Ingabe izimpawu zikagesi zenhliziyo yakho nazo zivaliwe? Ake sixoxe nge-Bifascicular Block!

Ingabe ngezinye izikhathi uvele ube namehlo aluhlaza okwesibhakabhaka bese uzizwa unesizungu ? Noma uzizwa sengathi inhliziyo yakho ishaya ngokushesha kakhulu noma ihamba kancane? Mhlawumbe othile omaziyo uke wabhekana nento efana nale. Ngezinye izikhathi lokhu kungabangelwa ukuphazamiseka okuncane ohlelweni lukagesi lwenhliziyo yethu, njengohlelo lokuxhuma izintambo endlini. Namuhla, sizokhuluma ngesimo esikhethekile lapho isignali kagesi ihamba kancane noma iphazamiseka cishe ezingxenyeni ezimbili kwezintathu zezindlela eziyinhloko ohlelweni lokuxhuma izintambo zikagesi lwenhliziyo - lokho kubizwa ngokuthi (i-Bifascicular Block) .

Kuyini lokhu (i-Bifascicular Block)? Ake sikuqonde kalula?

Kalula nje, `(Bifascicular Block)` uhlobo lwe-heart block. Ukuze inhliziyo yethu isebenze njengepompo, idinga ukuthola izimpawu zikagesi ngendlela ehlelekile. Lezi zimpawu zikagesi zihamba ngezindlela ezikhethekile enhliziyweni. Sibiza lezi zindlela ngokuthi `amagatsha e-bundle``. Kufana nezintambo endlini edinga ukukhanyisa izibani.

Ake sithi kunezindlela ezintathu eziyinhloko enhliziyweni yethu ezithwala le miyalezo kagesi. Ku-"Bifascicular Block"`, izimpawu zikagesi zihamba kancane kakhulu noma ziphazamiseka ezindleleni ezimbili zalezi ezintathu. Igama elithi "Bi" lisho "ezimbili". Igama elithi "Fascicle" libhekisela emagatsheni amakhulu amangqamuzana emisipha yenhliziyo. Ngakho-ke, uma kukhona ukuvaleka kwezimbili zalezi zindlela, izimpawu zikagesi zithunyelwa sekwephuzile kancane emakamelweni aphansi enhliziyo ("ama-ventricles"). Lokhu kungashintsha isigqi senhliziyo nendlela epompa ngayo igazi.

Odokotela bakubiza lokhu ngokuthi “ukuvinjwa kwenhliziyo okungaphelele.” Lesi simo singabangelwa yisifo senhliziyo esizalwa naso noma ezinye izimo zenhliziyo. Ngezinye izikhathi, izimpawu zingase ziphele. Kodwa-ke, icala elibi le-Bifascicular Block elibangela izimpawu lingadinga ukwelashwa.

Zikuphi lezi zifanekiso ezinhliziyweni zethu?

Uyazi ukuthi inhliziyo yethu inezindawo ezine eziyinhloko. Amakamelo amabili aphezulu abizwa ngokuthi i-atria, kanti amakamelo amabili aphansi abizwa ngokuthi ama-ventricle. La makamelo ayafinyela futhi anwebeke ngendlela elawulwayo ukuze aphompe igazi emzimbeni wonke.

Ukuvimba kwe-bifascicular kuthinta la makamelo aphansi, noma ama-ventricle.

• I-ventricle yesokudla: Lena itholakala ohlangothini olungezansi lwesokudla lwenhliziyo. Yiyo ethatha igazi bese ilithumela emaphashini ukuze ithole umoya-mpilo. Le ventricle yesokudla inomzila owodwa kagesi oyinhloko (i-fascicle) – okungukuthiIgatsha lesikhwama kwesokudla .
• I-ventricle yesobunxele : Lokhu kutholakala ohlangothini olungezansi lwesobunxele lwenhliziyo. Yigumbi lokupompa elikhulu nelinamandla kakhulu enhliziyweni. Lithatha igazi elinomoya-mpilo bese lilipompa liye kuwo wonke umzimba nge- aorta . I-ventricle yesobunxele inezindlela ezimbili zikagesi eziyinhloko: i-fascicle yesobunxele yangaphambili kanye ne-fascicle yesobunxele engemuva . Ndawonye, ​​lezi ezimbili zakha igatsha le-bundle yesobunxele. Lezi zihlukana zibe yizigidi zemicu emincane ebizwa ngokuthi imicu ye-Purkinje.

