Ventricular tachycardia

Ventricular tachycardia (VT) ndi kugunda kwamtima kofulumira komwe kumayambira muzipinda zapansi zamtima (ma ventricles).

VT ndimayendedwe opitilira 100 pamphindi, osagunda mowirikiza katatu motsatana.

Vutoli limatha kukhala vuto lakumayambiriro kapena mochedwa la matenda amtima. Zitha kukhalanso mwa anthu omwe ali ndi:

• Matenda a mtima
• Mtima kulephera
• Opaleshoni ya mtima
• Myocarditis
• Matenda a mtima wa Valvular

VT imatha kupezeka popanda matenda amtima.

Minofu yotupa imatha kupangika mu minofu yama ventricles masiku, miyezi, kapena zaka zitadwala mtima. Izi zingayambitse tachycardia yamitsempha yamagetsi.

VT amathanso kuyambitsidwa ndi:

• Mankhwala osokoneza bongo (omwe amagwiritsidwa ntchito pochiza mtima wosagwirizana)
• Zosintha zamagetsi amwazi (monga potaziyamu wochepa)
• Kusintha kwa pH (acid-base)
• Kupanda mpweya wokwanira

"Torsade de pointes" ndi mtundu wina wa VT. Nthawi zambiri zimachitika chifukwa chobadwa ndi matenda amtima kapena kugwiritsa ntchito mankhwala ena.

Mutha kukhala ndi zizindikilo ngati kugunda kwa mtima munthawi ya VT kuli kothamanga kwambiri kapena kumatenga nthawi yayitali kuposa masekondi ochepa. Zizindikiro zimaphatikizapo:

• Kusapeza bwino pachifuwa (angina)
• Kukomoka (syncope)
• Kupepuka kapena chizungulire
• Zomverera zakumva kugunda kwa mtima (kugunda kwa mtima)
• Kupuma pang'ono

Zizindikiro zimatha kuyimilira mwadzidzidzi. Nthawi zina, sipakhala zizindikiro.

Wothandizira zaumoyo adzafuna:

• Kugunda kosakhalitsa
• Kutaya chidziwitso
• Kuthamanga kwa magazi kochepa kapena kotsika
• Kutentha mwachangu

Mayeso omwe angagwiritsidwe ntchito kuzindikira tachycardia yama ventricular ndi awa:

• Woyang'anira Holter
• ECG
• Kafukufuku wa Intracardiac electrophysiology (EPS)
• Kuyang'anira kayendedwe ka chojambulira kapena chida

Muthanso kukhala ndi ma chemistry amwazi ndi mayeso ena.

Chithandizo chimadalira pazizindikiro, ndi mtundu wamatenda amtima.

Ngati wina yemwe ali ndi VT ali pamavuto, angafunike:

• CPR
• Kutaya mtima (kugwedezeka kwamagetsi)
• Mankhwala (monga lidocaine, procainamide, sotalol, kapena amiodarone) operekedwa kudzera mumtsempha

Pambuyo pa gawo la VT, masitepe amatengedwa kuti akwaniritse magawo.

• Mankhwala otengedwa pakamwa angafunike kuti akalandire chithandizo chanthawi yayitali. Komabe, mankhwalawa atha kukhala ndi zovuta zina. Akugwiritsidwa ntchito pafupipafupi pamene mankhwala ena akupangidwa.
• Njira yowononga minofu ya mtima yomwe imayambitsa kugunda kwamtima kosadziwika bwino (yotchedwa ablation) itha kuchitidwa.
• Chowonjezera cha cardioverter defibrillator (ICD) chingalimbikitsidwe. Ndi chida chokhazikitsidwa chomwe chimazindikira kugunda kulikonse kowopsa, kofulumira. Kugunda kwachilendo kumeneku kumatchedwa arrhythmia. Ngati zichitika, ICD imatumiza kugwedezeka kwamagetsi pamtima kuti isinthe kayendedwe kabwino. Izi zimatchedwa defibrillation.

Zotsatira zake zimadalira momwe mtima uliri komanso zizindikilo zake.

Ventricular tachycardia mwina siyimayambitsa zizindikiro mwa anthu ena. Komabe, imatha kupha. Ndi chifukwa chachikulu chakufa kwadzidzidzi kwamtima.

Pitani kuchipinda chodzidzimutsa kapena itanani nambala yadzidzidzi yakomweko (monga 911) ngati mukuthamanga mofulumira, osasinthasintha, kukomoka, kapena kupweteka pachifuwa. Zonsezi zitha kukhala zizindikilo za tachycardia yama ventricular.

Nthawi zina, matendawa sangathe kupewedwa. Nthawi zina, imatha kupewedwa pochiza mavuto amtima komanso kupewa mankhwala ena.

Tachycardia yovuta kwambiri; V tach; Tachycardia - yamitsempha yamagazi

• Chodetsa cha mtima wamafuta - kutulutsa

• Chokhazika mtima chosintha mtima
• Chodetsa mtima cha mtima

Al-Khatib SM, Stevenson WG, Ackerman MJ, ndi al. Malangizo a 2017 AHA / ACC / HRS oyang'anira odwala omwe ali ndi ma ventricular arrhythmias komanso kupewa kufa kwamwadzidzidzi kwa mtima: lipoti la American College of Cardiology / American Heart Association Task Force pamayendedwe azachipatala ndi Heart Rhythm Society [kukonzanso kofalitsa kumawonekera J Ndine Coll Cardiol. 2018; 72 (14): 1760]. J Ndine Coll Cardiol. 2018; 72 (14): 1677-1749. PMID: 29097294 pubed.ncbi.nlm.nih.gov/29097294/.

Epstein EF, DiMarco JP, Ellenbogen KA, Estes NA 3, ndi al. 2012 ACCF / AHA / HRS idasinthiratu zomwe zidaphatikizidwa ndi malangizo a ACCF / AHA / HRS 2008 pazithandizo zochokera pazida zamatenda amtima: lipoti la American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Sosaiti. J Ndine Coll Cardiol. 2013; 661 (3): e6-75. PMID: 23265327 pubmed.ncbi.nlm.nih.gov/23265327/.

Magulu a Garan H. Ventricular arrhythmias. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 59.

Olgin JE, Tomaselli GF, Zipes DP. Ventricular 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: chaputala 39.