Ka tere ake te pao o tō ngākau? Me ako tātou mō tēnei (Atrial Flutter)!

I ētahi wā, e rongo ana koe kei te tere te patu o tō uma, engari i roto i te manawataki kotahi? He rite ki te pahu e patu tere ana, engari i roto i te manawataki auau. Ka puta pea tēnei i ētahi wā ina manukanuka, ina mataku rānei koe. Heoi, ki te puta pinepine tēnei, ki te haere tahi rānei me ētahi atu tohu, he tohu pea tēnei o te mate manawa e kiia nei ko te `(Atrial Flutter)`. Me titiro tātou he aha tēnei, he aha i puta ai, me ngā mea ka taea e koe te mahi mōna.

He aha te `(Atrial Flutter)`? Hei whakarāpopototanga...

Ki te kī māmā noa, ko te `(Atrial Flutter)` he āhuatanga e tere haere ai te patu o ngā rūma e rua o runga o te ngākau, te `atria`, engari i te ara kotahi, i roto i tētahi tauira motuhake. Ka kiia tēnei e ngā tākuta he manawataki ngākau rerekē (`supraventricular arrhythmia`) e tīmata ana i ngā wāhanga o runga o te ngākau.

Whakaarohia, i a tātou e noho puku ana, e okioki ana, ka pā te manawa i waenga i te 60 me te 100 ngā wā i te meneti. Koinei te tere o te manawa hauora. Engari i roto i te tangata he "Atrial Flutter", ka taea e ngā wāhanga o runga o te manawa, te atria, te pā te tere ki te 250 ki te 350 ngā wā i te meneti! Ka taea e koe te whakaaro i taua tere? Ina pā te atria ki te tere rawa, me tere ake te pā o ngā rūma e rua o raro o te manawa, ngā "ventricles" hei whakautu. I ētahi wā 150 ngā wā i te meneti, i ētahi wā tere ake rānei.

Ko te take matua mō tēnei he hapa o ngā tohu hiko o te ngākau. Ka patupatu tō tātou ngākau mā te whakamahi i tētahi pūnaha tohu e mahi ana pērā i ngā karere hiko. Ka puta tēnei ina he raruraru, he hapa rānei o ēnei tohu.

He momo `(Atrial Flutter)` rānei?

Ae, he maha ngā momo matua o te `(Atrial Flutter)`. Ka taea e te tākuta te mōhio he aha te momo mā te titiro ki tō `(ECG)`, arā, te kauwhata o te whakamātautau e ine ana i te mahi a te ngākau.

• 'Te Rerenga o te Atrium Noa' (koinei te momo tino noa): I roto i tēnei, ka haere ngā tohu hiko rerekē i te taha maui (ki te taha maui, pērā i te taha matau) i roto i te atrium matau o te ngākau.
• 'Te Rerenga o te Atrium Tūturu Whakamuri': I tēnei, ka haere ngā tohu hiko i roto i te porowhita matau (karaka).
• Te Rerenga o te Atrium Āhua Kore (he iti ake te kitea o tēnei, inā koa mēnā kāore anō kia pokangahia tō ngākau, kia tangohia rānei te uaua o te ngākau, ka whakangaro i ētahi o ngā kiko o te ngākau): I roto i tēnei, ka puta pea ngā tohu hiko rerekē i te atrium maui, i te atrium matau rānei. I ētahi wā, ka taea e ēnei tohu te haereere huri noa i te kiko whara i puta mai i te pokanga ngākau.

He aha ngā tohu o te `(Atrial Flutter)`?

He mea whakamiharo te korenga o ētahi tāngata e pāngia ana e te Atrial Flutter e whakaatu i ngā tohu . Heoi, he tokomaha pea ka pāngia e tētahi, e ētahi rānei o ēnei e whai ake nei:

• Te mate manawa: He āhua o te hemokai, te uaua rānei ki te manawa.
• Whatiwhati: He āhua hurihuri me te uaua ki te tū.
• Ngenge tinana: Te tino ngenge, te kore e taea te mahi i tetahi mea.
• Te tere o te pao o te ngākau: He kare ā-roto e pā ana te ngākau ki roto i tō uma. Tērā pea ka pāngia ētahi e te pao o te ngākau i roto i ō rātou kaki, i te korokoro rānei.
• Te tere o te pā: Ki te rongo koe i tō pā, ka tino tere.
• Te mamae o te uma, te kikī rānei: Tērā pea ka rite ki te kikī o tō uma, ka mamae rānei.
• Te āhua o te hemonga (te hemonga): Kātahi ka kikorangi ō kanohi, ā, ka pērā koe me te mea ka hemo koe.
• Māmā te upoko : He āhua o te māmā o te upoko, me te kore e taea te pupuri i ō waewae ki te whenua.

