Kua rongo koe i te tere o te pao o tō ngākau, i te puhoi rawa rānei, i te kore rānei e pao? He mea noa te mataku ina pā mai tēnei momo mea. He maha ngā tāngata kua pā mai tēnei āhuatanga i tētahi wā o ō rātou oranga. I roto i te rongoā, ka kiia tēnei āhuatanga rerekē o te manawataki o te ngākau ko te 'Arrhythmia' (e kīia ana ko te 'arrhythmia'). Nō reira kaua e mataku, i tēnei rā ka kōrerohia e tātou ngā mea katoa i roto i tētahi huarahi māmā ka taea e koe te mārama.
He aha tonu te arrhythmia?
Ki te kī māmā noa, ko te arrhythmia he pākia o te ngakau e te koretake o te manawa. Ka kiia hoki tēnei ko te 'dysrhythmia'.
Whakaarohia kei te rite tō tātou ngākau ki te kaiwhakatangi pahu i roto i tētahi tira puoro. Ka pai te tangi o te waiata mēnā ka patu ia i ngā pahu ki te rangi tika, me te tere tika hoki. Pērā anō hoki tō tātou ngākau. Me patu i roto i te manawataki tika, me te whakarite. Ko reira anake ka taea ai e ia te pupuhi i te nui tika o te toto whai hāora ki te tinana katoa.
I roto i te arrhythmia, ka pakaru tēnei manawataki.
- Tērā pea kei te tere rawa te pao o te ngākau.
- Tērā pea ka puhoi rawa te pao o te ngākau.
- Ka taea rānei te purei kāore i te auau , me te kore he pao kotahi.
Ka tīmata pea ēnei āhuatanga i ngā wāhanga rerekē o te ngākau.
He āhuatanga kino tēnei hei wehi māu?
He mea noa te puta ake o tēnei pātai ki roto i tō hinengaro. He maha ngā momo arrhythmia. Ko ētahi momo kāore e kino, ā, kāore e hiahiatia he maimoatanga. Heoi, ko ētahi he kino rawa atu. Ka taea e rātou te whakararu i te manawa ohorere. He rerekē anō hoki ngā momo arrhythmia kei waenganui i ēnei pito e rua.
Ko te mea nui ko tō tākuta anake ka taea te kī atu ki a koe he aha te momo arrhythmia kei a koe, me te mea me rongoā, me te aha hoki te mahi mēnā e tika ana. Nō reira, he mea nui rawa te rapu tohutohu hauora, kaua e tātaritanga whaiaro.
He aha ngā momo matua o te arrhythmia?
Ka whakarōpūhia e ngā tākuta ngā arrhythmias i runga i te wāhi i tīmata ai i roto i te ngākau. Me kī māmā noa iho. E whā ngā rūma matua o te ngākau, e rua kei runga, e rua kei raro.
| Momo arrhythmia | Hei whakarāpopototanga... |
|---|---|
| Ngā Arrhythmias Supraventricular | Ka tīmata ēnei i ngā rūma o runga o te ngākau (atria) . Ko te tikanga o 'Supraventricular' ko 'kei runga ake i ngā rūma o raro'. |
| Ngā Arrhythmias Ventricular | Ka tīmata ēnei i ngā rūma o raro (ventricles) o te ngākau. |
| Ngā Bradyarrhythmias | Ko ēnei ngā take o ngā raruraru o te pūnaha tohu hiko o te ngākau, e puhoi rawa ai te patu o te ngākau. Ka puta pea ēnei i ngā raruraru o te taputapu whakateretere tūturu o te ngākau (pūnga SA) me ngā ara e kawe ana i ngā tohu (pērā i te pūnga AV). |
Ko te Atrial Fibrillation te momo arrhythmia tino kitea i Sri Lanka me te ao katoa. Nō te momo Supraventricular tēnei.
He aha ngā tohu e pā ana ki te tangata e pāngia ana e te arrhythmia?
Ka pāngia ētahi tāngata e te arrhythmia, engari kāore he tohu. Ka kiia tēnei he arrhythmia "mureless". Heoi, ki te puta ngā tohu, ka uru atu pea ēnei ki:
| Tohu | Te āhua o te āhua |
|---|---|
| Ngā Whakaterenga o te Ngākau | E pā ana te kaha o te patupatu o tō ngākau, te tukinga o tō uma, te pekepeke o tō uma. |
| Pōuriuri , Māmā rānei te Upoko | Pōuriuri , pōturi rānei . |
| Ngā wā hemo | Ka ngaro whakarere te māramatanga, ka hinga. |
| Te poto o te manawa | Te poto o te manawa, pērā i te piki arawhata. |
| Te mamae o te uma | Te mamae, te kore whakamarie rānei, pērā i te kikī o te uma. |
| Ngoikore , ngenge rānei | Te tino ngenge me te kore ora, kāore he take. |
He aha tēnei e tupu ai? He aha ngā āhuatanga mōrearea?
