ʻAʻole anei e hana pono nā hōʻailona uila o kou puʻuwai? E kamaʻilio kākou e pili ana i ka Trifascicular Block!

Ua noʻonoʻo paha ʻoe i ke ʻano kupaianaha o ka hana ʻana o kou puʻuwai? Ua like ia me kahi ʻōnaehana uila liʻiliʻi, e hoʻouna ana i nā hōʻailona uila i nā ʻāpana like ʻole o ka puʻuwai e hoʻomau i ke kuʻi pono ʻana. Akā i kekahi manawa, hiki ke loaʻa nā keakea liʻiliʻi i nā ala o kēia mau hōʻailona uila. ʻO ia ka manawa e kamaʻilio ai mākou e pili ana i kahi "Heart Block." I kēia lā e kamaʻilio mākou e pili ana i kahi ʻano kikoʻī o ka poloka puʻuwai, i kapa ʻia he trifascicular block.

He aha kēia mau ʻāpana liʻiliʻi i loko o ka puʻuwai? Aia i hea lākou?

ʻAe, e nānā kākou i kēia mau "fascicles". I ka ʻōlelo maʻalahi, he mau puʻupuʻu kūikawā kēia o nā olonā ʻiʻo e lawe ana i nā leka uila i loko o ka puʻuwai. Ua kapa ʻia kēia mau mea he "bundle branchs." Aia kēia mau mea ma nā keʻena ʻelua o lalo o ka puʻuwai, ʻo ia hoʻi nā "ventricles." ʻO kēia mau fascicles ka mea e hoʻouna koke i nā hōʻailona uila, e hoʻoulu ai i nā keʻena puʻuwai e ʻaelike pono a hoʻopumu i ke koko.

E like me kou ʻike, ʻo ko kākou puʻuwai ke ʻano nui o ka ʻōnaehana hoʻopuni koko. He ʻehā ona keʻena nui:

• Atria: ʻO nā keʻena ʻelua o luna.
• Ventricles: ʻO nā keʻena haʻahaʻa ʻelua. Hoʻopilikia ka poloka trifascicular i kēia mau keʻena haʻahaʻa ʻelua.

I kēia manawa, e nānā kākou i nā fascicles i loko o kēia mau keʻena haʻahaʻa ʻelua:

• ʻO ka Ventricle ʻĀkau: ʻO kēia ke keʻena haʻahaʻa ma ka ʻaoʻao ʻākau o ka puʻuwai. Mai ʻaneʻi, hoʻouna ʻia ke koko i nā māmā ma o nā Pulmonary Arteries e loaʻa ai ka oxygen. Hoʻokahi wale nō fascicle o ka ventricle ʻākau. Ua kapa ʻia ʻo ia ʻo ka Right Bundle Branch .
• ʻO ka Ventricle Hema: ʻO kēia ke keʻena haʻahaʻa ma ka ʻaoʻao hema o ka puʻuwai. Hoʻopuka ia i ke koko oxygenated ma o ka aorta i ke koena o ke kino. ʻO ka ventricle hema ka keʻena pamu nui loa a ikaika loa i loko o ka puʻuwai. Loaʻa iā ia ʻelua fascicles, ʻo ka Left Anterior Fascicle a me ka Left Posterior Fascicle . I ka hui pū ʻana, hana kēia mau mea ʻelua i ka Left Bundle Branch . Hoʻokaʻawale hou ʻia kēia mau fascicles i miliona o nā olonā liʻiliʻi i kapa ʻia ʻo Purkinje Fibers.

E noʻonoʻo i kēia ʻano, ua like kēia mau fascicles me nā uea uila i loko o kahi hale. Ke hoʻā ʻoe i ke kuapo (ʻo ia hoʻi, ke hiki aku ka hōʻailona i ka puʻuwai), kahe ka uila ma kēia mau uea a hoʻā i ke kukui uila (ʻo ia hoʻi, ʻo ka ʻūlū ʻana o ka ʻiʻo o ka puʻuwai). No laila he aha ka mea e hana ai inā he mea e haki ai ma kekahi wahi o kēia mau uea? ʻĀ, ʻo ia ka mea e hana ai i loko o kahi poloka puʻuwai.