Ka rerekē pea ēnei tohu i ia tangata, i ia tangata. Mō ētahi tāngata, ka haere mai, ka haere atu, mō ētahi atu ia, ka mau tonu pea.

He aha i puta ai tēnei `(Atrial Flutter)`? He aha ngā take?

E ai ki tā mātou i kōrero ai i mua ake nei, ko te take matua mō tēnei he tere rawa, he auau rawa hoki te whakaputanga o ngā tohu hiko i roto i te atria o te ngākau. Koinei te take ka tīmata te atria ki te whakawhāiti rawa. He maha ngā take ka whai wāhi ki tēnei:

• Ngā mate o te takirere o te ngākau: Ina kore ngā takirere o te ngākau e kati, e tuwhera tika rānei.
• Ngā mate ngakau whānau: Ka whānau mai ētahi tāngata me ētahi ngoikoretanga ngakau.
• Mate pūkahukahu: Te whaiti, te aukati rānei i ngā pūkahukahu e tuku toto ana ki te ngākau.
• Te ngoikore o te ngākau: He āhuatanga e kore ai e taea e te ngākau te pupuhi i te toto e ranea ana ki te tinana.
• Te toto toto tiketike: Te toto toto tiketike.
• Te kaha rawa o te mahi tairoiti (Hyperthyroidism): Te nui rawa o te whakaputanga o ngā homoni tairoiti.
• Ngā mate pūkahukahu: Hei tauira, te COPD.
• He pokanga ngākau tata nei.

Ko wai kei te mōrearea nui ake ki te whakawhanake i te "Atrial Flutter"?

Ka piki ake te mōrearea o te whakawhanake i te "Atrial Flutter" i te pakeketanga. Kua kitea hoki he nui ake te tūponotanga o te pāngia o ngā tāne e tēnei mate i ngā wāhine.

Hei tāpiritanga, ka taea hoki e ētahi atu āhuatanga hauora me ngā whanonga te whakanui ake i tēnei mōrearea:

• Mena kei a koe ētahi atu mate manawa (hei tauira, te ngoikore o te manawa, te mate takirere).
• Te toto toto tiketike.
• Te ngoikore o te mahi tairoi (ina koa te hyperthyroidism).
• Mate huka (‘Diabetes Mellitus’).
• Ngā mate pūkahukahu (hei tauira, te mate pūkahukahu ārai mau tonu - `COPD`, `Pulmonary Embolism`).
• Te nui rawa o te inu waipiro ('Te mate whakamahi waipiro').
• Te apnea moe aukati.
• Te momonatanga.

He aha ngā raruraru ka pā mai i te `(Atrial Flutter)`?

Ina pāngia koe e te `(Atrial Flutter)`, kāore tō ngākau e mahi pai ana. Whakaarohia he rite ki tētahi raina huihuinga i roto i tētahi wheketere. Ka rere te toto mai i tētahi rūma ki tētahi atu i mua i te wehenga atu i te ngākau.

Engari ina pāngia koe e te `(Atrial Flutter)`, me te mea kei te tere rawa te oma o te teihana mahi tuatahi i runga i tēnei `raina huihuinga`. Nā te tere rawa o te patu a te atria o te ngākau, kāore i a rātou te wā ki te whakakī tika i te toto. Waihoki, kāore ngā toto katoa i roto i te atria e whai wā ki te neke ki ngā rūma o raro (`ventricles`). Nō reira , kāore te tinana e whiwhi toto e ranea ana.

Ka taea e tēnei te whakaputa i ngā raruraru matua e rua:

1. Te mōrearea o te toto totoka me te whiu, te mate ngakau rānei: Nā te mea kāore i te nui te wā e rere ai te toto katoa mai i te atria, ka toe tonu ētahi toto ki roto i te atria. Ka taea e ēnei toto e noho ana i te wāhi kotahi te huri hei toto totoka. Mena ka haere ēnei toto totoka ki te roro, ka taea e rātou te pāngia e te pararutiki, ā, ki te mau ki roto i ngā uaua o te ngakau, ka taea e rātou te pāngia e te mate ngakau. Koinei te raruraru tino morearea o te `(Atrial Flutter)`.

