Ka pōuriuri koe, ka pā te mamae o tō uma, ka kikorangi ō kanohi, ā, me te mea kei te tata koe ki te hemo? I ētahi wā, he tohu pea tēnei mō te manawataki o te ngākau. I tēnei rā, e kōrero ana tātou mō tētahi mate onge engari he tino morearea. Ko tōna ingoa ko Torsades de Pointes (he kupu Wīwī, e whakahuatia ana ko "torsades de pointes"). He ahua rerekē pea te ingoa, engari he mea nui kia mōhio ki tōna tikanga me āna mahi.
He aha te Torsades de Pointes?
He tere rawa, he rerekē, he morearea hoki te manawataki o te ngākau e tīmata ana i ngā rūma e rua o raro o tō ngākau (ventricles). Hei whakamārama, he momo motuhake tēnei o te tere o te manawataki (Ventricular Tachycardia). I te nuinga o te wā, ko te tere o te manawataki o te tangata hauora kei waenga i te 60 me te 100 ngā pao i te meneti. Heoi, ina puta tēnei āhuatanga, ka piki ake te tere o te manawataki ki te 150 ki te 300 ngā pao i te meneti .
He mea morearea tēnei nā te mea ka taea te mate ohorere o te ngākau, kāore he whakatūpato .
Ki te tirohia tō EKG (electrocardiogram), he tauira motuhake kei te kitea e ngā tākuta i roto i tēnei āhuatanga. He tauira o ngā ngaru e takahurihuri ana ki mua, ki muri, pērā i te koiri. Ko te tikanga o te kupu Wīwī "Torsades de Pointes" ko te "whakakorikori i ngā pūwāhi." I ahu mai tōna ingoa i te āhua takahurihuri o te EKG.
I te nuinga o te wā ka puta tēnei āhuatanga me tētahi atu raruraru i roto i te mahi hiko o te ngākau. Ka kiia ko te wā QT roa. He māmā noa iho, ko te wā QT te wā e pau ana i ngā rūma o raro o tō ngākau ki te patu kotahi, kātahi ka whakarite mō te patu e whai ake nei. Mēnā he roa rawa tēnei wā (QT roa), ka puta pea he patu tāpiri, ka puta ai te Torsades de Pointes.
He aha ngā tohu o tēnei mate?
Ko te mea whakamataku i konei, ko te haurua o te hunga e pāngia ana e tēnei mate kāore e pāngia e tetahi tohu . Ko te hunga e pāngia ana e ngā tohu ka pāngia pea e ēnei e whai ake nei. Me tino tupato koe ki ēnei.
| Tohu | He whakamārama māmā |
|---|---|
| Pōuriuri | Ka puta tēnei ina kore te ngākau e pupuhi tika i te toto, ka heke te rere o te toto ki te roro. |
| Ngā tere o te manawa | Ka tīmata koe ki te rongo i te tere o te patu o tō ngākau, i te kore rānei e tika ana te patu. |
| Mārama te upoko | Kei te tata ngaro taku mārama. |
| Te hemo | Ka puta pea tēnei i te aukatinga wā poto o te rere o te toto ki te roro. |
| Te hopukanga o te ngākau | He tino morearea tēnei āhua. Ka mutu ohorere te patu a te ngākau. |
He aha tēnei e tupu ai? He aha ngā take?
E rua ngā momo take matua mō tēnei.
1. Ngā take whānau: Ka whānau mai ētahi tāngata me te mate ira e kiia nei ko te 'Long QT Syndrome'. Ko te tikanga tēnei kei roto i ō rātou whānau tēnei mate. He nui ake te mōrearea o ēnei tāngata ki te whakawhanake i te Torsades de Pointes.
2. Ngā take o muri mai: Koinei te mea tino noa. Ka taea te whakaroa i te 'wā QT' mā te whakamahi i ētahi rongoā me te whakaiti i ngā taumata o ngā electrolytes i roto i te tinana. Ka piki ake te mōrearea o te Torsades de Pointes.
