Ua ālai ʻia hoʻi nā hōʻailona uila o kou puʻuwai? E kamaʻilio kākou e pili ana i ka Bifascicular Block!

Loaʻa koke iā ʻoe i kekahi manawa nā maka polū a manaʻo ʻoe ua poniuniu ? A i ʻole ke manaʻo nei ʻoe e kuʻi wikiwiki ana kou puʻuwai a lohi paha? Malia paha ua ʻike kekahi āu i ʻike ai i kahi mea e like me kēia. I kekahi manawa hiki ke hana ʻia kēia mau mea e nā haunaele liʻiliʻi i loko o ka ʻōnaehana uila o ko mākou puʻuwai, e like me ka ʻōnaehana uwea i loko o kahi hale. I kēia lā, e kamaʻilio mākou e pili ana i kahi kūlana kūikawā kahi e hele mālie ai ka hōʻailona uila a i ʻole e hoʻopau ʻia ma kahi o ʻelua hapakolu o nā ala nui i loko o ka ʻōnaehana uwea uila o ka puʻuwai - ʻo ia ka mea i kapa ʻia ʻo (Bifascicular Block) .

He aha kēia (Bifascicular Block)? E hoʻomaopopo maʻalahi kākou?

I ka ʻōlelo maʻalahi, ʻo `(Bifascicular Block)` kahi ʻano poloka puʻuwai. I mea e hana ai ko kākou puʻuwai e like me ka pamu, pono ia e loaʻa nā hōʻailona uila ma ke ʻano maʻamau. Hele kēia mau hōʻailona uila ma nā ala kūikawā i loko o ka puʻuwai. Kāhea mākou i kēia mau ala he ``nā lālā bundle``. Ua like ia me nā uea i loko o kahi hale e pono ai ke hoʻā i nā kukui.

E noʻonoʻo ʻoe he ʻekolu mau ala nui i loko o ko kākou puʻuwai e lawe ana i kēia mau leka uila. I loko o kahi "Bifascicular Block", hele mālie loa nā hōʻailona uila a i ʻole e hoʻopau ʻia ma ʻelua o kēia mau ala ʻekolu. ʻO "Bi" ke ʻano he "ʻelua". ʻO "Fascicle" e pili ana i nā lālā pūʻolo o nā ʻiʻo puʻuwai. No laila, i ka wā e paʻa ai i ʻelua o kēia mau ala, hoʻouna iki ʻia nā hōʻailona uila i nā keʻena haʻahaʻa o ka puʻuwai (ʻo "ventricles"). Hiki i kēia ke hoʻololi i ke ʻano o ka puʻuwai a me ke ʻano o ka pamu ʻana i ke koko.

Ua kapa ʻia kēia e nā kauka he "poloka puʻuwai piha ʻole." Hiki ke hana ʻia kēia ʻano e ka maʻi puʻuwai hānau ʻole a i ʻole nā ​​​​​​maʻi puʻuwai ʻē aʻe. I kekahi manawa, e nalowale paha nā hōʻailona. Eia nō naʻe, ʻo kahi hihia koʻikoʻi o ka Bifascicular Block e hoʻoulu ai i nā hōʻailona e pono ai ke mālama ʻia.

Aia i hea kēia mau ʻāpana palupalu i loko o ko kākou puʻuwai?

Ua ʻike ʻoe he ʻehā mau keʻena nui o ko kākou puʻuwai. Ua kapa ʻia nā keʻena ʻelua o luna he atria, a ua kapa ʻia nā keʻena ʻelua o lalo he ventricles. Hoʻopaʻa kēia mau keʻena a hoʻonui i ke ʻano i kāohi ʻia e pamu i ke koko ma ke kino holoʻokoʻa.

Hoʻopilikia ka poloka bifascicular i kēia mau keʻena haʻahaʻa, a i ʻole ventricles.

• ʻĀkau ʻākau: Aia kēia ma ka ʻaoʻao ʻākau haʻahaʻa o ka puʻuwai. ʻO ia ka mea e lawe i ke koko a hoʻouna iā ia i nā māmā e loaʻa ai ka oxygen. Hoʻokahi wale nō ala uila nui (fascicle) o kēia ʻākau ʻākau - ʻo ia hoʻiLālā pūʻolo ʻākau .
• ʻAna hema : Aia kēia ma ka ʻaoʻao hema haʻahaʻa o ka puʻuwai. ʻO ia ke keʻena pamu nui loa a ikaika loa i loko o ka puʻuwai. Lawe ia i ke koko oxygenated a pamu iā ia i ke koena o ke kino ma o ka aorta . Loaʻa i ka ʻana hema ʻelua mau ala uila nui: ka fascicle mua hema a me ka fascicle hope hema . I ka hui pū ʻana, hana kēia mau mea ʻelua i ka lālā pūʻolo hema. Māhele hou kēia i nā miliona o nā olonā liʻiliʻi i kapa ʻia ʻo nā olonā Purkinje.

