So ECG no kae sɛ RBBB (Right Bundle Branch Block)? Mma ɛnhaw wo, momma yɛnhwehwɛ nea eyi yɛ ankasa!

Ebia na wɔayɛ wo ECG bere a woreyɛ aduruyɛ mu nhwehwɛmu, te sɛ bere a wokɔɔ oduruyɛfo nkyɛn wɔ yare foforo bi ho, anaa bere a wufii adwuma foforo ase no. Ebia na ɛhaw wo kakra na wosuro bere a wuhuu krataa bi wɔ saa ECG amanneɛbɔ no so a ɛka sɛ ‘Right Bundle Branch Block’, anaa RBBB no. Ebia woasusuw sɛ, "O me Nyankopɔn, so biribi a anibere wom asɛe me koma?" Ɛyɛ ade a ɛfata sɛ wubesusuw saa bere a wuhu asɛmfua a wunnim saa no. Nanso ansa na ehu bɛbɔ wo no, momma yɛnte eyi ase pefee na yɛnte ase wɔ ɔkwan a ɛnyɛ den so. Mpɛn pii no, eyi nyɛ aniberesɛm sɛnea wususuw no.

Sɛ yɛbɛka no tiawa a, dɛn ne Right Bundle Branch Block (RBBB)?

Nea ɛbɛyɛ na yɛate eyi ase no, ma yenni kan nhwɛ sɛnea yɛn koma yɛ adwuma. Fa no sɛ wo koma te sɛ ofie ketewa bi a ɛwɔ adan anan. Sɛnea ɛbɛyɛ a kanea no bɛsɔ na fan ahorow no atumi ayɛ adwuma wɔ ofie yi mu no, ɛsɛ sɛ anyinam ahoɔden, anaa ‘current’ wɔ hɔ. Saa ara na yɛn koma no wɔ n’ankasa anyinam ahoɔden nhyehyɛe a ɛbɛbɔ yiye.

Saa anyinam ahoɔden sɛnkyerɛnne yi fi ase wɔ ‘master switch’ bi a ɛwɔ koma no atifi. Yɛfrɛ no `(Sinoatrial node)` anaa SA node. Efi hɔ no, anyinam ahoɔden sɛnkyerɛnne no fa koma no atifi adan abien (atria) no mu na ɛkɔ ‘junction box’ bi a wɔfrɛ no `(Atrioventricular node)` anaa AV node mu.

Efi saa nhyiam adaka yi mu no, wɔkyekyɛ anyinam ahoɔden sɛnkyerɛnne no mu yɛ no nhama atitiriw abien a ɛkɔ adan atitiriw abien (ventricles) a ɛwɔ koma no ase no mu. Saa nhama abien yi ne nea yɛfrɛ no ‘bundle branches’. Baako kɔ nifa dan no mu (nifa bundle branch), na ɔfoforo no kɔ benkum dan no mu (benkum bundle branch).

Nea ɛsɛ sɛ ɛba mpɛn pii ne sɛ anyinam ahoɔden sɛnkyerɛnne no fa nhama abien yi nyinaa so ahoɔhare koro ne bere koro mu, na ɛma koma no mu adan abien a ɛwɔ fam no twetwe (bɔ) bom.

Nanso, wɔ obi a ɔwɔ Right Bundle Branch Block (RBBB) mu no, ‘wire’ a ɛkɔ nifa so no siw kakra, anaasɛ ahoɔhare a sɛnkyerɛnne no de tu no so tew kakra. Ɛte sɛ nea ‘current’ no resen brɛoo kakra dodo wɔ waya dedaw bi so. Esiane eyi nti, nifa so ahurututu no nya sɛnkyerɛnne no akyiri kakra sen benkum no. Esiane eyi nti, nifa so ahurututu no bɔ sekan fã ketewaa bi pɛ bere a benkum ahurututu no abɔ akyi.

RBBB ahorow atitiriw abien na ɛwɔ hɔ. Sɛ sɛnkyerɛnne no aka akyi paa a, wɔfrɛ no ‘Complete RBBB’, na sɛ ɛka akyi kakra pɛ a, wɔfrɛ no ‘Incomplete RBBB’. Mpɛn pii no, RBBB a enni mũ no nyɛ aniberesɛm te sɛ RBBB a edi mũ.

Hena na ɛda adi sɛ obehu tebea yi?

Eyi betumi ato obiara. Nnipa a wɔwɔ apɔwmuden a wonni nyarewa mpo betumi anya RBBB. Nanso, saa tebea yi abu so kɛse bere a yɛrenyin no. Sɛnea nhama a ɛwɔ ofie dedaw mu no tumi yɛ mmerɛw kakra no, saa ara na koma no anyinam ahoɔden nhyehyɛe nso tumi brɛ ase kakra bere a yɛrenyin no.

