Masaini emagetsi emwoyo wako akavharwawo here? Ngatitaurei nezveBifascicular Block!

Dzimwe nguva unongoerekana wava nemaziso ebhuruu wonzwa dzungu here? Kana kuti unonzwa sekuti moyo wako uri kurova nekukurumidza kana kuti zvishoma nezvishoma? Pamwe mumwe munhu waunoziva akasangana nechimwe chinhu chakadai. Dzimwe nguva izvi zvinogona kukonzerwa nekukanganisika kudiki muhurongwa hwemagetsi emwoyo yedu, sehurongwa hwemagetsi mumba. Nhasi, tichataura nezvemamiriro ezvinhu akakosha apo chiratidzo chemagetsi chinofamba zvishoma nezvishoma kana kukanganiswa muzvikamu zviviri muzvitatu zvenzira huru muhurongwa hwemagetsi emoyo - izvo zvinonzi (Bifascicular Block) .

Chii ichi (Bifascicular Block)? Ngatinzwisise zviri nyore?

Zvichitaurwa zviri nyore, `(Bifascicular Block)` rudzi rwechivharo chemwoyo. Kuti mwoyo wedu ushande sepombi, unofanirwa kugamuchira zviratidzo zvemagetsi nenzira yakarongeka. Zviratidzo zvemagetsi izvi zvinofamba munzira dzakakosha mumoyo. Tinodana nzira idzi kuti `bundle branches``. Zvakafanana newaya dziri mumba dzinoda kubatidza mwenje.

Fungidzira kuti kune nzira nhatu huru mumoyo medu dzinotakura mashoko aya emagetsi. Mu "Bifascicular Block" (Block yeBifascicular), zviratidzo zvemagetsi zvinofamba zvishoma nezvishoma kana kuti zvinokanganiswa munzira mbiri idzi nhatu. "Bi" zvinoreva "mbiri". "Fascicle" zvinoreva matavi emasero emhasuru dzemwoyo. Saka, kana paine kuvharika munzira mbiri idzi, zviratidzo zvemagetsi zvinotumirwa kunonoka kumakamuri epasi emwoyo ("ventricles"). Izvi zvinogona kuchinja mutinhimira wemwoyo uye nzira yaunopomba nayo ropa.

Vanachiremba vanoti izvi "kuvharika kwemoyo kusina kukwana." Dambudziko iri rinogona kukonzerwa nechirwere chemwoyo chekuzvarwa nacho kana zvimwe zvirwere zvemoyo. Dzimwe nguva, zviratidzo zvinogona kupera. Zvisinei, nyaya yakakura yeBifascicular Block inokonzera zviratidzo ingada kurapwa.

Mafascicle aya ari kupi mumoyo medu?

Unoziva kuti mwoyo wedu une makamuri makuru mana. Makamuri maviri epamusoro anonzi atria, uye makamuri maviri epasi anonzi maventricles. Makamuri aya anogumira uye anokura nenzira inodzorwa kuti apombe ropa mumuviri wese.

Kuvharika kwezvikamu zviviri (bifascicular block) kunokanganisa makamuri epasi aya, kana kuti maventricles.

• Vhiki yekurudyi: Iri riri pasi kurudyi kwemoyo. Ndiyo inotora ropa roritumira kumapapu kuti riwane okisijeni. Vhiki yekurudyi iyi ine nzira imwe chete huru yemagetsi (fascicle) - ndiko kutiBazi repaketi rekurudyi .
• Ventricular yekuruboshwe : Iyi iri kurutivi rwezasi rwekuruboshwe rwemoyo. Ndiyo imba huru uye yakasimba yekupomba mumoyo. Inotora ropa rine oxygen yoripomba kuenda kumuviri wese kuburikidza neaorta . Ventricular yekuruboshwe ine nzira mbiri huru dzemagetsi: yekuruboshwe anterior fascicle uye yekuruboshwe posterior fascicle . Pamwe chete, idzi mbiri dzinoumba bazi reruboshwe bundle. Idzi dzinopatsanurana kuita mamiriyoni efibers madiki anonzi Purkinje fibers.

Chii chinonzi Heart Block neBundle Branch Block?

Kuvharika kwemoyo kunoitika kana paine dambudziko nehurongwa hwemagetsi hwemoyo. Izvi zvinokonzera kunonoka kwekutumira masaini emagetsi pakati pemakamuri emwoyo. Nekuda kweizvozvo, makamuri emwoyo anogumira nekuda kwemutinhimira. Izvi zvinokanganisa kuyerera kweropa mumoyo, kurova kwemoyo, uye kurova kwemoyo.

