Ke hele nei paha kou puʻuwai i kekahi manawa ma ke ʻano ʻē? E kamaʻilio kākou e pili ana i ka 'Idioventricular Rhythm'!

Manaʻo paha ʻoe i kekahi manawa he ʻano ʻokoʻa iki ke ʻano o ka paʻi ʻana o kou puʻuwai? Malia paha he wikiwiki iki ia, a i ʻole he ʻano ʻē loa kona paʻi ʻana? Mai hopohopo, ʻo ka hapa nui o ka manawa ʻaʻole kēia he mau pilikia koʻikoʻi. Eia nō naʻe, he mea nui iā ʻoe e makaʻala i kēia kūlana a mākou e kamaʻilio ai i kēia lā, i kapa ʻia ʻo 'Idioventricular Rhythm'.

He aha ka `Idioventricular Rhythm`? E hoʻomaopopo maʻalahi kākou!

I ka ʻōlelo maʻalahi, ʻo ka "Idioventricular Rhythm" he ʻano puʻuwai kahi e kuʻi mālie ai nā keʻena haʻahaʻa o kou puʻuwai, ʻo ia hoʻi nā "ventricles" , ma mua o ka maʻamau. E noʻonoʻo e pili ana, aia ka "pacemaker kūlohelohe", a i ʻole "node sinoatrial", ma nā keʻena kiʻekiʻe o ko kākou puʻuwai. Inā ʻaʻole hana pono kēia pacemaker, manaʻo nā cell ma ka ʻaoʻao haʻahaʻa o ka puʻuwai, "ʻAe, e kuʻi kākou i ka puʻuwai." Akā, hiki iā lākou ke kuʻi mālie iki.

ʻO ka maʻamau, ma kēia "Idioventricular Rhythm", ʻaʻole i emi ka paʻi ʻana o ka puʻuwai ma mua o 50 mau manawa i ka minuke .

Eia nō naʻe, aia kekahi ʻokoʻa liʻiliʻi ʻē aʻe, ua kapa ʻia ʻo 'Accelerated Idioventricular Rhythm (AIVR).' A laila ʻo ka helu o ka puʻuwai ma waena o 50 a me 110 mau kuʻi i kēlā me kēia minuke. He ʻokoʻa kēia mai ke kūlana i kapa ʻia ʻo 'Ventricular Tachycardia' (Ventricular Tachycardia), kahi e kuʻi wikiwiki ai ka puʻuwai (ʻoi aku ma mua o 100 mau kuʻi i kēlā me kēia minuke), ʻeā?

ʻAʻole pono e huikau kēia me nā pilikia ʻē aʻe o ka puʻuwai, ʻeā?

ʻAe, he nui nā kūlana ʻē aʻe e pili ana i ka ʻōʻō o ka puʻuwai. No laila, hiki ke huikau ʻia kēia `Idioventricular Rhythm` me kekahi. ʻO ia hoʻi ʻo `Junctional Rhythm`.

• ʻO ke mele Idioventricular: Hoʻomaka kēia ma nā keʻena haʻahaʻa o ka puʻuwai, nā ventricles.
• ʻO ke ʻano hui pū ʻana: Hoʻomaka kēia ma ka hui ʻana ma waena o nā keʻena o luna a me lalo o ka puʻuwai (e pili ana me ka AV node).

Ua ʻike anei ʻoe i ka ʻokoʻa? ʻOiai ua hoʻomaka nā ʻano mele ʻelua ma kahi kūpono ʻole o ka puʻuwai, ua ʻokoʻa nā wahi hoʻomaka ʻelua.

ʻO wai ka mea i ʻoi aku ka pilikia o kēia kūlana?

ʻOiai hiki i kekahi ke loaʻa i kahi kūlana i kapa ʻia ʻo "Idioventricular Rhythm," ʻoi aku ka nui o ka loaʻa ʻana o kekahi poʻe. ʻO lākou kēia:

• ʻO nā kānaka me ka poloka puʻuwai piha a koʻikoʻi paha.
• ʻO nā kānaka me nā pilikia me ka pacemaker maoli o ka puʻuwai, e like me ke ʻano o ka sinus arrest a i ʻole ka sinoatrial nodal block.
• ʻO ka poʻe i loaʻa i ka 'hōʻeha puʻuwai'.
• ʻO ka poʻe e hoʻohana ana i kekahi mau lāʻau lapaʻau (ʻoi aku hoʻi nā mea no ka maʻi puʻuwai) a me nā lāʻau lapaʻau kū ʻole i ke kānāwai.
• He mea kākaʻikahi loa, hiki ke loaʻa i nā poʻe me nā pilikia puʻuwai hānau.

