Ke hoʻomaka koke nei kou puʻuwai e kuʻi wikiwiki? E kamaʻilio kākou e pili ana i ka PSVT (Paroxysmal Supraventricular Tachycardia)!

Ua ʻike anei ʻoe i ka piʻi koke ʻana o kou puʻuwai, ka paʻi ʻana i kou umauma, a laila he manawa pōkole o ka noho maʻamau? Ua manaʻo paha ʻoe he mea maʻamau wale nō kēia, a i ʻole kekahi mea e hana ʻia ke makaʻu iki ʻoe. Eia naʻe, i kekahi manawa ʻaʻole ia. I kēia lā e kamaʻilio mākou e pili ana i kahi kūlana i kapa ʻia ʻo 'Paroxysmal Supraventricular Tachycardia' a i ʻole 'PSVT', kahi e hoʻololi koke ai i ka puʻuwai. Mai hopohopo, e kamaʻilio mākou e pili ana i kēia ma ke ʻano maʻalahi hiki iā ʻoe ke hoʻomaopopo.

He aha ka PSVT?

I ka ʻōlelo maʻalahi, ʻo `PSVT` kahi ʻano ʻē i ke kuʻina o ko kākou puʻuwai, ʻo ia hoʻi, ke ʻano o ko kākou puʻuwai (`arrhythmia`). I kēia hihia, hoʻomaka koke ka puʻuwai e kuʻi wikiwiki loa. A laila, me ka wikiwiki, lohi hou ka puʻuwai i kona wikiwiki maʻamau. Kāhea mākou i kēia mau puʻuwai wikiwiki koke he `paroxysms`. Hoʻokumu ʻia kēia kūlana e ka hana uila maʻamau e hoʻomaka ana ma nā keʻena ʻelua o luna o ka puʻuwai, i kapa ʻia ʻo `atria`. Kāhea mākou i nā keʻena ʻelua o lalo o ka puʻuwai, i kapa ʻia ʻo `ventricles`. Hana pū kēia mau keʻena ʻehā e pamu i ke koko ma loko o ko mākou kino.

No laila, ua hoʻokumu ʻia ka `PSVT` e kahi hana uila maʻamau ʻole i loko o kēia mau atria, ka mea e hoʻoulu ai iā lākou e ʻūlū wikiwiki a mau. Akā ʻo ka mea nui, ʻaʻole ʻo `PSVT` he maʻi mau e pono ai ka mālama ʻana a i ʻole he mea hoʻoweliweli i ke ola. I kekahi manawa hiki ke mālama ʻia me ka ʻole o ka lāʻau lapaʻau. Inā pono, e ʻōlelo nā kauka i nā lāʻau lapaʻau, kekahi mau lāʻau lapaʻau puʻuwai, a me ka mea kakaikahi loa, he `pacemaker`. Inā manaʻo ʻoe i kahi mea ʻē e pili ana i ke ʻano o ka paʻi ʻana o kou puʻuwai, ʻoi aku ka maikaʻi o ka ʻike ʻana i ke kauka a nānā iā ia.

Pehea e hana maʻamau ai ko kākou puʻuwai?

Ma mua o ko kākou hoʻomaopopo ʻana i ke ʻano o ka PSVT, e nānā kākou i ke ʻano o ka hana maʻamau o ko kākou puʻuwai. I loko o ka puʻuwai olakino, hoʻomaka ka puʻuwai ma kahi ʻāpana liʻiliʻi o ka ʻiʻo ma ka atria. Kāhea mākou iā ia ʻo ka node sinoatrial (SA node). ʻO kēia ka mea e hana ana e like me ka pacemaker kūlohelohe o ka puʻuwai.

Hoʻouna kēia `SA node` i nā hōʻailona uila e hoʻoulu ai i ka atria e ʻūlū a hoʻopumu i ke koko. A laila hele kēia mau hōʻailona i nā ventricles ma o kahi pūʻolo liʻiliʻi ʻē aʻe o nā cell i kapa ʻia ʻo `atrioventricular node` (AV node). Hoʻouna ka `AV node` i nā hōʻailona uila i nā ventricles e ʻūlū. Penei ke kuʻi ʻana o ko kākou puʻuwai ma ke ʻano maʻamau.

