Kodi mtima wanu umayamba kugunda mofulumira mwadzidzidzi? Tiyeni tikambirane za PSVT (Paroxysmal Supraventricular Tachycardia)!

Kodi mudayamba mwakumanapo ndi kukwera kwadzidzidzi kwa kugunda kwa mtima wanu, kugunda pachifuwa panu, kenako mphindi yochepa ya moyo wabwinobwino? Mwina mudaganiza kuti izi ndi zachilendo, kapena chinthu chomwe chimachitika mukachita mantha pang'ono. Komabe, nthawi zina sizimachitika. Lero tikambirana za vuto lotchedwa `Paroxysmal Supraventricular Tachycardia` kapena `PSVT`, lomwe limayambitsa kusintha kwadzidzidzi kwa kugunda kwa mtima. Musadandaule, tikambirana izi m'njira yosavuta yomwe mungamvetse.

Kodi PSVT ndi chiyani?

Mwachidule, `PSVT` ndi kusakhazikika kwa kayimbidwe ka mtima wathu, ndiko kuti, kachitidwe ka kugunda kwa mtima wathu (`arrhythmia`). Pankhaniyi, mtima umayamba kugunda mofulumira kwambiri. Kenako, mwadzidzidzi, kugunda kwa mtima kumachepa kufika pa kayimbidwe kake kabwinobwino. Timatcha izi kuti kugunda kwa mtima mwachangu 'paroxysms'. Vutoli limayamba chifukwa cha ntchito yamagetsi yosazolowereka yomwe imayamba m'zipinda ziwiri zapamwamba za mtima, zotchedwa `atria`. Timatcha zipinda ziwiri zapansi za mtima, zotchedwa `ventricles`. Zipinda zinayizi zimagwirira ntchito limodzi kupompa magazi m'thupi lathu lonse.

Kotero, `PSVT` imayamba chifukwa cha ntchito yamagetsi yosazolowereka m'ma atria awa, zomwe zimapangitsa kuti achepetsedwe mwachangu komanso mosalekeza. Koma chofunika ndichakuti `PSVT` nthawi zonse si matenda omwe amafunika chithandizo kapena omwe amaika moyo pachiswe. Nthawi zina imatha kuchiritsidwa popanda chithandizo chilichonse. Ngati pakufunika kutero, madokotala amalangiza mankhwala, mankhwala ena amtima, ndipo nthawi zina, `pacemaker`. Ngati mukumva china chake chachilendo ndi momwe mtima wanu umagunda, ndibwino kuti mukawone dokotala ndikumuyesa.

Kodi mtima wathu umagwira ntchito bwanji mwachibadwa?

Tisanamvetse tanthauzo la PSVT, tiyeni tiwone momwe mtima wathu umagwirira ntchito nthawi zambiri. Mu mtima wathanzi, kugunda kwa mtima kumayambira mu minofu yaying'ono mu atria. Timaitcha kuti sinoatrial node (SA node). Ichi ndi chomwe chimagwira ntchito ngati pacemaker yachilengedwe ya mtima.

`SA node` iyi imatumiza zizindikiro zamagetsi zomwe zimapangitsa kuti atria igwire ndikupopa magazi. Zizindikirozi zimapita ku ma ventricles kudzera mu mtolo wina wa maselo otchedwa `atrioventricular node` (AV node). `AV node` imatumiza zizindikiro zamagetsi ku ma ventricles kuti agwire. Umu ndi momwe mtima wathu umagunda mwadongosolo.

Kodi pali mitundu ya PSVT?

Inde, pali matenda ena ambiri omwe ali m'gulu lalikulu la `PSVT`. Izi zitha kuchitika chifukwa cha kulumikizana kwa magetsi kopitilira kamodzi kuchokera ku zipinda zapamwamba za mtima kupita ku zipinda zotsika, kaya mwachindunji kapena kudzera mu `AV node`. Izi zimapangitsa kuti mtima ugwire mofulumira (`tachycardia`). Nthawi zina, kugunda kwa mtima mwachangu kumeneku kungayambenso kuchokera ku 'kuyang'ana kosakwiya' m'zipinda zapamwamba za mtima.

