Ke kānalua ʻoe, ua hoʻomaka koke anei kou puʻuwai e kuʻi wikiwiki a wikiwiki hoʻi, me he mea lā e holo ana? A i ʻole ke manaʻo nei ʻoe i kahi mea ʻē, e like me ke kani ʻana i loko o kou umauma? Nui ka poʻe i ʻike i kēia. ʻO ka inoa lapaʻau no kēia ʻo Atrial Tachycardia. Mai makaʻu i kou lohe ʻana i ka inoa. ʻAʻole kēia he kūlana weliweli. I kēia lā, e kamaʻilio maʻalahi mākou e pili ana i kēia, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.
I ka ʻōlelo maʻalahi, he aha ka Atrial Tachycardia?
Ua like ko kākou puʻuwai me kahi hale liʻiliʻi me ʻehā lumi. ʻElua lumi luna a ʻelua lumi haʻahaʻa. Kāhea mākou i kēia mau lumi ʻelua o luna ʻo ka atria. ʻO ka maʻamau, he ʻōnaehana uila ko ko kākou puʻuwai. Kuʻi ka puʻuwai ma ke ʻano maʻamau e like me nā hōʻailona e puka mai ana mai kēia ʻōnaehana.
ʻO ka Atrial Tachycardia ka wā e hoʻomaka ai nā keʻena ʻelua o luna o ka puʻuwai, ʻo ia hoʻi ka atria, e kuʻi wikiwiki loa ma mua o ka maʻamau. ʻO ka puʻuwai, ka mea maʻamau e kuʻi 60-100 manawa i kēlā me kēia minuke, hiki i kēia manawa ke kuʻi wikiwiki e like me 100 a 250 manawa i kēlā me kēia minuke. E noʻonoʻo i kēlā wikiwiki! He ʻano ʻē kēia o ka puʻuwai, kahi i kapa ʻia ma ka lāʻau lapaʻau he "arrhythmia". He kūlana kēia i kapa ʻia ʻo "SVT - supraventricular tachycardia".
Akā ʻo ka mea nui, ʻaʻole kēia he mea weliweli i ka hapa nui o nā hihia. Me ka mālama maikaʻi ʻana, hiki ke kāohi ʻia, a i kekahi manawa ho'ōla loa ʻia. Hoʻonui iki ʻia ka pilikia o kēia maʻi me ka ʻelemakule.
Aia kekahi mau ʻano nui o kēia maʻi?
ʻAe, hiki ke hana ʻia kēia ma nā ʻano nui ʻelua. He mea maikaʻi ke ʻike, e Kauka, no ka mea ke hoʻohana nei paha ʻoe i kēia mau huaʻōlelo.
| ʻAno | Ua wehewehe maʻalahi ʻia |
|---|---|
| ʻAno Hoʻi Komo | ʻO kēia ka manawa ʻaʻole e hele pololei nā hōʻailona uila o ka puʻuwai, akā, e kaapuni ana a puni kahi ʻeha ma ka puʻuwai. Ua like ia me ke kaʻa e hele ana a puni kahi pōʻai no ka mea ua ālai ʻia ke alanui. ʻO kēia ke kumu o ka puʻuwai e kuʻi wikiwiki a wikiwiki hoʻi. |
| ʻAno Kūlohelohe | ʻO kēia ka manawa e hoʻomaka ai kahi wahi kikoʻī hoʻokahi (focus) i loko o ka puʻuwai e hoʻopuka i nā hōʻailona uila wikiwiki a ʻano ʻē. ʻAʻole maʻamau kēia he mea weliweli, akā inā hoʻomau ia no ka manawa lōʻihi, hiki iā ia ke hana i nā pilikia. |
No kekahi poʻe, hiki ke ʻike ʻia kēia ʻano "Focal" ma mua o hoʻokahi wahi. Ua kapa ʻia kēia ʻano "Multifocal". I kēlā hihia, hiki ke paʻakikī iki ka mālama ʻana, no ka mea, ʻaʻole hoʻomaka ka pilikia ma kahi hoʻokahi.
