Aia kekahi pilikia koʻikoʻi me ke kuʻina o ka puʻuwai? E kamaʻilio kākou e pili ana i ka Ventricular Arrhythmia.

Ua manaʻo paha ʻoe e like me ka wikiwiki o ka puʻuwai a i ʻole ka lele ʻana o ka puʻuwai? Ua ʻike ka poʻe he nui i kēia. Akā i kekahi manawa ʻaʻole maʻamau kēia a hiki ke lilo i hōʻailona o kahi pilikia koʻikoʻi me kou puʻuwai. No ka laʻana, kapa mākou i nā arrhythmias ventricular nā loli rhythm e hana ʻia ma nā keʻena haʻahaʻa o ka puʻuwai. ʻOiai ʻaʻohe mea ʻino o kekahi o kēia mau mea, hiki i kekahi mau ʻano ke hoʻoweliweli i ke ola.

Pehea e pili ai kēia i ka hana a ka puʻuwai?

I ka ʻōlelo maʻalahi, ua like kou puʻuwai me kahi pamu ikaika me nā keʻena ʻehā. ʻO nā keʻena liʻiliʻi ʻelua ma luna ua kapa ʻia ʻo atria, a ʻo nā keʻena nui a ikaika ʻelua ma lalo ua kapa ʻia ʻo ventricles.

Hoʻopuka ka ventricle ʻākau i ke koko i nā māmā e loaʻa ai ka oxygen. A laila hoʻi ke koko i hoʻopiha ʻia me ka oxygen i ka puʻuwai, kahi e hoʻopuka ʻia ai i ke koena o ke kino ma o ka ventricle hema. No laila hiki iā ʻoe ke ʻike he kuleana nā ventricles ʻelua o lalo no ka hoʻopuka ʻana i ke koko ma ke kino holoʻokoʻa .

No laila, inā he hoʻopilikia ʻana i ke mele maʻamau o kēia mau cell, hiki iā ia ke loaʻa nā hopena koʻikoʻi.

• Ka haʻalulu Cardiogenic: He kūlana kēia i hiki ʻole ai i ka puʻuwai ke pamu i ke koko kūpono, e hoʻonele ana i nā ʻōkana o ke kino i ka oxygen e pono ai lākou.
• Hoʻopau koke ʻia ka puʻuwai: ʻO kēia ka wā e pau koke ai ka puʻuwai me ka ʻole o ka ʻōlelo aʻo .

He aha nā ʻano nui o ka Ventricular Arrhythmia?

ʻEkolu mau ʻano nui o kēia maʻi. E kamaʻilio kākou e pili ana iā lākou pākahi.

1. Nā puʻuwai keu (Preventricular Contractions - PVCs)

ʻO kēia nā mea e like me ka "kuʻi keu" i loko o ka puʻuwai. ʻAʻole lākou e pōʻino . Loaʻa i ka hapa nui o ka poʻe kekahi mea e like me kēia i kekahi manawa o ko lākou ola. Eia nō naʻe, inā loaʻa iā ʻoe kahi maʻi e hoʻololi ai i ke ʻano o kou puʻuwai, a inā loaʻa iā ʻoe kēia mau kuʻi keu (PVCs) pinepine a no ka manawa lōʻihi paha, he kumu ia e hopohopo ai.

2. Ka Tachycardia Ventricular (VT)

ʻO kēia ka manawa e hoʻomaka ai nā keʻena haʻahaʻa o ka puʻuwai, a i ʻole atria, e kuʻi i ka wikiwiki i hiki ʻole ke noʻonoʻo ʻia. Hoʻokumu ʻia kēia e kahi kīnā i loko o ka ʻōnaehana uila o ka puʻuwai. I kekahi mau hihia, hiki i kēia kūlana `Ventricular Tachycardia` (VT) ke lilo i mea koʻikoʻi a lilo i ke kūlana weliweli `Ventricular Fibrillation`, a mākou e kūkākūkā ai ma hope.

