Dyspnea yotchedwa Paroxysmal nightcty, yomwe nthawi zambiri imatchedwa "PND" ndi madokotala, ndi chizindikiro chodetsa nkhawa makamaka chimene chimayambitsa vuto la mtima . Munthu amene ali ndi PND adzadzidzimuka mwadzidzidzi ku tulo tofa nato ndi dyspnea (mpweya wochepa), ndipo adzamupeza iyeyo akuwombera mpweya, akukokera, ndikumva kuti akukakamizika kuti achoke pabedi ndikukhala ndi chikhalidwe choyenera.
Osachepera amene ali ndi vutoli amakhala pamphepete mwa bedi, ndipo nthawi zambiri amamva kuti akufunikira kupita kutseguka.
Kupuma bwino kumapindulitsa pa mphindi zingapo. Ngakhale zitatha zizindikirozo, komabe sizingatheke kuti tibwerere patatha kanthawi ka PND, chifukwa cha nkhawa yomwe chizindikiro chodetsa nkhaŵa ndi chodabwitsa chimapanga.
Nthawi zina PND sichithetsa mwamsanga ndipo m'malo mwake ikhoza kupitiriza. Chifukwa chakuti zizindikiro zimakhala zovuta kwambiri kunyalanyaza, chochitika chokhazikika cha PND chimaitanitsa ku 911 kapena ulendo wopita ku chipinda chodzidzimutsa.
Kaya ndi zosankha zake zokha, PND nthawi zonse ndi chizindikiro choopsa chomwe nthawi zambiri chimasonyeza kuti mtima wa munthu ukupitirirabe. Choncho, aliyense amene akumana ndi PND amafunika kuonana ndi adokotala nthawi yomweyo, ngakhale zizindikirozo zitangoyamba mwamsanga.
Zimayambitsa
Paroxysmal usiku wa dyspnea amayamba chifukwa cha kusweka mtima kwa mtima , makamaka nthawi zambiri (koma osati nthawi zonse) mwa anthu omwe ali ndi zigawo za dyspnea ndi zovuta, kapena za orthopnea (kupuma pang'ono pamene wagona).
Anthu omwe ali ndi PND kawirikawiri amakhala ndi edema (kutupa) m'mapazi awo ndi miyendo yomwe, pamtima mtima, kawirikawiri imasonyeza kuti madzi akuwongolera.
Kwa anthu omwe ali ndi vuto la mtima, kugona kuti agone akhoza kubweretsa kusintha kwa madzi m'thupi. Chifukwa chimodzi, madzi amadzimadzi amatha kusintha kuchoka m'magazi n'kulowa m'magazi, omwe amachititsa kuti phulusa la plasma liyambe.
Kuwonjezera apo, ena mwa madzi owonjezera, mphamvu yokoka "yasokoneza" miyendo kapena mimba patsiku amatha kuchoka kumbali za thupi pamene munthuyo wagona. Madzi oterewa amatha kubwezeretsanso m'mapapu.
Nthawi zina kusintha kwa madziwa kumapangitsa kuti mpweya usafulumire mwamsanga pamene munthu wokhala ndi mtima wagwetsedwa. Kusinthasintha kwadzidzidzi kumeneku kumachititsa chizindikiro cha orthopnea. Anthu amene atulukira mwamsanga amaphunzira kukweza mutu wa mabedi awo, zomwe zimakhudza kusunga zifuwa zawo. Izi zimathandiza kuti madzi asasunthike kumapapo. (Ichi ndi chifukwa chake madokotala nthawi zambiri amafunsa odwala awo omwe ali ndi mtima wosagwirizana ndi miyendo ingati yomwe amagwiritsa ntchito usiku - ndizovuta kulingalira za digiri ya orthopnea yomwe munthuyo akukumana nayo.)
Koma ndi PND madzi akusintha osati chifukwa cha zizindikiro nthawi yomweyo. M'malo mwake, zimakhala zochitika zambiri zomwe potsiriza (pambuyo pa munthuyo atakhala ndi mwayi wogona) zimapangitsa kuchedwa - ndipo kawirikawiri kumakhala koopsa kwambiri kwa dyspnea. Chifukwa cha kuyambika kwayamba kwa zizindikiro kwa anthu omwe ali ndi PND sichikuwonekera bwinobwino. Zimaganiziridwa kuti mwinamwake kupuma kwa ubongo kungathe kukhumudwa pamene mukugona mu anthu omwe ali ndi mtima wolephera, kapena kuti kuchepa kwa adrenaline pamene akugona kungathe kukhumudwitsa mtima, ndipo pang'onopang'ono amalola kuti madzi akudziwike m'mapapu.
Kodi PND Ingapangidwe ndi Malamulo Osiyana ndi Kulephera kwa Mtima?
Njira "yolondola" yogwiritsira ntchito mawu akuti "PND" sizinagwirizane ndi madokotala. Kafukufuku wamaphunziro a anthu ambiri amaganiza kuti PND ndizojambula, ndipo amatha kuzigwiritsa ntchito okha kwa odwala omwe ali ndi vuto la mtima. Kugwiritsa ntchito kumeneku kumapereka tanthauzo lapadera ku "PND." Anthu omwe ali ndi mtima wotsutsa amene amapanga PND amakhala ovuta kwambiri kuvutika mtima kwambiri. Izi zikutanthauza kuti ayenera kukhala ndi chithandizo chamankhwala nthawi yomweyo kuti athetse vutoli, mwinamwake chiopsezo chowopsya cha moyo cholephera kuchitika.
Ndiye pamene akatswiri a cardi ati "PND" iwo akupanga zonse zizindikiro ndi chitsimikizo.
Komabe, mwatchutchutchu, "paroxysmal nocturnal dyspnea" imangotanthauza "kuperewera kwadzidzidzi kwa mpweya usiku," ndipo izi zingagwiritsidwe ntchito ku matenda aliwonse omwe angabweretse dyspnea pogona. Kotero, pakati pa zamankhwala ambiri, "PND" imangotanthauzira chizindikiro. Choncho, mudzamva "PND" yomwe ikugwiritsidwa ntchito ku matenda osiyanasiyana omwe angayambitse dyspnea mwadzidzidzi usiku. Mavuto amenewa ndi ochuluka ndipo amagwiritsa ntchito kugona kwa mphuno , mphumu , ndi pulmonary embolus . Amaphatikizansopo matenda a mtima kusiyana ndi kupwetekedwa mtima kwa mtima monga diastolic mtima kulephera komanso matenda a mtima ischemia (monga ndi matenda oopsa ).
Mawu Ochokera
Si kwa inu kuti muwone ngati dyspnea yanu yovuta usiku ndi chifukwa cha kulephera kwa mtima kapena chifukwa china. Ndi kwa dotolo wanu. Chimene muyenera kudziwa ndi chakuti PND nthawizonse imasonyeza kuti vuto lalikulu lachipatala likuchitika. Zirizonse zomwe zimayambitsa, muyenera kupeza thandizo lachipatala nthawi yomweyo ngati mukudwala matendawa.
> Zotsatira:
> Yambani CW, Jessup M, Bozkurt B, et al. 2013 ACCF / AHA Malangizo othandizira kulamulira kwa mtima: Chidule Chachidule: Lipoti la American College Association of Cardiology Foundation / American Heart Association Task Force pa ndondomeko zoyendetsera ntchito. Circulation 2013; 128: 1810.