He aha nā hōʻailona āu e ʻike ai?
I kekahi manawa hiki i kēia ʻano ke hele mai a hele aku me ka ʻole o nā hōʻailona. Eia nō naʻe, nui ka poʻe e ʻike i kekahi mau hōʻailona. Hiki i kēia mau hōʻailona ke like me nā maʻi puʻuwai koʻikoʻi ʻē aʻe, no laila ʻoi aku ka maikaʻi o ka makaʻala iā lākou a ʻike koke i ke kauka.
| No wai? | Nā Hōʻailona Maʻamau |
|---|---|
| No nā mākua |
|
| No nā pēpē a me nā keiki liʻiliʻi |
|
ʻO ka mea nui loa: Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, mai manaʻo he Atrial Tachycardia ia. Eia naʻe, mai lawe māmā a e nīnau pono i kāu kauka no ka ʻōlelo aʻo.
No ke aha lā kēia e hana nei? He aha nā kumu?
ʻAe, e nānā kākou i ke kumu e hoʻomaka koke ai kēia mau keʻena o luna o ka puʻuwai e kuʻi me he pupule lā. Aia paha he ʻekolu mau kumu nui no kēia.
1. Hana ʻakomi
I ka ʻōlelo maʻalahi, aia kahi kikowaena nui e kāohi ana i ka wikiwiki o ko kākou puʻuwai. Akā i kekahi manawa, ʻo kekahi pūnaewele a i ʻole kahi hui o nā pūnaewele i loko o ka puʻuwai e lilo i "luna" a hoʻomaka e hoʻouna i nā hōʻailona uila wikiwiki me ka hoʻolohe ʻole i ke kikowaena nui. Hiki ke hana ʻia kēia e nā kaulike ʻole o nā pae sodium, potassium, a me calcium o ke kino.
2. Hana i hoʻāla ʻia
Hana ʻia kēia i ka wā e hoʻoulu ʻia ai lākou e kahi kemika kūlike ʻole i loko o nā ʻiʻo puʻuwai a hoʻopuka i nā hōʻailona uila pono ʻole i ka wā e pono ai. Ua like ia me kahi alarm e kani ana i ka manawa kūpono ʻole.
3. Ke komo hou ʻana
Inā he mea keʻakeʻa ma ke ala o nā hōʻailona uila o ka puʻuwai, e like me kahi ʻeha mai kahi hana ʻoki mua, ʻaʻole e hele pololei nā hōʻailona uila ma o ka mea keʻakeʻa a e hoʻomaka e puni iā ia. Ma kēia ʻano, paʻa nā hōʻailona uila i loko o kahi loop a hoʻomau i ka hoʻoulu ʻana i ka puʻuwai, e hoʻoulu ai i ka puʻuwai e kuʻi wikiwiki.
Nā mea e hoʻonui ai i ka pilikia o kēia maʻi
ʻOiai hiki ke loaʻa kēia ʻano i kekahi, hoʻonui kekahi mau mea i ka pilikia.
- Maʻi puʻuwai mua
- Ma hope o ka loaʻa ʻana o kahi hāʻule puʻuwai ma mua
- Nā maʻi e pili ana i ka māmā
- Nā hemahema o ke kaulike electrolyte i loko o ke kino
- ʻO ka inu nui ʻana
- Nā ʻano maʻi like ʻole
- Ua emi nā pae oxygen i loko o ke kino
- Nā hopena ʻawahia o kekahi mau lāʻau lapaʻau e like me `(Digoxin)`
- Ka hoʻohana nui ʻana i ka caffeine (kī, kofe) a me nā mea hoʻonāukiuki ʻē aʻe
Hiki ke kāohi ʻia kekahi o kēia mau kumu pilikia i kekahi ʻano, no ka laʻana ma ka hoʻēmi ʻana i ka inu ʻana i ka waiʻona a me ka caffeine, ka ʻai ʻana i ka meaʻai momona, a me ka hoʻoikaika kino.
