Ngati muli ndi chizoloŵezi chodziwika mtima, choyamba choyamba kuchilandira ndi dokotala wanu kuti azindikire kwenikweni mtundu wa arrhythmia. Kusanthula zizindikiro za mtima zimakhala zophweka, zovuta za mdierekezi, kapena kwinakwake. Kupanga matendawa ndi kophweka ngati muli ndi arrhythmia yosatha kapena yotsalira-ndiye nkhani yojambula electrocardiogram (ECG) ndikulemba kukhalapo ndi mtundu wa arrhythmia omwe mukukumana nawo.
Mwamwayi, nthawi zambiri mtima wamakhalidwe a mtima ndiwopeka-amadza ndi kupita popanda chenjezo. Pazochitikazi, zizindikiro zanu zimakhala ngati zochitika zapadera, nthawi zambiri zimatha masekondi pang'ono chabe, kotero kulembetsa ECG yachiwiri-seveni sizingathe kuwonetsa arrhythmia, ndipo kuyesedwa kwina n'kofunikira. Koma mfundo yofunikira ikhale yofanana: kuti azindikire mtima wamaganizo, arrhythmia wokhayo ayenera "kutengedwa" pamtundu wina wa mtima wojambula nyimbo.
Mapulogalamu ndi Mayesero
Ngati dokotala akuganiza kuti mukukhala ndi matenda a mtima, funso loyambirira ndiloti mayendedwewa akhoza kukhala oopsa. Ngati mwadzidzidziza kuti mulibe chizungulire , kapena muli ndi syncope (kutaya chidziwitso) makamaka makamaka ngati muli ndi matenda a mtima - dokotala wanu angaganize kuti mwina muli ndi chiwopsezo choopsa, monga ventricular tachycardia kapena mtima wamkati .
Ngati ndi choncho, muyenera kuikidwa kuchipatala pamsana woyang'anira mtima mpaka mutha kugwiritsidwa ntchito bwinobwino, ndipo ngati nkofunikira, mankhwala amayamba.
Mbiri ya Zamankhwala ndi Kufufuza Kwambiri
Ngati dokotala akuwona kuti zizindikiro zanu sizowopsya, iye akhoza kuyamba ndi kuunika kwa thupi ndikuyang'ananso zizindikiro zanu ndi zochitika zomwe zingayambitse.
Mwachitsanzo, ngati akuganiza kuti muli ndi matenda a chithokomiro kapena matenda a mtima omwe amachititsa kuti muyambe kuyesa, mukhoza kuyesedwa pazifukwazi. Kuwonjezera pamenepo, mukhoza kukhala ndi mayeso oyang'anira mtima monga electrocardiogram kapena echocardiogram.
Electrocardiogram
Zizindikiro zowonjezereka zowonjezereka monga piritations , kutopa pang'ono, kapena chizungulire chochepa, nthawi yayitali, sizingatheke kuti ziwonetsetse kuti moyo wanu umatha kuika moyo wanu pansi. Kawirikawiri, izi zimachitidwa poyesera kulembetsa electrocardiogram (ECG) panthawi ya zizindikiro. Ndi ECG yofunika, muli ndi electrode okhudzana ndi chifuwa chanu chomwe chimapangitsa mphamvu yanu kugwiritsira ntchito magetsi, kuphatikizapo nthawi komanso mapeto a mtima wanu. Zingakhale zofunikira kugwiritsa ntchito ECG yotheka yomwe mungathe kuvala mukamachita zochitika zanu tsiku ndi tsiku.
Holter Monitor
Ngati zizindikiro zanu zimachitika tsiku ndi tsiku kapena pafupifupi tsiku ndi tsiku, kusankha bwino chifukwa cha vutoli kungakhale kugwiritsa ntchito mawonekedwe a Holter, chipangizo chotchedwa ECG chomwe chimakumbukira nyimbo yanu nthawi 24-48. Mungapemphedwe kuti musunge diary yosamala, podziwa nthawi yomwe zizindikiro za zizindikiro zimayambira. Zolembazo zitha kugwirizanitsidwa ndi nyimbo zojambula kuti ziwonetse ngati zizindikiro zimagwirizanitsa ndi chiwalo cha mtima.
Zochitika Zowonongeka
Ngati zizindikiro zanu zimachitika mobwerezabwereza kuposa tsiku lililonse kapena masiku angapo kapena zimachitika mofulumira kwambiri, chisankho chabwino chingakhale chowunika chochitika, mtundu wina wa ECG. Muzilumikiza ku thupi lanu pamene muli ndi zizindikiro ndikusindikiza batani kuti mulembe zomwe magetsi amachititsa pa nthawiyo.
Zokonzera Zokonza
Njira ina ngati zizindikiro zanu zimachitika mobwerezabwereza ndi patch kufufuza ngati chigoba cha Zio, chojambulira chanthawi yaitali chojambula chomwe chingasunge mpaka masabata awiri a zojambula mosalekeza za mtima wanu ndikuzindikira ndi kulemba zizindikiro zilizonse za mtima zomwe mungakhale nazo .