Mayina ena odziwika bwino a mitundu iyi ya tachycardia ndi awa:

• "Atrioventricular nodal re-entrant tachycardia (AVNRT)"
• "Orthodromic reciprocating tachycardia (ORT)"
• "Tachycardia yotsutsana ndi madontho a m'magazi"
• `Tachycardia ya mtima`
• `Kuthamanga kwa mtima`

Ngakhale izi zingawoneke ngati zasayansi pang'ono, ndikofunikira kuti madokotala amvetse bwino momwe matenda anu alili ndikupereka chithandizo choyenera kwambiri.

Kodi izi ndizofala bwanji?

Matenda a mtima (arrhythmias) ndi ofala kwambiri. Anthu mamiliyoni ambiri ku Sri Lanka ndi padziko lonse lapansi amavutika ndi matenda enaake a mtima.

Matenda a Supraventricular tachycardias (SVT) ndi matenda ofala kwambiri a mtima, makamaka mwa ana aang'ono ndi makanda. Amafalanso kwambiri mwa ana omwe ali ndi matenda a mtima obadwa nawo.

N’chifukwa chiyani PSVT imeneyi imachitika? Kodi zimayambitsa chiyani?

PSVT (yomwe imatchedwanso re-entry tachycardia) ndi matenda a mtima omwe amapezeka mu atria. Amayamba pamene pali vuto lamagetsi losazolowereka mu atria. Izi zikutanthauza kuti malo okhudzidwa kwambiri mu atria kapena short circuit munjira zamagetsi za mtima zimapangitsa kuti zizindikiro zamagetsi ziyambe kuzungulira. Apa ndi pamene atria imayamba kufooka mofulumira komanso mosalekeza.

Zizindikiro zamagetsi zachilendozi zimatha kuchitika ngati pali njira yowonjezera yamagetsi (`njira yowonjezera`) pakati pa atria ndi ma ventricles, kaya mwachindunji kapena kudzera mu `AV node`. Mwachitsanzo, anthu omwe ali ndi vuto lotchedwa `Wolff-Parkinson-White syndrome` ali ndi njira yowonjezera iyi m'mitima yawo. Kenako, ngati zizindikiro zamagetsi zimayenda kudzera mu njira yowonjezerayi mofulumira kuposa momwe zimayendera kudzera mu `AV node` yachibadwa, mtima umayamba kugunda mofulumira kwambiri.

Monga matenda ena a mtima (arrhythmias), PSVT ikhoza kukhala yobadwa nayo. Izi zikutanthauza kuti ngati wina m'banja mwanu ali nayo, mumakhala ndi mwayi waukulu woti muipeze. Kuphatikiza apo, pali zifukwa zina zambiri zomwe zingayambitse vutoli. Tiyeni tiwone zomwe zili:

• Ndi ukalamba: Chifukwa mtima umasintha ndi ukalamba.
• Kuchepa kwa magazi m'thupi: Pamene thupi sililandira mpweya wokwanira.
• Kusowa madzi m'thupi komanso kutopa kwambiri: Izi zitha kupangitsa kuti mtima uvutike.
• Zakumwa ndi zakudya zokhala ndi caffeine: Zinthu monga tiyi, khofi, chokoleti, ndi zakumwa zina zopatsa mphamvu.
• Zakudya zina: Anthu ena amatha kugunda kwambiri atatha kudya zakudya zokhala ndi mafuta ambiri, shuga, kapena chakudya chopatsa mphamvu. Mwachitsanzo, mungamve chifuwa chanu chikugunda mutadya chakudya chochuluka kapena mutachita phwando.
• Mankhwala ena: Mwachitsanzo, pseudoephedrine, yomwe imapezeka m'mankhwala ena ochepetsa kutsekeka kwa mphuno.
• Kumwa mowa mopitirira muyeso.
• Kudwala matenda a mtima kapena kuwonongeka kwa mtima chifukwa cha opaleshoni ya mtima.
• Matenda a mtima: makamaka matenda a mitsempha ya mtima (CAD).
• Kuthamanga kwa magazi (BP).
• Kupsinjika maganizo ndi nkhawa: Kupsinjika maganizo komwe kumachitika chifukwa cha zinthu monga mayeso omwe akubwera, mavuto a kuntchito, kapena mavuto a m'banja.
• Kusintha kwa mahomoni: Panthawi yosiya kusamba kwa akazi, kapena panthawi ya mimba. Ndipotu, kugunda kwa mtima kumachitika kawirikawiri panthawi ya mimba.
• Kunenepa kwambiri (kunenepa kwambiri) ndi kunenepa kwambiri.
• Kusuta fodya ndi kugwiritsa ntchito zinthu zopangidwa ndi fodya.
• Mavuto a kapangidwe ka mtima: Mwachitsanzo, matenda a valavu ya mtima.
• Mavuto a chithokomiro: makamaka `Hyperthyroidism` (chithokomiro chogwira ntchito mopitirira muyeso).

