Ingabe inhliziyo yakho izwa sengathi ishaya ngokushesha okukhulu? Ake sifunde nge-A-fib ene-RVR! (I-Atrial Fibrillation ene-RVR)

Wake wazizwa sengathi inhliziyo yakho ishaya sengathi iyahlanya, noma uzizwa sengathi unomuzwa ongajwayelekile esifubeni sakho? Noma uzizwa sengathi unenkinga yokuphefumula noma unesiyezi? Lokhu kungase kungabi nje ezinye izinto. Namuhla sizokhuluma ngalolu hlobo lwenkinga oluvela enhliziyweni, okungukuthi, isimo lapho inhliziyo ishaya ngokungajwayelekile futhi ngokushesha okukhulu, esibizwa ngokuthi `(Atrial Fibrillation with Rapid Ventricular Rate)` noma `(A-fib with RVR)` ngamafuphi. Ungesabi, kubaluleke kakhulu ukuqaphela lokhu.

Iyini ngempela i-A-fib ene-RVR?

Kalula nje, `(A-fib with RVR)` yisimo lapho isigqi senhliziyo yakho, noma iphethini yokushaya, iba yinto engajwayelekile. Sinezindawo ezimbili eziphezulu enhliziyweni yethu, esizibiza ngokuthi i-atria. Lezi `(atria)` yilapho izimpawu zikagesi ezitshela inhliziyo ukuthi ishaye ziqala khona. Kodwa kumuntu one-`(Atrial Fibrillation)`, lezi zimpawu zikagesi ziyaphazamiseka, azihlelekile, futhi izindawo eziphezulu `(atria)` ziqala ukufinyela ngokushesha okukhulu. Kunjengokungathi othile ushaya isigubhu njengohlanya.

Manje lezi zimpawu zikagesi eziphithizelayo ziya emakamelweni amabili aphansi enhliziyo, ama-ventricle. Bese ukushaya kwalawo ma-ventricle kuba okungajwayelekile futhi kusheshe kakhulu . Yilokho okubizwa ngokuthi "i-A-fib ene-RVR". Lokho kusho ukuthi inhliziyo ishaya izikhathi ezingaphezu kwe-100 ngomzuzu.

Cabanga ngakho njengephampu yamanzi. Uma ingasebenzi kahle, ayikwazi ukupompa igazi elilidingayo emzimbeni. Yilokho okwenzekayo uma une-`(A-fib ene-RVR)`. Inhliziyo ayinaso isikhathi esanele sokugcwalisa igazi kahle, ngakho ayikwazi ukupompa igazi elinomoya-mpilo elanele emzimbeni.

Sivame kangakanani lesi simo?

Ungase ucabange ukuthi lesi yisifo esithinta abantu abambalwa kakhulu. Kodwa empeleni, i-"Atrial Fibrillation" yisimo esivame kakhulu phakathi kokuphazamiseka kwe-cardiac rhythm. Uma ubheka izibalo ezweni elifana neMelika, izigidi zabantu zihlushwa yilesi simo. Lesi simo sibonakala kakhulu naseSri Lanka.

Ziyini izimpawu zalokhu? Ungakubona kanjani?

Akuwona wonke umuntu obhekana nezimpawu ezifanayo. Abanye abantu bangase babe nalesi simo ngaphandle kwezimpawu. Kodwa-ke, kunezimpawu ezithile ezivamile:

• Ukushaya kwenhliziyo : Kungase kuzwakale sengathi inhliziyo yakho ishaya noma ishaya esifubeni sakho.
• Isiyezi : Kungase kuzwakale sengathi ikhanda lakho liyazungeza, ngezinye izikhathi kuze kube sezingeni lokuthi awukwazi ukuma.
• Ukuquleka: Abanye abantu bangase balahlekelwe ingqondo futhi bawe uma lesi simo sibi kakhulu.
• Ubuhlungu besifuba : Isifuba singase sizwakale sengathi siyancipha noma siyacindezela.
• Ukuphelelwa umoya : Hhayi nje kuphela uma ukhathele kancane, kodwa ngisho noma umile nje, ungase uzizwe sengathi uphelelwa umoya.
• Ukukhathazeka okuvamile`(Ukukhathazeka)`: Ungase uzizwe ukwesaba nokukhathazeka ngaphandle kwesizathu.
• Ukukhathala : Kungakhathaliseki ukuthi ulala kangakanani, ungase uzizwe ukhathele futhi ungenampilo.

