Kua kite koe, kua pāngia rānei e te tere ohorere o te pao o tō ngākau? I ētahi wā he mea noa tēnei, engari i ētahi wā he take hei āwangawanga. I tēnei rā ka kōrero tātou mō tētahi āhuatanga e kiia nei ko
te Monomorphic Ventricular Tachycardia , e piki haere ai te tere o te pao o te ngākau i tētahi ara rerekē. Ahakoa he roa te ingoa, kia māmā noa iho.
He aha te Monomorphic Ventricular Tachycardia?
He kupu ngāwari noa iho tēnei, he pākia te manawa,
he arrhythmia rānei. Koinei te wā ka tīmata te pākia o ngā rūma o raro o tō ngākau, e kiia nei ko
ngā ventricles , i tētahi tere tino morearea. I runga i te āhua me te wā e puta ai tēnei, ka taea te noho hei raruraru morearea, tae atu ki te mate. Whakaarohia, ko tēnei āhua o
te Ventricular Tachycardia (VT) , ka kaha ake te kino, ka huri hei arrhythmia whakamate e kiia nei ko te
Ventricular Fibrillation (V-fib) . Ki te puta tēnā, ka mutu te ngākau. Ki te mea kei te taha koe o tētahi, ā, ka ngaro whakarere tōna mohio, ā, kāore he pākia,
he mea nui kia waea atu ki te 911 tonu (ki te nama ohorere rānei), kia tīmata wawe te CPR (Cardiopulmonary Resuscitation), ā, kimihia he AED (Automated External Defibrillator) mēnā kei te tata mai tētahi. Ki te kore koe e mōhio ki te tuku CPR , ka whakangungua ngā kaiwhakautu ohorere ki te ako i a koe ki te tuku CPR mā te waea. Ki te mea kei tētahi wāhi tūmatanui koe, he maha ngā whare me ngā whare wānanga he AED . He taputapu tino nui ēnei hei whakaora i ngā oranga i ngā wā penei.
He aha te tikanga o te ingoa o tēnei āhuatanga?
Ko te ingoa "monomorphic ventricular tachycardia" ka wehea ki ōna wāhanga, ā, ko tōna tikanga:
- Mono (Mono-) : Kotahi.
- -morphic : āhua.
- Pūnaha Auaha : Ka hono atu ki ngā rūma o raro o tō ngākau, arā, ngā pūnaha maui me ngā pūnaha matau.
- Tere- : Tere.
- -ngākau : ngākau
Arā, ko
te ventricular tachycardia (VT) he āhuatanga e tere ai te pao o ngā rūma o raro o tō ngākau, engari kāore e pupuhi tika te toto. Ko te tikanga ka puta mai tēnei i ngā ara iahiko hiko rerekē i roto i te uaua ventricular. Ko te kupu "monomorphic" i ahu mai i te huarahi
e tuhia ai tēnei manawataki o te ngākau ki te electrocardiogram (ECG).Ko tētahi – e kiia ana ko
te ECG , ko
te EKG rānei – e ahu mai ana i tōna āhua. I roto i
te VT monomorphic, he rite tonu te āhua o ngā ngaru katoa i runga i te
ECG . Tata ki te 70% o ngā tūroro
VT he momo monomorphic tēnei. Ka ine te
ECG i te ngohe hiko o te ngākau mā te whakamahi i ētahi pūoko, e kiia nei ko
ngā irahiko (12 te nuinga), e piri ana ki te kiri o tō uma. Ka hopukina e ēnei irahiko te ngohe hiko ka whakaatuhia hei raupapa ngaru ki runga pepa, ki te mata rānei. Ko te tikanga o
te VT Monomorphic he rite tonu te āhua o ēnei ngaru katoa.
E rua ngā momo matua o te VT monomorphic:
E rua ngā momo matua o tēnei mate:
- Kāore e mau tonu : Ko tēnei momo VT monomorphic e roa ana mō te neke atu i te toru ngā pao karapīpiti, engari iti iho i te 30 hēkona. Heoi, ka taea e ia te puta pinepine. Ina tupu tēnei, ka uaua ki te kite.
