Matenda a sinus amachira pamene nthenda ya sinus imayamba kukhala ndi matenda okwanira kuyambitsa ubongo (mtima wautali) womwe umabala zizindikiro. Anthu omwe ali ndi matenda a sinus odwala amafunikira chithandizo ndi pacemaker yosatha kuti athetse zizindikiro zawo.
Kuphatikiza pa zizindikiro zoopsa za matendawa, matenda a sinus syndrome amakhalanso ndi zizindikiro za matenda opatsirana pogonana , omwe angafune chithandizo china.
Matenda a sinus wodwala ndi matenda a anthu achikulire, ndipo amawonekera kwambiri kwa anthu oposa zaka 70.
N'chiyani Chimayambitsa Matenda Oipa a Matenda?
Chinthu chofala kwambiri cha matenda a sinus wodwala ndi matenda a zaka zokhudzana ndi zaka zomwe zimakhudza nthenda ya sinus (kamangidwe kakang'ono kamene kamene kamayambitsa magetsi). "Fibrosis" amatanthawuza kuti minofu yachibadwa imaloledwa ndi mawonekedwe a minofu. Pamene fibrosis imakhudza nthenda ya sinus, bradycardia imatha. Ndipo pamene bradycardia imayambitsidwa ndi vuto la nthenda ya sinus, imatchedwa "sinus bradycardia."
Zomwezo, fibrosis zokhudzana ndi zaka zomwe zimakhudza nthenda ya sinus zingasokonezenso minofu ya m'thupi. Matendawa amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda kamene timayambitsa matenda a sinus odwala.
Komanso, iyi fibrosis ingasokonezenso kachidindo ka AV . Ngati izo zitero, sinus bradycardia ikhoza kutsatiridwa ndi zigawo za mtima .
Kotero mu matenda a sinus odwala pangakhale kwenikweni zifukwa ziwiri za bradycardia - sinus bradycardia, ndi mtima wachitetezo.
Nthaŵi zina matenda ena angakhudze node ya sinus, yopanga sinus bradycardia. Izi ziphatikizapo:
- amyloidosis
- sarcoidosis
- Matenda a Chagas
- hypothyroidism
- kupweteka kwa mtima
Komabe, fibrosis yokhudzana ndi ukalamba ndiyo yomwe imayambitsa matenda a sinus syndrome.
Ndi Zizindikiro Ziti Zogwirizana ndi Odwala Matenda a Chimuna?
Zizindikiro zotchuka kwambiri ndizo chifukwa cha kuchepa kwa mtima, ndipo zimaphatikizapo:
Mu anthu ena omwe ali ndi matenda a sinus matenda, zizindikirozi zimangowoneka pamene ayesa kudzipereka, ndipo adzamva bwino pamene akupumula. Pazochitikazi vuto lalikulu ndiloti silingathe kuchulukitsa mtima woyenera pa nthawi ya ntchito, chikhalidwe chomwe chimatchedwa "nthawi yosadziwika nthawi ."
Matenda Odwala Matenda a Chimfine ndi Matenda Aakulu
Anthu omwe ali ndi matenda a sinus omwe ali ndi zizindikiro za matenda a atrial nthawi zambiri amakhala ndi zizindikiro za sinus bradycardia, ndipo kuwonjezera iwo akhoza kukhala ndi zizindikiro za tachycardia (kuthamanga mtima kwa mtima), makamaka kuponyera . Anthu omwe ali ndi ziŵerengero za mitima yazengereza komanso yofulumira akuti ali ndi matenda a bradycardia-tachycardia, kapena " matenda oopsa kwambiri ."
Chizindikiro chovuta kwambiri chokhudzana ndi matenda olimbitsa mtima ndi syncope. Kutayika kwa chidziwitso kawirikawiri kumachitika mwamsanga kanthawi kakang'ono ka matenda a atrial akutha msanga, motsogolere kuima kwa nthawi yayitali mu mtima.
Kupuma kwa nthawi yaitali kumachitika chifukwa, pamene nthenda ya sinus ili kale "yodwala," kachilombo ka mafilimu a atrial amawonjezera kuwonjezera ntchito yake.
Kotero, pamene mafinyria a atrial amatha mwadzidzidzi, nthenda ya sinus ingafune masekondi angapo kuti "adzuke" ndipo ayambe kupanga magetsi a magetsi kachiwiri. Panthawi imeneyi, mwina sipangakhale kugunda kwa mtima kwa masekondi khumi kapena kuposerapo - kumatsogolera kumaso, kapena syncope.
Kodi Matenda a Sitius Amatenga Bwanji?