Pehea e hoʻokaʻawale ʻia ai nā poloka puʻuwai?

Hoʻokaʻawale nā ​​kauka i kēia mau poloka puʻuwai, a i ʻole "AV Blocks," i ʻekolu mau ʻano nui e pili ana i ko lākou koʻikoʻi:

1. Poloka kekelē mua: He lohi iki kēia i nā hōʻailona uila mai ka atria a i nā ventricles. He "Pōpōka piha ʻole" kēiaNo laila, ʻo ka hapa nui o ka manawa, ʻaʻohe hōʻailona a ʻaʻohe pono e mālama ʻia.

2. Poloka kekelē ʻelua: I kēia hihia, hele kekahi mau hōʻailona uila i nā ʻāpana, akā ʻaʻole kekahi. He poloka piha ʻole kēia. Hiki i kēia ke hoʻolohi i ka wikiwiki o ka puʻuwai, i kapa ʻia ʻo "bradycardia." A i ʻole hiki i ka wikiwiki o ka puʻuwai ke lilo i mea ʻē, i kapa ʻia ʻo "arrhythmia." Inā holomua kēia poloka kekelē ʻelua i ke kekelē ʻekolu, pono paha ka lāʻau lapaʻau.

3. Poloka o ke kekelē ʻekolu: He poloka piha kēia. ʻAʻohe hōʻailona uila i hoʻouna ʻia mai ka atria i nā ventricles. Hoʻomalu ʻia ke ʻano o ka puʻuwai e ka AV node, ka pūʻulu o His, a i ʻole nā ​​ventricles ponoʻī. Hoʻolohi nui kēia i ka helu o ka puʻuwai. Hiki i kēia ke hoʻoweliweli i ke ola, no laila pono koke ka lāʻau lapaʻau.

No laila he aha maoli ka Trifascicular Block?

ʻO ke ʻano o ka huaʻōlelo "tri" ʻekolu. No laila, i loko o kahi poloka trifascicular, aia kahi poloka ma ʻekolu mau wahi o ka ʻōnaehana alakaʻi o ka puʻuwai, ma lalo o ka "AV Node".

I ka ʻōlelo maʻalahi, ʻo ka poloka trifascicular kahi pilikia me nā hōʻailona uila ma ka lālā pūʻolo ʻākau a me ka lālā pūʻolo hema (ʻo ia hoʻi, nā fascicles hema mua a me hope). Ua manaʻo ʻia kēia he poloka puʻuwai piha . ( Inā he poloka ma kekahi o ka lālā pūʻolo ʻākau a me ka fascicle hema, ua kapa ʻia ʻo ia he "bifascicular block.")

ʻO ia hoʻi, ʻo kekahi me ka poloka trifascicular he mau kūlana ʻelua kēia:

• Poloka Lālā Pūʻolo ʻĀkau: Ma kēia, lohi ka hōʻailona uila mai ka fascicle ʻākau a i ka lālā pūʻolo hema.
• Poloka Lālā Pūʻulu Hema: ʻO kēia ka wā e hele mālie ai ka hōʻailona uila ma o ka ventricle hema. I ka poloka trifascicular, hoʻopilikia ka poloka i nā fascicles hema mua a me hope.

E noʻonoʻo i ka mea e hana ʻia ana i ke kaʻa ke pani ʻia nā alanui nui ʻekolu i ka manawa hoʻokahi. Pēlā nō ka mea e hana ʻia ana i nā leka i loko o ka puʻuwai.

Pehea ka maʻamau o kēia mau ālai puʻuwai?

