuyo pochita izi. Anthu onse omwe ali ndi matenda a atrial ayenera kuphunzira momwe angathetsere vutoli kunyumba.

Anthu omwe ali ndi matenda a fibrillation nthawi zambiri amafunika kumwa mankhwala ochepetsa magazi. Mankhwalawa amagwiritsidwa ntchito pochepetsa chiopsezo chokhala ndi magazi omwe amayenda mthupi (ndipo zomwe zimatha kuyambitsa sitiroko, mwachitsanzo). Mkhalidwe wosasinthasintha wamtima womwe umachitika ndi atril fibrillation umapangitsa magazi kuundana mosavuta.

Mankhwala ochepetsa magazi amaphatikizapo heparin, warfarin (Coumadin), apixaban (Eliquis), rivaroxaban powder (Xarelto), edoxaban (Savaysa) ndi dabigatran (Pradaxa). Mankhwala osokoneza bongo monga aspirin kapena clopidogrel amathanso kuperekedwa. Komabe, ochepetsa magazi amawonjezera mwayi wakutaya magazi, ndiye kuti si aliyense amene angawagwiritse ntchito.

Njira ina yopewera sitiroko kwa anthu omwe sangathe kumwa mankhwalawa mosamala ndi Watchman Device, yomwe yavomerezedwa posachedwa ndi FDA. Izi ndizobzala zazing'ono zooneka ngati dengu zomwe zimayikidwa mkati mwamtima kuti zitseke pamtima pomwe pakaundana kwambiri. Izi zimalepheretsa mawonekedwe kupanga.

Wopereka chithandizo adzaganizira za msinkhu wanu komanso mavuto ena azachipatala posankha njira zopewera sitiroko zomwe zingakuthandizeni.

Chithandizo chimatha kuchepetsa vutoli. Anthu ambiri omwe ali ndi matenda a atrial amachita bwino kwambiri ndi chithandizo.

Matenda a Atrial amayamba kubwerera ndikuipiraipira. Itha kubwereranso mwa anthu ena, ngakhale atalandira chithandizo.

Mitsempha yomwe imabooka ndikupita kuubongo imatha kuyambitsa sitiroko.

Itanani omwe akukuthandizani ngati muli ndi matenda a atrial fibrillation kapena flutter.

Lankhulani ndi omwe amakupatsani zomwe mungachite kuti muthane ndi zovuta zomwe zimayambitsa matenda a atrial ndi flutter. Pewani kumwa mowa mwauchidakwa.

Fibrillation yamatenda; A-ulusi; Afib

• Matenda a atrial - kutulutsa
• Mtima pacemaker - kutulutsa
• Kutenga warfarin (Coumadin, Jantoven) - zomwe mungafunse dokotala wanu

• Mtima - gawo kupyola pakati
• Mtima - kuwonera kutsogolo
• Mitsempha yamtima yakumbuyo
• Mitsempha yamkati yamkati
• Kachitidwe kachitidwe ka mtima

Januwale CT, Wann LS, Calkins H, et al. 2019 AHA / ACC / HRS idasinthiratu malangizo a 2014 AHA / ACC / HRS oyang'anira odwala omwe ali ndi matenda a atrial: lipoti la American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society mu mogwirizana ndi Society of Thoracic Surgeons. Kuzungulira. Zosintha. 2019; 140 (6) e285. PMID: 30686041 adatulutsidwa.ncbi.nlm.nih.gov/30686041.

Meschia JF, Bushnell C, Boden-Albala B, ndi al. Maupangiri othandizira kupewa kupwetekedwa: mawu a akatswiri azaumoyo ochokera ku American Heart Association / American Stroke Association. Sitiroko. 2014; 45 (12): 3754-3832. (Adasankhidwa) PMID: 25355838 pubed.ncbi.nlm.nih.gov/25355838. (Adasankhidwa)

Morady F, Zipes DP. Matenda a Atrial: mawonekedwe azachipatala, njira, ndi kasamalidwe. 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 38.

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