Ke manaʻo nei ʻoe i kekahi manawa e lele ana kou puʻuwai i kahi kuʻi? A i ʻole ke manaʻo nei ʻoe e like me ka manu e lele ana i kona mau ʻēheu i loko o kou umauma, a i ʻole ke kuʻi ikaika nei kou puʻuwai a lele i luna a i lalo? Ua ʻike ka poʻe he nui i kēia. ʻO ka hapa nui o ka manawa, ʻaʻohe mea e hopohopo ai. Ma nā ʻōlelo lapaʻau, ua kapa ʻia kēia ʻano he Premature Ventricular Contractions, a i ʻole PVCs no ka pōkole. No laila i kēia lā, e kamaʻilio kākou e pili ana i ke ʻano o kēia mau PVC, no ke aha lākou e hana ai, a me nā mea e pono ai mākou e ʻike e pili ana iā lākou.
I ka ʻōlelo maʻalahi, he aha kēia mau PVC?
ʻAe, no ka hoʻomaopopo ʻana i kēia, e nānā mua kākou i ke ʻano o ka hana ʻana o ko kākou puʻuwai. E noʻonoʻo ua like ko kākou puʻuwai me kahi hale me kahi ʻōnaehana uila liʻiliʻi. Aia wale nō ke loaʻa i kēia hale ka uila i ka manawa kūpono e hiki ai i nā kukui a me nā peʻahi ke hana pono. Loaʻa i ko kākou puʻuwai kahi ʻōnaehana uila like.
ʻO ka maʻamau, ma ka atrium ʻākau ma ka piko o ka puʻuwai, aia kahi hui liʻiliʻi o nā cell i kapa ʻia ʻo ka sinoatrial node a i ʻole SA node. ʻO kēia ke 'kuhikuhi haku' o ko kākou puʻuwai. Hoʻomaka ka hōʻailona uila mua e haʻi i ka puʻuwai e kuʻi ma ʻaneʻi. A laila hele kēia hōʻailona ma loko o ka puʻuwai a hele i nā keʻena nui ʻelua ma lalo o ka puʻuwai, ʻo ia hoʻi nā ventricles. Ke loaʻa kēia hōʻailona, e ʻaelike pono ka ʻiʻo o ka puʻuwai a hoʻopuka i ke koko i ke kino. ʻO kēia ke kaʻina hana maʻamau.
Akā i loko o kahi PVC, ʻokoʻa iki kekahi mea. Ma kahi o ka hōʻailona uila e hoʻomaka ai ka puʻuwai e kuʻi mai ke 'kuʻi nui' (SA node), hoʻomaka koke ia mai ke keʻena haʻahaʻa o ka puʻuwai `(ventricle). Ua like ia me ke hoʻā ʻana i ke kukui i loko o kahi lumi ʻokoʻa ma kahi o ke kuapo nui i loko o kahi hale. Hoʻopilikia iki kēia i ka rhythm o ka puʻuwai. Ma muli o kēia kuʻi keu, ua lohi iki ka puʻuwai maʻamau aʻe. ʻO ia ka manawa e manaʻo ai mākou ua 'nalowale i kahi puʻuwai'. Hiki i ka kuʻi aʻe ke manaʻo ikaika iki.
ʻO ka hapa nui o ka manawa, ʻaʻole koʻikoʻi nā PVC. Ma kahi o 75% o ka poʻe olakino i ʻike iā lākou i kekahi manawa o ko lākou ola. Akā inā hana pinepine lākou, he mea nui e kamaʻilio me ke kauka.
Hiki i nā kauka ke hoʻohana i nā inoa ʻē aʻe no kēia ʻano, no laila e hoʻomanaʻo i kēia mau inoa:
- Nā paʻakikī ventricular mua
- Nā extrasystole ventricular
- Nā kuʻi mua o ka ventricle
ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i nā PVC?
ʻOiai hiki i kekahi ke loaʻa nā PVC, ʻoi aku ka nui o ka pilikia o kekahi poʻe.
- No ka poʻe ʻelemakule.
- No ka poʻe me ka maʻi puʻuwai.