Wahi a nā loea, ma kahi o hoʻokahi i loko o 10 mau kānaka ma luna o 70 mau makahiki me ka mōʻaukala o ka maʻi puʻuwai e loaʻa i ka poloka puʻuwai kekelē ʻekolu i kekahi manawa o ko lākou ola.

He aha nā kumu o ka poloka trifascicular?

Piʻi ka pilikia o ka loaʻa ʻana o kekahi ʻano poloka puʻuwai me ka makahiki. I kekahi manawa hiki ke hana ʻia kēia mau poloka me ke kumu ʻole. Hiki nō hoʻi ke kumu ʻia e ka maʻi puʻuwai hānau.

Eia nō naʻe, ʻo ka hapa nui, ʻo ka poloka trifascicular ka mea i hōʻino ʻia i ka puʻuwai. Hiki ke hana ʻia kēia hōʻino e nā mea e like me:

• Maʻi ʻAʻa Coronary
• Puʻuwai i hoʻonui ʻia (Hypertrophic Cardiomyopathy)
• Nā Hōʻeha Puʻuwai
• Nā Maʻi Puʻuwai ʻē aʻe
• Maʻi Valve Puʻuwai
• Hoʻonui ʻia ka nui o ka potassium i loko o ke koko (Hyperkalemia)
• ʻO ke ʻoki puʻuwai minimally invasive a i ʻole ke ʻoki puʻuwai hāmama
• Ka Hana Nui ʻana o ke Aʻalolo Vagus
• Ka maʻi rumatika
• ʻO Sarcoidosis (kahi maʻi e hōʻiliʻili ai nā ʻāpana mumū liʻiliʻi ma nā wahi like ʻole o ke kino)

He aha nā hōʻailona o kahi poloka trifascicular?

ʻAʻole pinepine ka poloka puʻuwai palupalu (kekelē mua a ʻelua paha) i nā hōʻailona. Eia nō naʻe, me ka poloka trifascicular, ua hoʻopilikia ʻia nā lālā pūʻolo ʻekolu, no laila ʻoi aku ka nui o nā hōʻailona e kū mai. Hiki iā ʻoe ke ʻike:

• ʻEha a paʻa paha ka umauma (Angina)
• Ka Pōʻino a me ka Maʻule (Syncope)
• Luhi
• Nā palpitations o ka puʻuwai (manaʻo e like me ka wikiwiki o kou puʻuwai a i ʻole e lele ana i kahi hahau)
• Ka luaʻi
• Pōkole o ka hanu

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​​​mai hoʻowahāwahā iā lākou. He mea nui e ʻike i ke kauka no ka ʻōlelo aʻo.

He aha nā pilikia e hiki mai ana o ka poloka trifascicular?

ʻO ka poloka puʻuwai e paʻakikī ai i ka puʻuwai ke pamu i ke koko ma ke kino holoʻokoʻa. Hiki i kēia ke alakaʻi i nā pilikia e hoʻoweliweli i ke ola e like me:

• Puʻuwai puʻuwai kūpono ʻole (Arrhythmia)
• Maʻi hohola
• Ka hāʻule ʻana o ka puʻuwai
• Make koke ʻana o ka puʻuwai (Make ma muli o ka hāʻule puʻuwai koke) `(Make koke ʻana o ka puʻuwai / Paʻa koke ʻana o ka puʻuwai)`

Ma muli o ke koʻikoʻi o kēia mau maʻi, ke ʻōlelo nei mākou he mea nui loa ka ʻimi koke ʻana i ka lāʻau no nā pilikia puʻuwai e like me kēia.

Pehea e ʻike ʻia ai ka poloka Trifascicular?

Hoʻohana nā kauka i kahi hoʻāʻo i kapa ʻia ʻo "electrocardiogram" e ʻike i nā loli i loko o ka ʻōnaehana uila o ka puʻuwai. Ua kapa ʻia kēia he ECG (E.C.G.) no ka pōkole. Kapa pū kekahi poʻe iā ia he EKG (E.K.G.).