- Pūmau : He VT monomorphic tēnei e roa ake ana i te 30 hēkona, e hiahiatia ana rānei ētahi maimoatanga hei whakahoki i te manawataki o te ngākau ki tōna auau noa.
He aha te rerekētanga i waenga i te tachycardia ventricular monomorphic me te tachycardia ventricular polymorphic?
He rite te
Polymorphic Ventricular Tachycardia ki te monomorphic
VT , engari kotahi te rerekētanga nui. Ko te tikanga o te "Polymorphic" he "āhua rerekē." I te
ECG , ka huri ngā ngaru o te polymorphic
VT mai i tētahi pao ki tētahi pao. Ko te tikanga o tēnei he nui ake te pōturi o te mahi hiko o tō ngākau i tērā o te monomorphic
VT .
Ko wai te mea tino pāngia e tēnei āhuatanga?
He nui ake te kitea
o te tachycardia ventricular i roto i ngā tāne . Ka pāngia ngā pakeke, inā koa ngā kaumātua, me te hunga he mate manawa, inā koa ko te hunga he iti
te ejection fraction . Ka pā anō hoki ki ngā tamariki, engari he tino onge. I te nuinga o te wā ka pā ki te hunga he
mate manawa hanganga kei roto i te whānautanga. Waihoki, ko ngā āhuatanga e hua ai
te tachycardia ventricular , pērā i
te Brugada syndrome ,
te arrhythmogenic right ventricular cardiomyopathy rānei, ka taea te tuku iho.
He pēhea te noa o tēnei āhuatanga?
I te Hononga o Amerika anake
, ko te ventricular tachycardia me te arrhythmia e pā ana ki tēnei mea e kiia nei ko
te ventricular fibrillation e mate ai te 300,000 i ia tau.
He aha te pānga o tēnei āhuatanga ki tōku tinana?
Ko te tachycardia ventricular monomorphic te take o te raruraru o te pūnaha hiko o tō ngākau. Nā te raruraru ka tere rawa te patu o ngā ventricles, ā, kāore e whai wā ki te whakakī i te toto i mua i te patu anō. Ka taea hoki e ngā ventricles te patu i te wā hē, ka ngaro te manawataki me ngā rūma o runga o te ngākau. Ka kino haere
te tachycardia ventricular , ka huri hei
fibrillation ventricular (V-fib) . He āhuatanga anō hoki tēnei kāore e taea e ngā rūma o raro o te ngākau te whakakī i te toto, engari he kino ake. I roto i
te V-fib , kāore ngā ventricles e patu tika, engari ka wiri noa iho. Nā te mea kāore te ngākau e pupuhi tika i te toto, ka taea e
te fibrillation ventricular te arahi ngāwari ki
te ohorere cardiogenic , ki
te hopu ohorere rānei o te ngākau. Ko te tikanga tēnei kāore e taea e tō ngākau te pupuhi i te toto e ranea ana hei whakatutuki i ngā hiahia o tō tinana. I ētahi wā ka taea e
te tachycardia ventricular te haere tika ki te whakaeke ngākau me te kore e uru ki te
V-fib .
Ko te hopu ohorere o te ngākau he āhuatanga ka mate pea i roto i ngā meneti mena kāore e tukuna tonutia
te CPR (e kiia ana ko
te Mate Ngakau Ohorere mena kāore e taea te whakaora i te tūroro).
He aha ngā tohu o te tachycardia ventricular monomorphic?
Tērā pea ka pāngia ētahi tāngata e te monomorphic
VT engari kāore he tohu. Mēnā kāore he tohu, he poto noa te wā e pāngia ai
te VT , ā, kāore e kino rawa. Ko ngā tohu o te monomorphic
VT ko:
- Te tere o te pātaki (te kore rānei o te pātaki) : I roto i te VT monomorphic, ko te tere o te manawa kei waenga i te 140 me te 180 ngā pātaki ia meneti (ko ngā uara teitei ake he kino ake, ā, he nui ake te tūponotanga ka pāngia koe e ngā tohu). I ētahi wā, ka ngaro katoa tō pātaki, ko te tikanga kei te pāngia koe e te mate manawa.