Nhwehwɛmu ada no adi sɛ ebedu mfe 80 a, nnipa 100 biara mu bɛyɛ 11 (anaasɛ 11%) benya RBBB tebea yi. Enti wubetumi ahu sɛ ɛnyɛ nea ɛntaa nsi saa.

Dɛn ne RBBB ho sɛnkyerɛnne ahorow?

Eyi ne ade a ɛho hia na ɛyɛ awerɛkyekye sen biara a ɛsɛ sɛ wuhu. Wɔ nnipa dodow no ara fam no, yare no ho sɛnkyerɛnne biara nni hɔ. Ebia wunnim mpo sɛ wowɔ RBBB. Ebia wɔrenhu kosi sɛ wɔbɛyɛ ECG esiane biribi foforo nti. Worennya wo koko mu yaw biara, wo home a ɛyɛ tiaa, anaasɛ worentotɔ piti esiane RBBB nkutoo nti.

Eyi kyerɛ sɛ sɛ wowɔ saa sɛnkyerɛnne ahorow yi a, ebia ɛnyɛ RBBB na efi, na mmom aduruyɛ mu tebea foforo a ɛhyɛ wo ase. Enti, sɛ wowɔ sɛnkyerɛnne a ɛte saa a, akyinnye biara nni ho sɛ ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn.

Dɛn ne nneɛma a ɛde RBBB ba?

Ɛwom sɛ RBBB betumi aba nnipa a wɔwɔ apɔwmuden mu a ntease biara nnim de, nanso ebetumi afi aduruyɛ mu tebea horow bi ne nneɛma afoforo nso mu aba. Ma yɛnhwɛ nneɛma atitiriw a ɛde ba no bi.

Ɔkwan bɛn so na oduruyɛfo no hu eyi na osi so dua?

Mpɛn pii no, wɔde ECG, anaa Electrocardiogram , na ɛkyerɛ sɛ obi anya RBBB. Nea ɛka sɔhwɛ yi ho ne sɛ wode sticker bɛbata wo moma so, wo nsa, ne wo nan ho na wɔkyerɛw anyinam ahoɔden a ɛwɔ wo koma mu no. Ɛnyɛ den sɛ oduruyɛfo a ne ho akokwaw betumi ahu sɛ wowɔ RBBB denam ECG nhyehyɛe yi a ɔbɛhwɛ so.

Nanso, oduruyɛfo no nnyae. Tebea afoforo pii wɔ hɔ a ebia ɛyɛ aniberesɛm kɛse a ɛkyerɛ ECG nhyehyɛe a ɛte sɛ RBBB. Enti oduruyɛfo no bɛhwɛ wo ECG no yiye ahwɛ ahu sɛ wunni saa tebea horow yi.

Tebea horow a ɛtete saa no bi ni:

• Ventricular Tachycardia: Tebea a emu yɛ den a koma no fã a ɛwɔ fam no bɔ ntɛmntɛm yiye.
• Brugada Syndrome: Awosu mu tebea bi a ebetumi ama koma no agyae mpofirim.
• Incomplete Left Bundle Branch Block: Nsɛnkyerɛnne kwan a ɛwɔ benkum so no siw a enni mũ, te sɛ nea ɛwɔ nifa so no ara pɛ.

Enti, sɛ wo ECG amanneɛbɔ ka sɛ RBBB mpo a, ɛsɛ sɛ oduruyɛfo a ɔhwɛ wo mu no de nsɛm a etwa to ne afotu a ɛfa ho ma.

So RBBB hia ayaresa?

Asɛmpa paa nso wɔ ha.

Ɛte sɛ awo agyiraehyɛde bi wɔ wo nipadua so. Ɛwɔ hɔ, nanso ɛnhaw wo. Ebia oduruyɛfo no bɛka akyerɛ wo sɛ bra mu pɛnkoro afe biara na yɛ ECG, na woahwɛ sɛ nsakrae bi aba anaa. Sɛ ɛnyɛ ɛno a, enhia sɛ wɔde nnuru anaa oprehyɛn foforo biara di dwuma.

Nanso, sɛ wowɔ RBBB esiane komayare foforo nti (te sɛ nea wɔabobɔ din wɔ nea ɛde ba ho kyerɛwtohɔ a ɛwɔ atifi hɔ no mu) a, ɛnde wɔnsa RBBB no. Wɔsa tebea a ɛhyɛ ase no. Sɛ nhwɛso no, sɛ wo koma ayɛ kɛse esiane mogya mmoroso nti na RBBB fi saa tebea yi mu a, ayaresa no ne sɛ wobɛhwɛ wo mogya mmoroso so. Sɛ komayare na ɛde ba a, ɛsɛ sɛ wokɔ so sa.

Dɛn ne obi a ɔwɔ RBBB daakye? So biribi wɔ hɔ a ɛsɛ sɛ yesuro?