Kuzindikira matenda a sinus matenda sikungakhale kovuta. Kafukufuku woyenera nthawi zambiri amaoneka bwino pamene munthu amene akudandaula za zizindikiro zake zimapezeka kuti ali ndi sinus bradycardia yaikulu pa electrocardiogram (ECG) yawo . Matenda osiyanasiyana a matenda a sinus syndrome amapezeka ngati wodwalayo ali ndi matenda a sinus amapezedwanso kuti ali ndi zizindikiro za matenda oopsa.
Chifukwa fibrosis yomwe imayambitsa matenda a sinus nthawi zina imakhudza kachilombo ka HIV, anthu omwe ali ndi matenda okhwima maganizo angakhalenso ndi mtima wochepa, ndipo chifukwa chake, amayamba kuchepa mtima kwambiri pamene ali ndi matenda a atrial. Choncho, nthawi iliyonse munthu amene ali ndi matenda a atrial amapezeka kuti amachedwa kuchepa mtima (popanda mankhwala omwe amachititsa kuchepetsa mtima), ayenera kupereka dokotala chidziwitso champhamvu kuti matenda a sinus syndrome amapezeka.
Madokotala angapangitse kuti matendawa asagwiritsidwe ntchito pokhapokha atayang'ana mtima wa wodwala pa nthawi yochita masewera olimbitsa thupi - mwachitsanzo, panthawi yoyesedwa . Chifukwa chakuti chronotropic sitingakwanitse kukhala okalamba ndipo amachiritsidwa mosavuta (ndi pacemaker yomwe imamvetsera), ndizofunikira kwa anthu okalamba omwe akutopa ndi zochepa kapena zochepa kuti atsimikizire kuti madokotala awo ayesetse.
Kodi Matenda a Tchimo a Tchimo Amatani?
Pafupifupi anthu onse omwe ali ndi matenda a sinus syndrome ayenera kuchiritsidwa ndi pacemaker yosatha.
Kachimake kameneka ndi kofunika kwambiri kwa anthu omwe ali ndi vuto lachisoni la matenda a sinus syndrome, pa zifukwa ziwiri. Choyamba, anthuwa ali ndi chiopsezo chachikulu chokumana ndi syncope (kuchokera pa kupumula kwa nthawi yayitali pamene chithokomiro cha mankhwala chimatha). Ndipo chachiwiri, mankhwala ambiri omwe amagwiritsidwa ntchito pochiza matenda opatsirana pogonana - beta blockers , calcium channel blockers , ndi mankhwala osokoneza bongo - angapangitse matenda amtundu wa sinus kwambiri. Kukhazikitsa pacemaker kudzateteza syncope, ndipo kumalola dokotala kuti azichiza matenda opatsirana pogwiritsa ntchito mankhwala oopsa kwambiri.
Mawu Ochokera
Mu matenda a sinus syndrome, matenda a nthenda ya sinus amachititsa bradycardia yokwanira kutengera zizindikiro - kawirikawiri, zosavuta kapena zosavuta. Matendawa angaperekedwe ndi tizilombo toyambitsa matenda omwe, kuphatikizapo matenda a sinus, amapanga magawo a syncope. Matenda a sinus odwala amadwala ndi pacemaker yosatha.
> Zosowa
> Epstein AE, DiMarco JP, Ellenbogen KA, ndi al. Mauthenga a ACC / AHA / HRS 2008 Malangizo Othandiza Kugwiritsa Ntchito Chipangizo cha Cardiac Rhythm Zolakwika: Lipoti la American College of Cardiology / American Heart Association Ntchito Yogwiritsa Ntchito Malangizo Othandizira (Komiti Yolemba Kubwereza Bungwe la ACC / AHA / NASPE 2002 Lotsogoleredwe Loyamba Kukhazikitsa ya Cardiac Pacemakers ndi Antiarrhythmia Devices): inakhazikitsidwa mogwirizana ndi American Association for Thoracic Surgery ndi Society of Thoracic Surgeons. Kuyendayenda kwa 2008; 117: e350.
> Fogoros RN, Mandrola JM. Phunziro la Electrophysiology mu Kufufuza kwa Bradycardia: SA Node, AV Node, ndi Wake-Purkinje System. Mu: Fogoros 'Electrophysiologic Testing, Edition Yachisanu ndi chimodzi. Wiley Blackwell, 2017.
> Josephson, ME. Ntchito ya Sinus Function. Mu: Clinical Cardiac Electrophysiology: Njira ndi Kutanthauzira, 4, Lippincott, Williams, & Wilkins, Philadelphia 2008. p.69-92.