Aia kekahi pilikia me ka ʻōnaehana uila o kou puʻuwai? E kamaʻilio kākou e pili ana i ka Bundle Branch Block ma nā ʻōlelo maʻalahi!

Ua loaʻa anei iā ʻoe kahi ECG a ʻike i nā huaʻōlelo 'Bundle Branch Block' ma ka hōʻike? A i ʻole ua manaʻo paha ʻoe i kahi ʻano ʻē a kaumaha paha i loko o kou puʻuwai, akā ʻaʻole hiki iā ʻoe ke ʻike pono i ke kumu. I kekahi manawa hiki ke loaʻa kēia ʻano me ka ʻole o nā hōʻailona. I kēia lā, e kamaʻilio mākou e pili ana i kēia ʻano i kapa ʻia ʻo 'Bundle Branch Block', ma ke ʻano maʻalahi loa, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

He aha ka Bundle Branch Block? E hoʻomaopopo maʻalahi kākou!

ʻAe, e nānā i kēia manawa... ua like ko kākou puʻuwai me kahi motika liʻiliʻi, ʻeā? Pono ia e hoʻomau i ka hana. I mea e kuʻi ai kēia puʻuwai, pono ia i kahi hōʻailona uila liʻiliʻi. Ua like ia me ke au i loko o ko mākou hale e hoʻā i nā kukui. Hele kēia mau hōʻailona uila ma nā ala kikoʻī i loko o ka puʻuwai. ʻO kēia mau ala ka mea a mākou e kapa nei he "lālā bundle." Hele nā ​​​​hōʻailona uila ma o kēia mau mea a haʻi aku i nā keʻena nui ʻelua ma lalo o ka puʻuwai, ʻo ia hoʻi nā "ventricles," e ʻōlelo, "ʻAe, i kēia manawa e ʻaelike ʻoukou a e pamu i kekahi koko."

ʻO ka maʻamau, ʻo kēia mau keʻena puʻuwai ʻelua e ʻūlū i ka manawa like. ʻO ia ka manawa e pamu pono ai ka puʻuwai i ke koko. Eia naʻe, i ka wā e loaʻa ai kahi "Bundle Branch Block", ʻo ia hoʻi, aia kahi mea keʻakeʻa a i ʻole ka pale ʻana i ke ala hōʻailona uila aʻu i ʻōlelo ai, ʻo ia hoʻi, i loko o ka "bundle branch". Me he mea lā ua haki a ua ālai ʻia paha kahi uea i kekahi wahi. A laila, ʻaʻole e hele pono kēlā hōʻailona uila, ua lohi. Ma muli o kēia, ʻaʻole e ʻūlū nā keʻena ʻelua i ka manawa like. ʻUmi kekahi, a ʻumi kekahi ma hope iki. ʻO kēia ka mea a mākou e kapa nei he ʻano puʻuwai maʻamau ʻole.

Eia naʻe, ʻaʻole pono nā poloka lālā pūʻolo āpau i ka mālama nui. ʻO ka hapa nui o ka manawa, ʻimi nā kauka i nā kūlana ʻē aʻe e hoʻoulu ai i ka pilikia a hoʻāʻo e mālama iā lākou.

Aia kekahi mau ʻano o ka Bundle Branch Block?

ʻAe, aia ʻelua ʻano nui o ka poloka lālā pūʻolo, ma muli o ka hopena o ka ʻaoʻao ʻākau o ka puʻuwai a i ʻole ka ʻaoʻao hema.

1. Poloka Lālā Pūʻulu ʻĀkau (RBBB): ʻO kēia ka wā e ālai ʻia ai ke ala e lawe ana i nā hōʻailona uila i ka ventricle ʻākau. I ka ʻōlelo maʻalahi, aia kahi pilikia me ke kaula ʻākau.

2. Pale Lālā Pūʻolo Hema (LBBB): ʻO kēia ka wā e paʻa ai ke ala e lawe ana i nā hōʻailona uila i ka ventricle hema. ʻO ke ʻano kēia he pilikia me ka pale lālā pūʻolo hema.

I kekahi manawa, hoʻokahi wale nō o kēia mau lālā e hoʻopilikia ʻia. A i ʻole, he mea kākaʻikahi loa, e hoʻopilikia ʻia nā lālā ʻelua i ka manawa like.

ʻO wai ka mea hiki ke hoʻomohala i kēia (Bundle Branch Block)? Pehea ka maʻamau o ia mea?

