Matenda a Imfa Yosayembekezereka (SAD)

Kodi munamvapo za munthu wina amene anamwalira mwadzidzidzi ali wachinyamata komanso wathanzi? Kodi munayamba mwadzifunsapo kuti zimenezo zingachitike bwanji? Nthawi zina zimatha chifukwa cha vuto lomwe tikambirane lero lotchedwa Sudden Arrhythmic Death Syndrome (SADS) . Ichi ndi chinthu choopsa kwambiri, koma ndikofunikira kudziwa za icho.

Kodi matenda a imfa ya mtima mwadzidzidzi (SADS) ndi chiyani?

Mwachidule, uwu ndi matenda a mtima. Nthawi zambiri, ndi chinthu chomwe mumalandira cholowa , zomwe zikutanthauza kuti chikhoza kuperekedwa kuchokera ku mibadwomibadwo. Chomwe chimachitika pamenepa ndi chakuti pali vuto ndi makina amagetsi mumtima mwanu. Taganizirani izi, mtima wathu umagwira ntchito ngati jenereta yaying'ono. Ndi zizindikiro zamagetsi zomwe zimapangitsa mtima kugunda bwino. Chifukwa chake, pakakhala vuto ndi makina awa, kayimbidwe ka mtima kamakhala kosazolowereka . Ngati izi sizikuthandizidwa bwino, mungafunike kukumana ndi imfa yadzidzidzi. Ndicho chifukwa chake ndizoopsa.

Kodi mitundu ikuluikulu ya SADS ndi iti?

Pali mitundu ingapo ya SADS. Iliyonse ya izo ili ndi kusiyana pang'ono. Tiyeni tiwone mitundu ina yayikulu:

• Matenda a Brugada: Uwu ndi mkhalidwe umene zipinda zapansi za mtima, zotchedwa atria, zimakhala ndi kugunda kwa mtima kofulumira komanso kosasinthasintha (polymorphic ventricular tachycardia).
• Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT): Iyi ndi matenda omwe maselo a mtima amagunda mofulumira komanso mosagwirizana. Matendawa amatha kuchitika makamaka panthawi yochita masewera olimbitsa thupi kapena kupsinjika maganizo.
• Matenda a Long QT (LQTS): Apa ndi pamene minofu ya mtima wanu imatenga nthawi yayitali kukonzekera kugunda kwina, ndiko kuti, kubwezeretsanso mphamvu (kubwezeretsa mphamvu kapena kubwezeretsanso mphamvu). Zili ngati batire yomwe imatenga nthawi yayitali kubwezeretsanso mphamvu. Mukayang'ana EKG, kusiyana pakati pa mafunde a Q ndi T kumatchedwa nthawi ya QT. Nthawi iyi ikakhala yayitali kwambiri, maselo a mtima amatha kuyamba kugunda mofulumira kwambiri (ventricular tachycardia) kapena mosakhazikika (ventricular fibrillation).
• Matenda a QT afupi (SQTS): Izi ndi zosiyana ndi QT yayitali. Zimatanthauza kuti maselo a mtima amatenga nthawi yochepa kwambiri kuti akonzekere kugunda kwina. Izi zingayambitse zipinda zapamwamba za mtima (atrial fibrillation) kugunda molakwika, kapena zipinda zapansi (ventricular tachycardia) kugunda mofulumira, kapena kugwedezeka molakwika (ventricular fibrillation).
• Matenda a Timothy: Uwu ndi matenda osowa kwambiri. Ndi mtundu wa matenda a QT aatali.
• Matenda a Wolff-Parkinson-White (WPW):Apa ndi pamene njira yowonjezera, yosazolowereka imapangidwa kuti zizindikiro zamagetsi ziziyenda pakati pa zipinda zapamwamba (atria) ndi zipinda zapansi (mitra). Izi zimawonjezera pa njira yachizolowezi, yomwe ingayambitse mtima kugunda mofulumira kwambiri (tachycardia).

Kodi matenda a SADS amenewa ndi ofala bwanji?

