Koj lub plawv sab xis puas tsis muaj zog? Cia peb kawm txog tus kab mob ARVD (Arrhythmogenic Right Ventricular Dysplasia) txaus ntshai no?

Auj, puas muaj tej lub sij hawm koj xav tias koj lub hauv siab dhia ceev ceev, koj xav tias koj ua tsis taus pa, lossis koj tsuas xav tias koj lub plawv nres xwb? Tej zaum koj twb tau hnov ​​​​tias tej lub sij hawm txawm tias ib tug neeg ncaws pob hluas thiab noj qab nyob zoo kuj tuaj yeem muaj lub plawv nres tau. Qhov ntawd yog qhov peb yuav tham txog hnub no, tab sis nws yog ib qho kab mob plawv uas tsis tshua muaj neeg paub. Qhov no hu ua "Arrhythmogenic Right Ventricular Dysplasia", lossis luv luv ARVD.

ARVD (Arrhythmogenic Right Ventricular Dysplasia) yog dab tsi? Cia peb nkag siab yooj yim heev!

Hais yooj yim xwb, ARVD yog ib yam kab mob uas cuam tshuam rau cov leeg nqaij plawv, ib hom 'cardiomyopathy'. Peb lub plawv muaj plaub chav. Qhov tshwm sim hauv qhov no yog tias cov leeg nqaij hauv chav qis ntawm sab xis ntawm koj lub plawv, 'lub ventricle sab xis', loj hlob es tsis yog cov rog thiab cov ntaub so ntswg fibrous. Xav txog nws zoo li cov leeg nqaij noj qab haus huv tau raug rhuav tshem thiab hloov nrog ib yam dab tsi zoo li rog.

Thaum qhov no tshwm sim, yuav ua li cas? Lub plawv sab xis ntawm lub plawv maj mam ncab, nyias dua, thiab tsis tuaj yeem nias kom raug. Qhov ntawd txhais tau tias nws lub peev xwm los tso ntshav mus rau lub plawv tsis muaj zog.

Qhov tseem ceeb tshaj plaws, cov rog lossis cov nqaij mos uas tshiab tsim los cuam tshuam rau cov teeb liab hluav taws xob ntawm lub plawv. Yog vim li ntawd ntau tus neeg uas muaj ARVD thiaj li muaj lub plawv dhia tsis xwm yeem (arrhythmias). Qhov no tuaj yeem ua rau muaj kev phom sij heev, vim nws ua rau muaj kev pheej hmoo ntawm kev nres plawv tam sim ntawd lossis tuag.

Tus kab mob ARVD no kuj hu ua 'Arrhythmogenic Right Ventricular Cardiomyopathy' (ARVC). Qee zaum nws kuj tuaj yeem cuam tshuam rau sab laug, yog li nws kuj hu ua 'Arrhythmogenic Cardiomyopathy' (ACM).

Cov theem ntawm ARVD yog dab tsi?

Yog koj muaj ARVD, nws tuaj yeem dhau ntau theem raws sijhawm.

1. Theem zais: Thaum lub sijhawm no, tej zaum koj yuav tsis muaj tsos mob dab tsi. Txawm li cas los xij, koj yuav muaj lub plawv dhia tsis xwm yeem thaum koj tawm dag zog. Qhov xav tsis thoob yog, qee qhov kev kuaj mob thaum lub sijhawm no yuav qhia tau tias tsis muaj dab tsi tsis ncaj ncees lawm.

2. Theem Hluav Taws Xob: Nyob rau theem no, koj yuav muaj feem ntau dua rau kev mob plawv dhia tsis xwm yeem. Koj kuj muaj feem ntau dua ntawm kev tuag sai sai ntawm lub plawv. Kev siv ECG tuaj yeem kuaj pom cov teeb meem plawv dhia no.

3. Theem Qauv: Nyob rau theem no, qhov kev pheej hmoo ntawm lub plawv dhia tsis zoo (ventricular rhythms) thiab kev tuag tam sim ntawd ntawm lub plawv yog siab dua. Kev kuaj duab, xws li kev luam theej duab, tuaj yeem pom tseeb tias muaj kev hloov pauv hauv cov qauv ntawm koj lub plawv.

