Koj lub plawv dhia puas tsis sib xws? Cia peb kawm txog Ventricular Dyssynchrony hauv txoj kev yooj yim!

Koj puas muaj tej lub sij hawm koj xav tias ua tsis taus pa, nkees tas li, lossis ob txhais ceg o? Tej zaum tej zaum cov no yog cov cim qhia tias koj lub plawv muaj teeb meem. Hnub no peb yuav tham txog ib qho mob uas cuam tshuam rau kev ua haujlwm ntawm lub plawv, tab sis peb yuav tsis tau hnov ​​​​​​ntau txog nws. Qhov ntawd yog ventricular dyssynchrony , lossis raws li cov kws kho mob hu ua, "(Ventricular Dyssynchrony)"`. Txawm hais tias lub npe yuav zoo li nyuaj me ntsis, cia peb piav qhia yooj yim.

Ventricular Dyssynchrony yog dab tsi?

Hais yooj yim xwb, ventricular arrhythmia yog thaum ib lossis ntau lub chav hauv qab ntawm koj lub plawv, hu ua ventricles , ntaus tsis sib npaug thiab tsis sib koom tes. Xav txog tias muaj kev ncua me ntsis li ntawm 40 milliseconds ntawm cov feem sib txawv ntawm koj lub plawv lub hlwb pib cog lus, lossis ntawm ib lub cell pib cog lus piv rau lwm lub. Qhov ntawd tuaj yeem suav tias yog arrhythmia.

Peb lub plawv tsuas ua haujlwm tau zoo thaum cov leeg nqaij hauv nws cov chav sib zog tib lub sijhawm thiab tib txoj kev. Feem ntau, cov teeb liab hluav taws xob mus ncig lub plawv raws li txoj kev npaj. Thaum ob lub chav loj ntawm lub plawv tau txais lub teeb liab kom sib zog, cov leeg nqaij hauv cov chav ntawd yuav tsum sib zog tib yam thiab tib lub sijhawm. Tshwj xeeb, koj lub plawv sab laug, lub chav nqus dej tseem ceeb ntawm lub plawv, yuav tsum sib zog ua ke. Nws zoo li thawb los ntawm ob sab mus rau hauv nruab nrab.

Txawm li cas los xij, yog tias lub teeb liab no tsis mus txog ob lub plawv tib lub sijhawm, cov leeg nqaij yuav tsis tuaj yeem cog lus tib lub sijhawm. Qhov ntawd yog qhov peb hu ua dyssynchrony no.

Kev sib txuas ntawm lub cev tsis sib xws tuaj yeem cuam tshuam rau koj lub cev hauv cov hauv qab no:

• Nws txo qhov ua haujlwm ntawm koj lub plawv.
• Cov qhov dej uas feem ntau pab cov ntshav ntws mus rau ib qho kev taw qhia xwb tuaj yeem ua rau cov ntshav ntws rov qab (mus rau qhov tsis raug).
• Cov ntshav uas koj lub plawv tso tau (Cardiac Output) txo qis.

Cov hom mob plawv dhia tsis xwm yeem yog dab tsi?

Muaj ntau hom kev sib txuas ntawm tes tseem ceeb:

• Atrioventricular Dyssynchrony: Qhov no yog thaum cov chav sab saud (atria) thiab cov chav qis (ventricles) ntawm koj lub plawv cog lus yam tsis muaj kev sib koom tes.
• Interventricular Dyssynchrony: Hauv qhov no, koj cov ventricles sab laug thiab sab xis (chambers qis dua) cog lus ntawm ntau lub sijhawm sib txawv.
• Intraventricular Dyssynchrony: Hauv qhov no, cov leeg nqaij hauv ntau qhov chaw ntawm tib lub cell sib cog lus rau lub sijhawm sib txawv. Xav txog nws zoo li phab ntsa ntawm ib chav sib cog lus rau lub sijhawm sib txawv, es tsis txhob raug thawb mus rau hauv tib lub sijhawm.

Leej twg raug kev cuam tshuam ntau tshaj plaws los ntawm cell asynchrony?

Tus mob no feem ntau pom muaj rau cov neeg uas muaj cov mob hauv qab no:

• Cov neeg uas muaj teeb meem plawv tsis ua haujlwm.
• Sab laug Bundle Ceg Thaiv (LBBB).
• Txoj Cai Bundle Ceg Thaiv (RBBB).
• Kab mob plawv.
• Ntshav siab.
• Lwm yam kab mob plawv.

