Ke kuʻi wikiwiki nei kou puʻuwai? E aʻo kākou e pili ana i kēia (Junctional Tachycardia) !

Ua loaʻa anei iā ʻoe a i ʻole kekahi o kou ʻohana, ʻoiai he keiki liʻiliʻi, kahi puʻuwai wikiwiki loa? A i ʻole ua makaʻu iki ʻoe i ka wā i haʻi aku ai ke kauka iā ʻoe i ka inoa (Junctional Tachycardia)? Mai hopohopo. He maʻi kakaikahi kēia, akā ke hoʻomaopopo maʻalahi ʻoe, e ʻike ʻoe i kahi manaʻo nui o ka hōʻoluʻolu. E kamaʻilio kākou e pili ana i kēia lā.

He aha ka (Junctional Tachycardia)? I ka ʻōlelo maʻalahi loa...

I ka ʻōlelo maʻalahi, ʻo (Junctional Tachycardia) kahi kūlana kahi i ʻokoʻa iki ai ke ʻano o ko kākou puʻuwai, ʻo ia hoʻi ke ʻano o ka paʻi ʻana o ko kākou puʻuwai, a ʻoi aku ka wikiwiki o ka hana. I ka pololei, ʻo ka mea e hana ʻia ma ʻaneʻi, ʻaʻole e hoʻomaka ka puʻuwai mai kahi kūpono, akā e hoʻomaka ana mai kahi ʻē aʻe a hoʻomaka e holo wikiwiki.

E noʻonoʻo, he ʻōnaehana uila ko ko kākou puʻuwai. ʻO kēia ka mea e hāʻawi ai i ka puʻuwai i ka hōʻailona e kuʻi i ka manawa kūpono. ʻO ka maʻamau, hoʻomaka kēia hōʻailona mai kahi wahi liʻiliʻi i kapa ʻia ʻo (Sinoatrial node) ma ka piko o ka puʻuwai. Ua like ia me ke kuapo nui i loko o ko mākou hale. Mai laila mai, hele ka leka uila ma loko o ka puʻuwai a hoʻoulu i ka ʻiʻo puʻuwai e ʻūlū a kuʻi. Kāhea mākou i kēia (Normal Sinus Rhythm).

Eia nō naʻe, i kekahi manawa inā loaʻa kekahi mea i kēia (Sinoatrial node), ʻaʻole hiki ke hana pono. E like me ka mea hana keaka pani i loko o kahi pāʻani ke maʻi ka mea hana keaka nui, aia kahi ʻē aʻe i loko o ka puʻuwai, ʻo ia hoʻi, ka (Atrioventricular node) aia ma waena o nā keʻena o luna a me lalo o ka puʻuwai (hiki ke kapa ʻia kēia ʻo "junction" o ka puʻuwai), e lawe i ke kuleana o ka hoʻomaka ʻana o ka puʻuwai. Ma kēia ʻano, ʻo ka puʻuwai e kuʻi wikiwiki ana mai ka hui ʻana o ka puʻuwai ua kapa ʻia ʻo (Junctional Tachycardia).

ʻO ka maʻamau, i ka wā e hoʻomaha ai mākou, kuʻi ko mākou puʻuwai ma waena o 60 a me 100 mau manawa i kēlā me kēia minuke. Eia nō naʻe, i loko o kekahi kanaka me ka "Junctional Tachycardia", kuʻi ka puʻuwai ma mua o 100 mau manawa i kēlā me kēia minuke, i kekahi manawa ʻoi aku ka wikiwiki.

He aha nā ʻano nui o ka (Junctional Tachycardia)?

Hiki ke hana ʻia kēia ʻano kū ʻole o ka puʻuwai ma nā ʻano nui ʻelua.

1. ʻO ke kumu mua a i ʻole ka hānau ʻana (Junctional Tachycardia)

ʻO kēia ke ʻano kakaikahi loa. Hiki i kekahi mau pēpē ke loaʻa i kēia maʻi i ka wā hānau. Inā hana ʻia kēia, hiki i nā keʻena haʻahaʻa (ventricles) o ka puʻuwai o ke pēpē ke kuʻi i ka wikiwiki loa, ma kahi o 200 a 250 mau manawa i kēlā me kēia minuke. He maʻi koʻikoʻi loa kēia.