2. Te Mate Puku me te Ngākau: Ina tere tonu te patu o te ngākau, ka ngenge, ka ngoikore hoki te uaua o te ngākau. Waihoki, kāore e whai wā ngā rūma o raro o te ngākau ki te whakakī tika, nō reira ka heke te nui o te toto e pupuhihia ana e te ngākau. Ki te haere tonu tēnei, ka taea e te ngākau te uru ki te āhua o te ngoikore o te ngākau.

Ko te mea nui: Ehara te Atrial Flutter i te mea hei mea ngāwari. Ki te kore e rongoatia tika, ka arahi pea ki ngā raruraru nui.

Me pēhea te tautuhi i te atrial flutter?

Mena kei a koe ngā tohu kua whakahuatia ake nei, ka tirotirohia pea koe e te tākuta, ā, ki te tika, ka whakahaerehia ētahi o ngā whakamātautau e whai ake nei:

• Te hiko o te manawa (ECG, EKG rānei): Koinei te whakamātautau tino nui. Ka tuhia te ngohe hiko o tō ngākau. Mena he wiri atrial tōu, ka puta ngā rārangi o te kauwhata i roto i tētahi tauira motuhake , pērā i te tauira niho kani, i te tauira taiapa picket rānei .
• `Echocardiogram` (Echo): He rite tēnei ki te matawai i te ngākau. Ka taea e ia te tirotiro mō ngā toto totoka i roto i te atria o te ngākau. Ka taea hoki e ia te tirotiro i te āhua o ngā takirere ngākau me te mahi a te uaua ngākau, me ētahi atu mea.
• Ngā whakamātautau toto: Ka taea e ēnei whakamātautau te āwhina ki te whakatau mēnā he repe tairoi e kaha rawa ana te mahi, he kore taurite o ngā irahiko i roto i te toto, he raruraru rānei.
• Ngā whakamātautau mahi a ngā pūkahukahu: Ka mahia ēnei hei tirotiro i te pai o te mahi a ngā pūkahukahu, nā te mea ka pā pea ētahi mate pūkahukahu ki te manawataki o te ngakau.
• `Aroturuki Holter` `Aroturuki Takahanga` rānei:I ētahi wā ka haere koe ki te tākuta, ka ngaro pea te tere o te manawa. Mēnā ka tupu tēnā, ka tonoa pea koe kia mau i tētahi taputapu iti hei hopu i tō manawa mō ētahi rā.

He aha ngā maimoatanga mō te `(Atrial Flutter)`?

I te rongoā i te atrial flutter, ko te mea tuatahi ko te rongoā i te mate taketake e puta ai. Hei tauira, mēnā he raruraru tairoi, ka rongoāhia. Hei tāpiri, he maimoatanga motuhake mō te atrial flutter. Kei roto i ēnei ko ngā rongoā me ngā tikanga.

He tokomaha te hunga ka taea te whakahaere i tēnei āhuatanga mā te rongoā. Pērā i ngā rongoā katoa, tera pea ngā pānga taha, engari he iti noa iho ngā mōrearea ki te whakataurite ki ngā painga. Ki te kore e whai hua te rongoā, ka tūtohu pea tō tākuta i ētahi atu tikanga.

Ngā rongoā

Ko ngā momo rongoā matua e hoatu ana mō te `(Atrial Flutter)` ko:

• Ngā rongoā whakaheke i te tere o te ngakau: Kei roto i ēnei ko ngā rongoā e kiia nei ko ngā "Calcium channel blockers" me ngā "Beta-blockers". Ka mahi ēnei mā te whakahaere i te tere o te pao o te ngakau.
• Ngā rongoā ārai-arrhythmic: Ka ngana ēnei rongoā ki te aukati i te tere, te koretake o te manawa o te ngakau, ka whakahoki i te manawa ki tōna auau noa.
• Ngā rongoā ārai toto toto, ngā rongoā whakaiti toto rānei: He mea tino nui tēnei. Ka hoatu ēnei rongoā hei ārai i te hanganga o ngā toto toto kua whakahuatia ake nei, me te ārai i ngā āhuatanga pēnei i te pararutiki.