Xav txog yawg Somapala los ntawm peb lub zos. Nws tau raug mob '(Lub Plawv Tsis Ua Haujlwm)' tau ib ntus lawm. Tsis ntev los no, nws tau ua pa nyuaj thiab qaug zog zuj zus. Thaum tus kws kho mob kuaj nws, nws hais tias nws kuj muaj tus mob no hu ua '(Ventricular Dyssynchrony)' hauv nws lub plawv, yog vim li cas nws cov tsos mob thiaj li hnyav zuj zus tuaj.

Tus mob no feem ntau tshwm sim li cas?

Kwv yees li ib feem peb ntawm cov neeg uas muaj qee yam mob plawv tsis ua haujlwm yuav muaj hom kev sib txuas ntawm lub hlwb no. Kwv yees li 2% ntawm cov neeg laus hauv cov tebchaws uas muaj kev vam meej raug kev txom nyem los ntawm kev mob plawv tsis ua haujlwm. Tsis tas li ntawd, ntawm 6% thiab 10% ntawm cov neeg hnub nyoog tshaj 65 xyoo muaj mob plawv tsis ua haujlwm. Yog li, qhov mob no kuj yog ib yam dab tsi uas pom tau tias muaj feem cuam tshuam nrog qhov ntawd.

Cov tsos mob yog dab tsi?

Kev ua haujlwm tsis zoo ntawm lub plawv (cellular dyssynchrony) ua rau cov tsos mob ntawm lub plawv tsis ua haujlwm hnyav dua, lossis ua rau muaj cov tsos mob tshwj xeeb. Cov no yog cov tseem ceeb:

• Ua pa nyuaj (tshwj xeeb tshaj yog thaum koj nkees).
• Xav tias nkees heev (txawm tias tsuas yog ib pliag xwb los xij).
• Hnoos (tej zaum yuav mob tas li).
• Kev o (edema) hauv lub cev (tshwj xeeb tshaj yog nyob rau thaj chaw xws li ob txhais ceg thiab pob luj taws).

Dab tsi yog cov ua rau cell asynchrony?

Muaj ntau yam teeb meem plawv sib txawv uas ua rau muaj qhov no. Ib txhia ntawm lawv yog:

• Kev Ua Haujlwm Tsis Zoo ntawm Lub Plawv.
• Cov nqaij caws pliav uas ua rau muaj mob plawv.
• Kev Ncua Sij Hawm Hluav Taws Xob, uas suav nrog cov xwm txheej xws li Sab laug Bundle Branch Block thiab Sab xis Bundle Branch Block.
• Mob plawv.
• Cov ntshav ntws tsis txaus rau cov leeg nqaij plawv (Ischemia).

Yuav ua li cas thiaj kuaj tau tus mob no?

Koj tus kws kho mob yuav xub nug koj txog koj cov tsos mob thiab ua qhov kev kuaj lub cev kom ntsuas koj lub plawv ua haujlwm. Qee zaum , mloog koj lub plawv nrog lub stethoscope kuj tseem tuaj yeem muab lub tswv yim rau koj txog qhov asynchrony no.

Qhov kev kuaj mob tseem ceeb uas siv los kuaj xyuas cov teeb meem nrog lub plawv lub zog hluav taws xob yog electrocardiogram (ECG) . Nws tuaj yeem kuaj pom cov mob xws li Right Bundle Branch Block thiab Left Bundle Branch Block, uas ua rau lub plawv dhia tsis sib xws. Yog tias pom cov mob no ntawm ECG, tus kws kho mob yuav xa koj mus kuaj ntxiv.

Cov kws kho mob feem ntau siv echocardiogram los kuaj xyuas cov teeb meem plawv dhia tsis xwm yeem. Qhov no ua rau lawv pom tias cov chav plawv, cov qhov valve, thiab cov leeg nqaij ua haujlwm li cas.

Lwm yam kev ntsuam xyuas kuj tuaj yeem ua tau:

• Kev luam theej duab Positron Emission Tomography (PET).
• Kev ntsuas Multigated Acquisition (MUGA).
• Kev Siv Duab Xam Plawv Sib Nqus (MRI) Los Saib Xyuas Lub Plawv.
• Kev thaij duab computer (CT scan).
• Kev luam theej duab Single Photon Emission Computed Tomography (SPECT).

Yuav kho cov cell asynchrony li cas?

Cov kws kho mob yuav kho tau qhov mob uas ua rau koj lub cell tsis sib xws.

Feem ntau, kev kho mob plawv rov ua haujlwm sib xws (CRT) (tseem hu ua CRT lossis biventricular pacemaker) tuaj yeem pab lub plawv twj zoo dua los ntawm kev tswj lub suab ntawm ob sab ntawm lub plawv. Txawm li cas los xij, kev kho mob no tsuas yog txhim kho cov tsos mob hauv 50% txog 70% ntawm cov neeg uas tau txais kev kho mob no. Cov neeg uas muaj kev tsis sib xws hnyav yuav muaj feem ntau dua.