Kodi zizindikiro za PSVT ndi ziti?

Zizindikiro za PSVT nthawi zambiri zimayamba mwadzidzidzi ndipo zimatha mwadzidzidzi. Kwa anthu ena zimatha kukhala zofatsa, komanso zovuta kwa ena. Mutha kumva kugunda kwa mtima mofulumira mutatha kuchita masewera olimbitsa thupi, mutatha kugona tulo tosakwanira, kapena munthawi ya nkhawa yayikulu.

Zizindikiro zazikulu ndi izi:

• Kugunda kwa mtima mwachangu komanso kosasinthasintha. Nthawi zambiri kugunda kwa mtima kumapitirira 100 pamphindi (BPM), koma nthawi zina kumafika 250 BPM. Ana aang'ono omwe ali ndi PSVT amatha kukhala ndi kugunda kwa mtima kokwera kwambiri.
• Kumva kugunda, kugunda, kapena kugunda pachifuwa, pakhosi, kapena pakhosi (`kugunda kwa mtima`). Anthu ena amati zimamveka ngati "ng'oma ikugunda mkati mwa chifuwa." Mungamve kugunda kwa mtima kwamphamvu komanso kofulumira.
• Kusintha kwadzidzidzi kwa kugunda kwa mtima. Mtima wanu ungagunde mofulumira kwa mphindi kapena maola angapo, kenako mwadzidzidzi umayambanso kugunda bwino. (Mtima wa munthu wamkulu umakhala pakati pa kugunda 60 ndi 100 pamphindi.)

Matenda a `PSVT` akachitika, mungakumane ndi zizindikiro zina zingapo:

• Kumva nkhawa komanso chizungulire.
• Kupweteka pachifuwa, kusapeza bwino, kapena kumva ngati chifuwa chagwirana.
• Kuvuta kupuma kapena kupuma movutikira (dyspnea).
• Chizungulire ndi mutu wopepuka, maso abuluu.
• Kutaya chidziwitso (syncope) kapena kukomoka.
• Kutopa kwambiri kapena kutopa.
• Kusanza.

Kodi mungadziwe bwanji ngati muli ndi PSVT?

Mukapita kukaonana ndi dokotala, iye adzakufunsani kaye za zizindikiro zanu ndikumvetsera mtima wanu pogwiritsa ntchito stethoscope. Kenako, adzalamula kuti muyesedwe magazi. Kuyezetsa magazi kumeneku kumayesa momwe chithokomiro chanu chimagwirira ntchito komanso mavuto ena m'magazi mwanu.

Kenako, dokotalayo adzakujambulani electrocardiogram (EKG kapena ECG). Iyi ndi mayeso omwe angachitike mu ofesi ya dokotala ndipo amatenga mphindi 15. EKG imalemba momwe mtima wanu umagwirira ntchito komanso kugunda kwa mtima wanu kudzera mu masensa omwe ali pakhungu lanu. Nthawi zina, ngati mukukumana ndi PSVT panthawi yochita masewera olimbitsa thupi, mungapemphedwe kuti muyesere kupsinjika maganizo.

Ngati EKG sikuwonetsa kugunda kwa mtima kosakhazikika, dokotala wanu mwina angakupatseni chowunikira chomwe chimayenda, chomwe chimadziwikanso kuti Holter monitor kapena patch monitor, kuti muzivale kwa masiku angapo kapena mwezi umodzi. Ichi ndi chipangizo chaching'ono chomwe mungavale m'thupi lanu. Chimalemba nthawi zonse kugunda kwa mtima wanu komanso kugunda kwa mtima kosakhazikika (ngati kulipo).

