Kodi mtima wanu ukugunda mofulumira mwadzidzidzi? Tiyeni tikambirane za AVNRT (Atrioventricular Nodal Reentrant Tachycardia) !

Kodi nthawi zina mumamva ngati mtima wanu ukugunda mofulumira kwambiri popanda chifukwa? Kapena mumamva ngati chinachake chikuzungulira pachifuwa panu, ndipo mukuvutika kupuma? Izi nthawi zina zimatha kutsagana ndi zinthu monga chizungulire, kupsinjika pang'ono pachifuwa panu, ndi zina zotero. Zinthu izi sizinthu zosayembekezereka chabe. Izi zitha kukhala chizindikiro cha matenda otchedwa AVNRT (Atrioventricular Nodal Reentrant Tachycardia) omwe tikambirane lero. Musadandaule, tiyeni tikambirane za izi mosavuta.

Kodi AVNRT (Atrioventricular Nodal Reentrant Tachycardia) ndi chiyani?

Mwachidule, AVNRT ndi vuto lomwe mtima wanu umayamba kugunda mofulumira kwambiri chifukwa cha kusintha pang'ono kwa magetsi a mtima wanu. Ndi limodzi mwa magulu akuluakulu a matenda otchedwa Supraventricular Tachycardia (SVT) , omwe ndi kugunda kwa mtima mwachangu komwe kumayambira m'zipinda zapamwamba za mtima (atria). Ndipotu, AVNRT ndi mtundu wofala kwambiri wa SVT.

Kawirikawiri, tikakhala pa mpumulo, mtima wathu umagunda pakati pa nthawi 60 ndi 100 pa mphindi. Koma mwa munthu amene ali ndi AVNRT, mwadzidzidzi, popanda chenjezo, kugunda kwa mtima kumatha kukwera kuchoka pa 140 mpaka 280 pa mphindi, kapena mofulumira kwambiri. Tangoganizirani zimenezo! Zitha kukhala kwa kanthawi, ndipo nthawi zina zimatha kukhala kwa nthawi yayitali.

AVNRT ndi SVT ndi matenda omwe ali m'gulu lalikulu la arrhythmias . Arrhythmia ndi vuto lililonse lomwe mtima umagunda molakwika, zomwe zikutanthauza kuti umagunda mofulumira kwambiri, pang'onopang'ono kwambiri, kapena mwanjira yachilendo.

Ndani amene ali ndi mwayi waukulu wopeza AVNRT?

Ndipotu, aliyense akhoza kudwala matendawa otchedwa AVNRT. Komabe, amapezeka kwambiri mwa akazi kuposa amuna. Komanso, achinyamata, athanzi omwe alibe matenda ena akuluakulu nawonso akhoza kudwala matendawa. Choncho, musaganize kuti, "Ndili ndi thanzi labwino, izi sizingandichitikire."

N’chifukwa chiyani AVNRT imachitika? N’chiyani chimachitika mumtima?

Kuthamanga ndi kayimbidwe ka kugunda kwa mtima wathu kumayendetsedwa ndi makina amagetsi ovuta kwambiri. Izi zimayamba ndi gulu lapadera la minofu yotchedwa Sinoatrial node (SA node) m'chipinda chakumanja chakumtunda (atrium) cha mtima. SA node iyi imagwira ntchito ngati chothandizira mtima wathu mwachilengedwe.

Mu mtima wathanzi, chizindikiro chamagetsi kuchokera ku node iyi ya SA chimapangitsa zipinda ziwiri zapamwamba za mtima (atria) kuti zikoke, ndikukankhira magazi m'zipinda zapansi (mitsempha). Chizindikiro chamagetsi ichi chimayenda m'njira zapadera kupita kumalo otchedwa node ya Atrioventricular (node ​​ya AV) . Node iyi ya AV ili ngati chipata pakati pa zipinda zapamwamba ndi zapansi. Kuchokera pamenepo, chizindikirocho chimayenda kupita ku zipinda zapansi (mitsempha) ndikuzipangitsa kuti zikoke. Umu ndi momwe mtima wabwinobwino umapopera magazi m'thupi lonse mwadongosolo.

Komabe, ngati pali vuto ndi dongosolo lamagetsi ili, mtima ukhoza kugunda molakwika. Izi zikutanthauza kuti, ukhoza kuthamanga, kuchepetsa liwiro, kapena kamvekedwe kake kakhoza kukhala kosokonezeka. Ndicho chimene timachitcha kuti arrhythmia.