- No nā poʻe me ke koko kiʻekiʻe (hypertension).
- No ka poʻe i loaʻa mua i ka hāʻule puʻuwai.
- No ka poʻe me ka puʻuwai palupalu.
- No nā poʻe me ka hypertrophic cardiomyopathy.
He aha nā hōʻailona o nā PVC? He aha kā mākou manaʻo?
ʻO ka mea kupaianaha, he nui ka poʻe i loaʻa i nā PVC a ʻaʻole lākou e ʻike i kekahi mau hōʻailona. He ulia paha ia ke hana kāu kauka i kahi EKG no kekahi mea ʻē aʻe. Akā inā he mau hōʻailona, eia ke ʻano maʻamau:
| Hōʻailona | Pehea kona manaʻo |
|---|---|
| Nā Palpitations o ka Puʻuwai | Kuʻi ʻē ka puʻuwai i loko o ka umauma. Me he mea lā e 'lele' ana ka puʻuwai, e 'ʻōwili ana', e 'lele' ana. |
| Ke lele nei ka umauma | Hiki paha iā ʻoe ke manaʻo e like me ka manu e pā ana i kona mau ʻēheu i loko o kou umauma. |
| Ke kuʻi nei i ka ʻāʻī | Hiki paha i kekahi poʻe ke manaʻo ikaika i ka puʻuwai keu ma o nā aʻa koko ma ko lākou ʻāʻī. |
| Pōʻino/Māmā ke poʻo | Inā nui nā PVC e kū mai ana i ka lālani, hiki iā ʻoe ke manaʻo e nalowale ana kou ʻike a i ʻole ka manaʻo poniuniu ma muli o ka emi iki ʻana o ke kahe o ke koko i ka lolo. |
| Pōkole o ka hanu | ʻIke pinepine ʻia kēia i ka wā e loaʻa ai nā PVC i loko o kekahi mea i loaʻa mua i kahi maʻi puʻuwai ʻē aʻe. |
Ua like anei kēia manaʻo no nā kānaka a pau?
ʻAʻole. Loaʻa paha i kekahi poʻe he mau haneli o nā PVC i ka lā a ʻaʻole lākou e manaʻo i kekahi mea. Loaʻa paha i kekahi poʻe hoʻokahi a ʻelua paha i ka lā a ʻike nui iā ia. ʻOkoʻa ia mai kēlā kanaka a i kēia kanaka.
No ke aha mākou e loaʻa ai nā PVC? He aha nā kumu?
Aia kekahi mau manawa i hiki ʻole ke loaʻa kahi kumu kikoʻī no nā PVC. Eia nō naʻe, hiki i kēia mau mea ke kumu a hoʻonui paha i nā PVC.
- Ke Kaumaha a me ka Hopohopo: Ke kaumaha a makaʻu paha kākou, hana ko kākou kino i kahi hormone i kapa ʻia ʻo adrenaline. Hiki i kēia ke hoʻoulu i ka ʻōnaehana hōʻailona uila o ka puʻuwai a hoʻoulu i nā PVC.
- Kafeina a me ka ʻona: ʻO ka caffeine a me ka ʻona, i loaʻa i nā mea e like me ke kofe, ke kī, ke kokoleka, a me kekahi mau mea inu palupalu, hiki ke hoʻoulu i ka puʻuwai i kūpono ʻole.
- Nā Kaulike ʻole o ka Electrolyte: He mau minelala koʻikoʻi ka Potassium a me ka magnesium no ka hana pono ʻana o nā hōʻailona uila i loko o ko mākou kino. Hiki i nā pae haʻahaʻa o kēia mau mea ke alakaʻi i nā PVC.
- Maʻi puʻuwai: E like me ka mea i ʻōlelo ʻia ma mua, hiki ke hana ʻia nā PVC e nā kūlana e like me ka hōʻeha puʻuwai, ke koko kiʻekiʻe, a me ka maʻi o ke aʻa coronary.
- Nā kūlana olakino ʻē aʻe: Hiki ke hana ʻia kēia mau mea e nā kūlana e like me ka hyperthyroidism a me ka anemia.
