ʻO ka maʻi make koke ʻana o ka arrhythmic (SAD)

Ua lohe paha ʻoe i kekahi kanaka ʻōpiopio a olakino i make koke? Ua noʻonoʻo paha ʻoe pehea e hiki ai kēlā? I kekahi manawa hiki ke kumu o kahi maʻi a mākou e kamaʻilio ai i kēia lā i kapa ʻia ʻo Sudden Arrhythmic Death Syndrome (SADS) . He mea koʻikoʻi loa kēia, akā he mea nui e makaʻala i ia mea.

He aha ka Sudden Cardiac Death Syndrome (SADS)?

I ka ʻōlelo maʻalahi, he maʻi puʻuwai kēia. ʻO ka hapa nui o ka manawa, he mea ia āu e hoʻoilina ai , ʻo ia hoʻi, hiki ke hoʻoili ʻia mai kēlā hanauna a i kēia hanauna. ʻO ka mea e hana ʻia ma kēia, aia kahi pilikia me ka ʻōnaehana uila i loko o kou puʻuwai. E noʻonoʻo e pili ana i ia mea, hana ko mākou puʻuwai e like me kahi mīkini hana liʻiliʻi. ʻO nā hōʻailona uila ia e hoʻokō pono ai i ka puʻuwai. No laila, i ka wā e loaʻa ai kahi pilikia me kēia ʻōnaehana, lilo ka ʻōuli o ka puʻuwai i mea ʻē . Inā ʻaʻole mālama pono ʻia kēia, pono paha ʻoe e kū i ka make koke. ʻO ia ke kumu he mea weliweli.

He aha nā ʻano nui o SADS?

Aia kekahi mau ʻano o SADS. He ʻokoʻa iki ko kēlā me kēia. E nānā kākou i kekahi o nā ʻano nui:

• ʻO Brugada syndrome: He ʻano kēia kahi e ulu ai nā keʻena haʻahaʻa o ka puʻuwai, i kapa ʻia ʻo atria, i kahi puʻuwai wikiwiki a kūpono ʻole (polymorphic ventricular tachycardia).
• Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT): He ʻano kēia e paʻi wikiwiki ai nā hunaola puʻuwai a me ke ʻano ʻole. Hiki ke loaʻa kēia ʻano i ka wā o ka hoʻoikaika kino a i ʻole ke kaumaha noʻonoʻo.
• QT ‍ (Long QT syndrome - LQTS): , , `(repolarizing or recharging)` . . `(EKG)` , Q T `(QT interval)` . , `(ventricular tachycardia)` , ‍ `(ventricular fibrillation)` .
• ʻO ka maʻi QT pōkole (SQTS): ʻO kēia ke kū'ē i ka QT lōʻihi. ʻO ia hoʻi, ʻaʻole lōʻihi ka manawa e hoʻomākaukau ai nā hunaola o ka puʻuwai no ka hahau aʻe. Hiki i kēia ke hana i nā keʻena o luna o ka puʻuwai (atrial fibrillation) e hahau kūpono ʻole, a i ʻole nā ​​keʻena o lalo (ventricular tachycardia) e hahau wikiwiki, a i ʻole e haʻalulu kūpono ʻole (ventricular fibrillation).
• ʻO ka maʻi Timothy: He ʻano laha ʻole kēia. He ʻano maʻi QT lōʻihi nō hoʻi.
• ʻO ka maʻi Wolff-Parkinson-White (WPW):ʻO kēia ka manawa e hana ʻia ai kahi ala keu a ʻano ʻē no nā hōʻailona uila e hele ma waena o nā keʻena o luna (atria) a me nā keʻena o lalo (mitra). He mea hoʻohui kēia i ke ala maʻamau, hiki ke hoʻoulu i ka puʻuwai e kuʻi wikiwiki loa (tachycardia).

Pehea ka maʻamau o kēia mau kūlana SADS?