Lezi zimpawu zingaba zincane kakhulu ngezinye izikhathi, futhi zibe zimbi kakhulu ngezinye izikhathi. Ngakho-ke uma uhlangabezana nanoma yini efana nale, kungcono ukubona udokotela .

Kungani lokhu kwenzeka? Yiziphi izizathu?

Kunezici eziningana ezingabangela i-'A-fib ene-RVR'. Eziyinhloko yilezi:

• Isifo semithambo yenhliziyo: Lokhu kusho ukuvaleka kwemithambo yegazi ehambisa igazi enhliziyweni.
• Umfutho wegazi ophakeme : Sonke siyalazi igama elithi "umfutho wegazi ophakeme".
• Ukwehluleka kwenhliziyo : Inhliziyo ayikwazi ukupompa igazi elanele emzimbeni.
• I-obstructive sleep apnea: Ukuyeka ukuphefumula ngesikhathi sokulala ngenkathi uhona.
• Ukuhlinzwa kwenhliziyo: Le ngozi ingase iqhubeke izinsuku eziningana noma amasonto ngemva kokuhlinzwa kwenhliziyo.

Ubani osengozini enkulu yalokhu?

Abanye abantu banamathuba amaningi okuthola lesi simo. Bheka ukuthi uwela kulesi sigaba yini:

• Abantu abangaphezu kweminyaka engama-50 ubudala : Le ngozi iyanda njengoba iminyaka ikhula.
• Abantu abane-body mass index (BMI) engaphezu kuka-30 : Lokhu kusho ukuthi bakhuluphele kakhulu uma kuqhathaniswa nobude babo.
• Abantu abane-obstructive sleep apnea.
• Abantu abaphuza utshwala obuningi : Ingozi iphezulu uma uphuza utshwala obuningi nsuku zonke noma njalo.
• Abantu abaphuza i-caffeine eningi kakhulu : Akukuhle futhi ukuphuza ikhofi noma itiye eningi kakhulu emini.
• Uma othile emndenini wakho eke waba ne-"A-fib" : Kungase kube nethonya lofuzo.

Khumbula: Ukuba nesinye noma ngaphezulu salezi zici eziyingozi akusho ukuthi nakanjani uzoba ne-"A-fib ene-RVR". Kodwa-ke, kubalulekile ukuzazi lezi zinto.

Yiziphi izinkinga ezingabangelwa yilokhu?

Uma i-`A-fib ene-RVR` ingelashwa kahle, kungase kube nezinkinga ezithile eziyingozi.

• Isikhathi esinciphile sokuba amakamelo angaphansi enhliziyo agcwale igazi.
• Imisipha yenhliziyo idinga umoya-mpilo owengeziwe .
• I-Cardiomyopathy : Isimo lapho imisipha yenhliziyo iba buthakathaka futhi ikhule khona.
• Isifo sohlangothi : Isifo sohlangothi singaba khona uma kwakheka ihlule legazi enhliziyweni bese liya ebuchosheni, livimbe umthambo wegazi. Lena inkinga eyingozi kakhulu .
• Umfutho wegazi ophansi .
• Ukwehluleka kwenhliziyo okubangelwa ukuminyana.

Yingakho kubalulekile ukuqaphela lesi simo nokufuna ukwelashwa ngokushesha.

Kuhlolwa kanjani lokhu? Yiziphi izivivinyo ezenziwayo?

Uma unezimpawu ezishiwo ngenhla, uma ubona udokotela, uzokuxilonga, akubuze ngomlando wakho wezokwelapha, bese eyalela ukuhlolwa okuningana ukuqinisekisa isimo.

Ukuhlolwa okuvame kakhulu yile:

• I-Electrocardiogram (ECG noma EKG) : Lokhu kurekhoda umsebenzi kagesi wenhliziyo. Kungabona ngokucacile ukuthi kukhona yini `(A-fib ene-RVR)`.
• I-Echocardiogram : Lokhu kufana nokuskena kwenhliziyo nge-ultrasound. Kungahlola ukuthi amakamelo nama-valve enhliziyo asebenza kahle yini, nokuthi inhliziyo inkulu kangakanani.
• I-cardiac CT scan noma i-MRI scan : Lokhu kunganikeza ulwazi oluningiliziwe mayelana nesakhiwo senhliziyo.
• Ukuhlolwa kwegazi : Lokhu kusiza ekutholeni izinto ezifana nezinkinga ze-thyroid kanye nezinguquko kuma-electrolyte egazini.

Iyini indlela yokwelapha lokhu?