Palinso SEEQ MT system, yomwe ingalembe ndi kuyang'anira kwa masiku 30. Zoipa za oyang'anira zida ndizoti zingakhale zodula chifukwa sichikhoza kubwezeretsanso ndipo zingatenge nthawi yowonjezerapo kuti mutenge zotsatira zanu, koma ndizosavuta, zosagwira madzi, zosavuta kuzigwiritsa ntchito, komanso zokhazikika.
Echocardiogram
Chojambula chojambula ndi mtundu wa ultrasound yopweteka yomwe imagwiritsidwa ntchito kuyang'ana kukula ndi kapangidwe ka mtima wanu, komanso momwe zimagwirira. Mukhoza kukhala ndi echocardiogram pamene mukuchita masewera kapena mukupumula.
Chokhazikika Chothandizira
Ngati zizindikiro zanu zimakhala zosavuta kwambiri, pali zojambula zochepa zomwe zingagwiritsidwe ntchito kwa zaka zitatu kuti muzitha kulembetsa mtima wanu komanso kuti mutenge masewera omwe amachititsa chidwi kwambiri. Chipangizochi chimayikidwa pansi pa khungu lanu m'chifuwa chanu ndipo chingakhale chothandiza makamaka ngati mwadwala matenda osokoneza bongo kuti mudziwe chomwe chinayambitsa.
Kutanthauzira ECG
Cholinga chojambula mtima wanu pa nthawi ya zizindikiro ndi kuyesa kugwirizanitsa zizindikiro zanu ndi kujambula kwa ECG pamene zizindikiro zikuchitika. Momwemo, kuti apeze matendawa, zizindikirozo ziyamba pamene arrhythmia imachita, ndi kuthetsa pamene arrhythmia ayima. Ngati chithunzichi chikuwoneka, ndizowona kuti arrhythmia ikupereka zizindikiro.
Kawirikawiri, anthu amafotokoza zizindikiro nthawi zina pamene mtima wamtima umakhala wabwinobwino; kapena, kachigawo kakang'ono kadzalembedwa panthawi yomwe palibe zizindikiro. Pansi pa izi, zikutheka kuti zizindikiro zomwe mukukumana nazo sizili chifukwa cha arrhythmia, ndipo dokotala wanu ayambe kuganizira zosiyana siyana za zizindikiro zanu.
Ngati dokotala wanu sakupeza chiwerengero cha mayendedwe pamtima pakuyesedwa, komabe amakayikira kuti muli nawo, akhoza kuyesa kugwiritsa ntchito imodzi mwa mayesero awa:
Mayesero opsinjika
Popeza kuti arrhythmias ena imayambitsa kapena kuwonjezereka mwa kuchita masewera olimbitsa thupi kapena kuchita khama, dokotala wanu akhoza kuyesa kupanikizika , kuyang'anitsitsa mtima wanu pamene mukugwira ntchito pa bicycle kapena sitima. Ngati pali chifukwa chomwe simungathe kuchita masewera olimbitsa thupi, mungapatsedwe mankhwala osokoneza mtima m'malo mwake.
Zowonongeka Pulogalamu Yoyesa
Ngati mwakhala mukudandaula, dokotala wanu angafunike kuyesera patebulo . Pamene mukugona pansi patebulo, ntchito yanu ya mtima ndi kuthamanga kwa magazi zimayang'aniridwa. Mungaperekedwe mzere wovuta (IV) ngati mukufuna mankhwala. Gome amatsindikizidwa kuti ziwone ngati mukuyimirira pamene adokotala akuyang'anira kusintha kulikonse kwa magazi ndi / kapena ntchito ya mtima.
Pulogalamu ya Electrophysiology (EPS)
Ngati arrhythmia ndi yovuta kapena dokotala akuvutika kupeza kapena akuganiza kuti akhoza kuopseza moyo, iye angapange kufufuza kwa electrophysiology (EPS), kuyesa kachipatala kamene kamakhala ndi electrode catheters (makina osinthika, osungunuka ndi zitsulo nsonga zamagetsi) amalowetsedwa mu mtima mwanu kuti aphunzire dongosolo lamagetsi la mtima.
Zimene muyenera kuyembekezera: Ngati dokotala atakuuzani za EPS, mudzabweretsedwa ku labotale ya electrophysiology (labotale yapadera ya catheterization) komwe mudzagona pa tebulo lofufuzira. Mudzapatsidwa anesthesia, ndipo mwinamwake wochepetsetsa pang'ono, ndiyeno magetsi amtundu wa electrode adzalowetsedwa mu mitsempha yanu imodzi kapena yambiri. Catheters amalowetsedwa kupyolera mu katoto kakang'ono kapena pogwiritsa ntchito ndodo ya singano, kawirikawiri mdzanja lanu, kubuula, kapena khosi. Kawirikawiri amagwiritsa ntchito catheters awiri kapena atatu, ndipo akhoza kuikidwa pa siteti imodzi. Pogwiritsira ntchito fluoroscopy, yomwe ili yofanana ndi x-ray, catheters yapititsidwa kupyolera mu mitsempha ya mitsempha ndipo imaikidwa m'madera ena mkati mwa mtima wanu.
