Ke pilikia nei ʻoe me kou puʻuwai? E kamaʻilio kākou e pili ana i ka Heart Block!

Ua loaʻa anei iā ʻoe ka ʻeha o ka umauma, ka pōkole o ka hanu, a i ʻole ka manaʻo e kuʻi ana kou puʻuwai i ke ʻano ʻē? Ua manaʻo paha ʻoe ua puni ka poʻo a ua nāwaliwali paha. I kekahi manawa, he mau hōʻailona kēia o kahi maʻi i kapa ʻia ʻo 'heart block', kahi e kū mai ana i ka wā ʻaʻole holo pono nā hōʻailona uila i loko o ka puʻuwai. I kēia lā, e kamaʻilio mākou e pili ana i kēia me nā kikoʻī, akā maʻalahi, me he mea lā e kamaʻilio ana ʻoe me kahi hoaaloha.

He aha ka Heart Block? I ka ʻōlelo maʻalahi...

E noʻonoʻo iā ia e like me kahi motika liʻiliʻi e pono ai ka uila e hana. Ma ke ʻano like, loaʻa i ko kākou puʻuwai kahi ʻōnaehana hōʻailona uila e kuʻi ai. Hoʻomaka kēia mau hōʻailona mai nā keʻena ʻelua o luna o ka puʻuwai (a mākou e kapa nei he `(Atria)`) a hele i nā keʻena ʻelua o lalo o ka puʻuwai (`(Ventricles)`). Ma waena o kēia mau keʻena o luna a me lalo, e like me ke kukui uila, aia kahi e hoʻomalu ai i nā hōʻailona. Ua kapa ʻia ʻo ia ʻo `(AV node)` (atrioventricular node).

I kēia manawa, ʻo ka poloka puʻuwai ke loaʻa kekahi ʻano keʻakeʻa i ke ala e hele ai nā hōʻailona uila mai luna a i lalo o ka puʻuwai. Malia paha e hele mālie nā hōʻailona, ​​a i ʻole ʻaʻole hiki kekahi o nā hōʻailona i nā keʻena haʻahaʻa, a i ʻole e pau loa ka hele ʻana o nā hōʻailona.

He aha ka mea e hana ʻia a laila? ʻAʻole paha e hana pono ka puʻuwai. Hiki i ka puʻuwai ke kuʻi mālie, a hiki ke hoʻokuʻu ʻia kekahi mau kuʻi. I nā hihia koʻikoʻi, hiki i kēia ke hoʻopilikia i ka holo ʻana o ke koko ma ke kino holoʻokoʻa, e hana ana i nā pilikia koʻikoʻi. Hoʻomaka pinepine kēia ʻano ma hope o ke ola, ma mua o ka wā hānau. Ua kapa ʻia kēia he "Atrioventricular (AV) block" a i kekahi manawa ua kapa ʻia ʻo "conduction disorder".

Aia kekahi mau ʻano poloka puʻuwai?

ʻAe, hiki i kēia mau poloka puʻuwai ke hele mai i nā ʻano like ʻole a ma nā pae like ʻole. ʻO ia hoʻi, ua hoʻokaʻawale ʻia lākou e like me ka nui o ka pale ʻia ʻana o ka hōʻailona uila a me ka pinepine o ka hana ʻana.