Izindaba ezinhle ukuthi kunezindlela zokwelapha ezisebenzayo ze-A-fib nge-RVR. Udokotela wakho unemigomo emibili eyinhloko: ukulawula izimpawu zakho, nokuvimbela izinkinga ezishiwo ngenhla ukuthi zingabi khona.

Okulandelayo kusetshenziswa kakhulu njengokwelashwa:

• Ukulinganisela Ama-Electrolyte : Njengoba ukwanda noma ukwehla kwama-electrolyte njenge-potassium ne-magnesium emzimbeni kungathinta isigqi senhliziyo, ukwelashwa kusetshenziswa ukuze kugcinwe kahle.
• Imithi : Ukwelashwa okuyinhloko kwalokhu imithi.

Yimiphi imithi/ukwelashwa okusetshenziswayo?

Kunezinhlobo eziningana zemithi enikezwa i-'A-fib ene-RVR':

• Ama-Beta-blocker : Isibonelo, i-metoprolol (i-Lopressor® noma i-Toprol®XL). Lawa asebenza ngokunciphisa kancane izinga lokushaya kwenhliziyo nokunciphisa ingcindezi enhliziyweni.
• Ama-calcium channel blockers : Isibonelo, i-diltiazem (i-Diltzac® noma i-Cardizem®). Lolu hlobo lomuthi luphinde lwehlise izinga lokushaya kwenhliziyo ngokulawula ukungena kwe-calcium emangqamuzaneni emisipha yenhliziyo.
• Imithi yokulwa nokushaya kwenhliziyo : Isibonelo, i-amiodarone (i-Pacerone® noma i-Cordarone®) noma i-digoxin (i-Lanoxin® noma i-Cardoxin®). Lokhu kusiza ukubuyisela isigqi senhliziyo esingajwayelekile.

Into ebaluleke kakhulu! Uma une-`(A-fib)`, kunethuba elikhulu lokuthi kwakheke amahlule egazi ngaphakathi kwenhliziyo. Uma la mahlule egazi eya ebuchosheni, kungenzeka ukuthi kube ne-`(Stroke)`. Ngakho-ke, ama-anticoagulant , noma lokho esikubiza ngokuthi "ama-blood thinners", cishe njalo anikezwa.

Kwabanye abantu abangakwazi ukuqhubeka nokusebenzisa le mithi yokunciphisa igazi, inqubo ekhethekile ebizwa ngokuthi ukuvalwa kwe-left atrial appendage ingenziwa ukuze kuvinjelwe ukwakheka kwamahlule egazi.

Ngezinye izikhathi kunzima ukulawula lesi simo ngemithi yodwa. Ezimweni ezinjalo, kungadingeka ezinye izindlela zokwelapha:

• Ukususwa kwe-catheter : Lokhu kuhilela ukuthola izindawo zenhliziyo lapho kuvela khona izimpawu zikagesi ezingaguquki, nokudlulisa i-catheter encane (ithubhu elincane) emlenzeni noma engalweni iye enhliziyweni, 'kukhubaza' izindawo lapho kuvela khona izimpawu ezingaguquki. Khona-ke izimpawu ezingaguquki ziyayeka ukuza.
• I-Pacemaker : Abanye abantu banesisetshenziswa esincane esifakwe ngaphansi kwesikhumba ukulawula ukushaya kwenhliziyo yabo. Lokhu kubizwa ngokuthi i-pacemaker. Sithumela izimpawu zikagesi enhliziyweni, ikakhulukazi uma ukushaya kwenhliziyo kuhamba kancane.
• Ukuguqulwa kwenhliziyo ngogesi : Lokhu kuhilela ukunikeza isidambisi-zinhlungu esifushane kanye nokuletha ukushaqeka kukagesi okulawulwa ngaphandle enhliziyweni, okubuyisela ngokushesha isigqi senhliziyo.
• Inqubo ye-Maze : Lena inqubo eyinkimbinkimbi kancane. Kwenziwa ukusikwa okuncane e-atria yenhliziyo ukuze kudalwe izindlela ezifanele zokuhamba kwezimpawu zikagesi. Lokhu kuvame ukwenziwa ngesikhathi sokuhlinzwa kwenhliziyo okunye.

Ingabe ikhona imiphumela emibi yokwelashwa?

Njenganoma yikuphi ukwelashwa kwezokwelapha, imiphumela ethile emibi noma izinkinga zingavela ngalokhu kwelashwa kwe-`(A-fib with RVR)`. Kodwa-ke, akwenzeki kuwo wonke umuntu, futhi ngokuvamile zincane.