Ke ana nei kēia hoʻāʻo ECG i ka hana uila o ka puʻuwai. Ke ana pū nei hoʻi ia i ka lōʻihi o ka hele ʻana o nā hōʻailona uila ma o ka puʻuwai. Hōʻike ia i ka manawa e hana ai nā keʻena ʻehā o ka puʻuwai.

He hoʻāʻo ʻeha ʻole ka ECG a ʻaʻole komohewa.Ma kahi o 15 mau minuke ka lōʻihi. Ma kēia, ua hoʻopili ʻia nā "electrodes" liʻiliʻi e like me ka ʻāpana i kou umauma, nā lima, a me nā wāwae. Hoʻopili ʻia kēia mau electrodes i kahi mīkini ECG me nā uwea. Hoʻopaʻa kēia mīkini i ka hana uila o kou puʻuwai ma ke ʻano he kiʻi. (ʻAʻole hoʻouna ka ECG i ka uila i kou kino, no laila mai hopohopo no kēlā.)

Pehea e mālama ʻia ai ka poloka trifascicular?

He nui ka poʻe me ka poloka trifascicular e pono e hana i ke ʻoki kino e hoʻokomo i kahi mea hana i loko o ko lākou puʻuwai e kaohi i ka puʻuwai o ko lākou puʻuwai.

• Pacemaker: Hoʻouna kēia i nā hōʻailona uila i ka puʻuwai, e hoʻoulu ana i nā keʻena o ka puʻuwai e kuʻi i kahi mele. Ua like ia me ka hāʻawi ʻana i ka puʻuwai i kahi "paʻi" iki mai waho.
• Hana pū kekahi mau mea i kapa ʻia ʻo "Implantable Cardioverter Defibrillators (ICDs)" e like me ka pacemaker. Eia kekahi, i ka wā e loaʻa ai ka pilikia o ka hopu koke ʻana o ka puʻuwai, hāʻawi kēia mau ICD i kahi haʻalulu uila i ka puʻuwai e hoʻihoʻi hou i ka paʻi maʻamau.

E nānā ke kauka iā ʻoe a hoʻoholo i ke ʻano o ka lāʻau lapaʻau kūpono iā ʻoe.

Hiki ke pale ʻia ka poloka trifascicular?

ʻOiai ʻaʻole hiki iā mākou ke kāohi i kekahi mau kumu, aia kekahi mau mea hiki iā mākou ke hana e pale i ke olakino o ko mākou puʻuwai. Hiki i kēia mau mea ke kōkua i ka hōʻemi ʻana i ka pilikia o nā kūlana e like me ka poloka trifascicular:

• E ʻai i ka meaʻai olakino no ka puʻuwai a hoʻoikaika kino mau.
• E kaupalena i ka inu ʻana i ka waiʻona.
• E ʻimi i nā ala olakino e hoʻokele ai i ke kaumaha .
• E hoʻemi i ke kaumaha (inā pono) a mālama i ke kaumaha olakino.
• E mālama i nā kūlana e hoʻokaumaha ai i ka puʻuwai, e like me ke koko kiʻekiʻe, ka maʻi diabetes, a me ka cholesterol kiʻekiʻe.
• E noi i ke kōkua e hoʻōki i ka puhipaka a pale aku i ka uahi lua.

ʻOiai paha he mea paʻakikī iki ka hoʻokomo ʻana i kēia mau mea i kou nohona i ka wā mua, e pōmaikaʻi ia i kou puʻuwai i ka wā lōʻihi.

He aha ke kūlana o ka poʻe me nā poloka puʻuwai Trifascicular?

