Te Matenga Ohorere o te Matenga (SAD)

Kua rongo kē koe i tētahi tangata taitamariki, hauora hoki, ka mate ohorere? Kua whakaaro kē koe me pēhea tēnei e tupu ai? I ētahi wā, tera pea nā tētahi mate ka kōrerohia e tātou i tēnei rā, ko te Sudden Arrhythmic Death Syndrome (SADS) . He mea tino nui tēnei, engari he mea nui kia mōhio ki tēnei.

He aha te Matenga o te Ngākau ohorere (SADS)?

He māmā noa iho, he mate ngakau tēnei. I te nuinga o te wā, he mea tuku iho tēnei, arā, ka taea te tuku iho i tētahi whakatipuranga ki tētahi whakatipuranga. Ko te mea ka tupu i roto i tēnei ko te raru o te pūnaha hiko o tō ngākau. Whakaarohia, he rite te mahi a tō tātou ngākau ki tētahi pūkaha hiko iti. Ko ngā tohu hiko te mea e tika ai te patu o te ngākau. Nō reira, ina raru tēnei pūnaha, ka rerekē te tere o te ngākau. Ki te kore tēnei e rongoatia tika, tera pea ka mate ohorere koe. Koia te take he morearea.

He aha ngā momo matua o te SADS?

He maha ngā momo o tēnei mate e kiia nei ko te SADS. He iti noa ngā rerekētanga o ia momo. Me titiro tātou ki ētahi o ngā momo matua:

• Te mate Brugada: He āhuatanga tēnei e tere ai te ngakau, kāore i te auau (polymorphic ventricular tachycardia) i roto i ngā rūma o raro o te ngākau, e kiia nei ko te atria.
• Te Tachycardia Ventricular Polymorphic Catecholaminergic (CPVT): He āhuatanga anō hoki tēnei e tere ana, e kore e taurite te pā o ngā pūtau o te ngākau. Ka puta pea tēnei āhuatanga i te wā e kaha ana te mahi tinana, e ahotea hinengaro rānei.
• Te mate QT roa (LQTS): Koinei te wā e roa ake ai te whakarite o tō uaua ngākau mō te pao e whai ake nei, arā, te whakahou (repolarize, whakahou rānei). He rite ki te pākahiko e roa ake ana te utu. Ki te tirohia he EKG, ko te rerekētanga i waenga i ngā ngaru Q me T e kiia ana ko te wā QT. Ina roa rawa tēnei wā, ka tīmata ngā pūtau ngākau ki te pao tere rawa (ventricular tachycardia) ki te kore rānei e tika (ventricular fibrillation).
• Te mate QT poto (SQTS): He rerekē tēnei i te QT roa. Ko tōna tikanga he poto rawa te wā e pau ana i ngā pūtau o te ngākau ki te whakarite mō te pao e whai ake nei. Ka taea e tēnei te pāorooro i ngā rūma o runga o te ngākau (atrial fibrillation), te pāorooro rānei i ngā rūma o raro (ventricular tachycardia), te wiri rānei i ngā rūma o raro (ventricular fibrillation).
• Te mate o Timothy: He tino onge tēnei mate. He momo mate QT roa anō hoki.
• Te mate Wolff-Parkinson-White (WPW):Koinei te wā ka hangaia he ara anō, he ara rerekē hei haere mā ngā tohu hiko i waenga i ngā rūma o runga (atria) me ngā rūma o raro (mitra). He tāpiritanga tēnei ki te ara noa, ka tere rawa te pao o te manawa (tachycardia).

He pēhea te noa o ēnei āhuatanga SADS?

Kāore ēnei i te tino kitea, engari kāore hoki i te mea kāore i te kitea. Hei tauira, ko te mate QT roa (LQTS) kua whakahuatia i mua ake nei e kiia ana ka pā ki te kotahi i roto i te 2,000 pēpi hou. He iti ake te kitea o te mate Brugada , he iti iho i te 1% o te taupori e pāngia ana. Ko te mate e kiia nei ko te CPVT ka pā ki te kotahi i roto i te tekau mano.