Cov teeb meem ntawm kev kho mob CRT

Tej teeb meem nram qab no yuav tshwm sim thaum nruab 'CRT' (lub tshuab pacemaker bi-polar) (cov no tsis tshua muaj, tab sis zoo kom paub txog):

• Mob ntsws ua pa.
• Cov ntshav sib sau ua ke ntawm phab ntsa hauv siab thiab lub ntsws (Hemothorax).
• Lub plawv raug tho.
• Kev txhawb zog ntawm cov leeg nqaij uas tsis yog lub plawv.
• Cov hlua khi ntawm lub pacemaker txav mus rau qhov chaw.

Kuv yuav zoo dua sai npaum li cas tom qab kho tas?

Kev kho mob CRT txo qhov kev sib dhos ntawm cov hlwb yuav luag tam sim ntawd. Ib txhia neeg pib zoo siab dua hauv ob peb lub lis piam tom qab muab cov khoom siv cog rau hauv. Kuj tseem muaj cov txiaj ntsig mus sij hawm ntev:

• Txhim kho qhov ntau ntawm cov ntshav uas koj lub plawv nqus tau (Cardiac Output).
• Txo cov ntshav rov qab los ntawm lub mitral valve.
• Txhim kho qhov zoo ntawm koj lub neej.
• Qhov deb koj taug kev tau rau feeb yuav nce ntxiv.

Siv tshuaj dab tsi?

Rau cov mob uas ua rau atrial fibrillation, xws li lub plawv tsis ua haujlwm, cardiomyopathy, lossis ntshav siab, tus kws kho mob yuav sau ntawv rau cov tshuaj xws li:

• Cov tshuaj Angiotensin-Converting Enzyme (ACE) inhibitors.
• Cov tshuaj thaiv Angiotensin II Receptor (ARBs).
• Cov tshuaj Beta-Blockers.
• Cov tshuaj diuretics (diuretics).

Txawm hais tias cov tshuaj no yuav ua rau koj lub plawv ua haujlwm zoo dua qee yam, lawv tsis tuaj yeem thim rov qab qhov asynchrony uas tshwm sim los ntawm kev ua haujlwm hluav taws xob tsis zoo. Yog vim li cas kev kho mob zoo li CRT thiaj li tsim nyog.

Koj yuav ua li cas thiaj txo tau qhov kev pheej hmoo ntawm kev sib txuas ntawm tes?

Qhov zoo tshaj plaws uas koj ua tau yog saib xyuas koj lub plawv kom zoo. Yog koj ua li ntawd, koj yuav tiv thaiv tau qee yam mob uas ua rau lub hlwb tsis sib xws.

Qee txoj hauv kev los tiv thaiv koj lub siab:

• Noj cov zaub mov uas muaj roj tsawg (txo cov roj thiab cov khoom noj kib).
• Ua si nawv tsawg kawg yog 30 feeb feem ntau hnub (txawm tias taug kev los kuj zoo).
• Tswj koj qhov hnyav kom noj qab nyob zoo.
• Noj tshuaj raws nraim li tus kws kho mob tau hais.

Yuav ua li cas yog tias kuv muaj cell asynchrony?

Kab mob plawv sab laug (LVD) tsis raug kho, thiab qhov tshwm sim tsis zoo. Cov neeg uas muaj LVD muaj feem yuav mob plawv ntau dua li cov neeg uas tsis muaj mob. Koj tuaj yeem muaj kab mob plawv hauv ib qho (lossis ob qho tib si) ntawm koj lub plawv, tab sis koj lub plawv sab laug yog qhov tseem ceeb uas tso cov ntshav uas muaj oxygen ntau thoob plaws koj lub cev. Qhov no yog ib qho tseem ceeb heev.

Ib txoj kev kho mob hu ua 'CRT' (dual-cell pacemaker) tuaj yeem pab cov neeg uas muaj mob plawv tsis ua haujlwm kom txo tau kev pw hauv tsev kho mob thiab ua neej ntev dua.

Nco ntsoov tias, qhov ua rau muaj qhov tsis sib xws kuj cuam tshuam rau qhov tshwm sim. Qee tus neeg tus mob yuav phem dua lwm tus.

Kuv yuav saib xyuas kuv tus kheej li cas?

