Ke kuʻi wikiwiki nei kou puʻuwai? E kamaʻilio kākou e pili ana i ka AVNRT (Atrioventricular Nodal Reentrant Tachycardia)!

Ke manaʻo nei ʻoe i kekahi manawa e kuʻi wikiwiki ana kou puʻuwai me ke kumu ʻole? A i ʻole ke manaʻo nei ʻoe e wili ana kekahi mea i loko o kou umauma, a paʻakikī iā ʻoe ke hanu? Hiki i kēia ke hele pū me nā mea e like me ka poniuniu, ka ʻūlū iki i loko o kou umauma, a pēlā aku. ʻAʻole wale kēia mau mea he mau mea maʻamau. He hōʻailona paha kēia o kahi maʻi i kapa ʻia ʻo AVNRT (Atrioventricular Nodal Reentrant Tachycardia) a mākou e kamaʻilio nei i kēia lā. Mai hopohopo, e kamaʻilio maʻalahi kākou e pili ana i kēia.

He aha ka AVNRT (Atrioventricular Nodal Reentrant Tachycardia)?

I ka ʻōlelo maʻalahi, ʻo AVNRT kahi kūlana e hoʻomaka koke ai kou puʻuwai e kuʻi wikiwiki loa ma muli o kahi loli liʻiliʻi i ka ʻōnaehana uila o kou puʻuwai. ʻO ia kekahi o kahi hui nui o nā kūlana i kapa ʻia ʻo Supraventricular Tachycardia (SVT) , ʻo ia hoʻi nā mele puʻuwai wikiwiki e hoʻomaka ana ma nā keʻena o luna o ka puʻuwai (ka atria). ʻO ka ʻoiaʻiʻo, ʻo AVNRT ke ʻano maʻamau o SVT.

ʻO ka maʻamau, i ka wā e hoʻomaha ai mākou, kuʻi ko mākou puʻuwai ma waena o 60 a me 100 mau manawa i kēlā me kēia minuke. Akā i loko o kekahi kanaka me AVNRT, me ka ʻole o ka ʻōlelo aʻo, hiki i ka helu o ka puʻuwai ke lele mai 140 a 280 mau kuʻi i kēlā me kēia minuke, a ʻoi aku paha ka wikiwiki. E noʻonoʻo i kēlā! Hiki ke mau no kekahi manawa, a i kekahi manawa hiki ke mau iki aʻe.

ʻO AVNRT a me SVT nā kūlana e pili ana i ka māhele nui o nā arrhythmias . ʻO ka arrhythmia kekahi kūlana e kuʻi ai ka puʻuwai i ke ʻano kūpono ʻole, ʻo ia hoʻi ke kuʻi wikiwiki loa, lohi loa, a i ʻole ma ke ʻano ʻē.

ʻO wai ka mea i ʻoi aku ka paʻakikī ke hoʻomohala i ka AVNRT?

ʻOiaʻiʻo, hiki i kekahi ke loaʻa i kēia maʻi i kapa ʻia ʻo AVNRT. Eia nō naʻe, ʻoi aku ka maʻamau o ia i nā wahine ma mua o nā kāne. Eia kekahi, hiki i nā pākeke ʻōpio olakino me nā maʻi nui ʻē aʻe ke loaʻa i kēia maʻi. No laila, mai manaʻo, "Ua olakino wau, ʻaʻole e hiki mai kēia iaʻu."

No ke aha e hana ʻia ai ka AVNRT? He aha ka mea e hana ʻia ana i loko o ka puʻuwai?

Hoʻokele ʻia ka wikiwiki a me ke kuʻina o ko mākou puʻuwai e kahi ʻōnaehana uila paʻakikī loa. Hoʻomaka kēia me kahi hui kūikawā o nā olonā ʻiʻo i kapa ʻia ʻo ka node Sinoatrial (SA node) ma ke keʻena ʻākau o luna (atrium) o ka puʻuwai. Hana kēia node SA ma ke ʻano he pacemaker kūlohelohe o ko mākou puʻuwai.

