So wo koma mu anyinam ahoɔden nsɛnkyerɛnne ntumi nyɛ adwuma yiye? Momma yɛnka Trifascicular Block ho asɛm!

So woasusuw sɛnea wo koma yɛ adwuma ma ɛyɛ nwonwa no ho pɛn? Ɛte sɛ anyinam ahoɔden nhyehyɛe ketewaa bi, a ɛde anyinam ahoɔden nsɛnkyerɛnne kɔ koma no afã horow ma ɛkɔ so bɔ yiye. Nanso ɛtɔ mmere bi a, ntwitwiridii nketenkete betumi aba akwan a anyinam ahoɔden nsɛnkyerɛnne yi fa so no mu. Ɛno ne bere a yɛka "Heart Block" ho asɛm. Ɛnnɛ yɛbɛka koma mu yare pɔtee bi a wɔfrɛ no trifascicular block ho asɛm.

Dɛn ne saa fascicles yi wɔ koma no mu? Ɛhe na wɔwɔ?

Okay, afei momma yɛnhwɛ nea saa "fascicles" yi yɛ. Sɛ yɛbɛka no tiawa a, eyinom yɛ ntini mu nhama soronko a wɔde anyinam ahoɔden nkrasɛm kɔ koma no mu. Wɔsan frɛ eyinom "bundle branches." Eyinom wɔ koma no ase adan abien a ɛne "ventricles" no mu. Saa ntini ahorow yi ne nea ɛde anyinam ahoɔden nsɛnkyerɛnne kɔ ntɛmntɛm, na ɛma koma no mu adan no twetwe yiye na ɛbɔ mogya.

Sɛnea wunim no, yɛn koma ne akwaa titiriw a ɛma mogya fa nipadua no mu. Ɛwɔ adan atitiriw anan:

• Atria: Pia abien a ɛwɔ soro no.
• Ventricles: Nkwammoaa abien a ɛwɔ fam no. Trifascicular block ka saa adan abien a ɛwɔ fam yi.

Afei ma yɛnhwɛ fascicles a ɛwɔ saa adan abien a ɛwɔ fam yi mu:

• Right Ventricle: Eyi ne ɔdan a ɛwɔ fam a ɛwɔ koma no nifa so no. Efi ha no, wɔde mogya fa Ahurututu mu Ntini no mu kɔ ahurututu no mu ma ɛgye mframa pa. Ventricle nifa no wɔ fascicle biako pɛ. Wɔfrɛ no Right Bundle Branch .
• Benkum Ventricle: Eyi ne dan a ɛwɔ fam a ɛwɔ koma no benkum so. Ɛde mogya a oxygen wom fa aorta no mu kɔ nipadua no fã a aka no mu. Benkum so ahurututu no ne dan a ɛsõ na ahoɔden wom sen biara a wɔde pɔmpɛ gu mu wɔ koma no mu. Ɛwɔ ntini abien, Benkum Anim Fascicle ne Benkum Akyi Fascicle . Saa baanu yi nyinaa bom yɛ Benkum Baa Dwumadibea no . Saa fascicles yi mu kyekyɛ kɔ so yɛ nhama nketewa ɔpepem pii a wɔfrɛ no Purkinje Fibers.

Susuw ho saa kwan yi so, saa fascicles yi te sɛ anyinam ahoɔden nhama a ɛwɔ ofie mu. Sɛ wodan switch no (i.e., bere a sɛnkyerɛnne no du koma no mu) a, anyinam ahoɔden sen fa nhama yi so na ɛsɔ kanea no (i.e., koma no ntini no twetwe). Enti sɛ biribi twa nhama yi mu wɔ baabi a, dɛn na ɛba? Wiɛ, ɛno ne nea ɛkɔ so wɔ komayare mu.

Ɔkwan bɛn so na wɔkyekyɛ Koma mu Nneɛma mu?

Nnuruyɛfo kyekyɛ komayare yi, anaa "AV Blocks" mu gu ahorow atitiriw abiɛsa a egyina sɛnea emu yɛ den so:

1. First-degree Block: Eyi yɛ anyinam ahoɔden nsɛnkyerɛnne a efi atria kɔ ventricles no mu a ɛkyɛ kakra. Eyi yɛ ``Blockage a enni mũ``Enti, mpɛn pii no, yare no ho sɛnkyerɛnne biara nni hɔ na ɛho nhia sɛ wɔsa yare.