Leej twg raug kev txom nyem tshaj plaws los ntawm ARVD no?

Cov kws kho mob pom qhov mob no feem ntau ntawm cov tub ntxhais hluas.Uas yog, ntawm cov tub ntxhais hluas lossis cov tub ntxhais hluas. ARVD kuj tau raug txheeb xyuas tias yog ib qho ua rau muaj kev tuag sai sai ntawm lub plawv hauv qee tus neeg ncaws pob hluas. Qee qhov kev tshawb fawb qhia tias tus mob no feem ntau tshwm sim rau cov txiv neej .

Hais txog qhov mob ARVD no feem ntau tshwm sim, nws yog ib yam kab mob uas tsis tshua muaj. Feem ntau muaj ib tug ntawm 1,000 tus neeg lossis ib tug ntawm 5,000 tus neeg. Nws tuaj yeem tshwm sim yam tsis muaj leej twg hauv tsev neeg muaj, tab sis feem ntau nws khiav hauv tsev neeg.

Cov tsos mob ntawm ARVC yog dab tsi? Cia peb paub!

Tej zaum koj yuav tsis muaj cov tsos mob ntawm ARVD thaum ntxov, tab sis muaj kev pheej hmoo ntawm kev tuag tam sim ntawd ntawm lub plawv.

Cov tsos mob tseem ceeb uas pom tau yog:

• Kab mob plawv dhia tsis xwm yeem: Cov no tuaj yeem ua rau muaj kev phom sij heev. Kwv yees li ib nrab ntawm cov neeg uas muaj cov kab mob plawv dhia tsis xwm yeem no, qhov tshwm sim tuaj yeem ua rau tuag taus lossis yuav luag tuag taus. Kab mob plawv dhia tsis xwm yeem feem ntau yog kab mob plawv dhia tsis xwm yeem, uas tshwm sim rau 77% ntawm cov neeg uas muaj tus mob no.
• Supraventricular arrhythmias: Qhov feem ntau yog ib qho mob hu ua atrial fibrillation.
• Lub plawv dhia ceev: Qhov no yuav zoo li muaj ib yam dab tsi dhia hauv koj lub hauv siab. Qhov no yog tshwm sim los ntawm lub plawv dhia tsis zoo li qub.
• Kiv taub hau, mob taub hau me ntsis lossis tsaus muag: Qhov no kuj yog los ntawm lub plawv dhia tsis xwm yeem.
• Mob hauv siab.
• Kev tuag sai sai ntawm lub plawv: Qhov no qee zaum yog thawj qhov cim ntawm ARVD.
• Ua tsis taus pa.
• O ntawm ob txhais ceg, pob luj taws, taw, lossis plab.
• Lub plawv tsis ua haujlwm.

Cov tsos mob no feem ntau pib thaum muaj hnub nyoog 20 txog 50 xyoo. Cov kws kho mob feem ntau kuaj pom tias muaj tus kab mob ARVD thaum lawv tseem hluas (feem ntau ua ntej hnub nyoog 40 xyoo).

Dab tsi yog cov ua rau mob ARV?

Kwv yees li ntawm 60% ntawm cov neeg uas muaj ARVD muaj kev hloov pauv caj ces. Cov kws tshawb fawb tau txheeb xyuas tsawg kawg yog 13 lub noob caj ces uas ua rau muaj tus kab mob.

Cov noob caj noob ces tsis zoo no ua rau cov protein uas pab cov hlwb plawv txuas thiab sib txuas lus puas tsuaj. Qhov no ua rau cov hlwb plawv hauv lub plawv sab xis sib cais thiab tuag. Qhov no feem ntau tshwm sim thaum muaj kev ntxhov siab lossis kev siv zog ntau dhau.