Hiki ke loaʻa i kekahi manawa ka Accelerated Idioventricular Rhythm (AIVR) i nā mea pāʻani olakino. Eia nō naʻe, ʻike pinepine ʻia i nā poʻe me nā maʻi puʻuwai ʻē aʻe, e like me:

• ʻO ka ischemic cardiomyopathy (ICM) kahi nāwaliwali o ka ʻiʻo o ka puʻuwai ma muli o ke ālai ʻia ʻana o nā kīʻaha koko e hoʻolako ana i ka puʻuwai.
• ʻO ka maʻi puʻuwai rumatika (hōʻino ʻia nā kiwikā o ka puʻuwai ma hope o ka maʻi ʻāʻī).
• Dilated cardiomyopathy (dilated cardiomyopathy - lilo ka ʻiʻo o ka puʻuwai i nāwaliwali a hoʻonui ʻia).
• ʻO nā maʻi coronary acute (acute coronary syndromes - ke oki koke ʻana o ke kahe koko i ka puʻuwai).
• ʻO ka myocarditis koʻikoʻi (ka mumū koʻikoʻi/ka pehu ʻana o ka ʻiʻo puʻuwai).

He aha nā hōʻailona? A i ʻole ʻaʻole ʻoe e manaʻo iki i kekahi mea?

Eia kahi ʻoiaʻiʻo kupanaha! ʻO ka hapa nui o ka manawa, ʻaʻole ʻike ka poʻe me ka `Idioventricular Rhythm` i kekahi mau hōʻailona . ʻAe, he ʻoiaʻiʻo. E noʻonoʻo, ʻaʻole ʻike kekahi poʻe he loaʻa iā lākou kēia ʻano, a ʻike ʻia ia ma ka manawa kūpono ke hana ʻia kahi `ECG` no kekahi mea ʻē aʻe.

Eia nō naʻe, hiki i kekahi poʻe ke loaʻa nā hōʻailona. Inā loaʻa, hiki iā lākou ke ʻike:

• Luhi: Hiki paha iā ʻoe ke luhi.
• Pōniuniu: Manaʻo paha ʻoe e like me ke wili nei kou poʻo a manaʻo paha ʻoe e nalowale ana kou kaulike.
• Nāwaliwali/Nalowale ka ʻike: Hiki i kekahi poʻe ke nalowale koke ka ʻike a hāʻule. He hōʻailona koʻikoʻi kēia.
• Nā palpitations o ka puʻuwai: E manaʻo paha ʻoe e wikiwiki ana kou puʻuwai, me he mea lā e kuʻi nui ana i loko o kou umauma.

E hoʻomanaʻo, ʻaʻole i ʻike nā kānaka a pau i kēia mau hōʻailona. Eia nō naʻe, inā ʻike pinepine ʻoe iā lākou, ʻoi aku ka maikaʻi o ke ʻike ʻana i ke kauka.

No ke aha e hana ʻia ai kēia `Accelerated Idioventricular Rhythm (AIVR)`? He aha nā kumu?

Aia kekahi mau kumu kikoʻī o ka `Accelerated Idioventricular Rhythm (AIVR)` a mākou i kūkākūkā ai ma mua, ʻo ia hoʻi ke ʻano o ka puʻuwai e kuʻi ana ma ka wikiwiki ma waena o 50-110 mau kuʻi i kēlā me kēia minuke. Eia kēia mau mea:

• ʻO Myocarditis (ka mumū o ka ʻiʻo puʻuwai).
• Ma hope o ka hāʻule puʻuwai.
• Kekahi mau ʻano 'cardiomyopathies' (cardiomyopathy - maʻi ʻiʻo puʻuwai).
• Ma hope o ke ola hou ʻana (no ka laʻana, ma hope o ka hōʻeha puʻuwai, i ka wā i hoʻōla hou ʻia me ka `CPR`).
• He pae kiʻekiʻe loa o ka electrolyte potassium i loko o ke kino.
• ʻO ka ʻawahia i hoʻokumu ʻia e ka lawe nui ʻana i ka lāʻau lapaʻau puʻuwai 'Digoxin (Digitek® a i ʻole Cardoxin®)'.