Aia kekahi mau ʻano o PSVT?

ʻAe, he nui nā kūlana ʻē aʻe ma lalo o ka māhele ākea o `PSVT`. Hiki ke hana ʻia kēia mau mea e ke alo o nā pilina uila keu he nui mai nā keʻena o luna o ka puʻuwai a i nā keʻena o lalo, ma ke ʻano pololei a i ʻole ma o ka `AV node`. ʻO kēia ke kumu o ka puʻuwai e kuʻi wikiwiki (`tachycardia`). I kekahi manawa, hiki i kēia wikiwiki o ka puʻuwai ke hoʻomaka mai kahi `hoʻonāukiuki ʻia` ma nā keʻena o luna o ka puʻuwai.

ʻO kekahi o nā inoa maʻamau no kēia ʻano tachycardia:

• ʻO ka tachycardia hoʻihoʻi hou ʻana o ka nodal atrioventricular (AVNRT)
• ʻO ka tachycardia reciprocating orthodromic (ORT)
• ʻO ka tachycardia reciprocating antidromic
• ʻO ka tachycardia atrial
• ʻO ke kani ʻana o ka atrium

ʻOiai paha he ʻano ʻepekema iki kēia, he mea nui i nā kauka ke hoʻomaopopo pono i kou kūlana a hāʻawi i ka lāʻau kūpono loa.

Pehea ka maʻamau o kēia?

He mea maʻamau loa nā maʻi puʻuwai (arrhythmias). He miliona miliona ka poʻe ma Sri Lanka a puni ka honua e ʻeha nei i kekahi ʻano maʻi puʻuwai.

ʻO nā tachycardia supraventricular (SVT) ke ʻano maʻamau o ka maʻi puʻuwai, ʻoi aku hoʻi i nā keiki ʻōpio a me nā pēpē. ʻOi aku ka maʻamau o lākou i nā keiki me ka maʻi puʻuwai hānau.

No ke aha e hana ʻia ai kēia PSVT? He aha nā kumu?

ʻO ka PSVT (i kapa ʻia hoʻi he re-entry tachycardia) he maʻi puʻuwai e kū mai ana ma ka atria. Hana ʻia ia i ka wā e loaʻa ai ka hana uila maʻamau ʻole ma ka atria. ʻO ke ʻano kēia, ʻo kahi wahi hypersensitive ma ka atria a i ʻole kahi kaapuni pōkole ma nā ala uila o ka puʻuwai ke kumu o ka hoʻomaka ʻana o nā hōʻailona uila e hele pōʻai. ʻO kēia ka manawa e hoʻomaka ai ka atria e ʻūmiʻi wikiwiki a mau.

Hiki ke loaʻa kēia mau hōʻailona uila ʻē inā he ala uila keu ('ala keu') ma waena o ka atria a me nā ventricles, ma ke ʻano pololei a i ʻole ma o ka 'AV node'. No ka laʻana, ʻo ka poʻe me ke ʻano i kapa ʻia ʻo 'Wolff-Parkinson-White syndrome' he ala keu kēia i loko o ko lākou mau puʻuwai. A laila, inā hele wikiwiki nā hōʻailona uila ma o kēia ala keu ma mua o ka hele ʻana ma o ka 'AV node' maʻamau, hoʻomaka ka puʻuwai e kuʻi wikiwiki loa.

E like me nā maʻi puʻuwai ʻē aʻe (arrhythmias), hiki i ka PSVT ke hoʻoilina. ʻO ke ʻano kēia inā loaʻa i kekahi o kou ʻohana, ʻoi aku ka nui o kou loaʻa ʻana iā ia. Eia kekahi, aia kekahi mau kumu ʻē aʻe e hiki ai ke hoʻoulu i kēia ʻano. E nānā kākou i ko lākou ʻano:

