Ke manaʻo nei ʻoe i kekahi manawa e kuʻi wikiwiki ana kou puʻuwai a makaʻu ʻoe, a i ʻole ke ʻano o ka puʻuwai e like ʻole me ke kuʻi ʻana? E like me kāu hoʻokani ʻana i ka pahu, hoʻomaka koke kou puʻuwai e kuʻi wikiwiki, lohi, a lele paha i kahi kuʻi. I kēia lā ke kamaʻilio nei mākou e pili ana i kahi lāʻau lapaʻau kūikawā a nā kauka e hoʻohana ai i ia mau hihia. Ua kapa ʻia kēia ʻo 'Chemical Cardioversion'. ʻOiai he paʻakikī iki ka inoa, he maʻalahi loa ke ʻano o kēia.
I ka ʻōlelo maʻalahi, he aha ka Chemical Cardioversion?
ʻO ke Kemika Cardioversion kahi hana e hoʻohana ana i nā lāʻau lapaʻau e hoʻihoʻi i kahi ʻano puʻuwai maʻamau i kahi ʻano maʻamau. Ua like ia me kahi mākaʻi kaʻa e hele mai ana e kāohi i kahi kaʻa haunaele a kuhikuhi i nā kaʻa ma ke ʻano maʻamau. Maanei, ʻo ka 'mākaʻi kaʻa' ka lāʻau lapaʻau a ke kauka e hāʻawi ai iā ʻoe.
ʻO ka holomua o kēia lāʻau lapaʻau e pili ana i kekahi mau kumu, e like me ke kumu o kou puʻuwai puʻuwai kūpono ʻole, pehea ka lōʻihi o kou loaʻa ʻana i ke ʻano, a me ke ʻano o ka lāʻau lapaʻau a kāu kauka e koho ai.
ʻO nā lāʻau lapaʻau i hāʻawi ʻia no kēia lāʻau lapaʻau e hana nui i kekahi mau mea:
- Hoʻomāmā iki ia i kou mau kīʻaha koko, e maʻalahi ai ke kahe ʻana o ke koko.
- Hoʻomaha i nā ʻiʻo o ka puʻuwai.
- Hoʻemi ia i ke kaumaha ma luna o ka puʻuwai, ʻo ia hoʻi, ka ukana o ka puʻuwai.
- Hoʻokele ia i ka wikiwiki o nā hōʻailona uila e hōʻike ana i ka puʻuwai e kuʻi.
ʻO ka maʻamau, hoʻomaka ko mākou puʻuwai ma ke ʻano i hoʻonohonoho pono ʻia. Hoʻomaka ʻia kēia hōʻailona uila e kahi pacemaker kūlohelohe i loko o ka puʻuwai i kapa ʻia ʻo ka sinoatrial node. A laila hele kēia hōʻailona ma o nā ʻāpana o ka puʻuwai ma ke ʻano hoʻonohonoho pono, e hoʻoulu ai i ka puʻuwai e ʻūlū pono a pamu i ke koko. Inā he pilikia me ke ʻano o ka hele ʻana o kēia mau hōʻailona, lilo ke ʻano o ka puʻuwai i mea ʻē.
Ke hoʻopilikia ʻia ke kani o ka puʻuwai, ʻaʻole ia e pamu pono i ke koko ma ke kino holoʻokoʻa. Pono ko kākou mau hunaola lolo, e like me nā hunaola ʻē aʻe, i ka oxygen. Lawe ʻia kēia oxygen e ke koko. No laila, ke emi ke kahe ʻana o ke koko, hiki ke loaʻa nā hōʻailona e like me ka dizziness (vertigo), ka luhi, ka pōkole o ka hanu, a me ka ʻeha o ka umauma .
No ke aha mākou e pono ai i kēia lāʻau lapaʻau?
Inā paʻi wikiwiki loa kou puʻuwai a i ʻole he ʻano ʻē kou, pono paha ʻoe i ka cardioversion kemika. Nui nā kumu e hiki ai i kou puʻuwai ke lilo i ʻano ʻē. E noʻonoʻo ua hoʻomaka koke kou hoaaloha ʻo Nimal e manaʻo i kona umauma e paʻi ana. I kona hele ʻana i ke kauka wale nō i ʻike ai ʻo ia ua hoʻopilikia kahi maʻi koʻikoʻi i kona puʻuwai.
A he nui nā kumu ʻē aʻe:
- ʻO kekahi mau lāʻau lapaʻau āu e lawe ai: Hiki i kekahi mau lāʻau lapaʻau ke hoʻololi i ka ʻāʻī o ka puʻuwai ma ke ʻano he hopena ʻaoʻao.