Pehea e ʻike ai ke kauka i kēia?

Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​a i ʻole no kekahi kumu ʻē aʻe, ke ʻike ʻoe i ke kauka, e nānā pono mua ʻo ia iā ʻoe ('hoʻokolohua kino'). A laila e nīnau ʻo ia e pili ana i kou mōʻaukala olakino a me ka mōʻaukala ʻohana.

Eia kekahi, hiki ke hana ʻia nā hoʻokolohua ma lalo nei e hoʻoholo pono ai inā loaʻa kēia kūlana `Idioventricular Rhythm`:

• Electrocardiogram (ECG/EKG): ʻO kēia ka hoʻāʻo koʻikoʻi loa. Hoʻopaʻa ia i ka hana uila o ka puʻuwai. Ma ka Idioventricular Rhythm, hōʻike ka ECG e kuʻi ana nā keʻena haʻahaʻa o ka puʻuwai i kahi mele maʻamau, akā ʻo nā keʻena o luna (atria) he ʻano ʻē a ʻaʻohe paha.
• `Holter monitor`: Ua like kēia me kahi mīkini `ECG` liʻiliʻi. Akā, pono ʻoe e ʻaʻahu iā ia no 24 a i ʻole 48 mau hola. Hiki iā ia ke nānā i ke ʻano o ka loli ʻana o kou puʻuwai i kou hele ʻana i kāu mau hana o kēlā me kēia lā. I kekahi manawa, ʻaʻole paha e ʻike ʻia kēia mau ʻano puʻuwai ʻē i ka manawa pōkole e pono ai e loaʻa kahi `ECG`.

He aha nā lāʻau lapaʻau? He mea maoli anei kēia e makaʻu ai?

Eia ka nūhou maikaʻi! No ka hapa nui o nā kānaka, ʻaʻole weliweli kahi kūlana i kapa ʻia ʻo "Idioventricular Rhythm" ("benign") a ʻaʻole pono ia i kekahi lāʻau kūikawā. I ka hapa nui o nā hihia, e nalo wale ia ma kāna iho.

Eia nō naʻe, inā hoʻoholo kāu kauka e mālama iā ia, e mālama pinepine ʻia ia ma ka mālama ʻana i ka pilikia kumu i hoʻokumu ai i ke kūlana. Eia kekahi laʻana:

• Inā ua hoʻokumu ʻia kēia kūlana e kahi lāʻau lapaʻau, e hoʻōki a hoʻololi paha i kēlā lāʻau lapaʻau.
• Inā he pilikia me ka hana o ka puʻuwai (e.g. poloka puʻuwai), e mālama iā ia.

I kēia manawa, inā hoʻomau ka `Accelerated Idioventricular Rhythm (AIVR)`, a ke emi nei hoʻi kou koko, a laila hiki i ke kauka ke hana i kēia mau mea e hoʻihoʻi i ka puʻuwai puʻuwai maʻamau:

• Ke hāʻawi ʻana i nā lāʻau lapaʻau e like me `Atropine (Atreza® a i ʻole Sal-Tropine®)` a i ʻole `isoproterenol`.
• Ke hoʻohana nei i kahi hāmeʻa kūikawā (e laʻa, kahi pacemaker manawa pōkole) e hoʻihoʻi i ke ʻano o nā keʻena o luna o ka puʻuwai.

He aha kā mākou e hana ai e hōʻemi i kēia pilikia?

ʻOiai ʻaʻole ia he mea ʻino ka Idioventricular Rhythm i ka hapanui o nā hihia, hiki ke hoʻemi iki ʻia ka pilikia o ka hoʻomohala ʻana i ia mau kūlana ma ka hana ʻana i nā hana e mālama ai i ke olakino o ko mākou puʻuwai.

• E hoʻoikaika kino mau a ʻai i ka meaʻai olakino no ka puʻuwai (haʻahaʻa i ka ʻaila, ka paʻakai, a me ke kō, kiʻekiʻe i nā huaʻai a me nā mea kanu).
• E hoʻāʻo e mālama i nā pae electrolyte o kou kino (ʻoi aku ka potassium) ma ke ʻano maʻamau . He mea nui ka ʻai kaulike no kēia.