ʻOiaʻiʻo, hiki i kekahi ke loaʻa i kēia kūlana i kapa ʻia ʻo "Bundle Branch Block". Eia nō naʻe, me ka makahiki a inā he mau maʻi puʻuwai ʻē aʻe kou, ʻoi aku ka kiʻekiʻe o ka pilikia o ka loaʻa ʻana o kēia.

• Poloka lālā pūʻolo ʻākau `(RBBB)`:ʻOi aku ka maʻamau o kēia ma mua o ka `(LBBB)`. E noʻonoʻo, i ka hiki ʻana i ka makahiki 50, ma kahi o hoʻokahi i loko o 100 mau kānaka (0.8%) e loaʻa paha kēia. Akā i ka hiki ʻana i ka makahiki 80, ma kahi o 11 i loko o 100 mau kānaka (11.3%) e loaʻa paha kēia maʻi.
• Pale lālā puʻupuʻu hema (LBBB): ʻAʻole kēia i maʻamau e like me RBBB. Ma nā ʻāina e like me ʻAmelika Hui Pū ʻIa, hoʻopilikia ia ma waena o 0.06% a me 0.1% o ka heluna kanaka. Eia nō naʻe, i ka poʻe me ka puʻuwai hāʻule, ma kahi o hoʻokahi hapakolu o lākou e loaʻa paha iā LBBB.

Pehea ka hopena o ka poloka lālā pūpū i ke kino?

Kāhea mākou i ka ʻōnaehana e kaohi ana i ko mākou puʻuwai ʻo ka "ʻōnaehana hoʻoili puʻuwai". ʻO kēlā mau ala aʻu i ʻōlelo ai ma mua, ʻo nā "lālā pūpū", he mau ʻāpana nō hoʻi ia o kēia ʻōnaehana. No laila, ma muli o kahi o kēia mea e ālai ai, loli ke ʻano o kona hopena i ko mākou kino.

• Poloka lālā ʻākau (RBBB): Inā loaʻa iā ʻoe ka RBBB, aia ka poloka ma ke ala e lawe ana i ka hōʻailona uila i ka ventricle ʻākau. ʻO kēia ke kumu e ʻūlū ai kou ventricle hema ma mua o ka ventricle ʻākau.
• Poloka lālā pūʻolo hema (LBBB): Inā loaʻa iā ʻoe ka LBBB, aia ka poloka ma ke ala e lawe ana i ka hōʻailona uila i ka ventricle hema. ʻO kēia ke kumu o ka ʻūlū ʻana o ka ventricle ʻākau ma mua o ka hema. ʻO kēia ka mea e paʻakikī ai i ka puʻuwai ke pamu i ke koko me ka maikaʻi. I ka manawa pinepine, inā ʻike ʻia ʻoe me LBBB, ʻo ia hoʻi he maʻi puʻuwai ʻē aʻe kou.
• Ka ālai ʻana o nā lālā pūʻolo ʻākau a me ka hema: He kūlana koʻikoʻi kēia. Inā hana ʻia kēia, hiki ke ālai loa ʻia nā hōʻailona uila mai nā keʻena o luna o ka puʻuwai a i nā keʻena o lalo (atrial fibrillation). Hiki i kēia ke hana i ka wikiwiki o ka puʻuwai (bradycardia) a hiki ke alakaʻi i nā pilikia olakino koʻikoʻi ʻē aʻe.

He aha nā kumu nui o ka poloka lālā bundle?

Aia kekahi mau kumu like ʻole e hiki ai ke hana ʻia kahi "Bundle Branch Block". E nānā kākou i ke ʻano o lākou:

• Maʻi puʻuwai hānau
• Dilated cardiomyopathy (kahi ʻano e nāwaliwali ai a hoʻonui ʻia ka ʻiʻo o ka puʻuwai)
• ʻO ka myocardial infarction, a i ʻole e like me kā mākou e ʻike nei, he hōʻeha puʻuwai
• ʻO ka maʻi puʻuwai, ʻoi aku hoʻi ka maʻi coronary artery
• Ka hāʻule ʻana o ka puʻuwai
• Ka maʻi puʻuwai (myocarditis)
• Maʻi valve puʻuwai
• Ke koko kiʻekiʻe (hypertension)
• ʻO ka cardiomyopathy hypertrophic (kahi ʻano e mānoanoa ai ka ʻiʻo o ka puʻuwai)
• Ka nāwaliwali a paʻakikī paha o ka puʻuwai puʻuwai (cardiomyopathy)

