Matenda otchedwa Wolff-Parkinson-White (WPW) ndi chikhalidwe cha mtima chogonana chomwe chimakhudza magetsi a mtima. Anthu obadwa ndi WPW nthawi zambiri amakhala ndi kusintha kosinthika pa electrocardiogram (ECG) yawo , ndipo nthawi zambiri amakhala ndi tachycardia (SVT) yodalirika , mtundu wa zizindikiro zozizwitsa, zomwe zimapangitsa munthu kukhala ndi mtima wambiri . Kuwonjezera pamenepo, nthawi zina anthu omwe ali ndi WPW akhoza kukhala ndi mitundu ina yowopsa yamagayimu ya mtima.
Kodi WPW Ndi Chiyani?
Anthu omwe ali ndi WPW amabadwa ndi kugwirizana kosagwirizana ndi magetsi komwe kumagwirizanitsa limodzi la atria (zipinda zam'mwamba) ndi chimodzi mwa zinyumba za m'mtima. Kugwirizana kwa magetsi kosayenera kumatchedwa njira zoyendetsera njira. Njira zowonjezeramo zimapangitsa kuti thupi likhale ndi maganizo omwe zimakhala zovuta za thupi.
Chifukwa Chakupeza Njira Zofunikira Ndizofunika
Njira zowonjezera ndizofunikira chifukwa zimapereka zofunikira kuti apange mtundu wina wa SVT - SVT wotchedwa atrioventricular reciprocating tachycardia (AVRT) . AVRT ndi mtundu wa reentrant tachycardia .
Njira yowonjezeramo imapanga mgwirizano wowonjezera wa magetsi pakati pa atrium ndi ventricle, ndipo pochita izi kumaliza dera lamagetsi. Dongosolo losazolowereka limalola AVRT kukula.
Pogwiritsa ntchito "AVRT", panthawi ya SVT magetsi amayendayenda kuchoka ku atrium kupita ku ventricle pogwiritsa ntchito njira yachibadwa (ndiko, kachidindo ka AV ), ndiyeno amabwerera ku atrium (kutanthauza, "obwerera" atrium) kudutsa njira yolumikizira.
Maganizo a magetsi amatha kuyendetsa dera lonse mosalekeza, kupanga arrhythmia. Maganizo amayendetsa njira yolowera njira kuchokera ku ventricle kupita ku atrium chifukwa, ndi AVRT, ndiyo njira yokha yomwe njira yopezeramo magetsi imatha kupanga magetsi.
Nchifukwa chiyani WPW Yosiyana ndi Yopanga AVRT?
Kusiyana pakati pa AVRT iyi ndi AVRT yomwe imawonetsedwa ndi WPW ndi yakuti, mu WPW, njira yopezeramo njira imatha kuyendetsa magetsi m'magulu onse awiri - kuyambira pa atrium mpaka ventricle komanso kuchokera ku ventricle mpaka pa atrium.
Chotsatira chake, panthawi ya retrant tachycardia mu WPW, kugwedeza kwa magetsi nthawi zambiri kumayenda pansi pa njira yowonjezeramo kupita ku zinyama zazing'ono, kenako kubwerera ku atria kupyolera mu chidziwitso cha AV, kenako kubwerera mmbuyo njira yowonjezeramo kupita ku zinyama zowonjezera - ndikupitiriza kubwereza chimodzimodzi dera. Izi ndizosiyana ndi kuyenda kwa odwala omwe ali ndi AVRT.
Chifukwa chiyani WPW Ndi Yofunika?
Kukhoza kwa njira yowonjezeretsera ku WPW kuyendetsa magetsi kuchokera ku atria kupita ku zinyama zazing'ono n'kofunika pa zifukwa zitatu.
Choyamba, nthawi yachibadwa ya sinus , mphamvu yokoka ya magetsi ikufalikira pa atria imayendera mipweya yonse kudzera muzithunzi za AV komanso kudzera njira yowonjezeramo. Kuchititsa chidwi kotereku kwa mlengalenga kumapanga chitsanzo chodziwika pa ECG - makamaka "kusuntha" kwa QRS complex yomwe imatchedwa "delta wave". Podziwa kukhalapo kwa chigwa cha ECG, dokotala akhoza kuwonetsa WPW.
