E kamaʻilio kākou e pili ana iā Heart Block ma nā ʻōlelo maʻalahi!

Ua like ko kākou puʻuwai me kahi mīkini kupaianaha e hana ana i kahi mele kikoʻī, ʻeā? Akā i kekahi manawa, hele iki kēia mele ma waho o ka manaʻo. Ua manaʻo paha ʻoe ua kuʻi mālie kou puʻuwai, lele koke i kahi kuʻi, a i ʻole ua paʻa kou umauma. ʻO kekahi o nā kumu nui o kēia, he ʻano i kapa ʻia ʻo 'Heart Block'. Mai makaʻu i kou lohe ʻana i kēia inoa. I kēia lā e kamaʻilio mākou e pili ana i kēia, ʻo ia hoʻi, ke ālai ʻana o nā hōʻailona uila o ka puʻuwai, ma ke ʻano maʻalahi loa hiki iā ʻoe ke hoʻomaopopo.

I ka ʻōlelo maʻalahi, he aha ka Heart Block?

I mea e hoʻomaopopo ai i kēia, e nānā mua kākou i ke ʻano o ka hana ʻana o ko kākou puʻuwai. E noʻonoʻo ua like kou puʻuwai me kahi hale me ʻehā lumi. Aia ʻelua lumi ma ka papahele kiʻekiʻe (ka mea a mākou e kapa nei ʻo Atria) a ʻelua lumi ma ka papahele lalo (ʻo ia hoʻi nā Ventricles). I mea e paʻi ai ka puʻuwai, pono e hele kahi hōʻailona uila mai ka papahele kiʻekiʻe a i ka papahele lalo.

I ka hele ʻana o kēia hōʻailona uila mai nā keʻena luna a i nā keʻena haʻahaʻa, hele ia ma kahi hui liʻiliʻi (i kapa ʻia ʻo ka AV node ma ka ʻepekema lapaʻau) ma waena o nā mea ʻelua. ʻO ke ālai ʻana o ka puʻuwai ke ʻano he keʻakeʻa, lohi, a i ʻole ka pau ʻana o ka hōʻailona uila i kona hele ʻana ma kēia hui.

He aha ka mea e hana ʻia ke hele pono ʻole kēia hōʻailona uila? No ka mea, ʻaʻole i loaʻa i nā keʻena (nā cell) o ka puʻuwai ka hōʻailona i ka manawa kūpono, kuʻi mālie ka puʻuwai a lele paha i kekahi mau kuʻi . I nā hihia koʻikoʻi, ʻaʻole hiki i ka puʻuwai ke pamu i ke koko lawa i ke kino. Hiki i kēia ke hōʻemi i ke kahe koko i ke kino holoʻokoʻa.

ʻOi aku ka nui o ka hiki ke ulu aʻe kēia maʻi ma hope o ke ola, ʻoiai me ka ʻelemakule, ma mua o ka wā hānau. Ua kapa ʻia hoʻi ʻo ia he poloka Atrioventricular (AV).

He aha nā ʻano nui o ka poloka puʻuwai?

ʻOkoʻa ke koʻikoʻi o ka Heart Block ma muli o ke kiʻekiʻe o ka hoʻopilikia ʻana i ka hōʻailona uila. No laila, ua māhele mākou iā ia i ʻekolu mau ʻano nui. E nānā kākou i kēia papa e hoʻomaopopo maʻalahi i kēia.

ʻIke hou aku e pili ana i ka Heart Block pae ʻelua...

• ʻAno Mobitz I: He kūlana kēia kahi e lohi ai ka hōʻailona uila, a laila lohi, a laila hala koke, a laila hoʻomaka hou. He kūlana ʻoi aku ka koʻikoʻi o kēia.
• ʻAno Mobitz II: ʻAʻole kēia he hōʻailona hōʻike. He ʻano uila koke ia, hiki ʻole ke kāohi ʻia, ʻaʻole i lohe ʻia. He ʻano ʻē a lohi ka helu o ka puʻuwai. ʻOi aku ka koʻikoʻi o kēia ma mua o ke ʻano I. Pono pinepine kēia ʻano i kahi pacemaker.

Loaʻa iā ʻoe kēia mau hōʻailona?