2. Lua a i ʻole Postoperative (Junctional Tachycardia)

ʻO kēia ke ʻano maʻamau. Hiki ke loaʻa, ʻoi aku hoʻi i nā keiki ʻōpio i loaʻa ka pilikia puʻuwai hānau ma hope o ke ʻoki ʻana e hoʻoponopono ai. No ka laʻana, hiki i kekahi mau pēpē i hana ʻia ke ʻoki ʻana e hoʻoponopono i kahi maʻi puʻuwai i kapa ʻia ʻo Tetralogy of Fallot ke loaʻa i kēia maʻi. Hiki ke loaʻa ma waena o 5% a me 11% o nā keiki i hana ʻia ke ʻoki.

He (SVT) anei ka (Junctional Tachycardia)?

ʻAe, ʻo (Junctional Tachycardia) he ʻano (SVT). ʻO (SVT) ke kū nei no (Supraventricular Tachycardia). ʻO ia hoʻi, he puʻuwai wikiwiki e hoʻomaka ana ma nā keʻena o luna o ka puʻuwai (ma luna o nā Ventricles).

ʻO wai ka mea i hoʻopilikia nui ʻia e kēia kūlana?

He mea kākaʻikahi loa ka Junctional Tachycardia i nā pākeke. Eia nō naʻe, ʻoi aku ka maʻamau i nā pēpē a me nā kamaliʻi liʻiliʻi. E like me ka mea i ʻōlelo ʻia ma mua, hiki ke hana ma muli o kahi kumu hānau (he mea kākaʻikahi loa ia) a i ʻole ma hope o ke ʻoki puʻuwai.

He aha nā hōʻailona? Pehea mākou e ʻike ai iā lākou?

I kekahi manawa hiki ke loaʻa kēia ʻano me ka ʻole o nā hōʻailona. Akā inā ʻike ʻia nā hōʻailona, ​​​​hiki iā lākou ke komo pū me:

• Nā Palpitations : Manaʻo paha ia e like me kekahi e holo ana i loko o kou umauma, a i ʻole e lele ana kou puʻuwai i hoʻokahi a ʻelua paha kuʻi.
• Pōniuniu : Hiki iā ʻoe ke manaʻo i ka pōniuniu a paʻakikī ke kū.
• Nāwaliwali : Hiki iā ʻoe ke nalowale koke ka ʻike a hāʻule.
• Manaʻo luhi loa : Manaʻo paha ʻoe ua luhi loa ʻoe a ʻaʻole hiki iā ʻoe ke hana i kekahi mea.

Inā loaʻa kēia mau hōʻailona, ​​ʻoiai hoʻi i kahi keiki ʻōpiopio, he mea nui loa e ʻimi koke i ke kōkua lapaʻau.

He aha nā kumu o ka (Junctional Tachycardia)?

Aia kekahi mau kumu e hiki ai ke hoʻopilikia i ka "node Sinoatrial" i loko o ko kākou puʻuwai e hana pono i nā hōʻailona uila. ʻO ia ke kumu e loaʻa ai ka "Junctional Tachycardia".

Eia kekahi laʻana, hiki ke kū mai kēia ʻano ma muli o ka ʻawahia o ka lāʻau (Digoxin) (nā inoa inoa Cardoxin® a i ʻole Digitek®).

Eia kekahi mau kumu ʻē aʻe:

• Myocarditis : Ka mumū o ka ʻiʻo o ka puʻuwai.
• He hōʻeha puʻuwai .
• Hoʻololi i ka valve puʻuwai a i ʻole kekahi ʻoki puʻuwai ʻē aʻe.
• Maʻi puʻuwai hānau : He kumu kakaikahi kēia.
• ʻO ka ablation catheter kahi lāʻau lapaʻau no kekahi maʻi puʻuwai ʻē aʻe.
• Maʻi Lyme .

Pehea e ʻike ai i ka (Junctional Tachycardia)?

ʻO ka hoʻāʻo nui e ʻike ai i kēia kūlana ʻo ia ka (Electrocardiogram - ECG). Hoʻopaʻa kēia i ka hana uila o ka puʻuwai. ʻO ke kanaka me (Junctional Tachycardia) e loaʻa iā ia kahi nalu P e nalowale ana mai ka ECG. ʻO kēia nalu P ka hōʻailona e hoʻomaka ana ka puʻuwai e kuʻi mai ka (Sinoatrial node).

Ma waho aʻe o ka ECG, e lawe kāu kauka i kāu mōʻaukala olakino piha. Hiki iā ia ke kauoha i nā hoʻokolohua hou aʻe, e like me nā hoʻokolohua koko a me kahi echocardiogram, ʻo ia hoʻi kahi ultrasound o ka puʻuwai.

Pehea e mālama ʻia ai?

