Kodi mtima wanu ukumva ngati ukugunda mofulumira kwambiri? Tiyeni tiphunzire za A-fib yokhala ndi RVR! (Atrial Fibrillation yokhala ndi RVR)

Kodi munayamba mwamvapo ngati mtima wanu ukugunda ngati wamisala, kapena mukumva ngati muli ndi vuto lachilendo pachifuwa panu? Kapena mukumva ngati mukuvutika kupuma kapena mukuzunguzika? Izi sizingakhale zinthu zina chabe. Lero tikambirana za vuto lamtunduwu lomwe limachitika mumtima, kutanthauza kuti, vuto lomwe mtima umagunda molakwika komanso mwachangu kwambiri, lotchedwa `(Atrial Fibrillation with Rapid Ventricular Rate)` kapena `(A-fib with RVR)` mwachidule. Musachite mantha, ndikofunikira kwambiri kudziwa izi.

Kodi A-fib yokhala ndi RVR ndi chiyani kwenikweni?

Mwachidule, `(A-fib yokhala ndi RVR)` ndi vuto lomwe kamvekedwe ka mtima wanu, kapena kachitidwe ka kugunda, kamakhala kosazolowereka. Tili ndi zipinda ziwiri zapamwamba mumtima mwathu, zomwe timazitcha atria. `(atria)` izi ndi komwe zizindikiro zamagetsi zomwe zimauza mtima kugunda zimayambira. Koma mwa munthu amene ali ndi `(Atrial Fibrillation)`, zizindikiro zamagetsi izi zimakhala zosokoneza, zosagwira ntchito, ndipo zipinda zapamwamba `(atria)` zimayamba kuchepa mwachangu kwambiri. Zili ngati wina akumenya ng'oma ngati wamisala.

Tsopano zizindikiro zamagetsi zosokonezazi zimapita ku zipinda ziwiri zapansi pa mtima, ma ventricle. Kenako kugunda kwa ma ventricle amenewo kumakhala kosasinthasintha komanso mwachangu kwambiri . Ndicho chimene chimatchedwa ``A-fib with RVR''. Izi zikutanthauza kuti mtima umagunda nthawi zoposa 100 pamphindi.

Taganizirani ngati pompu yamadzi. Ngati sikugwira ntchito bwino, singathe kupompa magazi omwe amafunikira m'thupi. Ndicho chimene chimachitika mukakhala ndi `(A-fib with RVR)`. Mtima ulibe nthawi yokwanira yodzaza ndi magazi bwino, kotero sungathe kupompa magazi okwanira okhala ndi mpweya m'thupi.

Kodi vutoli ndi lofala bwanji?

Mungaganize kuti uwu ndi matenda omwe amakhudza anthu ochepa kwambiri. Koma kwenikweni, "Atrial Fibrillation" ndiye matenda ofala kwambiri pakati pa matenda a mtima. Ngati muyang'ana ziwerengero m'dziko ngati America, anthu mamiliyoni ambiri amavutika ndi vutoli. Matendawa akuwonekeranso kwambiri ku Sri Lanka.

Kodi zizindikiro za izi ndi ziti? Kodi mungazindikire bwanji?

Si aliyense amene amakumana ndi zizindikiro zomwezo. Anthu ena akhoza kukhala ndi vutoli popanda zizindikiro zilizonse. Komabe, pali zizindikiro zina zodziwika bwino:

• Kugunda kwa mtima : Kungamveke ngati mtima wanu ukugunda kapena kugunda mkati mwa chifuwa chanu.
• Chizungulire : Zingamveke ngati mutu wanu ukuzungulira, nthawi zina mpaka kufika poti simungathe kuima.
• Kukomoka: Anthu ena amatha kutaya chidziwitso ndikugwa ngati vutoli lili lalikulu.
• Kupweteka pachifuwa : Pakhoza kukhala ululu womwe umawoneka ngati chifuwa chikuchepa kapena chikukanikizidwa.
• Kupuma movutikira: Sikuti mukakhala otopa pang'ono kokha, komanso ngakhale mutangoyima, mungamve ngati mulibe mpweya.
• Nkhawa pafupipafupi`(Nkhawa)`: Mungamve mantha ndi nkhawa popanda chifukwa.
• Kutopa : Kaya mugone tulo totani, mungakhalebe otopa komanso opanda moyo.