• ʻO ka poloka puʻuwai kekelē mua: I kēia hihia, hele ka hōʻailona uila i nā keʻena haʻahaʻa o ka puʻuwai (nā ventricles), akā lohi iki. Aia kahi lohi iki i kona hele ʻana ma o ka AV node. ʻO kēia ke ʻano palupalu loa o ka poloka. ʻAʻole ʻike ka hapa nui o ka poʻe he loaʻa iā lākou.
• ʻO ka poloka puʻuwai kekelē ʻelua (ʻaʻole i piha): Ma kēia, ʻo kekahi o nā hōʻailona uila o ka puʻuwai e hiki i nā keʻena haʻahaʻa, ʻaʻole lākou āpau. Aia kekahi ʻano ʻelua o kēia:
• ʻAno I, `(Mobitz ʻAno I)` a i ʻole `(Wenckebach's AV block)`: He ʻano ʻoi aku ka liʻiliʻi o ke koʻikoʻi o kēia. Hoʻolohi mālie ka hōʻailona uila, a laila e lele ana i hoʻokahi puʻuwai.
• ʻAno II (ʻAno II), `(Mobitz ʻAno II)`: Ma kēia, ʻoiai ka hapa nui o nā hōʻailona e hele i nā keʻena, i kekahi manawa e pau koke kekahi o nā hōʻailona. A laila lilo ka puʻuwai i mea ʻē, e kuʻi mālie ana ma mua o ka maʻamau. He ʻoi aku ka koʻikoʻi o kēia, a pono paha ʻoe i kahi `(Pacemaker)` (kahi mea liʻiliʻi e kōkua ai i ka mālama ʻana i ka puʻuwai i ka wikiwiki maʻamau).
• Poloka puʻuwai kekelē ʻekolu: He poloka piha kēia.ʻAʻole hele nā ​​hōʻailona uila mai nā keʻena o luna o ka puʻuwai (`(Atria)`) i nā keʻena o lalo (`(Ventricles)`). Hoʻopilikia nui kēia i ke ʻano o ka puʻuwai e pamu ai i ke koko i ke kino. He maʻi koʻikoʻi loa kēia, a ʻaneʻane pono mau ka lāʻau i kahi `(Pacemaker)`.

He aha nā hōʻailona o kēia?

Hiki ke ʻokoʻa nā hōʻailona o ka poloka puʻuwai mai kēlā kanaka a kēia kanaka, ma muli o ke koʻikoʻi o ka poloka a pehea e pili ai i ka hana o ka puʻuwai.

ʻO nā hōʻailona i ʻike pinepine ʻia:

• ʻEha umauma
• Luhi, luhi
• Paʻakikī ka hanu ʻana
• Manaʻo e like me ka wikiwiki o kou puʻuwai (palpitations)
• Hoʻonui ʻia ka hanu ʻana
• Ka luaʻi
• Pōʻino, manaʻo e like me ʻoe e milo ana.
• Ka nalowale o ka ʻike (nāwaliwali)

Eia nō naʻe, ʻaʻohe paha o nā hōʻailona o ka poʻe me ka poloka puʻuwai kekelē mua. ʻIke ʻia ia i kekahi manawa ke hana ke kauka i kahi electrocardiogram (EKG) i ka wā o ka nānā maʻamau.

I ke kekelē ʻekolu o ka puʻuwai, hiki ke koʻikoʻi loa nā hōʻailona, ​​​​​​no ka mea, e lohi nui ana ka helu o ka puʻuwai. Inā loaʻa iā ʻoe nā hōʻailona koʻikoʻi, he mea nui e ʻimi koke i ke kōkua lapaʻau.

He aha nā kumu o ka poloka puʻuwai?

Aia kekahi mau kumu e hiki ke kōkua i ka poloka puʻuwai. ʻO kekahi o nā kumu nui:

• Maʻi hohola
• ʻO ka maʻi ʻaʻa coronary (CAD)
• Maʻi ʻiʻo puʻuwai ('Cardiomyopathy')
• Nā maʻi valve puʻuwai
• Ka pōʻino i wehewehe ʻole ʻia i ka ʻōnaehana hōʻailona uila o ka puʻuwai
• Nā pilikia kūkulu puʻuwai hānau
• Ka hōʻeha o ka puʻuwai i ka wā o ke ʻoki puʻuwai hāmama
• Nā hopena ʻaoʻao o kekahi mau lāʻau lapaʻau (e.g., nā lāʻau lapaʻau e like me `(Beta-blockers)`, `(Digitalis)`, `(Calcium channel blockers)`)
• Ka hōʻike ʻana i nā mea ʻawahia
• ʻO ka apnea hiamoe obstructive
• Maʻi thyroid
• ʻO kekahi mau maʻi, no ka laʻana `(Lyme disease)`
• Nā maʻi autoimmune
• Nā ʻano ʻino genetic

ʻO wai ka mea i pilikia nui no kēia?