- Nā maʻi: Hiki i nā maʻi bacteria a viral paha ke hoʻopilikia i ka ʻiʻo o ka puʻuwai.
- Hoʻouka Puʻuwai: Hiki i ka hoʻouka puʻuwai ke hōʻino i ka ʻōnaehana uila o ka puʻuwai.
- Nā loli i ke ʻano o ka puʻuwai: maʻi puʻuwai hānau a i ʻole nā loli e hana ʻia ma hope.
- ʻO ka Pulmonary Embolism: He pilikia kēia.
- Ka Hāʻule ʻana o ka Puʻuwai Paʻa: Ke nāwaliwali ka puʻuwai a emi iho kona hiki ke pamu i ke koko.
- Nā maʻi o ka māmā: Nā kūlana e like me COPD a i ʻole Emphysema.
He aha nā ʻano o nā mele puʻuwai e hiki ke mālama ʻia me kēia ʻano hana?
Hoʻohana ʻia ka cardioversion kemika e mālama i nā ʻano mele puʻuwai like ʻole, e like me:
| Ka inoa o ka puʻuwai ʻano ʻē (Arrhythmia Name) | He wehewehe maʻalahi |
|---|---|
| ʻO ka Fibrillation Atrial (Afib) | He kūlana maʻamau kahi e kuʻi wikiwiki ai a kū ʻole ai nā keʻena o luna o ka puʻuwai (atria). |
| Ka Lele ʻAtrial | Ua kuʻi wikiwiki aʻe nā keʻena o luna o ka puʻuwai, akā ma kahi ʻano i hoʻonohonoho pono ʻia ma mua o Afib. |
| ʻO ka Tachycardia Supraventricular (SVT) | He puʻuwai wikiwiki loa e hoʻomaka ana ma ka ʻaoʻao o luna o ka puʻuwai. |
| ʻO ka Tachycardia Ventricular (VT) | He puʻuwai wikiwiki e hoʻomaka ana ma nā keʻena haʻahaʻa (ventricles) o ka puʻuwai. Hiki i kēia ke lilo i mea koʻikoʻi. |
ʻO ka ʻokoʻa ma waena o ka Electrical Cardioversion a me kēia
Ua ʻike paha ʻoe iā ia ma nā kiʻiʻoniʻoni, kahi e hāʻawi ai lākou i kahi haʻalulu i ka umauma e hoʻomaka hou i ka puʻuwai. Ua kapa ʻia ʻo 'Electrical Cardioversion.' Pili ia i ka hoʻouna ʻana i kahi haʻalulu uila i kāohi ʻia i ka puʻuwai e 'hoʻonohonoho hou' i ka ʻōnaehana uila. Pili ka Chemical Cardioversion i ka hāʻawi ʻana i ka lāʻau lapaʻau e hana i ka mea like.
Na kāu kauka e hoʻoholo i ka lāʻau lapaʻau maikaʻi loa nāu ma muli o kou kūlana. No ka laʻana, inā haʻahaʻa loa kou koko, hiki i kāu kauka ke hoʻoholo e hana i ka cardioversion uila.
He aha ka mea e hana ʻia ma mua o ka lāʻau lapaʻau a pehea mākou e hoʻomākaukau ai?
E hāʻawi aku kāu kauka iā ʻoe i kekahi mau kuhikuhi ma mua o kēia lāʻau lapaʻau. He mea nui loa ia e hahai pololei iā lākou.
1. Ke hōʻalo ʻana i ka meaʻai a me ka mea inu: E noi ʻia ʻoe e hōʻalo i ka ʻai ʻana a i ʻole ka inu ʻana i kekahi mea no kahi o 8 mau hola ma mua o ka mālama ʻana.
2. E nānā i nā ʻūpā koko: Inā ʻaʻole kūlike kou puʻuwai no nā lā ʻelua a ʻoi, aia kahi manawa e hana ʻia ai nā ʻūpā koko liʻiliʻi i loko o kou puʻuwai. Inā hoʻi koke kou helu puʻuwai i ka maʻamau ma hope o kēia lāʻau lapaʻau, inā haki ka ʻūpā a paʻa i loko o kahi kīʻaha koko i loko o kou lolo, hiki iā ia ke hana i kahi maʻi koʻikoʻi e like me ka hahau ʻana. No ka nānā ʻana i kēlā pilikia, e noi paha kāu kauka iā ʻoe e hana i kahi scan kūikawā i kapa ʻia ʻo Transesophageal Echocardiogram (TEE) . ʻO kēia ke komo ʻana i kahi ʻōmole liʻiliʻi i lalo o kou puʻu a nānā pono i ke kua o kou puʻuwai e ʻike inā he mau ʻūpā koko.