He uaua ki te tohu i tētahi tino take o te arrhythmia. He maha ngā take pea. Me titiro tātou ki ngā tino take me ngā āhuatanga mōrearea.
Ngā take o te arrhythmia
- Te mate o te uaua coronary ( te aukati i ngā oko toto o te ngakau )
- toto toto tiketike
- Ngā huringa o te uaua o te ngākau (Cardiomyopathy)
- Ngā mate o te takirere ngākau
- Te whara i puta mai i te whakaeke ngakau o mua
- Ngā taurite koretake o te irahiko i roto i te toto
- Te tukanga whakaora i muri i te pokanga ngakau
- Ētahi atu mate (hei tauira, ngā raruraru tairoi)
Ngā āhuatanga e whakanui ake ai i te mōrearea
- Te whakamahi i ngā hua tupeka (te momi hikareti)
- Te inu nui rawa
- Te kai nui rawa i ngā inu me ngā kai kei roto te kawheine (tī, kawhe, cola)
- Te whakamahi i ngā mea whakaohooho, pērā i ētahi rongoā makariri
- toto toto tiketike
- Taumaha rawa (BMI neke atu i te 30)
- Te mate huka, te taumata huka toto tiketike rānei
- Te ngongoro me te apnea moe
He aha ngā hua kino ka puta mai mēnā kāore e rongoatia?
Ki te kore e rongoatia tika, ka taea e ētahi momo arrhythmia te whakaputa raruraru nui.
- Te ngoikore o te uaua o te ngākau ('Cardiomyopathy'): Ina pāorooro te ngākau mō te wā roa, ka ngoikore pea te uaua o te ngākau, ā, ka heke pea tōna kaha ki te pupuhi toto.
- Te hopukanga o te ngakau: Ka taea e ētahi arrhythmia ventricular kino te whakamutu ohorere i te patu o te ngakau.
- Whiu: I roto i ētahi arrhythmias, pērā i te atrial fibrillation, ka taea e ngā toto toto te hanga i roto i te ngākau. Mēnā ka haere tēnei toto toto ki te roro ka aukati i tētahi oko toto, ka pāngia e te pararutiki.
Me pēhea te kite a te tākuta i tēnei?
Ina haere koe ki te tākuta, ka pātai tuatahi ia mō ō tohumate, ā, ka tirotirohia koe. Tērā pea ka tirohia e ia tō manawa, ka whakarongo ki tō ngākau mā te whakamahi i te stethoscope hei tirotiro mēnā he pāorooro koretake te manawa.
I muri i tēnā, ka tonoa pea he maha ngā whakamātautau hei whakaū i te mate me te kimi i te take.
| Whakamātautau | He mea noa iho... |
|---|---|
| ECG (Electrocardiogram) | He whakamātautau e hopu ana i te ngohe hiko o te ngākau. Koinei te whakamātautau tino taketake e whakamahia ana hei kite i te arrhythmia. |
| Ngā whakamātautau toto | Tirohia ngā mea pēnei i te taumata tote o te tinana me ngā homoni tairoi. |
| Ngā Aroturuki Ā-Haereere (hei tauira, te Aroturuki Holter) | Ka whakauruhia he taputapu iti ki roto i tō tinana hei hopu tonu i te manawataki o tō ngakau mō ngā haora 24, neke atu rānei. |
| Te Echocardiogram (Echo) | He matawai ngākau. Ka taea e tēnei te tirotiro i ngā mea pēnei i te rahi, te āhua, me te mahi a ngā takirere ngākau. |
| Whakamātautau ahotea | Te tango i te ECG i a koe e whakakorikori tinana ana (e hikoi ana i runga i te mīhini oma). Mā tēnei ka āwhina ki te kite i ngā arrhythmias e puta ana i te wā e whakakorikori tinana ana. |
| Rangahau Hikohiko (EPS) | He whakamātautau motuhake e rangahau hōhonu ana i te pūnaha hiko o te manawa. |
He aha ngā maimoatanga mō tēnei?
Ko te maimoatanga e whakawhirinaki ana ki te momo arrhythmia e pā ana ki a koe me tōna kaha. I ētahi wā, kāore he maimoatanga e hiahiatia ana. Mena e hiahiatia ana he maimoatanga, he maha ngā kōwhiringa.