• Me ka ʻelemakule: No ka mea, loli ka puʻuwai me ka ʻelemakule.
• Anemia: Ke loaʻa ʻole i ke kino ka lawa o ka oxygen.
• Ka maloʻo a me ka luhi nui: Hiki i kēia ke kau i ke kaumaha ma ka puʻuwai.
• Nā mea inu a me nā meaʻai i loaʻa ka caffeine: nā mea e like me ke kī, ke kofe, ke kokoleka, a me kekahi mau mea inu ikehu.
• Kekahi mau meaʻai: Hiki i kekahi poʻe ke ʻike i nā palpitations ma hope o ka ʻai ʻana i nā meaʻai momona, kō, a i ʻole nā ​​​​kalapona. No ka laʻana, hiki iā ʻoe ke manaʻo i kou umauma e kuʻi ana ma hope o ka ʻai nui a ma hope paha o kahi pāʻina.
• ʻO kekahi mau lāʻau lapaʻau: No ka laʻana, pseudoephedrine, i loaʻa i loko o kekahi mau decongestants no ka ihu congestion.
• Ka inu nui ʻana i ka waiʻona.
• Ua loaʻa mua kahi hōʻeha puʻuwai a i ʻole ka hōʻeha puʻuwai mai ke ʻoki puʻuwai.
• Maʻi puʻuwai: ʻoi aku hoʻi ka maʻi o ke aʻa coronary (CAD).
• Ke koko kiʻekiʻe (Hypertension).
• Ke kaumaha nui a me ka hopohopo: Ke kaumaha i hoʻokumu ʻia e nā mea e like me kahi hoʻokolohua e hiki mai ana, nā pilikia hana, a i ʻole nā ​​​​pilikia ʻohana.
• Nā loli hormonal: I ka wā menopause i nā wahine, a i ʻole i ka wā hāpai. ʻO ka ʻoiaʻiʻo, he mea maʻamau ka palpitations i ka wā hāpai.
• Ka momona (momona) a me ke kaumaha nui.
• Ka puhipaka a me ka hoʻohana ʻana i nā huahana paka.
• Nā pilikia kūkulu o ka puʻuwai: No ka laʻana, ka maʻi valve puʻuwai.
• Nā pilikia thyroid: ʻoi aku ka 'Hyperthyroidism' (ka nui o ka hana o ka thyroid).

He aha nā hōʻailona o ka PSVT?

Hoʻomaka koke nā hōʻailona PSVT a pau koke. Hiki ke akahai no kekahi poʻe, a koʻikoʻi no kekahi. Hiki iā ʻoe ke manaʻo i kēia puʻuwai wikiwiki ma hope o ka hoʻoikaika kino ʻana, ma hope o kahi lā hiamoe maikaʻi ʻole, a i ʻole i ka wā o ke kaumaha nui.

ʻO nā hōʻailona nui:

• He wikiwiki a ʻano ʻole ka helu o ka puʻuwai. ʻOi aku ma mua o 100 mau kuʻi i kēlā me kēia minuke (BPM), akā i kekahi manawa he kiʻekiʻe a hiki i 250 BPM. ʻOi aku paha ka kiʻekiʻe o ka helu o ka puʻuwai o nā keiki ʻōpio me PSVT.
• Ke manaʻo nei i kahi ʻano ʻūlū, kuʻi, a i ʻole ke kuʻi ʻana i ka umauma, ka ʻāʻī, a i ʻole ka ʻāʻī (`palpitations`). Wahi a kekahi poʻe ua like ia me "ke kuʻi nei kahi pahu i loko o ka umauma." Hiki paha iā ʻoe ke manaʻo i kahi pulse ikaika a wikiwiki.
• Nā loli koke i ka helu o ka puʻuwai. Hiki i kou puʻuwai ke kuʻi wikiwiki no kekahi mau minuke a i ʻole mau hola, a laila hoʻomaka koke e kuʻi maʻamau. (ʻO ka helu maʻamau o ka puʻuwai no kahi pākeke ma waena o 60 a me 100 mau kuʻi i kēlā me kēia minuke.)