- Te tere o te manawa : He ahua whakararuraru tēnei o te pā o tō manawa, engari kāore he pā o te manawa. Tērā pea ka rite ki te tere o te manawa, te patupatu, te pekepeke, te wiri rānei.
- Mamae o te uma (Angina) : Ka puta tēnei ina kore e ranea te rere o te toto i roto i tō ngākau.
- Te whanoke , te māuiui rānei : Ka puta tēnei ina kore te ngākau e pupuhi i te toto e ranea ana hei whakarato i te hāora e hiahiatia ana ki te roro.
- Te Matepukupuku : Ka puta pea tēnei i muri i te whanoke ina tino kino te VT . Ka taea te ngaro katoa o te māramatanga, te tata tonu rānei ki te matepukupuku.
- Te Pōrearea o te Manawa: Ka kore te hāora i roto i tō tinana nā te ngoikore o te tohanga toto , ka uaua ai te manawa .
He aha ngā take o te tachycardia ventricular monomorphic?
He maha ngā take ka puta ai
te VT Monomorphic. Ko ētahi o ēnei ko:
- Mate ngakau ischemic : Ka taea e te ischemia, arā, te whakahekenga o te rere o te toto, te whakararuraru i te pūnaha hiko o tō ngakau, ā, ka puta te VT monomorphic.
- Cardiomyopathy : Ka taea e te hunga ngākau ngoikore me te whara (nā ngā take maha, hei tauira, te ischemia) te whakawhanake i ngā ara iahiko hiko rerekē ka arahi ki te VT .
- Ngā arrhythmia o mua : Ka taea e ngā āhuatanga e whakararuraru ana i te pūnaha hiko o tō ngākau te puta ake i a rātou anō, ka taea rānei te noho mai i te whānautanga. Ko tētahi tauira o tēnei ko te mate Brugada .
- Ngā raruraru hanganga o te ngākau : Ko te pūnaha hiko o tō ngākau e whakawhirinaki ana ki te āhua o tō ngākau. Ina huri taua āhua, ka piki ake, ka heke rānei te tawhiti e haerehia ana e te iahiko hiko. Ka taea e ēnei huringa te kore e taurite te wā o ngā hikoinga rerekē i roto i tō ngākau, ka puta ai te VT monomorphic. Ka pāngia pea koe e ngā āhuatanga hanganga o te ngākau i whānau mai koe me tēnei, ko ētahi o ēnei i riro mai i ō mātua.
- Ngā taurite kore o te irahiko : Ka puta ēnei ina nui rawa (kāore rānei i te rawaka) o ētahi kohuke o roto i tō tinana e hiahiatia ana e ngā pūtau o tō ngākau kia mahi tika ai.
- Ngā rongoā me ngā raau taero : Ka taea e ngā rongoā kua tohua (pēnei i te digitalis ) me ngā raau taero (pēnei i te methamphetamine , te cocaine rānei) te whakaputa i te VT monomorphic.
- Myocarditis : He mumura tēnei o te uaua o te ngākau. He maha ngā take ka pā mai, tae atu ki te mate pāwera.
- Ētahi atu āhuatanga : Ka taea hoki e ngā āhuatanga pēnei i te amyloidosis o te ngākau , te lupus, te rheumatoid arthritis rānei te whakaputa i te monomorphic VT .
He mate hopuhopu tēnei?
Kāore te Monomorphic
VT e horapa, nō reira kāore e horapa mai i tētahi tangata ki tētahi atu. Heoi, ko ētahi o ngā mate e hua ai tēnei mate he ira tuku iho. Ko te tikanga ka taea e ngā tamariki te tuku iho i tēnei mate mai i ō rātou mātua. Ka taea hoki te puta mai i te mumura i puta mai i ngā mate urutā, ka taea hoki te horapa i ētahi wā.
Me pēhea te tautuhi i te tachycardia ventricular monomorphic?