Kodi PSVT imachiritsidwa bwanji?

Kutengera thanzi lanu lonse ndi zizindikiro zanu, simungafunike chithandizo chilichonse. Ngati muli ndi vuto la mtima (arrhythmia), mudzatumizidwa kwa `cardiologist`. Iye angakulangizeni izi:

• Pewani kumwa mowa ndi caffeine (tiyi, khofi, zakumwa zina zoziziritsa kukhosi). Komanso, siyani kumwa mankhwala ena omwe ali ndi pseudoephedrine, monga mankhwala ochepetsa kutsekeka kwa magazi.
• Gonani bwino ndipo mupumule.
• Imwani madzi ambiri kuti mukhale ndi madzi okwanira.
• Pezani thandizo kuti muchepetse nkhawa ndi nkhawa, ndipo chitani masewera olimbitsa thupi opumula.
• Ngati muli onenepa kwambiri, chepetsani thupi lanu ndipo pitirizani kulemera bwino.
• Ngati mukusuta, siyani kusuta konse.

Komanso, mukakumana ndi vuto la `PSVT` ili, mutha kufunsa dokotala wanu za njira zina zochepetsera kugunda kwa mtima wanu kwakanthawi. Izi zimatchedwa `Vagal maneuvers`. Zitsanzo:

• Kuthira madzi ozizira pankhope panu nthawi imodzi.
• Kutsokomola mwanjira yapadera.
• Tsekani maso anu ndipo pang'onopang'ono pakanikizani maso anu.

Chofunika: Musayesere 'njira zochizira matenda a akazi' izi nokha, popanda kuphunzitsidwa bwino. Muyenera kufunsa dokotala wanu ndikuchita zomwezo monga momwe akulangizirani.

• Njira ina yochitira izi ndi `Valsalva maneuver`. Mu izi, mumapuma mpweya, kukanikiza mphuno yanu, kuigwira ngati kuti mwakhuta, kenako n’kutulutsa mpweya mwachangu, ngati kuti mukutulutsa baluni. Izi zingachepetsenso kugunda kwa mtima wanu pang’ono.

Ngati kugunda kwa mtima wanu kumasintha pafupipafupi, ngati kukupangitsani kusasangalala, kapena ngati muli ndi matenda ena a mtima, dokotala wanu angakulangizeni chithandizo. Mankhwala oterewa ndi awa:

• `Kuchotsa Catheter`:Izi zimaphatikizapo kuwononga pang'ono gawo la minofu ya mtima lomwe limatumiza zizindikiro zamagetsi zosakhazikika. Iyi ndi njira yothandizira yomwe imaphatikizapo kulowetsa chubu chaching'ono (catheter) kudzera mumtsempha, popanda kudula kwakukulu.
• `Massage ya Carotid sinus`: Pachifukwa ichi, dokotala amaika mphamvu pang'ono pamalo enaake pakhosi panu kuti achepetse kugunda kwa mtima wanu. Izi ziyenera kuchitidwa ndi dokotala yekha, ndipo simuyenera kuchita kunyumba.
• Zipangizo: Nthawi zina chipangizo monga `Implantable Cardioverter Defibrillator (ICD), `subcutaneous ICD` kapena `permanent pacemaker` chingalimbikitsidwe kuti chiyikidwe mumtima.
• Kusinthasintha kwa mtima ndi magetsi: Pachifukwa ichi, mtima umapatsidwa mphamvu yotetezeka yamagetsi (kugwedezeka kwa mphamvu), kuletsa kayimbidwe kosasinthasintha ndikulola mtima kugunda bwino.
• Mankhwala: Pali mankhwala omwe angathe kubwezeretsa kayimbidwe ka mtima ndikuletsa kusakhazikika kwa kayimbidwe ka mtima.

Kodi mungachepetse bwanji chiopsezo cha PSVT?