Ke kū mai kēia kūlana `PSVT`, hiki iā ʻoe ke ʻike i kekahi mau hōʻailona ʻē aʻe:

• Ke hopohopo nei a me ka poniuniu.
• ʻEha ka umauma, ka ʻoluʻolu ʻole, a i ʻole ka manaʻo o ka ʻūmiʻi ma ka umauma.
• Ka paʻakikī o ka hanu ʻana a i ʻole ka pōkole o ka hanu (dyspnea).
• Pōniuniu a me ke poʻo māmā, nā maka polū.
• Ka nalowale o ka ʻike (syncope) a i ʻole ka nawaliwali.
• Luhi nui a luhi paha.
• Ka luaʻi.

Pehea ʻoe e ʻike ai inā loaʻa iā ʻoe ka PSVT?

Ke hele ʻoe e ʻike i ke kauka, e nīnau mua ʻo ia iā ʻoe e pili ana i kāu mau hōʻailona a hoʻolohe i kou puʻuwai me ka stethoscope. A laila, e kauoha lākou i kahi hoʻāʻo koko. Nānā kēia hoʻāʻo koko i kāu hana thyroid a me nā pilikia ʻē aʻe i loko o kou koko.

ʻO ka mea aʻe, e hana ke kauka i kahi electrocardiogram (EKG a i ʻole ECG). He hoʻāʻo kēia e hiki ke hana ʻia ma ke keʻena o ke kauka a he 15 mau minuke ka lōʻihi. Hoʻopaʻa kahi EKG i ka hana uila o kou puʻuwai a me kou helu puʻuwai ma o nā mea ʻike i hoʻopili ʻia i kou ʻili. I kekahi manawa, inā ʻike ʻoe iā PSVT i ka wā o ka hoʻoikaika kino, e noi ʻia paha ʻoe e hana i kahi hoʻāʻo koʻikoʻi hoʻoikaika kino.

Inā ʻaʻole hōʻike ka EKG i kahi puʻuwai puʻuwai kūpono ʻole, e hāʻawi paha kāu kauka iā ʻoe i kahi monitor ambulatory, i ʻike ʻia hoʻi he monitor Holter a i ʻole patch monitor, e ʻaʻahu no kekahi mau lā a i ʻole hoʻokahi mahina. He mea liʻiliʻi kēia hiki iā ʻoe ke ʻaʻahu ma kou kino. Hoʻopaʻa mau ia i kou helu puʻuwai a me nā puʻuwai puʻuwai kūpono ʻole (inā he).

Pehea e mālama ʻia ai ka PSVT?

Ma muli o kou olakino holoʻokoʻa a me nā hōʻailona, ​​ʻaʻole paha ʻoe e pono i kekahi lāʻau lapaʻau. Inā he ʻano puʻuwai kūpono ʻole kou (he `arrhythmia`), e kuhikuhi ʻia ʻoe i kahi `cardiologist`. Hiki iā ia ke ʻōlelo i kēia mau mea:

• E hōʻalo i ka waiʻona a me ka caffeine (kī, kofe, kekahi mau mea inu palupalu). Eia kekahi, e ho'ōki i ka lawe ʻana i kekahi mau lāʻau lapaʻau i loaʻa ka pseudoephedrine, e like me nā decongestants.
• E hiamoe maikaʻi a e hoʻomaha.
• E inu i ka wai he nui e mālama i ka hydration kūpono.
• E kiʻi i ke kōkua e hōʻemi i ke kaumaha a me ka hopohopo, a hana i nā hoʻomaʻamaʻa hoʻomaha.
• Inā ʻoe he momona nui (momona), e hoʻēmi i ke kaumaha a mālama i ke kaumaha olakino.
• Inā ʻoe e puhipaka, e hoʻōki loa.

Eia kekahi, ke loaʻa iā ʻoe kēia kūlana `PSVT`, hiki iā ʻoe ke nīnau i kāu kauka e pili ana i kekahi mau ala e hoʻolohi ai i kou puʻuwai no kekahi manawa. Ua kapa ʻia kēia mau mea ʻo `Vagal maneuvers`. Nā Laʻana:

• Ke pīpī nei i ka wai anuanu ma kou alo i ka manawa hoʻokahi.
• Ke ʻū ʻana ma ke ʻano kūikawā.
• E pani i kou mau maka a kaomi mālie i kou mau lihilihi.