• Kusukela emithini : Abanye abantu bangase babe nezinto ezifana nekhanda elibuhlungu, umfutho wegazi ophansi, isiyezi, kanye nokuphazamiseka kwesisu.
• Izinqubo ezifana nokususwa kwe-catheter zingabangela i-cardiac tamponade noma, ngokungavamile, ukuhlaselwa yinhliziyo.
• Ama-pacemaker ngezinye izikhathi angasebenzi kahle.
• Ukushaya kwenhliziyo noma "i-A-fib" kungase kuphinde kwenzeke izinyanga eziningana ngemva kwenqubo ye-Maze .

Udokotela wakho uzokwazisa ngalokhu. Asikho isidingo sokukhathazeka, ngoba odokotela bahlala bezama ukunciphisa lezi zingozi.

Ngizozizwa ngingcono ngokushesha kangakanani ngemva kokwelashwa?

Lokhu kuncike kakhulu ekwelashweni okutholayo. Eminye imithi, njengemithi ye-intravenous (IV), ingasiza ekunciphiseni ukushaya kwenhliziyo yakho futhi iqale ukuzizwa ingcono ngemizuzu embalwa . Eminye imithi ingathatha isikhathi eside ukusebenza. Into ebaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo.

Ngingayinciphisa kanjani le ngozi?

Kunezinto eziningana ongazenza ukuze unciphise ingozi yakho yokuthola i-`(A-fib ene-RVR)`. Lezi azigcini nje ngokuba zinhle kulesi simo, kodwa futhi nasempilweni yakho iyonke:

• Vivinya umzimba ngesivinini esimaphakathi okungenani imizuzu eyi-150 ngesonto : ukuhamba, ukugibela ibhayisikili, noma ukubhukuda kuhle.
• Yidla ukudla okunempilo kwenhliziyo: Faka imifino, izithelo, ubhontshisi, okusanhlamvu okuphelele, nenhlanzi ekudleni kwakho. Nciphisa uwoyela, usawoti, noshukela.
• Nciphisa ukusetshenziswa kotshwala : Kungcono ukunciphisa utshwala ngangokunokwenzeka.
• Gwema imikhiqizo kagwayi ngokuphelele : Uma ubhema, yeka.
• Uma unezinye izimo zezokwelapha ezifana nomfutho wegazi ophakeme, i-cholesterol ephezulu, i-sleep apnea, noma isifo sikashukela, zilawule kahle.

Uma ngine-`(A-fib ene-RVR)`, yini okufanele ngiyilindele?

Ukuthola ukuthi une-`(A-fib ene-RVR)` kungaba yinto eshaqisayo. Kodwa khumbula, lesi yisimo esingalawulwa futhi ungaphila impilo enhle . Into ebalulekile ukusungula imikhuba enempilo okukhulunywe ngayo ekuqaleni, uphuze imithi udokotela wakho ayinikezayo ngqo, bese ucela ukwelashwa okukhethekile uma kudingeka.

Uma ingelashwa, ingaholela ezimweni ezimbi kakhulu njengesifo senhliziyo, ukwehluleka kwenhliziyo, noma isifo sohlangothi. Ukwelashwa okufana nokususwa kwe-catheter kuye kwabonakala kuphumelele kubantu abaningi. Inqubo ye-Maze inezinga lempumelelo elingu-80% kuya ku-90%, futhi inganikeza impumuzo yesikhathi eside ezimpawini.

Lesi simo sizohlala isikhathi esingakanani?

"(I-A-fib ene-RVR)" yisimo esingase sithathe iminyaka eminingi. Kwabanye abantu, ukuvama nobude balesi simo kunganda ngokuhamba kwesikhathi. Yingakho kubalulekile ukuqhubeka nokulandela iseluleko sikadokotela wakho nokuhlolwa njalo.

Ngizinakekela kanjani?

Impilo yakho isezandleni zakho. Khumbula lokhu:

• Thatha yonke imithi oyinikezwe udokotela wakho ngesikhathi esifanele. Ungaphuthelwa usuku olulodwa.
• Bona udokotela wakho ngesikhathi sokuqokwa okuhleliwe kokulandelela. Kubaluleke kakhulu ukubona ukuthi unjani.
• Vivinya umzimba njalo. Ngisho nento elula njengokuhamba nsuku zonke ingathuthukisa ikhwalithi yempilo yakho futhi ikusize wenze imisebenzi yansuku zonke kalula.

Kufanele ngimbone nini udokotela?