2. Second-degree Block: Wɔ eyi mu no, anyinam ahoɔden nsɛnkyerɛnne bi kɔ nkwammoaa no mu, nanso ebinom nkɔ. Eyi nso yɛ block a enni mũ. Eyi betumi ama koma no bɔ brɛoo, na wɔfrɛ no "bradycardia." Anaasɛ koma no bɔ betumi ayɛ nea ɛnkɔ so daa, na wɔfrɛ no "arrhythmia." Sɛ saa block a ɛto so abien yi kɔ so kodu nea ɛto so abiɛsa a, ebia ɛho behia sɛ wɔsa yare.

3. Third-degree Block: Eyi yɛ blockage koraa . Wɔmfa anyinam ahoɔden nsɛnkyerɛnne biara mfi atria no mu nkɔ ventricles no mu. AV node, His no bundle, anaa ventricles no ankasa na ɛhwɛ koma no nnyigyei so. Eyi ma koma no bɔ brɛoo kɛse. Eyi betumi de nkwa ato asiane mu, enti ayaresa ho hia ntɛm ara.

Enti dɛn ankasa ne Trifascicular Block?

Asɛmfua "tri" kyerɛ abiɛsa. Enti, wɔ trifascicular block mu no, blockage wɔ mmeae abiɛsa wɔ koma no conduction system no mu, wɔ "AV Node" ase.

Sɛ yɛbɛka no tiawa a, trifascicular block yɛ ɔhaw a ɛwɔ anyinam ahoɔden nsɛnkyerɛnne a ɛwɔ nifa bundle nkorabata ne benkum bundle nkorabata no nyinaa mu (kyerɛ sɛ, benkum anim ne benkum akyi fascicles nyinaa). Wobu eyi nso sɛ ɛyɛ koma a esiw koraa . ( Sɛ biribi asiw wɔ nifa bundle nkorabata ne benkum fascicle no biako pɛ mu a, wɔfrɛ no "bifascicular block.")

Ɛno kyerɛ sɛ, obi a ɔwɔ trifascicular block no wɔ tebea abien yi nyinaa:

• Right Bundle Branch Block: Wɔ eyi mu no, anyinam ahoɔden sɛnkyerɛnne a efi nifa fascicle kɔ benkum bundle branch no yɛ brɛoo.
• Benkum Bundle Branch Block: Eyi ne bere a anyinam ahoɔden sɛnkyerɛnne no fa benkum so ahurututu no mu brɛoo paa. Wɔ trifascicular block mu no, blockage no ka benkum anim ne benkum akyi fascicles no nyinaa.

Susuw nea ɛba kar so bere a wɔato akwan akɛse abiɛsa mu prɛko pɛ no ho hwɛ. Saa ara na ɛto nkrasɛm a ɛwɔ koma no mu no.

Saa komayare yi abu so dɛn?

Abenfo ka sɛ nnipa 10 biara a wɔadi boro mfe 70 a wɔanya komayare ho abakɔsɛm no mu biako benya komayare a ɛto so abiɛsa wɔ wɔn asetra mu bere bi.

Dɛn ne nneɛma a ɛde trifascicular block ba?

Asiane a ɛwɔ hɔ sɛ obi benya komayare biara no kɔ soro bere a obi nyin no. Ɛtɔ mmere bi a, saa akwanside ahorow yi betumi aba a ntease biara nnim. Ebetumi nso afi komayare a wonya fi awo mu na ɛde aba.

Nanso, mpɛn pii no, koma no a ɛsɛe na ɛde trifascicular block ba. Nneɛma te sɛ:

• Coronary Ntini mu Yare
• Koma a ɛtrɛw (Hypertrophic Cardiomyopathy) .
• Koma mu Nyarewa
• Koma Nyarewa Afoforo
• Koma mu Valve Yare
• Potassium dodow a ɛkɔ soro wɔ mogya mu (Hyperkalemia) .
• Koma Oprehyɛn a Ɛnyɛ Nneɛma Kɛse anaa Koma Oprehyɛn a Wɔbue Mu
• Vagus Nnerve Dwumadi a Ɛboro So
• Atiridiinini a Ɛma Ntini Mu
• Sarcoidosis (yare bi a nkwammoaa nketenkete a ɛma ɔhyew boaboa ano wɔ nipadua no afã horow) .

Dɛn ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ obi anya trifascicular block?

Mpɛn pii no, koma a ɛyɛ mmerɛw (nea edi kan anaa nea ɛto so abien) no mfa sɛnkyerɛnne biara mma. Nanso, sɛ wɔde trifascicular block di dwuma a, ɛka bundle nkorabata abiɛsa no nyinaa, enti ɛda adi sɛ sɛnkyerɛnne ahorow no bɛba. Ebia wubehyia:

• Koko mu yaw anaasɛ ɛyɛ den (Angina) .
• Atirimɔdensɛm ne Ɔtotɔ piti (Syncope) .
• Ɔbrɛ
• Koma a ɛbɔ (sɛ wote nka sɛ wo koma rebɔ ntɛmntɛm anaasɛ worehuruw abɔ) .
• Abofono
• Ɔhome a Ɛyɛ Tiaa

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa a, mmu w’ani ngu so. Ɛho hia sɛ wokɔ oduruyɛfo nkyɛn kɔhwehwɛ afotu.

