Kodi RBBB ndi Vuto Liti?
Nthambi yoyenera ya nthambi ndi njira yosadziwika yomwe imawonekera pa electrocardiogram (ECG) , yomwe imasonyeza kuti mtima wa magetsi siukugawidwa bwinobwino pamtunda. Mwachindunji, nthambi yamagulu yolumikiza bwino imatanthauza kuti kuyendetsa magetsi kwa ventricle yoyenera ikuchedwa.
Nchiyani Chimachititsa Mtolo Wobwino Wopinda Nthambi?
Nthambi ziwiri zikuluzikulu (kumanja ndi kumanzere) ndi njira zamagetsi zomwe zimapangitsa mphamvu ya magetsi kugwedezeka mofulumira komanso mofanana mwazitsulo zonsezi, kotero kuti kugunda kwa mtima kumagwirizanitsidwa bwino.
Pogwiritsa ntchito nthambi yowongoka bwino, pali chigawo chochepa kapena chokwanira cha mphamvu ya magetsi ku ventricle yoyenera. Bwalo la nthambi lachangu limachepetsa kuyendetsa magetsi kwa ventricle yoyenera. Pambuyo pake, ventricle yoyenera imalimbikitsidwa pambuyo poti ventricle ya kumanzere ikulimbikitsidwa, ndipo kuvomberana kwake kukuchedwa.
Mosiyana ndi tsamba lamanzere lachitetezo (momwe kuyambira kwa ventricle kumanzere kuli kuchepetsedwa), nthambi yosungiramo nthambi sichinyalanyaza ntchito yonse ya mtima mu njira iliyonse yowoneka. Choncho, nthambi yokha yolumikiza nthambiyo imayesedwa ngati chikhalidwe chokhwimitsa chomwe sichifuna mankhwala enieni.
Komabe, malo ogwirira ntchito yamatabwa adakali ofunika kwambiri. Chofunika chake chimagwirizana ndi mfundo yomwe nthawi zambiri imagwirizanitsidwa ndi chikhalidwe cha mtima kapena mapulaneti. Tsono pamene nthambi ya nthambi yowona bwino imapezeka, kafukufuku wamankhwala amafunika.
Kusanthula Gulu Loyenera la Nthambi
Bungwe la nthambi yamalonda limayambitsa kusintha kwa ECG, kotero madokotala amatha kupeza mosavuta vutoli pokhapokha atafufuza electrocardiogram.
Muchitetezo cha nthambi , QRS-gawo la ECG lomwe limayimira magetsi oyendayenda m'magulu a zitsulo-ndilolitali kuposa lachizoloŵezi, chifukwa zimatengera nthawi yochulukirapo kuti chidziwitsidwe.
Muchitetezo chokwanira cha mtolo, pali chikhalidwe chachikhalidwe ichi chikufutukula chimatengera mtsogolomu 12 (kapena "malingaliro") operekedwa ndi ECG yofanana. Kotero, pokhapokha podziwa chitsanzo cha kufalikira kwa QRS complex, kawirikawiri zimakhala zosavuta kuzindikira kukhalapo kwa malo ogulitsira nthambi.
N'chifukwa Chiyani Mtolo Wokongola Umakhala Wofunika Kwambiri?
Chiwerengero cha nthambi ya nthambi yowonjezera imakula ndi zaka. Zimangowoneka kawirikawiri kwa achinyamata, koma oposa 11 peresenti ya anthu azaka 80 amakhala ndi nthambi yabwino.
Bungwe la nthambi yowonjezera ndilofala, ndipo mankhwala ndi ofunika kwambiri, kusiyana ndi wothandizana naye, atasiya bundle nthambi. Pomwe palibenso nthambi yamagulu yoyenera, chofunika kwambiri ndicho kuyesa kuyang'ana chikhalidwe cha mtima kapena pulmonary.
Ngati palibe mkhalidwe woterewu utapezeka, malo ogulitsira katundu ogulitsa bwino angathe kuonedwa kuti ndi abwino kwambiri (osati ovulaza).
Nthambi Yabwino Yopangira Nthambi ndi Mtima Wowongoka ndi Matenda Olimbitsa Thupi
Nthambi yabwino yolumikiza katundu, yomwe imakhala mkati mwa mitsempha ya ventricle yoyenera, imangokhala pamwamba pa mphepo yam'mlengalenga. Izi zimapangitsa nthambi yabwino kuti iwonongeke ndi kutambasula nthawi iliyonse yoyenera kugwiritsira ntchito ventricle pansi pa nkhawa ya mtundu uliwonse.
Choncho, nthambi yamagulu yolumikiza katundu nthawi zambiri imachitika ndi chikhalidwe chilichonse chomwe chimakhudza ventricle yoyenera. Mkhalidwe umenewu ukhoza kuphatikizapo matenda amtundu wa matenda (CAD) , myocarditis (kutupa kwa mitsempha ya mtima), chilema cha malaria , chivundikiro cha septal defect, ndi matenda a valvular .
Kuwonjezera pamenepo, malo ogwirira ntchito pamalopo amatha kuwonetseredwa ndi vuto lililonse la mapapu lomwe limayambitsa matenda aakulu muzitsulo zoyenera, makamaka pang'onopang'ono. Kuchulukanso kwa magazi kungayambitse matenda osiyanasiyana a mapapo, kuphatikizapo matenda osokoneza bongo (COPD) omwe amachititsa kuti asagone .