Kuyini i-Heart Block kanye ne-Bundle Branch Block?

Ukuvinjwa kwenhliziyo kwenzeka uma kunenkinga ngesistimu yokuhambisa ugesi yenhliziyo. Lokhu kubangela ukubambezeleka kokudluliselwa kwezimpawu zikagesi phakathi kwamakamelo enhliziyo. Ngenxa yalokho, amakamelo enhliziyo ayafinyela ngaphandle kwesigqi. Lokhu kuthinta ukugeleza kwegazi enhliziyweni, ukushaya kwenhliziyo, kanye nokushaya kwenhliziyo.

`(I-Heart Block)` kanye `(I-Atrioventricular Block / AV Block)` ziyisimo esifanayo. `(I-Bundle Branch Block)` uhlobo lwe-`(I-Heart Block).` Kwenzeka uma kukhona ukuvaleka kwelinye lamagatsha e-bundle esikhulume ngawo.

Uhlelo lukagesi olusezinhliziyweni zethu lusebenza kanjani? Kuyamangalisa, akunjalo?

Cabanga ukuthi ngaphakathi kwenhliziyo kukhona uhlelo lwezintambo oluyinkimbinkimbi kakhulu, kodwa oluhlelekile kakhulu. Nansi indlela lesi siginali kagesi esihamba ngayo:

1. Isignali iqala endaweni ekhethekile e-atrium ephezulu yenhliziyo ebizwa ngokuthi i-SA node. Lena yi-pacemaker yemvelo yenhliziyo.

2. Lesi siginali bese sidlula ku-atria bese sifika kwenye indawo ekhethekile ebizwa ngokuthi i-AV node.

3. Ngemva kwe-AV node, isignali ingena endleleni ebizwa ngokuthi i-bundle of His.

4. Ukusuka lapho, ihlukana ibe yigatsha lesikhwama sokudla kanye negatsha lesikhwama lesobunxele, bese ekugcineni iya emicu emincane ebizwa ngokuthi ``Purkinje fibers`` emaseli ``ventricles``.

5. Uma lesi signali sitholwa, ama-ventricle ayafinyela bese epompa igazi. Bese inqubo iqala futhi kusukela ekuqaleni.

Konke lokhu kwenzeka ngemizuzwana embalwa, ngokumangalisayo, akunjalo?

Ingabe kukhona izinhlobo zama-heart blocks?

Yebo, odokotela bahlukanisa la ma-heart block (ama-AV block) ngokuya ngobunzima bawo:

• Ukuvinjwa kwe-degree yokuqala: Lokhu kubambezeleka okuncane kwezimpawu zikagesi ezivela ku-atria kuya kuma-ventricle. Kodwa-ke, lolu hlobo lokuvinjwa alunawo amathuba amaningi okubangela izimpawu futhi aludingi ukwelashwa.
• Ukuvimba kwesigaba sesibili: Yilapho ezinye izimpawu zikagesi, kodwa hhayi zonke, zivinjelwa khona ekufinyeleleni amaseli. Lokhu kungabangela ukushaya kwenhliziyo okuhamba kancane ( i-bradycardia ) noma ukushaya kwenhliziyo okungajwayelekile (i-arrhythmia). Uma lokhu kukubi kakhulu noma kubangela izimpawu ezikhathazayo, kungadingeka ukwelashwa.
• Ibhlogo lezinga lesithathu: Lokhu kubizwa nangokuthi “ibhloko yenhliziyo ephelele.” Lapha, akukho ukuxhumana phakathi kokusebenza kwe-atria nama-ventricle. Lokhu kusho ukuthi amakamelo aphezulu asebenza ngendlela okufanele asebenze ngayo, kanti amakamelo aphansi asebenza ngendlela okufanele asebenze ngayo. Kulesi simo, kufanele kufakwe i-pacemaker. Uma “ibhloko ye-bifascicular” iba nzima, lesi simo singavela.