Hoʻokaʻawale nā ​​​​kauka i kēia ʻano VT i kekahi mau ʻano ʻē aʻe:

• Pōkole a lōʻihi paha? (Hoʻomau ʻia vs. hoʻomau ʻole ʻia):Inā hoʻomau kēia puʻuwai wikiwiki no nā kekona he 30 a ʻoi, ua kapa ʻia ʻo ia he 'Sustained VT'. ʻOiai inā e pau ia no ka liʻiliʻi ma mua o 30 kekona, inā e hoʻoulu ia i kahi kūlana e like me ka 'Cardiogenic shock', hāʻule pū ia i loko o kēia māhele.
• ʻAno ECG: Hiki i nā kauka ke nānā i ka hana uila o kou puʻuwai me kahi hoʻāʻo i kapa ʻia ʻo `Electrocardiography (ECG a i ʻole EKG).` Ma kēia hoʻāʻo, ua hoʻopili ʻia kekahi mau mea ʻike i kou umauma a ua hoʻopaʻa ʻia kahi ʻano o nā nalu uila mai kou puʻuwai. I loko o kahi puʻuwai olakino, ua kapa ʻia kēia ʻano o nā nalu ʻo `Sinus rhythm.` I ke kūlana e like me VT, loli kēia ʻano. Hiki i nā kauka ke aʻo i kēia ʻano i hoʻololi ʻia e ʻike pono i ke ʻano o ka pilikia.

3. Ka Fibrillation Ventricular (V-fib)

ʻO kēia ka mea weliweli loa o kēia a pono e mālama ʻia i ka wā pilikia . ʻO ka mea e hana ʻia ma ʻaneʻi, ma kahi o ka pamu pono ʻana, haʻalulu a lele wale nā ​​keʻena haʻahaʻa o ka puʻuwai. No ka mea, ʻaʻole lākou e ʻaelike pono a pamu i ke koko, kokoke pau loa ke kahe ʻana o ke koko i ke kino. Ua kapa ʻia kēia ʻo 'Sudden cardiac arrest', kahi e pau koke ai ka puʻuwai. No ka mea, ʻaʻole kahe ke koko i ka lolo, nalowale kou ʻike i loko o kekahi mau kekona a hiolo. Inā ʻaʻole hoʻihoʻi ʻia ke kahe ʻana o ke koko i loko o kekahi mau minuke, he mea make kēia.

He aha nā hōʻailona o kēia maʻi?

ʻOkoʻa nā hōʻailona ma muli o ke ʻano. ʻO kekahi, e like me nā PVC, ʻaʻohe paha he mau hōʻailona iki. E nānā pono kākou i nā hōʻailona maʻamau o nā ʻano nui ʻelua.

He aha paha ke kumu o kēia?

Hiki i nā kumu like ʻole ke kumu o kēia mau kūlana.

Nā kumu o ka Ventricular Tachycardia (VT)

• Ka nāwaliwali a i ʻole ka mānoanoa o ka ʻiʻo o ka puʻuwai (Cardiomyopathy)
• Maʻi puʻuwai (ʻoi aku hoʻi nā maʻi e hoʻololi i ke ʻano o ka puʻuwai)
• Nā kūlana puʻuwai hānau
• Nā hemahema o ke kaulike electrolyte i loko o ke kino
• Maʻi hohola
• Ka hāʻule ʻana o ka puʻuwai
• Nā kūlana mumū o ka puʻuwai
• Ma hope o ke ʻoki puʻuwai
• Nā maʻi valve puʻuwai
• Ka nele o ka oxygen i ke kino
• Kekahi mau lāʻau lapaʻau

Nā kumu o ka Ventricular Fibrillation (V-fib)

• He hahau ikaika i ka umauma (e laʻa, ke kuʻi ʻia e ka pōpō e holo wikiwiki ana)
• Ka nāwaliwali a i ʻole ka mānoanoa o ka ʻiʻo o ka puʻuwai (Cardiomyopathy)
• Maʻi puʻuwai hānau
• Uila
• Maʻi hohola
• Ma hope o ke ʻoki puʻuwai
• Kekahi mau lāʻau lapaʻau
• ʻO ka Tachycardia Ventricular i kāohi ʻole ʻia

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

ʻO ka Ventricular Arrhythmia ka mea maʻamau i nā poʻe me ka maʻi puʻuwai mua. No laila, piʻi maoli ka pilikia me ka makahiki. Kiʻekiʻe loa kēia pilikia i nā poʻe me nā maʻi e hoʻololi i ke ʻano a i ʻole ke ʻano o ka puʻuwai.

Hiki ke loaʻa kekahi mau ʻano ʻino ʻole i nā kānaka o kēlā me kēia makahiki. Akā ʻo nā ʻano ʻoi aku ka weliweli, e like me ka `Sustained VT`, ʻoi aku ka maʻamau i nā poʻe me ka maʻi puʻuwai. Akā i kekahi manawa, hiki ke loaʻa i nā poʻe i loaʻa ʻole nā ​​​​hōʻailona a ʻike ʻole he maʻi puʻuwai ko lākou.

Pehea e ʻike ai ke kauka i kēia?