3. Nā Anticoagulants: No ka hōʻemi ʻana i ka pilikia o nā ʻūpā koko i ʻōlelo ʻia ma luna, e noi ʻia ʻoe e hoʻomaka e lawe i nā lāʻau hoʻokahe koko ma kahi o 3 mau pule ma mua o ka mālama ʻana. Pono ʻoe e hoʻomau i ka lawe ʻana i kēia mau lāʻau no kahi o 4 mau pule ma hope o ka mālama ʻana.
4. E haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe ai: He mea nui e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe ai, me nā lāʻau hōʻoluʻolu ʻeha ma luna o ke kauka, nā huaora, a me nā lāʻau lapaʻau lāʻau. Hiki i kekahi mau lāʻau lapaʻau ke launa pū me nā lāʻau lapaʻau i hāʻawi ʻia no kēia lāʻau lapaʻau.
He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?
ʻAʻole kēia he mea hiki iā ʻoe ke hana ma ka home. E hoʻokomo ʻia ʻoe i ka haukapila a e hāʻawi ʻia kēia lāʻau lapaʻau ma lalo o ka nānā mau ʻana.
- Kahi: E hoʻokomo ʻia ʻoe i loko o ka ʻāpana mālama koʻikoʻi (ICU) o ka haukapila a i ʻole kahi keʻena like kahi e hiki ai ke nānā pono ʻia ʻoe. Mai hopohopo, no kou palekana kēia. No ka mea, pono ʻoe e nānā pono ʻia no nā loli i kou puʻuwai ke hāʻawi ʻia ka lāʻau lapaʻau iā ʻoe.
- Nānā ʻana: E kau ʻia kahi laina IV (cannula) ma kou lima a e hoʻopili ʻia kahi mea nānā iā ia. E nānā mau kēia i kāu ECG (hana uila o ka puʻuwai), ke koko, a me nā pae oxygen.
- Pehea e hāʻawi ai i ka lāʻau lapaʻau:E hāʻawi ʻia ka lāʻau lapaʻau iā ʻoe ma ke ʻano he pila e lawe ai ma ka waha a i ʻole pololei i loko o kahi aa koko ma o kahi laina IV ma kou lima. I kekahi manawa, inā ʻaʻole holo pono ka mahele mua, e hāʻawi ʻia paha ʻoe i kahi mahele ʻē aʻe.
- Palekana: Aia nā kauka a me nā limahana kahu maʻi me ʻoe. Loaʻa iā lākou nā lako e like me ka defibrillator kokoke inā loaʻa kekahi ʻano ʻē aʻe. No laila, aia ʻoe i kahi wahi palekana loa.
He aha nā lāʻau lapaʻau i hoʻohana ʻia no kēia?
ʻO ka lāʻau lapaʻau a kāu kauka e hāʻawi ai iā ʻoe e hilinaʻi ia i ke ʻano o ka puʻuwai ʻano ʻē i loaʻa iā ʻoe. Hoʻohana ʻia kekahi o kēia mau lāʻau lapaʻau e mālama i ke koko kiʻekiʻe a me ka hāʻule ʻana o ka puʻuwai congestive.
Eia kekahi o nā ʻano lāʻau lapaʻau nui i hoʻohana ʻia:
- ʻAdenosine
- ʻAmiodarone
- Procainamide
- ʻIbutilide
- Nā mea pale Beta - e.g. Metoprolol
- Nā mea pale i ke kahawai calcium - e.g. Diltiazem
- ʻO Flecainide
- ʻO Propafenone
ʻOkoʻa ka hana a kēlā me kēia o kēia mau lāʻau lapaʻau, no laila hiki i kāu kauka ke koho i ka lāʻau lapaʻau kūpono loa iā ʻoe.
He aha ka mea e hana ʻia ma hope o ka lāʻau lapaʻau?
Ma hope o ka hāʻawi ʻia ʻana o ka lāʻau lapaʻau a hoʻi hou kou puʻuwai i ka maʻamau, hiki ke mālama ʻia ʻoe i loko o ka haukapila no 24 a 48 mau hola ma lalo o ka nānā ʻana e hōʻoia i ka paʻa o nā mea āpau. Ma hope o kēlā, hiki iā ʻoe ke hoʻi i ka home.