Hiki paha iā ʻoe ke hoʻonui i ka pilikia o ka loaʻa ʻana o ka hōʻeha puʻuwai inā:

• Inā he mau maʻi puʻuwai ʻē aʻe kou, e like me ka maʻi ʻaʻai coronary a i ʻole ka maʻi valve puʻuwai.
• Inā ua hānau ʻia ʻoe me kahi maʻi puʻuwai.
• Inā loaʻa iā ʻoe kahi maʻi e hoʻopilikia ai i ka puʻuwai, e like me ka `(Rheumatic heart disease)` a i ʻole `(Sarcoidosis)`.
• Inā lilo kou "aʻalolo vagus" (kahi aʻalolo e kōkua i ka kaohi ʻana i kou helu puʻuwai) i mea hana nui a hoʻolohi i kou helu puʻuwai.
• Inā ʻoe e lawe ana i nā lāʻau lapaʻau e hoʻolohi i nā hōʻailona uila o ka puʻuwai. Hiki i kēia ke komo pū me nā lāʻau lapaʻau no ka maʻi puʻuwai a me ke koko kiʻekiʻe (e.g., `(Beta-blockers)`, `(Diuretics)`, `(Calcium channel blockers)`, `(Digoxin)`), nā lāʻau lapaʻau no ka puʻuwai puʻuwai kūpono ʻole (`(Antiarrhythmics)`), nā mea hoʻomaha ʻiʻo, nā lāʻau hiamoe, a me nā lāʻau lapaʻau no ke kaumaha a me ka maʻi noʻonoʻo.

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

Inā ʻaʻole mālama pono ʻia nā poloka puʻuwai, hiki iā lākou ke alakaʻi i nā pilikia e hoʻoweliweli i ke ola. ʻO kēia mau mea:

• Ka hāʻule ʻana o ka puʻuwai (hiki ʻole i ka puʻuwai ke pamu i ke koko kūpono i ke kino)
• Puʻuwai puʻuwai kūpono ʻole ('Arrhythmia')
• Maʻi hohola
• Ka hopu koke ʻana o ka puʻuwai (kū koke ka puʻuwai)

Pehea e ʻike ai i ka poloka puʻuwai?

No ka ʻike ʻana inā loaʻa iā ʻoe ka puʻuwai puʻuwai, e hana kāu kauka i kēia mau mea:

• E nānā ʻia kāu mōʻaukala olakino.
• E nīnau e pili ana i ka mōʻaukala olakino o kou ʻohana.
• E nīnau lākou e pili ana i kou olakino laulā, nā ʻano ʻai, nā ʻano hoʻoikaika kino, a me nā hōʻailona.
• Nīnau lākou e pili ana i nā lāʻau lapaʻau āu e lawe ai (nā lāʻau lapaʻau i kuhikuhi ʻia e kāu kauka a me nā lāʻau lapaʻau āu e kūʻai ai mai ka hale kūʻai lāʻau lapaʻau).
• Nīnau lākou inā ʻoe e puhi paka a hoʻohana paha i nā lāʻau ʻē aʻe.
• E hoʻolohe lākou i kou puʻuwai a nānā i kou puʻuwai.
• E nānā i nā hōʻailona o ka hāʻule puʻuwai (e.g., ka pehu ʻana ma nā wāwae a me nā kuʻekuʻe wāwae).

Hiki paha i kāu cardiologist ke kuhikuhi iā ʻoe i kahi electrophysiologist (he loea i ka hana uila o ka puʻuwai).

He aha ke ʻano o nā hoʻokolohua e hana ʻia?

No ka hoʻomaopopo pono ʻana i kēia maʻi, hiki iā ʻoe ke hana i nā hoʻokolohua aʻe:

• Nā hoʻāʻo koko
• Nā hoʻokolohua genetic
• ʻElectrocardiogram (EKG)
• Monitor Ambulatory (kahi mea liʻiliʻi e hoʻopaʻa i kou helu puʻuwai i nā lā he nui)
• Loop recorder (kahi mea e nānā ai i ka puʻuwai no ka manawa lōʻihi)
• Ke aʻo ʻana i ka electrophysiology (kahi ʻano hana kūikawā e nānā ai i ka ʻōnaehana uila o ka puʻuwai)
• Hoʻāʻo koʻikoʻi hoʻoikaika kino ('Hoʻāʻo koʻikoʻi hoʻoikaika kino' - ke nānā nei i ke ʻano o ka hana a ka puʻuwai i ka wā o ka hoʻoikaika kino)

Pehea e mālama ʻia ai?