Ingabe kunezinhlobo ezahlukene ze-Bifascicular Block?

Yebo, kunezindlela ezahlukene ze-`(Bifascicular Block)`. Ezivame kakhulu yilezi:

• Ibhulokhi yegatsha lesikhwama sokudla kanye nebhulokhi ye-fascicular yangaphambili kwesobunxele.
• Futhi, kungase kube nebhulokhi yegatsha lesikhwama sokudla kanye nebhulokhi ye-fascicular engemuva kwesobunxele.
• Ngezinye izikhathi, igatsha lesikhwama sesobunxele lingavinjelwa ngokuphelele (okusho ukuthi kokubili ama-fascicle angaphambili nangemuva kwesobunxele avinjiwe, kodwa igatsha lesikhwama sesokudla liphelele).

Sivame kangakanani lesi simo?

I-Bifascicular Block itholakala kubantu abangaba ngu-1.5% abenza i -ECG . Lokho akusho ukuthi ayivamile kangako.

Kungani lokhu (i-Bifascicular Block) kwenzeka? Ziyini izimbangela?

I-Bifascicular Block ivame ukubangelwa yisifo senhliziyo esizalwa naso. Lokhu kusho ukuthi umuntu uzalwa enezinguquko ezithile esakhiweni senhliziyo. Ngezinye izikhathi, izimpawu zalesi sifo senhliziyo esizalwa naso zingase zivele kamuva, mhlawumbe esemncane noma eseminyakeni ephakathi. Ingozi yokuba ne-heart block nayo iyanda njengoba iminyaka ikhula .

Akuvamile, lesi simo singabangelwa ushintsho lwezakhi zofuzo (ukuguqulwa kwezakhi zofuzo) oludluliselwa emndenini kuya emndenini. Lokhu kubizwa ngokuthi i-progressive familial heart block. Lolu shintsho lwezakhi zofuzo lungabangela izicubu zesibazi (fibrosis) noma i-calcium deposits (calcification) enhliziyweni. Lezi zinguquko zingabangela futhi i-heart block.

Ngaphezu kwalokho, i-"Bifascicular Block" ingabangelwa futhi ukulimala kwenhliziyo. Lo monakalo ungaba:

• Ngenxa yokuhlaselwa yinhliziyo (i-myocardial infarction).
• Ngenxa yezinye izifo zenhliziyo .
• Ngenxa yesifo se-valve yenhliziyo .
• Ngenxa yamazinga aphezulu e-potassium egazini (i-hyperkalemia).

Ziyini izimpawu ze-Bifascicular Block? Ingabe nawe unazo lezi?

Ukuvaleka kwenhliziyo okungaphelele (izinga lokuqala noma lesibili) kungase kungabangela noma yiziphi izimpawu. Kodwa-ke, uma kuvela izimpawu, uphawu oluyinhloko abantu abaningi abalutholayo ukuquleka (i-syncope). Lokhu kwenzeka lapho izinga lokushaya kwenhliziyo lihamba kancane kakhulu (i-bradycardia) noma lihamba kancane kakhulu (i-arrhythmia) ngoba igazi alimpompi kahle emzimbeni.

Ngezinye izikhathi, i-`(Bifascicular Block)` ingaqhubekela phambili ifinyelele ekuvinjweni okuphelele (izinga lesithathu). Kuleso simo, izimpawu zivame ukwenzeka. Kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha uma unesinye noma ngaphezulu kwalezi zimpawu ezilandelayo:

• Ubuhlungu besifuba noma ukuqina (i-angina).
• Isiyezi.
• Ukuzizwa ukhathele kakhulu njalo.
• Ukuzwa inhliziyo ishaya ngendlela engavamile (ukushaya kwenhliziyo).
• Isicanucanu.
• Ukuphelelwa umoya.