Izi sizofala kwambiri, koma sizipezekanso. Mwachitsanzo, matenda a QT (LQTS) omwe atchulidwa kale akuti amakhudza pafupifupi mwana m'modzi mwa ana 2,000 obadwa kumene. Matenda a Brugada ndi osowa kwambiri, ndipo amakhudza anthu ochepera 1% mwa anthu onse. Matenda otchedwa CPVT amakhudza munthu m'modzi mwa anthu 10,000.

Koma, monsemo, anthu pafupifupi 200,000 amafa chifukwa cha kumangidwa kwa mtima mwadzidzidzi (SCA) chaka chilichonse ku United States kokha. Palinso malipoti akuti ana ndi achinyamata pafupifupi 4,000 amafa chifukwa cha matenda a SADS chaka chilichonse. Ndiye, si chinthu chaching'ono, eti?

Kodi zizindikiro za SADS ndi ziti?

Ngakhale kuti pali mitundu yosiyanasiyana ya matenda a SADS, pali zizindikiro zina zodziwika bwino. Komabe, anthu ena sangakumane ndi zizindikiro zilizonse.

Zizindikiro zodziwika bwino:

• Kukomoka kapena kugwidwa ndi khunyu kungachitike panthawi yochita masewera olimbitsa thupi, kapena mukasangalala kwambiri kapena mukuchita mantha.
• Kupweteka pachifuwa kungachitike panthawi yochita masewera olimbitsa thupi.
• Mungathe kupuma movutikira panthawi yochita masewera olimbitsa thupi.

Tsopano tiyeni tiwone zizindikiro zosiyanasiyana zomwe zimagwirizana ndi mtundu uliwonse wa SADS.

Zizindikiro za Brugada syndrome

Ngakhale anthu ambiri alibe zizindikiro, ena angakumane ndi izi:

• Kulephera kwa mtima kungachitike, makamaka pamene munthu akugona.
• Kukomoka.
• Kugwedezeka.
• Kachitidwe kosayenera ka kupuma.

Zizindikiro za catecholaminergic polymorphic ventricular tachycardia (CPVT)

Sipangakhale zizindikiro mpaka matenda a mtima atayamba, koma anthu ena amatha kukomoka akamachita masewera olimbitsa thupi.

Zizindikiro za Long QT Syndrome (LQTS)

Pafupifupi theka la anthu omwe ali ndi LQTS alibe zizindikiro. Koma anthu ena:

• Kusakhazikika kwa mtima kotchedwa Torsades de Pointes kungayambitse matenda a mtima.
• Kukomoka.
• Kugwedezeka.

Zizindikiro za Short QT Syndrome (SQTS)

Anthu pafupifupi 40% omwe ali ndi vutoli alibe zizindikiro zilizonse. Koma ena:

• Kugunda kwa mtima .
• Kukomoka.
• Matenda amtima.

Zizindikiro za matenda a Timothy

Zinthu zomwe zimawoneka mu izi ndi izi:

• Kukomoka.
• Matenda amtima.
• Nthawi zina pamakhala zala ndi/kapena zala zokhala ndi ukonde.
• Nkhani za chitukuko.

Zizindikiro za matenda a Wolff-Parkinson-White (WPW)

Zizindikiro za WPW ndi izi:

• Kugunda kwa mtima.
• Kumva chizungulire (kufooka mutu).
• Kuvuta kupuma.
• Kukomoka.
• Kugwedezeka.

Chofunika: Ngati inu kapena munthu amene mumamudziwa ali ndi chimodzi mwa zizindikiro izi, muyenera kufunsa upangiri wa dokotala.

Kodi zifukwa za SADS ndi ziti?

Kawirikawiri, wachinyamata akamwalira mwadzidzidzi, ndipo kapangidwe ka mtima wake kakuoneka bwino akamafufuzidwa, madokotala amakayikira kuti anali ndi vuto la mtima losakhazikika lomwe silinadziwike, lomwe ndi vuto la kugunda kwa mtima kosakhazikika. Matenda a SADS omwe amayambitsa matenda a mtima amenewa, omwe tidakambirana kale, nthawi zambiri amapatsirana kuchokera kwa kholo kupita kwa mwana . Izi zikutanthauza kuti, amachokera ku majini. Kuthekera kwa matenda amenewa kupatsirana kwa ana kumatha kusiyana kutengera jini yomwe ikukhudzidwa komanso gawo la mtima lomwe lakhudzidwa.