Aia ka lāʻau lapaʻau i ke kumu o ke kūlana a me kāu mau hōʻailona. Inā hoʻomaka ke ʻano maʻamau ʻole ma hope o ke ʻoki puʻuwai, hiki i kāu kauka ke:

• Ke hoʻoponopono nei i kahi kaulike ʻole o nā electrolytes i loko o ke kino.
• E nānā inā he kuni kou, a inā pēlā, e mālama iā ia.
• Ke kuhikuhi ʻana i ka lāʻau lapaʻau e hoʻolohi i ka helu o ka puʻuwai.

Aia kekahi mau lāʻau lapaʻau ʻē aʻe:

• Hiki ke hāʻawi ʻia nā lāʻau lapaʻau e hoʻolohi i ka helu o ka puʻuwai a hoʻihoʻi iā ia i kahi mele maʻamau, e like me (Amiodarone) (nā inoa inoa Cordarone® a i ʻole Pacerone®).
• ʻO nā ʻano lapaʻau i kapa ʻia ʻo (Catheter ablation) a i ʻole (Cryoablation) kekahi. Ma kēia, hoʻokomo ʻia kahi catheter i loko o ka ʻāpana o ka puʻuwai e hoʻoulu ana i nā hōʻailona uila kūpono ʻole a luku i kēlā wahi. ʻO (Cryoablation) kahi ʻano hana e hoʻohana ana i ke anu nui loa.
• ʻO ka hoʻoikaika ʻana o ka atrial overdrive: He hoʻāʻo e hoʻihoʻi i ke ʻano o ka puʻuwai i ka maʻamau me ka hoʻohana ʻana i kahi hāmeʻa waho, e like me ka pacemaker.

Aia kekahi mau pilikia i ka mālama ʻana?

Ma hope o ka mālama ʻana i ka (Catheter ablation), i kekahi manawa hiki ke hoʻi mai kēia ʻano mele ʻē. Eia kekahi, me ka (Catheter ablation) i nā pākeke, aia kahi pilikia o ka (Atrioventricular block) (ʻo ia hoʻi, kahi ālai ʻana o ke alakaʻi aʻe e lawe ana i ka hōʻailona uila ma hope o ka (Sinoatrial node)). No ka mea he haʻahaʻa kēia pilikia, hoʻohana pinepine nā kauka i ke ʻano (Cryoablation). Inā ʻaʻole holomua ka mālama ʻana i ka (Ablation) ma hope o ʻelua manawa, pono paha ʻoe e hoʻokomo i kahi (Pacemaker) (kahi mea liʻiliʻi e kaohi ana i ka puʻuwai).

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

ʻO ka maʻamau, ma hope o ka hoʻohemo ʻana o ka catheter, hiki iā ʻoe ke hoʻi i ka home a hoʻomaka hou i kāu mau hana maʻamau. Eia nō naʻe, pono paha ʻoe e kali i kekahi mau lā ma mua o ka hana ʻana i kekahi mau hana paʻakikī. E hāʻawi kāu kauka iā ʻoe i nā ʻōlelo kikoʻī e pili ana i kēia.

Hiki ke hoʻemi ʻia ka pilikia o ka (Junctional Tachycardia)?

Hiki i nā kauka ke hōʻemi i ka pilikia o ka hoʻomohala ʻana i ka Junctional Tachycardia ma ka hāʻawi ʻana i kekahi mau lāʻau lapaʻau ma mua a i ka wā o ke ʻoki kino. Eia kekahi laʻana:

• (Makenesium)
• (Propranolol) (nā inoa inoa Inderal®XL a i ʻole InnoPran®XL)
• (Dexmedetomidine) (Hoʻohana ʻia kēia i kekahi manawa i ka wā o ke ʻoki puʻuwai ma nā keiki ʻōpio)

He aha ka mea hiki i kekahi me ka (Junctional Tachycardia) ke manaʻo?

Ke loaʻa a mālama ʻia ke kumu o kēia ʻano maʻamau ʻole, e hoʻomaikaʻi mālie ʻia nā hōʻailona. Eia nō naʻe, pono ʻoe e noho i ka haukapila a hiki i ka hoʻomaikaʻi ʻana o kou kūlana "Junctional Tachycardia".

ʻOkoʻa ka hopena (Outlook) o kēia kūlana mai kēlā ʻano a i kēia ʻano.

