Ma ke ʻano he makuahine a makua paha, ʻike mākou i kou hopohopo no kāu keiki. Ua manaʻo anei ʻoe i ka piʻi koke ʻana o ka puʻuwai o kāu keiki, a i ʻole e like me ka wikiwiki o ke kuʻi ʻana? A i ʻole ke manaʻo nei ʻoe e kuʻi ana kou puʻuwai i hoʻokahi manawa, a laila kū no kekahi manawa a laila hoʻomaka hou ke kuʻi (he kuʻi i haʻalele ʻia)? He mea maʻamau ka makaʻu ke ʻike ʻoe i kahi mea e like me kēia. Akā ma mua o ko mākou makaʻu ʻana, e makaʻala kākou i kēia. Ma ka ʻōlelo lapaʻau, kapa mākou i kēia ʻano he Arrhythmia.
I ka ʻōlelo maʻalahi, he aha kēia arrhythmia rhythm heart?
He mea maʻalahi loa ka arrhythmia. ʻO ia hoʻi ka loli o ke kuʻina o ko kākou puʻuwai. ʻO ka maʻamau, kuʻi like ko kākou puʻuwai, ma ke ʻano maʻamau. Ua like ia me nā lima o ka uaki e kani ana i ka wikiwiki like. ʻO ka mea e hana ʻia ana i ka arrhythmia, ʻo ia ka hele hewa ʻana o kēia kuʻina.
Aia kekahi mau mea e hiki ke hana ma ʻaneʻi:
- Hiki i ka puʻuwai ke kuʻi wikiwiki loa .
- E kuʻi mālie paha ka puʻuwai.
- Hiki ke loaʻa kahi kuʻi i hoʻokuʻu ʻia.
- Hiki ke loaʻa kahi puʻuwai hou aʻe .
Hiki i kēia maʻi ke hoʻopilikia i nā pākeke a me nā keiki ʻōpio. ʻO ka hapa nui o ka manawa, ʻaʻole ia he mea koʻikoʻi a ʻaʻole pono ka mālama ʻana. Eia nō naʻe, he mea nui e makaʻala i kēia, no ka mea, hiki i nā hihia kakaikahi loa ke lilo i mea koʻikoʻi.
No laila, pehea lā ke kuʻi ʻana o ko kākou puʻuwai?
I mea e hoʻomaopopo ai i kēia, pono kākou e ʻike iki e pili ana i ka ʻōnaehana uila kupaianaha i loko o ko kākou mau puʻuwai. E noʻonoʻo e like me ka ʻōnaehana kukui i loko o kou home. E like me ke kukui e hoʻā ana i ka wā e hoʻohuli ai ʻoe i ke kuapo, e paʻi ana ko kākou mau puʻuwai i ka wā e loaʻa ai nā hōʻailona uila.
Penei ke kaʻina hana:
1. ʻO ka hōʻailona mua: Hoʻomaka kēlā me kēia puʻuwai me kahi hui o nā cell ma ka atrium ʻākau o ko kākou puʻuwai. Kāhea mākou i kēia ʻo ka sinoatrial (SA) node . ʻO kēia ka 'pacemaker' maoli o ko kākou puʻuwai. Ua like ia me ke alakaʻi o kahi hui mele.
2. ʻO ka ʻūmiʻi ʻana o ke atrium: ʻO ka hōʻailona uila mai ke kikowaena SA ke kumu o ka ʻūmiʻi ʻana o nā keʻena ʻelua o luna o ka puʻuwai, ʻo ia hoʻi ka atria. A laila hoʻomoʻa ʻia ke koko i loko o kēlā mau keʻena i loko o nā keʻena ʻelua o lalo, ʻo ia hoʻi nā ventricles.
3. Ka hoʻoili ʻana o nā hōʻailona: A laila hele kēia hōʻailona uila i kahi hui ʻē aʻe o nā cell i kapa ʻia ʻo ka atrioventricular (AV) node . Ua like kēia me kahi uea e lawe ana i ka uila mai nā keʻena o luna a i nā keʻena o lalo.
4. ʻOki ʻana o ka puʻuwai: A laila hoʻouna ka node AV i kahi hōʻailona ʻē aʻe i nā keʻena ʻelua ma lalo, ʻo ia hoʻi nā ventricles. Hoʻoulu kēia hōʻailona i nā ventricles e ʻoki ikaika, e pamu ana i ke koko mai ka puʻuwai a i ke koena o ke kino.