Me ka mālama kūpono, ʻaʻole e holomua ka hapa nui o ka poʻe me ka poloka puʻuwai trifascicular i ka poloka puʻuwai piha. Hoʻonui ka pilikia inā waiho ʻole ʻia ka poloka puʻuwai trifascicular. Hiki i kēia ke alakaʻi i kahi puʻuwai puʻuwai kūpono ʻole (arrhythmia), kahi mea e ʻoi aku ka nui o ka make ma mua o ka poloka puʻuwai. ʻO ka mālama kūpono - maʻamau me kahi mea hana e like me ka pacemaker - hiki ke kōkua i ka hōʻemi ʻana i kēia pilikia.

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

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​e ʻike pono i ke kauka:

• Inā ʻoe e manaʻo nei ua luhi loa.
• Inā manaʻo ʻoe he kūlike ʻole kou puʻuwai.
• Inā loaʻa iā ʻoe ka ʻeha nui o ka umauma.
• Inā pilikia ʻoe i ka hanu ʻana.
• Inā loaʻa iā ʻoe nā hōʻailona o ka hāʻule puʻuwai (e laʻa, ʻeha nui o ka umauma e pālahalaha ana i lalo o kou lima, ʻeha o ka ʻāwae, ka hou ʻana).
• Inā he luaʻi hiki ʻole ke wehewehe ʻia.

Inā loaʻa iā ʻoe kekahi o kēia mau mea, mai manaʻo wale, "He mea maʻamau wale nō kēia." E ʻimi koke i ke kōkua lapaʻau.

He aha kaʻu e nīnau aku ai i kaʻu kauka?

Inā ua ʻike ʻia ʻoe me ka poloka trifascicular, makemake paha ʻoe e nīnau i kāu kauka i nā nīnau e like me:

• He aha ke kumu i loaʻa ai iaʻu kēia poloka trifascicular?
• Pehea e hiki ai iaʻu ke hōʻemi i koʻu pilikia o ka loaʻa ʻana o ka hōʻeha puʻuwai a i ʻole nā ​​​​maʻi puʻuwai ʻē aʻe?
• Pono anei au i kahi pacemaker a i ʻole ICD?
• He aha nā pilikia o ka hoʻokomo ʻana i kahi pacemaker a i ʻole ICD?
• Pono anei au e hopohopo e pili ana i nā hōʻailona o nā pilikia?

ʻO ka nīnau ʻana i kēia mau nīnau e kōkua iā ʻoe e hoʻomaopopo maikaʻi i kou kūlana a komo i ka mālama ʻana.

Nā mea nui e hoʻomanaʻo (Leka Lawe-Home)

ʻO ka poloka puʻuwai trifascicular kahi poloka i nā ala nui ʻekolu e lawe ana i nā hōʻailona uila ma o ka puʻuwai. Pale kēia i ka puʻuwai mai ka ʻaelike ʻana a me ka pamu ʻana i ke koko. ʻO ke kolu o ke kekelē, a i ʻole ka poloka puʻuwai piha, hiki ke hana i nā puʻuwai puʻuwai kūpono ʻole e hoʻoweliweli i ke ola (arrhythmias) a i ʻole ka make koke ʻana o ka puʻuwai.

ʻOi aku ka nui o ka pilikia o ka poʻe ma luna o 70 mau makahiki a me ka poʻe me ka maʻi puʻuwai. Hiki i kahi ECG ke ʻike i nā pilikia me ka ʻōnaehana uila o ka puʻuwai. Hiki i kāu kauka ke ʻōlelo aku i kahi mea hana e like me ka pacemaker a i ʻole ICD. Hoʻouna kēia mau mea hana i nā hōʻailona uila i nā keʻena o ka puʻuwai e hoʻomau i ko lākou kuʻi ʻana i kahi mele.

E mālama i kou puʻuwai. Inā manaʻo ʻoe i kekahi mea ʻē, mai hoʻowahāwahā. ʻO ka ʻimi koke ʻana i ke kōkua lapaʻau e hoʻopakele i kou ola.

ʻAka trifascicular, poloka puʻuwai, ʻōnaehana uila o ka puʻuwai, ECG, pacemaker, maʻi puʻuwai, puʻuwai