1. Ngā rongoā
He maha ngā momo rongoā. Kāore e rite katoa ngā rongoā. Mā tō tākuta koe e āwhina ki te kimi i te rongoā me te horopeta tika māu.
- Ngā rongoā ārai-arrhythmic: Ngā rongoā e hoatu ana hei whakahoki i te manawataki koretake ki te āhua noa (manawataki sinus) hei ārai rānei i te putanga mai o te arrhythmia.
- Ngā rongoā whakahaere i te tere o te manawa: Ngā rongoā e hoatu ana hei whakahaere i te tere o te manawa.
- Ngā rongoā ārai toto totoka/antiplatelet: Ngā rongoā e hoatu ana hei whakaiti i te mōrearea o te toto totoka (hei tauira, warfarin, aspirin).
2. Ngā Huringa Āhua Noho
He mea tino nui ēnei.
- Te whakahaere i te toto toto me te mate huka.
- Te whakamutu rawa i te momi hikareti.
- Te whakawhāiti i te inu waipiro.
- Whakaitihia, whakamutua rānei te whakamahi i te kawheine me ngā mea whakaohooho.
- Te pupuri i te taumaha hauora.
3. Ngā Whakaora Motuhake
- Te Cardioversion: Ko te tuku i te ru hiko kua whakahaeretia ki te ngākau hei whakahoki mai i te manawataki o te ngākau kia noa.
- Te Whakakore i te Catheter: Ka tukuna he ngongo angiangi (catheter) mā roto i tētahi uaua i te waewae, i te ringa rānei ki te ngākau, ā, ka whakakorehia he wāhanga iti o te kiko o te ngākau e puta ai te arrhythmia mā te pūngao hiko auau teitei.
4. Ngā taputapu e mau ana ki te tinana
- Pūrere Whakaterenga Tuturu: He taputapu e hoatu ana ki te hunga he puhoi rawa te pā o te ngakau (bradycardia). Ka tukuna he tohu hiko iti hei pupuri i te tere o te ngakau ki te taumata noa.
- Pūrere Whakamātautau Cardioverter Tāpui (ICD): He taputapu tēnei e aroturuki tonu ana i te manawataki o te ngākau. Mēnā ka kitea he manawataki tere, rerekē (tachycardia/fibrillation ventricular) ka mōrearea pea te ora, ka tukuna he ru ki te ngākau hei whakahoki mai i te manawataki.
5. Pokanga
I ētahi wā, me mahi pokanga hei rongoā i te mate manawa e takoto ana (te mate takirere, ngā uaua kua āraia) e puta ai te arrhythmia. He pokanga motuhake te tikanga Maze mō te atrial fibrillation.
Āhea ahau me toro atu ki te tākuta? Āhea te wā me haere ahau ki te ETU?
Mena kei te pāngia koe e te arrhythmia, he mea nui kia haere koe ki te whare hauora i te wā tika, kia tirohia hoki koe e ai ki ngā tohutohu a tō tākuta. Heoi anō, i ētahi wā me rapu wawe koe i te tohutohu hauora.
Waea atu ki tō tākuta mēnā kei te kino haere ō tohumate (hei tauira, te mamae o te uma, te whanoke), kei te auau haere rānei te puta, kaua e tatari kia tae ki te rā e haere ai koe ki te whare hauora.
Ngā āhuatanga me haere tonu koe ki te Wāhanga Maimoatanga Ohotata (ETU):
Ki te pāngia koe e tētahi o ngā tohu e whai ake nei, kaua e whakaroa, me haere tonu ki te ETU (Emergency Treatment Unit) o te hōhipera tata.
- He uaua nui ki te manawa
- Mamae o te uma
- Whati nui
- Te hemo
Karere Tangohia ki te Kāinga
- He pākia te ngakau o te tangata e te arrhythmia. Ehara i te mea he kino rawa ēnei i ngā wā katoa, engari he morearea ētahi momo.
- Mena ka pā mai ngā tohu pēnei i te mamae o te uma, te whanoke, te uaua ki te manawa, te ngaro rānei o te māramatanga, me toro atu koe ki te tākuta.
- Mā ngā whakarerekētanga ngāwari o te āhua noho (te whakamutu i te momi hikareti, te whakaiti i te waipiro, me te whakahaere i te taumaha) ka tino āwhina i te whakahaere i te arrhythmia.
- Mena kua tohua he rongoā ki a koe, kaua rawa e mutu te tango, kaua hoki e whakarerekē i te horopeta me te kore he tohutohu a tō tākuta.
- Mēnā he āhuatanga ohorere (mamae nui te uma, uaua ki te manawa, ngaro te māramatanga), haere tonu ki te ETU.
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