5. Hoʻomaha a me ka hoʻomaka hou:ʻO ka hope loa, hoʻomaha nā ʻāpana ʻelua. I ka manawa like, hiki mai kahi hōʻailona hou mai ka node SA, a hoʻomaka kahi puʻuwai hou.
Ke hana pono ʻia kēia kaʻina hana, pololei ka helu o ko kākou puʻuwai a me ke ʻano o ka puʻuwai. Akā inā no kekahi kumu ua hoʻopilikia ʻia kēia ʻōnaehana uila, a laila hana ʻia kahi arrhythmia.
He maʻi maʻamau ka arrhythmia i waena o nā keiki. I ka hapa nui o ka manawa, ʻaʻohe mea ʻino kēia mau mea. Eia nō naʻe, ʻaʻole hiki ke lilo i mea koʻikoʻi, no laila he mea nui e makaʻala i nā hōʻailona ʻē.
He aha nā ʻano arrhythmias e kū mai ana i nā keiki?
Aia kekahi mau ʻano arrhythmia e kū mai ana i nā pākeke a me nā keiki. E hoʻokaʻawale kākou iā lākou e like me kēia no ka maʻalahi o ka hoʻomaopopo ʻana.
| ʻAno o ka arrhythmia | He wehewehe maʻalahi |
|---|---|
| Nā ʻano e hoʻomaka ana ma nā keʻena o luna o ka puʻuwai (atria) (Supraventricular Tachycardia - SVT) | |
| ʻO ka tachycardia reentrant AV nodal a me ka tachycardia reentrant Orthodromic | ʻO kēia ke ʻano maʻamau o SVT i ʻike ʻia i nā keiki. E noʻonoʻo e like me ka hoʻohuli ʻana i ke kukui a me ke pio ʻana, kahi e wikiwiki koke ai ka puʻuwai a laila hoʻi i ka maʻamau. Hiki nō hoʻi kēia i nā keiki me ke ʻano i kapa ʻia ʻo Wolff-Parkinson-White syndrome , i hana ʻia e kahi pilina uila keu ma waena o nā keʻena o luna a me lalo o ka puʻuwai. |
| ʻO ka haʻalulu o ke atrium | Ma kēia, ʻoiai ke kuʻi wikiwiki nei ka puʻuwai, hana ʻia ia ma kahi ʻano paʻa a like. |
| ʻO ka fibrillation atrial | I kēia, ʻoi aku ka wikiwiki o ka puʻuwai a ma ke ʻano haunaele a ʻano ʻē. Eia nō naʻe, he mea kakaikahi loa kēia i nā keiki. |
| Nā ʻūmiʻi atrial mua (PACs) | ʻO kēia ka manawa e loaʻa ai kahi kuʻi hou ma mua o ka puʻuwai maʻamau. Manaʻo paha ʻoe ua hala ʻoe i kahi kuʻi a i ʻole he kuʻi hou kāu. |
| Nā ʻano e hoʻomaka ana ma nā keʻena haʻahaʻa (nā cell) o ka puʻuwai | |
| Nā ʻūmiʻi ventricular mua (PVCs) | Ua like kēia me ma mua, akā hoʻomaka kēia kuʻi keu ma nā keʻena haʻahaʻa (nā cell) o ka puʻuwai. |
| ʻO ka tachycardia ventricular (V-tach) | He kūlana koʻikoʻi kēia kahi e kuʻi wikiwiki ai ka puʻuwai ma muli o nā hōʻailona uila e puka mai ana mai nā keʻena haʻahaʻa o ka puʻuwai. |
| ʻO ka fibrillation ventricular | He kūlana weliweli loa kēia. I kēia hihia, ʻaʻole e ʻūlū pono nā keʻena haʻahaʻa o ka puʻuwai, akā e haʻalulu wale. Pale kēia i ke koko mai ka pamu ʻia ʻana a puni ke kino. |
| Nā ʻano ʻē aʻe | |
| ʻO Bradycardia | ʻO ke ʻano kēia, lohi ka helu o ka puʻuwai. I ka hapa nui o ka manawa, ʻaʻole kēia he mea weliweli, ʻoiai inā ʻaʻohe hōʻailona o ke keiki. |
| Poloka puʻuwai | ʻO ka mea e hana ʻia ana ma kēia, ʻo ia ka hoʻopaneʻe ʻia ʻana a i ʻole ka ālai loa ʻia ʻana o ka hōʻailona uila e hele ana mai nā keʻena o luna o ka puʻuwai a i nā keʻena o lalo. |
| ʻO ka maʻi sinus maʻi | ʻO kēia ka manawa e hana pono ʻole ai ka pacemaker kūlohelohe o ka puʻuwai, ʻo ia hoʻi ka SA node. Eia naʻe, ʻaʻole ʻike ʻia kēia i nā keiki ʻē aʻe, koe wale nō nā keiki me ka maʻi puʻuwai hānau. |
He mea maʻamau ka Sinus Arrhythmia i nā keiki?