Eia kekahi, hiki ke hana ʻia ka poloka lālā ʻākau (RBBB) e nā maʻi māmā. Eia kekahi laʻana:

• ʻO ka maʻi pulmonary obstructive mau loa (COPD), kahi maʻi māmā lōʻihi
• ʻO ka embolism pulmonary
• Ke koko kiʻekiʻe i loko o nā māmā (Pulmonary hypertension - PH)

Eia nō naʻe, i kekahi manawa ʻaʻole hiki ke loaʻa ke kumu kikoʻī no kēia "Bundle Branch Block". Hiki i ka puʻuwai o ia poʻe ke olakino ma nā ʻano ʻē aʻe a pau.

He aha nā hōʻailona o ka poloka lālā bundle?

ʻO kekahi o nā mea kupanaha e pili ana i kēia, ʻo ia ka hapa nui o ka manawa, ʻaʻohe hōʻailona ʻoiai inā he "Bundle Branch Block" kou. Eia nō naʻe, inā loaʻa nā hōʻailona, ​​​​hiki iā lākou ke komo pū me nā mea e like me:

• Pōʻino
• Nāwaliwali, nalowale o ka ʻike `(syncope)`
• Manaʻo e like me ʻoe e aneane maule ana (presyncope)

Eia naʻe, e like me kaʻu i ʻōlelo ai, inā he poloka ma nā lālā ʻākau a me ka hema o ka puʻuwai, ʻokoʻa iki paha nā hōʻailona, ​​a ʻoi aku paha ka ʻike nui ʻia:

• He puʻuwai puʻuwai kūpono ʻole (arrhythmia)
• Ka paʻakikī o ka hanu ʻana (dyspnea)
• Ka lohi o ka puʻuwai (bradycardia)

ʻOi aku ka ʻike ʻia o nā hōʻailona i nā kūlana e like me kēia:

• Inā he maʻi puʻuwai ʻē aʻe kāu.
• Inā he mea keakea ma nā lālā pūʻolo ʻākau a me hema.
• Inā ʻoi aku ka koʻikoʻi o ka pae `(Bundle Branch Block)`.

Pehea e ʻike ai inā he Bundle Branch Block kaʻu?

Hoʻohana nā kauka i ʻelua mau hoʻāʻo nui e ʻike i ka poloka lālā bundle:

1. Electrocardiogram (EKG a i ʻole ECG): Ua hana ʻia paha kēia iā ʻoe. Hoʻokomo ʻia nā pepili liʻiliʻi i kapa ʻia ʻo electrodes ma kou umauma, nā lima, a me nā wāwae, a hoʻopaʻa kahi mīkini i ka hana uila o kou puʻuwai ʻoiai ʻoe e moe mālie ana. Hiki i kēia ke nānā i ke ʻano o ka hele ʻana o nā hōʻailona uila o ka puʻuwai a hoʻoholo inā he poloka lālā pūpū kou, a inā pēlā, inā paha ma ka ʻaoʻao ʻākau a hema paha.

2. Echocardiogram (echo): Pili kēia i ka hoʻopili ʻana i kahi gel i kou umauma, ke kau ʻana i kahi mea liʻiliʻi (wand) ma luna o kou umauma, a me ka hoʻohana ʻana i nā nalu kani alapine kiʻekiʻe e kiʻi i nā kiʻi o nā keʻena a me nā valve o kou puʻuwai. Hiki i kāu kauka ke ʻike i ke ʻano o ka paʻi ʻana o kou puʻuwai, pehea e pamu ai i ke koko, a inā he mau maʻi puʻuwai ma lalo.

Inā ua ʻike ʻia ʻoe me ka poloka lālā bundle, e nānā pū kāu kauka no nā kūlana olakino ʻē aʻe e pili ana. Hiki iā lākou ke hana i nā hoʻokolohua e like me:

• Ana o ke koko (e nānā inā kiʻekiʻe ke kaomi (hypertension) a haʻahaʻa paha (hypotension)).
• He hoʻāʻo koko e nānā i nā pae cholesterol i loko o ke koko.
• ʻO ke catheterization cardiac (kahi hoʻāʻo e nānā i nā kīʻaha koko o ka puʻuwai)
• Hana ʻia kahi "hoʻāʻo koʻikoʻi puʻuwai nuklea" e nānā ai i ka maʻi ʻaʻa coronary.
• ʻO ka hoʻāʻo ʻana i ka hana o ka puʻuwai he hoʻāʻo ia e nānā ai i ka hana maikaʻi o nā māmā.