ʻAʻole maʻamau kēia mau mea, akā ʻaʻole lākou i nele. No ka laʻana, ua manaʻo ʻia ka maʻi QT lōʻihi i ʻōlelo ʻia ma mua (LQTS) e hoʻopilikia i kahi o hoʻokahi i loko o 2,000 mau pēpē hānau hou. ʻOi aku ka liʻiliʻi o ka maʻi Brugada , e hoʻopilikia ana ma lalo o 1% o ka heluna kanaka. ʻO ke kūlana i kapa ʻia ʻo CPVT e hoʻopilikia ana i kahi o hoʻokahi i loko o ʻumi tausani.

Akā, ma ka laulā, ma kahi o 200,000 mau kānaka e make ana mai ka hopu ʻana o ka puʻuwai koke (SCA) i kēlā me kēia makahiki ma ʻAmelika Hui Pū ʻIa wale nō. Ua hōʻike ʻia hoʻi he 4,000 mau keiki a me nā ʻōpio e make ana mai kēia mau kūlana SADS i kēlā me kēia makahiki. No laila, ʻaʻole ia he mea liʻiliʻi, ʻeā?

He aha nā hōʻailona o SADS?

ʻOiai he nui nā ʻano like ʻole o SADS, aia kekahi mau hōʻailona maʻamau. Eia nō naʻe, ʻaʻole paha e ʻike kekahi poʻe i kekahi mau hōʻailona.

Nā hōʻailona maʻamau:

• Hiki ke ʻike ʻia ka maʻi ʻūlū a i ʻole ka hopu ʻana i ka wā o ka hoʻoikaika kino, a i ʻole i ka wā e pīhoihoi nui ai a makaʻu paha ʻoe.
• Hiki ke loaʻa ka ʻeha o ka umauma i ka wā o ka hoʻoikaika kino.
• Hiki paha iā ʻoe ke loaʻa ka pōkole o ka hanu i ka wā o ka hoʻoikaika kino.

I kēia manawa, e nānā kākou i nā hōʻailona like ʻole e pili ana i kēlā me kēia ʻano SADS.

Nā hōʻailona o ka maʻi Brugada

ʻOiai ʻaʻole i loaʻa i ka hapa nui o ka poʻe nā hōʻailona, ​​​​hiki i kekahi ke ʻike i kēia mau mea:

• Hiki ke loaʻa ka hopu ʻana o ka puʻuwai , ʻoiai i ka wā e hiamoe ana.
• Ka mae ʻana.
• Nā ʻōhūhū.
• He ʻano hanu kūpono ʻole.

Nā hōʻailona o ka catecholaminergic polymorphic ventricular tachycardia (CPVT)

ʻAʻohe paha he mau hōʻailona a hiki i ka wā e loaʻa ai ka hānō puʻuwai, akā hiki i kekahi poʻe ke manaʻo i ka nāwaliwali i ka wā e hoʻoikaika kino ai.

Nā Hōʻailona o ka Long QT Syndrome (LQTS)

Ma kahi o ka hapalua o ka poʻe me LQTS ʻaʻohe o lākou mau hōʻailona. Akā, ʻo kekahi poʻe:

• Hiki i kahi arrhythmia kikoʻī i kapa ʻia ʻo Torsades de Pointes ke hoʻoulu i ka hāʻule puʻuwai.
• Ka mae ʻana.
• Nā ʻōhūhū.

Nā Hōʻailona o ka Short QT Syndrome (SQTS)

Ma kahi o 40% o ka poʻe me kēia maʻi ʻaʻohe hōʻailona. Akā ʻo kekahi poʻe:

• Nā Palpitations .
• Ka mae ʻana.
• Maʻi hohola.

Nā hōʻailona o ka maʻi Timothy

ʻO nā hiʻohiʻona e ʻike ʻia ma kēia:

• Ka mae ʻana.
• Maʻi hohola.
• I kekahi manawa he mau manamana lima a me/a i ʻole nā ​​​​manamana wāwae me ka ʻupena.
• Nā pilikia hoʻomohala.