Yiziphi izinkinga ezingabangelwa yilokhu?

Ukuvinjwa kwenhliziyo kuphazamisa ikhono lenhliziyo lokupompa igazi emzimbeni. "I-Bifascicular Block" (i-incomplete block) ngezinye izikhathi ingaqhubekela ekuvinjweni kwe-third-degree (ephelele). Uma lokhu kwenzeka, izinkinga ezifana nalezi:

• Ukushaya kwenhliziyo okungajwayelekile (i-Arrhythmia).
• Isifo senhliziyo.
• Ukwehluleka kwenhliziyo.
• Ukufa kwenhliziyo okungazelelwe / ukuboshwa kwenhliziyo okungazelelwe.

Ungakhathazeki! Akuwona wonke umuntu ozobhekana nalezi zinkinga. Iseluleko esifanele sezokwelapha kanye nokwelashwa kunganciphisa kakhulu le ngozi.

Ungayixilonga kanjani ngokunembile i-Bifascicular Block?

Isivivinyo esiyinhloko sokuxilonga i-Bifascicular Block yi -ECG. Lokhu kubizwa nangokuthi i-EKG. Lokhu kulinganisa umsebenzi kagesi wenhliziyo yakho. Kuyisivivinyo esilula kakhulu, esingenabuhlungu. Kuthatha cishe imizuzu eyi-15.

Udokotela uzobeka izitikha ezincane (ezibizwa ngokuthi ama-electrode) esifubeni sakho, ezingalweni, nasemilenzeni. Izintambo ezixhunywe kula ma-electrode zixhunywe emshinini we-ECG. Lo mshini uqopha umsebenzi kagesi wenhliziyo yakho njengegrafu. Ama-electrode awathumeli ugesi emzimbeni wakho. Kunalokho, alinganisa kuphela umsebenzi kagesi emzimbeni wakho. Ngokubheka le grafu, udokotela angabona ukuthi kukhona yini ushintsho noma ukuvaleka kwephethini yesignali kagesi yenhliziyo.

Ingabe kukhona ukwelashwa? Yini engenziwa?

Uma une-`(Bifascicular Block)` futhi ungenazo izimpawu, ungase ungadingi ukwelashwa. Kodwa-ke, udokotela wakho uzoqapha impilo yenhliziyo yakho eduze. Bangase benze izivivinyo ze-`(ECG)` ezivamile ukuze babone ukuthi isimo siya siba sibi yini futhi sikhula sibe yi-third-degree (ephelele) heart block. Uma lokho kwenzeka, kuyadingeka ukwelashwa.

Kodwa uma unenhliziyo engajwayelekile (i-arrhythmia) noma izimpawu ezifana nokuquleka (i-syncope), udokotela wakho angase akuncomele ukuhlinzwa ukuze kufakwe i -pacemaker . Kunezinhlobo ezimbili ze-pacemaker:

• Ama-pacemaker: Lawa athumela izimpawu zikagesi emakamelweni enhliziyo ukuze aqhubeke eshaya ngesigqi, njengokunikeza inhliziyo usizo olwengeziwe.
• Ama-ICD (ama-ICD) afakwayo: Lawa asebenza njenge-pacemaker. Ngaphezu kwalokho, i-ICD ingathola ukushaya kwenhliziyo okungajwayelekile bese iyilungisa ngokuletha ukushaqeka okuncane kukagesi enhliziyweni. Ingaphinde iqalise kabusha inhliziyo uma kwenzeka ukushaya kwenhliziyo kungazelelwe.

Lawa madivayisi afakwa ngudokotela wenhliziyo (i-electrophysiologist).

Ingabe zikhona izindlela zokuvimbela i-Bifascicular Block?

Uma sikhuluma iqiniso, kunezinto eziningi ezingaba nomthelela ekuhlulekeni kwenhliziyo esingenakukwazi ukuzilawula, njengesifo senhliziyo esizalwa naso noma ukuguga.