Ngā rongoā e whakanui ana i te mōrearea:
- Ko ētahi rongoā e whakahaere ana i te manawataki o te ngakau (Antiarrhythmics)
- Ētahi paturopi
- Ētahi rongoā mō te ruaki (Ngā rongoā ārai-mimi)
- Ngā rongoā ārai harore
- Ko ngā rongoā ārai hinengaro he rongoā e whakamahia ana hei rongoā i ētahi mate hinengaro.
- Ētahi rongoā mō te mate pukupuku
He mea nui: Ki te mea kei te tango koe i ēnei momo rongoā, kaua e mataku. Ehara i te katoa ka pāngia e tēnei mate. Engari he mea tino nui kia kōrero koe ki tō tākuta mō tēnei, kia mōhio hoki ki ngā mōrearea.
He aha ngā āhuatanga mōrearea mō tēnei?
He nui ake te tūponotanga o ētahi tāngata ki te pāngia e tēnei mate. Ko ēnei āhuatanga mōrearea ko:
- Kei a koe tētahi āhuatanga e kiia nei ko te 'Long QT Syndrome'.
- Kei a koe ētahi atu mate ngakau.
- He wahine (he nui ake te mōrearea o ngā wāhine)
- Neke atu i te 65 tau te pakeke.
- Te ngoikore o te tairoi.
- Nā te whiu i pāngia ai ia.
- Te whakamahinga o ngā rongoā diuretic.
- Te puhoi o te manawa (Bradycardia).
- He iti ngā taumata o te konupūmā, te konupora, te pāhare pāporo rānei i roto i te tinana.
- Te nui rawa o te korere, te ruaki rānei.
Ka taea te whakaiti i te mōrearea?
Āe, ka taea e koe. He iti noa ngā mea ka taea e koe te mahi:
- Mena kei te pāngia tētahi o tō whānau e te 'Long QT Syndrome', me whakamātau koe mō taua mate. Mena kei a koe, me toro atu ki tētahi tohunga ngakau i mua i te tīmatanga o tētahi kaupapa whakakori tinana.
- Kia tūpato ki ngā rongoā e tangohia ana e koe: Mena kei te tango koe i tētahi rongoā ka roa ake te `QT interval`, pātai atu ki tō tākuta mēnā ka taea e koe te tango i tētahi atu rongoā hei whakakapi. Ina tīmata koe i tētahi rongoā hou, pātai atu ki tō tākuta kia kore ai e raru te rongoā e tangohia ana e koe i tēnei wā.
- Whakaarohia te kai totika: Ki te taunaki tō tākuta, whakanuia ake ō taumata konupūmā, konupora, me te pāhare pāporo.
- Tangohia tō rongoā i te wā tika: Hei ārai i te hokinga mai o tēnei mate, whakamahia te rongoā kia rite ki te whakahau a tō tākuta.
- Inumia he nui te wai: Kia mau tonu te nui o te wai me te tote i roto i te tinana.
- Kia mōhio ki te tere o tō manawa: Akohia he aha te tere o tō manawa noa, me pēhea te ine.
- Mena kua hoatu he taputapu aroturuki manawa ki a koe: Mena kua hoatu e tō tākuta he taputapu aroturuki manawa ki a koe hei mau ki te kāinga, kia mau tonu.
Me pēhea te tautuhi i te mate?
Ko te huarahi matua ki te tautuhi i tēnei ko te whakamātautau `EKG` (Electrocardiogram) . Ka taea e ngā tākuta te kite i tēnei mā te titiro ki te tauira `twisted` motuhake me te `QT interval` roa e kitea ana i runga i te `EKG`.
Hei tāpiritanga, ka taea hoki ēnei whakamātautau te mahi:
- Ngā whakamātautau toto: Tirohia ngā taumata o ngā irahiko i roto i te tinana, pērā i te konupora me te pāhare pāporo.
- Echocardiogram: He matawai hei tirotiro i te hanganga me te mahi a te ngākau.
- Aroturuki Manawa: He taputapu e mau ana mō ētahi rā, e aroturuki tonu ana i te manawataki o te manawa.
Me pēhea te rongoā?