Yam tsawg kawg yog 30% txog 50% ntawm cov neeg mob ARVD muaj keeb kwm tsev neeg.Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum muaj cov txheeb ze thawj thiab thib ob (niam txiv, cov kwv tij, cov menyuam, cov xeeb ntxwv, cov txiv ntxawm, cov phauj, cov tub xeeb ntxwv, cov ntxhais xeeb ntxwv) ntawm tus neeg uas muaj ARVD raug kuaj los ntawm kws kho mob. Txawm tias tsis muaj tsos mob los xij, cov txheeb ze hluas yuav tsum nrhiav kev pab tswv yim los ntawm kws kho mob.

Cov kws tshawb nrhiav tau pom ob hom kev txais qub txeeg qub teg hauv ARVDs:

1. 'Autosomal dominant': Ib tug niam txiv muaj qhov kev hloov pauv ntawm cov noob caj noob ces. Hauv cov tsev neeg zoo li no, cov menyuam muaj 50% feem pua ​​​​​​ntawm kev tau txais tus kab mob no. Txawm li cas los xij, cov tsos mob thiab hnub nyoog ntawm kev pib ntawm tus kab mob tuaj yeem sib txawv ntawm cov tswv cuab hauv tsev neeg. ARVD feem ntau tshwm sim hauv qee thaj chaw, xws li Ltalis.

2. `Autosomal recessive` (tsis tshua muaj): Ob leeg niam txiv muaj qhov kev hloov pauv ntawm cov noob caj noob ces, tab sis lawv tsis qhia cov tsos mob. `Kab mob Naxos` yog ib qho piv txwv ntawm qhov no. Nws ua rau txheej sab nraud ntawm daim tawv nqaij tuab (`hyperkeratosis`) thiab cov plaub hau tuab, "zoo li plaub yaj" (`plaub yaj zoo li plaub yaj`) ntawm xib teg thiab xib taws.

ARVD kuj tseem tuaj yeem tshwm sim los ntawm lwm yam laj thawj:

• Cov teeb meem tsis zoo ntawm lub plawv sab xis.
• Kab mob viral los yog inflammatory 'myocarditis' (mob ntawm cov leeg plawv).
• Vim li cas tseem tsis tau pom.

Yuav kuaj mob ARVD (Arrhythmogenic Right Ventricular Dysplasia) li cas?

Koj tus kws kho mob tuaj yeem kuaj mob ARVD raws li koj keeb kwm kho mob, kev kuaj lub cev, thiab ntau yam kev kuaj mob.

Koj tus kws kho mob yuav kuaj pom ARVD yog tias koj muaj ntau yam teeb meem hauv qab no ua ke:

• Kev ua haujlwm tsis zoo ntawm lub plawv sab xis.
• Qhov muaj cov nqaij rog lossis cov nqaij fibro-fatty nyob rau hauv cov leeg nqaij plawv ('myocardium') ntawm sab xis ntawm lub plawv.
• Ib daim ntawv qhia txog 'ECG/EKG' (Electrocardiogram) uas tsis zoo li qub.
• Lub plawv dhia tsis sib xws (arrhythmias): Piv txwv li, supraventricular tachycardia, ventricular tachycardia, lossis ventricular fibrillation, tshwj xeeb tshaj yog thaum lub sijhawm ua si.
• Keeb kwm tsev neeg ntawm ARVD.

Nyob ntawm seb koj muaj pes tsawg yam ntawm cov yam no, koj tus kws kho mob yuav muab kev kuaj mob rau koj tias "paub tseeb," "kab ciam teb," lossis "ua tau." Qee zaum, tab sis tsis yog txhua lub sijhawm, koj tus kws kho mob kuj tseem yuav xa koj mus kuaj caj ces .

Cov kev kuaj mob twg siv los kuaj mob ARVD?