- ʻO kekahi mau lāʻau lapaʻau: ʻO kekahi mau lāʻau lapaʻau i lawe ʻia no nā kūlana e like me ka hānō hiki ke hana i nā PVC.
Pehea ʻoe e ʻike ai i kēia, e Kauka?
Inā loaʻa iā ʻoe kēia mau hōʻailona, e nīnau mua kāu kauka iā ʻoe e pili ana i kāu mau hōʻailona a me ka mōʻaukala olakino ʻohana. A laila e hoʻolohe lākou i kou puʻuwai me kahi stethoscope. Eia kekahi, hiki iā lākou ke hana i kēia mau hoʻokolohua.
- Electrocardiogram (EKG/ECG): ʻO kēia ka hoʻāʻo maʻalahi loa. Hoʻokomo ʻia nā mea ʻike liʻiliʻi e like me ka sticker ma kou umauma, nā lima, a me nā wāwae a hoʻopaʻa i ka hana uila o kou puʻuwai no kekahi mau minuke. Hiki i kēia ke hōʻike maopopo i nā PVC āpau i loaʻa.
- Nānā Holter: I kekahi manawa, ʻaʻole hele mai nā PVC i nā manawa a pau. Inā hele mai lākou i kekahi mau manawa i ka lā, ʻaʻole paha e ʻike ʻia lākou e kahi EKG maʻamau. I kēlā mau hihia, e hoʻokomo kāu kauka iā ʻoe i kahi mīkini liʻiliʻi no 24 a 48 mau hola. E hoʻopaʻa mau kēia i ka mele o kou puʻuwai. Ua like ia me ka mālama ʻana i kahi puke moʻolelo o kou puʻuwai.
- Hoʻāʻo ʻana i ke kaumaha o ka naʻau: Hana ʻia kahi EKG i kou hele ʻana ma luna o kahi treadmill. Kōkua kēia i ka ʻike inā piʻi a emi paha nā PVC i ka wā hoʻoikaika kino.
- Echocardiogram: He scan ultrasound kēia o ka puʻuwai. Hiki iā ia ke nānā i nā mea he nui, e like me ke ʻano o ka puʻuwai, ka nui o nā keʻena, pehea e hana ai nā valves, a pehea e hoʻopuehu ai i ke koko. He mea nui loa kēia e ʻike ai inā aia kekahi maʻi puʻuwai ʻē aʻe ma lalo o nā PVC.
- Nā Hoʻāʻo Koko: Hiki ke hana ʻia nā hoʻāʻo koko e nānā i nā pae potassium a me ka magnesium o ke kino, nā pae hormone thyroid, a inā he anemia.
Pono anei nā PVC i ka mālama ʻia?
ʻO kēia ka mea nui loa. Inā he PVCs ka mea maʻamau i kahi kanaka olakino me ka ʻole o nā maʻi puʻuwai ʻē aʻe, ʻaʻohe lāʻau lapaʻau e pono ai. E haʻi aku kāu kauka iā ʻoe e hana i kekahi mau hoʻololi liʻiliʻi i ke ʻano o ka nohona.
Eia nō naʻe, pono paha ka lāʻau lapaʻau i nā hihia e like me kēia:
- Inā ke hoʻopilikia nei kāu mau hōʻailona i kou ola o kēlā me kēia lā.
- Inā kiʻekiʻe loa ka helu o nā PVC i kēlā me kēia lā (no ka laʻana, ʻoi aku ma mua o 15% o nā kuʻi puʻuwai āpau he PVC).
- Inā ua emi ka hiki o ka puʻuwai ke pamu i ke koko (ejection fraction) ma muli o nā PVC.
- Inā he maʻi puʻuwai koʻikoʻi ʻē aʻe ma lalo o nā PVC.