Hei tautuhi i te monomorphic
VT , me whakahaere he whakamātautau
ECG i roto i te hōhipera. Ka taea e te tākuta te whakamahi i tēnei whakamātautau
heiKa taea te tautuhi i tēnei āhuatanga mā te āhua ngaru e whakaatuhia ana. Ko te huarahi anake hei tautuhi i
te VT monomorphic ko te whakamahi i te
ECG . Nā te mea koinei anake te huarahi ki te kite i te āhua ngaru ōrite o te ngohe hiko o te ngākau. Mena he
VT monomorphic kore-pūmau tōu, arā, ka haere mai, ka haere atu, me whai whakamātautau koe e whakamahi ana i ngā mātāpono ōrite ki
te ECG , engari kāore e hiahiatia kia noho koe ki te hōhipera. Ka kiia ēnei
he aroturuki haereere . He taputapu ēnei ka taea te tuhi raraunga
ECG mō te wā roa. Ka taea e koe te kawe ki te kāinga ka mau mō ngā rā, mō ngā wiki rānei, i runga i te momo aroturuki.
Me pēhea te rongoā i te monomorphic ventricular tachycardia? Ka taea te rongoā?
Mena kāore
he tachycardia ventricular tonu i a koe, ā, kāore hoki he tohu, kāore pea koe e hiahia ki te rongoā mō
te tachycardia ventricular . Heoi, ka tohutohu pinepine tō tākuta kia tirohia koe mō ngā tohu e whakaatu ana he raruraru pea tēnei āhuatanga māu. Nā te mea ka taea e
te tachycardia ventricular tonu te arahi ki te whakaeke ngakau (ahakoa tika, mā te huri rānei ki te
V-fib ), he mea nui kia whakahokia tō ngakau ki te auau noa. He maha ngā wā ka hiahiatia he maimoatanga kotahi, neke atu rānei, mai i ngā rongoā ki te pokanga. I runga i te take o te monomorphic
VT , ka taea te rongoā i te nuinga o te wā, engari kāore e taea te whakaora i ngā wā katoa. Ko te taea te whakaora i tō āhuatanga, kāore rānei, ka whakawhirinaki ki te take matua.
He aha ngā rongoā me ngā maimoatanga e whakamahia ana mō te tachycardia ventricular monomorphic?
Ko te maimoatanga mō
te VT monomorphic he tikanga kei roto i tētahi, neke atu rānei o ēnei e whai ake nei:
- Ngā Rongoā : Ka taea e ngā rongoā ārai-arrhythmia te whakaiti i te mōrearea o ngā raruraru me te mate mai i te ventricular tachycardia . Ka taea hoki e ētahi atu rongoā te āwhina i tō ngākau kia hoki ki tōna auau noa. Ko ētahi o ēnei rongoā ka hoatu noa ki a koe i te hōhipera, nā te mea ka hoatu tika ki roto i tō tinana mā te raina intravenous (IV) , mā te werohanga rānei. Ko ētahi atu rongoā ka taea e koe te tango i ia rā hei pire.
- Te whakakore i te fibrillation hiko : Ko te whakamahi i te iahiko hiko hei "oho" i tō ngākau kia rite ki te auau o te manawa. He tikanga tēnei mō te wā kāore i te pumau tō āhua whānui, hei tauira, ina tino iti tō toto toto nā te ventricular tachycardia .
- Ngā pēhitanga o te uma : Ko ēnei ngā tikanga e whakamahia ana i roto i te CPR . Koinei te mea e mahia tonutia ana mēnā kei te pāngia koe e te mate manawa nā te ventricular tachycardia . Mēnā he pātītī tōu, kāore ēnei e hiahiatia.
- Hāora, whakaurunga ngongo, me te whakapūngao manawa : Mā te hoatu hāora tāpiri ki a koe (pērā i te whakamahi i te ngongo i raro i tō ihu) ka āwhina i te whakaiti i te taumahatanga o tō ngākau. Mēnā ka tino pōturi tō āhua, ā, kāore e taea e koe te manawa, me whakauru pea he ngongo ki roto i a koe. Ko te tikanga o tēnei ko te whakauru i tētahi ngongo ki raro i tō korokoro, ki roto hoki i tō pūngao manawa. Ka honoa te ngongo ki tētahi mīhini e kiia nei ko te whakapūngao manawa , e mahi ana i te mahi manawa māu.