`(Heart Block)` uye `(Atrioventricular Block / AV Block)` mamiriro akafanana. `(Bundle Branch Block)` rudzi rwe`(Heart Block).` Zvinoitika kana paine kuvharika mune rimwe rematavi emapazi atakataura nezvawo.

Magetsi ari mumoyo medu anoshanda sei? Zvinoshamisa, handiti?

Fungidzira kuti mukati memoyo mune sisitimu yekubatanidza waya yakaoma kwazvo, asi yakarongeka. Heino kurongeka kunoita chiratidzo ichi chemagetsi:

1. Chiratidzo chinotanga panzvimbo yakakosha muatrium yepamusoro yemoyo inonzi SA node. Iyi ndiyo pacemaker yechisikigo yemoyo.

2. Chiratidzo ichi chinobva chafamba nemuatria chosvika pane imwe nzvimbo yakakosha inonzi AV node.

3. Mushure meAV node, chiratidzo chinopinda munzira inonzi bundle of His.

4. Kubva ipapo, inopatsanurana kuita bazi repamusana rekurudyi nebazi repamusana rekuruboshwe, uye pakupedzisira inoenda kune shinda diki dzinonzi ``Purkinje fibers`` dziri mumasero ``ventricles``.

5. Kana chiratidzo ichi chagamuchirwa, maventricle anogumburwa uye anopomba ropa. Zvadaro maitiro acho anotanga zvakare kubva pakutanga.

Zvese izvi zvinoitika mukati memasekonzi mashoma, zvinoshamisa, handiti?

Kune mhando dzema heart blocks here?

Ehe, vanachiremba vanoronga mablock emwoyo aya (AV blocks) zvichienderana nekuoma kwawo:

• Kuvharika kwedanho rekutanga: Uku kunonoka kudiki kwemagetsi kubva kuatria kuenda kumaventricle. Zvisinei, rudzi urwu rwekuvharika haruwanzo kukonzera zviratidzo uye haruwanzodi kurapwa.
• Kuvharika kwedanho rechipiri: Apa ndipo panovharika mamwe masaini emagetsi, asi kwete ese, kuti asasvike mumasero. Izvi zvinogona kukonzera kurova kwemoyo kunononoka ( bradycardia ) kana kurova kwemoyo kusina kurongeka (arrhythmia). Kana izvi zvakakomba kana zvichikonzera zviratidzo zvinonetsa, kurapwa kungadiwa.
• Chivharo chedhigirii rechitatu: Izvi zvinonziwo "chivharo chemwoyo chakazara." Pano, hapana hukama huripo pakati pekushanda kweatria nemaventricles. Izvi zvinoreva kuti makamuri epamusoro anoshanda sezvaanofanira, uye makamuri epasi anoshanda sezvaanofanira. Mumamiriro ezvinhu aya, pacemaker inofanira kuiswa. Kana "chivharo chebifascicular" chikakura, chirwere ichi chinogona kukura.

Kune mhando dzakasiyana dzeBifascicular Block here?

Ehe, kune mapatani akasiyana e`(Bifascicular Block)`. Anonyanya kuzivikanwa ndeaya:

• Chivharo chebazi cheruboshwe rwerudyi nebhuroko repamberi reruboshwe.
• Uyewo, panogona kunge paine branch block yekurudyi uye branch yekumashure yefascicular yekuruboshwe.
• Dzimwe nguva, bazi rekuruboshwe rinogona kuvharika zvachose (zvichireva kuti mativi ese ekuruboshwe ekumberi neekumashure akavharika, asi bazi rekuruboshwe rekurudyi harina kuvharika).

Dambudziko iri rakajairika zvakadii?

Bifascicular Block inowanikwa muvanhu vanosvika 1.5% vanoitwa ECG . Izvi hazvirevi kuti hazviwanzoitiki.

Sei izvi (Bifascicular Block) zvichiitika? Ndezvipi zvinokonzera?

Kuvharika kwemoyo muzvikamu zviviri (Bifascicular Block) kunowanzo kukonzerwa nechirwere chemwoyo chakaberekwa nacho. Izvi zvinoreva kuti munhu anozvarwa aine shanduko muchimiro chemwoyo. Dzimwe nguva, zviratidzo zvechirwere ichi chemwoyo chakaberekwa nacho zvinogona kuoneka gare gare, zvichida mudiki kana pakati nepakati. Njodzi yekuvharika kwemoyo inowedzerawo nekukwegura .

Kashoma, chirwere ichi chinogonawo kukonzerwa nekuchinja kwemajini (gene mutation) kunopfuudzwa kubva kumhuri kuenda kumhuri. Izvi zvinonzi progressive familial heart block. Kuchinja kwemajini uku kunogona kukonzera mavanga (fibrosis) kana calcium deposits (calcification) mumoyo. Kuchinja uku kunogonawo kukonzera kuvharika kwemoyo.