He aha ka poloka puʻuwai a me ka poloka lālā Bundle?

Hana ʻia ka poloka puʻuwai ke loaʻa kahi pilikia me ka ʻōnaehana alakaʻi uila o ka puʻuwai. Hoʻopaneʻe kēia i ka hoʻoili ʻana o nā hōʻailona uila ma waena o nā keʻena o ka puʻuwai. ʻO ka hopena, ʻūlū nā keʻena o ka puʻuwai ma waho o ke ʻano mele. Hoʻopilikia kēia i ke kahe koko ma o ka puʻuwai, ka puʻuwai, a me ka helu o ka puʻuwai.

ʻO ke ʻano like ʻo `(Poloka Puʻuwai)` a me `(Poloka Atrioventricular / Poloka AV)`. ʻO `(Poloka Lālā Bundle)` kekahi ʻano o `(Poloka Puʻuwai).` Hana ʻia ia i ka wā e paʻa ai kekahi o nā lālā pūpū a mākou i kamaʻilio ai.

Pehea ka hana ʻana o ka ʻōnaehana uila i loko o ko kākou puʻuwai? He mea kupaianaha ia, ʻeā?

E noʻonoʻo i loko o ka puʻuwai aia kahi ʻōnaehana uea paʻakikī loa, akā ua hoʻonohonoho pono ʻia. Eia ke kaʻina o ka hele ʻana o kēia hōʻailona uila:

1. Hoʻomaka mua ka hōʻailona ma kahi kūikawā ma ka atrium luna o ka puʻuwai i kapa ʻia ʻo ka node SA. ʻO kēia ka pacemaker kūlohelohe o ka puʻuwai.

2. A laila hele kēia hōʻailona ma o ka atria a hōʻea i kahi kūikawā ʻē aʻe i kapa ʻia ʻo ka AV node.

3. Ma hope o ke kikowaena AV, komo ka hōʻailona i kahi ala i kapa ʻia ʻo ka pūʻulu o His.

4. Mai laila mai, māhele ʻia i ka lālā pūʻolo ʻākau a me ka lālā pūʻolo hema, a ma hope loa e hele i nā olonā maikaʻi i kapa ʻia ʻo "nā olonā Purkinje" i loko o nā pūnaewele "ventricles".

5. Ke loaʻa kēia hōʻailona, ​​​​​​e ʻūlū nā ventricles a hoʻopumu i ke koko. A laila hoʻomaka hou ke kaʻina hana mai ka hoʻomaka.

Hana ʻia kēia mau mea a pau i loko o kekahi mau kekona, he mea kupaianaha ia, ʻeā?

Aia kekahi mau ʻano poloka puʻuwai?

ʻAe, hoʻokaʻawale nā ​​kauka i kēia mau poloka puʻuwai (AV blocks) e like me ko lākou koʻikoʻi:

• Poloka kekelē mua: He lohi iki kēia i nā hōʻailona uila mai ka atria a i nā ventricles. Eia nō naʻe, ʻaʻole hiki ke hoʻoulu i nā hōʻailona kēia ʻano poloka a ʻaʻole pono ka mālama ʻana.
• Poloka kekelē ʻelua: ʻO kēia kahi e ālai ʻia ai kekahi mau hōʻailona uila, akā ʻaʻole nā ​​​​mea āpau, mai ka hiki ʻana i nā ʻāpana. Hiki i kēia ke hana i ka wikiwiki o ka puʻuwai ( bradycardia ) a i ʻole ka puʻuwai puʻuwai kūpono ʻole (arrhythmia). Inā he koʻikoʻi kēia a i ʻole ke kumu o nā hōʻailona hoʻopilikia, pono paha ka lāʻau lapaʻau.
• Poloka kekelē ʻekolu: Ua kapa ʻia hoʻi kēia he "poloka puʻuwai piha." Maanei, ʻaʻohe pilina ma waena o ka hana ʻana o ka atria a me nā ventricles. ʻO ke ʻano kēia e hana nā keʻena o luna e like me kā lākou pono, a hana nā keʻena o lalo e like me kā lākou pono. I kēia kūlana, pono e hoʻokomo ʻia kahi pacemaker. Inā lilo kahi "poloka bifascicular" i mea koʻikoʻi, hiki ke ulu kēia kūlana.

