Mphamvu yamagetsi ya mtima imayendetsa kuthamanga kwa mtima ndikuonetsetsa kuti zipinda zosiyanasiyana za mgwirizano wa mtima zimagwirizanitsidwa bwino. Ntchito izi ndi zovuta komanso zovuta-monga momwe chizindikiro cha magetsi chimachokera ku atria kupita ku zinyama, kusiyana pakati pa gawo limodzi la magawo khumi pa sekondi kungapangitse kuti mtima ugwire bwino.
Ndi dongosolo la physiologic limene limafuna mlingo uwu wachindunji ndi zovuta, pali njira iliyonse yomwe ingasokonezedwe kapena yosokonezeka. Choncho, musadabwe kuti arrhythmias ya mtima ingabwere chifukwa cha zifukwa zambiri.
Izi zikutanthauza, pakati pazinthu zina, kuti chiyeso chovuta poyesa ndi kuchiza munthu amene ali ndi mtima wamaganizo ndicho kuzindikira, makamaka momwe zingathere, chifukwa chachikulu cha vuto la mtima. Kuchepetsa kapena kuchepetsa vutoli nthawi zambiri ndi njira yabwino kwambiri yothandizira odwala.
Zomwe zimayambitsa matenda a mtima zimatha kukhala m'magulu angapo. Pano pali kufotokozera mwachidule za magulu akuluakulu a mavuto amene nthawi zambiri amachititsa arrhythmias, owerengedwa (mochuluka) kuchokera ochuluka kwambiri mpaka osachepera.
Kusamvetseka Kwachikhazikitso
Mankhwalawa amachititsa kuti thupi lisamaganizire mozama, monga kupuma, thukuta, ndi mtima.
Bradycardias (yochedwa mtima miyendo) ndi tachycardia (miyendo yolimba ya mtima) nthawi zambiri zimachitika chifukwa cha kuwonjezereka kwa (motsatira) vagal tone , kapena mawu achisomo. Kuthamanga kwambiri, ndi bradycardia, zimachokera ku (mwachitsanzo), nthawi ya kusanza, kudzimbidwa kwakukulu, kapena kutsekemera mkodzo.
Kulankhula mokoma mtima (kwambiri adrenaline) chifukwa chovutika maganizo kapena mantha amodzidzidzimutsa angayambitse tachycardia.
Chinyengo chochizira arrhythmias chifukwa cha kusalinganikirana kwodziimira ndiko kuchotsa chifukwa cha vagal wochuluka kapena mawu achifundo. Izi zimayambira pamene kusamvetsetsana kwaokha kumathetsedwa.
Matenda a Mtima
Mtundu uliwonse wa matenda a mtima ukhoza kusokoneza magetsi a mtima ndipo imayambitsa matenda a mtima. Mankhwala omwe amachokera ku matenda a mtima angathe kuwonetsa mtundu wonse wa mtima wam'mimba.
Komabe, matenda a mtima ndi omwe amachititsa kuti zisokonezo zenizeni zikhale zoopsa. Matenda a mtima ndi omwe amachititsa kuti thupi likhale ndi moyo woopsya ndi matenda a mitsempha , matenda a mtima, matenda a mtima .
Ndipotu, chiopsezo cha imfa mwadzidzidzi ndipamwamba kwambiri kwa anthu omwe ali ndi mtima wamtima kapena kulephera mtima kuti chimodzi mwa zolinga zazikulu za dokotala mukamawachiritsa odwalawa ayenera kutenga ndondomeko zofunika kuti kuchepetsa ngoziyi .
Mankhwala
Makamaka mwa anthu amene angathe kukhala ndi mtima wokhala ndi mtima wamtundu wa mtima (mwachitsanzo, chifukwa cha matenda a mtima kapena matenda a chibadwa), mankhwala osiyanasiyana akhoza kuchititsa kuti chiwalochi chichitike.
Mndandanda wa mankhwala omwe angayambitse arrhythmias ndi waukulu kwambiri.
Mitundu ya mankhwala omwe nthawi zambiri amagwirizanitsidwa ndi magayimu a mtima ndi awa:
- Digoxin .
- Mankhwala oletsa antiarrythmic , makamaka quinidine, disopyramide, procainamide, sotalol, ndi mapepala.
- Cocaine.
- Mowa , makamaka pambuyo poledzera.
- Maantibayotiki , kuphatikizapo erythromycin, azithromycin, clarithromycin, ndi ciprofloxacin.
- Ma antihistamines osakhala pansi, monga terfenadine ndi aseizole.
- Mankhwala a Psychotropic, makamaka haloperidol, thorazine, ndi methadone.
Matenda Achibadwa
Kuyambira m'chaka cha 2000, ofufuza apeza mitundu yambiri yosinthika kwa majini yomwe tsopano ikufotokoza zambiri zapachiyambi za m'maganizo.
Pano pali mndandanda wa ambiri omwe amadziwika kuti ndi amitundu.
Pamene kafukufuku akupita, ndizowonjezereka kuti ma arrhythmias ena adzawonjezedwa pandandanda uwu:
- Matenda a QT aatali .
- Matenda a Brugada .
- Mitundu ina ya mtima wachitsulo ndi nthambi ya nthambi .
- Matenda a sinus wodwalayo kwa achinyamata.
- Mitundu ina ya mafinya a atrial .
- Mitundu ina ya tachycardia ya ventricular .
