Zambiri zamatenda tachycardia

Multifocal atrial tachycardia (MAT) ndi kugunda kwamtima mwachangu. Zimachitika pomwe zizindikilo zambiri (zamagetsi) zimatumizidwa kuchokera kumtunda wam'mwamba (atria) kupita kumtima wam'munsi (ma ventricles).

Mtima wa munthu umatulutsa zikhumbo zamagetsi, kapena zikwangwani, zomwe zimauza kuti igunde. Nthawi zambiri, zizindikilozi zimayambira mdera la chipinda chakumanja chotchedwa sinoatrial node (sinus node kapena SA node). Node iyi imadziwika kuti "yopanga pacemaker" yamtima. Zimathandiza kuchepetsa kugunda kwa mtima. Mtima ukazindikira chizindikiritso, chimagwira (kapena kumenya).

Kugunda kwa mtima kwa achikulire ndi pafupifupi kumenyedwa kwa 60 mpaka 100 pamphindi. Kugunda kwamtima kumathamanga kwambiri kwa ana.

Mu MAT, malo ambiri omwe amatulutsa moto ku atria nthawi yomweyo. Zizindikiro zambiri zimabweretsa kugunda kwamtima mwachangu. Nthawi zambiri imakhala pakati pa 100 mpaka 130 kumenyedwa pamphindi kapena kupitilira akulu. Kugunda kwa mtima kumapangitsa mtima kugwira ntchito kwambiri osasuntha magazi moyenera. Ngati kugunda kwa mtima kukuthamanga kwambiri, pamakhala nthawi yocheperako kuti chipinda chamtima chidzaze ndi magazi pakati pomenya. Chifukwa chake, magazi osakwanira amapopedwa kuubongo ndi thupi lonse ndikumupukuta.

MAT ndi ofala kwambiri kwa anthu azaka 50 kapena kupitilira apo. Kawirikawiri zimawoneka mwa anthu omwe ali ndi zikhalidwe zomwe zimachepetsa mpweya wabwino m'magazi. Izi ndi monga:

• Chibayo cha bakiteriya
• Matenda osokoneza bongo (COPD)
• Kulephera kwa mtima
• Khansa ya m'mapapo
• Kulephera kwa mapapo
• Kuphatikizika kwa pulmonary

Mutha kukhala pachiwopsezo chachikulu cha MAT ngati muli:

• Matenda a mtima
• Matenda a shuga
• Anachitidwa opaleshoni m'masabata 6 apitawa
• Mankhwala osokoneza bongo a theophylline
• Sepsis

Pamene kugunda kwa mtima kuli kochepera 100 kumenyedwa pamphindi, arrhythmia amatchedwa "kuyendayenda kwa atrial pacemaker."

Anthu ena sangakhale ndi zizindikilo. Zizindikiro zikachitika, zimatha kuphatikiza:

• Kukhazikika pachifuwa
• Mitu yopepuka
• Kukomoka
• Kumva kuti mtima ukugunda mosasinthasintha kapena mwachangu kwambiri (palpitations)
• Kupuma pang'ono
• Kuchepetsa thupi komanso kulephera kukula bwino mwa makanda

Zizindikiro zina zomwe zingachitike ndi matendawa:

• Kupuma kovuta kugona
• Chizungulire

Kuyezetsa thupi kumawonetsa kugunda kwamphamvu kopitilira 100 pamphindi. Kuthamanga kwa magazi kumakhala kwabwino kapena kotsika. Pakhoza kukhala zizindikilo zosayenda bwino.

Kuyesa kopeza MAT kumaphatikizapo:

• ECG
• Phunziro la Electrophysiologic (EPS)

Oyang'anira mtima amagwiritsidwa ntchito kujambula kugunda kwamtima mwachangu. Izi zikuphatikiza:

• Kuwunika kwa Holter kwa maola 24
• Zojambula zojambulidwa, zazitali zomwe zimakulolani kuti muyambe kujambula ngati zizindikiro zikuchitika

Ngati muli m'chipatala, mungayang'anitsidwe mtima wanu maola 24 patsiku, koyambirira.

Ngati muli ndi vuto lomwe lingayambitse MAT, vutoli liyenera kuthandizidwa kaye.

Chithandizo cha MAT chimaphatikizapo:

• Kupititsa patsogolo magazi okosijeni
• Kupereka magnesium kapena potaziyamu kudzera mumitsempha
• Kuyimitsa mankhwala, monga theophylline, omwe amatha kukweza kugunda kwa mtima
• Kutenga mankhwala kuti muchepetse kugunda kwa mtima (ngati kugunda kwa mtima kukuthamanga kwambiri), monga calcium channel blockers (verapamil, diltiazem) kapena beta-blockers

MAT imatha kuwongoleredwa ngati zomwe zimayambitsa kugunda kwamtima mwachangu zithandizidwa ndikuwongoleredwa.

Zovuta zingaphatikizepo:

• Matenda a mtima
• Kulephera kwa mtima
• Kuchepetsa kupopera kwamtima

Imbani wothandizira zaumoyo wanu ngati:

• Muli ndi kugunda kwamtima mwachangu kapena mosasinthasintha ndi zizindikilo zina za MAT
• Muli ndi MAT ndipo zizindikiro zanu zikuipiraipira, sizikusintha ndi chithandizo chamankhwala, kapena mumakhala ndi zizindikilo zatsopano

Pochepetsa chiopsezo chokhala ndi MAT, thandizani zovuta zomwe zimayambitsa nthawi yomweyo.

Zosokoneza matenda tachycardia

• Mtima - gawo kupyola pakati
• Mtima - kuwonera kutsogolo
• Kachitidwe kachitidwe ka mtima

Olgin JE, Zipes DP. Supraventricular 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 37.

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