Ke manaʻo koke nei ʻoe i ka poniuniu, ke kuʻi nei kou umauma, polū kou mau maka, a ke manaʻo nei ʻoe e aneane nalowale ana ʻoe? I kekahi manawa hiki i kēia ke hōʻailona o kahi ʻano puʻuwai weliweli. I kēia lā ke kamaʻilio nei mākou e pili ana i kekahi ʻano maʻi kakaikahi akā hiki ke weliweli. Ua kapa ʻia ʻo Torsades de Pointes (he huaʻōlelo Farani, i haʻi ʻia ʻo "torsades de pointes"). He mea ʻē paha ke kani ʻana o ka inoa, akā he mea nui e ʻike i kona manaʻo a me kāna mea e hiki ai ke hana.
ʻO ka ʻōlelo maʻalahi, he aha ʻo Torsades de Pointes?
He ʻano wikiwiki loa kēia, ʻano ʻē, a weliweli hoʻi e hoʻomaka ana ma nā keʻena haʻahaʻa ʻelua o kou puʻuwai (ventricles). I ka pololei, he ʻano kūikawā kēia o ka wikiwiki o ka puʻuwai (Ventricular Tachycardia). ʻO ka maʻamau, ʻo ka puʻuwai o ke kanaka olakino ma waena o 60 a me 100 mau kuʻi i kēlā me kēia minuke. Eia nō naʻe, i ka wā e hana ʻia ai kēia ʻano, hiki ke piʻi ka piʻi ʻana o ka puʻuwai i 150 a 300 mau kuʻi i kēlā me kēia minuke .
He mea weliweli kēia no ka mea aia kahi hiki ke make koke ka puʻuwai me ka ʻole o ka hōʻike mua ʻana .
Inā ʻoe e nānā i kāu EKG (electrocardiogram), aia kekahi ʻano kikoʻī a nā kauka e ʻike ai i kēia kūlana. He ʻano ia o nā nalu e wili ana i mua a i hope, e like me ka wili. ʻO ka huaʻōlelo Farani "Torsades de Pointes" ʻo ia hoʻi "ka wili ʻana o nā kiko." Loaʻa kona inoa mai ke ʻano wili o ka EKG.
ʻO ka maʻamau, hiki mai kēia kūlana me kahi pilikia ʻē aʻe i ka hana uila o ka puʻuwai. Ua kapa ʻia ʻo ia he wā QT lōʻihi. I ka ʻōlelo maʻalahi, ʻo ka wā QT ka manawa e pono ai no nā keʻena haʻahaʻa o kou puʻuwai e kuʻi hoʻokahi a laila hoʻomākaukau no ka kuʻi aʻe. Inā lōʻihi loa kēia manawa (QT lōʻihi), hiki ke loaʻa kahi kuʻi hou, e hana ana i nā Torsades de Pointes.
He aha nā hōʻailona o kēia maʻi?
ʻO ka mea weliweli ma ʻaneʻi, ʻo ka hapalua o ka poʻe me kēia maʻi ʻaʻole lākou e ʻike i kekahi mau hōʻailona . ʻO ka poʻe i ʻike i nā hōʻailona e ʻike paha i kēia mau mea. Pono ʻoe e makaʻala loa i kēia mau mea.
| Hōʻailona | He wehewehe maʻalahi |
|---|---|
| Pōʻino | Hana ʻia ia ke ʻole e pamu pono ka puʻuwai i ke koko, e hopena ana i ka emi ʻana o ke kahe koko i ka lolo. |
| Nā Palpitations | Hoʻomaka ʻoe e manaʻo i kou puʻuwai e kuʻi wikiwiki ana a i ʻole ke ʻano kūpono ʻole. |
| Māmā ke poʻo | Ua like au me he mea lā e nalowale ana koʻu ʻike. |
| Ka mae ʻana | Hiki ke hana ʻia e ka haki ʻana o ke kahe koko i ka lolo no ka manawa pōkole. |
| Hoʻopau ʻia ka puʻuwai | He kūlana weliweli loa kēia. Oki koke ka puʻuwai i ke kuʻi ʻana. |
No ke aha e hana ʻia ai kēia? He aha nā kumu?
ʻElua mau ʻano kumu nui no kēia.
1. Nā kumu hānau: Ua hānau ʻia kekahi poʻe me kahi maʻi genetic i kapa ʻia ʻo `Long QT Syndrome`. ʻO ke ʻano kēia ua loaʻa iā lākou kēia maʻi i loko o ko lākou ʻohana. ʻOi aku ka nui o ka pilikia o kēia poʻe i ka hoʻomohala ʻana i ka Torsades de Pointes.
2. Nā kumu ma hope: ʻO kēia ka mea maʻamau. Hiki ke hoʻolōʻihi ʻia ka `QT interval` ma o ka hoʻohana ʻana i kekahi mau lāʻau lapaʻau a me ka hoʻemi ʻana i nā pae o nā electrolytes i loko o ke kino. Hoʻonui kēia i ka pilikia o Torsades de Pointes.