Nā hōʻailona o ka Wolff-Parkinson-White syndrome (WPW)

ʻO nā hōʻailona o WPW:

• Nā Palpitations.
• Manaʻo poniuniu (māmā ke poʻo).
• Paʻakikī ka hanu ʻana.
• Ka mae ʻana.
• Nā ʻōhūhū.

Mea nui: Inā ʻoe a i ʻole kekahi mea āu i ʻike ai i hoʻokahi a ʻoi aku paha o kēia mau hōʻailona, ​​​​pono ʻoe e ʻimi i ke kōkua lapaʻau.

He aha nā kumu o SADS?

I ka manawa pinepine, i ka wā e make koke ai kekahi kanaka ʻōpio, a ʻike ʻia ke ʻano o ko lākou puʻuwai ma ke nānā ʻana, manaʻo nā kauka he arrhythmia i ʻike ʻole ʻia ko lākou, he puʻuwai puʻuwai kūpono ʻole. ʻO nā kūlana SADS e hoʻoulu ai i kēia mau arrhythmias, a mākou i kamaʻilio ai ma mua, ua hoʻoili pinepine ʻia mai ka makua a i ke keiki . ʻO ia hoʻi, ua hele mai lākou mai nā genes. Hiki ke ʻokoʻa ka likelika o ka hoʻoili ʻia ʻana o kēia mau kūlana i nā keiki ma muli o ka gene i pili a me ka ʻāpana o ka puʻuwai i hoʻopilikia ʻia.

Pehea e ʻike ai nā kauka iā SADS?

Inā loaʻa i kahi ʻōpio nā hōʻailona i ʻōlelo ʻia ma luna, a inā ua make koke kekahi o ko lākou ʻohana ma mua o 40 mau makahiki, hiki i ke kauka ke kānalua iā SADS. ʻOkoʻa nā ʻano hana diagnostic ma muli o ke ʻano o SADS.

ʻO nā ʻano diagnostic i hoʻohana nui ʻia:

• Electrocardiogram (EKG): Hoʻāʻo kēia i ka hana uila o ka puʻuwai.
• Ka hoʻāʻo ʻana i ka genetic: Hoʻāʻo kēia no nā ʻano loli genetic e pili ana me SADS.
• Hoʻāʻo koʻikoʻi Treadmill: Hoʻāʻo kēia i ke ʻano o ka pane ʻana o ka puʻuwai i ka hoʻoikaika kino.
• Hoʻāʻo hoʻonāukiuki Catecholamine: Hoʻokele ʻia kahi lāʻau kūikawā a nānā ʻia ka pane a ka puʻuwai.
• Nānā Holter: He hāmeʻa e hoʻopaʻa mau ana i ka puʻuwai no kahi manawa o 24 mau hola.
• Echocardiogram: He scan ultrasound kēia e nānā ana i ke ʻano a me ka hana o ka puʻuwai.
• ʻO ke ultrasound fetal: Hiki ke hana ʻia kēia ʻoiai ke pēpē i loko o ka ʻōpū.
• Hoʻāʻo hōʻoia catheterization cardiac: He hoʻāʻo kahi e hoʻokomo ʻia ai kahi ʻōmole lahilahi i loko o ka puʻuwai.
• Haʻawina Electrophysiologic: Ma kēia haʻawina, ua hoʻokomo ʻia nā kaula maikaʻi i loko o ka puʻuwai e nānā pono i ka ʻōnaehana uila o ka puʻuwai.

He aha nā lāʻau lapaʻau no SADS?

ʻOkoʻa nā ʻano lapaʻau ma muli o ke ʻano o SADS, no laila he mea nui e ʻike pono i ke ʻano āu.