Noma kunjalo, ungathatha izinyathelo zokulondoloza nokuvikela impilo yenhliziyo yakho. Lezi zinyathelo zifaka:

• Uma ubhema, cela usizo lokuyeka. Gwema ngisho nokubhema intuthu ebhemayo.
• Yidla ukudla okunempilo kwenhliziyo futhi ube nomkhuba wokuzivocavoca nsuku zonke.
• Nciphisa ukusetshenziswa kotshwala.
• Lawula izimo ezilimaza inhliziyo ezifana nomfutho wegazi ophakeme, isifo sikashukela, kanye ne-cholesterol ephezulu.
• Thola izindlela ezinempilo zokuphatha ukucindezeleka.
• Zama ukugcina isisindo esinempilo.

Nakuba lezi zinto zingase zingakuvimbeli ngokuphelele ukuthuthukiswa kwe-`(Bifascicular Block), zizokusiza nakanjani ukugcina impilo yenhliziyo yakho yonke isesimweni esihle.

Singaphila yini nalesi simo? Siyini isimo sengqondo?

Iningi labantu abane-Bifascicular Block abadingi ukwelashwa. Ngisho noma kudingeka ukwelashwa, izimpawu zivame ukuphela ngemva kokufakwa kwe-pacemaker.

Ngokwelashwa okufanele, ingozi yokuthi lesi simo siqhubekele ekuvinjweni kwenhliziyo ngokuphelele iphansi kakhulu. Eqinisweni, umonakalo ongabangelwa ukushaya kwenhliziyo okungajwayelekile okungalashwanga (i-arrhythmia) mkhulu kunomonakalo obangelwa ukuvimba kwenhliziyo. Ngakho-ke, kubalulekile ukufuna iseluleko sezokwelapha ngesikhathi esifanele futhi uthole ukwelashwa uma kudingeka.

Ngingayibona nini udokotela?

Uma unesinye noma ngaphezulu kwalezi zimpawu ezilandelayo, xhumana nodokotela ngokushesha:

• Ukuzizwa ukhathele kakhulu.
• Ukushaya kwenhliziyo okungajwayelekile.
• Ubuhlungu obukhulu esifubeni.
• Ubunzima bokuphefumula.
• Izimpawu zokuhlaselwa yinhliziyo (isib. ubuhlungu obukhulu phakathi kwesifuba obuphuma engalweni).
• Ukucanuzela kwenhliziyo ngaphandle kwesizathu.

Yimiphi imibuzo ebalulekile okufanele uyibuze udokotela?

Uma uya kudokotela, ungabuza nale mibuzo:

• Kungani ngithole le `(Bifascicular Block)`?
• Yini okufanele ngiyenze ukuze nginciphise ingozi yami yokuhlaselwa yinhliziyo noma esinye isifo senhliziyo?
• Ingabe ngidinga i-pacemaker noma i-ICD?
• Yiziphi izingozi zokufakelwa i-pacemaker noma i-ICD?
• Ingabe kufanele ngikhathazeke ngezinkinga? Ziyini izimpawu?

Ukubuza le mibuzo kuzokusiza ukuthi uqonde kangcono isimo sakho futhi ucacelwe ukuthi yini okufanele uyenze ngokulandelayo.

Okokugcina, izinto okudingeka uzikhumbule

I-bifascicular block iwukuvinjelwa kwezindlela ezimbili kwezintathu eziyinhloko ezithwala izimpawu zikagesi enhliziyweni. Lokhu kungashintsha isigqi senhliziyo nendlela epompa ngayo igazi. Abanye abantu bangase bangabi nazimpawu, kanti abanye bangase babe nezimpawu ezifana nokuquleka.

Into ebaluleke kakhulu ukungesabi ngalokhu, kodwa ukufuna iseluleko esifanele sezokwelapha. Lokhu kungatholakala ngokuhlolwa okulula njenge-ECG. Uma kudingeka, lesi simo singalawulwa ngempumelelo ngokwelashwa okufana ne-pacemaker. Nakekela inhliziyo yakho, phila impilo enempilo, futhi ungahlala uphilile!