Matenda otchedwa postural orthostatic tachycardia syndrome (POTS) ndi chikhalidwe chimene mtima wawonjezeka kuti ufike pamwambamwamba pamene munthu akuyimirira. Anthu omwe ali ndi POTS amakhala ndi zizindikiro nthawi zonse. Zomwe zimakhala zozizwitsa zimakhala ndi mutu wautali komanso zam'mimba , zomwe zimakhala zosiyana kwambiri ndi zofatsa kuti zisasinthe.
Kuphatikiza pa kufulumira kwa mtima, nthawi zina amakhalanso ndi vuto la magazi awo poima. Kwa anthu 40% omwe amapezeka ndi POTS potsiriza adzakhala ndi gawo limodzi la syncope (kutuluka).
POTS ndi vuto la achinyamata. Ambiri omwe ali ndi vutoli ali pakati pa zaka 14 ndi 45, ndipo kawirikawiri iwo ali ndi thanzi labwino. Azimayi ali ndi mwayi wambiri kuti akhale POTS kuposa amuna. Chidziwitso cha POTS chikuwoneka kuti chiripo m'mabanja ena.
Nchiyani chimayambitsa POTS?
Akatswiri amatsutsana pazifukwa za POTS. Ena amanena kuti izi zimaphatikizapo kutero (monga ngati atagona pabedi) kapena kutaya madzi m'thupi, koma izi ndizokhalitsa ndipo zimachoka mwamsanga, pomwe POTS imakhala ikupitirirabe.
Zowonjezereka, POTS ndi mawonekedwe a dysautonomia , banja la zinthu zomwe zimayambitsa kusamvetsetsana mu dongosolo lokhazikika la mantha - gawo la mitsempha yomwe imayendetsa ntchito "zopanda kuzindikira" za thupi, monga kuchepa, kupuma ndi mtima.
Pamene dongosolo lodzidzimitsa la mitsempha lilibebwino, zizindikiro zonse zimatha, kuphatikizapo mtima wamtima, kupuma, dongosolo lakumagawa , minofu ndi khungu.
Pali syndromes angapo omwe amaganiza kuti ndi chifukwa cha dysautonomia, kuphatikizapo fibromyalgia , matenda otopa aakulu , matenda osokoneza bongo komanso sinasidaciadia yosayenera .
Komabe, anthu omwe ali ndi dysautonomia nthawi zambiri amakhala ndi zizindikiro zomwe zimakhala pakati pa syndromes.
Chomwe chimayambitsa POTS - kapena, pazinthu, dysautonomias - sichidziwika. Komabe, monga momwe amachitira ma dysautonomias, kuyamba kwa POTS nthawi zambiri kumakhala mwadzidzidzi, ndipo kawirikawiri kumatenda matenda opatsirana kwambiri (monga matenda oipa a fuluwenza); zochitika zachisokonezo (monga kuthyoka fupa, kubereka kapena kuchita opaleshoni); kuwonetsa poizoni (monga Agent Orange); kapena kupanikizika kwamtima (monga kufooka kwa nkhondo kapena kupsinjika maganizo).
Maphunziro mwa anthu omwe ali ndi POTS amasonyeza kuti iwonso adasintha dongosolo la mitsempha lomwe limakhudza kwambiri m'munsi mwake, ndipo akhoza kukhala ndi magazi ochepa kwambiri kuposa omwe aliwonse.
Zizindikiro ndi POTS
Anthu omwe ali ndi POTS akhoza kukhala ndi zizindikiro zosiyanasiyana pamene ali owongoka; zizindikiro zimasiyana mozama kwa munthu aliyense. M'magulu ambiri a POTS, zizindikiro ndi zochepa. Kwa ena, zizindikiro sizikulepheretsa.
Zizindikiro zowonjezereka zimagwedezeka, kupsinjika, chizungulire, masomphenya olakwika, zofooka, mantha ndi nkhawa. Pang'ono ndi pang'ono, syncope ikhoza kuchitika.