• Electrocardiogram (ECG/EKG): Ib qho kev kuaj uas saib xyuas kev ua haujlwm hluav taws xob ntawm lub plawv.
• Transthoracic echocardiogram: Zoo ib yam li kev siv ultrasound ntawm lub plawv, nws tuaj yeem saib cov chav plawv, cov qhov dej, thiab lub peev xwm nqus dej.
• `Holter monitor`: Qhov no zoo li lub tshuab `ECG` me me uas koj hnav rau 24 txog 48 teev. Nws sau koj lub plawv dhia thoob plaws hnub.
• Kev kuaj mob angiogram ntawm sab xis ntawm lub plawv: Qhov no tsis tshua muaj neeg siv.
• Kev kuaj mob electrophysiology:Ib qho kev kuaj tshwj xeeb los xyuas seb puas muaj teeb meem nrog lub plawv lub zog hluav taws xob.
• Kev thaij duab magnetic resonance imaging (MRI): Qhov no tuaj yeem tsim cov duab ntxaws ntxaws ntawm lub plawv. Qhov no tseem ceeb heev rau kev kuaj pom cov khoom xws li cov rog hauv lub plawv sab xis hauv ARVD.
• 'Kev thaij duab plawv (CT)': Qhov no yog lwm txoj hauv kev los tau txais cov duab ntawm lub plawv.
• 'Biopsy' (siv cov qauv nqaij): Qhov no kuj tsis tshua muaj neeg ua. Yuav muab ib daim nqaij me me ntawm lub plawv coj mus kuaj.

Cov kev kho mob rau ARV yog dab tsi?

Tam sim no tsis muaj tshuaj kho tau ARVD. Txawm li cas los xij, koj tus kws kho mob yuav sim ua cov hauv qab no:

• Tswj koj lub plawv dhia tsis xwm yeem ('ventricular arrhythmias').
• Tiv thaiv cov ntshav txhaws.
• Tswj koj lub plawv tsis ua haujlwm.

Cov kev kho mob rau ARVI yog:

• Cov tshuaj tiv thaiv kev mob plawv dhia tsis xwm yeem: Tiv thaiv kom lub plawv dhia tsis xwm yeem mus sij hawm ntev thiab/lossis kev tuag tam sim ntawd. Qhov no yog kev kho mob uas cov kws kho mob feem ntau siv. Tej zaum yuav muaj cov tshuaj sau rau koj xws li sotalol lossis amiodarone.
• Cov tshuaj kho ntshav siab: Cov tshuaj xws li cov tshuaj diuretics (uas tshem tawm cov kua dej ntau dhau ntawm lub cev) lossis beta-blockers (uas txo qhov ua haujlwm ntawm lub plawv).
• Tshuaj tiv thaiv kev ntshav txhaws (cov tshuaj ua kom ntshav nyias): Cov tshuaj xws li warfarin raug muab los tiv thaiv kev ntshav txhaws.
• Kev siv tshuaj Radiofrequency catheter ablation: Kev kho mob rau cov teeb meem plawv dhia tsis xwm yeem uas tsis tau tswj los ntawm tshuaj. Qhov no suav nrog kev rhuav tshem ib thaj chaw me me ntawm lub plawv uas ua rau lub plawv dhia tsis xwm yeem.
• Lub tshuab ua kom lub plawv dhia ceev (ICD): Ib lub cuab yeej me me uas muab tso rau hauv lub plawv ntawm cov neeg uas muaj feem yuav tuag tam sim ntawd. Yog tias nws pom lub plawv dhia ceev heev, nws yuav pom thiab xa hluav taws xob mus rau lub plawv kom kho nws.
• Hloov plawv: Qhov no ua tiav thaum txhua yam kev kho mob tsis ua haujlwm. Tsuas yog ib feem pua ​​me me ntawm cov neeg uas muaj tus kab mob no, kwv yees li 2% txog 4%, xav tau lub plawv tshiab.

Nco ntsoov, tej zaum koj yuav xav tau ntau tshaj ib txoj kev kho mob rau tus kab mob no thoob plaws koj lub neej.

Puas muaj teeb meem lossis cov kev mob tshwm sim ntawm kev kho mob?

Yog, muaj qee yam uas yuav tsum tau ceev faj txog nrog qee qhov kev kho mob.

• Yog koj noj tshuaj warfarin, koj yuav tsum tau kuaj ntshav tas li . Koj tus kws kho mob yuav tsum xyuas kom koj tau txais cov tshuaj kom raug. Koj cov tshuaj yuav raug hloov kho raws li cov txiaj ntsig ntawm kev kuaj.
• Txawm hais tias kev kho mob catheter ablation thaum xub thawj ua tiav rau ntau tus neeg, vim tias tus kab mob hnyav zuj zus tuaj, kwv yees li 60% ntawm cov neeg yuav muaj kev rov tshwm sim ntawm lawv lub plawv dhia tsis xwm yeem.
• Cov xov hlau hauv lub cuab yeej ICD tuaj yeem txav mus los lossis tsis ua haujlwm zoo, yog li koj yuav tsum tau kuaj xyuas lawv tas li .