Ko te maimoatanga e whakawhirinaki ana ki te pūtake o te mate. Ko te tangata e pāngia ana e te mate whānau Long QT Syndrome ka hiahia kia roa ake te maimoatanga i te tangata e pāngia ana e te mate i puta mai i te rongoā.
| Momo maimoatanga | Whakaahuatanga |
|---|---|
| Ngā rongoā | |
| Te whakamutu i te rongoā e puta ai te raruraru | Ko te mea tuatahi kia mutu te whakamahi a te tākuta i te rongoā e whakaaro ana ia koia te take o tēnei. |
| Konupūmā me/ranei te pāhare pākawa | Mena he iti te taumata o ēnei tote i roto i te tinana, ka hoatu mā te uaua hei whakahoki i te taumata ki te āhua noa. |
| Ngā aukati-beta | Ka hoatu hei whakahaere i te tere o te manawa, me te hunga e pāngia ana e te `Long QT Syndrome'. |
| Ētahi atu tikanga me ngā taputapu (Ngā Tukanga) | |
| Kaiwhakatere tere | Mō te hunga he tino iti te tere o te manawa, ka whakauruhia he taputapu iti hei pupuri i te manawataki tika. |
| ICD (Whakaiti i te Ngakau o te Tāpui) | He taputapu anō hoki tēnei kua whakatōkia ki roto i te tinana. Ina kitea he manawataki morearea o te ngākau, ka tukuna aunoatia he ru hiko hei whakahoki i te ngākau ki te āhua noa. |
| Te Whakakorenga o te Karu Hiko/Te Whakakorenga o te Fibroilation | I roto i tētahi āhuatanga ohorere, ka tukuna he ru hiko ki te uma hei whakahoki mai i te manawataki o te ngakau kia noa. |
Āhea ahau me toro atu ki te tākuta?
Ki te pāngia koe e ngā tohu pēnei i te tere o te pā o te manawa, te mamae o te uma, te whanoke, te kikorangi o ngā kanohi, te ngaronga rānei o te māramatanga, haere tonu ki te Tari Ohotata o te hōhipera (ETU). He ohotata tēnei.
Mena me noho koe ki te hōhipera nā te Torsades de Pointes, me hoki koe ki te kāinga mō tētahi tirotiro ā-muri i roto i ngā wiki e rua. Nā te mea he mate tēnei e tūpono ana ki te mate ohorere, he mea nui kia noho tonu koe i raro i te tirotiro tonu a te taote ngakau.
Ka taea e koe te pātai atu ki tō tākuta i ēnei pātai:
- I whānau mai ahau me te mate QT roa, nā te rongoā rānei i puta ai?
- He aha ngā tūponotanga ka pā anō tēnei āhuatanga ki ētahi atu tāngata o tōku whānau?
- He rongoā anō kei a au hei whakakapi mō te mea i puta ai tēnei mōrearea?
Mā te maimoatanga, ka taea te whakahaere i tēnei mate, ā, ka taea e koe te noho ora pai. Heoi, ki te kore e rongoatia, ka mate pea. Nō reira, he mea tino nui kia whai i ngā tohutohu a tō tākuta me te haere ki ngā whare hauora i ngā rā kua whakaritea.
Karere Tangohia ki te Kāinga
- He tino tere te oma o te ngakau, he mate te Torsades de Pointes.
- Tērā pea ka puta tēnei i tētahi āhuatanga ira ('Long QT Syndrome') nā ētahi rongoā me te korenga o te tote i roto i te tinana rānei.
- Ki te puta mai ngā tohu pēnei i te mamae ohorere o te uma, te whanoke, te ngaro rānei o te māramatanga, he āhuatanga ohorere tēnei. Haere tonu ki te ETU (Emergency Treatment Unit) .
- Kaua rawa e mutu te tango i tō rongoā, kaua hoki e whakarerekē i te horopeta me te kore he tohutohu a tō tākuta.
- Mena ka tautuhia tēnei mate, he mea nui te maimoatanga auau me te tirotiro i raro i te maru o te tākuta ngakau.
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