ʻOkoʻa ke ʻano o ka mālama ʻana no ka poloka puʻuwai mai kēlā kanaka a kēia kanaka. Hiki ke lawe ʻia ʻoe i ka haukapila e nānā i kou puʻuwai. No ka mālama ʻana i kou kūlana, e noʻonoʻo kāu kauka puʻuwai i kēia mau mea:

• He aha ke ʻano o ka poloka puʻuwai āu e loaʻa nei?
• Pehea ke koʻikoʻi?
• Pehea kona hopena i ka hana o kou puʻuwai?
• He aha kou mau hōʻailona?

I kekahi manawa, nalowale ka poloka puʻuwai ke hoʻololi ʻoe i nā lāʻau lapaʻau āu e lawe ai a mālama paha i kahi maʻi puʻuwai ʻē aʻe. Akā, pono paha kekahi i kahi pacemaker, no ka manawa pōkole a mau loa paha, e hoʻouna i nā hōʻailona uila i ka puʻuwai.

• Ke ālai ʻana o ke kekelē mua: ʻAʻole paha ʻoe e pono i ka lāʻau lapaʻau.
• Pale ʻana o ke kekelē ʻelua: Inā loaʻa iā ʻoe ke ʻano I, ʻaʻole paha ʻoe e pono i ka lāʻau lapaʻau. Akā inā loaʻa iā ʻoe nā hōʻailona, ​​​​pono paha ʻoe i kahi pacemaker manawa pōkole a mau loa paha e hoʻomau i ka paʻi pono ʻana o kou puʻuwai.
• Pale ʻana o ke kekelē ʻekolu: ʻO ka poʻe me kēia ʻano e pono mau i kahi pacemaker.

Inā makemake ʻoe i kahi pacemaker, e haʻi aku kāu kauka iā ʻoe e pili ana i ia mea, ke ʻano kūpono loa iā ʻoe, a me ka mea e manaʻo ai ma mua, i ka wā, a ma hope o ka hoʻokomo ʻia ʻana o ka pacemaker.

He aha nā pilikia/nā hopena ʻaoʻao o ka lāʻau lapaʻau?

Inā loaʻa iā ʻoe kahi pacemaker manawa pōkole a mau loa paha, hiki iā ʻoe ke loaʻa nā hopena ʻaoʻao e like me:

• Nā pilikia me ka papahana hāmeʻa
• Nā hana hewa o nā lako
• Maʻi
• Nā ʻūpā koko
• Ka pōʻino o ka puʻuwai

ʻEhia ka lōʻihi e ho'ōla ai mai kēia lāʻau lapaʻau?

Ma hope o ka loaʻa ʻana o kahi pacemaker, pono ʻoe e noho ma ka haukapila no hoʻokahi pō. Pono ʻoe e hiki ke hoʻi hou i kāu mau hana maʻamau i loko o kekahi mau lā a i ʻole mau pule. E nīnau i kāu kauka e pili ana i nā mea e hana ʻole ai ma hope o ke ʻoki ʻana.

Hiki ke pale ʻia nā hōʻeha puʻuwai?

Hiki iā ʻoe ke pale i kekahi o nā kumu o ka hāʻule ʻana o ka puʻuwai, e like me ka maʻi puʻuwai.

Nā mea hiki iā ʻoe ke hana e mālama i kou puʻuwai a me kou kino i ke olakino e like me ka hiki:

• E ola i kahi nohona olakino no ka puʻuwai. ʻO ia hoʻi ka ʻai ʻana i nā meaʻai olakino no ka puʻuwai, ka hoʻoikaika kino mau , ka hiamoe lawa i kēlā me kēia pō, ka hōʻemi ʻana i ke kaumaha, ka palena ʻana i ka waiʻona, a me ka pale ʻana i ka puhipaka a me ka hoʻohana ʻana i nā lāʻau lapaʻau.
• E kamaʻilio me kāu kauka e pili ana i nā lāʻau lapaʻau a me nā mea hoʻohui āu e lawe ai. Hiki iā ia ke nānā e ʻike inā he mea āu e lawe nei e hoʻololi nei i nā pae maʻamau o kekahi mau mea i loko o kou kino (e like me ka potassium, calcium, a me ka magnesium, he mea nui ia no ka ʻōnaehana uila o ka puʻuwai). Hiki i kāu kauka ke hoʻoponopono i kāu mau lāʻau lapaʻau inā pono.