Pehea ʻoe e ʻike ai i kēia, e Kauka?
Ke haʻi mai ʻoe iā mākou e pili ana i kāu mau hōʻailona, e nānā ke kauka iā ʻoe a, inā kānalua lākou i kēia ʻano, e kuhikuhi lākou iā ʻoe no kekahi mau hoʻokolohua.
- Hoʻokolokolo kino: Ke kau ke kauka i kahi stethoscope i kou puʻuwai a hoʻolohe, lohe paha ʻoe i ka puʻuwai wikiwiki.
- ECG (Electrocardiogram): ʻO kēia ka hoʻāʻo maʻalahi loa a maʻalahi loa. Hoʻopili ʻia nā mea ʻike e like me ka sticker i kou umauma a me nā lima a me nā wāwae e hoʻopaʻa i ka hana uila o kou puʻuwai.
- Nānā Holter: I kekahi manawa, ʻaʻole hiki ke hana mau ʻia kēia mau puʻuwai wikiwiki. No laila, ʻaʻole paha e ʻike ke kauka iā lākou ke nānā ʻo ia iā ʻoe. I kēia hihia, e hāʻawi ʻia ʻoe i kahi mīkini ECG liʻiliʻi hiki iā ʻoe ke komo no hoʻokahi a ʻelua paha lā a i ʻole hoʻokahi pule paha. Hoʻopaʻa ia i ka hana o kou puʻuwai i ka lā holoʻokoʻa.
- Haʻawina Electrophysiology: He hoʻokolohua paʻakikī iki kēia. Hana ʻia ia ma kahi haukapila. Hoʻokomo ʻia kahi ʻōmole lahilahi ma o kahi kīʻaha koko i loko o ka puʻuwai, a lawe ʻia kahi palapala ʻāina o ka ʻōnaehana uila o ka puʻuwai e ʻike pono ai i kahi o ka pilikia.
- Mea Hoʻopaʻa Loop Implantable: Inā loaʻa iā ʻoe nā hōʻailona e kū mai ana i kēlā me kēia mau mahina, hiki ke hoʻohana ʻia kahi mea liʻiliʻi i hoʻokomo ʻia ma lalo o ka ʻili e nānā i ka helu o kou puʻuwai no nā mahina, a hiki paha i nā makahiki.
He aha nā lāʻau lapaʻau?
Aia nā lāʻau lapaʻau maikaʻi no kēia. E koho kāu kauka i ka lāʻau lapaʻau kūpono loa iā ʻoe ma muli o kou kūlana, ke ʻano o kou mau hōʻailona, a me ke kumu.
| ʻAno lapaʻau | He aha ka mea e hana nei? |
|---|---|
| Nā lāʻau lapaʻau |
|
| Lapaʻau ablation | He lāʻau lapaʻau kūpono loa kēia. Pili ia i ka hoʻopau ʻana i kahi ʻāpana liʻiliʻi loa o ka puʻuwai e hana ana i nā hōʻailona uila hewa.
|
Hiki ke ho'ōla loa ʻia kēia?
ʻO ka hapa nui o ka manawa, ʻae! ʻOi loa aku no ka poʻe me ke ʻano "Focal", ʻo ka lāʻau "(Catheter ablation)" he kiʻekiʻe loa ka nui o ka ho'ōla ʻana . I kekahi manawa, inā i hoʻokumu ʻia e kekahi maʻi ʻē aʻe, e nalowale paha ka puʻuwai wikiwiki ke mālama ʻia kēlā ʻano.
Inā he asymptomatic kēia ʻano a loaʻa wale no ka manawa pōkole, hiki i kāu kauka ke hoʻoholo e nānā iā ʻoe me ka ʻole o ka lāʻau lapaʻau.
Āhea ʻoe e ʻike ai i ke kauka?