Dɛn ne nsɛnnennen a ebetumi aba wɔ trifascicular block mu?

Koma a esiw no ma ɛyɛ den ma koma no sɛ ɛbɛfa mogya akɔ nipadua no nyinaa mu. Eyi betumi de nsɛnnennen a ɛde nkwa to asiane mu te sɛ:

• Koma a ɛbɔ daa (Arrhythmia) .
• Koma a Ɛyare
• Koma a Ɛnyɛ Den
• Koma mu Owu Mpofirim (Owu a efi komayare a ɛba mpofirim mu) `(Koma mu Owu a ɛba mpofirim / Koma a ɛtwetwe mpofirim)`

Esiane sɛ eyinom yɛ tebea horow a emu yɛ den nti, yɛka sɛ ɛho hia yiye sɛ yɛhwehwɛ komayare te sɛ eyinom ho ayaresa ntɛm.

Ɔkwan bɛn so na wohu Trifascicular Block?

Nnuruyɛfo de sɔhwɛ bi a wɔfrɛ no "electrocardiogram" di dwuma de hu nsakrae a ɛba koma no anyinam ahoɔden nhyehyɛe mu. Wɔsan frɛ eyi ECG (E.C.G.) tiawa. Nnipa binom nso frɛ no EKG (E.K.G.).

Saa ECG sɔhwɛ yi susuw anyinam ahoɔden a ɛwɔ koma no mu. Ɛsan nso susuw bere tenten a egye ansa na anyinam ahoɔden nsɛnkyerɛnne afa koma no mu. Ɛkyerɛ bere a egye ansa na koma no mu adan anan no nyinaa atumi ayɛ adwuma.

ECG yɛ nhwehwɛmu a ɛnyɛ yaw, a ɛnyɛ nea wɔde hyɛ nipadua mu.Egye bɛyɛ simma 15. Wɔ eyi mu no, wɔde "electrodes" nketewa a ɛte sɛ patch abata wo moma so, wo nsa, ne wo nan ho. Wɔde nhama na ɛde saa electrode ahorow yi bata ECG afiri bi ho. Saa afiri yi kyerɛw wo koma anyinam ahoɔden dwumadi sɛ graph. (ECG no mfa anyinam ahoɔden nkɔ wo nipadua mu, enti mma ɛno ho nhaw wo.)

Ɔkwan bɛn so na wɔsa trifascicular block yare?

Ɛsɛ sɛ wɔyɛ nnipa pii a wɔwɔ trifascicular block no oprehyɛn de afiri bi hyɛ wɔn koma mu na ama wɔatumi ahwɛ wɔn koma no so.

• Pacemaker: Eyi de anyinam ahoɔden nsɛnkyerɛnne kɔ koma no mu, na ɛma koma no mu adan no bɔ denneennen. Ɛte sɛ nea wode "push" kakra ma koma no fi abɔnten.
• Mfiri bi a wɔfrɛ no "Implantable Cardioverter Defibrillators (ICDs)" nso yɛ adwuma te sɛ nea ɛma koma no bɔ kɛse. Nea ɛka ho no, sɛ asiane wɔ hɔ sɛ koma no bɛtɔ mpofirim a, saa ICD ahorow yi de anyinam ahoɔden kɔ koma no mu ma ɛsan bɔ sɛnea ɛsɛ.

Oduruyɛfo no bɛhwehwɛ wo mu na wakyerɛ ayaresa ko a ɛfata wo.

So wobetumi asiw trifascicular block ano?

Bere a yentumi nni nneɛma bi a ɛde ba no so no, nneɛma bi wɔ hɔ a yebetumi ayɛ de abɔ yɛn koma akwahosan ho ban. Eyinom betumi aboa ma asiane a ɛwɔ tebea horow te sɛ trifascicular block mu no so atew:

• Di aduan a ahoɔden wom na teɛteɛ w’apɔw mu daa.
• To nsa a wonom ano hye.
• Hwehwɛ akwan pa a wobɛfa so adi adwennwen ho dwuma .
• Tew wo mu duru so (sɛ ɛho hia a) na kura mu duru a ɛfata mu.
• Di tebea horow a ɛde ɔhaw ba koma no so, te sɛ mogya mmoroso, asikreyare, ne srade a ɛdɔɔso ho dwuma.
• Srɛ mmoa na ama woagyae sigaretnom na woakwati sigaretnom.