He aha ka mea e hana ai inā loaʻa iaʻu kahi poloka puʻuwai?

Inā loaʻa iā ʻoe ka poloka puʻuwai kekelē mua, e nīnau i kāu cardiologist a electrophysiologist paha inā pono ʻoe e hana i kekahi hoʻololi i kou nohona a i ʻole nā ​​​​lāʻau lapaʻau. ʻAʻole pinepine kēia ʻano poloka puʻuwai e hoʻopilikia i kāu mau hana maʻamau.

ʻO ka maʻamau, ʻaʻole i kaupalena nui ka loaʻa ʻana o kahi pacemaker i kou hiki ke komo i nā haʻuki a me nā leʻaleʻa. Eia nō naʻe, he mea nui loa ia e hahai i nā ʻōlelo a kāu kauka e hōʻoia i ka hana pono ʻana o kāu pacemaker.

Pehea ka lōʻihi o ke ālai ʻana o ka puʻuwai?

ʻO ka lōʻihi o kou paʻa ʻana o ka puʻuwai ma muli o ke kumu. ʻO ka hoʻololi ʻana i ka lāʻau lapaʻau e hoʻoulu ai i ka paʻa ʻana o ka puʻuwai me kekahi lāʻau lapaʻau ʻē aʻe e hoʻoponopono paha i ka pilikia. Akā inā i hoʻokumu ʻia ka paʻa ʻana o ka puʻuwai e kekahi mea ʻē aʻe, he maʻi ia no ke ola holoʻokoʻa.

He aha ka nānā ʻana no ka poloka puʻuwai?

He maʻi koʻikoʻi paha ka poloka puʻuwai. Inā ʻaʻole mālama ʻia, hiki i ka poloka puʻuwai koʻikoʻi ke alakaʻi i ka hopu koke ʻana o ka puʻuwai. Akā ʻoi aku ka maʻamau, hiki i ka poloka puʻuwai i mālama ʻole ʻia ke hoʻoulu i ka poniuniu a i ʻole ka māʻule ʻana.

Me ka mālama ʻana, pili kou kūlana i kou mau makahiki a me nā kūlana olakino ʻē aʻe āu.

Pehea e mālama ai iaʻu iho? (ʻOi loa aku inā he pacemaker kāu)

Inā he pacemaker kāu, e hoʻomanaʻo i kēia mau mea:

• E noho mamao aku mai nā mea hana makeneka a me nā mea hana e hoʻopuka ana i kahi kahua uila. ʻO ia hoʻi, e noho ma ka liʻiliʻi he 6 ʻīniha ka mamao mai nā kelepona paʻalima. No ka laʻana, mai waiho i kāu kelepona paʻalima i loko o ka ʻeke o kou pālule.
• I kou hele ʻana ma nā wahi nānā palekana (e like me nā kahua mokulele, nā ʻaha hoʻokolokolo), e haʻi aku i nā mea nānā he pacemaker kou a pono e pale i nā wands lima. E lawe mau i kahi kāleka me ʻoe e hōʻike ana i ke ʻano o kāu pacemaker.
• E haʻi aku i kāu poʻe lawelawe olakino āpau (nā kauka, nā kauka niho) he pacemaker kou. Hiki i kekahi mau kaʻina hana lapaʻau, e like me nā hoʻokolohua magnetic resonance imaging (MRI), ke hoʻopilikia i kāu pacemaker. Ma hope o kekahi mau ʻano ʻoki kino, pono paha kāu kauka e hoʻolālā hou i kāu pacemaker.

Āhea ʻoe e pono ai e ʻike i ke kauka?