ʻOkoʻa nā hōʻailona ma muli o ke koʻikoʻi o ka poloka puʻuwai. ʻAʻole paha ʻoe e ʻike i kekahi mea i ka wā e loaʻa ai nā hōʻailona o kāu hoaaloha.

• ʻO ka poʻe me ka poloka puʻuwai kekelē mua ʻaʻohe o lākou mau hōʻailona . ʻIke ʻia ia ma ka hanana i ka wā o kahi hoʻāʻo ECG (electrocardiogram) no kekahi kumu ʻē aʻe.

Akā i ka lua a me ke kolu o nā kahua, i ka lohi ʻana o ka puʻuwai, nā hōʻailona e like me:

• ʻEha a ʻeha paha ka umauma
• Luhi nui me ke kumu ʻole
• Paʻakikī ka hanu ʻana a i ʻole ka pōkole o ka hanu
• Nā palpitations o ka puʻuwai (manaʻo e like me ka wikiwiki o kou puʻuwai)
• Pōʻino a me ke poʻo māmā
• Ka mae ʻana
• Ka luaʻi

He aha nā kumu o ka poloka puʻuwai?

ʻO kekahi mea e hōʻino ai i ka ʻōnaehana uila o ka puʻuwai hiki ke hana i kēia. Eia kekahi o nā kumu nui:

• Hoʻouka puʻuwai: Ka hōʻino ʻia ʻana o nā ʻiʻo puʻuwai i hana ʻia e ka hoʻouka puʻuwai.
• ʻO ka maʻi o ke aʻa coronary (CAD): Ka hoʻohaiki ʻana o nā aʻa e hoʻolako koko i ka puʻuwai.
• Cardiomyopathy: Ka nāwaliwali a i ʻole ka mānoanoa o ka ʻiʻo o ka puʻuwai.
• Nā maʻi kīwila puʻuwai: Kekahi mau pilikia me nā kīwila puʻuwai.
• Kekahi mau lāʻau lapaʻau: Kekahi mau lāʻau lapaʻau no ke koko kiʻekiʻe a me nā maʻi puʻuwai (e.g. Beta-blockers, Calcium channel blockers).
• Maʻi puʻuwai hānau: Ke kū ʻana o kekahi mau loli i ke ʻano o ka puʻuwai i ka wā hānau.
• Nā ʻeha i ka wā o ke ʻoki puʻuwai hāmama.
• Kekahi mau maʻi: Nā maʻi e like me ka maʻi Lyme.
• Nā maʻi ʻē aʻe: ka maʻi thyroid, sarcoidosis, a me nā mea ʻē aʻe.

Pehea e loaʻa ai kēia?

Ke hele ʻoe e ʻike i ke kauka, e nīnau ʻo ia iā ʻoe e pili ana i kēia mau mea:

• He aha kou mau hōʻailona a pehea ka lōʻihi o kou loaʻa ʻana iā lākou?
• Aia kekahi o kou ʻohana i loaʻa i ka maʻi puʻuwai?
• E pili ana i nā lāʻau lapaʻau āu e lawe ai.
• E pili ana i kou nohona (ʻai ʻana, inu ʻana, hoʻoikaika kino, puhipaka).

A laila, e nānā ke kauka iā ʻoe, e hoʻolohe i kou puʻuwai, e nānā i ka helu o kou puʻuwai, a inā pono, e kuhikuhi iā ʻoe i kahi cardiologist.

No ka hōʻoia ʻana i ka maʻi, hiki ke hana ʻia nā hoʻokolohua aʻe:

• ECG (Electrocardiogram): ʻO kēia ka hoʻāʻo koʻikoʻi a maʻalahi loa. Hoʻopaʻa ia i ka hana uila o ka puʻuwai.
• Nānā Ambulatory (Holter Monitor): ʻAʻole paha e loaʻa mau ka poloka puʻuwai, no laila e hāʻawi ʻia ʻoe i kahi mea liʻiliʻi e hoʻopaʻa ai i ka hana o kou puʻuwai no 24 a 48 mau hola.
• Hoʻāʻo Koʻikoʻi Hoʻoikaika Kino: Lawe ʻia kahi ECG i kou hele ʻana a holo paha ma luna o ka treadmill, e nānā ana pehea e loli ai ka helu o kou puʻuwai me ka hoʻoikaika kino.
• Haʻawina Electrophysiology (Haʻawina EP):He hoʻāʻo paʻakikī iki kēia. Hoʻokomo ʻia kahi uea lahilahi i loko o ka puʻuwai e kuhikuhi i kahi kikoʻī o ka pilikia ma ka ʻōnaehana uila.