Ngā Tukanga Hauora

Mena kāore e ranea te rongoā anake, ka taea hoki e koe te mahi i ngā mea penei:

• Te Whakarerekētanga o te Kāti: Ko te whakahoki ohorere i te tere o te manawa ki te āhua noa, mā te rongoā, mā te hoatu rānei i tētahi ru hiko iti ki te uma. Ka mahia tēnei i raro i te rongoā whakamoe, kia kore ai koe e mamae.
• Te Whakakore i te Catheter: He maimoatanga uaua ake tēnei. I roto i tēnei, ka whakauruhia he ngongo angiangi (catheter) mā roto i te oko toto e anga atu ana ki te ngākau, ka kimi i te wāhi iti o te kiko i roto i te ngākau e puta ai ngā tohu hiko rerekē, ā, ka whakangaromia mā te whakamahi i te auau irirangi, i te cryoablation rānei. Ka mutu ngā tohu rerekē.
• Te Whakatikatika i te Pacemaker, te Implantable Cardioverter Defibrillator rānei (ICD): Mena kua whakauruhia kētia tētahi taputapu pēnei ki roto i tō ngākau, ka taea e koe te whakahaere i te atrial flutter mā te huri i ōna tautuhinga.

He raruraru kei roto i te maimoatanga?

He tino onge, ka puta mai ngā raruraru iti mai i ngā maimoatanga pēnei i te "(Catheter Ablation)". Hei tauira:

• Mate pāwera
• Te toto
• Te pakaru o te oko toto
• Ngā toto totoka
• Te whiu (tino onge)

Heoi, he tino iti noa iho ēnei mōrearea. Mā tō tākuta tēnei e whakamārama atu ki a koe.

He pēhea te whai huatanga o tēnei maimoatanga?

• `Te Whakaora i te Ngākau`: Ko te ōrau angitu o tēnei mahi kei waenganui i te 70% me te 90%. Ko te tikanga, 70-90 i roto i te 100 tāngata ka hoki anō te manawa o te ngākau ki te noho noa.
• Te Whakakorenga i te Catheter: Mō ētahi tāngata, ko te mōrearea o te atrial flutter i muri i te whakakorenga catheter he iti iho i te 5%. Heoi, ka rerekē pea tēnei reiti angitu i runga i te momo atrial flutter me te āhua o te tūroro. I roto i ngā take uaua pēnei i te atrial flutter rerekē, ka eke te reiti angitu ki te 70%.

Kia pēhea te roa o te wā e ora ai i muri i te maimoatanga?

I muri i te tango i te wheua, me āta tupato koe mō te wiki tuatahi. Ka kīia atu kia kaua e mahi i tetahi mea pēnei i te hiki taumaha, te taraiwa rānei mō te wiki pea. Whai muri i tēnā, ka taea e koe te hoki mārire ki ngā mahi o ia rā.

Ka taea te ārai i te Atrial Flutter?

Kāore e taea te whakahaere i ētahi āhuatanga mōrearea, pērā i te pakeketanga. Heoi, mā ngā mea pērā i te whakawhāiti i te inu waipiro ka āwhina i te whakaiti i tēnei mōrearea. He mea nui anō hoki kia whiwhi maimoatanga hauora tika mō ētahi atu āhuatanga hauora ka puta ai te atrial flutter (pērā i te toto toto tiketike, te mate huka, me ngā raruraru tairoi).

He aha ngā mea ka tumanakohia e au mēnā kei a au te `(Atrial Flutter)`?

He mate uaua te rongoā katoa i te Atrial Flutter, ā, he nui te mōrearea o ngā raruraru pēnei i te whiu, nō reira me toro atu koe ki tō tākuta mō ngā wā tirotiro i muri mai puta noa i tō oranga. He mea nui kia kaua e mahue ēnei wā tirotiro, nā te mea he nui ake te tūponotanga ka hoki anō te Atrial Flutter. Ka taea e tēnei te arahi i te maha o ngā wā ki te hōhipera mō ētahi tāngata.

Me pēhea taku tiaki i ahau anō?

