Ke kuʻi nei kou puʻuwai i ka ʻano kūpono ʻole? E kamaʻilio kākou e pili ana i ka Sick Sinus Syndrome!

Ua manaʻo paha ʻoe e like me ke kuʻi ʻole ʻana o kou puʻuwai? I kekahi manawa, kuʻi wikiwiki loa ia, a i kekahi manawa, kuʻi wikiwiki loa ia. Inā loaʻa iā ʻoe kēia manaʻo ʻē, a inā paha he pilikia kēia i loaʻa i kekahi kokoke iā ʻoe, he mea nui e makaʻala i kēia kūlana a mākou e kamaʻilio nei i kēia lā, i kapa ʻia ʻo Sick Sinus Syndrome. Mai hopohopo, e kamaʻilio maʻalahi kākou e pili ana.

I ka ʻōlelo maʻalahi, he aha ka Sick Sinus Syndrome?

E noʻonoʻo i ko kākou puʻuwai me he hui mele lā. No ka hāʻawi ʻana i kēia hui i ke mele kūpono, ʻo ia hoʻi, e hoʻokō pono i ka puʻuwai, aia kahi 'pacemaker' maoli liʻiliʻi. I ka lāʻau lapaʻau, kapa mākou i kēia ʻo ka node sinoatrial, a i ʻole 'SA node'. I mea pololei, ʻo ia ka hōʻailona uila nui e haʻi aku i ka puʻuwai e "kuʻi i kēia manawa."

I kēia manawa, ma kēia kūlana i kapa ʻia ʻo `Sick Sinus Syndrome`, ʻo ka mea e hana ʻia ana, ʻo ia ka pau ʻana o ka hana pono ʻana o ka pacemaker kūlohelohe o ka puʻuwai, ʻo ia hoʻi ka `SA node`. ʻAʻole hiki iā ia ke mālama i ke ʻano kūpono. Hiki ke hana ʻia kēia e kekahi mau mea:

• He lohi loa ka helu o ka puʻuwai: Ua kapa ʻia kēia he "bradycardia". ʻOi aku ka lohi o ka helu o ka puʻuwai ma mua o ka maʻamau.
• Ke hoʻololi nei ma waena o ka wikiwiki a me ka lohi: I kekahi manawa e kuʻi wikiwiki loa ka puʻuwai, a laila hoʻomaka koke e kuʻi lohi hou. Ua kapa ʻia kēia he "tachy-brady syndrome".
• Kū ka puʻuwai no kekahi manawa: I kekahi manawa hiki i ka SA node ke hoʻōki i ka hoʻouna ʻana i kekahi mau hōʻailona no kahi o ʻekolu kekona. Kāhea mākou i kēia he pause sinus a i ʻole arrest. I kēia manawa, hoʻāʻo kekahi ʻāpana o ka puʻuwai e hoʻouna i kahi hōʻailona. Akā inā ʻaʻole ia e holo pono, hiki iā ʻoe ke mae a nalowale ka ʻike.

ʻAʻole maʻamau loa kēia ʻano, akā piʻi aʻe ka likelika o kona hiki ʻana me ka makahiki.

He aha nā hōʻailona o kēia maʻi?

I ka hapanui o nā hihia, ʻaʻohe paha he mau hōʻailona i nā pae mua o kēia maʻi. Eia nō naʻe, inā loaʻa nā hōʻailona ma muli o ka puʻuwai haʻahaʻa a kiʻekiʻe paha, penei paha lākou e like ai:

No ke aha lā e kū mai ai kēia kūlana?

I kekahi manawa, ʻaʻole hiki ke loaʻa ke kumu no kēia, akā aia kekahi mau kumu i ʻike ʻia.

• Ka ʻelemakule (kumu maʻamau): I ko kākou ʻelemakule ʻana, e like me nā mea āpau i loko o ko kākou kino, hiki i ka ʻōnaehana hōʻailona uila o ka puʻuwai a me ka node SA ke hoʻonāwaliwali mālie.
• ʻO ke ʻoki puʻuwai: Hiki ke hōʻino ʻia ka node SA i ka wā o ke ʻoki puʻuwai.
• ʻO kekahi mau lāʻau lapaʻau: ʻO kekahi mau lāʻau lapaʻau no ke koko kiʻekiʻe, nā puʻuwai puʻuwai kūpono ʻole (arrhythmias) (e.g., beta-blockers, calcium channel blockers) hiki ke hana i kēia ʻano.
• Nā kūlana olakino ʻē aʻe:Hiki ke hana ʻia kēia e nā mea e like me ka maʻi puʻuwai, ka nāwaliwali o nā ʻiʻo o ka puʻuwai (cardiomyopathy), a me nā kūlana e kū mai ana ma hope o ka hāʻule ʻana o ka puʻuwai.
• Nā maʻi ʻē aʻe e hoʻopilikia i ke kino: Hiki i nā maʻi e like me `(Sarcoidosis)` a me `(amyloidosis)` ke hoʻopilikia i ka puʻuwai.
• Nā pilikia hānau: Hiki i kekahi poʻe ke hānau ʻia me kēia ʻano pilikia puʻuwai.

ʻO wai ka mea i ʻoi aku ka pilikia o ka loaʻa ʻana o kēia maʻi?

Aia paha ʻoe i kahi pilikia kiʻekiʻe iki o ka hoʻomohala ʻana i kēia ʻano inā ʻoe:

• Inā ʻoe ma luna o 70 mau makahiki.
• Inā ua hana mua ʻoe i ke ʻoki puʻuwai.
• Inā ʻoe e hoʻohana ana i kekahi mau lāʻau lapaʻau, e like me kā mākou i kūkākūkā ai ma mua.
• Inā loaʻa iā ʻoe ka maʻi diabetes a i ʻole ke koko kiʻekiʻe.
• Inā ua loaʻa iā ʻoe nā maʻi ʻē aʻe e like me ka rheumatic fever.
• Inā he mau mana hoʻoilina.

