Ua ʻōlelo anei ka ECG ʻo RBBB (Right Bundle Branch Block)? Mai hopohopo, e ʻike pono kākou i ke ʻano o kēia!

Ua lawe ʻia paha kahi ECG iā ʻoe i ka wā o ka nānā ʻana i ke kauka, e like me kou hele ʻana e ʻike i ke kauka no kekahi maʻi ʻē aʻe, a i ʻole i kou hoʻomaka ʻana i kahi hana hou. Ua hopohopo iki paha ʻoe a makaʻu hoʻi i kou ʻike ʻana i kahi memo ma kēlā hōʻike ECG i ʻōlelo ʻia ʻo 'Right Bundle Branch Block', a i ʻole RBBB. Ua manaʻo paha ʻoe, "Auē kuʻu Akua, aia kekahi mea hewa nui me koʻu puʻuwai?" He mea maʻamau ke noʻonoʻo pēlā ke ʻike ʻoe i kahi huaʻōlelo maʻa ʻole. Akā ma mua o kou hopohopo, e hoʻomaopopo pono kākou i kēia. ʻO ka hapa nui o ka manawa, ʻaʻole kēia he mea koʻikoʻi e like me kou manaʻo.

I ka ʻōlelo maʻalahi, he aha ka Right Bundle Branch Block (RBBB)?

I mea e hoʻomaopopo ai i kēia, e nānā mua kākou i ke ʻano o ka hana ʻana o ko kākou puʻuwai. E noʻonoʻo ua like kou puʻuwai me kahi hale liʻiliʻi me ʻehā lumi. I mea e hoʻā ai nā kukui a holo ai nā peʻahi i loko o kēia hale, pono kahi lako uila, a i ʻole 'aupuni'. Ma ke ʻano like, loaʻa i ko kākou puʻuwai kāna ʻōnaehana uila ponoʻī e kuʻi pono ai.

Hoʻomaka kēia hōʻailona uila ma kahi 'kuhikuhi haku' ma ka piko o ka puʻuwai. Kāhea mākou iā ia ʻo `(Sinoatrial node)` a i ʻole SA node. Mai laila mai, hele ka hōʻailona uila ma o nā keʻena ʻelua o luna o ka puʻuwai (atria) a hōʻea i kahi 'pahu hui' i kapa ʻia ʻo `(Atrioventricular node)` a i ʻole AV node.

Mai kēia pahu hui, ua māhele ʻia ka hōʻailona uila i ʻelua mau uea nui e hele ana i nā keʻena nui ʻelua (ventricles) ma lalo o ka puʻuwai. ʻO kēia mau uea ʻelua ka mea a mākou e kapa nei he 'lālā bundle'. Hele kekahi i ke keʻena ʻākau (lālā bundle ʻākau), a hele kekahi i ke keʻena hema (lālā bundle hema).

ʻO ka mea maʻamau e hana ʻia, ʻo ia ka hele ʻana o ka hōʻailona uila ma kēia mau uaea ʻelua i ka wikiwiki like a me ka manawa like, e hoʻoulu ai i nā keʻena ʻelua o lalo o ka puʻuwai e ʻaelike (kuʻi) pū.

Eia nō naʻe, i loko o kekahi me ka Right Bundle Branch Block (RBBB) , aia kahi ālai iki i loko o ke 'uea' e hele ana i ka ʻaoʻao ʻākau, a i ʻole ka emi iki ʻana o ka wikiwiki o ka hōʻailona. Me he mea lā ke kahe mālie nei ke 'au' ma kahi uea kahiko. Ma muli o kēia, loaʻa i ka ventricle ʻākau ka hōʻailona ma hope iki o ka hema. Ma muli o kēia, kuʻi ka ventricle ʻākau i kahi hapa liʻiliʻi loa o kekona ma hope o ke kuʻi ʻana o ka ventricle hema.

ʻElua ʻano nui o ka RBBB. Inā lohi loa ka hōʻailona, ​​​​ua kapa ʻia ʻo 'RBBB Piha', a inā lohi iki wale nō, ua kapa ʻia ʻo 'RBBB Hoʻopau ʻole'. ʻO ka RBBB piha ʻole, ʻaʻole ia he koʻikoʻi e like me ka RBBB piha.

ʻO wai ka mea kūpono loa e ʻike i kēia maʻi?

Hiki i kēia ke hana i kekahi. Hiki i nā poʻe olakino maikaʻi ʻole ke loaʻa iā RBBB. Eia nō naʻe, ʻoi aku ka maʻamau o kēia ʻano i ko kākou ʻelemakule ʻana. E like me ka nāwaliwali iki ʻana o ke kaula uila i loko o kahi hale kahiko, hiki i ka ʻōnaehana uila o ka puʻuwai ke lohi iki i ko kākou ʻelemakule ʻana.