Engari, i te nuinga o te wā, tata ki te 200,000 ngā tāngata e mate ana i te hopukanga o te ngakau ohorere (SCA) i ia tau i te United States anake. E ai ki ngā pūrongo, tata ki te 4,000 ngā tamariki me ngā taiohi e mate ana i ēnei mate SADS i ia tau. Nō reira, ehara tēnei i te mea iti, tika?

He aha ngā tohu o te SADS?

Ahakoa he maha ngā momo SADS, he maha ngā tohu noa. Heoi, kāore pea ētahi tāngata e pāngia e tetahi tohu.

Ngā tohu noa:

• Tērā pea ka hemo te ngākau, ka haurangi rānei i te wā e whakakorikori tinana ana, i te wā rānei e tino harikoa ana, e mataku ana rānei koe.
• Tērā pea ka puta te mamae o te uma i te wā e whakakorikori ana.
• Tērā pea ka pāngia koe e te poto o te manawa i te wā e whakakorikori ana koe.

Nā, kia titiro tātou ki ngā tohu rerekē e pā ana ki ia momo SADS.

Ngā tohu o te mate Brugada

Ahakoa kāore he tohu o te nuinga o te tangata, ka pāngia pea ētahi e:

• Ka pā mai pea te hopukanga o te manawa , inā koa i te wā e moe ana.
• Te hemo.
• Ngā wiri.
• He tauira manawa rerekē.

Ngā tohu o te tachycardia ventricular polymorphic catecholaminergic (CPVT)

Kāore pea he tohu e puta tae noa ki te pā mai o te mate ngakau, engari ka ngoikore pea ētahi tāngata i te wā e whakakorikori ana.

Ngā Tohu o te Mate QT Roa (LQTS)

Tata ki te haurua o te hunga whai LQTS kāore he tohu. Engari ko ētahi tāngata:

• Ka taea e te arrhythmia motuhake e kiia nei ko te Torsades de Pointes te whakararu i te ngakau.
• Te hemo.
• Ngā wiri.

Ngā Tohu o te Short QT Syndrome (SQTS)

Tata ki te 40% o te hunga whai mate pēnei kāore he tohu. Engari ko ētahi:

• Ngā tere o te manawa .
• Te hemo.
• Te whakaekenga o te ngākau.

Ngā tohu o te mate Timothy

Ko ngā āhuatanga ka kitea i roto i tēnei ko:

• Te hemo.
• Te whakaekenga o te ngākau.
• I ētahi wā he whatuwhatu ngā maihao me/ngā matimati rānei o ngā ringa.
• Ngā take whanaketanga.

Ngā tohu o te mate Wolff-Parkinson-White (WPW)

Ko ngā tohu o te WPW ko:

• Ngā tere o te manawa.
• Te pōuriuri o te upoko.
• Te uaua ki te manawa.
• Te hemo.
• Ngā wiri.

He mea nui: Mena kei a koe, kei tētahi atu rānei o ēnei tohumate, me rapu tohutohu hauora koe.

He aha ngā take o te SADS?

He maha ngā wā, ina mate ohorere te taiohi, ā, ka kitea he āhua noa te hanganga o tōna ngākau ina tirohia, ka whakapae ngā tākuta he arrhythmia kāore anō kia kitea, he ngakau pākiki. Ko ngā āhuatanga SADS e puta ai ēnei arrhythmia, i kōrerohia e tātou i mua ake nei, he maha ngā wā ka tukuna iho i te mātua ki te tamaiti . Arā, i ahu mai i ngā ira. Ka rerekē te tūponotanga ka tukuna iho ēnei āhuatanga ki ngā tamariki i runga i te ira e pā ana me te wāhanga o te ngākau e pāngia ana.

Me pēhea te kimi a ngā tākuta i te SADS?