Chachiwiri, pa AVRT yomwe ikuwonetsedwa ndi WPW, kugwiritsira ntchito magetsi kumayambitsa zitsulo zokhazokha kupyolera mu njira yopezeramo njira (mmalo mopyola njira yachizolowezi, njira yoyamba ya AV. Zotsatira zake, QRS zimakhala zovuta kwambiri, zomwe zimagwiritsa ntchito tachycardia (VT) m'malo mwa SVT.
Kuwonetsa AVRT yowonongeka ndi WPW ya VT kungapangitse chisokonezo chachikulu ndi alamu osafunikira kwa ogwira ntchito zachipatala, ndipo zingachititse mankhwala osayenera.
Chachitatu, ngati wodwala ali ndi WPW ayenera kukhala ndi mafinyriyamu - a arrhythmia omwe atria akuyambitsa magetsi pamtunda mofulumira kwambiri - zikhumbozi zimatha kuyenda njira yowonjezeramo ndipo zimapangitsa kuti tizilombo toyambitsa matenda tiziyenda mofulumira kwambiri, kugunda kwa mtima mwamphamvu. (Kawirikawiri, kachilombo ka HIV kamateteza mavitamini kuti asamangidwe mofulumizitsa panthawi ya mafinya.) Choncho kwa odwala omwe ali ndi WPW, matenda opatsirana pogonana angakhale vuto loopsya.
Zizindikiro ndi WPW
Zizindikiro za SVT zomwe zimayambitsidwa ndi WPW zili zofanana ndi SVT iliyonse. Zimaphatikizapo mapiritsi , kumutu , ndi chizungulire . Ma Episodes nthawi zambiri amatha mphindi zingapo mpaka maola angapo.
Ngati matenda a atrial amafunika kuchitika, komabe mtima wachangu mofulumira kwambiri ukhoza kutaya chidziwitso, ngakhale kumangidwa kwa mtima .
Kuchiza WPW
Msewu wobwereza womwe umapanga SVT mu WPW umaphatikizapo kachilombo ka AV, kapangidwe kamene kamaperekedwa ndi vagus nerve . Choncho odwala omwe ali ndi WPW amatha kuimitsa masewera awo a SVT mwa kutenga njira zowonjezera mitsempha yawo, monga Valsalva oyendetsa , kapena kulowetsa nkhope yawo mu madzi oundana kwa masekondi pang'ono. Kwa anthu ena omwe ali ndi magawo ochepa chabe a SVT, mankhwalawa angakhale okwanira.
Kugwiritsira ntchito mankhwala osokoneza bongo pofuna kupewa njira zachidule za WPW zogwira ntchito, ndipo njirayi siigwiritsidwa ntchito nthawi zambiri lero.
Komabe, njira yowonjezeramo ku WPW ikhoza kuthetseratu (kupitirira 95 peresenti ya nthawi) kuchotsedwa ndi mankhwala opatsirana , komwe njira yowonjezeramo imayang'aniridwa mosamala ndi kudulidwa. Thandizo la ablation nthawi zonse ndilobwino kwambiri kwa wina yemwe ali ndi WPW amene ali ndi arrhythmias.
Kuwonjezera pamenepa, chifukwa kuyambika kwa mankhwala oopsa ku WPW kungachititse kuti mtima ufulumire mwamsanga, ndipo chifukwa chakuti mavitamini ambiri amatha kufalikira (ndipo akhoza kukhala ofala kwambiri kwa anthu omwe ali ndi WPW kusiyana ndi anthu ambiri), akatswiri ambiri amalimbikitsira aliyense ndi WPW molimba mtima taganizirani za mankhwala opatsirana.
> Zotsatira:
> Pachipatala ndi Congenital Electrophysiology Society (PACES), Heart Rhythm Society (HRS), American College of Cardiology Foundation (ACCF), et al. PACES / HRS Kulumikizana kwa Odziwika Pogwiritsa Ntchito Malingaliro Othandiza Odwala Pang'ono ndi Odwala Wodwala ndi Wolff-Parkinson-White (WPW, Ventricular Preexcitation) Electrocardiographic Chitsanzo: Chinakhazikitsidwa mu mgwirizano pakati pa ana ndi Congenital Electrophysiology Society (PACES) ndi Heart Rhythm Society (HRS) ). Ovomerezedwa ndi mabungwe olamulira a PACES, HRS, American College of Cardiology Foundation (ACCF), American Heart Association (AHA), American Academy of Pediatrics (AAP), ndi Canadian Heart Rhythm Society (CHRS). Mtima; 9: 1006.