Ke hele ʻoe e ʻike i ke kauka, e nīnau mua ʻo ia iā ʻoe i nā nīnau, e nīnau e pili ana i kāu mau hōʻailona, ​​a e lawe i kahi mōʻaukala olakino. A laila e nānā ʻo ia iā ʻoe. ʻO ia hoʻi ka hoʻolohe ʻana i kou puʻuwai a me ka lawe ʻana i kou koko.

He aha ke ʻano o nā hoʻokolohua e hana ʻia?

ʻO ka hoʻāʻo nui i hoʻohana ʻia e ʻike ai i kēia kūlana ʻo ia ka ECG (Electrocardiography) . Ua kamaʻilio mākou e pili ana i kēia ma mua. Ma kēia, ua hoʻopaʻa ʻia ka hana uila o ka puʻuwai ma ke ʻano he ʻano nalu, a nānā ke kauka iā ia e ʻike i nā ʻano ʻē.

Akā i kekahi manawa, ʻaʻole mau kēia ʻano mele ʻē. I ia mau hihia, ʻaʻole paha e ʻike ʻia e kahi ECG maʻamau. I ia mau hihia, hiki i kāu kauka ke hāʻawi iā ʻoe i kahi mea hana hiki iā ʻoe ke komo no hoʻokahi a ʻoi aku paha mau lā.

• Nā mea nānā Holter:He mea hana kēia e like ka nui me ke kelepona paʻalima. Loaʻa iā ia nā uea i hoʻopili ʻia i nā mea ʻike āu e kau ai ma kou umauma. Hoʻopaʻa mau ia i kou puʻuwai no 24 a 48 mau hola.
• Nā mea nānā Ambulatory: Ua like kēia me kahi mea nānā Holter, akā hiki ke hoʻohana ʻia no ka manawa lōʻihi, i kekahi manawa a hiki i 30 mau lā. Hele mai kekahi mau ʻano me kahi pihi āu e kaomi ai ke manaʻo ʻoe i kahi hōʻailona. ʻO kekahi he ʻakomi, e hoʻopaʻa ana i kahi mele kūpono ʻole i ka wā e ʻike ʻia ai.

He aha nā lāʻau lapaʻau no kēia?

Inā hiki ke ho'ōla piha ʻia kēia maʻi, aia ia ma muli o ke kumu. I kekahi manawa hiki ke mālama ʻia a ho'ōla ʻia ke kumu. Eia nō naʻe, inā i hoʻokumu ʻia e kahi maʻi mau, e like me ke ʻano hānau ʻia, he mea paʻakikī ke ho'ōla. I kēlā hihia, ʻo ka pahuhopu o ka mālama ʻana, ʻo ia ka mālama ʻana i ka maʻi a hoʻēmi i kona hopena i kou ola.

Lapaʻau ulia pōpilikia

• CPR (Cardiopulmonary Resuscitation): Inā ua kū ka puʻuwai o kekahi a ʻaʻohe pulse, pono e hoʻomaka koke ʻia ka CPR. ʻO ke ʻano kēia o ka mālama ʻana i ke kahe koko ma ke kaomi ʻana i ka umauma. ʻAʻole ia he manaʻo maikaʻi e hoʻōki i ka CPR a hiki i ka hōʻea ʻana mai o kahi ambulance a i ʻole e lawe ʻia mai kahi mīkini 'AED' a hoʻohana ʻia.
• ʻO ka Defibrillator Waho ʻAkomi (AED): He mea hana kēia e kālailai i ka puʻuwai o ke kanaka a, inā pono, e hāʻawi i kahi haʻalulu uila (`shock`) e hoʻihoʻi i ke ʻano o ka puʻuwai. Hiki ke hoʻoponopono ʻia nā ʻano `VT` a me `V-fib` me kahi haʻalulu uila ma kēia ʻano.
• Nā lāʻau lapaʻau: Aia nā lāʻau lapaʻau kūikawā i hāʻawi ʻia e kaohi i ka ʻōʻō o ka puʻuwai.