• Ko te mea nui ko te pupuri i ō wā tirotiro me tō tākuta. I ia tau, ka aromatawaihia e tō tākuta tō mōrearea ki te whiu, me te whai whakaaro ki ō mate hauora kē atu. Mena he nui tō mōrearea, ka tonoa pea koe kia haere tonu te tango i ngā rongoā ārai toto.
• Tangohia te rongoā kua tohua i te wā tika.
• Me whakarerekē i te āhua noho hauora (hei tauira, te whakamutu i te kai hikareti, te whakaiti i te waipiro, te kai i ngā kai hauora, te whakakori tinana).

Āhea ahau me toro atu ki taku tākuta?

Me toro atu koe ki tō tākuta i ngā wā katoa. I tēnei wā, ki te pāngia koe e te mate pāwera ki tētahi rongoā e hoatu ana ki a koe, ki te rerekē rānei ō tohumate, ki te kino rānei, ki te puta rānei he tohumate hou, toro atu ki tō tākuta tonu.

Āhea ahau me haere ki te rūma ohorere (ER)?

Mena he tere ake tō manawa i te 150 ngā pātaki i te meneti (ka taea e koe te rongo mā te titiro ki tō pātaki) i a koe e okioki ana, me rapu awhina hauora tonu koe, ā, ki te tika, me haere ki te rūma whawhati tata. Waihoki, ki te pāngia koe e te mamae nui o te uma, te uaua ki te manawa, te ngaro rānei o te māramatanga, me haere tonu koe ki te hōhipera.

He aha ngā pātai me pātai atu e au ki taku tākuta?

Ka taea e koe te whakaaro ki te pātai i ēnei pātai ina tūtaki koe ki te tākuta:

• Kei a au te `(Atrial Flutter)`, tētahi atu momo mate manawataki o te ngākau rānei?
• He aha te rongoā pai rawa atu mōku? He aha ngā painga me ngā huakore?
• He aha te mōrearea o te whiu? Me aha ahau hei whakaiti i tēnei?
• He aha ngā tohu e tika ana kia tino āwangawanga ahau?
• He aha ngā huringa me mahi e au i roto i tōku āhua noho?

He morearea te `(Atrial Flutter)`?

Ehara te Atrial Flutter i te mate e morearea ana ki te ora, engari he mate kino. E ai ki tā tātou i kōrero ai i mua, ki te kore e rongoatia, ka arahi pea ki ngā raruraru morearea ki te ora, pērā i te whiu, te mate ngakau, te ngoikore rānei o te ngakau.

He mea noa te kore e pai te āhua ina tere rawa te tere o tō manawa. Kaua e manukanuka, ka taea e tō tākuta te whakarato i tētahi maimoatanga pai mō te `(Atrial Flutter)`. Ka taea e ēnei maimoatanga te whakaiti i te tūponotanga o te whakawhanake i ēnei raruraru kino. Koia te mea nui kia mau tonu ō wā whakarite ki tō tākuta me te whai i ana tohutohu. Mā tō tākuta koe e āwhina ki te whakatau i te maimoatanga pai rawa atu mō tō āhua.

Nā, he aha ngā mea hei maumahara mā tātou i tēnei pūrākau?

• Ko te wiri o te atrium he āhuatanga e tere rawa ai te pā o ngā rūma o runga o te manawa, engari i roto i tētahi tauira motuhake.
• Ko ētahi o ngā tohu ko te uaua ki te manawa, te whanoke, me te kikī o te uma. Tērā pea kāore he tohu o ētahi tāngata.
• Ko te mea tino mōrearea ko te tūponotanga o te toto totoka ka puta ai ngā āhuatanga pēnei i te whiu .
• Ka taea te kite ngāwari i tēnei mā te ECG.
• He maimoatanga kei reira pērā i ngā rongoā me te "(Ablation)".
• Ahakoa i muri i te maimoatanga, he mea tino nui kia kite koe i tētahi tākuta hei tirotiro i a koe anō puta noa i tō oranga.
• Mena he nui ake i te 150 ngā pao o tō manawa i te meneti i te wā okiokinga, rapua tonutia he tohutohu hauora.

Mena he pātai anō āu mō tēnei, kaua e wehi ki te kōrero ki tō tākuta. Māna e whakamārama ngā mea katoa ki a koe.

` Te Rerenga o te Atrium, Te Manawa, Ngā Mate Manawa, ECG, Atrium, Ngā Pūtau, Te Pararutiki, Te Manawa, Te Korenga o te Manawa, Te Whakakorenga o te Catheter