- Ngā Pūwhakaiti-Whakaoho-Kaiwhakatō (ICD) : Mena he VT monomorphic tōu, ka taea e ngā taputapu whakauru te tiaki i a koe mai i ngā whakaekenga ngakau. Ko te ICD he taputapu ka taea e te taote pokanga te whakanoho ki roto i tō uma ka hono atu ki tō ngakau mā te whakamahi i ngā waea (e kiia ana he taura ). Ka taea e te ICD te kite i te arrhythmia me te tuku i te ru hiko iti hei whakahoki i tō ngakau ki te manawataki noa.
- Te Whakakorenga : I ētahi wā, ka taea e ngā kaiwhakarato hauora te hanga i tētahi kiko whara i roto i tō ngākau hei wawahi i ngā ara iahiko hiko e puta ai te VT monomorphic. Ka kiia tēnei tikanga ko te whakakorenga . Ka taea tēnei te mahi mā te pokanga, mā te catheter rānei. Mā te catheter, ka whakauruhia e te kaiwhakarato hauora tētahi taputapu rite ki te ngongo ki roto i tētahi oko toto nui (ko tētahi kei tō huha o runga te nuinga) ka arahina ki runga ki tō ngākau. Kia tae ki roto i te ngākau, ka whakamahia e rātou te wera tino tika, te kaha makariri rawa rānei hei hanga i tētahi whara e pakaru ai te ara iahiko hiko hapa.
Ngā raruraru/ngā pānga taha o te maimoatanga
Ka rerekē rawa ngā raruraru me ngā pānga taha ka pā ki a koe i ēnei maimoatanga. Ko tō tākuta te tangata pai rawa atu hei kōrero ki a koe he aha te mea ka tupu pea i roto i tō keehi, nā te mea ka taea e ia te whakaaro ki ngā maimoatanga e hiahiatia ana e koe (kua whiwhi kē rānei koe), tō hītori hauora, me ngā āhuatanga motuhake katoa.
Me pēhea taku tiaki i ahau anō/te whakahaere i ngā tohumate?
Nā te mea e hiahiatia ana he
ECG hei tātaritanga i te monomorphic
VT , e kore e taea e koe te mōhio kei a koe me te kore e rapu tohutohu hauora. Arā, e kore e taea e koe te rongoā i a koe anō me te kore e kite i te tākuta.
Kia pēhea te tere o taku pai ake i muri i te maimoatanga?
He tokomaha te hunga ka tīmata te pai ake o te ahua i muri i te maimoatanga, inā koa mēnā ka whakaroa te maimoatanga i te tere o te manawa, ā, ka whakahokia te manawa ki te auau noa. I ētahi atu wā, me hiahia pea koe ki ētahi atu maimoatanga, ki te pokanga rānei i mua i tō tīmatanga ki te pai ake. Mēnā me pokanga koe, kāore pea koe e tino pai tae noa ki muri i te tikanga. Ko tō tākuta te tangata pai hei kōrero ki a koe mō te wā whakaora me te mea he mea ka taea e koe te mahi hei āwhina i a koe kia tere ake te ora.
Ka taea e au te whakaiti i te mōrearea o tēnei mea, te ārai rānei i te katoa?
I te nuinga o te wā, ko
te VT monomorphicHe raruraru kāore e taea te matapae. Ko tōna tikanga, kāore e taea te ārai. Ko te huarahi anake hei ārai ko te karo i ngā āhuatanga, i ngā mahi rānei e nui ake ai te tūponotanga ka pāngia koe. Hei tauira, ko te karo i te whakamahi i ngā raau taero pēnei i
te methamphetamine ,
te cocaine rānei. Mena he mate kē atu tōu e puta ai te monomorphic
VT , ka taea pea e koe te whakaiti i tō tūponotanga
ki te VT mā te karo, te whakaroa rānei i taua mate. Heoi, kāore e taea tonu tēnei. Mena he mate tuku iho, he mate whānau rānei te take o te monomorphic
VT , kāore e taea te ārai.
Mena kei a au tēnei āhuatanga, he aha taku e tumanako ai?
Mena kāore he tohu o te monomorphic
VT i a koe, kāore pea koe e hiahia ki te awhina hauora. Mena kei a koe ngā tohu o te monomorphic
VT , me rapu
awhina hauora ohorere tonu koe. Nā te mea ka taea e
te ventricular tachycardia te arahi ngāwari ki te whakaeke ngakau (i taua wā tonu, i te huri rānei hei
V-fib ).