ʻAe. ʻOiai paha e kani weliweli paha ka inoa, ʻaʻole maoli ka Sinus Arrhythmia he arrhythmia. He kūlana maʻamau a olakino hoʻi ia. Loaʻa i kēlā me kēia keiki.
ʻO kēia ka manawa e piʻi iki ai ka puʻuwai o ka pēpē i ka wā e hanu ai lākou a emi iki i ka wā e hanu ai lākou. ʻAʻole kēia e hōʻike i kekahi mau hōʻailona a ʻaʻole pono ka lāʻau lapaʻau. ʻO ka ʻoiaʻiʻo, he hōʻailona ia e olakino maikaʻi ana ka puʻuwai o ka pēpē.
He aha nā hōʻailona o ka arrhythmia i loko o kahi keiki?
Hiki ke ʻokoʻa loa nā hōʻailona ma muli o ke ʻano o ka arrhythmia i loaʻa i kāu keiki. ʻAʻole paha e hōʻike iki kekahi mau keiki i kekahi mau hōʻailona. Eia nō naʻe, inā ʻike ʻoe i kēia mau mea i kāu keiki, e hoʻolohe pono.
- Inā ʻoe e kamaʻilio e pili ana i ka ʻeha o ka umauma .
- Ka paʻakikī i ka ʻai ʻana a me ka hānai waiū . ʻO kēia wale nō ka hōʻailona e ʻike ai kahi pēpē hānau hou.
- Ka poniuniu, ka māmā o ke poʻo, a i ʻole ka nāwaliwali (syncope) .
- Inā ʻoe e manaʻo ua luhi loa a nāwaliwali paha .
- Inā ʻōlelo ʻoe ke manaʻo nei ʻoe e kuʻi ana kou puʻuwai , e manaʻo paha ʻoe e like me kahi pulelehua e lele ana i loko o kou umauma, a i ʻole e holo wikiwiki ana kou puʻuwai (palpitations).
- Ke hopohopo mau nei a me ka huhū . ʻO nā keiki ʻōpio hiki ʻole ke hōʻike i ko lākou mau manaʻo e hana paha lākou ma kēia ʻano.
- Ka paʻakikī o ka hanu ʻana (dyspnea) .
I ka liʻiliʻi loa, ʻo ka hōʻailona mua paha he hopu ʻana, nalowale ka ʻike, a i ʻole ka make koke ʻana o ka puʻuwai. No laila, inā loaʻa kekahi mea koʻikoʻi e like me kēia , e lawe koke i kāu keiki i ka keʻena pilikia o ka haukapila (ETU) .
He aha nā kumu o ka arrhythmia i nā keiki?
ʻO ka hapa nui o ka manawa, ʻaʻohe pilikia ʻē aʻe o nā keiki me nā kūlana e like me SVT me ko lākou mau puʻuwai. Eia nō naʻe, aia kekahi mau kumu e hiki ke kōkua i ka hoʻomohala ʻana o nā ʻano arrhythmia ʻē aʻe.
- Cardiomyopathy: ʻO kēia ke ʻano e lilo ai ka puʻuwai puʻuwai i mānoanoa, hoʻonui ʻia, a paʻakikī paha.
- Nā kūlana hoʻoilina: No ka laʻana, nā kūlana e like me ka lōʻihi o ka QT syndrome (kahi kūlana e lōʻihi ai ka manawa e hoʻouka hou ai i ka ʻōnaehana uila o ka puʻuwai).
- Kekahi mau lāʻau lapaʻau: Kekahi mau lāʻau lapaʻau, ʻoi aku hoʻi nā mea i hāʻawi ʻia i nā keiki ma nā keʻena mālama koʻikoʻi.
- Maʻi puʻuwai hānau: Kekahi mau ʻano ʻē i loko o ka puʻuwai i loaʻa i ka wā hānau .
- Nā kūlike ʻole o nā kemika i loko o ke kino: Hoʻonui a emi paha i nā mea e like me nā electrolytes i loko o ke koko.