Nā lāʻau lapaʻau e hoʻonui ai i ka pilikia:
- ʻO kekahi mau lāʻau lapaʻau e kaohi ana i ka puʻuwai (Antiarrhythmics)
- Kekahi mau lāʻau antibiotic
- Kekahi mau lāʻau lapaʻau no ka luaʻi ʻana (Antiemetics)
- Nā lāʻau antifungal
- ʻO nā antipsychotics nā lāʻau lapaʻau i hoʻohana ʻia e mālama ai i kekahi mau maʻi noʻonoʻo.
- ʻO kekahi mau lāʻau lapaʻau no ka maʻi kanesa
He mea nui: Inā ʻoe e lawe nei i kēia ʻano lāʻau lapaʻau, mai hopohopo. ʻAʻole e ʻike nā kānaka a pau i kēia maʻi. Akā, he mea nui loa ia e kamaʻilio me kāu kauka e pili ana i kēia a e makaʻala i nā pilikia.
He aha nā kumu pilikia no kēia?
ʻOi aku ka nui o ka hiki i kekahi poʻe ke loaʻa i kēia maʻi. ʻO kēia mau mea pilikia:
- Loaʻa iā ʻoe kahi maʻi i kapa ʻia ʻo 'Long QT Syndrome'.
- Loaʻa nā maʻi puʻuwai ʻē aʻe.
- ʻOiai he wahine (ʻoi aku ka nui o ka pilikia o nā wahine)
- ʻOiai ma luna o 65 mau makahiki .
- ʻO ka thyroid hana ʻole.
- Ua loaʻa i ka hahau.
- Ka hoʻohana ʻana i nā lāʻau diuretic.
- Ka lohi o ka puʻuwai (Bradycardia).
- Nā pae haʻahaʻa o ka calcium, magnesium, a i ʻole potassium i loko o ke kino.
- Ka nui o ka maʻi pākī a i ʻole ka luaʻi ʻana.
Hiki ke hoʻemi ʻia ka pilikia?
ʻAe, hiki nō iā ʻoe. Aia kekahi mau mea hiki iā ʻoe ke hana:
- Inā loaʻa i kekahi o kou ʻohana ka `Long QT Syndrome`, e hoʻāʻo iā ʻoe iho no ia. Inā loaʻa iā ʻoe, e ʻike i kahi kauka cardiologist ma mua o ka hoʻomaka ʻana i kahi papahana hoʻoikaika kino.
- E makaʻala i nā lāʻau lapaʻau āu e lawe nei: Inā ʻoe e lawe ana i kahi lāʻau lapaʻau e hiki ke hoʻolōʻihi i ka `QT interval`, e nīnau i kāu kauka inā hiki iā ʻoe ke lawe i kahi lāʻau lapaʻau ʻē aʻe. Ke hoʻomaka nei i kahi lāʻau lapaʻau hou, e noi i kāu kauka e hōʻoia ʻaʻole ia e hoʻopilikia i ka lāʻau lapaʻau āu e lawe nei.
- E noʻonoʻo e pili ana i ka meaʻai: Inā ʻōlelo kāu kauka, e hoʻonui i kāu calcium, magnesium, a me ka potassium.
- E lawe i kāu lāʻau lapaʻau i ka manawa kūpono: I mea e pale ai i kēia ʻano mai ka hoʻi hou ʻana, e hoʻohana i ka lāʻau lapaʻau e like me ke kauoha a kāu kauka.
- E inu i ka wai nui: E mālama i ka wai a me ka paʻakai kūpono i loko o ke kino.
- E ʻike i ka helu o kou puʻuwai: E aʻo i ke ʻano o ka helu maʻamau o ka puʻuwai a pehea e ana ai.
- Inā ua hāʻawi ʻia ʻoe i kahi mea nānā puʻuwai: Inā ua hāʻawi kāu kauka iā ʻoe i kahi mea nānā puʻuwai e ʻaʻahu ai ma ka home, e hōʻoia e ʻaʻahu iā ia.
Pehea e hana ʻia ai ka hōʻailona?
ʻO ke ala nui e ʻike ai i kēia me ka hoʻāʻo ʻana o ka `EKG` (Electrocardiogram) . Hiki i nā kauka ke ʻike i kēia ma ka nānā ʻana i ke ʻano `twisted` ʻokoʻa a me ka `QT interval` lōʻihi i ʻike ʻia ma ka `EKG`.
Eia kekahi, hiki ke hana ʻia kēia mau hoʻokolohua:
- Nā hoʻāʻo koko: E nānā i nā pae o nā electrolytes i loko o ke kino, e like me ka magnesium a me ka potassium.
- Echocardiogram: He scan e nānā i ke ʻano a me ka hana o ka puʻuwai.
