Ingabe ukushaya kwenhliziyo yakho kubonakala kuhamba kancane? Kungase kube ngenxa ye-Junctional Escape Rhythm (Junctional Escape Rhythm)!

Ingabe ngezinye izikhathi uzizwa sengathi inhliziyo yakho ishaya kancane, noma ngendlela engavamile? Cabanga nje, uqhubeka nomsebenzi wakho wansuku zonke bese uzizwa ukhathele kakhulu , uphelelwa umoya lapho ukhuphuka izitebhisi, futhi uzizwa sengathi uzowa phansi ikhanda lakho lijikeleza. Lolu hlobo lwento aluvele lwenzeke nje, akunjalo? Kungaba ushintsho oluncane ohlelweni lokubonisana kwenhliziyo yakho. Namuhla sizokhuluma ngesimo esisodwa esinjalo, esibizwa ngokuthi i-Junctional Escape Rhythm . Ungakhathazeki, sizoxoxa ngalokhu kalula.

Iyini ngempela le Junctional Escape Rhythm?

Kalula nje, leli gama linikezwa iqiniso lokuthi inhliziyo yakho iqala ukushaya phansi kancane kunalokho okufanele ikwenze. Cabanga ngakho njengomshini omncane osebenza nohlelo lukagesi. Kudinga 'isignali kagesi' ukuze ishaye kahle. Lesi signali sivame ukuqala phezulu kwenhliziyo ebizwa ngokuthi i-sinoatrial node (noma 'i-SA node`). Kufana nomqhubi oyinhloko esiteshini sokuqala esitimeleni. Nguye onikeza umyalo othi, 'Kulungile, shaya manje.'

Kodwa-ke, uma kwenzeka okuthile kule `SA node`, kufana nokuthi umqhubi ulele. Ngemuva kwalokho ngeke akwazi ukuqala ukushaya kwenhliziyo kahle, noma noma ngabe kwenzeka, ngeke kube namandla ngokwanele.

Ngakho-ke, kwenzekani uma lokho kwenzeka? Inhliziyo ayihlali nje lapho. Ezansi kancane enhliziyweni, endaweni lapho kuhlangana khona amakamelo aphezulu (i-atria) namakamelo aphansi (ama-ventricles), i-atrioventricular node (noma i-AV node) ithi, "Kulungile, ngizothatha izintambo," bese inhliziyo iqala ukushaya. Kufana nokuthi uma umqhubi esiteshini sokuqala elele, umqhubi esiteshini esilandelayo uyathatha izintambo futhi adonse isitimela. Lokhu akuwona umsebenzi wakhe ojwayelekile, kodwa uyakwenza ngoba akakwazi ukuyeka ukusebenza.

Kodwa-ke, ukushaya kwenhliziyo okwenzeka ngale ndlela akusheshi njengalokho okuvela ku-'SA node'. Ngenkathi ukushaya kwenhliziyo okuvamile komuntu ophilile kuphakathi kwama-beats angu-60 no-100 ngomzuzu, kule 'Junctional Escape Rhythm' izinga liphakathi kwama-beats angu-40 no-60 ngomzuzu . Okusho ukuthi, kancane kancane.

Ubani okungenzeka kakhulu ukuthi athinteke yilesi simo?

Nakuba lesi simo singathinta noma ubani, abanye abantu basengozini enkulu. Isibonelo, izifundo zithole ukuthi inani elikhulu labantu abangaphezu kweminyaka engu-65 abanesifo senhliziyo bangase babe nokungasebenzi kahle kwezinga elithile kwe-SA node. Ngakho-ke, ngenkinga enjalo, amathuba okuthuthukisa isigqi se-junctional aphakeme.