Mea nui: Mai hoʻāʻo i kēia mau 'vagal maneuvers' ma kāu iho, me ka ʻole o ke aʻo kūpono. Pono ʻoe e kūkākūkā me kāu kauka a hana iā lākou e like me kāna e ʻōlelo ai iā ʻoe.

• ʻO kekahi ʻano hana ʻē aʻe ka `Valsalva maneuver`. Ma kēia, lawe ʻoe i ka hanu i loko, ʻūmi i kou ihu, paʻa me he mea lā ua piha ʻoe, a laila hanu wikiwiki, me he mea lā e hoʻopiha ana ʻoe i kahi pōpō. Hiki i kēia ke hoʻēmi iki i kou puʻuwai.

Inā loli pinepine kou helu puʻuwai, inā hoʻoluhi lākou iā ʻoe, a inā he mau maʻi puʻuwai ʻē aʻe kāu, hiki i kāu kauka ke ʻōlelo i ka lāʻau lapaʻau. ʻO ia mau lāʻau lapaʻau:

• ʻO ka hoʻopau ʻana i ka catheter:ʻO kēia ke kumu o ka hōʻino iki ʻana i ka ʻāpana o ka ʻiʻo o ka puʻuwai e hoʻouna ana i nā hōʻailona uila maʻamau ʻole. He lāʻau lapaʻau kēia e pili ana i ka hoʻokomo ʻana i kahi ʻōmole liʻiliʻi (catheter) ma o kahi aʻa, me ka ʻole o ka hana ʻana i kahi ʻoki nui.
• ʻO ka lomilomi sinus Carotid: Ma kēia, hoʻopili ke kauka i ke kaomi mālie i kahi kikoʻī ma kou ʻāʻī e hoʻolohi i ka helu o kou puʻuwai. Pono ke kauka e hana i kēia, ʻaʻole pono ʻoe e hana ma ka home.
• Nā Mea Hana: I kekahi manawa, ua ʻōlelo ʻia e hoʻokomo i kahi mea hana e like me ka `Implantable Cardioverter Defibrillator (ICD), `subcutaneous ICD` a i ʻole `permanent pacemaker` i loko o ka puʻuwai.
• ʻO ke cardioversion uila: Ma kēia, hāʻawi ʻia ka puʻuwai i nā haʻalulu uila palekana (nā hoʻoluliluli ikehu), e hoʻōki ana i ke ʻano kuʻuna ʻole a ʻae i ka puʻuwai e kuʻi maʻamau.
• Nā lāʻau lapaʻau: Aia nā lāʻau lapaʻau e hiki ke hoʻihoʻi i ka puʻuwai o ka puʻuwai a pale i nā ʻano hewa o ka puʻuwai.

Pehea e hōʻemi ai i ka pilikia o PSVT?

ʻAʻole paha e hiki ke pale loa i ka PSVT. Eia nō naʻe, hiki iā ʻoe ke hōʻemi i kou pilikia ma ka hahai ʻana i kahi nohona olakino a me ka noho olakino. Eia kekahi mau mea hiki iā ʻoe ke hana e hōʻemi i kou pilikia:

• E hahai i kahi papaʻai olakino no ka puʻuwai ( haʻahaʻa i ka ʻaila, ka paʻakai, a me ke kō, a kiʻekiʻe i nā mea kanu, nā huaʻai, a me nā greens).
• Inā he mau mea kāu (`triggers`) āu i ʻike ai ke kumu o kēia kūlana `PSVT`, e noho mamao aku mai ia mau mea.
• E hoʻoikaika kino maikaʻi, e noho hana ikaika, a e hoʻāʻo e mālama i ke kūlana kino maikaʻi.
• Inā ʻoe he momona loa, e hoʻēmi i ke kaumaha, e kamaʻilio me kāu kauka, a e mālama i ke kaumaha olakino.
• Inā loaʻa iā ʻoe ke koko kiʻekiʻe (hypertension), e kāohi iā ia.
• E mālama i nā pae cholesterol olakino.
• Inā ʻoe e puhipaka, e hoʻōki loa.
• Inā loaʻa iā ʻoe a i ʻole kāu keiki kahi maʻi puʻuwai e hoʻonui ai i ka pilikia o PSVT, e kamaʻilio me kāu kauka e pili ana i ia mea. E hāʻawi ʻo ia iā ʻoe i nā ʻōlelo aʻoaʻo kikoʻī e pili ana i ke ola kino a me ka hōʻemi ʻana i kou pilikia o ka maʻi puʻuwai.