I loko o ka puʻuwai olakino, ʻo kahi hōʻailona uila mai kēia node SA e hoʻoulu ai i nā keʻena ʻelua o luna o ka puʻuwai (atria) e ʻūlū, e hoʻokuke ana i ke koko i loko o nā keʻena haʻahaʻa (nā aʻa koko). A laila hele kēia hōʻailona uila ma nā ala kūikawā i kahi i kapa ʻia ʻo ka node Atrioventricular (node ​​AV) . Ua like kēia node AV me ka puka ma waena o nā keʻena o luna a me lalo. Mai laila mai, hele ka hōʻailona i nā keʻena haʻahaʻa (nā aʻa koko) a hoʻoulu iā lākou e ʻūlū. Pēlā ka puʻuwai maʻamau e pamu ai i ke koko ma ke kino holoʻokoʻa ma ke ʻano maʻamau.

Eia nō naʻe, inā he pilikia me kēia ʻōnaehana uila, hiki i ka puʻuwai ke kuʻi kūpono ʻole. ʻO ia hoʻi, hiki iā ia ke wikiwiki, lohi, a i ʻole hiki i ke ʻano ke lilo i haunaele. ʻO ia ka mea a mākou e kapa nei he arrhythmia.

Ma AVNRT, aia kekahi mea i kapa ʻia he ala uila liʻiliʻi keu (reentrant circuit) kokoke i ka AV node. Hiki i kēia ke lilo i mea i loaʻa i ka wā hānau. I kekahi manawa, ma muli o ka ʻūlū mua ʻana o ka puʻuwai, komo ka hōʻailona uila i kēia ala keu a hoʻomaka e kaʻapuni i loko o nā pōʻai. E noʻonoʻo iā ia e like me kahi kaapuni pōkole i loko o kahi kaapuni uila liʻiliʻi. ʻO ia ka manawa e hoʻomaka koke ai ka puʻuwai e kuʻi wikiwiki, a hiki ke noho pēlā.

Ma muli o ka loaʻa ʻana o kēia ʻano ma kekahi poʻe o kekahi mau ʻohana, aia kekahi manaʻo he hoʻoilina paha ʻo AVNRT, akā ʻaʻole i ʻike ʻia ke kumu kikoʻī.

He aha nā hōʻailona o AVNRT?

ʻAʻole he kūlana hoʻomau ʻo AVNRT. He kūlana episodic ia. ʻO ke ʻano kēia, hiki ke piʻi koke ka puʻuwai wikiwiki a laila e pau no kekahi manawa pōkole. Loaʻa i kekahi poʻe kēia mau hōʻailona no nā makahiki, akā hiki ke lōʻihi ka manawa e ʻike pono ai i ka mea e hana nei.

ʻO kēia nā hōʻailona maʻamau:

• ʻO ka ʻeha ma ka ʻāʻī a i ʻole ka umauma , kahi manaʻo e like me ka hanu ʻia.
• Pōniuniu , i kekahi manawa he manaʻo o ka māmā.
• He puʻuwai wikiwiki loa (ma kahi o 140-280 mau kuʻi i kēlā me kēia minuke).
• Palpitations - ʻO kēia ke ʻano o ka paʻi ʻana o kou puʻuwai. Hiki ke ʻike ʻia kēia ma nā ʻano like ʻole.
• Polyuria - ʻO ke ʻano kēia o ka mimi pinepine ʻana a me ka nui. Hoʻokumu ʻia kēia e kekahi mau loli hormonal i ke kino ke kuʻi wikiwiki ka puʻuwai.
• Paʻakikī ka hanu ʻana , me he mea lā e pau ana kou hanu.

He aha ke ʻano o kēia mau palpitations?

ʻO ka poʻe me AVNRT e wehewehe i kēia ʻano puʻuwai e like me:

• Me he mea lā e piʻi ana a e iho ana kekahi mea i loko o ka umauma (e hoʻohuli ana) .
• E lele mālie ana, e like me ka lele ʻana o ka pulelehua.
• Ka manaʻo o ka ʻūmiʻi a piha paha i ka ʻāʻī a i ʻole ka puʻu.
• E like me ke kuʻi ʻana i ka pahu me ka leo nui.
• Kuʻi wikiwiki ka puʻuwai e like me ka heihei (Racing) .