Akukhona lokho kuphela, lesi simo singathinta nabanye abantu:

• Abasubathi abaziqeqesha kahle: Ngezinye izikhathi lolu hlobo lwesigqi lungabonakala ngoba ukushaya kwenhliziyo yabo okuphumuzayo kuphansi.
• Izingane ezincane: Ngezinye izikhathi lokhu kungenzeka nasezinganeni, kodwa akuvamile kakhulu.
• Abantu abanesifo esibizwa ngokuthi i-'Sick Sinus Syndrome':Nakulokhu, i-SA node ayisebenzi kahle, ngakho-ke ezinye izingxenye zenhliziyo kufanele zilawule ukushaya kwenhliziyo.

Zingaba yini izimpawu zalokhu?

Esikhathini esiningi, ungase ungabi nazimpawu . Kungatholakala ngengozi ngesikhathi sokuhlolwa kwe-ECG okwenziwe ngesinye isizathu. Kodwa-ke, uma kuvela izimpawu, zingase zihlanganise:

• Ukuzizwa ukhathele kakhulu (`Ukukhathala`): Ukuzizwa sengathi awunawo amandla, ukhathele kangangokuthi ufuna ukulala usuku lonke.
• Ukuquleka noma ukuxhuzula: Lokhu kungenzeka uma izinga lokushaya kwenhliziyo lehla kakhulu, kunciphisa inani legazi eligeleza liye ebuchosheni.
• Ukuzungeza noma ukuba nekhanda elikhanyayo: Lokhu kungenzeka uma umi noma uma uvuka ngokuzumayo.
• Ukushaya kwenhliziyo: Kungase kuzwakale sengathi inhliziyo yakho ishaya ngaphakathi esifubeni sakho, noma kungase kuzwakale sengathi igxumagxuma ngokuzumayo.
• Ukuphefumula kanzima: Abanye abantu bangase bazizwe bephelelwa umoya uma bekhathele kancane.

Kungani lokhu kwenzeka? Yiziphi izizathu?

Kunezizathu eziningana zokuthi kungani i-SA node yakho ingayeka ukuthumela izimpawu zikagesi noma ibe buthaka. Yilokhu okubangela i-Junctional Escape Rhythm. Ake sibheke izizathu eziyinhloko.

Ezinye izimo zezokwelapha kanye nokwelashwa kungabangela lokhu:

• I-sleep apnea: Lesi yisimo lapho uyeka ukuphefumula isikhathi esifushane ngenkathi ulele. Lokhu kungathinta inhliziyo yakho.
• Ukwelashwa ngemisebe: Ukwelashwa ngemisebe, ikakhulukazi umdlavuza esifubeni, kungalimaza uhlelo lukagesi lwenhliziyo.
• Ukuhlaselwa yinhliziyo: Ukuhlaselwa yinhliziyo kungalimaza imisipha yenhliziyo kanye ne-SA node.
• I-Myocarditis: Ukuvuvukala kwemisipha yenhliziyo okubangelwa yinto efana nokutheleleka ngegciwane.
• Ukuvuvukala kwesikhwama esizungeze inhliziyo (i-pericarditis): Lokhu kungathinta nokusebenza kwenhliziyo.
• Ukulimala esifubeni sakho: Uma uthola ukushaywa okubukhali esifubeni, njengasengozini.
• Isifo se-Lyme: Lesi sifo esithwalwa yizimpukane singathinta nenhliziyo.
• I-Hypothyroidism: Ukungasebenzi kahle kwe-thyroid gland.
• Ukuhlinzwa okuthile: Ikakhulukazi ngemva kokuhlinzwa okuhlobene nenhliziyo.

Lokhu kungabangelwa futhi eminye imithi:

Eminye imithi inciphisa ukusebenza kwe-SA node, futhi lesi sigqi sokuphuma kwe-junctional singase senzeke.