• ʻO ke kumu mua a i ʻole Congenital (Junctional Tachycardia)He paʻakikī ke mālama ʻia ke ʻano. Hiki iā ia ke alakaʻi i nā kūlana koʻikoʻi e like me ka (Heart failure) (heart failure), (Complete heart block) (ka pale piha ʻana o nā hōʻailona uila o ka puʻuwai), a me ka (Ventricular fibrillation) (ka hahau ʻana i nā keʻena haʻahaʻa o ka puʻuwai me ke kāohi ʻole ʻia). Inā ʻaʻole mālama ʻia, aia kahi 9% o ka manawa e make ai. Eia nō naʻe, inā hoʻomaka kēia ʻano ma hope o nā mahina ʻeono mua o ke ola, ʻoi aku ka maikaʻi o ka hopena.
• ʻO ka maʻamau, ʻike ʻia ka Secondary a i ʻole Postoperative Junctional Tachycardia i ʻelua a ʻekolu mau lā ma hope o ke ʻoki ʻana, akā hoʻopau pinepine ʻia i loko o hoʻokahi pule. Hiki iā ia ke hoʻoulu i ke koko haʻahaʻa, ka poniuniu, a me ka nalowale o ka ʻike.

Āhea wau e ʻike ai i ke kauka?

Pono ʻoe e ʻike i kāu kauka no kahi manawa hoʻopaʻa ma hope o ʻelua pule ma hope o kou hoʻi ʻana mai ka haukapila. Pono nō hoʻi ʻoe e hoʻomau i ka loaʻa ʻana o ka lāʻau no ke kūlana kumu i hoʻokumu ai i ka tachycardia junctional.

Āhea wau e hele ai i ka lumi pilikia (ER)?

Inā ua loaʻa iā ʻoe kahi ablation catheter, e ʻimi koke i ke kōkua lapaʻau inā loaʻa iā ʻoe kekahi o nā hōʻailona ma lalo nei ma kahi o ke komo ʻana o ka catheter (ʻo ia hoʻi ka ʻūhā):

• Inā pehu koke ia.
• Inā ʻaʻole e pau ke kahe ʻana o ke koko ma hope o ke kaomi ʻana a me ka paʻa ʻana.

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

Ke ʻike ʻoe ua loaʻa iā ʻoe a i ʻole kāu keiki kēia maʻi, he mea maʻamau ka loaʻa ʻana o nā nīnau he nui. Mai makaʻu e nīnau i kāu kauka e pili ana i kēia mau mea:

• He aha ke ʻano o ka Junctional Tachycardia i loaʻa i kaʻu/kaʻu keiki?
• He aha ka lāʻau lapaʻau maikaʻi loa no koʻu maʻi?
• Aia kekahi manawa kūpono e loaʻa ai i kaʻu mau keiki ʻē aʻe kēia maʻi?

Inā loaʻa i kāu keiki ka Junctional Tachycardia, e nīnau i kāu kauka e pili ana i nā hōʻailona a hoʻomaopopo iā lākou. A laila, inā hana hou kekahi mea e like me kēia, hiki iā ʻoe ke ʻike koke. Mai makaʻu e nīnau e pili ana i ka lāʻau lapaʻau e loaʻa ana i kāu keiki a me nā pilikia e pili ana. ʻO ka ʻike ʻana i kēia mau mea āpau e kōkua iā ʻoe e hana i nā hoʻoholo maikaʻi loa no ka pono o kāu keiki.

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

Mai makaʻu ke lohe ʻoe i ka inoa (Junctional Tachycardia). He pilikia kēia me ke kani o ka puʻuwai, akā:

• Hiki ke ʻike ʻia kēia. Hiki ke ʻike ʻia kēia ma o nā hoʻokolohua e like me ka ECG.
• Aia nā lāʻau lapaʻau. Ma muli o ke kumu, hiki ke kāohi ʻia me nā lāʻau lapaʻau a i ʻole nā ​​​​​​ʻano hana e like me (Ablation).
• ʻO ke ʻano e kū mai ana, ʻoiai ma hope o ke ʻoki ʻana, he manawa pōkole wale nō ia. E hoʻomaikaʻi ia i loko o kekahi mau lā.
• E kamaʻilio ākea me kāu kauka. E kamaʻilio me kāu kauka e pili ana i kāu mau nīnau a me nā makaʻu a e ʻoluʻolu.

ʻO ka mea nui loa, ʻo ia ka hoʻomanaʻo ʻana ʻaʻole ʻoe hoʻokahi. Ua mākaukau mau nā kauka a me nā limahana mālama ola e kōkua iā ʻoe.

Ke makemake nei iā ʻoe a me kou ʻohana i ke olakino maikaʻi!

ʻO ka puʻuwai, ka maʻi puʻuwai, ka tachycardia, ka maʻi puʻuwai pediatric, ka ECG, ke ʻoki puʻuwai, ka tachycardia Junctional