Kodi ndikutanthauzanji kuti arrhythmia?
Tentacarcardia ya Reentrant ndi banja la magetsi a mtima ofulumira omwe amachititsidwa ndi kugwirizana kosagwirizana kwa magetsi pamtima. Kulumikizana kosavomerezeka kumapanga maulendo amagetsi, omwe angasokoneze mtima wamtima.
Ndi chizoloŵezi chodziwika bwino cha mtima (chomwe chimatchedwa chikhalidwe chachibadwa cha sinus ), mtima wa magetsi umachokera mu nthenda ya sinus , ndipo imafalikira mofanana pambali pa zipinda zam'kati mwa mtima (zomwe zimachititsa atria kugwirizanitsa), ndiyeno zimapitiriza kufalikira mofanana pamtima zipinda zam'mlengalenga (zomwe zimachititsa kuti mabomba am'mimba azigwira ntchito).
Mphindi zochepa pang'onopang'ono magetsi atsopano amapangidwa ndi nthenda ya sinus, ndipo ndondomeko yonse ikubwereza.
Komabe, ngati dera loyendetsa magetsi likupezeka pamtima, reitrant arrhythmia imakhala yotheka. Chigwirizano chotchedwa arrhythmia chimachitika ngati m'maganizo a magetsi (kaya ndi chizoloŵezi chodziwika bwino cha mphamvu ya magetsi, kapena chizoloŵezi chosawonongeka cha magetsi chomwe chimapangidwa ndi makina osokoneza bongo (PAC) kapena chipangizo cham'mimba chisanafike msanga (PVC) mikhalidwe. Kuganiza koteroko kungakhale "kutengedwa" mkati mwa dera, motero kumayamba kuyamba kuyendayenda mozungulira, mobwerezabwereza. Pogwiritsa ntchito makoswe onse, kuzungulira kumapanga mtima watsopano. Thupi latsopanoli, losazolowereka limatchedwa reentrant arrhythmia (chifukwa mphamvu ya magetsi "imalowetsanso" dera ndi lapulo lililonse).
Popeza palibe kupuma pakati pa zipolopolo za mtima pa nthawi yowonjezereka (chifukwa chakuti mphutsi zimayendayenda mozungulira nthawi zonse), nthawi zambiri mtima umakhala wothamanga pa nthawi yowonongeka. (Ndiko tachycardia ilipo.)
Mitundu ya Reentrant Tachycardia
Pali mitundu iwiri yambiri ya reachrant tachycardias - supraventricular tachycardia (SVT) ; komanso tacycardia (VT) ndi ventricular fibrillation (VF) .
Reentrant Supraventricular Tachycardias
Kulumikizana kwa magetsi kosalongosoka kumene kumayambitsa SVT kawirikawiri kumachokera kubadwa - kotero maginthmias awa amawoneka ochiritsika, achinyamata. Reentrant SVT ingayambitse zizindikiro zazikulu, koma sizingowonjezereka kapena zoopsa. Mitundu yosiyanasiyana ya SVT nthawi zambiri imatchulidwa malinga ndi chikhalidwe cha reentrant circuit yomwe imawapanga. Mitundu yayikulu ya SVT ikuphatikizapo:
- Sinus node reentrant tachycardia (SNRT) , momwe chigawo choyendayenda chikuphatikizapo nambala ya sinus.
- AV nodal reentrant tachycardia (AVNRT) , momwe maulendo obwereza akuphatikizapo kachilombo ka AV .
- Kachilombo ka atrial tachycardia, komwe kachigawo kakang'ono kameneka kamapezeka mkati mwa atria.
- Atrioventricular reentrant reachrant tachycardia (AVRT) , momwe maulendo oyendetsa magetsi ali ndi kugwirizana kwa magetsi ("kudutsa pamtunda") pakati pa atria ndi ventricles. Pali mitundu yambiri yosiyana-siyana ya reitrant tachycardia, koma bwino kwambiri ndi Wolff-Parkinson-White syndrome (WPW) .
- Ntchentche yotchedwa Atrial flutter , yomwe ndi mtundu wapadera wa atrial reachrant tachycardia momwe mzere woyendayenda umakhala waukulu kwambiri.
- Mafilimu a Atrial amagwiritsidwa ntchito ngati mtundu wapadera wa tachycardia yodwalayo yomwe imabweretsa maulendo angapo opititsa patsogolo.
Matenda a atrial amasiyana ndi mitundu ina ya SVT yowonjezera, chifukwa nthawi zambiri sichifukwa cha kusokonekera kwa thupi la magetsi, koma nthawi zambiri zimayambitsidwa ndi kukula kwa mavuto a mtima. Matenda opatsirana pogonana amapezeka kawirikawiri kwa anthu achikulire kusiyana ndi mitundu ina ya SVT.
Tentarctica Tentycardia
Mosiyana ndi SVT, kugwirizana kwa magetsi komwe kumapangitsa VT kapena VF nthawi zambiri sikupezeka kuchokera kubadwa. Mmalo mwake, kugwirizana kumeneku kumabwera chifukwa cha kupweteka kwa minofu ya mtima yomwe imapezeka ndi mitundu yambiri ya matenda a mtima (makamaka matenda a mitsempha yam'thupi - CAD - kapena mtima wosalimba ).
Izi zikutanthauza kuti anthu omwe amatha kukhala ndi VT kapena VF amakhala okalamba, ndipo amakhala ndi vuto lalikulu la mtima. Mwamwayi, chiopsezo chokhala ndi VT kapena VF ndi chofala ku CAD ndi mtima wosalimba, ndipo chifukwa chake anthu ambiri omwe ali ndi vutoli amafa imfa yadzidzidzi.
Zotsatira:
Antzelevich C. Njira zofunikira zowonongeka mwachidule. Malingaliro Otsopano mu Maphunziro a Zamoyo Zachilengedwe 2001, 16: 1-7
Link MS. Kuchita zachipatala. Kufufuza ndi njira yoyamba yothandizira opangira tachcardiadia. N Engl J Med 2012; 367: 1438.