I nā hihia koʻikoʻi, he mea kākaʻikahi loa ia, hiki i ka AVNRT ke hana i nā hōʻailona koʻikoʻi a me nā pilikia. Eia kekahi laʻana:

• ʻEha ka umauma .
• Ka huikau .
• Ka nalowale o ka ʻike (Syncope) .
• Ke koko haʻahaʻa (Hypotension) .
• Pūʻiwa - He mea laha ʻole kēia.

Pehea e ʻike ai nā kauka i ka AVNRT?

No ka ʻike ʻana inā he AVNRT kou a i ʻole kekahi arrhythmia ʻē aʻe, e hana ke kauka i kēia mau mea:

1. Ke nīnau ʻana e pili ana i kou mōʻaukala olakino: E nīnau ʻia ʻoe e pili ana i nā maʻi āu i loaʻa ai ma mua, nā hōʻailona hou āu i loaʻa ai, a me nā lāʻau lapaʻau, nā wikamina, nā mea hoʻohui, a me nā lāʻau lapaʻau āu e lawe nei.

2. Hoʻokolohua kino:E ana lākou i nā mea e like me kou helu hanu ʻana, ke koko, a me ka helu puʻuwai. E hoʻolohe pū lākou i kou puʻuwai me kahi stethoscope.

3. Electrocardiogram (EKG): ʻO kēia ka hoʻāʻo koʻikoʻi loa. Ana ka EKG i ka hana uila o kou puʻuwai, e like me ka lōʻihi a me ka lōʻihi o kēlā me kēia puʻuwai. Hiki ke kōkua nui i ka hōʻoia ʻana i kahi hōʻailona, ​​ʻoiai inā hiki iā ʻoe ke loaʻa i kahi EKG ʻoiai e kuʻi wikiwiki ana kou puʻuwai.

Eia kekahi, hiki i kāu kauka ke kauoha i nā hoʻokolohua ʻē aʻe e aʻo hou e pili ana i kou puʻuwai:

• Nā hoʻāʻo koko: E nānā i nā pilikia ʻē aʻe e hiki ke hoʻopilikia i kou puʻuwai (e laʻa, nā pilikia thyroid, anemia).
• Echocardiogram (Echo): Lawe kēia i nā kiʻi o ka puʻuwai (e like me ka ultrasound) e nānā i nā pilikia me ke ʻano o ka puʻuwai a i ʻole ke ʻano o ka pamu ʻana i ke koko.
• Nānā Holter a i ʻole kekahi mea nānā ambulatory ʻē aʻe: He mea liʻiliʻi kēia āu e ʻaʻahu ai no kekahi mau lā. Hoʻopaʻa mau ia i kou puʻuwai i kou wā e hana ana i kāu mau hana o kēlā me kēia lā. Inā ʻaʻohe arrhythmia i ka wā o kahi EKG, hiki ke hopu ʻia me kēia ʻano mea hana.
• Hoʻāʻo koʻikoʻi hoʻoikaika kino: Nānā ʻia kou helu puʻuwai i kou holo ʻana ma luna o ka treadmill a holo paha i kahi paikikala paʻa. Hiki i kekahi poʻe ke ʻike i kēia puʻuwai wikiwiki i ka wā o ka hoʻoikaika kino.
• Ke aʻo ʻana i ka Electrophysiological (EP) a me ka palapala ʻāina o ka puʻuwai: He hoʻāʻo paʻakikī kēia. Pili ia i ka hoʻokomo ʻana i kahi uea lahilahi (catheter) ma o kahi aa koko i loko o ka puʻuwai e kuhikuhi pono i kahi e hoʻomaka ai ka arrhythmia a pehea e hana ʻia ai. Hana pinepine ʻia kēia hoʻāʻo ma mua o kahi lāʻau i kapa ʻia he catheter ablation.

He aha nā lāʻau lapaʻau e loaʻa ana no AVNRT?