Uma uphinda uhlangabezana nanoma yiziphi zalezi zimpawu, noma uma uhlangabezana nezintsha, bona udokotela ngokushesha:

• Ubuhlungu besifuba.
• Uma izinga lokushaya kwenhliziyo yakho lingaphezu kwama-beats ayi-100 ngomzuzu uma uphumule.
• Isiyezi.
• Ubunzima bokuphefumula.

Kufanele ngiye nini e-Emergency Treatment Unit (ETU) ?

Uma unalezi zimpawu, kufanele uye e-Emergency Treatment Unit (ETU) ngokushesha :

• Izimpawu zesifo sohlangothi : Ikhanda elibuhlungu kakhulu ngokuzumayo, ukubona okufiphele, ubunzima bokukhuluma, ubunzima bokuhamba, kanye nokugoba kolunye uhlangothi lobuso.
• Ukopha ngokweqile ngenxa yokunciphisa igazi: Ukuhlanza okubomvu, ukuphuma kwendle ebomvu noma emnyama, ukuphuma komchamo obomvu.
• Ubuhlungu besifuba noma ezinye izimpawu zokuhlaselwa yinhliziyo noma ukumiswa kwenhliziyo : Ukuphefumula kanzima, ukungakhululeki esiswini okukhulu, kanye nokujuluka.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma uvakashela udokotela wakho, ungabuza le mibuzo ukuze uthole ukuqonda okucacile ngesimo sakho:

• Kukangaki ngidinga ukubona udokotela (ukulandelela)?
• Kuthatha isikhathi esingakanani ukubona imiphumela yezinguquko zendlela yokuphila?
• Yimuphi umuthi ongincoma wona? Iyini imbangela yalokho?
• Ingabe kufanele ngithole ukwelashwa okufana nokuhlinzwa kwenhliziyo, ukuhlinzwa kwe-ablation, noma inqubo ye-maze?

Ukuzwa ukushaya kwenhliziyo okungajwayelekile kungaba yinto ekhathazayo. Kodwa-ke, kunezindlela zokwelapha ezisebenzayo zalesi simo esibizwa ngokuthi "i-A-fib ene-RVR". Udokotela wakho angakusiza ukhethe ukwelashwa okufanele wena. Ngokubona udokotela wakho ngesikhathi nangokuthatha imithi oyinikezwe njengoba uyalelwe, ungasiza ekuvikeleni impilo yakho.

Umyalezo Ofanele Uwuthathe Ekhaya: Izinto Ezibaluleke Kakhulu Okufanele Uzikhumbule

Kulungile, ake sifingqe ezinye zezinto okudingeka uzikhumbule kulokho esikhulume ngakho:

• ``(A-fib with RVR)`` yisimo lapho isigqi senhliziyo singajwayelekile futhi sishaya ngokushesha okukhulu.
• Uma uhlangabezana nezimpawu ezifana nokuqina kwesifuba, isiyezi, noma ubunzima bokuphefumula , qiniseka ukuthi ufuna iseluleko sikadokotela.
• Lokhu kungabangelwa yizinto eziningana, okuhlanganisa umfutho wegazi ophakeme kanye nesifo senhliziyo.
• Isifo sohlangothi singenye yezinkinga eziyingozi kakhulu zalokhu, ngakho-ke kubaluleke kakhulu ukuthatha imithi yokunciphisa igazi.
• Kunezindlela ezahlukene zokwelapha, njengemithi kanye nokususwa kwe-catheter.
• Izinguquko zendlela yokuphila enempilo (ukudla kahle, ukuzivocavoca, nokuyeka ukubhema) zisiza kakhulu ekulawuleni lesi simo.
• Phuza imithi njengoba nje udokotela emyalile. Landela udokotela ngezinsuku ezihleliwe.
• Uma uhlangabezana nezimpawu zesixwayiso eziphuthumayo (izimpawu zokuhlaselwa yisifo sohlangothi, ukopha okukhulu, ubuhlungu obukhulu besifuba) , hamba esibhedlela ngokushesha.

Awuwedwa. Baningi abantu abaphila nalesi simo. Ngokwelashwa okufanele nendlela yokuphila, nawe ungaphila impilo enempilo. Ungesabi ukukhuluma nodokotela bakho uxazulule izinkinga zakho.

Ukushaya kwenhliziyo okusheshayo , isifo senhliziyo, i-A-fib, i-RVR, ukushaya kwenhliziyo okusheshayo, ubuhlungu besifuba, isifo sohlangothi