Mu AVNRT, pali chinthu chotchedwa njira yamagetsi yaying'ono (reentrant circuit) pafupi ndi node ya AV. Ichi chingakhale chinthu chomwe chimapezeka pobadwa. Nthawi zina, chifukwa cha kupindika kwa mtima msanga, chizindikiro chamagetsi chimalowa munjira yowonjezerayi ndikuyamba kuzungulira mozungulira. Taganizirani ngati njira yaifupi mu njira yamagetsi yaying'ono. Pamenepo ndi pomwe mtima umayamba kugunda mofulumira mwadzidzidzi, ndipo ukhoza kukhalabe choncho.

Popeza anthu angapo m'mabanja ena ali ndi vutoli, pali kukayikiridwa kuti AVNRT ikhoza kukhala yobadwa nayo, koma chifukwa chenicheni cha majini sichinadziwikebe.

Kodi zizindikiro za AVNRT ndi ziti?

AVNRT si vuto lopitirira. Ndi vuto la nthawi zina . Izi zikutanthauza kuti kugunda kwa mtima mofulumira kungabwere mwadzidzidzi kenako nkusiya kwa kanthawi kochepa. Anthu ena amakhala ndi zizindikirozi kwa zaka zambiri, koma zingatenge nthawi kuti adziwe chomwe chikuchitika.

Zizindikiro zodziwika kwambiri ndi izi:

• Kusamva bwino pakhosi kapena pachifuwa , kumva ngati munthu wadzimbidwa.
• Chizungulire , nthawi zina kumva ngati mutu wopepuka.
• Kugunda kwa mtima mofulumira kwambiri (pafupifupi kugunda 140-280 pamphindi).
• Kugunda kwa mtima - Uku ndi kumverera kwa mtima wanu kugunda. Izi zitha kumveka m'njira zosiyanasiyana.
• Polyuria - Izi zikutanthauza kukodza pafupipafupi komanso mochuluka. Izi zimachitika chifukwa cha kusintha kwa mahomoni m'thupi pamene mtima ukugunda mofulumira.
• Kuvuta kupuma , kumva ngati ukupuma movutikira.

Kodi kugunda kwa mtima kumeneku kumamveka bwanji?

Anthu omwe ali ndi AVNRT amalongosola kugunda kwa mtima uku motere:

• Zikumveka ngati chinachake chikukwera ndi kutsika m'chifuwa (kugwedezeka) .
• Akuuluka pang'onopang'ono, ngati gulugufe akuuluka.
• Kumva kupsinjika kapena kudzaza m'khosi kapena pakhosi.
• Monga kugunda ng'oma mokweza.
• Mtima umagunda mofulumira ngati mu mpikisano (Mpikisano) .

Kawirikawiri, pazochitika zoopsa kwambiri, AVNRT ingayambitse zizindikiro ndi mavuto aakulu. Mwachitsanzo:

• Kupweteka pachifuwa .
• Chisokonezo .
• Kutaya chidziwitso (syncope) .
• Kuthamanga kwa magazi pang'ono (Hypotension) .
• Kudabwa - Izi ndizosowa kwambiri.

Kodi madokotala amazindikira bwanji matenda a AVNRT?

Kuti adziwe ngati muli ndi AVNRT kapena arrhythmia ina, dokotala adzachita izi:

1. Kufunsa za mbiri yanu yachipatala: Mudzafunsidwa mafunso okhudza matenda aliwonse omwe mudadwalapo kale, zizindikiro zilizonse zomwe mudadwalapo posachedwapa, ndi mankhwala aliwonse, mavitamini, zowonjezera, ndi mankhwala omwe mukumwa.

2. Kuyezetsa thupi:Adzayesa zinthu monga momwe mumapumira, kuthamanga kwa magazi, ndi kugunda kwa mtima. Adzamvetseranso mtima wanu pogwiritsa ntchito stethoscope.

3. Electrocardiogram (EKG): Iyi ndi njira yofunika kwambiri yoyezera. EKG imayesa momwe mtima wanu umagwirira ntchito, monga nthawi ndi nthawi ya kugunda kwa mtima kulikonse. Zingakhale zothandiza kwambiri potsimikizira kuti mwapezeka ndi matenda, makamaka ngati mutha kupeza EKG pamene mtima wanu ukugunda mofulumira.