Zizindikiro zimenezi nthawi zina zimakhala zochepa kwambiri, komanso zoopsa kwambiri nthawi zina. Choncho ngati mukukumana ndi vuto ngati ili, ndi bwino kupita kwa dokotala .

N’chifukwa chiyani izi zikuchitika? Kodi zifukwa zake ndi ziti?

Pali zinthu zingapo zomwe zingayambitse `A-fib ndi RVR`. Zinthu zazikulu ndi izi:

• Matenda a mitsempha ya mtima: Izi zikutanthauza kutsekeka kwa mitsempha yomwe imapereka magazi kumtima.
• Kuthamanga kwa magazi : Tonsefe tikudziwa mawu oti "kuthamanga kwa magazi".
• Kulephera kwa mtima : Mtima sungathe kupompa magazi okwanira kupita m'thupi.
• Kulephera kupuma bwino mu tulo: Kusiya kupuma mu tulo pamene mukugona.
• Opaleshoni ya mtima: Chiwopsezochi chikhoza kupitirira kwa masiku angapo kapena milungu ingapo pambuyo pa opaleshoni ya mtima.

Ndani amene ali pachiwopsezo chachikulu cha izi?

Anthu ena ali ndi mwayi waukulu wopeza vutoli. Onani ngati muli m'gulu ili:

• Anthu opitirira zaka 50 : Chiwopsezochi chimawonjezeka ndi ukalamba.
• Anthu omwe ali ndi BMI yoposa 30 : Izi zikutanthauza kuti ali ndi kunenepa kwambiri poyerekeza ndi kutalika kwawo.
• Anthu omwe ali ndi vuto la kupuma movutikira.
• Anthu amene amamwa mowa wambiri : Chiopsezo chimakhala chachikulu ngati mumamwa mowa wambiri tsiku lililonse kapena pafupipafupi.
• Anthu amene amamwa khofi wambiri : Si bwinonso kumwa khofi kapena tiyi wambiri masana.
• Ngati wina m'banja mwanu wakhala ndi "A-fib" : Pakhoza kukhalanso ndi mphamvu ya majini.

Kumbukirani: Kukhala ndi chimodzi kapena zingapo mwa zinthuzi sizikutanthauza kuti mudzakhala ndi "A-fib yokhala ndi RVR". Komabe, ndikofunikira kudziwa izi.

Kodi izi zingayambitse mavuto otani?

Ngati `A-fib yokhala ndi RVR` sinachiritsidwe bwino, mavuto ena oopsa angachitike.

• Kuchepa kwa nthawi kuti zipinda zapansi za mtima zidzaze ndi magazi.
• Minofu ya mtima imafunika mpweya wochuluka .
• Matenda a mtima : Matenda omwe minofu ya mtima imafooka ndikukulitsidwa.
• Stroke : Stroke ikhoza kuchitika ngati magazi ataundana mumtima n’kupita ku ubongo, n’kutseka mtsempha wamagazi. Imeneyi ndi vuto loopsa kwambiri .
• Kuthamanga kwa magazi kotsika .
• Kulephera kwa mtima kotsekeka.

Ndicho chifukwa chake ndikofunikira kudziwa za vutoli ndikupeza chithandizo mwachangu.

Kodi izi zimazindikirika bwanji? Ndi mayeso ati omwe amachitidwa?

Ngati muli ndi zizindikiro zomwe tatchula pamwambapa, mukapita kwa dokotala, adzakuyesani, adzakufunsani za mbiri yanu yachipatala, kenako adzakulamulani kuti muyesedwe kangapo kuti atsimikizire vutoli.

Mayeso odziwika kwambiri ndi awa:

• Electrocardiogram (ECG kapena EKG) : Iyi imalemba momwe magetsi a mtima amagwirira ntchito. Imatha kuzindikira bwino ngati pali `(A-fib yokhala ndi RVR)`.
• Echocardiogram : Izi zili ngati ultrasound scan ya mtima. Imatha kuwona ngati zipinda ndi ma valve a mtima akugwira ntchito bwino, komanso kukula kwa mtima.
• Kujambula kwa mtima kwa CT kapena MRI : Izi zingapereke chidziwitso chatsatanetsatane chokhudza kapangidwe ka mtima.
• Kuyezetsa magazi : Izi zimathandiza kuzindikira zinthu monga mavuto a chithokomiro ndi kusintha kwa ma electrolyte m'magazi.

Kodi chithandizo cha izi ndi chiyani?

