Chifukwa cha imfa mwadzidzidzi mwa othamanga achinyamata
Arrhythmogenic bwino ventricular cardiomyopathy (AVRC) ndi chibadwa cha thupi chimene chimakhala ndi minofu yambiri ya mtima yomwe imasinthidwa ndi minofu ya fibrous, mafuta, makamaka mu ventricle yoyenera. Chifukwa chachikulu chomwe AVRC chilili chofunika ndi chakuti chikhoza kupanga ziwalo zoopsa za mtima . (AVRC ndi dzina "latsopano" la chikhalidwe ichi, chomwe chimatchedwa "arrhythmogenic right ventricular dysplasia.")
AVRC ndi yachilendo, koma sizodziwika. Ikhoza kupezeka mwa mmodzi mwa akulu mpaka 2000 mpaka 5000 ngati mukufuna. Komabe, nthawi yokhayo yomwe anthu amamva kawirikawiri ndi AVRC ndi pamene wothamanga wamng'ono amamwalira mwadzidzidzi, popeza AVRC ndi imodzi mwa ziwalo za mtima zomwe zikugwirizana ndi imfa yadzidzidzi m'mathamanga achinyamata .
Kodi Zizindikiro za AVRC ndi Ziti?
Pamene AVRC ndi matenda a mtima - ndiko kuti, matenda a mitsempha ya mtima - kawirikawiri imayambitsa mavuto a minofu omwe ali okwanira kuti athetse mtima . M'malo mwake, chidziwitso chake chachipatala ndi chakuti zimayambitsa matenda a mtima - makamaka mapuloteni am'mawa asanakhalepo , ventricular tachycardia , ndipo nthawi zina zimakhala zozizira .
Zizindikiro za AVRC zimagwirizana ndi arrhythmias zomwe zingachititse. Anthu omwe ali ndi AVRC amakonda kufotokozera zigawo za mapeto , kumutu, kapena syncope . Mwamwayi, imfa yadzidzidzi ikhonza kuchitika, ndipo mwatsoka mwatsoka, imfa yadzidzidzi ikhoza kukhala chizindikiro choyamba kuti pali vuto la mtima.
Ngakhale kuti AVRC ingayambitse imfa mwadzidzidzi ikhoza kuchitika nthawi iliyonse, chochitika ichi chikhoza kuchitika panthawi zozizira. Ichi ndi chifukwa chake AVRC ndi imodzi mwa zinthu zomwe zimapangitsa imfa mwadzidzidzi mwa othamanga, othamanga achinyamata.
Anthu ambiri omwe ali ndi AVRC - mpaka 40% - sangakhale ndi zizindikiro zilizonse, ndipo amapezeka ngati atayesedwa chifukwa cha matendawa chifukwa am'banja mwawo amapezeka kuti ali nawo.
Kodi AVRC Idziwika Bwanji?
Kuzindikira AVRC kumachitika mwa kuyang'ana electrocardiogram (yomwe nthawi zambiri imasonyeza kusinthika kwa QRS complex), ndi echocardiogram (yomwe nthawi zambiri imasonyeza kusayenerera kwa thupi m'mimba mwachitsulo choyenera - ndipo nthawi zina kuchokera kumbuyo kwa ventricle).
Ngati matendawa akukayikira, nthawi zina MRI ya mtima ikhoza kuthandizira zinthu. Kuyezetsa magazi kungathandizenso kupeza matendawa, ndipo akulimbikitsidwa kwa anthu onse omwe ali ndi vutoli.
Ngakhale kuyesa kwa electrophysiologic nthawi zina kumathandiza kusiyanitsa tachycardia ya ventricular chifukwa cha AVRC kuchokera ku ventricular tachycardia yomwe imayambitsa matenda ena a mtima, kuyesa sikuthandiza nthawi zonse, ndipo sikukusowa.
Kamodzi kafukufukuyo atapangidwanso, kuyang'ana kwa majini kumalimbikitsidwanso kwa achibale oyambirira. Pafupifupi mmodzi mwa atatu omwe ali pachibale choyamba cha munthu yemwe ali ndi AVRC adzakhalanso ndi vutoli.
Kuchiza AVRC
Cholinga chachikulu pakupewa AVRC ndikuteteza kufa kwadzidzidzi kufa kwa tachycardia kapena fibrillation.
Chifukwa chakuti imfa mwadzidzidzi imayanjanitsidwa ndi masewero olimbitsa thupi, othamanga omwe ali ndi AVRC ayenera kupewa masewera onse okwera mpikisano, kuphatikizapo kupatulapo ntchito zochepa monga golf kapena bowling.
Kuwonjezera pamenepo, ayenera kupewa chilichonse chimene chimapangitsa kuti anthu azichita zinthu zambiri.
Ma arrhythmias okhudzana ndi AVRC amawoneka kuti akutsitsimutsidwa ndi chidziwitso chachisomo - gawo la mchitidwe wamatope wodzikweza umene umachulukitsa mayendedwe a adrenaline, ndipo ali ndi udindo pa nkhondo kapena kuyankha kwa ndege. Ichi ndichifukwa chake zolimbitsa thupi ndizovuta kwa AVRC. Choncho, akatswiri a mtima wamkulu amalimbikitsa kugwiritsa ntchito beta blockers mu chikhalidwe ichi, kuti amvetsetse zotsatira za adrenaline mu mtima.
Anthu omwe ali ndi kachilombo koyambitsa matendawa amawalimbikitsa kwambiri anthu ambiri omwe ali ndi AVRC, makamaka kwa aliyense yemwe ali ndi kachilombo ka mtima kakang'ono, kamene kali ndi tachycardia, yomwe ili ndi syncope yomwe sichinafotokozedwe.
Kwa anthu omwe ali ndi AVRC omwe alibe zochitikazi, chiopsezo cha imfa mwadzidzidzi chikuwonekera kukhala chochepa - malinga ngati akutsatira zoletsera zochita zolimbitsa thupi ndikuyambitsa zovuta zawo.
Kwa anthu omwe ali ndi AVRC omwe akhala akuthandizira njira zowonjezereka, zimaoneka ngati zabwino ngati atapewa kuchita masewera olimbitsa thupi, kutenga beta, kulandira mankhwala osokoneza bongo, komanso (nthawi zina) kutenga mankhwala osokoneza bongo .
Mawu Ochokera
Arrhyhythmogenic bwino ventricular cardiomyopathy ndi matenda omwe angapangitse kuti thupi likhale loopsa, ndipo ndi chimodzi mwa zifukwa zomwe zimachititsa imfa mwadzidzidzi m'mathamanga achinyamata. Mwachiwawa, anthu omwe ali ndi vutoli nthawi zambiri amachita bwino.
> Zotsatira:
> Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 Mtsogoleli wa AHA / ACC / HRS Wotsogoleredwa ndi Odwala ndi Ventricular Arrhythmias ndi Kupewa Imfa Yachimwibwi: Mwachidule: Lipoti la American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines ndi Heart Rhythm Society. Mtima Rhythm 2017.
> Ruwald AC, Marcus F, Estes NA 3, ndi al. Chiyanjano cha Zokondweretsa ndi Zosangalatsa Zosangalatsa Kuchita ndi Zochitika Zamtima Pakati pa Odwala Ndi Arrhythmogenic Yabwino Kwambiri Yogwira Mtima: Zotsatira kuchokera ku North American Multidisciplinary Study Of Arrhythmogenic Right Ventricular Cardiomyopathy. Mtima; 36: 1735.