Pehea e mālama ʻia ai ka Heart Block?

Hoʻoholo ʻia ka lāʻau lapaʻau i ke ʻano o ka poloka puʻuwai āu e loaʻa ai, pehea kona koʻikoʻi, a me nā hōʻailona āu e loaʻa ai.

• Pale Puʻuwai kekelē mua: ʻAʻole pono kēia i ka lāʻau lapaʻau . Na kāu kauka e nānā iā ʻoe.
• Pale Puʻuwai kekelē ʻelua: ʻAʻole pono paha ka lāʻau lapaʻau ʻo Mobitz Type I inā ʻaʻohe hōʻailona. Eia nō naʻe, inā he mau hōʻailona, ​​a i ʻole Mobitz Type II, pono paha kahi pacemaker e mālama i ka rhythm o ka puʻuwai.
• Pale Puʻuwai kekelē ʻekolu: Pono pinepine ka poʻe me kēia ʻano i kahi pacemaker .

He aha kēia Pacemaker?

He mea liʻiliʻi loa ka pacemaker, i hoʻohana ʻia e ka pila. Hoʻokomo ʻia ia ma lalo o ka ʻili o kou umauma i ka wā o ke ʻoki kino liʻiliʻi. Hoʻopili ʻia kahi uea lahilahi mai kēia i kou puʻuwai. Hana ka pacemaker ma ka hoʻouna ʻana i nā hōʻailona uila i kou puʻuwai i ka wā e kuʻi mālie ana, e hoʻomau ana i ka kuʻi ʻana i kahi mele maʻamau.

Nā mea e noʻonoʻo ai i ka wā e noho ai me kahi pacemaker

Hiki iā ʻoe ke ola i kahi ola maʻamau ma hope o ke kau ʻia ʻana o kahi pacemaker, akā pono ʻoe e makaʻala e pili ana i kēia mau mea:

• E noho mamao aku mai nā kahua magnetic ikaika: Mai hele kokoke i nā mea e like me nā mīkini MRI.
• Nā Kelepona Paʻalima: Mai lawe i kāu kelepona i loko o ka ʻeke hoʻokahi me kāu pacemaker. E mālama iā ia ma ka liʻiliʻi he 6 ʻīniha ka mamao.
• Nā nānā palekana, e like me nā kahua mokulele: E haʻi aku i nā luna palekana he pacemaker kāu. A e lawe mau i kahi kāleka e hōʻike ana he pacemaker kāu.
• E hoʻomaopopo i nā kauka ʻē aʻe: Inā ʻoe e hele ana e ʻike i ke kauka niho a i ʻole kekahi kauka ʻē aʻe, e haʻi iā lākou he pacemaker kou.

Āhea ʻoe e ʻike ai i kāu kauka?

Inā loaʻa iā ʻoe kahi poloka puʻuwai, he mea nui loa ia e hele i nā keʻena lapaʻau i nā manawa i hoʻonohonoho ʻia e like me ke kauka. Inā loaʻa iā ʻoe kahi pacemaker, pono ʻoe e nānā mau i kāna hana pono ʻana.

Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, ​​e kāhea koke aku i kāu kauka:

• Pōʻino a poʻo hina paha
• ʻEha umauma
• Nā palpitations o ka puʻuwai a i ʻole ka lele ʻana o nā kuʻi
• Manaʻo nāwaliwali
• Paʻakikī ka hanu ʻana
• Ka pehu ʻana o nā wāwae a me nā kuʻekuʻe wāwae

Inā loaʻa iā ʻoe nā hōʻailona o ka hōʻeha puʻuwai (ʻeha nui o ka umauma, paʻakikī ka hanu ʻana) a i ʻole nā ​​​​hōʻailona o ka hopu ʻana o ka puʻuwai (nalowale koke ka ʻike), e hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa.