Syncope (chigwirizano chauchimo) ndikutaya kwadzidzidzi kwadzidzidzi, komwe kumatchedwa kutaya, kapena kutuluka. Ndichizoloŵezi chodziwika bwino - anthu ambiri amapita kamodzi m'miyoyo yawo. Komabe, syncope nthawi zonse ndizovuta, chifukwa zingasonyeze vuto lalikulu, ndipo chifukwa chakuti kutaya chidziwitso kumatha kuvulaza.
Kotero, ngati muli ndi gawo la syncope, muyenera kuyesedwa ndi dokotala wanu kuti mudziwe chifukwa chake.
Kupirira
Syncope imachitika pamene magazi akupita ku ubongo amachepetsedweratu, chifukwa mphindi zisanu kapena zisanu ndi chimodzi. Mwazi wa magazi umatha kusokonezedwa chifukwa cha zifukwa zosiyanasiyana. Mwamwayi, nthawi zambiri, syncope ndi chizoloŵezi chosakhalitsa chimene sichimayambitsa matenda aakulu. Kotero nthawi zambiri, malinga ngati chidziwitso cha syncopal sichinayambe kuvulaza kwambiri, chochitikacho sichidzakhala ndi phindu la nthawi yaitali.
Komabe, nthawi zina syncope ndi chizindikiro chakuti choopsa kapena ngakhale chowopsya chotengera chikhalidwe cha mankhwala chingakhalepo. Ichi ndi chifukwa chake, ngati muli ndi chidziwitso cha syncope, nkofunika kuti muwonane ndi dokotala wanu.
Zotsatira Zogwirizana
Syncope ingabwere chifukwa cha zochitika zosiyanasiyana zamankhwala. Ndipotu, chiwerengero chachikulu cha zochitika zingathe kuwonetsa kuti syncope ndi chiyembekezo chovuta komanso chowopsyeza kwa madokotala omwe sagwirizana ndi vutoli mwadongosolo komanso mwadongosolo.
Madokotala omwe ali ndi luso lofufuza syncope nthawi zambiri amapanga zifukwa zomwe zingayambitse m'magulu awiri - syncope chifukwa cha matenda a mtima, ndi syncope chifukwa cha zifukwa zosagwirizana ndi mtima. Pafupifupi mitundu yonse yowopsya ya syncope ili m'gulu la mtima. Mwamwayi, zifukwa za mtima za syncope nthawi zambiri zimakhala zosavuta kudziwa ndi kusanthula mwachidule - mwachindunji, mwa kutenga mbiri yabwino ya zachipatala ndikuchita kafukufuku weniweni.
Ndipo panthawi yomwe mtima wanu wasokonezeka, inu ndi dokotala wanu mukhoza kutsimikiziridwa kuti ngakhale zili choncho, simungathe kuika moyo wanu pachiswe - ndipo zotheka zanu zingatheke popanda lingaliro lofunika kwambiri.
Zimayambitsa
Zotsatira za Mtima
Pafupifupi munthu mmodzi mwa anthu anayi omwe ali ndi syncope adzakhala ndi vuto la mtima. Mitundu iwiri ya matenda a mtima ingapangitse syncope - mavuto a mtima omwe angalepheretse kutaya kwa magazi kudzera mu mtima, ndi mtima wa arrhythmias .
Matenda a mtima:
Kulepheretsa magazi kudutsa mu mtima kungayambitse kuchepa kwa magazi komwe mtima ukubwera, motero kubera ubongo kukwanira magazi. Matenda amtima angapo amachititsa kuti magazi asatuluke pamtima . Izi zikuphatikizapo:
- Matenda a mtima a valve omwe amapangitsa stenosis, makamaka aortic stenosis ndi mitral stenosis
- Matenda a hypertrophic cardiomyopathy , omwe, nthawi zina, amachepetsa kutuluka kwa magazi kudutsa pa valve ya aortic
- Kulepheretsa mu chotengera chachikulu cha magazi pafupi ndi mtima (monga chiwindi chachikulu cha pulmonary )
- Matenda a mtima (monga myxoma ya atrial, chotupa chothetsa mphamvu chomwe chingalepheretse mtsempha wa mitral)
Cidiac arrhythmias:
Arrhythmias ya cardiac ndizovuta kwambiri chifukwa cha syncope kusiyana ndi zomwe zimapangitsa kuti thupi likhale lovuta. Mwamwayi, pafupifupi chimango chilichonse chomwe chingayambitse syncope chingayambitsenso imfa mwadzidzidzi, ngati arrhythmia ikupitirira kwa mphindi zingapo.
Arrhythmias ikhoza kuchepetsa ntchito ya mtima m'njira ziwiri - pakupangitsa mtima kukhala wocheperachepera, kapena poupanga mofulumira kwambiri.
Kulowera pang'ono mtima (wotchedwa bradycardia) kungabweretse syncope mwa kuchititsa mtima kupweteka pang'onopang'ono kuti ubongo supeza magazi okwanira. Ngati bradycardia imapezeka kuti imayambitsa syncope, ndipo ngati bradycardia ikuganiza kuti ikhoza kubwereranso, chithandizo chotheka chingaperekedwe mwa kuika mtima wopanga mtima.
Kaya sinus bradycardia kapena block heart ikhoza kutulutsa kwambiri bradycardia.
Mapuloteni a mtima omwe amatchedwa "tachycardia" angayambitsenso syncope mwa kupangitsa mtima kugunda mofulumira kotero kuti sungathe kupopera bwino. Ngakhale pali mitundu yambiri ya tachycardia, yomwe imayambitsa syncope ndi ventricular tachycardia ndi ventricular fibrillation . Magulu amenewa amatha kupha moyo ndipo amabala imfa mwadzidzidzi .
Mbiri yachipatala yosamala komanso kuunika kwa thupi - pamodzi ndi electrocardiogram (ECG) - iyenera kupatsa dokotala chidziwitso chokwanira kuti adziwe ngati zilizonse za mtima wanu ndizo chifukwa cha syncope. Ndipo ngati mtima umaganiziridwa kuti ndiwowoneka, nthawi yomweyo, kuunika kwa mtima kukufunika, komwe kungaphatikizepo echocardiogram , test stress , kapena njira zina zothandizira. Dokotala wanu angaganize ngakhale kuti muyenera kupita kuchipatala kuti muteteze nokha mpaka matendawa atsembedwa pansi, ndipo chithandizo choyenera chikuperekedwa.
Mwamwayi, komabe, nthawi zambiri, kuyesa koyeso koyambirira kwa mankhwala kumayambitsa chifukwa cha mtima cha syncope. Dokotala wanu amatha kuyang'anitsitsa zosiyana ndi zomwe zimayambitsa matenda.
Zomwe Sizichititsa Maganizo
Pali mitundu itatu yambiri ya mavuto osagwirizana ndi mtima omwe amachititsa kuti syncope - zizindikiro zapakhungu, zimayambitsa matenda, ndi zifukwa zapopopotolo.
Zotsatira za Neurological:
Mavuto a mitsempha amachititsa kuti pakhale vuto losautsa la syncope, lomwe limawerengera 1 peresenti ya zigawo za syncopal. Pali zinthu zitatu zokha za ubongo zomwe zingathe kupanga syncope:
- Kuthamanga kwa ischemic kochepa (TIAs) , kawirikawiri kumagwiritsa ntchito mitsempha ya vertebrobasilar . Mitsempha ya vertebrobasilar ndi mitsempha ya mitsempha kumbuyo kwa khosi, pafupi ndi msana wa msana, umene umapereka ubongo wa ubongo - gawo la ubongo lomwe, mwa zina, liri ndi udindo wosunga chidziwitso. Kuthamanga kwa magazi m'mitsempha ya vertebrobasilar kungayambitse syncope.
- Subclavia kuba ziwalo
- Mavuto ovomerezeka a hydrocephalus (NPH)
Matenda a ubongo omwe nthawi zambiri amasokonezeka ndi syncope ndi khunyu . Chisokonezo chimachitika chifukwa chakuti khunyu ikugwedezeka, monga syncope, imayambitsanso kutaya nthawi. Koma kugwidwa nthawi zambiri sikumayambitsidwa ndi kusokonezeka kwa kutaya kwa magazi ku ubongo - mmalo mwake, zimayambitsidwa ndi ntchito zamagetsi zosagwirizana mu ubongo. Dokotala nthawi zambiri amaganiza kuti matenda a chiwopsezo ndi omwe amachititsa kuti munthu asathenso kudziŵa pamene chochitikachi chimaphatikizapo kayendetsedwe kawonekedwe komwe kawirikawiri kamapezeka ndi kulanda. Chodziwika bwino cha matenda a khunyu kawirikawiri chimatsimikiziridwa ndi electroencephalogram (EEG) - mayesero omwe amalemba ntchito za magetsi. Ndikofunika kuchita zoyezetsa zofunikira ndikudziwitsanso bwino, popeza chithandizo cha matenda opatsirana ndi osiyana kwambiri ndi chithandizo cha syncope. Tsoka ilo, anthu omwe ali ndi mitundu yoipa ya syncope (kawirikawiri achinyamata) nthawi zambiri amadziwika kuti alibe vuto la kulumala.
Zotsatira Zamagetsi:
Ocheperapo ndi 1% a anthu omwe ali ndi syncope amakhala ndi zinthu zamagetsi monga chifukwa. Zomwe zimayambitsa syncope zimaphatikizapo hypoxia (yochepetsetsa mpweya m'magazi, nthawi zambiri amatanthauza mapapu amphamvu komanso owoneka bwino omwe alipo); hyperventilation , yomwe imachitika chifukwa cha nkhaŵa yaikulu kapena mantha ; komanso hypoglycemia (shuga wotsika magazi), omwe ayenera kuganiza kuti ali ndi matenda a shuga, makamaka omwe amatenga insulini .