Nthawi zina POTS imagwidwa ndi matenda ena a dysautonomia , kotero anthu omwe ali ndi POTS angakhalenso ndi zizindikiro zowonjezera monga mimba ya m'mimba, bloating, kutsekula m'mimba, kudzimbidwa, mabala ndi ululu ndi kutopa kwakukulu.
Kuchita bwino kwambiri kuthamanga kwa mtima komwe kumapezeka pamene kuimirira sikungatsimikizire kuti zizindikiro zina (ngati zilipo) zidzatha.
Kodi POTS imadziwika bwanji?
Madokotala ayenera kudziwa matenda a POTS mwa kutenga mbiri yachipatala mosamala ndikuchita bwinobwino. Chinsinsi cha matendawa chikuwonetsa kuti kutentha kwa mtima kukuwonjezereka mwachidziwitso kuima kwabwino. Izi zikutanthauza kuti ngati muli ndi zizindikiro zosonyeza POTS, dokotala wanu ayenera kutenga magazi anu kawiri - kamodzi mukakhala pansi ndipo kamodzi mukaima.
Kawirikawiri, munthu akayimirira, mtima wake umawonjezeka ndi zipolowe 10 pa mphindi imodzi kapena pang'ono.
Ndi POTS, kuwonjezeka nthawi zambiri kumakhala kwakukulu kwambiri - nthawi zambiri kugunda 30 pa mphindi kapena kuposa. Nthawi zina kuwonjezeka kwachilendo kwa mtima kumangochitika pokhapokha wodwalayo ataimirira kwa mphindi zingapo.
Pachifukwa ichi, ngati POTS akuganiza kuti kuyesa kupukutira tebulo kungakhale kothandiza pofufuza.
Ngati kuwonjezeka kwachilendo kwa mtima kumayimilira, dokotala wanu ayenera kuyang'ana zifukwa zina zomwe zingayambitse thupi, monga kutaya madzi m'thupi, kutayika kuchokera ku bedi lalitali, matenda odwala matenda a shuga kapena mankhwala osiyanasiyana (makamaka mankhwala opatsirana pogwiritsa ntchito mankhwala kapena kuthamanga kwa magazi ). Ngati palibe zina mwazifukwazi zilipo, ndiye kuti matenda a POTS angapangidwe ndi chidaliro.
Kuwona kuti POTS imapanga cholinga chimenechi, kupeza mankhwala obwerezabwereza (kutanthauza kuti kuwonjezeka kwa mtima wamtima pamene ukuima), kumapatsa anthu omwe ali ndi POTS mwayi wopambana kuposa anthu omwe ali ndi mitundu yambiri ya dysautonomia, omwe chikhalidwe chawo chimabweretsa zochepa (ngati zilizonse) zofufuza zolinga. Anthu ambiri osauka omwe ali ndi dysautonomia amauzidwa ndi adokotala ambiri kuti amangokhala ndi "nkhawa." Madokotala kuti asaphonye matendawa ayenera kukhala osowa mwa anthu omwe ali ndi POTS.
Kodi POTS Imachita Zotani?
Mofanana ndi ma dysautonomias onse, kuchiza POTS kawirikawiri ndizoyeso ndi zolakwika, kuyesa njira zosiyanasiyana zochizira mpaka zizindikiro zidzasinthidwa - nthawi zambiri njira yomwe ingatenge milungu kapena miyezi. Komabe, malinga ngati adokotala ndi wodwalayo akhalabebe, zizindikiro zimatha kuyendetsedwa ndi anthu ambiri omwe ali ndi POTS.
Pali njira zitatu zothandizira mankhwala - kuwonjezera magazi, kugwiritsa ntchito mankhwala, ndi mankhwala osokoneza bongo.