Mena kei te pāngia tētahi taiohi e ngā tohu kua whakahuatia i runga ake nei, ā, mena kua mate ohorere tētahi o tōna whānau i mua i te 40 tau te pakeke, ka whakapae pea te tākuta he SADS. He rerekē ngā tikanga tātaritanga i runga i te momo SADS.

Ngā tikanga tātaritanga matua e whakamahia ana:

• Electrocardiogram (EKG): Mā tēnei ka whakamātautau i te ngohe hiko o te ngākau.
• Whakamātautau ira: Ka whakamātauhia e tēnei ngā rerekētanga ira e pā ana ki te SADS.
• Whakamātautau ahotea o te mīhini hikoi: Ka whakamātautau tēnei i te urupare a te ngākau ki te whakakori tinana.
• Whakamātautau whakaoho Catecholamine: Ka hoatu he rongoā motuhake, ā, ka tirohia te urupare a te ngākau.
• Aroturuki Holter: He taputapu e hopu tonu ana i te manawa o te ngakau mō te 24 hāora pea.
• Echocardiogram: He matawai ultrasound tēnei e tirotiro ana i te hanganga me te mahi o te ngākau.
• Te tirotiro i te tamaiti i roto i te kōpū: Ka taea tēnei te mahi i te wā kei roto tonu te pēpi i te kōpū.
• Whakamātautau tātaritanga whakaurunga catheter o te ngākau: He whakamātautau e whakaurua ai he ngongo angiangi ki roto i te ngākau.
• Rangahau hiko-tinana: I roto i tēnei rangahau, ka tukuna ngā waea angiangi ki roto i te ngākau hei tirotiro hohonu i te pūnaha hiko o te ngākau.

He aha ngā maimoatanga mō te SADS?

He rerekē ngā maimoatanga i runga i te momo SADS, nō reira he mea nui kia mōhiotia te momo e pāngia ana koe.

Te maimoatanga o te mate Brugada

• Pūrere whakatō i te whakapūmau i te manawa o te ngakau (ICD): He mīhini iti tēnei e whakatakotoria ana ki raro i te kiri. Mēnā ka tino rerekē te tere o te manawa, ka tukuna he ru hiko iti hei whakahoki mai i te tere o te manawa.
• Ngā rongoā pēnei i te Quinidine .
• Kaua e whakamahi i ngā rongoā e aukati ana i ngā awa konutai i roto i te ngākau.

Te Maimoatanga o te Tachycardia Ventricular Polymorphic Catecholaminergic (CPVT)

• Ka hoatu ki ēnei tāngata tētahi momo rongoā e kiia nei ko ngā beta-blockers .
• Mena e tika ana, ka whakauruhia he ICD.

Te Maimoatanga o te Mate QT Roa (LQTS)

Ka taea tēnei mā te whakamahi i ngā rongoā, i ngā mahi pokanga rānei:

• Ngā aukati-beta.
• He ICD .
• Te tango i te io o te ngākau maui: He pokanga iti rawa te whakaekenga e tapahi ana, e tango ana hoki i ētahi o ngā io motuhake e haere ana ki te ngākau.
• Kaua e whakamahi i ētahi rongoā e whakaroa ana i te wā QT i runga i tō EKG.

Te Maimoatanga o te Mate QT Poto (SQTS)

He rongoā, he taputapu anō hoki hei āwhina i tēnei:

• He ICD .
• Kuinitini.

Te maimoatanga o te mate Timothy

Ka whakamahia hoki tēnei rongoā me tētahi taputapu:

• Ngā aukati-beta.
• He ICD .
• Kaua e whakamahi i ngā rongoā e whakaroa ana i te wā QT i runga i tō EKG.