• I-Lithium: Umuthi osetshenziselwa ukwelapha izifo zengqondo.
• Ama-Beta-blocker: Uhlobo oluvamile lomuthi olusetshenziswa ekwelapheni umfutho wegazi ophakeme kanye nesifo senhliziyo.
• Ama-calcium channel blocker: Lawa anikezwa futhi ngenxa yomfutho wegazi ophakeme kanye nesifo senhliziyo.
• I-Digoxin: Umuthi osetshenziselwa ukwelapha ukwehluleka kwenhliziyo kanye nezinkinga ezithile zesigqi senhliziyo.
• Ama-opioid: Amaphilisi okudambisa izinhlungu anamandla.
• I-Adenosine: Umuthi osetshenziselwa ukuxilonga nokwelapha izinkinga zesigqi senhliziyo.
• I-Clonidine (isibonelo, i-Catapres® noma i-Kapvay®): Umuthi osetshenziselwa ukwelapha umfutho wegazi ophakeme.

Ukuthola kanjani lokhu?

Uma unezimpawu ezishiwo ngenhla, noma uma udokotela wakho esola lokhu, uzokuhlola.

• Umlando wezokwelapha kanye nokuhlolwa komzimba: Okokuqala, bazobuza ngezimpawu zakho, imithi oyiphuzayo, nokuthi ngabe kukhona yini emndenini wakho onesifo senhliziyo. Ngemuva kwalokho, bazokwenza ukuhlolwa ngokomzimba okuvamile.
• I-Electrocardiogram (ebizwa nangokuthi i-ECG noma i-EKG): Lolu vivinyo olubaluleke kakhulu. Luqopha umsebenzi kagesi wenhliziyo. Uma kukhona isigqi sokuphuma esihlangene, iphethini yaso ephawulekayo izobonakala ku-ECG (isibonelo, amaza e-P angekho noma ashintshiwe, ukushaya kwenhliziyo okuhamba kancane).
• Ukuhlolwa kwegazi: Lokhu kungasiza ekunqumeni ezinye izimbangela, njengezinkinga ze-thyroid noma ukungalingani kwama-electrolyte.
• I-ultrasound yenhliziyo (i-Echocardiogram): Lokhu kungabheka izinto ezifana nesakhiwo senhliziyo, umsebenzi wama-valve, kanye namandla okufinyela kwemisipha yenhliziyo.
• Isiqaphi sikaHolter: Ngezinye izikhathi, uma izimpawu zingekho ngaso sonke isikhathi, idivayisi efana nale ingasetshenziswa ukuqopha i-ECG isikhathi esingamahora angama-24 noma angama-48.

Yiziphi izindlela zokwelapha lokhu?

Ukwelashwa kuncike ekutheni unezimpawu noma cha nokuthi yini ebangela lesi simo.

• Uma ungenazo izimpawu: Ezimweni eziningi, uma uphilile futhi ungenazo izimpawu, akudingeki ukwelashwa okukhethekile. Udokotela wakho cishe uzovele akubheke.
• Uma kunezimpawu:
• Ukwelapha imbangela eyinhloko: Isibonelo, uma lesi simo sibangelwa umuthi, udokotela angase awuyeke umuthi noma ashintshele komunye umuthi. Uma kuyisimo esifana "nokuphefumula kokulala," kuzodingeka selashwe.
• Imithi: Uma izinga lokushaya kwenhliziyo liphansi kakhulu futhi kunezimpawu ezifana nokuzungeza, umuthi onjenge -atropine (isib., i-Atreza® noma i-Sal-Tropine®) unganikezwa isikhathi esifushane ukuze kwandiswe izinga lokushaya kwenhliziyo kancane.
• I-Pacemaker: Uma izimpawu ziqhubeka, izinga lokushaya kwenhliziyo liphansi kakhulu, noma imbangela eyinhloko ingathuthuki naphezu kokwelashwa, kungadingeka i-pacemaker ehlala njalo .Kunganconywa ukuthi kufakwe i-pacemaker. Lena idivayisi encane efakwa ngokuhlinzwa ngaphansi kwesikhumba sesifuba. Ithumela izimpawu zikagesi enhliziyweni, isize ukugcina ukushaya kwenhliziyo okuvamile. Kungadingeka ukuthi ifakwe lokhu kusukela eminyakeni ephakathi.
• Ukususwa kwe-catheter: Lokhu akuyona indlela evamile yokwelapha isigqi sokuphuma kwe-junctional, kodwa kungacatshangelwa kwezinye izimo ezikhethekile (isibonelo, uma kuhlotshaniswa nezinye izinkinga zesigqi njenge-AV nodal reentrant tachycardia). Lokhu kuhilela ukwenza imivimbo emincane ezindaweni zenhliziyo ezibangela izimpawu zikagesi ezingavamile, kuzimise.