Ɛwom sɛ ebia ɛbɛyɛ den kakra sɛ wode saa nneɛma yi bɛka w’asetra kwan ho mfiase no de, nanso ɛbɛboa wo koma bere tenten.

Tebea bɛn na nnipa a wɔwɔ Trifascicular Heart Blocks wɔ?

Sɛ wɔsa wɔn yare yiye a, nnipa dodow no ara a wɔwɔ koma a ɛyɛ trifascicular no nnya nkɔso nkɔ koma a ɛyɛ den koraa. Sɛ wɔannya koma a ɛwɔ trifascicular heart block no ho yare a, asiane no kɔ soro. Eyi betumi ama koma a ɛbɔ a ɛnteɛ (arrhythmia), a ɛda adi sɛ ɛbɛma obi awu sen koma a esiw. Ayaresa a ɛfata – mpɛn pii no wɔde afiri te sɛ pacemaker – betumi aboa ma asiane yi so atew.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ saa sɛnkyerɛnne yi bi a, hwɛ hu sɛ wobɛkɔ oduruyɛfo nkyɛn:

• Sɛ wote nka sɛ woabrɛ paa a.
• Sɛ wote nka sɛ wo koma bɔ ntɛmntɛm a.
• Sɛ wowɔ koko mu yaw a emu yɛ den a.
• Sɛ ɛyɛ den ma wo sɛ wobɛhome a.
• Sɛ wowɔ komayare ho sɛnkyerɛnne (sɛ nhwɛso no, wo koko mu yaw a emu yɛ den a ɛhyerɛn kɔ wo nsa so, wo hwene mu yaw, fifiri).
• Sɛ akisikuru a wontumi nkyerɛkyerɛ mu wɔ hɔ a.

Sɛ wowɔ eyinom mu biara a, nsusuw kɛkɛ sɛ, "Eyi yɛ asɛm a ɛbae ara kwa." Hwehwɛ nnuruyɛfo afotu ntɛm ara.

Dɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Sɛ wohu sɛ wowɔ trifascicular block a, ebia wobɛpɛ sɛ wubisa wo duruyɛfo nsɛm te sɛ:

• Dɛn na ɛmaa minyaa saa trifascicular block yi?
• Mɛyɛ dɛn atumi atew asiane a ɛwɔ hɔ sɛ menya komayare anaa komayare foforo so?
• So mihia afiri a ɛma me koma bɔ kɛse anaa ICD?
• Asiane bɛn na ɛwɔ mu sɛ wɔde afiri a ɛma koma no bɔ anaa ICD bɛhyɛ obi mu?
• So ɛsɛ sɛ mehaw me ho wɔ nsɛnnennen ho sɛnkyerɛnne ahorow ho?

Saa nsɛm yi a wubebisa no bɛboa wo ma woate wo tebea no ase yiye na wode wo ho ahyɛ ayaresa mu.

Nneɛma a ɛho hia sen biara a ɛsɛ sɛ wokae (Take-Home Message) .

Trifascicular heart block yɛ akwan titiriw abiɛsa a ɛde anyinam ahoɔden nsɛnkyerɛnne fa koma no mu no nyinaa siw. Eyi mma koma no ntumi ntwe mogya na ɛmfa mogya nkɔ. Koma a ɛyɛ den a ɛto so abiɛsa, anaasɛ ɛyɛ nea edi mũ betumi ama koma a ɛbɔ a ɛnteɛ (arrhythmias) anaasɛ koma no awu mpofirim mpo a ɛde ne nkwa to asiane mu.

Nnipa a wɔadi boro mfe 70 ne wɔn a wɔwɔ komayare no wɔ asiane kɛse mu. ECG tumi hu ɔhaw ahorow a ɛwɔ koma no anyinam ahoɔden nhyehyɛe mu. Ebia wo duruyɛfo bɛkamfo afiri bi te sɛ afiri a ɛma koma no bɔ anaa ICD akyerɛ wo. Saa mfiri yi de anyinam ahoɔden nsɛnkyerɛnne kɔ koma no dan mu ma ɛbɔ denneennen.

Hwɛ wo koma so yiye. Sɛ wote nka sɛ biribi yɛ soronko a, mmu w’ani ngu so. Sɛ wohwehwɛ aduruyɛ mu afotu ntɛm a, ebetumi agye wo nkwa.

` Trifascicular block, koma block, anyinam ahoɔden nhyehyɛe a ɛwɔ koma no mu, ECG, pacemaker, komayare, koma a ɛbɔ