Kodi madokotala amapeza bwanji SADS?

Ngati wachinyamata ali ndi zizindikiro zomwe zatchulidwa pamwambapa, ndipo ngati wina m'banja mwake adamwalira mwadzidzidzi mosayembekezereka asanakwanitse zaka 40, dokotala angaganize kuti ndi SADS. Njira zodziwira matenda zimasiyana malinga ndi mtundu wa SADS.

Njira zodziwira matenda zomwe zimagwiritsidwa ntchito kwambiri:

• Electrocardiogram (EKG): Izi zimayesa ntchito yamagetsi ya mtima.
• Kuyesa majini: Kuyesa uku kukuwonetsa kusiyanasiyana kwa majini komwe kumakhudzana ndi SADS.
• Kuyesa kupsinjika kwa Treadmill: Izi zimayesa momwe mtima umayankhira kuchita masewera olimbitsa thupi.
• Kuyesa kwa Catecholamine: Mankhwala apadera amaperekedwa ndipo momwe mtima umayankhira zimawonedwa.
• Chowunikira cha Holter: Chipangizo chomwe chimalemba kugunda kwa mtima mosalekeza kwa maola pafupifupi 24.
• Echocardiogram: Iyi ndi ultrasound scan yomwe imayang'ana kapangidwe ndi ntchito ya mtima.
• Kujambula kwa mwana wosabadwayo (fetal ultrasound): Izi zitha kuchitika mwana akadali m'mimba.
• Kuyesa kwa catheterization ya mtima: Kuyesa komwe chubu chopyapyala chimayikidwa mumtima.
• Kafukufuku wa zamagetsi: Mu kafukufukuyu, mawaya opyapyala amalowetsedwa mumtima kuti aone mozama momwe magetsi a mtima amagwirira ntchito.

Kodi mankhwala a SADS ndi otani?

Mankhwala amasiyana malinga ndi mtundu wa SADS, kotero ndikofunikira kudziwa mtundu weniweni wa matenda omwe muli nawo.

Chithandizo cha matenda a Brugada

• Chotsukira mtima choyimitsidwa (ICD): Ichi ndi makina ang'onoang'ono omwe amaikidwa pansi pa khungu. Ngati kugunda kwa mtima kwasintha kwambiri, chimayambitsa kugwedezeka pang'ono kwamagetsi kuti chibwezeretse kugunda kwa mtima.
• Mankhwala monga Quinidine .
• Pewani kugwiritsa ntchito mankhwala omwe amatseka njira za sodium mumtima.

Chithandizo cha Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT)

• Anthu awa amapatsidwa mtundu wa mankhwala otchedwa beta-blockers .
• Ngati pakufunika, ICD idzaikidwa.

Chithandizo cha Long QT Syndrome (LQTS)

Izi zitha kuchitika ndi zinthu monga mankhwala kapena opaleshoni:

• Beta-blockers.
• ICD .
• Kuchepetsa kuvulala kwa mtima kumanzere: Iyi ndi opaleshoni yochepa kwambiri yomwe imadula ndikuchotsa mitsempha ina yodziyimira payokha yomwe imapita kumtima.
• Pewani kugwiritsa ntchito mankhwala ena omwe amawonjezera nthawi ya QT pa EKG yanu.

Chithandizo cha Short QT Syndrome (SQTS)

Pali mankhwala ndi chida chochitira izi:

• ICD .
• Quinidine.

Chithandizo cha matenda a Timothy

Izi zimagwiritsanso ntchito mankhwala ndi chipangizo:

• Beta-blockers.
• ICD .
• Pewani kugwiritsa ntchito mankhwala omwe amawonjezera nthawi ya QT pa EKG yanu.