- Nā kumu ʻē aʻe: kuni, maloʻo ka wai, ke kaumaha, ka hiamoe ʻole, a i ʻole nā kūlana mumū i loko o ke kino.
- Nā maʻi: Nā maʻi viral a bacteria paha.
Pehea e ʻike pololei ai ke kauka i kēia maʻi?
ʻO ka hapa nui o ka manawa, ʻike ʻia kēia ke hana ke kauka i kahi nānā maʻamau i ke keiki. A i ʻole, ke haʻi aku ʻoe iā ia e pili ana i nā hōʻailona o kāu keiki, kānalua ke kauka a kuhikuhi iā ia no nā hoʻokolohua.
ʻO ka maʻamau, e hoʻolohe kahi pediatrician a i ʻole ke kauka puʻuwai pediatric i ka mōʻaukala olakino o ke keiki a me ka ʻohana, e hoʻolohe i ka puʻuwai o ke keiki, a laila e hana i nā hoʻokolohua e like me kēia inā pono.
- Nā hoʻāʻo koko: E nānā no nā lāʻau lapaʻau, nā maʻi, a i ʻole nā kemika kaulike ʻole.
- Echocardiogram (Echocardiogram - echo): Ua like kēia me ke scan o ka puʻuwai. Hoʻohana ia i nā nalu kani e nānā i ke ʻano a me ka hana o ka puʻuwai me nā kikoʻī.
- Electrocardiogram (ECG): He hoʻāʻo maʻalahi loa kēia a ʻeha ʻole. Hoʻokomo ʻia nā electrodes liʻiliʻi ma ka umauma o ke keiki e hoʻopaʻa i ka hana uila o ka puʻuwai. Hiki ke noi ʻia ke keiki e hele wāwae a holo paikikala paha no kēia hoʻāʻo.
- Haʻawina Electrophysiologic (EPS): Ma kēia, hoʻokomo ke kauka i kahi ʻōmole lahilahi loa ma o kahi kīʻaha koko ma ka lima a i ʻole ka wāwae o ke keiki i loko o ka puʻuwai a nānā pono i kahi e puka mai ai ka hōʻailona uila kūpono ʻole.
- Nānā Holter: He mea liʻiliʻi kēia e nānā ana i ka hana o ka puʻuwai o ke keiki no 24 mau hola a i ʻole kekahi mau lā. Hiki i ke keiki ke komo iā ia a hana i kā lākou mau hana o kēlā me kēia lā e like me ka maʻamau.
Inā ʻaʻole i maopopo loa kēia mau hoʻokolohua, hiki i ke kauka ke ʻōlelo aku e hoʻohana i kahi mea i kapa ʻia he loop recorder , kahi i hoʻokomo ʻia ma kahi ʻoki liʻiliʻi ma lalo o ka ʻili o ka umauma o ke keiki.
He aha nā lāʻau lapaʻau e hāʻawi ʻia i nā keiki?
ʻAʻole pono kekahi lāʻau lapaʻau i kekahi mau arrhythmias. E haʻi aku ke kauka iā ʻoe e nānā i ka helu o ka puʻuwai o ke keiki i kēlā me kēia manawa.
I nā hihia ʻē aʻe, mālama ʻia ke kūlana kumu e hoʻokumu ai i ka arrhythmia. No ka laʻana, inā he maʻi ia, hāʻawi ʻia nā antibiotics. Inā he kūlike ʻole kemika, hāʻawi ʻia ka lāʻau lapaʻau e hoʻoponopono iā ia.
Hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau e like me nā beta-blockers a i ʻole nā blockers kahawai calcium e kaohi i kou helu puʻuwai.
No ke keiki me ke kūlana koʻikoʻi, pono paha kēia mau ʻano lāʻau lapaʻau:
- Ablation: Ma kēia, hāʻawi ʻia ka wela a i ʻole ka ikehu i ka ʻiʻo o ka puʻuwai kahi e hoʻomaka ai ka arrhythmia, e pale ana i ka hōʻailona maʻamau mai ka hiki ʻana mai.
- Cardioversion: He kaʻina hana kēia e hoʻoponopono ai i kahi ʻano kuʻuna ʻole ma ka hāʻawi ʻana i kahi haʻalulu uila i ka puʻuwai. Hiki ke hana ʻia me ka lāʻau lapaʻau.