Lapaʻau ʻaʻole pilikia

• ʻO ka Ablation: Pili kēia i ke komo ʻana i kahi ʻōmole lahilahi, e like me ka cannula, i loko o ka puʻuwai a me ka hoʻohana ʻana i ka wela nui a i ʻole ke anu nui e hoʻopau i kahi ʻāpana liʻiliʻi loa o ka puʻuwai e hoʻoulu ai i nā hōʻailona uila ʻē. Hoʻōki kēia i ka rhythm ʻē mai ka hanana ʻana.
• ʻO ka Implantable Cardioverter Defibrillator (ICD): He mea liʻiliʻi kēia i hoʻokomo ʻia ma lalo o ka ʻili o ka umauma. Hiki iā ia ke hoʻouna koke i kahi haʻalulu uila e hoʻihoʻi i ka puʻuwai maʻamau ke ʻike ʻia kahi puʻuwai puʻuwai kūpono ʻole.
• Nā lāʻau lapaʻau: Aia nā lāʻau lapaʻau e hiki ke hāʻawi ʻia e kāohi i ke ʻano o ka ʻōpū i ka wā lōʻihi. Eia naʻe, ʻaʻole like ka maikaʻi o kēia mau mea no nā kānaka a pau, a hiki ke loaʻa kekahi mau hopena ʻaoʻao. No laila, pono ʻoe e kamaʻilio me kāu kauka e koho i ka lāʻau lapaʻau kūpono loa iā ʻoe.

He aha ka mea e hana ʻia ma hope o ka mālama ʻana? He aha kāu e hiki ai ke hana?

ʻO ka mea nui loa āu e hana ai, ʻo ia ke hahai pololei i nā ʻōlelo a kāu kauka . He mea nui loa ia e lawe i kāu mau lāʻau lapaʻau e like me ke kauoha a hele i nā keʻena lapaʻau i nā lā i hoʻonohonoho ʻia.

ʻOkoʻa ka manawa hoʻōla ma hope o ka mālama ʻana ma muli o ka mālama ʻana. Inā loaʻa iā ʻoe kahi ablation a i ʻole ICD, e hoʻomaka ʻoe e ʻoluʻolu i loko o kekahi mau lā. Me ka lāʻau lapaʻau, e ʻike ʻoe i kahi ʻokoʻa i loko o kekahi mau pule. ʻOkoʻa loa ke ʻano o kēia kūlana i ka wā e hiki mai ana ma muli o kou kūlana. Hiki i ke kauka e mālama nei iā ʻoe ke wehewehe maikaʻi loa i kēia iā ʻoe.

Hiki ke pale ʻia kēia kūlana?

Ma muli o ka hiki pinepine ʻana o kēia ʻano arrhythmias me ka manaʻo ʻole ʻia, ʻaʻole maʻalahi ka pale ʻana, ʻoiai inā he maʻi puʻuwai hānau kou.

Eia nō naʻe, hiki iā mākou ke hōʻemi pololei ʻole i ko mākou pilikia o ka hoʻomohala ʻana i kēia maʻi ma ka hōʻemi ʻana i ka pilikia o nā maʻi ʻē aʻe (e like me ka maʻi puʻuwai, ke koko kiʻekiʻe) e hiki ai ke alakaʻi i kēia maʻi. No ka hana ʻana i kēia:

• E hoʻōki loa i ka puhipaka (me nā cigarettes, vaping).
• E ʻai i ka meaʻai kaulike i ʻōlelo ʻia e kāu kauka.
• E noho ikaika kino e like me ka hiki.
• E mālama i ke kaumaha olakino .
• E kāohi i kāu inu ʻona .

Āhea wau e ʻike ai i ke kauka? Āhea wau e hele ai i ka ETU?

Inā ʻike ʻoe i kahi loli i kāu mau hōʻailona, ​​a inā hoʻomaka lākou e hoʻopilikia i kou ola o kēlā me kēia lā, e ʻike i kāu kauka. Eia kekahi, inā ʻaʻohe ou hōʻailona, ​​​​he mea nui e ʻike i ke kauka ma ka liʻiliʻi hoʻokahi manawa i ka makahiki no ka hoʻokolokolo kino piha e ʻike mua i nā maʻi.

Inā ʻike ʻoe i kekahi o nā hōʻailona koʻikoʻi ma lalo nei, e hele koke aku i ka ʻOihana Pilikia (ETU) o ka haukapila me ka hoʻokaʻulua ʻole.

• ʻEha nui o ka umauma (Angina)
• Paʻakikī ka hanu ʻana
• Ka nalowale ʻana o ka ʻike i wehewehe ʻole ʻia a i ʻole ka manaʻo pinepine o ka nāwaliwali (dizziness)

Hiki i ka Ventricular Arrhythmia ke ʻokoʻa loa mai kēlā kanaka a kēia kanaka, no laila ʻo ke ala maikaʻi loa e hoʻomaopopo a mālama i kou olakino, ʻo ia ke ʻimi i ka ʻōlelo aʻoaʻo lapaʻau inā manaʻo ʻoe he mau hōʻailona kēia.