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