Asɛmmisa yi ho mmuae gyina sɛ ebia wowɔ komayare afoforo anaasɛ wunni so. Momma yɛnhwɛ saa nsɛm abien no wɔ ɔkwan soronko so.

1. Sɛ wunni komayare foforo biara a (Anyɛ saa a, ɛyɛ apɔwmuden) .

Saa bere yi de, RBBB nyɛ biribiara a ɛsɛ sɛ ɛhaw yɛn ho. Ɛmma wo nkwa nna nyɛ tiaa anaasɛ ɛmma asiane a ɛwɔ hɔ sɛ wubenya komayare no nyɛ kɛse. Ɛyɛ ‘quirk’ ketewaa bi, anaasɛ ade soronko bi kɛkɛ, wɔ wo koma mu anyinam ahoɔden nhyehyɛe mu. Wubetumi akɔ w’asetra a ɛfata mu a ɔhaw biara nni ho.

2. Sɛ wowɔ komayare foforo (e.g. Koma a Ɛnyɛ Yiye, wɔ Koma Yare akyi) .

Wɔ tebea a ɛte saa mu no, RBBB yɛ biribi a ɛsɛ sɛ wosusuw ho. Eyi nkyerɛ sɛ wo tebea no asɛe esiane RBBB nti. Nanso, sɛ wowɔ RBBB a, ɛkyerɛ sɛ wo koma ayɛ basaa bi na ne dwumadi ayɛ mmerɛw kakra. Enti, sɛ wɔde RBBB ka komayare bi a ɛda adi te sɛ eyi ho a, asiane a ɛwɔ hɔ sɛ daakye nsɛnnennen bɛba daakye no betumi akɔ soro kakra.

Ɛno nti na ɛho hia kɛse sɛ ayarefo a wɔte saa no di ayaresa a wɔn duruyɛfo de ma wɔn komayare titiriw no akyi a sintɔ biara nni wɔn ho . Ɛsɛ sɛ wɔyɛ nneɛma te sɛ wɔn nnuru a wɔnom wɔ bere ano, wɔhwɛ wɔn aduan so, na wɔteɛteɛ wɔn apɔw mu yiye.

Sɛ wɔhyehyɛ RBBB pɛ a, ɛnkɔ. Ɛyɛ tebea a ɛtra hɔ daa.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn na mehwɛ yiye?

Sɛ wunim sɛ wowɔ RBBB a, ɛyɛ papa sɛ wo ne wo duruyɛfo bɛkɔ so adi nkitaho daa.

• Daa a wobɛkɔ akɔhwɛ: Sɛ mpo wunni ayaresa tebea foforo biara a, kɔ kɔhwɛ wo wɔ bere a wo duruyɛfo kamfo kyerɛ no mu (e.g. pɛnkoro afe biara). Sɛ wowɔ komayare afoforo a, hwɛ hu sɛ wobɛkɔ saa ayaresabea ahorow no.
• Nsɛnkyerɛnne foforo: Sɛ wunya sɛnkyerɛnne bi a na wunnya bi kan, te sɛ wo koko mu yaw, wo home tiaa, wo nan ho ahonhon, anaa wo totɔ piti a, kɔ oduruyɛfo nkyɛn ntɛm ara.
• Putupuru:Fa no sɛ wowɔ koko mu yaw a wuntumi nnyina ano, ɛyaw no hyerɛn kɔ wo nsa benkum, wo kɔn, anaa wo hwene mu, wo ho fifiri dɔɔso, na wote nka sɛ wo home yɛ den. Eyinom betumi ayɛ komayare ho sɛnkyerɛnne. Sɛ ɛba saa a, ntwentwɛn wo nan ase. Kɔ ayaresabea a ɛbɛn wo no Emergency Department (ETU) ntɛm ara.

Nsɛmmisa a ɛho hia a ɛsɛ sɛ wubisa wo duruyɛfo

Sɛ wo ECG amanneɛbɔ ka sɛ RBBB a, nsɛm yi a wubebisa bere a woakɔ wo duruyɛfo nkyɛn no betumi aboa wo ma woanya nsɛm a emu da hɔ kɛse.

• "Oduruyɛfo, so biribi pɔtee bi wɔ hɔ a enti mewɔ saa RBBB tebea yi?"
• "So ɛsɛ sɛ meyɛ nsakrae biara wɔ me da biara da asetra mu esiane eyi nti? Wɔ nneɛma te sɛ aduan, apɔw-mu-teɛteɛ, ne nea ɛkeka ho mu?"
• "Ɛnkyɛ dɛn na ɛsɛ sɛ mesan ba bɛhwɛ?"
• (Sɛ wowɔ komayare afoforo a) "So mewɔ asiane kɛse mu sɛ menya saa RBBB yi ne me komayare afoforo? Dɛn na ɛsɛ sɛ meyɛ de di so?"