So wo koma rebɔ mpofirim ma ɛyɛ nwonwa? So ebetumi aba sɛ ɛyɛ Brugada Syndrome?

So w’adwene ayera mpofirim, woate nka sɛ wo ho ayɛ wo hyew pɛn? Anaasɛ na wote nka sɛ koma bɔ ntɛmntɛm, anaasɛ na ɛyɛ den sɛ wobɛhome? Ɛtɔ mmere bi a, biribi a ɛnyɛ aniberesɛm pii betumi de eyinom aba. Nanso, wɔ nsɛm a ɛntaa nsi mu no, wobetumi ayɛ komayare bi a wɔfrɛ no Brugada Syndrome ho sɛnkyerɛnne. Momma yɛnka eyi ho asɛm kakra nnɛ, efisɛ ɛho hia sɛ yɛma yɛn ani da hɔ.

Dɛn ne Brugada Yare no?

Sɛ yɛbɛka no tiawa a, Brugada Syndrome yɛ tebea bi a ɛma anyinam ahoɔden yɛ adwuma wɔ ɔkwan a ɛnteɛ so wɔ wo koma no ase adan a wɔfrɛ no ventricles no mu. Eyi betumi ama wo koma atumi asɛe mpofirim . Wɔfrɛ eyi ventricular fibrillation anaa v-fib . Fa no sɛ wo koma rehuruhuruw sen sɛ wobɛbɔ mogya yiye. Eyi ma w’amemene no nnya mogya a ɛdɔɔso. Ɛno ne bere a w’adwene mu yɛ wo naa (syncope) .

Eyi betumi ayɛ tebea a asiane wom, efisɛ saa `v-fib` yi betumi ama koma awu mpofirim mpo . Mpɛn pii no, eyi ba bere a woagye w’ahome anaa woada no. Nhwehwɛmufo ka sɛ Brugada Syndrome na ɛma koma mu wuwu mpofirim bɛyɛ 4% wɔ wiase nyinaa.

Nanso eyi nyɛ yare a abu so koraa. Nnipa mpem du biara mu bɛyɛ baasa kosi baanan na wɔwɔ saa tebea yi.

Nsɛnkyerɛnne bɛn na ɛda adi?

Brugada Syndrome ho sɛnkyerɛnne betumi ada adi wɔ mfe biara mu. Nanso, wɔtaa fi ase bere a wɔadi bɛyɛ mfe 40. Ebia nnipa binom renkyerɛ yare no ho sɛnkyerɛnne biara koraa. Wɔkyerɛ sɛ nnipa bɛboro 70% nni sɛnkyerɛnne biara. Nanso, sɛ sɛnkyerɛnne ahorow no da adi ampa a, nea ɛka ho ne:

• Koma a ɛbɔ a ɛnteɛ (`ventricular arrhythmia`) : Eyi kyerɛ sɛ koma no nnyigyei a ɛyɛ basaa.
• Syncope: Nhumu a ɛyera mpofirim na ɔhwe ase.
• Dizziness : Nkate a ɛma obi twitwiw ne ho.
• Ɔhome a ɛyɛ den .
• Koma a ɛbɔ : Nkate a ɛma wohuruhuruw anaasɛ woretwa wo ho wɔ wo koko mu.
• Koma a ɛyɛ den : Ɛtɔ mmere bi a eyi ne sɛnkyerɛnne a edi kan a ɛda adi. Ebia nnipa binom bewuwu wɔ wɔn nna mu esiane eyi nti.

Nea ɛho hia: Sɛ wotaa hu saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa a, ɛbɛyɛ papa sɛ wobɛkɔ oduruyɛfo nkyɛn akɔhwehwɛ afotu.

Dɛn ne nneɛma a ɛkanyan Brugada yare no?

Nneɛma bi betumi ama Brugada yare no ho sɛnkyerɛnne ada adi mpofirim anaasɛ ayɛ kɛse. Yɛfrɛ eyinom `triggers`.

• Atiridii : Saa sɛnkyerɛnne ahorow yi betumi aba bere a obi a ɔwɔ Brugada yare no nya atiridiinini no.Ɛho hia yiye sɛ wobɛma atiridiinini no aba fam ntɛmntɛm . Sɛ wowɔ implantable cardioverter defibrillator (ICD) mpo a, ɛho da so ara hia sɛ wobrɛ atiridii no ase. Wobetumi de nnuru a wɔtɔn a wɔde tew atiridiinini a wɔtɔn wɔ nnurutɔnbea hɔ ayɛ eyi.
• Ɔhyew a ɛma obi brɛ / Nsu a ɛtɔ : Nsu a ɛkɔ nipadua no mu, ɔbrɛ esiane ɔhyew a ano yɛ den nti.
• Nnuru bi : .
• Nnuru a esiw sodium kwan.
• Lithium a wɔde yɛ nneɛma.
• Nnuru a wɔde kum adwenemhaw a wɔfrɛ no tricyclic.
• Nsã : Nsã a wɔnom dodo.
• Nnubɔne : Nnubɔne te sɛ cocaine ne wii a wɔde di dwuma.

Ɛho hia paa sɛ wubehu saa nneɛma yi na woakwati sɛnea wubetumi biara.

Dɛn ne nea enti a ɛte saa?

Ɛtɔ mmere bi a wonnim nea ɛde Brugada Syndrome ba ankasa . Anaasɛ ebetumi ayɛ awosu mu nneɛma . Ɛda so ara nnim awosu mu nsakrae pɔtee a ɛde saa yare yi ba nnipa bɛyɛ 70% mu.

Nanso, nnipa binom wɔ awosu mu nsakrae 18 anaa nea ɛboro saa. Eyinom mu nea abu so sen biara ne nsakrae a ɛba awosu mu abɔde bi a wɔfrɛ no SCN5A mu . Saa nsakrae ahorow yi sɛe ɔkwan a anyinam ahoɔden nsɛnkyerɛnne a ɛwɔ koma no mu fa so tu kwan no.

Eyi yɛ yare a wobetumi anya afi ɔwofo biako pɛ hɔ . Ɛne sɛ, obi a ɔwɔ awosu mu nkwaadɔm mu nsakrae a ɛne Brugada yare no wɔ abusuabɔ no ba wɔ hokwan 50% sɛ obenya bi.

Hena na ɛda adi sɛ obenya eyi? (Nneɛma a Ɛma Asiane) .

Saa yare yi abu so wɔ mmarima mu . Ɛtaa ba mmarima so bɛyɛ mpɛn 8 kosi 10 sen mmea.

Afei nso, sɛ obi a ɔwɔ w’abusua mu awu esiane komayare mpofirim nti, anaasɛ wɔahu sɛ ɔwɔ Brugada syndrome , a, ɛbɛyɛ nea nyansa wom sɛ wobɛyɛ eyi nso ho nhwehwɛmu.

Ade foforo ne sɛ wɔka sɛ saa yare yi abu so kakra wɔ nnipa a wofi Asia mu .

Ɔkwan bɛn so na oduruyɛfo hu eyi? (Nyare a Wɔahu) .

Sɛ oduruyɛfo betumi ahu sɛ wowɔ Brugada Syndrome a, ɔbɛyɛ nea edidi so yi:

• Wɔbɛma wo nipadua mu nhwehwɛmu .
• Wɔbɛhwɛ w’aduruyɛ ho abakɔsɛm mu .
• Wobebisa w’abusua akwahosan ho abakɔsɛm (biological family history) , titiriw sɛnea ɛbɛyɛ a wobehu sɛ ebia obi wɔ w’abusua mu a koma awu mpofirim anaa.
• Wɔbɛka akyerɛ wo sɛ yɛ sɔhwɛ titiriw pii .

Sɔhwɛ ahorow bɛn na wɔyɛ?