- Nā mea hana i hoʻokomo ʻia: Hoʻokomo ʻia kahi mea hana, e like me ka pacemaker a i ʻole ka implantable cardioverter defibrillator (ICD) , ma lalo o ka ʻili a hāʻawi i nā hōʻailona uila a i ʻole nā haʻalulu e kaohi i nā mele kūpono ʻole.
- ʻO ke ʻoki maze: Hana ke kauka ʻoki i nā ʻoki liʻiliʻi a i ʻole nā wela i loko o ka ʻiʻo puʻuwai e hoʻōki i nā hōʻailona uila maʻamau mai ka hele ʻana.
Pehea lā ka wā e hiki mai ana no ke keiki me kēia maʻi?
Pili nui kēia i ke ʻano o ka arrhythmia i loaʻa i ke keiki. ʻO ka hapa nui o nā arrhythmias i nā keiki he mea ʻino ʻole a ʻaʻohe hopena olakino lōʻihi. E ulu aʻe kekahi mau keiki i ke kūlana i ko lākou wā ʻelemakule. Hiki i kekahi ke hoʻomau i ka loaʻa ʻana o nā arrhythmias akā hiki ke ola i kahi ola maʻamau me ka ʻole o ka lāʻau lapaʻau.
Hiki ke mālama pono ʻia nā ʻano arrhythmia koʻikoʻi me nā lāʻau lapaʻau holomua i loaʻa i kēia lā.
Eia nō naʻe, he mea kakaikahi loa, inā waiho ʻole ʻia kahi arrhythmia koʻikoʻi me ka mālama ʻole ʻia, hiki iā ia ke alakaʻi i nā hopena koʻikoʻi e like me:
- Nā ʻūpā koko . Inā hele kēia mau mea i ka lolo, hiki iā lākou ke hana i ka hahau ʻana.
- Ka hāʻule ʻana o ka puʻuwai .
- Ka hōʻino ʻana i nā ʻōpū (e like me ka lolo, nā puʻupaʻa, nā māmā).
- Make koke ʻana o ka puʻuwai .
Aia kekahi mea hiki iaʻu ke hana ma ka home ke ʻike ʻia nā hōʻailona?
ʻAe. Inā loaʻa i kāu keiki nā hōʻailona e like me ka wikiwiki o ka puʻuwai, hiki iā ʻoe ke hoʻāʻo i kēia mau mea maʻalahi ma mua o ka ʻike ʻana i ke kauka. Ua kapa ʻia kēia mau mea ʻo 'vagal maneuvers'.
- E haʻi iā lākou e ʻū me ka leo nui a i ʻole e hoʻohālike e like me ka luaʻi .
- E kau i kahi ʻeke hau a i ʻole kahi lole i hoʻomoʻa ʻia i ka wai anuanu ma luna o ka maka o ke keiki.
- E hoʻāʻo i ka hana Valsalva: E noi i ke keiki e pani i ko lākou ihu a me ka waha a ʻomi me he mea lā e hanu ana i waho.
Hiki i kēia mau mea ke kōkua i ka kaohi ʻana i ka puʻuwai wikiwiki. Akā, he mau hopena manawa pōkole wale nō kēia. Inā hoʻomau nā hōʻailona a i ʻole pilikia kāu keiki, e ʻike pono i ke kauka.
Leka Lawe-Home
- He mea maʻamau ka arrhythmia (ka puʻuwai kūpono ʻole) i nā keiki. I ka hapanui o nā hihia, ʻaʻohe mea ʻino.
- E makaʻala i nā hōʻailona e like me ka wikiwiki koke o ka puʻuwai o kāu pēpē, ka lohi ʻana, ka ʻeha o ka umauma, ka poniuniu, a me ka paʻakikī i ka hānai waiū.
- He hōʻailona olakino ka Sinus Arrhythmia , ʻaʻole ia he maʻi. Mai makaʻu iā ia.
- Inā he kānalua a makaʻu paha kāu, ʻo ka mea maikaʻi loa e hana ai, ʻo ia ke kūkākūkā me ke kauka keiki.
- Inā ʻike ʻoe i nā hōʻailona koʻikoʻi (nalowale ka ʻike, nā hopu ʻana, paʻakikī nui ka hanu ʻana), e hele koke i ka Emergency Treatment Unit (ETU) o ka haukapila.
- Hiki ke mālama pono ʻia a kāohi ʻia ka hapa nui o nā maʻi arrhythmia. No laila, mai hopohopo a hahai i nā ʻōlelo aʻoaʻo lapaʻau kūpono.
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