Inā he pacemaker kāu, e nānā pinepine kāu kauka puʻuwai iā ia e hōʻoia i ka hoʻomau ʻana o ka hana maikaʻi. Hiki iā lākou ke nānā iā ʻoe ma kahi mamao, akā pono nō ʻoe i nā kipa pilikino makahiki kahi e hiki ai i kāu kauka ke nānā i kāu pacemaker a hana i nā hoʻoponopono e pono ai.

E kāhea i kāu kauka inā ʻike ʻoe i kekahi o kēia mau hōʻailona:

• Pōʻino a i ʻole ka nawaliwali
• ʻEha umauma
• Nā palpitations o ka puʻuwai a i ʻole ka lele ʻana o nā kuʻi
• Nāwaliwali
• Paʻakikī ka hanu ʻana
• Ka pehu ʻana o nā wāwae, nā kuʻekuʻe wāwae, a i ʻole nā ​​​​wāwae

I ka manawa hea ʻoe e pono ai e hele i ka Emergency Treatment Unit (ETU) ?

Inā loaʻa iā ʻoe kahi hōʻeha puʻuwai a i ʻole ka hopu ʻana o ka puʻuwai, pono ʻoe e mālama koke ʻia e ke kauka. E hoʻomaopopo i kou ʻohana a me nā hoa hana i kēia pilikia (a me nā hōʻailona). A laila hiki iā lākou ke kelepona iā 1990 (a i ʻole kāu helu pilikia kūloko).

He aha nā nīnau e pono iaʻu e nīnau aku i ke kauka?

ʻO kekahi mau nīnau hiki iā ʻoe ke nīnau i kāu kauka:

• He aha ke ʻano o ka poloka puʻuwai i loaʻa iaʻu?
• Pono anei au i ka lāʻau lapaʻau?
• He aha ka lāʻau lapaʻau maikaʻi loa noʻu?
• Inā loaʻa i kaʻu keiki ka maʻi puʻuwai hānau, hiki i kaʻu mau keiki e hiki mai ana ke loaʻa pū?

He mea maʻamau ka makaʻu i ka wā e loaʻa ai iā ʻoe ka ʻeha o ka umauma a i ʻole ka pilikia o ka hanu ʻana. Akā i ka wā e ʻike ʻia ai ʻoe he poloka puʻuwai, hiki iā ʻoe ke hoʻomaopopo i ke kumu o kēlā mau hōʻailona. ʻO ka nūhou maikaʻi, no ka poʻe e pono ai ka lāʻau lapaʻau, hiki i ka lāʻau lapaʻau a i ʻole ka pacemaker ke kōkua i ka mālama ʻana i kou puʻuwai e kuʻi maʻamau. I ke kūkākūkā ʻana i kāu hoʻolālā lapaʻau, e nīnau pono i kāu kauka e pili ana i nā mea i maopopo ʻole.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

He pilikia ka poloka puʻuwai me ka ʻōnaehana uila o ka puʻuwai. Hiki ke ʻano mai ka liʻiliʻi a i ka koʻikoʻi. Inā loaʻa iā ʻoe nā hōʻailona, ​​ʻoiai ka ʻeha o ka umauma, ka pōkole o ka hanu, a i ʻole ka hiolo ʻana, e ʻike koke i ke kauka.

ʻO ka mea pōmaikaʻi, aia nā lāʻau lapaʻau no kēia. Loaʻa i kekahi poʻe ka hōʻoluʻolu me ka hoʻololi ʻana i ka lāʻau lapaʻau, aʻo kekahi poʻe hiki ke ola i kahi ola maʻamau me kahi pacemaker. ʻO ka mea nui loa, ʻo ia ka mālama ʻana i kou puʻuwai, e hahai i nā ʻōlelo a kāu kauka, a e nīnau i kāu kauka inā he mau nīnau kāu. ʻAʻole ʻoe hoʻokahi, a aia nā kauka e hiki ke kōkua iā ʻoe ma kēia huakaʻi.

ʻO ka Pale o ka Puʻuwai, ka Pacemaker, nā Hōʻailona o ka Puʻuwai, ka Maʻi Puʻuwai, ke Ola Kino o ka Puʻuwai