Aia kekahi mau ʻano like ʻole o ka Bifascicular Block?

ʻAe, aia nā ʻano like ʻole o ka `(Bifascicular Block)`. ʻO nā mea maʻamau:

• Poloka lālā pūʻolo ʻākau a me ka poloka fascicular mua hema.
• Eia kekahi, aia paha kahi poloka lālā pūʻolo ʻākau a me kahi poloka fascicular hope hema.
• I kekahi manawa, hiki ke ālai loa ʻia ka lālā pūʻolo hema (ʻo ia hoʻi, ua ālai ʻia nā fascicles hema mua a me hope, akā ua paʻa ka lālā pūʻolo ʻākau).

Pehea ka maʻamau o kēia ʻano?

Loaʻa ka Bifascicular Block ma kahi o 1.5% o ka poʻe e hana ana i kahi ECG . ʻAʻole ia he manaʻo he mea kakaikahi ia.

No ke aha e hana ʻia ai kēia (Bifascicular Block)? He aha nā kumu?

Hoʻokumu pinepine ʻia ka Bifascicular Block e ka maʻi puʻuwai hānau. ʻO ia hoʻi, ua hānau ʻia ke kanaka me kekahi mau loli i ke ʻano o ka puʻuwai. I kekahi manawa, hiki ke ʻike ʻia nā hōʻailona o kēia maʻi puʻuwai hānau ma hope, malia paha i ka wā ʻōpio a i ʻole ka wā waena. Hoʻonui pū ʻia ka pilikia o ka loaʻa ʻana o ka puʻuwai block me ka makahiki .

I kekahi manawa, hiki ke hana ʻia kēia ʻano ma muli o kahi loli genetic (gene mutation) i hoʻoili ʻia mai ka ʻohana a i ka ʻohana. Ua kapa ʻia kēia he progressive familial heart block. Hiki i kēia loli genetic ke hana i ka ʻiʻo scar (fibrosis) a i ʻole nā ​​​​waiho calcium (calcification) i loko o ka puʻuwai. Hiki i kēia mau loli ke hana i ka puʻuwai block.

Eia kekahi, hiki ke hana ʻia ka "Bifascicular Block" e ka hōʻino ʻana i ka puʻuwai. Hiki i kēia hōʻino ke:

• Ma muli o ka hōʻeha puʻuwai (myocardial infarction).
• Ma muli o nā maʻi cardiovascular ʻē aʻe.
• Ma muli o ka maʻi valve puʻuwai .
• Ma muli o ke kiʻekiʻe o ka pae potassium i loko o ke koko (hyperkalemia).

He aha nā hōʻailona o kahi Bifascicular Block? Loaʻa iā ʻoe kēia mau mea pū kekahi?

ʻAʻole paha e hōʻike ʻia kekahi mau hōʻailona i ka poloka puʻuwai piha ʻole (kekelē mua a ʻelua paha). Eia nō naʻe, i ka wā e kū mai ai nā hōʻailona, ​​ʻo ka hōʻailona nui a ka poʻe he nui e ʻike ai, ʻo ia ka nāwaliwali (syncope). Hana ʻia kēia i ka wā lohi loa ka helu o ka puʻuwai (bradycardia) a lohi loa paha (arrhythmia) no ka mea ʻaʻole e hoʻopuka pono ʻia ke koko i ke kino.

I kekahi manawa, hiki i kahi `(Bifascicular Block)` ke holomua i kahi poloka piha (kēkelē ʻekolu). I kēlā hihia, ʻoi aku ka nui o nā hōʻailona e kū mai. He mea nui loa e ʻimi koke i ke kōkua lapaʻau inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona:

• ʻEha a ʻeha paha ka umauma (angina).
• Pōʻaiʻī.
• Ka manaʻo mau o ka luhi nui.
• Ke manaʻo nei i ka puʻuwai e kuʻi kūpono ʻole ana (palpitations o ka puʻuwai).
• Ka luaʻi.
• Pōkole o ka hanu.

He aha nā pilikia e hiki ai i kēia ke hana?