He aha ka mea e hana inā loaʻa iā ʻoe ka `Idioventricular Rhythm`? He aha kāu e manaʻo ai?

Eia hou, no ka hapa nui o nā kānaka, ʻaʻole kēia he kūlana weliweli a e hoʻopau ʻia me ka ʻole o ka lāʻau lapaʻau. Eia nō naʻe, inā ʻoe e ʻike pinepine nei i nā palpitations o ka puʻuwai a hoʻomau kēia ʻano ʻē me ka hoʻi ʻole i ka maʻamau, pono ʻoe e ʻimi i ke kōkua lapaʻau.

Āhea ʻoe e ʻimi ai i ke aʻo lapaʻau?

I ka hapanui o nā hihia, ʻaʻole pono ʻoe e hana i kekahi mea kūikawā no ka `Idioventricular Rhythm`. E nalo wale nō ia. Eia nō naʻe, inā ʻaʻole e hoʻomaikaʻi kēia ʻano ma kāna iho a ʻike ʻoe i nā hōʻailona e like me ka hāʻule ʻana, e ʻike koke i ke kauka.

ʻO ka mea nui loa: Inā manaʻo ʻoe ke loaʻa nei iā ʻoe nā hōʻailona o ka 'Hoʻouka Puʻuwai' (e.g. ʻeha nui ma waenakonu o ka umauma, paʻakikī ka hanu ʻana, luaʻi ʻana, hou nui ʻana), e kāhea koke i ka 1990 a kāhea i kahi kaʻa kaʻa!

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

Inā haʻi aku kāu kauka iā ʻoe he "Idioventricular Rhythm" kou, he mea maikaʻi ke nīnau i kēia mau nīnau:

• "E ke kauka, hiki iā ʻoe ke haʻi pololei mai iaʻu i ke kumu o koʻu 'Idioventricular Rhythm'?"
• "Inā makemake au i ka lāʻau lapaʻau no kēia, he aha ka lāʻau lapaʻau maikaʻi loa noʻu?"

ʻOiai ʻaʻole ia he pilikia nui ka `Idioventricular Rhythm`, hiki i nā ʻano puʻuwai ʻē aʻe ke lilo i mea weliweli. No laila, inā ʻike ʻoe i kahi puʻuwai ʻē, inā ʻike ʻoe i nā mea e like me ka dizziness, e ʻike koke i ke kauka. Inā haʻi kāu kauka iā ʻoe e hoʻomaka a hoʻōki paha i ka lawe ʻana i kekahi lāʻau lapaʻau, e hahai pololei i kēlā mau kuhikuhi. Eia kekahi, he mea nui loa ka hele ʻana no nā hoʻokolohua `follow-up` i nā lā i hoʻonohonoho ʻia.

Leka Lawe-Home

ʻAe, no laila e hoʻomanaʻo iki aku mākou iā ʻoe i kekahi mau mea nui mai nā mea a mākou i kamaʻilio ai:

• ʻO ka Idioventricular Rhythm kahi mele puʻuwai e hoʻomaka ana ma nā keʻena haʻahaʻa (nā cell) o ka puʻuwai a lohi pinepine ia.
• ʻO ka hapa nui o ka manawa, ʻaʻole kēia he kūlana weliweli, a ʻaʻole hōʻike ka nui o ka poʻe i nā hōʻailona.
• Eia nō naʻe, inā hoʻomau kēia ʻano me nā hōʻailona e like me ka nausea , pono ʻoe e ʻimi i ke kōkua lapaʻau.
• Hoʻoponopono pinepine ka lāʻau lapaʻau i ke kūlana kumu i hoʻokumu ai, a i kekahi manawa hiki ke mālama ʻia me ka lāʻau lapaʻau.
• E hahai mau i nā ʻōlelo a kāu kauka a hele i nā hoʻokolohua i hoʻonohonoho ʻia.

He mea nui loa ka mālama ʻana i kou puʻuwai. Lana koʻu manaʻo he kōkua kēia ʻike iā ʻoe!

ʻO ke ʻano Idioventricular, ke ʻano o ka puʻuwai, ka wikiwiki o ka puʻuwai, ka wikiwiki o ke ʻano Idioventricular, nā hōʻailona o ka maʻi puʻuwai, ECG, ka nānā ʻana o Holter