Kuv yuav tsum saib xyuas kuv tus kheej li cas? Yuav tsum hloov pauv dab tsi hauv kuv lub neej?

Nws yog ib qho tseem ceeb heev uas yuav tsum hloov qee yam hauv koj txoj kev ua neej kom koj lub siab kaj siab.

• Txwv kev haus cawv.
• Tsum tsis txhob siv cov khoom haus luam yeeb kiag li.
• Noj zaub mov zoo (tsis muaj roj ntau, txiv hmab txiv ntoo thiab zaub ntau)
• Txwv cov khoom noj thiab dej haus uas muaj caffeine (xws li kas fes, tshuaj yej, chocolate).
• Tswj koj lub cev kom hnyav txaus.
• Txwv kev ua ub ua no hnyav.

Qhov tseem ceeb tshaj plaws: Nco ntsoov nrog koj tus kws kho mob tham ua ntej koj pib ua si nawv. Tsis pom zoo kom ua kis las sib tw. Kev ua kis las uas tsis hnyav heev tej zaum yuav zoo.

Sib tham nrog koj tus kws kho mob tsis tu ncua thoob plaws koj txoj kev kho mob. Lawv yuav xyuas kom meej tias koj tau txais cov tshuaj kom raug. Tsis tas li ntawd, los ntawm kev mus ntsib kws kho mob tsis tu ncua, koj tuaj yeem pom txhua qhov kev hloov pauv hauv koj tus mob thaum ntxov.

Puas txo tau qhov kev pheej hmoo?

Yog, rau qee qhov. Yog tias ib tug neeg hauv koj tsev neeg muaj ARVD, kev kuaj mob sai li sai tau yog txoj hauv kev zoo tshaj plaws los txo koj qhov kev pheej hmoo. Kev kuaj mob yooj yim, tsis mob tuaj yeem qhia koj yog tias koj muaj kev pheej hmoo rau lub plawv dhia tsis zoo. Yog tias koj muaj, koj tus kws kho mob tuaj yeem pab koj tsim txoj kev npaj kho mob uas haum rau koj.

Lub neej cia siab ntev npaum li cas nrog ARVD?

Lub neej ntev ntawm tus kab mob ARVD yuav txawv nyob ntawm seb thaum twg kuaj pom tias muaj tus kab mob no. Qhov zoo tshaj plaws uas yuav tsum ua yog kuaj mob sai li sai tau thiab kho kom tsis txhob muaj lub plawv dhia tsis xwm yeem. Tus kab mob no yuav hnyav zuj zus mus.

Yog tias ARVD tsis raug kho, koj lub plawv sab xis tuaj yeem ua tsis tau haujlwm. Tom qab ntawd koj lub plawv sab laug kuj tuaj yeem ua tsis tau haujlwm thiab. Qhov no tuaj yeem ua rau muaj mob xws li 'lub plawv tsis ua haujlwm' thiab 'atrial fibrillation'. Cov kws tshawb fawb ntseeg tias qhov xwm txheej phem dua yog tias ARVD cuam tshuam rau ob lub plawv.

Tiam sis, nrog kev kho mob, koj tuaj yeem tau txais kev pab uas koj xav tau los txo qhov kev ntxhov siab rau koj lub plawv thiab tiv thaiv kev mob plawv txaus ntshai. Qee qhov kev tshawb fawb qhia tias qee tus neeg raug kuaj pom tias muaj tus kab mob tom qab hnub nyoog 65 xyoos. Kuj tseem kwv yees tias kwv yees li ib ntawm tsib tus neeg uas muaj ARVC pib muaj cov tsos mob tom qab hnub nyoog 50 xyoos. Yog li ntawd, nws muaj peev xwm ua neej nyob ntev nrog ARVC.