Nkhani yabwino ndi yakuti pali mankhwala othandiza a A-fib okhala ndi RVR. Dokotala wanu ali ndi zolinga ziwiri zazikulu: kuwongolera zizindikiro zanu, ndikuletsa mavuto omwe atchulidwa pamwambapa kuti asachitike.

Zotsatirazi zimagwiritsidwa ntchito makamaka ngati mankhwala:

• Kulinganiza Ma Electrolyte : Popeza kuwonjezeka kapena kuchepa kwa ma electrolyte monga potaziyamu ndi magnesium m'thupi kungakhudze kagwiridwe ka mtima, chithandizo chimagwiritsidwa ntchito kuti chikhale bwino.
• Mankhwala : Chithandizo chachikulu cha izi ndi mankhwala.

Ndi mankhwala/mankhwala ati omwe amagwiritsidwa ntchito?

Pali mitundu ingapo ya mankhwala operekedwa a `A-fib yokhala ndi RVR`:

• Beta-blockers : Mwachitsanzo, metoprolol (Lopressor® kapena Toprol®XL). Izi zimagwira ntchito pochepetsa pang'ono kugunda kwa mtima ndikuchepetsa kuthamanga kwa magazi pamtima.
• Mankhwala oletsa njira ya calcium : Mwachitsanzo, diltiazem (Diltzac® kapena Cardizem®). Mankhwala amtundu uwu amachepetsanso kugunda kwa mtima mwa kulamulira kulowa kwa calcium m'maselo a minofu ya mtima.
• Mankhwala oletsa kupweteka kwa mtima : Mwachitsanzo, amiodarone (Pacerone® kapena Cordarone®) kapena digoxin (Lanoxin® kapena Cardoxin®). Izi zimathandiza kubwezeretsa kayimbidwe ka mtima kosasinthasintha.

Chofunika kwambiri! Mukakhala ndi `(A-fib)`, pali mwayi waukulu woti magazi amaundana mkati mwa mtima. Ngati magazi amaundana amenewa apita ku ubongo, `(Stroke)` ikhoza kuchitika. Chifukwa chake, mankhwala oletsa magazi kuundana , kapena omwe timawatcha kuti "magazi ochepetsa magazi", nthawi zambiri amalembedwa.

Kwa anthu ena omwe sangathe kupitiriza kumwa mankhwala ochepetsa magazi awa, njira yapadera yotchedwa left atrial appendage closure ingachitike kuti magazi asaundane.

Nthawi zina zimakhala zovuta kuthetsa vutoli ndi mankhwala okha. Pazochitika zotere, njira zina zochiritsira zingafunike:

• Kuchotsa ma catheter : Izi zimaphatikizapo kupeza madera a mtima komwe zizindikiro zamagetsi zosakhazikika zimachokera, ndikulowetsa catheter yaying'ono (chubu chopyapyala) kudzera mwendo kapena mkono kupita kumtima, 'kulepheretsa' madera komwe zizindikiro zosakhazikika zikuchokera. Kenako zizindikiro zosakhazikika zimasiya kubwera.
• Chothandizira kupuma : Anthu ena ali ndi kachipangizo kakang'ono komwe kamayikidwa pansi pa khungu kuti kawongolere kugunda kwa mtima wawo. Ichi chimatchedwa chothandizira kupuma. Chimatumiza zizindikiro zamagetsi kumtima, makamaka pamene kugunda kwa mtima kuli pang'onopang'ono.
• Kusinthasintha kwa mtima ndi magetsi : Izi zimaphatikizapo kupereka mankhwala oletsa ululu kwa kanthawi kochepa ndikupereka mphamvu yamagetsi yoyendetsedwa ndi kunja kwa mtima, yomwe imabwezeretsa nthawi yomweyo kayimbidwe ka mtima.
• Njira yoyezera magazi : Iyi ndi njira yovuta pang'ono. Mabala ang'onoang'ono amapangidwa mu atria ya mtima kuti apange njira zoyenera zoyendera zizindikiro zamagetsi. Izi nthawi zambiri zimachitika pa opaleshoni ina ya mtima.

Kodi pali zotsatirapo zilizonse za mankhwalawa?

Monga momwe zimakhalira ndi chithandizo chilichonse chamankhwala, zotsatirapo zina kapena zovuta zimatha kuchitika ndi chithandizo cha `(A-fib with RVR)` ichi. Komabe, sizichitika kwa aliyense, ndipo nthawi zambiri zimakhala zazing'ono.