Kia pēhea te roa o te VT monomorphic?
He poto noa iho pea tēnei āhuatanga, he poto noa iho te roa, he meneti torutoru rānei te roa. Heoi, he mōrearea tēnei āhuatanga, nō reira kaua e tukua kia haere tonu. Koia te mea nui o te maimoatanga hauora ohorere hei ārai i ngā raruraru, i te mate rānei.
He aha te tirohanga mō tēnei āhuatanga?
Ko te tachycardia ventricular kore-pūmau , inā koa kāore he tohu, ehara i te mea kino. Mena kua
pāngia koe e te monomorphic VT , inā koa he tohu, me rapu awhina hauora ohorere koe. Ki te kore taua maimoatanga, ka kino ake pea te arrhythmia o tō ngākau, ka mutu katoa rānei.
Me pēhea taku tiaki i ahau anō?
Ko tō tākuta te tangata pai rawa atu hei ārahi i a koe ki ngā mea ka taea e koe te mahi hei tiaki i a koe anō i muri i te tātaritanga o te mate monomorphic
VT . I te nuinga o te wā, me mahi e koe ēnei mea:
- Tangohia ō rongoā kia rite ki te whakahaunga . He mea tino nui tēnei, nā te mea ka taea e ngā rongoā te āwhina i te aukati i te hurihanga o tō manawataki ngākau ki te monomorphic VT . Kaua e mutu te tango i ō rongoā me te kore e kōrero ki tō tākuta. Mena he pātai āu mō te tango, te penapena rānei i ō rongoā, kōrero ki tō tākuta, ki tō kaiwhakahaere rongoā rānei mō ētahi atu kōrero.
- Tirohia tō tākuta kia rite ki te taunakitanga . He mea tino nui te tiaki whai muri me ngā haerenga hauora hei ārai i ngā raruraru, i ētahi atu raruraru rānei o tēnei mate.
Āhea ahau me toro atu ki taku tākuta?
Me toro atu koe ki tō tākuta i ngā wā katoa e ai ki ngā taunakitanga. Me toro atu koe ki tō tākuta mēnā ka tīmata koe ki te kite i ngā tohumate, mēnā rānei ka rerekē ō tohumate, ka tīmata ki te whakararuraru i tō oranga. Me pātai atu hoki ki tō tākuta mō ētahi atu tohumate, ngā tohu whakatūpato rānei e hiahia ana koe ki te waea atu ki te tari o tō tākuta, ki te rapu awhina hauora rānei.
Āhea ahau me haere ki te Tari Whawhati Tata (ETU) ?
Mena kei a koe ētahi o ngā tohu o te monomorphic
VT , me haere koe ki te rūma whawhati tata o te hōhipera. Nā te mea he tino rite ngā tohu o tēnei mate ki ērā e kitea ana i roto i ētahi atu mate morearea, pērā i
te mate manawa ,
te pulmonary embolism rānei. Ko ngā tohu hei tūpato māu ko:
- Te mamae o te uma ( angina ).
- Te rongo i te pakū o tō ngākau.
- Te uaua ki te manawa.
- Pōuriuri, māuiui rānei te mahunga.
- Te moemoeā.
Hei whakamutunga, he karere hei kawe ki te kāinga:
He mate morearea pea te monomorphic ventricular tachycardia. Mēnā kei a koe ngā tohu o tēnei mate, he mea nui kia rapu awhina hauora tonu. Ko te wawe o tō rapunga maimoatanga, ko te nui ake o te tūponotanga ka taea e tō kaiwhakarato hauora te tautuhi me te rongoā i tō mate i mua i te kino haere. Ahakoa kāore e taea te whakaora i tēnei mate i ngā wā katoa, ka taea te rongoā kia taea ai e koe te hoki ki tō oranga me ngā mahi e tino pai ana ki a koe.
Ko te mea nui ko te noho marino me te whai i ngā tohutohu a tō tākuta. Te tere o te manawa, te tachycardia, te arrhythmia, te ECG, te mate manawa, te ventricular fibrillation, te hopu ohorere o te manawa
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