Ingabe zikhona izinkinga ngokwelashwa?

Njenganoma yikuphi ukwelashwa kwezokwelapha, kunezingozi ezithile ezihilelekile, ikakhulukazi uma kuziwa ekufakeni i-pacemaker:

• Ukutheleleka endaweni yokuhlinzwa.
• Amahlule egazi.
• Ukwakheka kwezicubu zezibazi ezizungeze i-pacemaker.
• Izintambo zedivayisi ziyahamba noma ziyaphuka lapho kufanele zibe khona.
• Ukulimala kwamaphaphu (okungavamile).

Kodwa-ke, lezi zivame ukuba yizinkinga ezincane odokotela abaziyo ukuthi bangazisingatha kanjani. Ukufakwa kwe-pacemaker ngokuvamile kuyinqubo ephephile kakhulu.

Kuthatha isikhathi esingakanani ukululama ngemva kokwelashwa?

Uma une-pacemaker, ngokuvamile ungabuyela emisebenzini yakho evamile zingakapheli izinsuku ezimbalwa. Kodwa-ke , kungadingeka ulinde isonto noma amabili ngaphambi kokwenza noma yini enye, njengokuphakamisa izinsimbi noma ukushayela , kuye ngemiyalelo kadokotela wakho. Uma welashwa ngemithi, uzozizwa ungcono njengoba izimpawu zakho ziqala ukuncipha.

Yini esingayenza ukuze sinciphise le ngozi?

Asikwazi ukulawula ezinye zezici ezibangela i-Junctional Escape Rhythm (isib. izimo zofuzo). Kodwa-ke, kunezinto ezithile esingazenza ukuze sinciphise ingozi yethu:

• Ukulandela indlela yokuphila enempilo: Ukudla ukudla okulinganiselayo, ukuzivocavoca njalo , nokugwema ukubhema kungasiza ekugcineni inhliziyo yakho iphilile.
• Phatha kahle izifo eziyisisekelo: Uma unezimo ezifana nesifo sikashukela, umfutho wegazi ophakeme, kanye nokuphefumula okunzima ngesikhathi sokulala, zitholele ukwelashwa okufanele.
• Izinto Ongazicabangela Ngemithi: Khuluma nodokotela wakho ngemithi oyiphuzayo. Uma kukhona okusolakala ukuthi umuthi othile ubangela inkinga, udokotela wakho uzofuna enye indlela. Ungalokothi uyeke ukuthatha umuthi ngaphandle kweseluleko sikadokotela.

Kwenzekani uma kukhona isigqi sokuphunyuka esihlangene? Liyini ikusasa?

Isibikezelo kubantu abane-Junctional Escape Rhythm ngokuvamile sihle, ikakhulukazi uma bengenazo izimpawu noma uma izimpawu zabo zingalawulwa ngokwelashwa. Uma une-pacemaker, ungaphila impilo evamile. Into ebaluleke kakhulu ukulandela imiyalelo kadokotela wakho bese uya kohlolwa njalo.

Kufanele ngizinakekele kanjani?

Uma une-Junctional Escape Rhythm, udokotela wakho cishe uzogxila esimweni esiyisisekelo esiyimbangela. Ngakho-ke, kuye ngesimo noma umuthi obangela inkinga, kungadingeka ukuthi uphuze umuthi ohlukile noma uthole ukwelashwa okunconywa udokotela wakho.