Kuphatikiza apo, dokotala wanu angakupatseni mayeso ena kuti mudziwe zambiri zokhudza mtima wanu:

• Kuyezetsa magazi: Yang'anani mavuto ena omwe angakhudze mtima wanu (monga matenda a chithokomiro, kuchepa kwa magazi m'thupi).
• Echocardiogram (Echo): Izi zimatenga zithunzi (monga ultrasound) za mtima kuti zione ngati pali vuto lililonse ndi kapangidwe ka mtima kapena momwe umapopera magazi.
• Chowunikira cha Holter kapena chowunikira china choyendera: Ichi ndi chipangizo chaching'ono chomwe mumavala kwa masiku angapo. Chimalemba nthawi zonse kugunda kwa mtima wanu pamene mukuchita ntchito zanu za tsiku ndi tsiku. Ngati palibe arrhythmia panthawi ya EKG, imatha kugwidwa ndi chipangizo chamtunduwu.
• Kuyesa kupsinjika maganizo: Kugunda kwa mtima wanu kumayesedwa pamene mukuthamanga pa treadmill kapena mukukwera njinga yosasuntha. Anthu ena angamve kugunda kwa mtima mofulumira kumeneku panthawi yochita masewera olimbitsa thupi.
• Kuphunzira za electrophysiological (EP) ndi mapu a mtima: Iyi ndi mayeso ovuta kwambiri. Amaphatikizapo kulowetsa waya woonda (catheter) kudzera mu mtsempha kupita kumtima kuti azindikire komwe arrhythmia imayambira komanso momwe ikuchitikira. Mayesowa nthawi zambiri amachitidwa chithandizo chotchedwa catheter ablation.

Ndi mankhwala ati omwe alipo a AVNRT?

Ngakhale anthu ambiri ali ndi AVNRT, si aliyense amene amafunikira chithandizo. Makamaka ngati zizindikiro zimachitika nthawi zina ndipo sizikuvutitsa kwambiri, chithandizo sichingakhale chofunikira. Komabe, gulu lanu lazaumoyo lingakutumizireni chithandizo m'matenda otsatirawa:

• Ngati muli pachiwopsezo cha mavuto aakulu .
• Ngati muli ndi zizindikiro zomwe zimasokoneza moyo wanu watsiku ndi tsiku , monga kusowa tulo.
• Ngati AVNRT imachitika pafupipafupi kapena kwa nthawi yayitali .

Pali njira zingapo zochizira:

1. Kuyendetsa maliseche: Nthawi zina mungathe kuletsa kugunda kwa mtima mofulumira kumeneku pogwiritsa ntchito zinthu zosavuta zomwe mungachite kunyumba. Mwachitsanzo, kukhosomola, kugwira mpweya wanu (Valsalva maneuver), ndikuyika nkhope yanu m'madzi ozizira . Dokotala wanu adzakuwonetsani momwe mungachitire izi.

2. Kusinthasintha kwa mtima ndi magetsi:Izi zimaphatikizapo kuyika ma paddle kapena ma clamp pachifuwa panu ndikupangitsa mtima wanu kugwedezeka ndi magetsi. Izi zingathandize kubwezeretsa kamvekedwe ka mtima wanu kukhala bwino. Izi nthawi zambiri zimachitika pakagwa ngozi.

3. Mankhwala: Pali mitundu ingapo ya mankhwala omwe amatha kulamulira kugunda kwa mtima ndi kamvekedwe kake. Mwachitsanzo, jakisoni wa Adenosine (iyi ndi jakisoni woperekedwa mumtsempha, womwe umachepetsa msanga kamvekedwe kake), mankhwala oletsa kupweteka kwa mtima (mankhwala apadera operekedwa kwa arrhythmia), oletsa Calcium channel , ndi oletsa Beta . Izi ziyenera kumwedwa monga momwe dokotala wanu wanenera.