ʻO kēia ka ʻāpana koʻikoʻi loa. Inā loaʻa iā ʻoe kekahi o nā hōʻailona i ʻōlelo ʻia ma luna, inā hoʻomau lākou, inā e ʻoi aku ka ʻino, a inā e hoʻopilikia lākou i kou ola o kēlā me kēia lā, mai hoʻonele i ka manawa a ʻike i kāu kauka.
Inā loaʻa iā ʻoe ka ʻeha umauma koke a koʻikoʻi, ka pōkole o ka hanu, ka maule ʻole i wehewehe ʻole ʻia a i ʻole ka poniuniu koʻikoʻi, e hele koke i ka haukapila kokoke loa i ka Emergency Department (ETU). He mau hōʻailona paha kēia o kahi maʻi koʻikoʻi.
Hiki iā ʻoe ke nīnau i kāu kauka i nā nīnau e like me kēia:
- He aha ke ʻano o ka Atrial Tachycardia i loaʻa iaʻu?
- He aha ka lāʻau lapaʻau maikaʻi loa noʻu?
- ʻEhia pinepine e pono ai iaʻu ke ʻike i ke kauka?
He mea weliweli anei kēia kūlana?
E like me ka mea i ʻōlelo ʻia ma mua, inā loaʻa kēia ʻano no ka manawa pōkole a nalowale, ʻaʻole ia he mea weliweli. Eia nō naʻe, inā hoʻomau kēia puʻuwai wikiwiki no ka manawa lōʻihi, hiki iā ia ke hoʻonāwaliwali i ka ʻiʻo o ka puʻuwai. Kapa mākou iā ia he `(Cardiomyopathy)`. Inā ʻaʻole mālama ʻia kēia, hiki iā ia ke alakaʻi i nā kūlana koʻikoʻi e like me `(Heart failure)` i ka wā e hiki mai ana.
ʻO ia ke kumu a mākou e ʻōlelo nei, inā loaʻa iā ʻoe nā hōʻailona, e ʻimi koke i ke kōkua lapaʻau. Me ka mālama koke ʻana, hiki iā ʻoe ke ola maikaʻi me ka ʻole o ka pōʻino lōʻihi.
He mea maʻamau i kekahi ke makaʻu a hopohopo ke lohe lākou e pili ana i kahi pilikia puʻuwai e like me kēia. Akā e hoʻomanaʻo, he ʻano kēia e hiki ke hoʻomalu pinepine ʻia a hoʻōla ʻia. E kamaʻilio ākea me kāu kauka e pili ana i kēia. E hoʻolohe ʻo ia i kou mau makaʻu a me nā kānalua a pau. A laila e loaʻa iā ʻoe ka ikaika nui e ola kūleʻa me kēia ʻano.
Leka Lawe-Home
- ʻO ka tachycardia atrial ka wā e paʻi wikiwiki ai nā keʻena o luna o ka puʻuwai (atria) ma mua o ka maʻamau.
- ʻAʻole kēia he kūlana weliweli i ka hapanui o nā hihia, akā pono ʻoe e nānā ʻia e ke kauka.
- Hiki ke ʻike ʻia nā hōʻailona e like me ka puʻuwai wikiwiki, ka poniuniu, ka ʻeha o ka umauma, a me ka paʻakikī o ka hanu ʻana.
- Aia nā lāʻau lapaʻau kūpono loa no kēia, e like me ka lāʻau lapaʻau a me ka ablation . I kekahi mau hihia, hiki ke ho'ōla loa ʻia.
- Hiki iā ʻoe ke hōʻemi i ka pilikia ma ka hoʻemi ʻana i nā mea e like me ka caffeine a me ka waiʻona a ma ke alakaʻi ʻana i kahi nohona olakino.
- Inā loaʻa iā ʻoe kekahi mau hōʻailona ulia pōpilikia e like me ka ʻeha nui o ka umauma a i ʻole ka maule ʻana, e hele koke i ka ETU (Emergency Treatment Unit) .
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