- Mea Nānā Puʻuwai: He mea hana i hoʻokomo ʻia no kekahi mau lā a nānā mau i ka mele o ka puʻuwai.
Pehea e mālama ʻia ai?
Aia ka lāʻau lapaʻau i ke kumu o ke kūlana. Pono ke kanaka me ka Long QT Syndrome hānau i ka lāʻau lapaʻau lōʻihi ma mua o kekahi me ke kūlana i hoʻokomo ʻia e ka lāʻau lapaʻau.
| ʻAno lapaʻau | Wehewehena |
|---|---|
| Nā lāʻau lapaʻau | |
| Ke ho'ōki nei i ka lā'au lapa'au e ho'oulu ai i ka pilikia | ʻO ka mea mua no ke kauka e hoʻōki i ka lāʻau lapaʻau āna i manaʻo ai ke kumu o kēia. |
| Makenesium a me/a i ʻole potassium | Inā haʻahaʻa ka nui o kēia mau paʻakai i loko o ke kino, hāʻawi ʻia lākou ma o ka intravenous e hoʻihoʻi iā lākou i ka maʻamau. |
| Nā mea pale beta | Hāʻawi ʻia ia e kaohi i ka helu o ka puʻuwai a no ka poʻe me ka `Long QT Syndrome'. |
| Nā ʻano hana a me nā mea hana ʻē aʻe (Nā Kaʻina Hana) | |
| Mea hoʻokele pacemaker | No ka poʻe me ka puʻuwai haʻahaʻa loa, ua hoʻokomo ʻia kahi mea liʻiliʻi e mālama iā ia i kahi mele kūpono. |
| ICD (Defibrillator Cardioverter Implantable) | He mea hana kēia i hoʻokomo ʻia i loko o ke kino. Ke ʻike ʻia kahi ʻano puʻuwai weliweli, hoʻouna koke ia i kahi haʻalulu uila e hoʻihoʻi i ka puʻuwai i ka maʻamau. |
| Ka hoʻololi uila/Defibrillation | I loko o kahi pilikia, e hāʻawi ana i kahi haʻalulu uila i ka umauma e hoʻihoʻi i ka ʻōuli maʻamau o ka puʻuwai. |
Āhea wau e ʻike ai i ke kauka?
Inā ʻike ʻoe i nā hōʻailona e like me ka pulse wikiwiki, ka ʻeha o ka umauma, ka poniuniu, nā maka polū, a i ʻole ka nalowale o ka ʻike, e hele koke i ka Emergency Department (ETU) o ka haukapila. He pilikia kēia.
Inā pono ʻoe e noho i ka haukapila ma muli o Torsades de Pointes, pono ʻoe e hoʻi i ka home no kahi nānā hou ʻana i loko o ʻelua pule. ʻOiai he ʻano kēia me ka pilikia o ka make koke ʻana, he mea nui e noho mau ʻoe ma lalo o ka nānā ʻana o kahi kauka puʻuwai.
Hiki iā ʻoe ke nīnau i kāu kauka i kēia mau nīnau:
- Ua hānau ʻia au me ka Long QT Syndrome, a i ʻole ua hana ʻia e ka lāʻau lapaʻau?
- He aha nā manawa kūpono e hiki mai ai kēia ʻano i nā poʻe ʻē aʻe o koʻu ʻohana?
- Aia kekahi lāʻau lapaʻau ʻē aʻe e hiki iaʻu ke lawe ma kahi o ka mea nāna i hoʻoulu i kēia pilikia?
Me ka mālama ʻana, hiki ke kāohi ʻia kēia kūlana a hiki iā ʻoe ke ola i kahi ola maikaʻi. Eia nō naʻe, inā ʻaʻole mālama ʻia, hiki ke make. No laila, he mea nui loa e hahai pololei i nā ʻōlelo a kāu kauka a hele i nā keʻena lapaʻau i nā lā i hoʻonohonoho ʻia.
Leka Lawe-Home
- ʻO ka Torsades de Pointes kahi ʻano puʻuwai wikiwiki loa a hoʻoweliweli i ke ola.
- Hiki ke kumu ʻia kēia e kahi maʻi hoʻoilina ('Long QT Syndrome') a i ʻole e kekahi mau lāʻau lapaʻau a me ka nele o ka paʻakai i loko o ke kino.
- Inā loaʻa iā ʻoe nā hōʻailona e like me ka ʻeha koke o ka umauma, ka poniuniu, a i ʻole ka nalowale o ka ʻike, he pilikia ia. E hele koke i ka ETU (Emergency Treatment Unit) .
- Mai ho'ōki i ka lawe ʻana i kāu lāʻau lapaʻau a hoʻololi paha i ka nui me ka ʻole o ke aʻo ʻana a kāu kauka.
- Inā ʻike ʻia kēia maʻi, he mea nui ka mālama mau ʻana a me ka nānā ʻana ma lalo o ke kauka cardiologist.
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