Ka mālama ʻana i ka maʻi Brugada

• ʻO ka defibrillator cardioverter implantable (ICD): He mīkini liʻiliʻi kēia i waiho ʻia ma lalo o ka ʻili. Inā lilo ka helu o ka puʻuwai i mea ʻino loa, hāʻawi ia i kahi haʻalulu uila liʻiliʻi e hoʻihoʻi i ka helu o ka puʻuwai.
• Nā lāʻau lapaʻau e like me Quinidine .
• E hōʻalo i ka hoʻohana ʻana i nā lāʻau lapaʻau e ālai ana i nā kahawai sodium i loko o ka puʻuwai.

Lapaʻau ʻana o ka Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT)

• Hāʻawi ʻia kēia poʻe i kahi ʻano lāʻau i kapa ʻia ʻo beta-blockers .
• Inā pono, e hoʻokomo ʻia kahi ICD.

Lapaʻau ʻana o ka Long QT Syndrome (LQTS)

Hiki ke hana i kēia me nā mea e like me ka lāʻau lapaʻau a i ʻole ke ʻoki ʻana:

• Nā mea pale beta.
• ʻO kahi ICD .
• Ka hoʻokaʻawale ʻana i ka ʻeha sympathetic cardiac hema: He hana ʻoki kino minimally invasive kēia e ʻoki a wehe i kekahi o nā aʻalolo autonomic e hele ana i ka puʻuwai.
• E hōʻalo i ka hoʻohana ʻana i kekahi mau lāʻau lapaʻau e hoʻolōʻihi i ka wā QT ma kāu EKG.

Lapaʻau no ka Short QT Syndrome (SQTS)

Aia ka lāʻau lapaʻau a me kahi mea hana no kēia:

• ʻO kahi ICD .
• Kuinidina.

Ka lāʻau lapaʻau no ka maʻi ʻo Timothy

Hoʻohana pū kēia i ka lāʻau lapaʻau a me kahi mea hana:

• Nā mea pale beta.
• ʻO kahi ICD .
• E hōʻalo i ka hoʻohana ʻana i nā lāʻau lapaʻau e hoʻolōʻihi i ka wā QT ma kāu EKG.

ʻO ka mālama ʻana i ka Wolff-Parkinson-White syndrome (WPW)

Hiki i nā lāʻau lapaʻau ke kōkua i ka pale ʻana i nā hōʻailona o WPW. Aia kekahi kaʻina hana i kapa ʻia ʻo ablation therapy . Hoʻopau kēia i ke ala uila keu. I kekahi manawa hiki i kēia ke ho'ōla loa iā WPW. Kuhikuhi pū nā kauka i nā lāʻau lapaʻau i kapa ʻia ʻo antiarrhythmics e hōʻemi i ka pilikia o nā rhythms puʻuwai kūpono ʻole.

Aia kekahi mau hopena ʻaoʻao i kēia mau lāʻau lapaʻau?

ʻAe, hiki i kekahi mau lāʻau lapaʻau ke loaʻa nā hopena ʻaoʻao liʻiliʻi.

• Hiki i kekahi poʻe ke paʻakikī i ka ʻae ʻana i nā beta-blockers i kauoha ʻia e kā lākou kauka.
• Ma hope o kēlā hana hoʻopau ʻana i ka hōʻeha ʻana o ka naʻau i haʻalele ʻia :
• Ka hou ʻana maʻamau ʻole.
• Nā lima maloʻo.
• Nā loli o ka mahana a i ʻole ke kala ma kekahi mau wahi o ka maka.
• Akā hiki i kēia ʻoki kino ke hoʻomaikaʻi nui i ka maikaʻi o ke ola.
• Ma muli o ka hāʻawi ʻana o ka hāmeʻa ICD i kahi haʻalulu uila e hoʻihoʻi i ka rhythm o ka puʻuwai, hiki ke lilo i mea ʻoluʻolu ʻole. Eia kekahi:
• Hiki ke loaʻa ka maʻi.
• ʻAʻole paha e hana pono ka hāmeʻa.

Pehea e hiki ai iaʻu ke hōʻemi i koʻu pilikia? Hiki ke pale ʻia ka SADS?