ʻOiai he nui ka poʻe i loaʻa i ka AVNRT, ʻaʻole pono ka lāʻau lapaʻau i nā kānaka a pau. ʻOiai inā loaʻa nā hōʻailona i kekahi manawa wale nō a ʻaʻole hoʻi he mea hoʻopilikia loa, ʻaʻole pono paha ka lāʻau lapaʻau. Eia nō naʻe, hiki i kāu hui mālama ola ke kuhikuhi iā ʻoe no ka lāʻau lapaʻau i nā hihia aʻe:

• Inā ʻoe i ka pilikia o nā pilikia koʻikoʻi .
• Inā loaʻa iā ʻoe nā hōʻailona e hoʻopilikia i kou ola o kēlā me kēia lā , e like me ka insomnia.
• Inā hana pinepine ʻia ka AVNRT a i ʻole no ka manawa lōʻihi .

Aia kekahi mau ʻano lapaʻau:

1. Nā hana Vagal: Hiki iā ʻoe ke hoʻōki i kēia puʻuwai wikiwiki me nā mea maʻalahi hiki iā ʻoe ke hana ma ka home. No ka laʻana, ke ʻū ʻana, ka paʻa ʻana i kou hanu (Valsalva maneuver), a me ke kau ʻana i kou maka i loko o ka wai anuanu . E hōʻike kāu kauka iā ʻoe pehea e hana ai i kēia mau mea.

2. Ka hoʻololi ʻana o ke cardio uila:ʻO kēia ke kau ʻana i nā hoe a i ʻole nā ​​​​​​pale ma kou umauma a me ka hāʻawi ʻana i kahi haʻalulu uila i kou puʻuwai. Hiki i kēia ke kōkua i ka hoʻihoʻi ʻana i ke ʻano o kou puʻuwai i ka maʻamau. Hana pinepine ʻia kēia i ka wā pilikia.

3. Nā lāʻau lapaʻau: Aia kekahi mau ʻano lāʻau lapaʻau e hiki ke kaohi i ka helu o ka puʻuwai a me ke ʻano o ka puʻuwai. No ka laʻana, ka inikini Adenosine (he inikini kēia i hāʻawi ʻia i loko o kahi aa koko, kahi e hoʻolohi koke ai i ka helu), nā lāʻau Antiarrhythmic (nā lāʻau lapaʻau kūikawā i hāʻawi ʻia no ka arrhythmia), nā mea pale i ke kahawai Calcium , a me nā Beta-blockers . Pono e lawe ʻia kēia mau mea e like me ke kauoha a kāu kauka.

4. Ka hoʻopau ʻana i ke catheter: Manaʻo pinepine ʻia kēia ʻo ia wale nō ka lāʻau lapaʻau no AVNRT. Ma kēia, e like me ke aʻo ʻana a EP i ʻōlelo ʻia ma mua, ua hoʻokomo ʻia kahi catheter lahilahi ma o kahi aʻa koko ma ka wāwae a i ʻole ka lima i ka puʻuwai, aia ke kaapuni reentrant, a hana ʻia kahi ʻeha liʻiliʻi me ka hoʻohana ʻana i ka ikehu radiofrequency a i ʻole cryoablation. Hoʻōki kēia i nā hōʻailona uila maʻamau ʻole mai ka hele ʻana ma ka puʻuwai, a hoʻōki ka arrhythmia. He lāʻau lapaʻau holomua kēia.

Pehea e hiki ai iaʻu ke hōʻemi i ka hanana ʻana o kēia maʻi?

ʻAʻohe ala i hōʻoia ʻia e pale aku ai i ka AVNRT. Eia nō naʻe, inā loaʻa iā ʻoe kēia maʻi, e ʻike paha ʻoe he mea nui ka wikiwiki o ka puʻuwai o kekahi mau mea. Kāhea mākou i kēia mau mea he "mea hoʻoulu."

Ma ka pale ʻana i kēia mau mea hoʻonāukiuki, hiki iā ʻoe ke hōʻemi i ke alapine (frequency) o nā hoʻouka kaua AVNRT.