Pamusoro pezvo, ``Bifascicular Block`` inogonawo kukonzerwa nekukuvara kwemoyo. Kukuvara uku kunogona kuva:

• Nekuda kwechirwere chemwoyo (myocardial infarction).
• Nekuda kwezvimwe zvirwere zvemwoyo .
• Nekuda kwechirwere chevharuvhu yemoyo .
• Nekuda kwehuwandu hwakawanda hwe potassium muropa (hyperkalemia).

Ndezvipi zviratidzo zveBifascicular Block? Iwe unayowo here?

Kuvharika kwemoyo kusina kukwana (kwedhigirii rekutanga kana rechipiri) kungasakonzera zviratidzo. Zvisinei, kana zviratidzo zvikaitika, chiratidzo chikuru chinowanikwa nevanhu vazhinji kufenda (syncope). Izvi zvinoitika kana kurova kwemoyo kuchinonoka (bradycardia) kana kunonoka (arrhythmia) nekuti ropa harisi kupombwa zvakanaka mumuviri.

Dzimwe nguva, `(Bifascicular Block)` inogona kufambira mberi kusvika pakuvhara kwakazara (dhigirii rechitatu). Kana zvakadaro, zviratidzo zvinowanzoonekwa. Zvakakosha kutsvaga rubatsiro rwechiremba nekukasika kana uine chimwe chezviratidzo zvinotevera:

• Kurwadziwa kwechipfuva kana kusimba (angina).
• Dzungu.
• Kunzwa kuneta kwakanyanya nguva dzose.
• Kunzwa moyo uchirova zvisina kujairika (kurova kwemoyo).
• Kusvotwa.
• Kushaya mweya.

Ndezvipi zvinetso zvinogona kukonzera izvi?

Kuvharika kwemoyo kunokanganisa kugona kwemoyo kupomba ropa mumuviri wese. "Bifascicular Block" (block isina kukwana) dzimwe nguva inogona kufambira mberi kusvika padanho rechitatu (yakazara). Kana izvi zvikaitika, matambudziko akadai se:

• Kurova kwemoyo kusina kurongeka (Arrhythmia).
• Kumira kurova kwemoyo.
• Kukundikana kwemoyo.
• Kufa kamwe kamwe kwemwoyo / kumira kamwe kamwe kwemoyo.

Usazvidya moyo! Havasi vese vanozosangana nematambudziko aya. Mazano akakodzera ekurapa uye kurapwa kunogona kuderedza njodzi iyi zvikuru.

Ungaongorora sei Bifascicular Block nemazvo?

Muedzo mukuru wekuongorora Bifascicular Block iECG. Izvi zvinonziwo EKG. Izvi zvinoyera mashandiro emagetsi emwoyo wako. Muedzo uyu uri nyore kwazvo, usingarwadzi. Unotora maminetsi angangoita gumi nemashanu.

Chiremba achaisa zvidhindo zvidiki (zvinonzi maelectrode) pachipfuva chako, maoko, nemakumbo. Waya dzakabatana nemaelectrode aya dzakabatana nemuchina weECG. Muchina uyu unonyora mashandiro emagetsi emoyo wako segirafu. Maelectrode haatumire magetsi mumuviri wako. Pane kudaro, anongoyera mashandiro emagetsi mumuviri wako. Nekutarisa girafu iyi, chiremba anogona kuona kana paine shanduko kana kuvharika kwechiratidzo chemagetsi chemoyo.

Pane kurapwa here? Chii chingaitwe?

Kana uine `(Bifascicular Block)` uye usina zviratidzo, ungasada kurapwa. Zvisinei, chiremba wako achanyatsoongorora hutano hwemwoyo wako. Vanogona kuita bvunzo dze`(ECG)` nguva dzose kuti vaone kana chirwere chiri kuipa uye chichikura kuita third-degree (complete heart block) block. Kana izvozvo zvikaitika, kurapwa kunodiwa.

Asi kana uine kurova kwemoyo kusina kurongeka (arrhythmia) kana zviratidzo zvakaita sekufenda (syncope), chiremba wako anogona kukurudzira kuvhiyiwa kuti uise pacemaker . Kune mhando mbiri dze pacemaker:

• Zvinobatsira mwoyo: Izvi zvinotumira masaini emagetsi kumakamuri emwoyo kuti arambe achirova zvine mutinhimira, sekunge zvichipa moyo rubatsiro rwakawedzerwa.
• MaICD (ICDs) Anogadziriswa Nesimba Remoyo: Anoshanda semuchina wekubatsira pacemaker. Pamusoro pezvo, ICD inogona kuona kurova kwemoyo kusina kurongeka uye kuigadzirisa nekupa kurohwa kwemoyo nemagetsi. Inogona zvakare kutangazve moyo kana mwoyo ukangoerekana wamira.