He aha ka mea e hiki mai ana i kekahi me PSVT? He aha ka wā e hiki mai ana?

ʻO ke kūlana no kekahi me PSVT e hilinaʻi ʻia i kekahi mau kumu, me kou makahiki a me kou olakino holoʻokoʻa. Hiki iā ʻoe ke kōkua i ka hoʻokele ʻana i kāu mau hōʻailona ma ka hana ʻana i nā hoʻololi i ke ʻano o ka nohona a me ka ʻai.

I ka hala ʻana o ka manawa, hiki i ka PSVT ke hoʻonāwaliwali i ka ʻiʻo o ka puʻuwai. I nā hihia koʻikoʻi, hiki i ka PSVT ke hoʻoulu i ka nalowale o ka ʻike a me ka hopu koke ʻana o ka puʻuwai. No laila, inā loaʻa iā ʻoe ka PSVT, he mea nui loa ia e ʻike pinepine i kāu kauka e nānā i ke olakino o kou puʻuwai.

ʻO ka nūhou maikaʻi, ma ka hapanui o nā hihia, hiki ke ho'ōla loa ʻia ka PSVT me kahi lāʻau i kapa ʻia ʻo ka catheter ablation.

Āhea wau e ʻike ai i ke kauka e pili ana i ka PSVT?

Inā he mau hopohopo kāu e pili ana i ka helu o kou puʻuwai, a inā he mau hōʻailona o ka puʻuwai kūpono ʻole (arrhythmia), e kamaʻilio pono me ke kauka. Inā ua ʻike ʻia ʻoe me PSVT, he mea nui loa ia e ʻike pinepine i kāu kauka cardiologist.

Inā loaʻa kēia mau mea, e ʻimi koke i ke kōkua lapaʻau:

• Inā ʻoe e manaʻo koke i ka luhi loa me ke kumu ʻole.
• Inā ʻoe e manaʻo ana he maule a nalowale paha kou ʻike.
• Inā ʻeha kou umauma, pilikia ka hanu ʻana, a i ʻole ka pōkole o ka hanu.

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

Hiki ke hopohopo ka Paroxysmal Supraventricular Tachycardia (PSVT) ke hana ʻia. Eia nō naʻe, ʻaʻole ia he mea hoʻoweliweli i ke ola a i ʻole ka hoʻoweliweli i ke ola. Eia nō naʻe, inā he mau hopohopo a nīnau paha kāu e pili ana i kou helu puʻuwai, ʻoi aku ka maikaʻi o ke ʻike ʻana i ke kauka no ka hoʻokolokolo piha ʻana e hōʻoia ʻaʻohe pilikia olakino koʻikoʻi.

ʻOiai ʻaʻole pono mau ka PSVT i ka lāʻau lapaʻau, aia nā lāʻau lapaʻau i loaʻa inā pono ʻoe iā lākou. Ma ka noho ʻana i ka hana, ka palena ʻana i nā mea e like me ka caffeine a me ka waiʻona, ka hahai ʻana i kahi nohona olakino, a me ka ʻike ʻana i kāu cardiologist i ka manawa kūpono, hiki iā ʻoe ke hōʻemi i kou pilikia o nā pilikia mai PSVT. No laila, e mālama i kou puʻuwai, no ka mea, ʻo ia kou koko ola!

Nā palpitations o ka puʻuwai, ka wikiwiki o ka puʻuwai, PSVT, Paroxysmal Supraventricular Tachycardia, arrhythmia, maʻi puʻuwai, ʻeha umauma, tachycardia