Ua hōʻike ka nui o ka poʻe ua luhi a ʻoluʻolu ʻole lākou i ka lāʻau i hāʻawi ʻia iā lākou. He mea maʻamau kēia, akā inā loaʻa iā ʻoe kekahi ʻoluʻolu nui, e ʻoluʻolu e haʻi i kāu kauka.
He aha nā pilikia a me nā pono o kēia lāʻau lapaʻau?
E like me nā lāʻau lapaʻau āpau, aia nā pono a me nā pilikia. E ʻōlelo wale kāu kauka i kēia lāʻau lapaʻau inā ʻoi aku ka maikaʻi o nā pono ma mua o nā pilikia.
| Nā Pōmaikaʻi | Nā Pōʻino/Nā Pilikia |
|---|---|
| Ka hiki ke hoʻihoʻi i ka puʻuwai i kahi mele maʻamau. | He mele hou ʻēHiki ke hiki mai a i ʻole e lilo i mea ʻino aʻe. |
| Ka hoʻemi ʻana i nā hōʻailona e like me ka dizziness, ka luhi, a me ka pōkole o ka hanu. | Aia kahi pilikia liʻiliʻi o ka haki ʻana o kahi ʻūpā koko a me ke kumu o ka hahau ʻana (hiki ke hoʻēmi ʻia kēia ma ka lawe ʻana i nā lāʻau hoʻokahe koko). |
| He koho ʻē aʻe i ka Electrical Cardioversion (ke ʻano o ka hāʻawi ʻana i ka haʻalulu). | Hiki ke loaʻa nā hopena ʻaoʻao e like me ka nausea a me ka luhi. |
| Hiki i kekahi mau lāʻau lapaʻau ke hala i nā mahina e hana ai. | |
| Inā ʻaʻole holomua ka lāʻau lapaʻau, pono paha nā lāʻau ʻē aʻe e like me ka Electrical Cardioversion a i ʻole Catheter Ablation. |
I ka manawa hea e pono ai ʻoe e ʻike koke i ke kauka?
Ke hoʻi ʻoe i ka home ma hope o ka mālama ʻana, he mea nui loa ia e makaʻala i nā hōʻailona ʻē. Inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei, e hele koke i ka haukapila Emergency Department (ETU) kokoke loa a kāhea aku paha i ka 1990.
- Nā palpitations o ka puʻuwai
- ʻO ka poniuniu nui
- Inā polū kou mau maka a manaʻo ʻoe he māmā ke poʻo (Lightheadedness)
- Nāwaliwali
- Ka hou nui koke ʻana (Sweatiness)
- Nā hopena maʻi e like me ka ʻūlū a me ka maneʻo
- ʻEha umauma
- Paʻakikī ka hanu ʻana
Ma mua a ma hope o ka mālama ʻana, e lawe i nā lāʻau lapaʻau a pau i kuhikuhi ʻia e kāu kauka me ka pololei a me ka manawa kūpono. Inā he kānalua kou e pili ana i ke ʻano o ka lawe ʻana i kāu lāʻau lapaʻau, e nīnau hou i kāu kauka no ka wehewehe ʻana.
Leka Lawe-Home
- ʻO ka cardioversion kemika kahi lāʻau lapaʻau e hoʻohana ana i nā lāʻau lapaʻau e hoʻihoʻi i ka rhythm o ka puʻuwai i ka maʻamau.
- Hana ʻia kēia no ka hōʻoia ʻana i kou palekana, ma ka haukapila, ma lalo o ka mākaʻikaʻi mau ʻana a ke kauka.
- Ma mua o ka mālama ʻana, he mea nui e hoʻomaopopo i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei, me nā huaora a me nā lāʻau Ayurvedic.
- E like me nā lāʻau lapaʻau a pau, aia kekahi mau pilikia, akā ke kuhikuhi nei kāu kauka i kēia lāʻau lapaʻau nāu no ka mea ʻoi aku ka nui o nā pono ma mua o nā pilikia.
- Ma hope o ka lāʻau lapaʻau, he mea nui loa ka lawe ʻana i nā lāʻau lapaʻau, ʻoiai nā lāʻau hoʻokahe koko, e like me ke kauoha.
- E ʻimi koke i ke kōkua lapaʻau inā loaʻa iā ʻoe nā hōʻailona pilikia e like me ka ʻeha o ka umauma, ka paʻakikī o ka hanu ʻana, a i ʻole ka poniuniu nui.
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