Unonzwa dzungu kamwe kamwe, chipfuva chako chichirova, maziso ako akaita bhuruu, uye unonzwa sekunge wava kuda kufa here? Dzimwe nguva izvi zvinogona kuva chiratidzo chekurova kwemoyo kune njodzi. Nhasi tiri kutaura nezvechimwe chirwere chisingawanzoitiki asi chinogona kuva nengozi. Chinonzi Torsades de Pointes (izwi rechiFrench, rinodaidzwa kuti "torsades de pointes"). Zita racho rinogona kunzwika serisinganzwisisike, asi zvakakosha kuziva zvarinoreva uye zvarinogona kuita.
Zvichitaurwa zviri nyore, chii chinonzi Torsades de Pointes?
Uku kurira kwemoyo kunokurumidza, kusina kujairika, uye kune njodzi kunotanga mumakamuri maviri epasi emwoyo wako (ventricles). Kutaura chokwadi, iyi imhando yakasarudzika yekurova kwemoyo nekukurumidza (Ventricular Tachycardia). Kazhinji, kurova kwemoyo wemunhu ane hutano kunosvika pakati pe60 ne100 kurova paminiti. Zvisinei, kana chirwere ichi chikaitika, kurova kwemoyo kunogona kuwedzera kusvika pakurova 150 kusvika 300 paminiti .
Izvi zvine njodzi nekuti pane mukana wekufa kamwe kamwe nemwoyo pasina yambiro .
Kana ukatarisa EKG yako (electrocardiogram), pane patani chaiyo iyo vanachiremba vanoona mumamiriro ezvinhu aya. Ipatani yemafungu anotenderera mberi nekudzoka, se coil. Izwi rechiFrench rekuti "Torsades de Pointes" rinoreva "kutenderera kwenzvimbo." Rinowana zita raro kubva pakutenderera kwe EKG.
Dambudziko iri rinowanzoitika kana paine rimwe dambudziko mukushanda kwemagetsi kwemoyo. Rinonzi nguva refu yeQT. Zvichitaurwa zviri nyore, nguva yeQT inguva inotora kuti makamuri epasi emoyo wako arove kamwe chete wobva wagadzirira kurova kunotevera. Kana nguva iyi yakareba zvisingawanzoitiki (QT refu), kurova kwekuwedzera kunogona kuitika, zvichikonzera Torsades de Pointes.
Ndezvipi zviratidzo zvechirwere ichi?
Chinhu chinotyisa apa ndechekuti hafu yevanhu vane chirwere ichi havana zviratidzo . Avo vanowana zviratidzo vanogona kusangana nezvinotevera. Unofanira kungwarira zvikuru nezvazvo.
| Chiratidzo | Tsananguro iri nyore |
|---|---|
| Dzungu | Izvi zvinoitika kana mwoyo usingapombi ropa nemazvo, zvichikonzera kudzikira kweropa rinoenda kuuropi. |
| Kurova kwemwoyo | Unotanga kunzwa moyo wako uchirova nekukurumidza kana kuti zvisina kurongeka. |
| Kusava nemusoro | Ndiri kunzwa sekunge ndava kuda kurasikirwa nepfungwa. |
| Kufenda | Zvinogona kukonzerwa nekumbomira kwenguva pfupi kweropa kuenda kuuropi. |
| Kusungwa kwemwoyo | Ichi chirwere chine njodzi zvikuru. Moyo unongoerekana wamira kurova. |
Sei izvi zvichiitika? Ndezvipi zvikonzero?
Kune zvikonzero zviviri zvikuru zveizvi.
1. Zvikonzero zvekuzvarwa nazvo: Vamwe vanhu vanozvarwa vaine chirwere chemajini chinonzi `Long QT Syndrome`. Izvi zvinoreva kuti vane chirwere ichi mumhuri mavo. Vanhu ava vari panjodzi huru yekubatwa nechirwere cheTorsades de Pointes.