• Kuchokera ku mankhwala : Anthu ena amatha kukhala ndi zinthu monga mutu, kuthamanga kwa magazi pang'ono, chizungulire, komanso kusokonezeka m'mimba.
• Njira monga kuchotsedwa kwa catheter zingayambitse matenda a mtima kapena, nthawi zina, matenda a mtima.
• Nthawi zina opanga ma pacemaker sangagwire ntchito bwino.
• Kugunda kwa mtima kapena "A-fib" kungabwerezedwenso kwa miyezi ingapo pambuyo pa opaleshoni ya Maze .

Dokotala wanu adzakudziwitsani za izi. Palibe chifukwa chodera nkhawa, chifukwa madokotala nthawi zonse amayesetsa kuchepetsa zoopsazi.

Kodi ndidzakhala bwino nthawi yayitali bwanji nditatha kulandira chithandizo?

Izi zimadalira kwambiri chithandizo chomwe mukulandira. Mankhwala ena, monga mankhwala operekedwa kudzera m'mitsempha (IV), angathandize kuchepetsa kugunda kwa mtima wanu ndikuyamba kumva bwino pakangopita mphindi zochepa . Mankhwala ena angatenge nthawi yayitali kuti agwire ntchito. Chofunika kwambiri ndikutsatira malangizo a dokotala wanu molondola.

Kodi ndingachepetse bwanji chiopsezochi?

Pali zinthu zingapo zomwe mungachite kuti muchepetse chiopsezo chanu chokhala ndi `(A-fib with RVR)`. Izi sizothandiza pa vutoli lokha, komanso pa thanzi lanu lonse:

• Kuchita masewera olimbitsa thupi pang'onopang'ono kwa mphindi zosachepera 150 pa sabata : kuyenda, kukwera njinga, kapena kusambira ndikwabwino.
• Idyani zakudya zopatsa thanzi pamtima: Phatikizani ndiwo zamasamba, zipatso, nyemba, tirigu wonse, ndi nsomba muzakudya zanu. Chepetsani mafuta, mchere, ndi shuga.
• Chepetsani kumwa mowa : Ndi bwino kuchepetsa mowa momwe mungathere.
• Pewani fodya kwathunthu : Ngati mukusuta, siyani.
• Ngati muli ndi matenda ena monga kuthamanga kwa magazi, cholesterol yambiri, kupuma movutikira, kapena matenda a shuga, samalani bwino.

Ngati ndili ndi `(A-fib with RVR)`, ndiyenera kuyembekezera chiyani?

Kudziwa kuti muli ndi `(A-fib with RVR)` kungakhale kodabwitsa pang'ono. Koma kumbukirani, iyi ndi vuto lomwe lingathe kuthetsedwa ndipo mutha kukhala ndi moyo wabwino . Chofunika kwambiri ndikukhala ndi zizolowezi zabwino zomwe tatchula kale, kumwa mankhwala omwe dokotala wanu wakupatsani, ndikupempha chithandizo chapadera ngati pakufunika kutero.

Ngati sichinachiritsidwe, chingayambitse matenda aakulu monga matenda a mtima, kulephera kwa mtima, kapena sitiroko. Mankhwala monga catheter ablation awonetsedwa kuti ndi othandiza kwa anthu ambiri. Njira ya Maze ili ndi chiwopsezo cha 80% mpaka 90%, ndipo ingapereke mpumulo kwa nthawi yayitali ku zizindikiro.

Kodi vutoli lidzatha liti?

``(A-fib with RVR)`` ndi matenda omwe nthawi zina amatha kukhala kwa zaka zambiri. Kwa anthu ena, kuchuluka ndi kutalika kwa matendawa kumatha kuwonjezeka pakapita nthawi. Ichi ndichifukwa chake ndikofunikira kupitiriza kutsatira malangizo a dokotala wanu ndikupita kukayezetsa nthawi zonse.

Kodi ndimadzisamalira bwanji?

Thanzi lanu lili m'manja mwanu. Kumbukirani izi:

• Imwani mankhwala onse omwe dokotala wanu wakupatsani molondola komanso pa nthawi yake. Musaphonye tsiku limodzi.
• Pitani kwa dokotala wanu pa nthawi yokumana ndi dokotala. Ndikofunikira kwambiri kuona momwe zinthu zilili.
• Kuchita masewera olimbitsa thupi nthawi zonse. Ngakhale kuyenda tsiku ndi tsiku kungakuthandizeni kukhala ndi moyo wabwino komanso kuchita ntchito za tsiku ndi tsiku mosavuta.