Mwina sizingatheke kupewa PSVT kotheratu. Komabe, mutha kuchepetsa chiopsezo chanu mwa kutsatira moyo wathanzi komanso kukhala ndi thanzi labwino. Nazi zinthu zina zomwe mungachite kuti muchepetse chiopsezo chanu:

• Tsatirani zakudya zabwino zomwe zimalimbitsa mtima ( mulibe mafuta ambiri, mchere, ndi shuga wambiri, komanso muli ndi ndiwo zamasamba zambiri, zipatso, ndi masamba obiriwira).
• Ngati muli ndi zinthu (`zoyambitsa`) zomwe mukudziwa kuti zimayambitsa vuto la `PSVT`, musamazichite.
• Kuchita masewera olimbitsa thupi bwino, pitirizani kuchita masewera olimbitsa thupi, ndipo yesetsani kukhala ndi thanzi labwino.
• Ngati muli onenepa kwambiri, chepetsani thupi, lankhulani ndi dokotala wanu, ndipo pitirizani kulemera kwanu.
• Ngati muli ndi kuthamanga kwa magazi (kuthamanga kwa magazi), chepetsani kuthamanga kwa magazi.
• Sungani mulingo wabwino wa cholesterol.
• Ngati mukusuta, siyani kusuta konse.
• Ngati inu kapena mwana wanu muli ndi vuto la mtima lomwe limawonjezera chiopsezo cha PSVT, lankhulani ndi dokotala wanu za vutoli. Iye adzakupatsani malangizo enieni a momwe mungakhalire ndi thanzi labwino komanso kuchepetsa chiopsezo chanu cha matenda a mtima.

Kodi n’chiyani chimachitikira munthu amene ali ndi PSVT? Kodi tsogolo lake ndi lotani?

Maonekedwe a munthu amene ali ndi PSVT amadalira zinthu zingapo, kuphatikizapo msinkhu wanu komanso thanzi lanu lonse. Mungathandize kuthana ndi zizindikiro zanu mwa kusintha moyo wanu komanso zakudya zanu.

Pakapita nthawi, PSVT imatha kufooketsa minofu ya mtima. Pa milandu yoopsa, PSVT ingayambitse kutaya chidziwitso komanso kulephera kwa mtima mwadzidzidzi. Chifukwa chake, ngati muli ndi PSVT, ndikofunikira kwambiri kukaonana ndi dokotala nthawi zonse kuti muwone momwe mtima wanu ulili.

Nkhani yabwino ndi yakuti nthawi zambiri, PSVT imatha kuchiritsidwa kwathunthu ndi chithandizo chotchedwa catheter ablation.

Kodi ndiyenera kupita liti kwa dokotala wokhudzana ndi PSVT?

Ngati muli ndi nkhawa iliyonse yokhudza kugunda kwa mtima wanu, kapena ngati muli ndi zizindikiro za kugunda kwa mtima kosakhazikika (arrhythmia), onetsetsani kuti mwalankhula ndi dokotala. Ngati mwapezeka ndi PSVT, ndikofunikira kwambiri kukaonana ndi dokotala wanu wa mtima nthawi zonse.

Ngati zinthu izi zitachitika, funsani upangiri wa dokotala nthawi yomweyo:

• Ngati mwadzidzidzi mwatopa kwambiri popanda chifukwa chomveka.
• Ngati mukumva kukomoka kapena kutaya chikumbumtima.
• Ngati mukumva kupweteka pachifuwa, kupuma movutikira, kapena kupuma movutikira.

Pomaliza, zomwe muyenera kukumbukira (Uthenga Wopita Nawo Kunyumba)

Paroxysmal Supraventricular Tachycardia (PSVT) ingakhale yoopsa ikachitika. Komabe, nthawi zambiri siimakhala yoopsa kapena yoopsa. Komabe, ngati muli ndi nkhawa kapena mafunso okhudza kugunda kwa mtima wanu, nthawi zonse ndibwino kupita kwa dokotala kuti akakufufuzeni mokwanira kuti muwonetsetse kuti palibe vuto lalikulu la thanzi.

Ngakhale kuti PSVT si nthawi zonse imafuna chithandizo, pali mankhwala omwe alipo ngati mukuwafuna. Mwa kukhalabe otanganidwa, kuchepetsa zinthu monga caffeine ndi mowa, kutsatira moyo wathanzi, komanso kuonana ndi dokotala wanu wa mtima pa nthawi yake, mutha kuchepetsa chiopsezo chanu cha mavuto ochokera ku PSVT. Chifukwa chake, samalirani mtima wanu, chifukwa ndi magazi anu!

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