Te maimoatanga o te mate Wolff-Parkinson-White (WPW)

Ka āwhina ngā rongoā ki te ārai i ngā tohu o te WPW. Tērā anō tētahi tikanga e kīia nei ko te ablation therapy . Ka whakangaromia e tēnei te ara hiko tāpiri. I ētahi wā ka taea e tēnei te whakaora katoa i te WPW. Ka tohua hoki e ngā tākuta ngā rongoā e kīia nei ko ngā antiarrhythmics hei whakaiti i te tūponotanga o ngā manawataki ngakau rerekē.

He pānga taha kei roto i ēnei maimoatanga?

Ae, tera pea ētahi maimoatanga e pāngia e ngā pānga taha iti.

• Tērā pea ka uaua ki ētahi tāngata te aro atu ki ngā beta-blockers kua tohua e tā rātou tākuta.
• Whai muri i tēnā, ka whakahaerehia te pokanga whakakore i te ngākau aroha o te taha maui :
• Te werawera rerekē.
• Ringaringa maroke.
• Ngā panonitanga o te pāmahana, o te tae rānei i ētahi wāhi o te mata.
• Engari ka taea e tēnei pokanga te whakapai ake i te kounga o te oranga.
• Nā te mea ka tukuna e te taputapu ICD he ru hiko hei whakahoki mai i te manawataki o te ngākau, ka ahua koretake pea. Waihoki:
• Tērā pea ka pā mai te mate urutā.
• Kāore pea te taputapu e mahi tika.

Me pēhea taku whakaiti i taku mōrearea? Ka taea te ārai i te SADS?

Mena kei te pāngia tetahi o tō whānau e te SADS, me mahi e ētahi atu mema o te whānau te CPR.Ki te mōhio koe ki te mahi, ā, ki te mea he Pūwhakamātautau Ārai Aunoa (AED) tāu i te kāinga, he tino whakamarie tēnei mō te tangata e pāngia ana e te SADS. He mea pai hoki te mōhio kei reira tetahi hei āwhina i roto i tētahi āhuatanga ohorere.

Ahakoa kāore e taea te ārai katoa i te SADS, ki te kitea tētahi o tō whānau kua pāngia e te mate, he mea nui kia whakamātauria kia kitea ai mēnā kei a rātou anō te whakarerekētanga ira. Ka taea e koe te kōrero ki tō tākuta kia whakatau ko wai me whakamātauria. Kia kitea rā anō tētahi kei te pāngia e te mate, ka taea te mahi i ngā mahi hei tiaki i a rātou, mā te rongoā, mā ētahi atu maimoatanga rānei.

He aha te heke mai mō te tangata whai SADS?

Kei te momo SADS kei a koe, te wawe o te tautuhi i tōna mate, me te tere o te tīmatanga o te maimoatanga. He mate mō te wā katoa , ā, i ētahi wā ka mate pea .

Heoi, he pai ake te tirohanga a te hunga whai mate Wolff-Parkinson-White (WPW) nā te mea ka taea e te rongoā ablation te whakatika i te raruraru. He iti ake te tūponotanga o te mate ohorere o te hunga whai mate QT roa (LQTS) . Heoi, he maha ngā tāngata ka whai hua mai i te ablation ventricular maui kāore. He iti noa ngā rangahau mō ngā āhuatanga pēnei i te mate QT poto (SQTS) , nā te mea he torutoru noa iho (tata ki te 200) ngā tūroro e pāngia ana e tēnei āhuatanga.

Nō reira, me nui ake ngā rangahau hei kimi i ngā maimoatanga pai rawa atu mō te hunga katoa e pāngia ana e te SADS.

Mā te whakatō i tētahi ICD ka taea te ārai i te mate ohorere o te ngākau nā te mea ka rongoāhia ngā manawataki ngākau rerekē. Ahakoa kāore e rongoā i te mate, he huarahi whai hua hei whakaiti i te mōrearea o te mate mai i ēnei mate.

Mena kei a koe te SADS, me pēhea koe e tiaki ai i a koe anō?