Magazi a magazi amatha kuyendetsedwa bwino mwa kulimbikitsa kudya kwa madzi, kudyetsa mchere wochuluka, ndi / kapena kumwa fludrocortisone, mankhwala opatsirana pogwiritsa ntchito mankhwala omwe amachepetsa mphamvu za impso kuti asiye sodium. Chifukwa chakuti kutentha kwa madzi nthawi zambiri kumakhala kofala, ndikofunika kwambiri kutengera madzi nthawi yoyamba m'mawa - musanayambe kugona, ngati n'kotheka.
Umboni tsopano ukusonyeza kuti maphunziro a nthawi yaitali aerobic amatha kusintha kwambiri POTS. Chifukwa zingakhale zovuta kwa anthu omwe ali ndi POTS kuchita masewera olimbitsa thupi omwe amawafuna kuti akhale owongoka, pulogalamu yochita masewera olimbitsa thupi yoyang'aniridwa ingakhale yofunikira. Kawirikawiri, mapulojekitiwa adzayamba ndi kusambira kapena kugwiritsa ntchito makina opangira mawotchi, omwe safuna kukhala oyenera. Kawirikawiri, patapita mwezi umodzi kapena awiri, munthu amene ali ndi POTS amatha kusintha, kuyenda kapena kuyendetsa njinga. Ngati muli ndi POTS, muyenera kupitiriza ntchito yanu nthawi zonse kuti musabwerere.
Mankhwala omwe agwiritsidwa ntchito ndi ena opambana kuti athetse POTS ndi midodrine ndi beta blockers . Malipoti ena amasonyeza kuti pyridostigmine (Mestinon) ingathandizenso. Mosiyana ndi mitundu ina ya dysautonomia, serotonin reuptake inhibitors (SSRIs) sichiwoneka ngati yopindulitsa mu POTS.
Ivabradine (mankhwala ogwiritsidwa ntchito mwa anthu osayenera tachycardia sinus), amagwiritsidwanso ntchito mogwira mtima kwa anthu ena omwe ali ndi POTS, ndipo maphunziro apamwamba akuyesa kuyesa mankhwalawa chifukwa chaichi.
Madokotala ambiri omwe amachititsa kuti POTS ayese njira zonse zitatu kuchokera pa bat. Chithandizo chayamba kukulitsa mphamvu yamadzimadzi, pulogalamu yochita masewero olimbitsa thupi imayikidwa, ndipo mankhwala opatsirana (nthawi zambiri ndi midodrine) ayamba. Makamaka ngati pulogalamu yayitali yayitali ingathe kukhazikitsidwa, mankhwalawa nthawi zambiri amatha.
Mawu Ochokera
POTS ndi chikhalidwe chomwe chimakhala chosokoneza komanso chokhumudwitsa anthu omwe ali achichepere, omwe ali ndi thanzi labwino omwe amavutika nalo. Nkhani yabwino ndi yakuti, munthu atakhala ndi matendawa, munthu yemwe ali ndi POTS ayenera kuyembekezera kuti azitha kuwongolera zokhudzana ndi zizindikiro zawo, malinga ngati iwo ndi madotolo awo sakulepheretsa kupeza chithandizo choyenera cha mankhwala omwe adzawagwiritsire ntchito .
> Zotsatira:
> Arnold AC, Okamoto LE, Diedrich A, et al. Propanolol Low-Dose ndi Exercise Capacity mu Postural Tachycardia Syndrome: Kuphunzira Kwambiri. Neurology 2013; 80: 1927.
> Freeman R, Wieling W, Axelrod FB, et al. Chigwirizano Chogwirizana pa Tanthauzo la Orthostatic Hypotension, Systope Yachilengedwe Yachilengedwe ndi Postural Tachycardia Syndrome. Auton Neurosci 2011; 161: 46.
> Kimpinski K, Figueroa JJ, Singer W, et al. Cholinga Chotsatira Chotsatira cha Postural Tachycardia Syndrome. Mayo Clin Pro 2012; 87: 746.
> Thieben MJ, Sandroni P, Sletten DM, et al. Postural Orthostatic Tachycardia Syndrome: Mayo Clinic Experience. Mayo Clin Proc 2007; 82: 308.