2. Zvikonzero zvinotevera: Izvi ndizvo zvinonyanya kuitika. `Nguva yeQT` inogona kuwedzerwa nekushandisa mimwe mishonga uye kudzikira kwemazinga e electrolytes mumuviri. Izvi zvinowedzera njodzi yeTorsades de Pointes.
Mishonga inowedzera njodzi:
- Mimwe mishonga inodzora kurova kwemoyo (Antiarrhythmics)
- Mamwe maantibayotiki
- Mimwe mishonga yekurutsa (Antiemetics)
- Mishonga inorwisa fungus
- Mishonga inorwisa pfungwa (antipsychotics) mishonga inoshandiswa kurapa zvimwe zvirwere zvepfungwa.
- Mimwe mishonga yekurapa kenza
Zvakakosha: Kana uri kutora mishonga yerudzi urwu, usavhunduke. Havasi vese vanozosangana nedambudziko iri. Asi zvakakosha kutaura nachiremba wako nezvazvo uye kuziva njodzi dzacho.
Ndezvipi zvinhu zvinokonzera njodzi iyi?
Vamwe vanhu vane mukana mukuru wekuwana chirwere ichi. Zvinhu izvi zvine njodzi ndeizvi:
- Kuva nechirwere chinonzi `Long QT Syndrome`.
- Kuva nezvimwe zvirwere zvemoyo.
- Kuva mukadzi (vakadzi vari panjodzi huru)
- Kuva nemakore anopfuura makumi matanhatu nemashanu ekuberekwa.
- Kusashanda zvakanaka kwethyroid.
- Ndatambura nesitiroko.
- Kushandisa diuretics.
- Kurova kwemoyo kunonoka (Bradycardia).
- Kushomeka kwecalcium, magnesium, kana potassium mumuviri.
- Kurutsa zvakanyanya kana kuti manyoka.
Njodzi yacho inogona kuderedzwa here?
Ehe, unogona zvechokwadi. Pane zvinhu zvishoma zvaunogona kuita:
- Kana mumwe munhu mumhuri yako aine `Long QT Syndrome`, zviongorore iwe pachako. Kana uine chirwere ichi, ona chiremba wemwoyo usati watanga chirongwa chekurovedza muviri.
- Chenjerera nezvemishonga yaunotora: Kana uri kutora mushonga unogona kuwedzera nguva ye 'QT interval', bvunza chiremba wako kana uchigona kutora mumwe mushonga panzvimbo pezvo. Paunotanga mushonga mutsva, bvunza chiremba wako kuti ave nechokwadi chekuti hauzokonzere matambudziko nemushonga wauri kutora parizvino.
- Funga nezvekudya kunovaka muviri: Kana chiremba wako akakurudzira, wedzera calcium, magnesium, uye potassium yako.
- Inwa mushonga wako nenguva: Kuti chirwere ichi chisadzokorore, shandisa mushonga wacho sezvawakarairwa nachiremba wako.
- Inwa mvura yakawanda: Chengetedza huwandu hwemvura nemunyu mumuviri.
- Ziva kurova kwemoyo wako: Dzidza kuti kurova kwemoyo kwakajairika chii uye kuti ungakuyera sei.
- Kana wakapihwa muchina wekutarisa moyo: Kana chiremba wako akakupa muchina wekutarisa moyo wekupfeka kumba, iva nechokwadi chekuupfeka.
Kuongororwa kwechirwere kunoitwa sei?
Nzira huru yekuziva izvi ndeyekuongororwa kwe `EKG` (Electrocardiogram) . Vanachiremba vanogona kuziva izvi nekutarisa patani yakasiyana ye `twisted` uye nguva refu ye `QT` inoonekwa pa `EKG`.
Uye zvakare, bvunzo idzi dzinogona kuitwawo:
- Kuongororwa kweropa: Tarisa huwandu hwema electrolytes mumuviri, akadai se magnesium ne potassium.
- Echocardiogram: Kuongororwa kwemoyo kunoongorora chimiro uye mashandiro emoyo.
