Arrhythmias

Arrhythmia ndi vuto la kugunda kwa mtima (kugunda) kapena mungoli wamtima. Mtima ukhoza kugunda mwachangu kwambiri (tachycardia), pang'onopang'ono (bradycardia), kapena mosasinthasintha.

Arrhythmia ikhoza kukhala yopanda vuto, chisonyezo cha mavuto ena amtima, kapena kuwopsa kwakanthawi m'thupi lanu.

Nthawi zambiri, mtima wanu umagwira ntchito ngati pampu yomwe imabweretsa magazi m'mapapu ndi thupi lonse.

Pofuna kuti izi zichitike, mtima wanu uli ndi makina amagetsi omwe amaonetsetsa kuti amalumikizana (kufinya) mwadongosolo.

• Mphamvu yamagetsi yomwe imawonetsa mtima wanu kuti igwirizane imayamba mdera la mtima wotchedwa sinoatrial node (yomwe imadziwikanso kuti sinus node kapena SA node). Ichi ndi mtima wanu wopanga pacemaker.
• Chizindikirocho chimasiya mfundo za SA ndikuyenda pamtima m'njira yamagetsi.
• Mauthenga osiyanasiyana amitsempha amawonetsa mtima wanu kuti ukugunda pang'onopang'ono kapena mwachangu.

Arrhythmias amayamba chifukwa cha mavuto amachitidwe amagetsi opangira mtima.

• Zizindikiro zachilendo (zowonjezera) zitha kuchitika.
• Zizindikiro zamagetsi zitha kutsekedwa kapena kuchepetsedwa.
• Zizindikiro zamagetsi zimayenda m'njira zatsopano kapena zosiyanasiyana kudutsa mumtima.

Zina mwazomwe zimayambitsa kugunda kwamtima kosadziwika ndi izi:

• Mavitamini potaziyamu kapena zinthu zina m'thupi
• Matenda a mtima, kapena minofu ya mtima yowonongeka kuchokera pamtima wapitawo
• Matenda amtima omwe amapezeka pakubadwa (kobadwa nako)
• Kulephera kwa mtima kapena kukulitsidwa kwa mtima
• Kuchuluka kwa chithokomiro

Arrhythmias amathanso kuyambitsidwa ndi zinthu zina kapena mankhwala, kuphatikiza:

• Mowa kapena mankhwala osokoneza bongo
• Mankhwala ena
• Kusuta ndudu (chikonga)

Zina mwazovuta zodziwika bwino pamtima ndi izi:

• Matenda a Atrial kapena flutter
• Atrioventricular nodal reentry tachycardia (AVNRT)
• Mtima kapena chipika cha atrioventricular
• Zambiri zamatenda tachycardia
• Paroxysmal supraventricular tachycardia
• Matenda odwala sinus
• Ventricular fibrillation kapena ventricular tachycardia
• Matenda a Wolff-Parkinson-White

Mukakhala ndi arrhythmia, kugunda kwanu kungakhale:

• Kuchedwa kwambiri (bradycardia)
• Mofulumira kwambiri (tachycardia)
• Zosasunthika, zosagwirizana, mwina ndizowonjezera kapena kumenyedwa

Arrhythmia imatha kupezeka nthawi zonse kapena itha kubwera ndikupita. Mutha kapena simungamve zisonyezo pomwe arrhythmia ikupezeka. Kapena, mutha kungodziwa zizindikiro mukakhala otanganidwa.

Zizindikiro zimatha kukhala zofatsa kwambiri, kapena zitha kukhala zowopsa kapena zoopsa.

Zizindikiro zomwe zimachitika mukamakhalako arrhythmia ndi monga:

• Kupweteka pachifuwa
• Kukomoka
• Kupepuka, chizungulire
• Khungu
• Kupindika (kumva kuti mtima wanu ukugunda mwachangu kapena mosasinthasintha)
• Kupuma pang'ono
• Kutuluka thukuta

Wothandizira zaumoyo amvera mtima wanu ndi stethoscope ndikumva kugunda kwanu. Kuthamanga kwanu kwamagazi kumatha kukhala kotsika kapena kwabwinobwino kapena ngakhale kukwera kwambiri chifukwa chosakhala bwino.

Kuyeza koyamba kudzachitika.

Zipangizo zowunika mtima nthawi zambiri zimagwiritsidwa ntchito kuzindikira vuto lagoli, monga:

• Holter polojekiti (pomwe mumavala chida chomwe chimalemba ndikusunga mawonekedwe amtima wanu kwa maola 24 kapena kupitilira apo)
• Wowonera zochitika kapena chojambulira chozungulira (chovala kwamasabata awiri kapena kupitilira apo, pomwe mumalemba nyimbo yanu mukamamva nyimbo yachilendo)
• Zosankha zina zowunika kwakanthawi

Echocardiogram nthawi zina imalamulidwa kuti ifufuze kukula kapena kapangidwe ka mtima wanu.