Chithandizo cha matenda a Wolff-Parkinson-White (WPW)

Mankhwala angathandize kupewa zizindikiro za WPW. Palinso njira yotchedwa ablation therapy . Izi zimawononga njira yowonjezera yamagetsi. Izi nthawi zina zimatha kuchiritsa kwathunthu WPW. Madokotala amaperekanso mankhwala otchedwa antiarrhythmics kuti achepetse chiopsezo cha kugunda kwa mtima kosazolowereka.

Kodi pali zotsatirapo zilizonse pa mankhwala awa?

Inde, mankhwala ena akhoza kukhala ndi zotsatirapo zazing'ono.

• Anthu ena angavutike kupirira ma beta-blockers omwe dokotala wawo wawapatsa.
• Pambuyo pa opaleshoni ya kumanzere ya mtima yokhudza sympathetic denervation :
• Kutuluka thukuta kosazolowereka.
• Manja ouma.
• Kusintha kwa kutentha kapena mtundu m'malo ena a nkhope.
• Koma opaleshoni iyi ingathandize kwambiri kuti moyo ukhale wabwino.
• Chifukwa chipangizo cha ICD chimayambitsa kugwedezeka kwamagetsi kuti chibwezeretse kamvekedwe ka mtima, chingakhale chosasangalatsa pang'ono. Komanso:
• Matenda angachitike.
• Chipangizocho sichingagwire ntchito bwino.

Kodi ndingachepetse bwanji chiopsezo changa? Kodi SADS ingapewedwe?

Ngati wina m'banja mwanu ali ndi SADS, achibale ena ayenera kuchita CPR.Ngati mukudziwa momwe mungachitire izi, komanso ngati muli ndi Automatic External Defibrillator (AED) kunyumba, zingakhale zotonthoza kwambiri kwa munthu amene ali ndi SADS. Chifukwa ndi bwino kudziwa kuti pali winawake woti akuthandizeni pakagwa ngozi.

Ngakhale kuti SADS singathe kupewedwa kotheratu, ngati wina m'banja mwanu wapezeka ndi vutoli, ndikofunikira kuyezetsa kuti muwone ngati ali ndi kusintha kwa majini. Mutha kulankhula ndi dokotala wanu kuti mudziwe yemwe ayenera kuyezetsa. Munthu akapezeka ndi vutoli, njira zitha kutengedwa kuti mutetezedwe, kaya ndi mankhwala kapena mankhwala ena.

Kodi tsogolo la munthu amene ali ndi SADS ndi lotani?

Zimatengera mtundu wa matenda a SADS omwe muli nawo, momwe amadziwira msanga, komanso momwe chithandizo chimayambidwira mwachangu. Ndi vuto la moyo wonse , ndipo nthawi zina limatha kupha .

Komabe, anthu omwe ali ndi matenda a Wolff-Parkinson-White (WPW) ali ndi chiyembekezo chabwino kwambiri chifukwa chithandizo cha ablation chingathetse vutoli. Anthu omwe amalandira chithandizo cha matenda a QT (LQTS) omwe ali ndi chiopsezo chochepa cha imfa yadzidzidzi. Komabe, anthu ambiri omwe angapindule ndi ablation ya ventricle yakumanzere sapindula. Pali kafukufuku wochepa kwambiri pa matenda monga short QT syndrome (SQTS) , chifukwa pali odwala ochepa (pafupifupi 200) omwe ali ndi vutoli.

Choncho, kafukufuku wowonjezereka akufunika kuti apeze mankhwala abwino kwambiri kwa aliyense amene ali ndi SADS.

Kuika ICD kungateteze imfa yadzidzidzi ya mtima chifukwa kumachiza kugunda kwa mtima kosazolowereka. Ngakhale sikuchiritsa vutoli, ndi njira yothandiza yochepetsera chiopsezo cha imfa chifukwa cha matenda amenewa.

Ngati muli ndi SADS, kodi mumadzisamalira bwanji?