Kodi ndiyenera kupita kwa dokotala liti?

Ngati mukumananso ndi zizindikiro izi, kapena ngati mukumana ndi zizindikiro zatsopano, pitani kwa dokotala nthawi yomweyo:

• Kupweteka pachifuwa.
• Ngati kugunda kwa mtima wanu kuli kopitirira 100 pa mphindi imodzi mukakhala mukupuma.
• Chizungulire.
• Kuvuta kupuma.

Kodi ndiyenera kupita ku Chipinda Chothandizira Anthu Odwala Mwadzidzidzi (ETU) liti?

Ngati muli ndi zizindikiro izi, muyenera kupita ku Emergency Treatment Unit (ETU) mwamsanga :

• Zizindikiro za sitiroko : Mutu waukulu mwadzidzidzi, kusawona bwino, kuvutika kulankhula, kuvutika kuyenda, komanso kugwada mbali imodzi ya nkhope.
• Kutuluka magazi ambiri chifukwa cha mankhwala ochepetsa magaziKusanza kofiira, kutuluka ndowe zofiira kapena zakuda, kutuluka mkodzo wofiira.
• Kupweteka pachifuwa kapena zizindikiro zina za matenda a mtima kapena kulephera kwa mtima : Kupuma movutikira, kusamva bwino m'mimba, ndi thukuta.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala wanga?

Mukapita kwa dokotala, mutha kufunsa mafunso awa kuti mumvetse bwino za matenda anu:

• Kodi ndiyenera kukaonana ndi dokotala kangati (kubwerezabwereza)?
• Kodi zimatenga nthawi yayitali bwanji kuti muwone zotsatira za kusintha kwa moyo?
• Kodi mukundilangiza mankhwala otani? Chifukwa chake ndi chiyani?
• Kodi ndiyenera kulandira chithandizo monga opaleshoni ya mtima, ablation, kapena njira ya maze?

Kumva kugunda kwa mtima kosakhazikika kungakhale kovutitsa. Komabe, pali njira zothandiza zochizira vutoli lotchedwa "A-fib with RVR". Dokotala wanu angakuthandizeni kusankha chithandizo choyenera kwa inu. Mukapita kwa dokotala wanu nthawi yake ndikumwa mankhwala omwe mwapatsidwa monga momwe mwalangizidwira, mungathandize kuteteza thanzi lanu.

Uthenga Wopita Nawo Kunyumba: Zinthu Zofunika Kwambiri Zokumbukira

Chabwino, tiyeni tifotokoze mwachidule zina mwa zinthu zomwe muyenera kukumbukira kuchokera pa zomwe takambirana:

• ``(A-fib with RVR)`` ndi vuto lomwe kayimbidwe ka mtima kamakhala kosasinthasintha ndipo kakugunda mofulumira kwambiri.
• Ngati mukuona zizindikiro monga kuuma pachifuwa, chizungulire, kapena kupuma movutikira , onetsetsani kuti mwapeza upangiri wa dokotala.
• Izi zitha kuchitika chifukwa cha zinthu zingapo, kuphatikizapo kuthamanga kwa magazi ndi matenda a mtima.
• Stroke ndi imodzi mwa mavuto oopsa kwambiri a izi, choncho ndikofunikira kwambiri kumwa mankhwala ochepetsa magazi.
• Pali njira zosiyanasiyana zochiritsira, monga mankhwala ndi kuchotsedwa kwa catheter.
• Kusintha moyo wathanzi (kudya bwino, kuchita masewera olimbitsa thupi, ndi kusiya kusuta) kumathandiza kwambiri pakuwongolera vutoli.
• Imwani mankhwalawo monga momwe dokotala wanenera. Pitani kwa dokotalayo pa masiku omwe akonzedwa.
• Ngati mukuona zizindikiro zadzidzidzi (zizindikiro za sitiroko, kutuluka magazi ambiri, kupweteka kwambiri pachifuwa) , pitani kuchipatala nthawi yomweyo.

Simuli nokha. Pali anthu ambiri omwe ali ndi vutoli. Ndi chithandizo choyenera komanso moyo wabwino, inunso mutha kukhala ndi moyo wathanzi. Musaope kulankhula ndi madokotala anu kuti akuthandizeni kuthetsa mavuto anu.

Kugunda kwa mtima , matenda a mtima, A-fib, RVR, kugunda kwa mtima mofulumira, kupweteka pachifuwa, sitiroko