Ua ʻike ʻia ma ka noiʻi ʻana i ka hiki ʻana i ka makahiki 80, ma kahi o 11 o kēlā me kēia 100 mau kānaka (a i ʻole 11%) e loaʻa i kēia kūlana RBBB. No laila hiki iā ʻoe ke ʻike ʻaʻole ia he mea laha ʻole.

He aha nā hōʻailona o ka RBBB?

ʻO kēia ka mea nui a hōʻoluʻolu hoʻi e ʻike. No ka hapa nui o ka poʻe, ʻaʻohe hōʻailona. ʻAʻole paha ʻoe e ʻike he RBBB kou. ʻAʻole paha e ʻike ʻia a hiki i ka hana ʻia ʻana o kahi ECG no kekahi kumu ʻē aʻe. ʻAʻole ʻoe e ʻike i ka ʻeha o ka umauma, ka pōkole o ka hanu, a i ʻole ka hiolo ʻana ma muli o RBBB wale nō.

ʻO ke ʻano kēia, inā loaʻa iā ʻoe kēia mau hōʻailona, ​​ʻaʻole paha ma muli o RBBB, akā ma muli o kekahi maʻi olakino ʻē aʻe. No laila, inā loaʻa iā ʻoe kēlā mau hōʻailona, ​​​​pono ʻoe e ʻike i ke kauka.

He aha nā kumu o RBBB?

ʻOiai hiki ke loaʻa ka RBBB i nā poʻe olakino me ke kumu ʻole, hiki ke hana ʻia e kekahi mau kūlana olakino a me nā kumu ʻē aʻe. E nānā kākou i kekahi o nā kumu nui.

Pehea e ʻike ai ke kauka a hōʻoia i kēia?

ʻIke pinepine ʻia ʻo RBBB me kahi ECG, a i ʻole Electrocardiogram . Pili kēia hoʻāʻo i ka hoʻopili ʻana i nā sticker i kou umauma, nā lima, a me nā wāwae a hoʻopaʻa i ka hana uila o kou puʻuwai. Hiki i ke kauka akamai ke ʻike maʻalahi inā he RBBB kāu ma ka nānā ʻana i kēia ʻano ECG.

Akā, ʻaʻole i pau ke kauka ma laila. Aia kekahi mau kūlana ʻē aʻe, ʻoi aku paha ka koʻikoʻi, e hōʻike ana i nā ʻano ECG e like me RBBB. No laila e nānā pono ke kauka i kāu ECG e hōʻoia ʻaʻole ʻoe i loaʻa i kēia mau kūlana.

Eia kekahi mau kūlana:

• ʻO ka Ventricular Tachycardia: He kūlana koʻikoʻi kahi e kuʻi wikiwiki ai nā keʻena haʻahaʻa o ka puʻuwai.
• ʻO Brugada Syndrome: He ʻano genetic e hiki ai ke hoʻopau koke i ka puʻuwai.
• Poloka Lālā Pūʻolo Hema i Hoʻopiha ʻole ʻia: He poloka piha ʻole o ke ala hōʻailona ma ka ʻaoʻao hema, e like me ka ʻaoʻao ʻākau.

No laila, ʻoiai inā ʻōlelo kāu hōʻike ECG ʻo RBBB, pono e hāʻawi ʻia ka hopena hope loa a me nā ʻōlelo aʻoaʻo e pili ana i ia mea e ke kauka nāna ʻoe e nānā.

Pono anei ka RBBB i ka mālama ʻia?

He nūhou maikaʻi loa nō hoʻi ma ʻaneʻi.

Ua like ia me kahi hōʻailona hānau ma kou kino. Aia ia ma laila, akā ʻaʻole ia e hoʻopilikia iā ʻoe. E haʻi aku paha ke kauka iā ʻoe e hele mai i hoʻokahi manawa i ka makahiki a loaʻa kahi ECG, e ʻike inā he loli. Ma waho aʻe o kēlā, ʻaʻole pono ia i kekahi lāʻau lapaʻau a ʻoki kino paha.

Eia nō naʻe, inā loaʻa iā ʻoe ka RBBB ma muli o kekahi maʻi puʻuwai ʻē aʻe (e like me nā mea i helu ʻia ma ka papa o nā kumu ma luna), a laila ʻaʻole mālama ʻia ka RBBB. Mālama ʻia ke kūlana kumu. No ka laʻana, inā ua hoʻonui ʻia kou puʻuwai ma muli o ke koko kiʻekiʻe a ua hoʻokumu ʻia ka RBBB e kēia kūlana, ʻo ka lāʻau lapaʻau ka kaohi ʻana i kou koko. Inā hoʻokumu ʻia e ka hōʻeha puʻuwai, pono ʻoe e hoʻomau i ka mālama ʻana.

He aha ka wā e hiki mai ana o kekahi me RBBB? Aia kekahi mea e makaʻu ai?