Nhwehwɛmu atitiriw pii wɔ hɔ a wɔde hu yare yi:

• Awosu mu nhwehwɛmu: Saa nhwehwɛmu yi betumi ahu sɛ ebia wowɔ awosu mu nkwaadɔm mu nsakrae pɔtee bi a ɛne Brugada yare no wɔ abusuabɔ denam wo nnompe anaa mogya a wobɛfa so. Ɛyɛ adwene pa nso sɛ wobɛma wɔayɛ nhwehwɛmu yi ahwɛ sɛ nnipa afoforo a wɔwɔ w’abusua mu nso wɔ saa awosu mu nkwaadɔm mu nsakrae yi anaa. Titiriw sɛ wowɔ obusuani bi a ɔbɛn wo (`busuani a odi kan`) a ɔwɔ Brugada yare no, te sɛ w’awofo, wo nuanom, anaa wo mma a, akyinnye biara nni ho sɛ ɛsɛ sɛ wɔyɛ wo nhwehwɛmu wɔ eyi ho .
• Electrocardiogram (EKG anaa ECG) : Wɔde eyi kyerɛw anyinam ahoɔden a ɛwɔ wo koma mu bere a ɛrebɔ no. Nnuruyɛfo hwehwɛ nhyehyɛe pɔtee bi (Brugada syndrome type 1 EKG nhyehyɛe) wɔ EKG no so. Ɛtɔ mmere bi a, wotumi hu ɔkwan bi a ɛyɛ mmerɛw a wɔfrɛ no type 2 anaa type 3, nanso ɛno nkutoo ntumi nsi yare no so dua. Nanso, esiane nneɛma a ɛkanyan a yɛadi kan aka ho asɛm (e.g. atiridii) nti, saa ɔkwan a ɛto so 2 anaa ɔkwan a ɛto so 3 yi betumi asesa akɔ ɔkwan a ɛto so 1 so. Ɛtɔ mmere bi a, wontumi nhu saa nhyehyɛe yi ntɛm ara wɔ EKG no so, enti oduruyɛfo no betumi ayɛ EKG no mprenu anaa mprɛnsa, na wasakra akwan a wɔfa so no. Ɛtɔ mmere bi a, wɔyɛ EKG nso bere a wɔadi aduan a ɛyɛ dɛ awie no.
• EKG a wɔde nnuru (drug challenge test) : Ansa na wobɛyɛ EKG no, ebia wo duruyɛfo bɛma wo aduru bi a ɛbɛboa ma wo EKG ada adi pefee sɛ wowɔ Brugada syndrome a. Wɔde sɔhwɛ yi di dwuma de hwɛ sɛ wo EKG no wɔ type 2 anaa type 3 pattern, a ebetumi asesa ayɛ type 1 pattern.

Wobetumi ayɛ nhwehwɛmu foforo a egyina wo EKG aba so:

• Electrophysiology (EP) sɔhwɛ : Eyi hwehwɛ sɛ wode afiri a ɛyɛ tratraa (catheter) bi fa ntini kɛse bi a ɛwɔ wo nan mu (femoral vein) mu kɔ wo koma mu de susuw anyinam ahoɔden dwumadi a ɛwɔ wo koma mu. Wobetumi ayɛ eyi sɛ wɔanhu sɛnea wɔahu yare no mu pefee wɔ nhwehwɛmu afoforo akyi a.
• Lab nhwehwɛmu: Wɔyɛ mogya mu nhwehwɛmu de hwɛ sɛnea electrolytes te sɛ potassium, calcium, ne magnesium dodow a ɛwɔ mogya no mu, na wɔhwɛ sɛ ebia nneɛma afoforo a ebetumi ama koma no ayɛ adwuma yiye anaa.

Ɔkwan bɛn so na wɔde sa yare? (Ayaresa)

Botae titiriw a ɛwɔ Brugada Syndrome ayaresa mu ne sɛ wobesiw ventricular arrhythmias a ɛba no ano na sɛ ɛba a, wobedi so ntɛm.