• Mena kua tohua he rongoā māu e tō tākuta, me tango kia rite ki te mea i tohua, kaua e mahue tetahi rā. Pērā anō hoki mō te tamaiti e pāngia ana e te SADS. Me hoatu te rongoā ki a rātou i te wā tika, ā, ehara i te mea pai kia kaua e tangohia tetahi horopeta kotahi.
• Me pātai atu ki tō tākuta, ki tō kaiwhakahaere rongoā rānei i mua i te tīmatanga o tētahi rongoā hou. He maha ngā rongoā, tae atu ki ngā paturopi noa me ngā rongoā ārai-whakapaipai, ka taea te taunekeneke me ngā rongoā mō tō ngākau. Ka pā hoki ēnei ki te wā QT, ka piki ake te mōrearea o te mate ohorere i roto i te tangata he roa te QT syndrome.
• Kia mārama ki te mahi a tō ICD (a tō tamaiti rānei). Me tirotiro hoki e tō tākuta i ia wā. Ka taea e ētahi tikanga hauora me ngā taputapu hiko o ia rā te whakararuraru i te mahi a tō ICD. Nō reira, kia mōhio koe ki ngā mea hei karo.
• Mena kei a tāu tamaiti te SADS, pātai atu ki te tākuta mēnā ka taea e ia te tākaro hākinakina me tōna āhua.

Āhea koe me toro atu ki te tākuta? Āhea koe me haere ki te rūma whawhati tata?

Mena kei a koe te SADS, he mea tino nui ngā tirotiro auau . Hei whakarite kei te tangohia e koe te nui o te rongoā tika. Mena kei a tāu tamaiti te SADS, me whakanui ake pea te horopeta o te rongoā i a ia e tipu ana, e taumaha ana hoki. Koia te mea tino nui kia tirotirohia ngā tamariki i ia wā. Mena kei a koe te ICD, tirohia tō tākuta i te iti rawa kia rua ngā wā i te tau.

Mēnā he āhuatanga ohorere:

• Mena kei roto tetahi i te mate manawa , waea atu ki te 911 (ki te nama whawhati tata rānei o tō whenua) tonu atu ka mahi i te CPR.
• Mena ka pāngia koe e tētahi o ēnei tohu, haere ki te rūma whawhati tata, waea atu rānei ki te 911 tonu:
• Ki te ngoikore koe, ki te pōuriuri, ki te tere rānei o te whanga o te puku.
• Mena ka pāngia koe e te mamae ohorere o te uma, e te uaua rānei ki te manawa.

He aha ngā pātai nui hei pātai atu ki tō tākuta?

Mena kei a koe, kei tētahi rānei o tō whānau te SADS, he mea nui kia pātai atu koe ki tō tākuta i ēnei pātai:

• He aha te momo SADS kei a au?
• He aha te maimoatanga e taunaki ana koe mō tōku āhua motuhake?
• Ka taea e koe te āwhina i ahau ki te whakatau ko wai o tōku whānau me whakamātauria mō tēnei?
• Me whakamahi he defibrillator?
• He rongoā kei reira me karo e au mō tōku mate?

Hei whakamutunga, kia maumahara ki ēnei mea!

Ahakoa he mate kino te SADS, mā te mōhio ki tēnei mate me te mahi i ngā mahi tika ka taea te tiaki i a koe me ō whanaunga. Mā te mōhio ki tō mate ka taea e koe te mārama ki ō whiringa. Mahi tahi me tō tākuta ki te whakatau ko tēhea te maimoatanga pai mōu, mō tō whanaunga rānei. He mea nui ngā tirotiro auau, inā koa mēnā he ICD tōu. Mā te whai AED ki te kāinga, me te whakarite kia mōhio te katoa ki te whakamahi me te mahi CPR ka taea te āwhina i a koe me tō whānau. Kaua e mataku, ko te mōhio te parepare pai rawa atu.

Te Matenga Ohorere, te SADS, te mate manawa, te ngakau rerekē, ngā mate ira, te mate ohorere, te pūnaha hiko o te manawa