ʻAʻole hiki ke hoʻemi ʻia ka pilikia?

ʻAʻole hiki iā mākou ke kāohi maoli i nā mea e like me nā genes a me ka ʻelemakule. Akā aia nā mea hiki iā mākou ke hana. ʻO ka mea nui loa, ʻo ia ka mālama pono ʻana i kou puʻuwai. Inā loaʻa iā ʻoe nā maʻi e like me ka maʻi diabetes a i ʻole ke koko kiʻekiʻe, e kāohi pono iā lākou. E kamaʻilio pinepine me kāu kauka a nīnau e pili ana i nā pilikia o nā lāʻau lapaʻau āu e lawe ai.

Pehea e hana ʻia ai ka hōʻailona?

Ke hele ʻoe e ʻike i ke kauka, e hoʻolohe mua ʻo ia i kāu mau hōʻailona a laila e hana i kahi hoʻokolokolo kino. No ka hōʻoia ʻana i kēia kūlana, pono e loaʻa kahi pilina maopopo ma waena o kāu mau hōʻailona a me ka lohi o ka puʻuwai (bradycardia).

Hiki i ke kauka ke hana i kekahi mau hoʻokolohua no kēia:

• ECG (Electrocardiogram): Hoʻāʻo kēia i ka hana uila o ka puʻuwai.
• Nā hoʻāʻo koko: E nānā i nā kumu ʻē aʻe, e like me ke kaulike ʻole o nā minelala (electrolytes) i loko o ke kino.
• Nānā i ka helu o ka puʻuwai: Hiki ke hāʻawi ʻia iā ʻoe kahi mea liʻiliʻi e komo ai ma ka home no 24 mau hola a ʻoi aku paha. E hoʻopaʻa kēia i kou helu o ka puʻuwai i ka lā holoʻokoʻa.
• Haʻawina Electrophysiology (haʻawina EP): I kekahi mau hihia, hiki ke hana ʻia kahi hoʻokolohua kūikawā e nānā i nā ala uila o ka puʻuwai ma ka haukapila.

He aha nā lāʻau lapaʻau? He mea anei ia e makaʻu ai?

ʻAʻohe mea e hopohopo ai. Aia nā lāʻau lapaʻau maikaʻi no kēia. Aia ka lāʻau lapaʻau i ka loaʻa ʻana o nā hōʻailona a i ʻole.

• Inā ʻaʻohe ou hōʻailona: Inā ʻaʻohe ou hōʻailona, ​​ʻaʻole paha ʻoe e pono i kekahi lāʻau lapaʻau. Na kāu kauka e nānā iā ʻoe.
• Inā i hana ʻia e ka lāʻau lapaʻau:Inā ʻo ke kumu o kēia kūlana he lāʻau lapaʻau āu e lawe nei, hiki i kāu kauka ke hoʻololi i ka lāʻau lapaʻau a hōʻemi paha i ka nui.
• Inā he mau hōʻailona: Inā he mau hōʻailona e like me ka poniuniu a me ka luhi nui, ʻo ka lāʻau maʻamau ka hoʻokomo ʻana i kahi pacemaker mau loa.

He aha kēia mea hana pacemaker?

He mea liʻiliʻi loa kēia, i hoʻohana ʻia e ka pila. Hoʻokomo ʻia ia ma lalo o ka ʻili o kou umauma ma o kahi ʻoki liʻiliʻi loa. Nānā mau ia i kou helu puʻuwai. Inā wikiwiki loa kou helu puʻuwai, hoʻouna ka pacemaker i kahi hōʻailona uila liʻiliʻi e kōkua i kou puʻuwai e kuʻi maʻamau. Hiki i kēia ke kōkua i ka hoʻopau loa ʻana i kāu mau hōʻailona a ʻae iā ʻoe e ola i ke ola maʻamau.

Āhea wau e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​e ʻimi koke i ke kōkua lapaʻau.

• Inā manaʻo ʻoe ua nāwaliwali a nalowale ka ʻike, e hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila. He mea kēia ʻaʻole pono e hoʻopaneʻe ʻia.
• Inā loaʻa iā ʻoe nā hōʻailona a mākou i kūkākūkā ai ma mua (ka pōʻino, ka ʻeha o ka umauma, ka paʻakikī o ka hanu ʻana), e ʻike koke i kāu kauka.
• Inā ua hoʻokomo mua ʻia kahi pacemaker a manaʻo ʻoe he pilikia me ia (e like me ka pehu ʻana, ka ʻeha ma kahi i hoʻokomo ʻia ai, a i ʻole ka hoʻi ʻana mai o nā hōʻailona kahiko), e kamaʻilio me kāu kauka.

He mea maikaʻi nō hoʻi e nīnau i kāu kauka i kēia mau nīnau:

• He aha kou manaʻo no ke kumu o kēia kūlana iaʻu?
• E pono anei iaʻu kahi pacemaker?
• Inā he pacemaker koʻu, ehia mau manawa e pono ai iaʻu e nānā ʻia?

ʻO ka maʻamau, e ʻoi aku ka ʻino o kēia kūlana i ka hala ʻana o ka manawa. No laila, he mea nui loa ka ʻike ʻana i ke kauka i ka manawa i hoʻonohonoho ʻia no ka nānā ʻana. Ma kēlā ala, hiki ke ʻike koke ʻia nā loli a hiki ke hāʻawi ʻia ka lāʻau lapaʻau e pono ai.