• Ngati dokotala wanu wakupatsani mankhwala, imwani monga momwe mwalangizidwira, osaphonya tsiku limodzi. Izi ndi zomwezo kwa mwana yemwe ali ndi SADS. Ayenera kupatsidwa mankhwala awo pa nthawi yake, ndipo si bwino kusiya kumwa mankhwala amodzi.
• Nthawi zonse funsani dokotala wanu kapena wamankhwala musanayambe mankhwala atsopano. Mankhwala ambiri, kuphatikizapo maantibayotiki wamba ndi mankhwala oletsa nseru, amatha kuyanjana ndi mankhwala anu a mtima. Angakhudzenso nthawi ya QT, zomwe zimawonjezera chiopsezo cha imfa yadzidzidzi kwa munthu yemwe ali ndi matenda a QT a nthawi yayitali.
• Mvetsetsani momwe ICD yanu (kapena ya mwana wanu) imagwirira ntchito. Komanso, dokotala wanu ayesedwe nthawi zonse. Njira zina zamankhwala ndi zida zamagetsi za tsiku ndi tsiku zimatha kusokoneza magwiridwe antchito a ICD yanu. Chifukwa chake, dziwani zomwe muyenera kupewa.
• Ngati mwana wanu ali ndi SADS, funsani dokotala ngati angathe kusewera masewera okhudzana ndi vuto lake.

Kodi muyenera kupita kuchipatala liti? Kodi muyenera kupita kuchipatala chadzidzidzi liti?

Ngati muli ndi SADS, kuyezedwa pafupipafupi ndikofunikira kwambiri. Izi ndi kuonetsetsa kuti mukumwa mankhwala okwanira. Ngati mwana wanu ali ndi SADS, mlingo wa mankhwalawo ungafunike kuwonjezeredwa pamene akukula ndikukula thupi. Ichi ndichifukwa chake ndikofunikira kwambiri kuti ana aziyezedwa pafupipafupi. Ngati muli ndi ICD, pitani kwa dokotala wanu osachepera kawiri pachaka.

Pakagwa mwadzidzidzi:

• Ngati wina ali ndi vuto la mtima , imbani 911 (kapena nambala yadzidzidzi ya dziko lanu) nthawi yomweyo ndikuchita CPR.
• Ngati mukukumana ndi zizindikiro izi, pitani ku chipinda chodzidzimutsa kapena imbani 911 nthawi yomweyo:
• Ngati mukumva kukomoka, chizungulire, kapena kuthamanga kwa mtima.
• Ngati mukumva kupweteka pachifuwa mwadzidzidzi kapena kupuma movutikira.

Kodi ndi mafunso otani ofunika kufunsa dokotala wanu?

Ngati inu kapena wina m'banja mwanu ali ndi SADS, ndikofunikira kwambiri kufunsa dokotala wanu mafunso awa:

• Kodi ndili ndi mtundu wanji wa SADS?
• Kodi mumalimbikitsa chithandizo chanji pa vuto langa?
• Kodi mungandithandize kudziwa kuti ndani m'banja langa amene akufunika kuyezetsa izi?
• Kodi ndikufunika defibrillator?
• Kodi pali mankhwala aliwonse omwe ndiyenera kupewa ndi vuto langa?

Pomaliza, kumbukirani zinthu izi!

Ngakhale kuti SADS ndi matenda oopsa, kuidziwa bwino ndikuchita zinthu zoyenera kungakuthandizeni inu ndi okondedwa anu. Kudziwa bwino matenda anu kungakuthandizeni kumvetsetsa zomwe mungachite. Gwirani ntchito ndi dokotala wanu kuti musankhe chithandizo chomwe chili chabwino kwa inu kapena wokondedwa wanu. Kuyezetsa pafupipafupi, makamaka ngati muli ndi ICD, ndikofunikira. Kukhala ndi AED kunyumba ndikuonetsetsa kuti aliyense akudziwa momwe angagwiritsire ntchito ndikuchita CPR kungakuthandizeni inu ndi banja lanu. Musachite mantha, kudziwa bwino ndiye chitetezo chabwino kwambiri.

` Matenda a Imfa Yosayembekezereka ya Arrhythmic, SADS, matenda a mtima, kugunda kwa mtima kosazolowereka, matenda a majini, imfa yadzidzidzi, dongosolo lamagetsi la mtima