Akayikidwa bwino, makina a electrode amagwiritsidwa ntchito kuchita zazikulu ziwiri: kulemba zizindikiro zamagetsi zomwe zimapangidwa ndi mtima wanu komanso kuyenda mofulumira mtima wanu. Pacing imakwaniritsidwa mwa kutumiza zizindikiro zochepa zamagetsi kupyolera mu catheter ya electrode. Mwa kulemba ndi kuyendetsa kuchokera kumalo okonzeka mkati mwa mtima wanu, mitundu yambiri yamagayimu ya mtima ikhoza kuphunzitsidwa bwino. Pamene ndondomeko yatha, catheter (s) ikuchotsedwa. Kutsekemera kumayang'aniridwa mwa kuyika kukakamiza pamalo ochepetsera malo kwa mphindi 30 mpaka 60.
Zomwe Iwo Amachita: EPS ikhoza kuthandizira kuyang'ana onse a bradycardias (otsika mtima arrhythmias) ndi tachycardias (mwamsanga mtima arrhythmias). Tachycardias amafufuzidwa pogwiritsa ntchito njira zothandizira kuti azitha kuyambitsa tachycardia. Ngati tachycardias ingayambitsidwe pa EPS, ndiye mwa kuphunzira zizindikiro zamagetsi zolembedwa kuchokera kumagetsi a electrode, chomwe chimayambitsa tachycardia chimatha kudziwika. Mukamaliza izi, mankhwala oyenera nthawi zambiri amakhala omveka bwino.
Kuvomereza Chithandizo: Pali njira zingapo EPS ingakuthandizireni inu ndi dokotala wanu kupanga zosankha za chithandizo. Njira zothandizira zomwe zingaganizidwe malinga ndi zotsatira za EPS zikuphatikizapo:
- Kuika phokoso la pacemaker: Ngati EPS ikutsimikizira kukhalapo kwa bradycardia, chidziwitso cha pacemaker chingathe kuikidwa nthawi yomweyo, panthawi yomweyo.
- Ablation: Ngati mwapadera tachycardia (SVT) -ndipo mitundu ina ya tricycardia ya ventricular (VT) -pezedwa, kupuma kwa poizoni nthawi zambiri kumakhala chithandizo cha kusankha. Njira yobweretsera nthawi zambiri imayendetsedwa panthawi yomweyi, mwamsanga kutsatira EPS.
- Kuika makina osokoneza bongo: Ngati mitundu yofulumira ya VT ndi / kapena ventricular fibrillation (VF) imadziwika pa EPS, kawirikawiri mankhwala osokoneza bongo ndi opanga mankhwala. Chipangizochi tsopano chikhoza kuikidwa mu labotale ya EP, mwamsanga kutsatira EPS. Zaka zapitazo, EPS idagwiritsidwa ntchito pozindikira mankhwala osokoneza bongo kwa odwala omwe ali ndi VT kapena VF, koma lero akudziwika kuti palibe mankhwala otsutsa omwe ali othandiza kuti athe kufa mosayembekezereka kuchokera ku mayendedwewa.
Zowopsa: Zowopsa za kukhala ndi EPS ndi zofanana ndizokhala ndi catheterization ya mtima. Ndondomekoyi ndi yotetezeka, koma chifukwa ndi njira zovuta zokhudzana ndi mtima, zingapo zingatheke. Sitiyenera kukhala ndi EPS pokhapokha ngati mukuganiza kuti zomwe mwapeza kuchokera mu ndondomekozi zidzakhala zopindulitsa kwambiri.
Zovuta zing'onozing'ono zimaphatikizapo kutuluka magazi kumalo a catheter kuika, kusokonezeka kwapakati pa mtima chifukwa cha catheter kukwiyitsa minofu ya mtima, komanso kusintha kwa kanthawi kozizira kwa magazi. Zovuta zowonjezereka zimaphatikizapo kuperewera kwa khoma la mtima lomwe limayambitsa matenda omwe amachititsa kuti thupi liwonongeke , kutuluka magazi, kapenanso chifukwa chakumangidwa kwa mtima, kumangidwa kwa mtima. Kuopsa kofa pa EPS kuli osachepera 1 pa 1,000.
> Zotsatira:
> American Heart Association. Mayesero Amodzi a Arrhythmia. Idasinthidwa pa December 21, 2016.
> Fung E, Järvelin MR, Doshi RN, ndi al. Mapulogalamu a Pulogalamu ya Electrocardiographic ndi Mawonekedwe Osakayika Otsata Mapulogalamu a Cardiac. Malire mu Physiology . 2015; 6: 149. lembani: 10.3389 / fphys.2015.00149.
> Levy S. Arrhythmia Utsogoleri kwa Udokotala Wachikulire. Zaposachedwa. Idasinthidwa pa 17 April, 2017.
> Chipatala cha Mayo Clinic. Mtima Arrhythmias. Chipatala cha Mayo. Idasinthidwa pa December 27, 2017.