• Landela iseluleko sezokwelapha ngqo.
• Thatha imithi yakho ngesikhathi.
• Uma une-pacemaker, landela imiyalelo kadokotela wakho ngayo (isib., ukungasebenzisi amadivayisi athile kagesi).
• Uma kukhona ushintsho ezimpawini (izimpawu ezintsha ziyanda, ziyavela), yazisa udokotela ngokushesha.

Kufanele ngifune nini iseluleko sezokwelapha?

• Uma unezimpawu ezishiwo ngaphambilini (ukukhathala, isiyezi, ikhanda elikhanyayo, ukuqina kwesifuba).
• Uma une-pacemaker, kuzodingeka ubone udokotela wakho cishe inyanga ngemuva kokuhlinzwa. Ngemva kwalokho, kuzodingeka uye kuma-aphoyintimenti okulandelela kanye noma kabili ngonyaka.
• Uma unomuzwa wokuthi i-pacemaker yakho ayisebenzi kahle (isib., uma izimpawu zakudala zibuya), noma uma unegciwane (ububomvu, ukuvuvukala, ubomvu) lapho i-pacemaker yakho yayifakwe khona, kufanele uxhumane nodokotela wakho ngokushesha.

Yimiphi imibuzo okufanele uyibuze udokotela?

Ungakhohlwa ukubuza le mibuzo uma ubona udokotela:

• "Ingabe ngidinga ukwelashwa kwale 'Junctional Escape Rhythm'?"
• "Yisiphi isizathu esiqondile se-'Junctional Escape Rhythm' yami?"
• "Yiziphi izinguquko zendlela yokuphila okudingeka ngizenze?"
• "Uma isimo esibangele lokhu siphinde senzeke, ingabe ngizophinde ngithole i-'Junctional Escape Rhythm'?"
• "Uma kudingeka 'i-pacemaker', yiziphi izinzuzo nezingozi?"
• "Yimiphi imisebenzi okufanele ngiyigweme?"

Nasi isifinyezo salokho esikuxoxile (Umyalezo Wokuya Ekhaya):

Kulungile, manje usuqonda kahle lokho ebesikhuluma ngakho okubizwa ngokuthi i-'Junctional Escape Rhythm'. Okwenzekayo kulokhu ukuthi lapho i-'SA node', okuyilapho ukushaya kwenhliziyo kuqala khona, yehluleka, i-'AV node', etholakala engxenyeni engezansi yenhliziyo, iqala ukushaya kwenhliziyo. Lokhu kuvame ukwehlisa ukushaya kwenhliziyo kancane (cishe ama-beats angu-40-60 ngomzuzu).

Abanye abantu bangase bangabi nazimpawu, kodwa abanye bangase babe nokukhathala, isiyezi, ikhanda elibuhlungu, kanye nokuqina kwesifuba. Ezinye izimo zezokwelapha (isib., ukuphefumula kokulala, ukwehluleka kwenhliziyo) kanye nemithi ethile (isib., ama-beta-blockers) zingabangela lokhu.

Into ebaluleke kakhulu ukuthi uma unalezi zimpawu, ungazinaki bese ubona udokotela ukuze uthole ukuthi kwenzekani ngempela. Lokhu kungatholakala ngokuhlolwa okulula njenge-ECG.

Ukwelashwa kungafaka imithi, futhi ngezinye izikhathi i-pacemaker, kuye ngembangela. Uma ungenazo izimpawu, ungase ungadingi ukwelashwa. Kodwa-ke, uma unezimpawu, udokotela wakho cishe uzogxila ekwelapheni imbangela eyinhloko. Khuluma nawe ngezinketho zakho zokwelapha, bese ubuza imibuzo uma kukhona okungacacile. Ngemva kwalokho, kubalulekile ukuthatha imithi yakho bese uthola ukuhlolwa njalo. Ngemuva kwalokho ungahlala uphilile futhi ungakhathazeki.

` I-Junctional Escape Rhythm, I-Heart Rhythm, I-Heartbeat, i-SA Node, i-AV Node, i-Pacemaker, Impilo Yenhliziyo