Nthawi zina, angiography ya coronary ikhoza kuchitidwa kuti muwone m'mene magazi amayendera kudzera mumitsempha mumtima mwanu.

Kuyesedwa kwapadera, komwe kumatchedwa kafukufuku wamagetsi (EPS), nthawi zina kumachitika kuti muwone bwino zamagetsi amtima.

Ngati arrhythmia ili yayikulu, mungafunike chithandizo mwachangu kuti mubwezeretse muyeso wabwinobwino. Izi zingaphatikizepo:

• Mankhwala amagetsi (defibrillation kapena cardioversion)
• Kukhazikitsa mtima wamtima wa kanthawi kochepa
• Mankhwala operekedwa kudzera mumitsempha kapena pakamwa

Nthawi zina, chithandizo chabwino cha angina kapena kulephera kwa mtima kwanu kumachepetsa mwayi wanu wokhala ndi arrhythmia.

Mankhwala otchedwa anti-arrhythmic mankhwala atha kugwiritsidwa ntchito:

• Pofuna kupewa arrhythmia kuti isadzachitikenso
• Kuti kugunda kwa mtima wanu kusakhale kothamanga kwambiri kapena kochedwa kwambiri

Ena mwa mankhwalawa amatha kukhala ndi zovuta zina. Atengereni monga mwakulandirira ndi omwe amakupatsani. Musasiye kumwa mankhwala kapena kusintha mlingo musanalankhule ndi omwe akukuthandizani.

Mankhwala ena oteteza kapena kuchiritsa mikhalidwe yachilendo ndi awa:

• Kuchotsa kwamtima, komwe kumawunikira malo omwe ali mumtima mwanu omwe atha kubweretsa mavuto amtima wanu
• An implantable cardioverter defibrillator, omwe amaikidwa mwa anthu omwe ali pachiwopsezo chachikulu chofa mwadzidzidzi mtima
• Permanent pacemaker, chida chomwe chimamveka mtima wanu ukamenya pang'onopang'ono. Imatumiza chizindikiritso pamtima panu chomwe chimapangitsa mtima wanu kugunda pamlingo woyenera.

Zotsatira zimadalira pazifukwa zingapo:

• Mtundu wa arrhythmia womwe muli nawo.
• Kaya muli ndi matenda amitsempha, mtima wosalimba, kapena matenda amtima a valvular.

Itanani omwe akukuthandizani ngati:

• Mumakhala ndi zizindikiro zilizonse zomwe zingachitike.
• Mwapezeka kuti muli ndi arrhythmia ndipo zizindikilo zanu zimakulirakulira kapena OSAKHALA bwino ndi chithandizo.

Kuchitapo kanthu popewa matenda amitsempha yamagazi kumachepetsa mwayi wanu wokhala ndi arrhythmia.

Nyimbo zosadziwika bwino; Bradycardia; Tachycardia; Fibrillation

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

• Mtima - gawo kupyola pakati
• Mtima - kuwonera kutsogolo
• Nyimbo yachibadwa yamtima
• Bradycardia
• Ventricular tachycardia
• Atrioventricular block - Kufufuza kwa ECG
• Kachitidwe kachitidwe ka mtima

Al-Khatib SM, Stevenson WG, Ackerman MJ, ndi al. Malangizo a AHA / ACC / HRS oyang'anira odwala omwe ali ndi ma ventricular arrhythmias komanso kupewa kufa kwamwadzidzidzi kwa mtima: Chidule cha Executive: Ripoti la American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Mtima Nyimbo. 2018; 15 (10): e190-e252. PMID: 29097320 adatulutsidwa.ncbi.nlm.nih.gov/29097320/.

Olgin JE. Njira kwa wodwalayo amaganiziridwa arrhythmia. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 56.

Tomaselli GF, Rubart M, Zipes DP. Njira za arrhythmias yamtima. 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 34.

Tracy CM, Epstein AE, Darbar D, ndi al. 2012 ACCF / AHA / HRS idasinthiratu malangizo a 2008 othandizira kugwiritsa ntchito zida zamatenda amtima: lipoti la American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. J Ndine Coll Cardiol. 2012; 60 (14): 1297-1313. (Adasankhidwa) PMID: 22975230 pubed.ncbi.nlm.nih.gov/22975230/.