4. Kuchotsa catheter: Nthawi zambiri izi zimaonedwa kuti ndi njira yokhayo yothandizira AVNRT. Mu izi, mofanana ndi kafukufuku wa EP womwe watchulidwa kale, catheter yopyapyala imadutsa mumtsempha womwe uli mwendo kapena mkono kupita kumtima, dera loloweramo limapezeka, ndipo chilonda chaching'ono chimapangidwa pogwiritsa ntchito mphamvu ya radiofrequency kapena cryoablation. Izi zimaletsa zizindikiro zamagetsi zachilendo kuti zisadutse mumtima, ndipo arrhythmia imasiya. Iyi ndi njira yothandiza kwambiri.

Kodi ndingachepetse bwanji kufalikira kwa vutoli?

Palibe njira yotsimikizika yopewera AVNRT. Komabe, ngati muli ndi vutoli, mungapeze kuti zinthu zina zimapangitsa kuti kugunda kwa mtima mwachangu kumeneku kukhale kovuta. Timatcha izi "zoyambitsa."

Mwa kupewa zinthu zimenezi, mutha kuchepetsa kuchuluka kwa kuukira kwa AVNRT.

Izi ndi zomwe zimayambitsa matenda omwe amakhudza anthu ambiri:

• Mowa
• Kafeini - imapezeka mu khofi, tiyi, ndi zakumwa zina zoziziritsa kukhosi.
• Mitundu ina ya masewera olimbitsa thupi (muyenera kulankhula ndi dokotala wanu za izi).
• Zakudya zina zowonjezera ku zitsamba .
• Mankhwala osaloledwa (Mankhwala osangalatsa) .
• Kusuta kapena kugwiritsa ntchito zinthu zopangidwa ndi fodya .
• Kupsinjika maganizo .

Kodi tsogolo la anthu omwe ali ndi AVNRT ndi lotani?

Kawirikawiri, AVNRT ingayambitse mavuto aakulu, monga kuima kwa mtima mwadzidzidzi. Komabe, kwa anthu ambiri, si vuto lomwe lingawononge moyo . Ngati litachitidwa bwino, anthu amatha kukhala ndi moyo wabwinobwino.

Ndili ndi AVNRT, ndiyenera kudzisamalira bwanji?

Kutsatira malangizo awa kudzakuthandizani kuthana ndi vuto lanu la AVNRT:

• Musagwiritse ntchito mankhwala ogulitsidwa kunja kwa ofesi ya dokotala kapena zakudya zina zowonjezera popanda kufunsa dokotala.
• Pitirizani kuonana ndi madokotala, monga dokotala wanu wa mtima, kuti akakufufuzeni.
• Imwani mankhwala onse omwe mwapatsidwa nthawi yake komanso moyenera.
• Dziwani zomwe zimayambitsa AVNRT yanu ndipo yesani kuzipewa.
• Ngati muwona kusintha kulikonse mu zizindikiro zanu (monga, zikuipiraipira kuposa kale, zimachitika kawirikawiri), uzani dokotala wanu za izi.

Kodi ndingachite masewera olimbitsa thupi ngati ndili ndi AVNRT?

Kuchita masewera olimbitsa thupi n'kofunika kwambiri pa thanzi la mtima. Anthu ambiri omwe ali ndi AVNRT amatha kuchita masewera olimbitsa thupi . Komabe, ndi bwino kulankhula ndi dokotala wanu za mtundu wa masewera olimbitsa thupi omwe ndi abwino kwa inu komanso ngati pali zoletsa zilizonse.

Kodi ndi liti pamene ndiyenera kupeza chithandizo chamankhwala mwamsanga chifukwa cha AVNRT?

Ngati muli ndi AVNRT, pitani kuchipatala mwamsanga ngati mukukumana ndi zizindikiro izi:

• Kupweteka pachifuwa .
• Ngati kugunda kwa mtima kwakhala kukuchitika kwa nthawi yayitali kapena kukuchitika pafupipafupi .
• Kumva mutu wopepuka, chizungulire, kapena kukomoka .
• Kuvuta kwambiri kupuma .

Pomaliza, kumbukirani izi.

AVNRT ndi matenda ofala a mtima. Pa vutoli, mtima umayamba kugunda mofulumira kwambiri kuposa masiku onse. Ngakhale kuti nthawi zambiri sizimayambitsa imfa, zizindikiro zina zimatha kukhala zovutitsa. Ngati muli ndi zizindikiro izi, musazengereze kupita kwa dokotala. Pali njira zambiri zothanirana ndi vutoli ndikupeza chithandizo ngati pakufunika kutero. Samalirani mtima wanu ndikukhala wathanzi!