- Chinoongorora moyo: Mudziyo unopfekwa kwemazuva akati wandei uye unogara uchiongorora rhythm yemoyo.
Inorapwa sei?
Kurapwa kunoenderana nechikonzero chechirwere ichi. Munhu ane chirwere cheLong QT Syndrome chaakaberekwa nacho achada kurapwa kwenguva refu kupfuura munhu ane chirwere chinokonzerwa nemishonga.
| Rudzi rwekurapwa | Tsananguro |
|---|---|
| Mishonga | |
| Kumisa mushonga uri kukonzera dambudziko | Chinhu chekutanga ndechekuti chiremba arege kushandisa mushonga waanofunga kuti ndiwo uri kukonzera izvi. |
| Magnesium uye/kana potassium | Kana huwandu hwemunyu uyu mumuviri hwakaderera, unopinzwa netsinga kuti udzoke pahunhu hwawo. |
| Beta-blockers | Inopihwa kudzora kurova kwemoyo uye kune avo vane `Long QT Syndrome'. |
| Dzimwe nzira nezvishandiso (Maitiro) | |
| Chinopa simba remoyo | Kune avo vane mwoyo yakaderera, mudziyo mudiki unoiswa kuti urambe uri muchimiro chakakodzera. |
| ICD (Implantable Cardioverter Defibrillator) | Ichi chishandiso chinoiswa mumuviri. Kana chikaona kuti mwoyo une njodzi, chinoerekana charova nemagetsi kuti mwoyo udzokere pakare. |
| Kuchinja kweMwoyo neMagetsi/Kuchinja kweMwoyo neMagetsi | Kana paine dambudziko, kurova chipfuva nemagetsi kuti mwoyo udzorere kurova kwemoyo kwakajairika. |
Ndinofanira kuona chiremba rini?
Kana ukaona zviratidzo zvakaita sekurova kwemwoyo nekukurumidza, kurwadziwa pachipfuva, dzungu, maziso ebhuruu, kana kurasikirwa nepfungwa, enda kuchipatara kuEmergency Department (ETU) nekukasika. Uku kurwadzisa.
Kana uchifanira kugara muchipatara nekuda kweTorsades de Pointes, unofanira kuenda kumba kuti unoongororwa mushure memavhiki maviri. Sezvo ichi chiri chirwere chine njodzi yekufa kamwe kamwe, zvakakosha kuti ugare uchitariswa nachiremba wemwoyo nguva dzose.
Unogona kubvunza chiremba wako mibvunzo iyi:
- Ndakazvarwa ndiine chirwere cheLong QT Syndrome here, kana kuti chinokonzerwa nemishonga?
- Mikana ipi yekuti chirwere ichi chingaitikewo kune vamwe vanhu mumhuri mangu?
- Pane mumwe mushonga wandingatora panzvimbo pewakonzera njodzi iyi here?
Nekurapwa, chirwere ichi chinogona kudzorwa uye unogona kurarama hupenyu hwakanaka. Zvisinei, kana chikasarapwa, chinogona kuuraya. Saka, zvakakosha kutevedzera mirairo yachiremba wako nemazvo uye kuenda kumakiriniki pamazuva akarongwa.
Mharidzo Yekuenda Nayo Kumba
- Torsades de Pointes mutinhimira wemwoyo unokurumidza zvikuru uye unotyisidzira hupenyu.
- Izvi zvinogona kukonzerwa nechirwere chemajini (`Long QT Syndrome`) kana kuti nemimwe mishonga uye kushomeka kwemunyu mumuviri.
- Kana uine zviratidzo zvakaita sekurwadziwa pachipfuva kamwe kamwe, dzungu, kana kurasikirwa nepfungwa, idambudziko. Enda kuETU (Emergency Treatment Unit) nekukasika.
- Usamborega kutora mushonga wako kana kuchinja mwero wemushonga usina kurairwa nachiremba wako.
- Kana chirwere ichi chikaonekwa, kurapwa nguva dzose uye kuteverwa nachiremba wemwoyo kwakakosha.
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