Midziyo iyi inoiswa nachiremba wemwoyo (electrophysiologist).

Pane nzira dzekudzivirira Bifascicular Block here?

Kutaura chokwadi, kune zvinhu zvakawanda zvinogona kukonzera kutadza kushanda kwemoyo zvatisingagoni kudzora, zvakaita sechirwere chemwoyo chatinozvarwa nacho kana kukwegura.

Zvisinei, unogona nguva dzose kutora matanho ekuchengetedza hutano hwemwoyo wako. Izvi zvinosanganisira:

• Kana uchisvuta, kumbira rubatsiro kuti urege. Dzivisa kunyangwe utsi hwemunhu anosvuta.
• Idya chikafu chine hutano uye tanga tsika yekurovedza muviri zuva nezuva.
• Deredza kunwa doro.
• Dzora zvirwere zvinokuvadza mwoyo zvakaita seBP, chirwere cheshuga, uye cholesterol yakakwira.
• Tsvaga nzira dzakanaka dzekugadzirisa kushushikana.
• Edza kuchengetedza huremu hwakanaka.

Kunyange zvazvo zvinhu izvi zvingasatadzise zvachose kukura kwe `(Bifascicular Block), zvichabatsira kuchengetedza hutano hwemwoyo wako wese huri mumamiriro akanaka.

Tingararama nemamiriro ezvinhu aya here? Ndeipi tarisiro?

Vanhu vazhinji vane Bifascicular Block havadi kurapwa. Kunyangwe kana zvichidikanwa kurapwa, zviratidzo zvinowanzopera mushure mekunge pacemaker yaiswa.

Kana ukarapa zvakanaka, njodzi yekuti chirwere ichi chirambe chichivhara mwoyo zvachose yakaderera. Kutaura zvazviri, kukuvara kunogona kukonzerwa nekurova kwemoyo kusina kurongeka (arrhythmia) kwakakura kupfuura kukuvara kunokonzerwa nekurova kwemoyo. Saka, zvakakosha kutsvaga mazano echiremba panguva yakakodzera uye kuwana kurapwa kana zvichidikanwa.

Ndinofanira kuona chiremba nguvai?

Kana uine chimwe chezviratidzo zvinotevera kana kupfuura, enda kuna chiremba nekukasika:

• Kunzwa kuneta zvakanyanya.
• Kurova kwemoyo kusina kurongeka.
• Kurwadziwa kwakanyanya pachipfuva.
• Kutadza kufema zvakanaka.
• Zviratidzo zvechirwere chemwoyo (semuenzaniso, kurwadziwa kwakanyanya pakati pechipfuva kunoyerera pasi peruoko).
• Kusvotwa pasina chikonzero.

Ndeipi mibvunzo inokosha yekubvunza chiremba?

Paunoenda kunoona chiremba, unogona zvakare kubvunza mibvunzo iyi:

• Sei ndakawana iyi `(Bifascicular Block)`?
• Chii chandinofanira kuita kuti ndideredze njodzi yangu yekubatwa nechirwere chemwoyo kana chimwe chirwere chemwoyo?
• Ndinoda pacemaker kana ICD here?
• Ndeipi njodzi dzekuisirwa pacemaker kana ICD?
• Ndinofanira kunetseka nezvematambudziko here? Zviratidzo zvacho ndezvipi?

Kubvunza mibvunzo iyi kuchakubatsira kunzwisisa zviri nani mamiriro ako ezvinhu uye kujekesa zvekuita zvinotevera.

Chekupedzisira, zvinhu zvaunofanira kurangarira

Kuvharika kweropa mumoyo kunokanganisa nzira mbiri panzira nhatu huru dzinotakura masaini emagetsi. Izvi zvinogona kuchinja mutinhimira wemoyo uye nzira yaunopomba nayo ropa. Vamwe vanhu vanogona kunge vasina zviratidzo, nepo vamwe vangaona zviratidzo zvakaita sekufenda.

Chinhu chinonyanya kukosha kusatya nezveizvi, asi kutsvaga mazano akakodzera ekurapa. Izvi zvinogona kuonekwa nekuongororwa kuri nyore senge ECG. Kana zvichidikanwa, chirwere ichi chinogona kudzorwa zvinobudirira nekurapwa senge pacemaker. Chengetedza moyo wako, rarama mararamiro ane hutano, uye unogona kuramba uine hutano!