ʻO ka pane i kēia nīnau e pili ana i ka loaʻa ʻana o nā maʻi puʻuwai ʻē aʻe. E nānā kākou i kēlā mau hihia ʻelua ma ke kaʻawale.

1. Inā ʻaʻohe ou maʻi puʻuwai ʻē aʻe (A i ʻole olakino)

I kēia manawa, ʻaʻohe mea e hopohopo ai ʻo RBBB. ʻAʻole ia e hoʻopōkole i kou ola a hoʻonui paha i kou pilikia o ka loaʻa ʻana o ka hōʻeha puʻuwai. He 'quirk' liʻiliʻi wale nō ia, a i ʻole kahi hiʻohiʻona kū hoʻokahi, i loko o ka ʻōnaehana uila o kou puʻuwai. Hiki iā ʻoe ke hele i kou ola maʻamau me ka ʻole o nā pilikia.

2. Inā loaʻa iā ʻoe kekahi maʻi puʻuwai ʻē aʻe (e.g. Heart failure, ma hope o ka Heart Attack)

I ia ʻano hihia, he mea e noʻonoʻo ai ʻo RBBB. ʻAʻole kēia manaʻo ua ʻoi aku ka ʻino o kou kūlana ma muli o RBBB. Eia nō naʻe, ʻo ka loaʻa ʻana o RBBB e hōʻike ana ua kaumaha kou puʻuwai a ua nāwaliwali iki kāna hana. No laila, i ka wā e hui pū ʻia ai ʻo RBBB me kahi maʻi puʻuwai e like me kēia, hiki ke hoʻonui iki ʻia ka pilikia o nā pilikia i ka wā e hiki mai ana.

ʻO ia ke kumu he mea nui loa ia no kēlā mau maʻi e hahai i ka lāʻau i hāʻawi ʻia e kā lākou kauka no ko lākou maʻi puʻuwai nui me ka ʻole o nā hemahema . Pono lākou e hana i nā mea e like me ka lawe ʻana i kā lākou lāʻau lapaʻau i ka manawa kūpono, kaohi ʻana i kā lākou ʻai, a me ka hoʻoikaika kino pono.

Ke hoʻokumu ʻia ʻo RBBB, ʻaʻole ia e nalo. He kūlana mau loa ia.

I ka manawa hea e pono ai iaʻu ke ʻike i ke kauka a e makaʻala?

Inā ʻike ʻoe he RBBB kou, he manaʻo maikaʻi e noho mau i ka launa pū ʻana me kāu kauka.

• Nā hālāwai maʻamau: ʻOiai inā ʻaʻohe ou maʻi olakino ʻē aʻe, e hele i nā nānā ʻana ma nā manawa i ʻōlelo ʻia e kāu kauka (e.g. hoʻokahi manawa i ka makahiki). Inā he mau maʻi puʻuwai ʻē aʻe kou, e hōʻoia e hele i kēlā mau keʻena lapaʻau.
• Nā hōʻailona hou: Inā loaʻa iā ʻoe nā hōʻailona i loaʻa ʻole iā ʻoe ma mua, e like me ka ʻeha o ka umauma, ka pōkole o ka hanu, ka pehu ʻana i kou mau wāwae, a i ʻole ka nāwaliwali, e ʻike koke i ke kauka.
• Pilikia:E noʻonoʻo ʻoe he ʻeha umauma hiki ʻole ke hoʻomanawanui, ua pālahalaha ka ʻeha i kou lima hema, ʻāʻī, a i ʻole ka ʻāwae, ua nui kou hou, a ua pōkole kou hanu. He mau hōʻailona paha kēia o ka hōʻeha puʻuwai. I kēlā hihia, mai hoʻokaʻulua. E hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa.

Nā nīnau koʻikoʻi e nīnau aku i kāu kauka

Inā ʻōlelo ʻia ma kāu hōʻike ECG ʻo RBBB, ʻo ka nīnau ʻana i kēia mau nīnau ke ʻike ʻoe i kāu kauka hiki ke kōkua iā ʻoe e loaʻa ka mālamalama hou aku.

• "E ke kauka, aia kekahi kumu kikoʻī no ke kumu o kēia maʻi RBBB iaʻu?"
• "Pono anei au e hana i kekahi mau hoʻololi i koʻu ola o kēlā me kēia lā ma muli o kēia? Ma nā mea e like me ka ʻai ʻana, ka hoʻoikaika kino, a pēlā aku?"
• "Pehea ka wikiwiki e hoʻi mai ai au e nānā?"
• (Inā loaʻa iā ʻoe nā maʻi puʻuwai ʻē aʻe) "Ke piʻi nei koʻu pilikia no ka loaʻa ʻana o kēia RBBB me koʻu mau maʻi puʻuwai ʻē aʻe? He aha kaʻu e hana ai e kāohi iā ia?"