• Yog koj tus kws kho mob tau sau tshuaj rau koj, nco ntsoov noj raws nraim li tau qhia . Noj tshuaj raws li tau qhia kom txog thaum koj tus kws kho mob hais kom koj tsum.
• Yog tias koj muaj lub tshuab ua pacemaker uas siv ob lub plawv dhia, nco ntsoov mus rau cov chaw kho mob raws li hnub teem tseg . Cov no yog qhov chaw uas koj tus kws kho mob tuaj yeem kuaj xyuas seb koj lub tshuab ua pacemaker puas ua haujlwm zoo. Qee lub tsev kho mob muaj cov chaw kho mob tshwj xeeb hu ua CRT clinics. Nyob ntawd, cov kws kho mob plawv thiab cov kws kho mob plawv ua haujlwm ua ke kom paub tseeb tias koj tau txais txiaj ntsig zoo tshaj plaws ntawm koj lub tshuab ua pacemaker.

Kuv yuav tsum mus ntsib kuv tus kws kho mob thaum twg?

• Yog tias koj tsis xis nyob dua nrog cov tshuaj uas tau muab rau koj.
• Yog tias muaj teeb meem nrog koj lub biventricular pacemaker.

Yog muaj li no, mus ntsib kws kho mob tam sim ntawd.

Kuv yuav tsum mus rau Chav Kho Mob Thaum Muaj Xwm Ceev (ETU) thaum twg?

Yog tias koj muaj cov tsos mob no , nrhiav kev pab kho mob tam sim ntawd:

• Mob hauv siab los yog tsis xis nyob.
• Vertigo (zoo li koj tig ib ncig).
• Ua pa nyuaj heev.
• Mob plab, xeev siab.
• Mob nraub qaum, mob caj dab, lossis mob lub puab tsaig.

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

Tsis txhob hnov ​​qab nug cov lus nug no thaum koj mus ntsib koj tus kws kho mob:

• Vim li cas kuv thiaj tsim tau lub cell asynchrony?
• Kuv puas tsim nyog rau kev kho mob 'CRT'?
• Puas muaj cov pab pawg txhawb nqa uas pab cov neeg uas muaj kab mob plawv?

Nws yog ib qho ib txwm muaj uas koj yuav ntxhov siab me ntsis thaum koj pom tias koj lub plawv tsis ua haujlwm zoo. Tab sis tsis txhob txhawj. Koj tus kws kho mob tuaj yeem nrhiav tau qhov ua rau koj lub plawv dhia tsis xwm yeem thiab xaiv qhov kev kho mob zoo tshaj plaws rau koj. Ua raws li cov lus qhia ntawm lub raj mis tshuaj kom raug. Kev noj koj cov tshuaj tib lub sijhawm txhua hnub yuav pab koj nco ntsoov noj nws. Cim koj cov hnub teem sijhawm rau ntawm daim ntawv qhia hnub lossis teeb tsa kev ceeb toom rau ntawm koj lub xov tooj. Qhov no yuav pab koj kom tsis txhob nco lawv.

Cov Lus Qhia Luv Luv thiab Cov Lus Qhia Txog Kev Yuav Mus Tsev

Zoo, yog li kuv vam tias koj tam sim no nkag siab zoo dua txog "Ventricular Dyssynchrony" uas peb tau tham txog hnub no.

Hais yooj yim xwb, qhov no yog ib qho mob uas cov chav qis (cov hlwb) ntawm lub plawv dhia tsis sib npaug, tsis sib haum. Qhov no tuaj yeem txo qhov ua haujlwm ntawm lub plawv, thiab tseem tuaj yeem ua rau muaj cov tsos mob xws li ua pa luv luv thiab qaug zog.

• Cov kev kuaj mob xws li '(ECG)' thiab '(Echocardiogram)' pab kuaj mob no.
• Ua ib qho kev kho mob, ntxiv rau kev kho tus kab mob hauv qab, kev kho mob pacemaker hu ua "Cardiac Resynchronization Therapy (CRT)" kuj tseem ceeb heev.
• Kev saib xyuas koj lub plawv thiab ua raws li kev noj qab haus huv yuav pab tau ntau yam hauv kev tiv thaiv cov mob zoo li no.
• Yog koj muaj cov tsos mob no, tsis txhob yig mus nrhiav kev pab kho mob. Qhov sai dua yog kuaj pom thiab kho tus kab mob, qhov tshwm sim yuav zoo dua.

Nco ntsoov tias, koj lub siab yog koj yam khoom muaj nqis tshaj plaws. Koj lub luag haujlwm yog tiv thaiv nws.

Kab mob plawv, ventricular dyssynchrony, ventricular tachycardia, heart attack, CRT, pacemaker