Eia nā mea hoʻonāukiuki e hoʻopilikia nei i ka hapa nui o nā kānaka:

• ʻAila
• Caffeine - loaʻa i loko o ke kofe, ke kī, a me kekahi mau mea inu palupalu.
• Kekahi mau ʻano hoʻoikaika kino (pono ʻoe e kamaʻilio me kāu kauka e pili ana i kēia).
• ʻO kekahi mau mea hoʻohui lāʻau lapaʻau .
• Nā lāʻau lapaʻau kū ʻole i ke kānāwai (Nā lāʻau lapaʻau leʻaleʻa) .
• Ka puhipaka a i ʻole ka hoʻohana ʻana i nā huahana paka .
• Kaumaha .

He aha ka wā e hiki mai ana no ka poʻe me AVNRT?

He mea kākaʻikahi loa, hiki i ka AVNRT ke hoʻoulu i nā pilikia koʻikoʻi, e like me ka hopu koke ʻana o ka puʻuwai. Eia nō naʻe, no ka hapa nui o ka poʻe, ʻaʻole ia he kūlana hoʻoweliweli i ke ola . Inā mālama pono ʻia, hiki i ka poʻe ke ola i kahi ola maʻamau.

Loaʻa iaʻu ka AVNRT, pehea lā wau e mālama ai iaʻu iho?

Ma muli o kēia mau ʻōlelo aʻoaʻo e kōkua iā ʻoe e mālama i kou kūlana AVNRT:

• Mai hoʻohana i nā lāʻau lapaʻau a i ʻole nā ​​​​mea hoʻopihapiha meaʻai me ka ʻole o ka nīnau ʻana i ke kauka.
• E hoʻomau i ka ʻike ʻana i nā kauka, e like me kāu kauka cardiologist, no nā nānā kino.
• E lawe i nā lāʻau lapaʻau a pau i kauoha ʻia iā ʻoe me ka pololei a me ka manawa kūpono.
• E ʻike i nā mea e hoʻoulu ai i kāu AVNRT a hoʻāʻo e pale aku iā lākou.
• Inā ʻike ʻoe i kekahi mau loli i kāu mau hōʻailona (e laʻa, ʻoi aku ka ʻino ma mua o ka wā ma mua, ʻoi aku ka pinepine), e haʻi i kāu kauka e pili ana i ia mea.

Hiki iaʻu ke hoʻoikaika kino inā loaʻa iaʻu ka AVNRT?

He mea nui loa ka hoʻoikaika kino no ke olakino o ka puʻuwai. Hiki i ka hapa nui o ka poʻe me AVNRT ke hoʻoikaika kino . Eia nō naʻe, ʻoi aku ka maikaʻi o ke kamaʻilio ʻana me kāu kauka e pili ana i ke ʻano o ka hoʻoikaika kino maikaʻi loa iā ʻoe a inā he mau kapu.

Āhea wau e ʻimi koke ai i ke kōkua lapaʻau no AVNRT?

Inā loaʻa iā ʻoe ka AVNRT, e ʻimi koke i ke kōkua lapaʻau inā ʻike ʻoe i kekahi o kēia mau hōʻailona:

• ʻEha ka umauma .
• Inā ua lōʻihi ka manawa e palpitations ai ka puʻuwai a i ʻole e hana pinepine ʻia ana .
• Manaʻo māmā ke poʻo, puni ka poʻo, a nāwaliwali paha .
• Paʻakikī nui ka hanu ʻana .

ʻO ka mea hope loa, e hoʻomanaʻo i kēia.

He maʻi maʻamau ka AVNRT no ka puʻuwai. I kēia kūlana, hoʻomaka koke ka puʻuwai e kuʻi wikiwiki ma mua o ka maʻamau. ʻOiai ʻaʻole ia he mea hoʻoweliweli i ke ola i ka hapa nui o nā hihia, hiki i kekahi mau hōʻailona ke hoʻopilikia. Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​​​mai kānalua e ʻike i ke kauka. Nui nā ala e mālama ai i kēia kūlana a loaʻa ka lāʻau lapaʻau inā pono. E mālama i kou puʻuwai a noho olakino!

AVNRT , nā palpitations o ka puʻuwai, ka wikiwiki o ka puʻuwai, SVT, arrhythmia, maʻi puʻuwai, ʻeha umauma, pōkole o ka hanu, nā pilikia o ka puʻuwai