Pehea e mālama ʻia ai ka Bundle Branch Block?

Inā ʻaʻohe ou hōʻailona a ʻaʻohe pilikia olakino koʻikoʻi ʻē aʻe, ʻaʻole paha ʻoe e pono i kekahi lāʻau lapaʻau kūikawā no ka poloka lālā bundle. Eia nō naʻe, inā he mau pilikia ʻē aʻe kāu, e like me ke koko kiʻekiʻe a i ʻole ka hāʻule ʻana o ka puʻuwai, pono paha ʻoe e lawe i nā lāʻau lapaʻau e kāohi iā lākou.

Akā inā loaʻa iā ʻoe nā hōʻailona e like me ka hāʻule ʻana, e kuhikuhi paha kāu kauka i kahi pacemaker . He mea liʻiliʻi kēia i hoʻokomo ʻia ma lalo o ka ʻili o kou umauma e kahi electrophysiologist cardiac. Hoʻouna ia i nā hōʻailona ma o nā uea i hoʻopili ʻia i kou puʻuwai, e mālama ana i kou puʻuwai e kuʻi ana i ka wikiwiki paʻa.

Inā loaʻa iā ʻoe ka hāʻule ʻana o ka puʻuwai a i ʻole ka dilated cardiomyopathy, hiki i kāu kauka ke ʻōlelo aku i kahi lāʻau i kapa ʻia ʻo Cardiac Resynchronization Therapy (CRT) . Hoʻohana kēia i kahi ʻano pacemaker kūikawā i kapa ʻia ʻo Biventricular Pacemaker . Kōkua kēia i nā keʻena ʻelua o ka puʻuwai e ʻaelike i ka manawa like. Hiki i kēia lāʻau CRT ke kōkua i ka hōʻemi ʻana i nā hōʻailona e like me ka pōkole o ka hanu.

Pehea e hōʻemi ai i ka pilikia o ka hoʻomohala ʻana i ka poloka lālā bundle?

I mea e pale aku ai iā kākou iho mai ka `(Bundle Branch Block)` a me nā maʻi puʻuwai ʻē aʻe, pono kākou e lawe i kahi nohona olakino. ʻO ia hoʻi:

• E ʻai i ka meaʻai olakino no ka puʻuwai (nā mea kanu, nā huaʻai, nā greens, nā meaʻai haʻahaʻa ka momona).
• E hoʻoikaika kino mau (e like me ka hele wāwae, ka holo ʻana, ke kaʻa paikikala).
• E mālama i ke kaumaha olakino .
• E kāohi i nā pae cholesterol .
• E hoʻōki loa i ka puhipaka a me ka hoʻohana ʻana i nā huahana paka .
• Inā kiʻekiʻe kou koko , e kaohi iā ia.
• E hele i nā hoʻokolohua lapaʻau maʻamau.

He aha nā pilikia inā he mau maʻi ʻē aʻe me ka Bundle Branch Block?

Inā loaʻa iā ʻoe kahi "Bundle Branch Block" me kēia mau kūlana, hiki ke hoʻonui iki ʻia ka pilikia i ke ola :

• Maʻi hohola
• Nā maʻi puʻuwai ʻē aʻe
• Ka hāʻule ʻana o ka puʻuwai

ʻO kahi mea e hoʻomanaʻo ai, inā loaʻa iā ʻoe kahi hihia hou o `(Left Bundle Branch Block - LBBB)` a ke ʻeha nei hoʻi i ka umauma, he hōʻailona paha ia o kahi maʻi koʻikoʻi, e like me ka hāʻule puʻuwai. Inā hana ʻia kēia, pono ʻoe e ʻimi koke i ke kōkua lapaʻau.

He aha ka mea e hana ʻia i kekahi me ka Bundle Branch Block? He aha ka mea e hiki mai ana?

ʻO ka Bundle Branch Block he maʻi ia no ke ola holoʻokoʻa . Hiki ke mau ka paʻa ʻana, a i ʻole e ʻoi aku ka ʻino i ka hala ʻana o ka manawa.

No ka mea, hiki i ka Left Bundle Branch Block (LBBB) ke lilo i hōʻailona mua o ka poloka puʻuwai piha, ua pāpā ʻia nā pailota ma nā ʻāina e like me US a me UK mai ka lele ʻana inā loaʻa iā lākou ka LBBB. Eia nō naʻe, inā ʻaʻole ʻoe he mau hōʻailona koʻikoʻi, ʻaʻole ia he hopena nui i kāu mau hana o kēlā me kēia lā ka loaʻa ʻana o ka Bundle Branch Block.