Wubetumi ama wo ho ayaresa ahorow te sɛ eyi:

• Nnuru te sɛ Isoproterenol .
• Nnuru te sɛ quinidine .
• Afiri ketewa bi a wɔde hyɛ koma no mu (Implantable Cardioverter Defibrillator - ICD) .: Sɛ woanya komayare (ventricular tachycardia), woatotɔ piti, anaasɛ wo koma agyae a, ebia wɔde ICD bɛhyɛ wo mu. Saa afiri yi hu koma no nnyigyei a ɛyɛ hu na ɛde anyinam ahoɔden ketewaa bi kɔ koma no mu ma ɛsan ba sɛnea na ɛte kan no.
• Ablation ( wɔ tebea horow bi mu): Eyi hwehwɛ sɛ wohu mmeae a ɛwɔ koma no mu a ɛde anyinam ahoɔden nsɛnkyerɛnne a ɛnteɛ reba no na wɔsɛe no.

Sɛ wunni yare no ho sɛnkyerɛnne mpo a, ebia wo duruyɛfo begyina w’abusua abakɔsɛm ne nea efii nhwehwɛmu mu aba so besi gyinae sɛ ɔde ICD bɛhyɛ mu. Ebia nnuruyɛfo binom besi gyinae sɛ wɔbɛhwɛ wo daa na sɛ wunya yare no ho sɛnkyerɛnne nkutoo a, wɔbɛsa wo yare. Nanso, ebia nnuruyɛfo afoforo rempene saa kwan yi so, efisɛ ebia wo yare no ho sɛnkyerɛnne a edi kan ne koma a wuwu mpofirim.

So nsɛnnennen bi wɔ ayaresa no mu?

ICD ahorow nyɛ mfiri a ɛnyɛ nkwaseasɛm 100%. Ɛtɔ mmere bi a nneɛma a ɛte sɛɛ betumi asi:

• Wubetumi ama ahodwiriw wɔ bere a ɛnteɛ mu .
• Ebia mfomso bi wɔ afiri no mu nhama no biako mu .
• Ebia ɔyare mmoawa bi bɛba afiri no ho.

Enti, bere a wɔde ICD ahyɛ mu akyi no, ɛho hia yiye sɛ wobɛkɔ akɔyɛ nhwehwɛmu sɛnea oduruyɛfo no kamfo kyerɛ no pɛpɛɛpɛ.

Bere tenten ahe na egye ansa na asa?

Sɛ wɔde ICD hyɛ mu wie a, wubetumi ayɛ wo dwumadi dodow no ara a wotaa yɛ no wɔ nna kakraa bi mu. Nanso, ebehia sɛ wugyae karka bɛyɛ dapɛn biako. Wubetumi ayɛ adwuma bi a emu yɛ den da biara da, nanso nnyɛ bi mma wobrɛ. Mma nneɛma a emu duru so anaasɛ nteɛteɛ w’apɔw mu denneennen kosi sɛ wo duruyɛfo bɛka akyerɛ wo.

So wobetumi asiw eyi ano? (Ayaresa a wɔde siw ano) .

Sɛ wunya Brugada Syndrome fi w’awofo hɔ a, wuntumi nsakra. Nanso, sɛ wunim sɛ obi wɔ w’abusua mu wɔ Brugada Syndrome a, wo ne w’abusuafo betumi ayɛ awosu mu nhwehwɛmu ahwɛ sɛ wowɔ bi anaa.

Afei nso, sɛ wowɔ anidaso sɛ wobɛwo ba a, wubetumi ne awosu ho ɔfotufo bi ahyia na wo ne wɔn akasa afa asiane a ɛwɔ eyi a wode bɛma wo mma no ho.

Dɛn na wubetumi ahwɛ kwan bere a wo ne Brugada yare no te no?

Aduru biara nni hɔ a wɔde sa Brugada Syndrome. Nanso, ayaresa betumi atew asiane a ɛwɔ hɔ sɛ koma kum mpofirim no so kɛse.

Nnipa a wɔwɔ Brugada yare no a wɔwɔ sɛnkyerɛnne ahorow nanso wonnya ayaresa no wɔ asiane kɛse mu sɛ koma betumi awu mpofirim. Asiane yi sua koraa wɔ nnipa a wonni sɛnkyerɛnne biara na wɔwɔ EKG a ɛfata no mu.

Mɛyɛ dɛn ahwɛ me ho? (Ne ho a wɔhwɛ) .