Hoʻopilikia ka poloka puʻuwai i ka hiki o ka puʻuwai ke pamu i ke koko a puni ke kino. Hiki i kahi "Bifascicular Block" (poloka piha ʻole) ke holomua i kahi poloka kekelē ʻekolu (piha). Ke hana ʻia kēia, nā pilikia e like me:

• Puʻuwai kūpono ʻole (Arrhythmia).
• Maʻi hohola.
• Ka hāʻule ʻana o ka puʻuwai.
• Make koke ʻana o ka puʻuwai / hopu koke ʻana o ka puʻuwai.

Mai hopohopo! ʻAʻole e ʻike nā kānaka a pau i kēia mau pilikia. Hiki i ke aʻo lapaʻau kūpono a me ka mālama ʻana ke hōʻemi nui i kēia pilikia.

Pehea e ʻike pololei ai i kahi poloka bifascicular?

ʻO ka hoʻāʻo nui e ʻike ai i ka Bifascicular Block he ECG. Ua kapa ʻia hoʻi kēia he EKG. Ana kēia i ka hana uila o kou puʻuwai. He hoʻāʻo maʻalahi loa ia a ʻeha ʻole. He 15 mau minuke ka lōʻihi.

E kau ke kauka i nā pepili liʻiliʻi (i kapa ʻia he electrodes) ma kou umauma, nā lima, a me nā wāwae. Hoʻopili ʻia nā uea i hoʻopili ʻia i kēia mau electrodes i kahi mīkini ECG. Hoʻopaʻa kēia mīkini i ka hana uila o kou puʻuwai ma ke ʻano he kiʻi. ʻAʻole hoʻouna nā electrodes i kekahi uila i kou kino. Akā, ana wale lākou i ka hana uila i loko o kou kino. Ma ka nānā ʻana i kēia kiʻi, hiki i ke kauka ke haʻi inā he loli a i ʻole ke ālai ʻia ʻana o ke ʻano hōʻailona uila o ka puʻuwai.

Aia kekahi lāʻau lapaʻau? He aha ka mea hiki ke hana ʻia?

Inā loaʻa iā ʻoe kahi `(Bifascicular Block)` a ʻaʻohe ou hōʻailona, ​​ʻaʻole paha ʻoe e pono i ka lāʻau lapaʻau. Eia nō naʻe, e nānā pono kāu kauka i ke olakino o kou puʻuwai. Hiki iā lākou ke hana i nā hoʻokolohua `(ECG)` maʻamau e ʻike ai inā e ʻoi aku ka ʻino o ke kūlana a lilo i poloka puʻuwai (piha) o ke kolu o ke kekelē. Inā hana ʻia kēlā, pono ka lāʻau lapaʻau.

Akā inā loaʻa iā ʻoe kahi puʻuwai puʻuwai kūpono ʻole (arrhythmia) a i ʻole nā ​​​​hōʻailona e like me ka nāwaliwali (syncope), hiki i kāu kauka ke ʻōlelo i ke ʻoki kino e hoʻokomo i kahi pacemaker . ʻElua ʻano o nā pacemaker:

• Nā Pacemakers: Hoʻouna kēia i nā hōʻailona uila i nā keʻena o ka puʻuwai e hoʻomau iā lākou e kuʻi me ke ʻano rhythmically, e like me ka hāʻawi ʻana i ka puʻuwai i kahi kōkua hou aku.
• Nā Implantable Cardioverter Defibrillators (ICDs): Hana kēia mau mea e like me ka pacemaker. Eia kekahi, hiki i ka ICD ke ʻike i kahi puʻuwai puʻuwai kūpono ʻole a hoʻoponopono iā ia ma ka hāʻawi ʻana i kahi haʻalulu uila liʻiliʻi i ka puʻuwai. Hiki iā ia ke hoʻomaka hou i ka puʻuwai i nā hihia o ka hopu koke ʻana o ka puʻuwai.

Hoʻokomo ʻia kēia mau mea hana e kahi cardiologist (electrophysiologist).

Aia kekahi mau ala e pale aku ai i ka Bifascicular Block?

I ka ʻoiaʻiʻo, he nui nā kumu e hiki ke kōkua i ka hāʻule ʻana o ka puʻuwai i hiki ʻole iā mākou ke kaohi, e like me ka maʻi puʻuwai hānau a i ʻole ka ʻelemakule.