Zotsatira za Vasomotor:
Kwa anthu ambiri omwe ali ndi syncope, ili ndi ndalama. Vasomotor syncope imachitika pamene njira zovuta za thupi zomwe zimapangitsa kuti magazi azikhala ochepa (mwina mwachangu kapena mwachisawawa), zomwe zimapangitsa kuti asiye kupanikizika kwa magazi , zomwe zimapangitsa ubongo kukhala ndi magazi ake.
Pali mitundu iwiri yambiri ya vasomotor syncope - orthostatic hypotension ndi vasovagal (kapena cardioneurogenic) syncope .
Orthostatic hypotension
Kawirikawiri pamene iwe uimirira, mitsempha ya magazi miyendo yako imakhala yowonjezera, yomwe imathandiza kuti magazi asasokoneze "miyendo yako, moteronso kuti ukhale ndi mphamvu yeniyeni ya magazi. Kwa anthu amene amakhulupirira kuti hypotension , chifukwa cha zifukwa zingapo, kuthamanga kwa magazi sikungathe kusungidwa. Ngati kuthamanga kwa magazi kukudumpha mokwanira, amatha kuzindikira pamene akuwongoka. Nthawi zambiri anthu amakalamba amawotchedwa Orthostatic hypotension, ndipo amayamba chifukwa cha mankhwala osokoneza bongo. Koma ikhozanso kuyambitsidwa ndi matenda a shuga, matenda a Parkinson, ndi matenda ena angapo a zachipatala.
Mkhalidwe wokhudzana ndi matenda a postural orthostatic tachycardia syndrome, kapena POTS . Zolemba zosiyana ndi zosiyana ndi zomwe zimagwiritsidwa ntchito ponena kuti: a) zimawoneka mwa achinyamata okha (makamaka anthu osakwanitsa zaka 45), ndipo b) pamene POTS ikhoza kutulutsa magazi otsika, vuto lalikulu ndilo liwiro la mtima pa kuyima. Anthu omwe ali ndi POTS amakhala ndi zizindikiro zambiri akamayimilira, nthawi zambiri kuphatikizapo zizindikiro, chizungulire ndi zofooka - ndipo pafupifupi 40% a iwo adzawona syncope kamodzi.
Vasovagal (cardioneurogenic) syncope
Vasovagal syncope (yemwenso amadziwika kuti cardioneurogenic syncope) ndi chifukwa chofala kwambiri cha syncope, mwinamwake amawerengera magawo oposa 80% onse a syncopal. Zimayambitsidwa ndi mitsempha ya mthupi mwadzidzidzi m'milingo poyang'ana kuganiza kowonjezereka kwa ubongo. Ngati muli ndi syncope ndipo mulibe mbiri ya matenda a mtima kapena vuto lalikulu la matenda a mtima, zimakhala zovuta kuti mutha kukhala ndi vasovagal syncope - momwemo muyenera kuphunzira zambiri za vutoli momwe mungathere. Werengani pano pothana ndi vasovagal syncope .
Kufufuza
Tsopano kuti tapenda momwe matenda aakulu angayambitsire syncope, ngati inu kapena wokondedwa wanu muli ndi syncope zingakhale zothandiza kudziŵa mmene madokotala ayenera kuyendera kupyolera muzochitika zonse, ndi kupeza bwino kuti adziwe bwinobwino.
Pano pali nkhani yomwe ikukambirana njira yowongoka komanso yodalirika yowonjezeretsa kuyeza kwa syncope .
> Zotsatira:
> Costantino G, Casazza G, Reed M, et al. Zizindikiro za Syncope Risk Stratification vs Chigamulo cha Chidziwitso: Chidziwitso cha Odwala Meta. Am J Med 2014; 127: 1126.e13.
> Huff JS, Decker WW, Quinn JV, et al. Mfundo zachipatala: Mavuto ovuta mu Kuunika ndi Kuyang'anira Odwala Achikulire Akupereka ku Dipatimenti ya Emergency ndi Syncope. Ann Emerg Med 2007; 49: 431.
> Strickberger SA, Benson DW, Biaggioni I, et al. AHA / ACCF Scientific Statement pa Kuunika kwa Syncope: Kuchokera ku American Heart Association Councils ku Clinical Cardiology, Asayansi Achimayi, Matenda a Mtima M'magulu a Achinyamata, ndi Stroke, ndi Quality of Care and Outcomes Research Interdisciplinary Working Group; ndi American College of Cardiology Foundation: mu mgwirizano ndi Heart Rhythm Society: Kuvomerezedwa ndi American Autonomic Society. Kuyendayenda kwa 2006; 113: 316 .