Hiki ke hoʻohana ʻia kēia mau mea ma ke ʻano he lāʻau lapaʻau:
| ʻAno lapaʻau | Wehewehena |
|---|---|
| Nā loli o ke ʻano o ka nohona | Ke haʻalele ʻana i ka caffeine, ka waiʻona, a me ka puhipaka. Ke mālama ʻana i ke kaumaha (noʻonoʻo ʻana, yoga, a pēlā aku). Ka lawa ʻana o ka hiamoe. |
| Nā lāʻau lapaʻau | Hiki i nā lāʻau lapaʻau e like me nā beta-blockers a i ʻole nā calcium channel blockers ke kāohi i ka helu o ka puʻuwai. I kekahi manawa hiki ke hāʻawi ʻia nā lāʻau anti-arrhythmic. |
| ʻO ka hoʻopau ʻana o ka catheter | Hoʻohana ʻia kēia lāʻau lapaʻau inā he nui kāu mau PVC i hiki ʻole ke kāohi ʻia me ka lāʻau lapaʻau. Ma kēia, ua hoʻokomo ʻia kahi paipu liʻiliʻi (catheter) ma o kahi aʻa koko i loko o kou ʻūhā i kou puʻuwai, ua ʻike ʻia nā pūnaewele kikoʻī e hana ana i nā PVC, a hoʻohana ʻia ka radiofrequency e luku i kēlā mau pūnaewele. He lāʻau lapaʻau maikaʻi loa kēia. |
Pono anei au e hopohopo e pili ana i nā PVC? Āhea wau e pono ai i ka mālama ulia pōpilikia?
ʻO ka maʻamau, ʻaʻole he pilikia nā PVC wale nō. Eia nō naʻe, inā loaʻa iā ʻoe nā PVC a me kēia mau hōʻailona i hui pū ʻia, e hele koke i ka ʻoihana pilikia o ka haukapila (ETU).
- ʻEha nui o ka umauma
- Paʻakikī nui ka hanu ʻana
- ʻO ka poʻo hina nui a i ʻole ka nāwaliwali (syncope)
- Delirium
Hōʻike kēia mau hōʻailona e hiki ke hana ʻia kekahi mea ʻoi aku ka koʻikoʻi ma mua o nā PVC. No laila, mai hoʻokaʻulua i ka nānā ʻana.
E hoʻomanaʻo, he maʻi maʻamau loa nā PVC. Kākaʻikahi lākou e hōʻeha i kahi kanaka me ka puʻuwai olakino i ka wā lōʻihi. Eia nō naʻe, inā hoʻomau a lilo paha i mea koʻikoʻi, hiki iā lākou ke alakaʻi i kahi maʻi i kapa ʻia ʻo cardiomyopathy, ʻo ia hoʻi ka nāwaliwali o ka ʻiʻo o ka puʻuwai. ʻO ia ke kumu he mea nui e ʻimi i ka ʻōlelo aʻo lapaʻau inā loaʻa iā ʻoe nā hōʻailona.
Leka Lawe-Home
- ʻO nā Premature Ventricular Contractions (PVCs) kahi maʻi maʻamau kahi e loli iki ai ke ʻano o ka puʻuwai. I ka hapa nui o ka manawa, ʻaʻole kēia he mea koʻikoʻi.
- ʻO nā manaʻo e like me ke 'palpitations o ka puʻuwai' a me ke 'fluttering umauma' nā hōʻailona maʻamau. Eia nō naʻe, ʻaʻole ʻike ka nui o ka poʻe i kekahi mau hōʻailona.
- Hiki i nā mea e like me ke kaumaha, ka caffeine, a me ka waiʻona ke hoʻonui i nā PVC. Hiki ke kōkua ka pale ʻana i kēia mau mea.
- Inā ʻike pinepine ʻoe i kēia mau hōʻailona, a inā paha ʻoe e hopohopo nei no lākou, e ʻike pono i kāu kauka.
- Inā hele pū nā hōʻailona e like me ka ʻeha nui o ka umauma a i ʻole ka nalowale o ka ʻike me nā PVC, he pilikia ia. E hele koke i ka haukapila.
- ʻAʻole pono ka poʻe me nā puʻuwai olakino i ka lāʻau lapaʻau. Inā pono, aia nā lāʻau lapaʻau kūpono loa i loaʻa.
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