Kuti muzindikire, nthambi yamagulu yolumikiza bwino ndi yowonongeka ndi chikhalidwe chilichonse chomwe chimapangitsa kuti zikhale zovuta mu ventricle yoyenera. Chizoloŵezi chofala kwambiri chomwe chimachita izi ndi kulumikizana kwa pulmonary .
Chotsatira chake, aliyense yemwe amapezeka kuti ali ndi nthambi ya nthambi yoyenera amagwiritsa ntchito kafukufuku wa zachipatala zomwe zimagwiritsa ntchito zizindikiro za matenda a mtima kapena mapapo. Chida cha X-ray ndi echocardiogram ndizogwiritsa ntchito zowonetsera pogwiritsa ntchito izi.
Chifukwa chakuti nthambi yabwino imakhala yotengeka ndi chirichonse chomwe chingathe kuchititsa ngakhale kupsinjika kwazing'ono mu ventricle yoyenera, nthambi yamagulu yolumikizira yabwino imapezeka pafupifupi pafupifupi 5 peresenti ya odwala omwe ali ndi catheterization ya mtima . Nthambi yachangu yachangu yachangu imapezeka pamene catheter imakwiyitsa nthambi yoyenera. Bwaloli lachitsulo laching'ono lachitsulo limathetsa mofulumira (mkati mwa mphindi) kamodzi kathetsa itachotsedwa.
Komabe, mwa anthu omwe asiya kale mtolo wa nthambi, kuchititsa ngakhale bwalo lachitetezo lachangu lachangu labwino likhoza kukhala lokhazikika pamtima mtima wathunthu , ndipo mtima ukhoza kuleka kugunda. Kotero, mwa anthu omwe ali ndi nthambi yotsalira yachitsulo omwe ali ndi catheterization yabwino ya mtima, nthawi zina pacemaker imayikidwa panthawiyi, kutsimikizira kuti mtima wamtima udzapitirizabe kusokonezedwa panthawi yophunzira.
Nthambi Yoyenera Yogwirira Ntchito ndi Kugwira Mtima kwa Mtima
Pogwiritsa ntchito timatabwa tomwe timagwiritsa ntchito kumanja kapena kumanzere, timagulu timene timagwiritsira ntchito timagulu timene timakhala tikukambirana motsatizana. Kutayika kwa kugwirizanitsa bwino pakati pazitsulo ziwirizi zingachepetse kupambana kwa mtima.
Komabe, kuchepetsa kuyenerera kwa mtima ndi kopanda phindu ndipo palibe zotsatira muchitetezo cha nthambi yoyenera. Kotero, mwachitsanzo, kugwiritsidwa ntchito kwa mankhwala opatsirana pogonana (CRT) sikunayamikiridwe kwa anthu omwe ali ndi nthambi yoyenera, ngakhale ali ndi vuto la mtima .
Kodi Bungwe la Nthambi Yolondola Lifunika Kukhala ndi Pulasitiki?
Bwalo la nthambi yowongoka, yokha, silimasowa chithandizo ndi pacemaker yosatha. Komabe, mwa anthu ena nthambi yamagulu yoyenera sizimachitika yokha, koma mmalo mwake imayimira kuwonetsa kokha kwa vuto lalikulu ndi kayendedwe ka magetsi ka mtima. Zikatero, pacemakeraker ikhoza kuchitidwa ngati matenda a sinus kapena matenda a mtima akudwala.
Mawu Ochokera
Bungwe la nthambi yokha ndilo vuto lachilendo lomwe silikusowa chithandizo. Komabe, aliyense yemwe akupezeka kuti ali nacho ayenera kukhala ndi kuyesayesa koyezetsa magazi kuti asatuluke matenda okhudza mtima kapena mapapo. Ngati palibe amene amapezeka, ndiye kuti mthunzi wa nthambi yoyenera nthawi zambiri ukhoza kulembedwa ngati chidziwitso chosafunikira, popanda chofunikira chamankhwala.
> Zotsatira:
> Badheka AO, Singh V, Patel NJ, et al. Nthawi ya QRS pa Electrocardiography ndi Cardiovascular Mortality (Kuchokera pa National Health and Nutrition Research Survey-III). Am J Cardiol 2013; 112: 671.
> Barsheshet A, Goldenberg Woyamba, Garty M, et al. Kuyanjana kwa Mtolo Wotsogolera Kukhalitsa Kwanthawi Yaitali (Zaka Zakai) Kufa kwa Odwala Amene Amalandira Chithandizo Chachizoloŵezi cha Odwala. Am J Cardiol 2011; 107: 540.
> Bussink BE, Holst AG, Jespersen L, et al. Mtolo Wokongola Wofesi: Nthambi, Zambiri za Fisk, ndi Zotsatira mwa Anthu Onse: Zotsatira Kuchokera ku Copenhagen City Heart Study. Mtima; 34: 138.
> Zhang ZM, Rautaharju PM, Soliman EZ, et al. Kuopsa kwa Mipingo Imene Imakhudzana ndi Ndalama Zofesi za Nthambi ndi Kukhalanso Kwambiri Kulimbana Kwambiri (Kuchokera ku Women's Health Initiative WHI). Am J Cardiol 2012; 110: 1489.