Ma ke ʻano o ka nānā ʻana, inā ʻaʻohe ou mau maʻi koʻikoʻi ʻē aʻe, ʻaʻole paha he hopena koʻikoʻi o ka Bundle Branch Block i kou olakino holoʻokoʻa a i ʻole ke ola. Eia nō naʻe, inā he mau maʻi ʻē aʻe kāu e hoʻopilikia ai i kou puʻuwai, hiki i ka Bundle Branch Block ke hoʻonui koke i kēlā mau maʻi a hoʻonui paha i kāu mau hōʻailona.

Inā loaʻa iaʻu (Bundle Branch Block), pehea wau e mālama ai iaʻu iho?

Inā loaʻa iā ʻoe ka poloka lālā bundle, e haʻi i kāu kauka i kēlā me kēia manawa āu e ʻike ai i kahi kauka hou. E kōkua kēia ʻike iā lākou e hoʻomaopopo maikaʻi i kou olakino puʻuwai a me ke olakino holoʻokoʻa.

E hōʻoia i kāu kauka e ʻike he poloka lālā pūʻolo kou, ʻoiai ma kēia mau hihia:

• Inā ʻoe e hana ana i kahi hoʻāʻo koʻikoʻi hoʻoikaika kino (no ka mea, hiki ke paʻakikī iki ke ʻike i kekahi mau maʻi ke loaʻa iā ʻoe ʻo LBBB).
• I ka hanana o kahi pilikia olakino, e like me ka hōʻeha puʻuwai.
• Inā ʻoe e hana ʻia ana i ke ʻoki no kekahi maʻi puʻuwai ʻē aʻe.

He manaʻo maikaʻi nō hoʻi e mālama i kahi kope o kāu hōʻike ECG, no ka mea, hiki ke kōkua i ka wā pilikia.

He aha nā manawa kūpono loa e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe nā hōʻailona hou, a inā e ʻoi aku ka ʻino o kāu mau hōʻailona, ​​e ʻike pono i ke kauka. E ʻimi koke i ke kōkua lapaʻau, ʻoiai inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona:

• Inā ʻoe e ʻeha ana i ka umauma, ka ʻoluʻolu ʻole, a i ʻole ka paʻa .
• Inā ʻoe e manaʻo ua luhi loa ʻoe .
• Inā manaʻo ʻoe e kokoke ana ʻoe e maule (presyncope).
• Inā nalowale kou ʻike .
• Inā pilikia ʻoe i ka hanu ʻana a i ʻole ua pau kou hanu ʻana.

I ka hōʻuluʻulu manaʻo (Leka Lawe-Home)

ʻAe, e hoʻomanaʻo wale kākou i ka `(Bundle Branch Block)` a mākou i kamaʻilio ai i kēia lā:

• ʻO ka Bundle Branch Block (BBB) ​​​​he ālai ia i ke ala hōʻailona uila i loko o ka puʻuwai. Hiki i kēia ke hana i nā puʻuwai puʻuwai kūpono ʻole.
• Hiki i kēia ke hoʻopili i ka ʻaoʻao ʻākau (RBBB), ka ʻaoʻao hema (LBBB), a i ʻole nā ​​​​ʻaoʻao ʻelua.
• ʻO ka hapa nui o ka manawa, ʻaʻohe hōʻailona .
• ʻIke nui ʻia kēia ma o nā hoʻāʻo 'ECG' a me 'Echo'.
• ʻAʻole pono mau ka mālama ʻana no ka 'BBB', akā he mea nui e mālama i ke kumu .
• Hiki i nā poʻe he nui ke ola i kahi ola maʻamau me ka poloka lālā bundle, akā hiki ke hoʻonui ʻia ka pilikia inā loaʻa iā ʻoe nā maʻi puʻuwai ʻē aʻe.

No laila, inā he kānalua kou no kēia ʻano maʻi, a ua haʻi ʻia mai e ke kauka maikaʻi, mai makaʻu. E hahai i nā kuhikuhi e pono ai, e ola i kahi nohona olakino. A laila hiki iā ʻoe ke noho olakino.

ʻO ka poloka lālā pūʻolo, maʻi puʻuwai, ECG, puʻuwai, uila puʻuwai, RBBB, LBBB