Inā loaʻa kekahi o kou ʻohana iā SADS, pono nā lālā ʻē aʻe o ka ʻohana e hana i ka CPR.Inā ʻike ʻoe pehea e hana ai, a inā he Automatic External Defibrillator (AED) kāu ma ka home, hiki iā ia ke lilo i mea hōʻoluʻolu nui i kahi mea me SADS. No ka mea, he mea maikaʻi ke ʻike aia kekahi ma laila e kōkua i kahi pilikia.

ʻOiai ʻaʻole hiki ke pale loa ʻia ka SADS, inā ua ʻike ʻia kekahi o kou ʻohana me ke ʻano, he mea nui e hoʻāʻo ʻia e ʻike inā loaʻa iā lākou ka hoʻololi ʻana o ka genetic. Hiki iā ʻoe ke kamaʻilio me kāu kauka e hoʻoholo i ka mea e hoʻāʻo ʻia. Ke ʻike ʻia kekahi me ke ʻano, hiki ke hana ʻia nā hana e pale aku iā lākou, me ka lāʻau lapaʻau a i ʻole nā ​​​​lāʻau lapaʻau ʻē aʻe.

He aha ka mea e hiki mai ana no kekahi me SADS?

Aia maoli nō ia i ke ʻano o ka SADS āu i loaʻa ai, pehea ka wikiwiki o ka ʻike ʻia ʻana, a pehea ka wikiwiki o ka hoʻomaka ʻana o ka mālama ʻana. He maʻi ia no ke ola holoʻokoʻa , a i kekahi manawa hiki ke make .

Eia nō naʻe, ʻoi aku ka maikaʻi o ka nānā ʻana o ka poʻe me ka Wolff-Parkinson-White syndrome (WPW) no ka mea hiki i ka ablation therapy ke hoʻoponopono i ka pilikia. ʻO ka poʻe i mālama ʻia no ka long QT syndrome (LQTS) he haʻahaʻa loa ka pilikia o ka make koke. Eia nō naʻe, ʻaʻole i loaʻa i ka nui o ka poʻe i hiki ke pōmaikaʻi mai ka ablation ventricular hema. He kakaikahi loa ka noiʻi ʻana ma nā kūlana e like me ka short QT syndrome (SQTS) , no ka mea, he kakaikahi wale nō (ma kahi o 200) mau maʻi me kēia ʻano.

No laila, pono ka noiʻi hou aku e ʻike i nā lāʻau lapaʻau maikaʻi loa no nā mea āpau me SADS.

ʻO ke kau ʻana i kahi ICD hiki ke pale i ka make koke ʻana o ka puʻuwai no ka mea mālama ia i nā ʻano puʻuwai maʻamau ʻole. ʻOiai ʻaʻole ia e ho'ōla i ke kūlana, he ala kūpono ia e hōʻemi ai i ka pilikia o ka make mai kēia mau kūlana.

Inā loaʻa iā ʻoe ka SADS, pehea ʻoe e mālama ai iā ʻoe iho?

• Inā ua kuhikuhi kāu kauka i ka lāʻau lapaʻau nāu, e lawe pololei e like me ke kauoha, me ka ʻole o ka hala ʻana i hoʻokahi lā. Pēlā nō hoʻi no ke keiki me SADS. Pono e hāʻawi ʻia kā lākou lāʻau lapaʻau i ka manawa kūpono, a ʻaʻole ia he manaʻo maikaʻi e hōʻalo i hoʻokahi mahele lāʻau.
• E nīnau mau i kāu kauka a kauka lāʻau paha ma mua o ka hoʻomaka ʻana i kahi lāʻau hou. Hiki i nā lāʻau lapaʻau he nui, me nā lāʻau antibiotic maʻamau a me nā lāʻau anti-nausea, ke launa pū me kāu mau lāʻau puʻuwai. Hiki iā lākou ke hoʻopilikia i ka wā QT, kahi e hoʻonui ai i ka pilikia o ka make koke ʻana i kekahi me ka maʻi QT lōʻihi.
• E hoʻomaopopo pehea e hana ai kāu (a i ʻole kāu keiki) ICD. Eia kekahi, e nānā mau ʻia e kāu kauka. Hiki i kekahi mau kaʻina hana lapaʻau a me nā mea uila o kēlā me kēia lā ke hoʻopilikia i ka hana o kāu ICD. No laila, e ʻike i ka mea e pale aku ai.
• Inā loaʻa i kāu keiki ka SADS, e nīnau i ke kauka inā hiki iā ia ke pāʻani i nā haʻuki me kona kūlana.