Kukalamba
Pa zifukwa zomwe sizikuwoneka bwino, ukalamba umagwirizanitsidwa ndi mtundu wa fibrosis wofala mkati mwa minofu ya mtima yomwe ingabweretse ku matenda a sinus syndrome, block heart or fibrillation. Matenda a mtima wokalamba ndi omwe amachititsa anthu okalamba kufunafuna pacemaker .
Matenda a Electrolyte ndi Metabolic
Matenda osiyanasiyana a serum electrolytes, ndi acidity ya magazi, amatha kuyambitsa maginthmias a mtima. Matendawa amapezeka kwambiri kwa anthu omwe ali ndi matenda a impso, matenda a shuga, akumwa mankhwala enaake (makamaka opatsa maulendo odzola ), akusokonezeka, kapena akudwala kwambiri.
Matenda a electrolyte ndi kagayidwe kachakudya omwe amachititsa kwambiri arrhythmias ndi awa:
- Hypokalemia (low potassium levels).
- Hyperkalemia (high potassium levels).
- Hypomagnesemia (low magnesium levels).
- Mankhwala a hypocalcemia (ma calcium otsika).
- Acidosis (magazi amawopsa).
- Alkalosis (magazi a alkaline).
Anesthesia
Arthmthmias ya mtima ndi ofala kwambiri kwa anthu omwe akudwala anesthesia. Ngakhale ambiri a arrhythmias ali abwino komanso osamalidwa mosavuta, ena akhoza kukhala owopsa komanso ovuta kuchiza.
Anesthesia imagwirizanitsidwa ndi mtima wamagayimu chifukwa cha zifukwa zingapo, kuphatikizapo:
- Mankhwala opweteka kwambiri.
- Matenda a electrolyte ndi kagayidwe kachakudya omwe angachitike panthawi ya anesthesia.
- Kusinthasintha kwa magazi m'magazi omwe angachitike panthawi ya anesthesia.
- Kusamvetseka kwachidziwitso pa nthawi ya anesthesia.
- Kusintha kwa kuthamanga kwa magazi nthawi ya anesthesia.
- Kuwonongeka kwa mtima pa nthawi yopaleshoni, makamaka opaleshoni ya mtima.
Matenda a mtima
Kusokonezeka kwa mtima kwa chifuwa chilichonse, kapena chifukwa cha opaleshoni ya mtima, kukhoza kupanga mtundu wa mtundu uliwonse wa mtundu uliwonse.
Idiopathic
"Idiopathic" ndilo lingaliro lachipatala la, "Ife sitikudziwa chomwe chinachititsa kuti izo zichitike." Chigamu cha mtima chimayesedwa kukhala chodziwika ngati, pambuyo pofufuzidwa mokwanira, chifukwa choyambira sichidziwika.
Zaka zaposachedwapa, ambiri a arrhythmias omwe amadziwika kuti ndi adiopathic amadziwikiratu kuti ali ndi chibadwa.
Zowopsa
Njira yabwino yochepetsera chiopsezo cha matenda a mtima ndi kuchita zonse zomwe mungathe pofuna kupewa matenda a mtima. Izi ndi chifukwa chosavuta: Magulu ambiri a mtima omwe ali oopsa kapena osokoneza moyo wa munthu amachokera ku matenda a mtima omwe angathe kupezeka kwambiri.
Kuchepetsa chiopsezo cha matenda a mtima kungakhale kovuta kwa anthu ambiri, koma kuli koyenera kuyesetsa-osati kuchepetsa chiopsezo cha arrhythmias koma (makamaka chofunika) kuchepetsa chiopsezo cha matenda a mtima omwe amachititsa arrhythmias mu yoyamba malo.
Zomwe zimayambitsa moyo wanu zomwe zingachepetse chiopsezo cha matenda a mtima ndi awa:
- Kusasuta, kapena kuima ngati mutero .
- Kusamalira cholesterol yokwera ndi / kapena triglycerides .
- Kuchita masewera olimbitsa thupi .
- Kupewa kapena kuchiza matenda oopsa .
- Kusamalira matenda a shuga .
- Kupewa kunenepa kwambiri, kapena kutaya thupi.
Ngakhale kuti maginito ambiri akudziwikiratu kuti ndi ofanana ndi a chibadwa, chibadwa cha mtima chimakhala chovuta kwambiri. Kuyesedwa kwa majeremusi a mtima wa arrhythmias sikukulimbikitsidwa kawirikawiri chifukwa kumasulira zotsatira za kuyesedwa mu malangizo othandiza sizingatheke.
Komabe, kwa anthu apabanja omwe ali ndi matenda a QT matenda, matenda a Brugada, kapena arrhythmias omwe amagwirizana ndi hypertrophic cardiomyopathy , kuyesa kwa majeremusi kungakhale kofunika pozindikira ngati chithandizo cha prophylactic chiyenera kuganiziridwa.
> Zotsatira:
> Fogoros RN, Mandrola JM. Kuyezetsa magazi m'lingaliro: Kufufuza ndi Chithandizo cha mtima wa Arrhythmias. Mu: Fogoros 'Electrophysiolgic Testing. Wiley Blackwell: 2017.
> Fu DG, Arrhythmia ya mtima: Kuzindikira, zizindikiro ndi chithandizo. Cell Biochem Biophys. 2015 Nov; 73 (2): 291-296.
> Wilde AAM, Bezzina CR. Genetics of Cardiac Arrhythmias. Mtima. 2005 Oct; 91 (10): 1352-1358.