Niaj hnub nim no, cov thev naus laus zis siab heev xws li CT thiab MRI tso cai rau kev kuaj mob thiab kho mob thaum ntxov, yog li kev cia siab mus sij hawm ntev rau cov neeg uas muaj ARVD yog qhov zoo.

Txawm li cas los xij, kev tuag tam sim ntawd tuaj yeem tshwm sim rau cov neeg uas tsis tau kuaj pom lossis tsis tau txais kev kho mob tsim nyog. ARVD tau hais tias yog qhov ua rau 11% ntawm kev tuag tam sim ntawd ntawm lub plawv hauv cov neeg hnub nyoog qis dua 35 xyoo thiab 22% ntawm kev tuag tam sim ntawd ntawm lub plawv hauv cov neeg ncaws pob.

Thaum twg kuv yuav tsum mus ntsib kws kho mob? Thaum twg kuv yuav tsum mus rau chav kho mob ceev?

Yog tias koj muaj ARVD, koj yuav tsum tau mus kuaj mob thoob plaws koj lub neej.Koj tus kws kho mob yuav tsum tau kuaj xyuas tsis tu ncua kom paub tseeb tias koj tau txais kev kho mob zoo. Yog tias koj muaj ICD, nws yuav tsum tau kuaj xyuas tsis tu ncua .

Yuav ua li cas thaum muaj xwm txheej ceev?

Yog tias muaj ib tug neeg poob siab tam sim ntawd thiab tsis teb koj cov xov tooj, hu rau 1990 (kev pabcuam tsheb thauj neeg mob thaum muaj xwm txheej ceev hauv Sri Lanka). Tom qab ntawd, yog tias ua tau, pib CPR (cardiopulmonary resuscitation), lossis tsawg kawg yog tes xwb CPR.

Yog tias koj muaj feem yuav mob plawv nres tam sim ntawd, nws yog ib lub tswv yim zoo kom cov neeg nyob hauv tsev nrog koj kawm CPR.

Kuv yuav tsum nug kuv tus kws kho mob li cas?

• Kuv puas ua tau kev tawm dag zog lossis koom nrog kev ua si? Yog tias ua tau, hom kev ua si twg?
• Kev kho mob twg zoo tshaj plaws rau kuv?
• Kuv puas xav tau ICD lub sijhawm no?

Vim tias ARVD nyuaj rau kuaj mob ua ntej cov tsos mob tshwm sim, nws yog ib qho tseem ceeb kom paub koj keeb kwm tsev neeg. Yog tias koj muaj kev pheej hmoo vim yog keeb kwm tsev neeg ntawm tus kab mob, koj tus kws kho mob tuaj yeem kuaj koj.

Cov Lus Qhia Txog Kev Coj Mus Tsev

Zoo, yog li tam sim no koj nkag siab zoo dua txog yam peb tau tham txog hnub no, ARVD. Txawm hais tias nws tsis tshua muaj, nws tuaj yeem yog ib qho mob plawv loj heev. Nws feem ntau yog tshwm sim los ntawm cov yam ntxwv caj ces . Yog li ntawd, yog tias ib tug neeg hauv koj tsev neeg muaj tus mob no, nws yog ib qho tseem ceeb heev uas yuav tsum tau kuaj lwm tus.

Los ntawm kev kuaj mob sai li sai tau, tau txais kev kho mob zoo, thiab hloov pauv koj txoj kev ua neej, koj tuaj yeem nyob zoo nrog tus kab mob no. Sib txuas lus nrog koj tus kws kho mob thiab ua raws li lawv cov lus qhia. Tsis tas li ntawd, xyuas kom tseeb tias koj cov neeg hlub paub txog 'CPR' tuaj yeem pab cawm koj txoj sia thaum muaj xwm txheej ceev. Tsis txhob ntshai, kev paub yog lub zog zoo tshaj plaws!

` ARVD, Arrhythmogenic Right Ventricular Dysplasia, kab mob plawv, mob plawv nres, cardiomyopathy, tuag sai sai hauv lub plawv, kab mob caj ces, mob plawv nres