Āhea ʻoe e ʻike ai i ke kauka? Āhea ʻoe e hele ai i ka lumi pilikia?

Inā loaʻa iā ʻoe ka SADS, he mea nui loa nā nānā mau ʻana . ʻO kēia ke hōʻoia e lawe ana ʻoe i ka nui kūpono o ka lāʻau lapaʻau. Inā loaʻa i kāu keiki ka SADS, pono paha e hoʻonui ʻia ka nui o ka lāʻau lapaʻau i kona ulu ʻana a me ka piʻi ʻana o ke kaumaha. ʻO ia ke kumu he mea nui loa i nā keiki ke loaʻa nā nānā mau ʻana. Inā loaʻa iā ʻoe kahi ICD, e ʻike i kāu kauka ma ka liʻiliʻi ʻelua i ka makahiki.

I ka hihia o ka pilikia:

• Inā loaʻa kekahi i ka hopu ʻana o ka puʻuwai , e kāhea koke i ka 911 (a i ʻole ka helu ulia pōpilikia o kou ʻāina) a hana i ka CPR.
• Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, ​​e hele koke i ka lumi pilikia a kāhea paha i 911:
• Inā ʻoe e manaʻo i ka nāwaliwali, ka poniuniu, a i ʻole he palpitations.
• Inā loaʻa iā ʻoe ka ʻeha koke o ka umauma a i ʻole ka paʻakikī o ka hanu ʻana.

He aha nā nīnau koʻikoʻi e nīnau aku ai i kāu kauka?

Inā loaʻa iā ʻoe a i ʻole kekahi o kou ʻohana ka SADS, he mea nui loa e nīnau i kāu kauka i kēia mau nīnau:

• He aha ke ʻano o ka SADS iaʻu?
• He aha ka lāʻau lapaʻau āu e ʻōlelo ai no koʻu kūlana kikoʻī?
• Hiki iā ʻoe ke kōkua mai iaʻu e ʻike i ka poʻe o koʻu ʻohana e pono e hoʻāʻo ʻia no kēia?
• Pono anei au i kahi defibrillator?
• Aia kekahi mau lāʻau lapaʻau e pono iaʻu e pale aku me koʻu maʻi?

ʻO ka hope, e hoʻomanaʻo i kēia mau mea!

ʻOiai he maʻi koʻikoʻi ka SADS, ʻo ka ʻike ʻana iā ia a me ka lawe ʻana i nā hana kūpono e hiki ke pale iā ʻoe a me kāu poʻe aloha. ʻO ka ʻike ʻana i kāu hōʻailona hiki ke kōkua iā ʻoe e hoʻomaopopo i kāu mau koho. E hana pū me kāu kauka e hoʻoholo i ka lāʻau lapaʻau maikaʻi loa iā ʻoe a i ʻole kāu mea aloha. He mea nui nā nānā mau ʻana, ʻoiai inā he ICD kāu. ʻO ka loaʻa ʻana o kahi AED ma ka home a me ka hōʻoia ʻana ua ʻike nā mea a pau pehea e hoʻohana ai a hana i ka CPR hiki ke kōkua iā ʻoe a me kou ʻohana. Mai hopohopo, ʻo ka ʻike ka pale maikaʻi loa.

ʻO ka maʻi make koke ʻana o ka puʻuwai, SADS, maʻi puʻuwai, puʻuwai ʻano ʻē, nā maʻi hoʻoilina, make koke, ʻōnaehana uila o ka puʻuwai