Eia nō naʻe, hiki iā ʻoe ke hana i nā hana e mālama a pale i ke olakino o kou puʻuwai. ʻO kēia mau mea:

• Inā ʻoe e puhipaka ana, e noi i ke kōkua e haʻalele. E pale i ka uahi lua.
• E ʻai i ka meaʻai olakino no ka puʻuwai a e hoʻomaʻamaʻa i ka hoʻoikaika kino i kēlā me kēia lā.
• E kaupalena i ka inu ʻana i ka waiʻona.
• E kāohi i nā maʻi e hōʻino ai i ka puʻuwai e like me ke koko kiʻekiʻe, ka maʻi diabetes, a me ka cholesterol kiʻekiʻe.
• E ʻimi i nā ala olakino e hoʻokele ai i ke kaumaha.
• E ho'āʻo e mālama i ke kaumaha olakino.

ʻOiai ʻaʻole paha e pale loa kēia mau mea i ka ulu ʻana o ka `(Bifascicular Block), e kōkua maoli nō lākou i ka mālama ʻana i ke olakino o kou puʻuwai holoʻokoʻa i ke kūlana maikaʻi.

Hiki iā kākou ke ola me kēia kūlana? Pehea ka manaʻo?

ʻAʻole pono ka hapa nui o ka poʻe me ka Bifascicular Block i ka lāʻau lapaʻau. ʻOiai inā pono ka lāʻau lapaʻau, nalo pinepine nā hōʻailona ma hope o ke kau ʻia ʻana o kahi pacemaker.

Me ka mālama pono ʻana, ua haʻahaʻa loa ka pilikia o kēia kūlana e holomua ana i kahi poloka puʻuwai piha. ʻO ka ʻoiaʻiʻo, ʻoi aku ka nui o ka pōʻino i hiki ke hana ʻia e ka puʻuwai puʻuwai kūpono ʻole i mālama ʻole ʻia (arrhythmia) ma mua o ka pōʻino i hana ʻia e ka poloka puʻuwai. No laila, he mea nui e ʻimi i ke aʻo lapaʻau i ka manawa kūpono a loaʻa ka lāʻau lapaʻau inā pono.

I ka manawa hea e pono ai iaʻu ke ʻike i ke kauka?

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o nā hōʻailona ma lalo nei, e ʻike koke i ke kauka:

• Manaʻo luhi loa.
• Puʻuwai kūpono ʻole.
• ʻEha nui o ka umauma.
• Paʻakikī ka hanu ʻana.
• Nā hōʻailona o ka hāʻule puʻuwai (e.g., ʻeha nui ma waenakonu o ka umauma e hoʻolaha ana i lalo o ka lima).
• Luhi me ke kumu ʻole.

He aha nā nīnau koʻikoʻi e nīnau aku ai i ke kauka?

Ke hele ʻoe e ʻike i ke kauka, hiki iā ʻoe ke nīnau i kēia mau nīnau:

• No ke aha i loaʻa ai iaʻu kēia `(Bifascicular Block)`?
• He aha kaʻu e hana ai e hōʻemi i koʻu pilikia o ka hōʻeha puʻuwai a i ʻole nā ​​maʻi puʻuwai ʻē aʻe?
• Pono anei au i kahi pacemaker a i ʻole ICD?
• He aha nā pilikia o ka hoʻokomo ʻana i kahi pacemaker a i ʻole ICD?
• Pono anei au e hopohopo e pili ana i nā pilikia? He aha nā hōʻailona?

ʻO ka nīnau ʻana i kēia mau nīnau e kōkua iā ʻoe e hoʻomaopopo maikaʻi i kou kūlana a e ʻike pono i ka mea e hana ai.

ʻO ka mea hope loa, nā mea e pono ai ʻoe e hoʻomanaʻo

ʻO ka poloka bifascicular kahi poloka o ʻelua o nā ala nui ʻekolu e lawe ana i nā hōʻailona uila i loko o ka puʻuwai. Hiki i kēia ke hoʻololi i ke ʻano o ka puʻuwai a me ke ʻano o ka pamu ʻana i ke koko. ʻAʻohe paha o kekahi poʻe i nā hōʻailona, ​​​​aʻo kekahi poʻe e ʻike paha i nā hōʻailona e like me ka hiolo ʻana.

ʻO ka mea nui loa, ʻaʻole ia e hopohopo no kēia, akā, e ʻimi i nā ʻōlelo aʻoaʻo lapaʻau kūpono. Hiki ke ʻike ʻia kēia me kahi hoʻāʻo maʻalahi e like me ka ECG. Inā pono, hiki ke hoʻomalu pono ʻia kēia kūlana me nā lāʻau lapaʻau e like me ka pacemaker. E mālama i kou puʻuwai, e ola i kahi nohona olakino, a hiki iā ʻoe ke noho olakino!