Sɛ oduruyɛfo ka kyerɛ wo sɛ wowɔ Brugada Syndrome a, ade a ɛho hia sen biara ne sɛ wobɛkwati nneɛma a ɛkanyan adwene a ebetumi asɛe saa nnyigyei no pii sɛnea wubetumi.

• Siw atiridii ano. Sɛ wunya atiridii a, fa si fam ntɛm.
• Twe wo ho fi nnuru ne nneɛma bi ho . Bisa wo duruyɛfo ma ɔmma wo nnuru a wo ho nyɛ wo den no din.
• Kwati nsa ne nnubɔne a ɛboro so koraa .
• Nom nsu pii na amma wo ho atɔ wo .
• Hwɛ yiye bere a woreyɛ dwumadi ahorow a emu yɛ den no .

Bere bɛn na ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn? / So ɛsɛ sɛ wokɔ baabi a wɔhwɛ wɔn a wɔwɔ ayaresa a egye ntɛmpɛ mu?

Sɛ wowɔ Brugada yare a, anyɛ yiye koraa no, ɛsɛ sɛ wokɔ wo duruyɛfo nkyɛn pɛnkoro afe biara kɔhwɛ wo . Sɛ wowɔ ICD a, anyɛ yiye koraa no, ɛsɛ sɛ woma wɔhwɛ mu mprenu afe biara . Sɛ wote nka sɛ biribi yɛ soronko a, ka kyerɛ wo duruyɛfo .

Putupuru! Sɛ wo koma atɔ wo a, worentumi mmoa wo ho. Enti, wubehia obi a ɔbɛboa wo. Sɛ wowɔ asiane mu sɛ koma bɛtɔ wo a, ka kyerɛ w’abusua sɛ wonsua CPR (Cardiopulmonary Resuscitation) , na frɛ 1990 (Sri Lanka ambulance adwumayɛbea a ɛhwɛ ntɛmpɛ so) anaa nɔma a ɛbɛn wo a wɔhwɛ ntɛmpɛ so. Afei nso ka asiane yi ho asɛm kyerɛ w’adwumam.

Nsɛmmisa a ɛho hia a ɛsɛ sɛ wubisa wo duruyɛfo

Sɛ wokɔ oduruyɛfo nkyɛn a, mma wo werɛ mmfi sɛ wubebisa nsɛm te sɛ eyinom:

• So ɛsɛ sɛ meyɛ ICD?
• Ɔkwan bɛn so na ɛsɛ sɛ wɔhwɛ ICD so?
• So wubetumi aka kuw bi a wɔboa a nnipa afoforo a wɔwɔ saa tebea yi betumi akɔka ho ho asɛm akyerɛ me?
• Nnuru bɛn na ɛsɛ sɛ mekwati? So wubetumi ama me list bi?
• So ɛsɛ sɛ wɔsɔ m’abusua mufo a aka no hwɛ sɛ ebia eyi te anaa?

Nkrasɛm a Wɔde Kɔ Fie

Ɛyɛ ade a ɛfata sɛ wobɛte nka sɛ woayɛ basaa bere a wuhu sɛ wowɔ tebea bi a ebetumi ama woanya komayare mpofirim no. Nanso, nim a wunim sɛ wowɔ asiane mu no ma wunya hokwan yɛ nneɛma bi de tew saa asiane no so . Wo duruyɛfo behu ayaresa a eye sen biara ama wo.

Sɛ ɛbɛyɛ yiye a, sɛ wo fie ne wo ba sukuu wɔ Automatic External Defibrillator (AED) . Afei nso, bisa w’afipamfo ne wo mfɛfo adwumayɛfo ma wonsua CPR. Saa nneɛma yi betumi aboa ma wɔagye nnipa nkwa. Di wo duruyɛfo akwankyerɛ akyi bere nyinaa, kɔ wo mu daa, na kwati nneɛma a ɛkanyan wo a ɛde wo nkwa to asiane mu .

` Brugada syndrome, koma a ɛnyɛ den, koma a ɛtwetwe mpofirim, awosu mu nyarewa, EKG, ICD, komayare