Cardiac Arrhythmia: Zimayambitsa, Zizindikiro, Chithandizo

Mtima arrhythmia (kapena osasamba kugunda) ndi matenda a dongosolo mtima, amene amakhala ndi arrhythmias aliyense mtima. Chodabwitsa kugwirizana ndi kusintha kwa nthawi zonse, pafupipafupi ndi ndondomeko ya mlingo mtima, kugunda kwa mtima kungakhale kwambiri kawirikawiri kapena (chitukuko tachycardia) kapena pang'onopang'ono kwambiri (bradycardia). Zina arrhythmias zingachititse kuti amangidwe mtima. Arrhythmias zimachitika pa msinkhu wina uliwonse, mu zipinda chapamwamba ndipo m'munsi a mtima, atria ndi ventricles, motero. Ena yonse ya matenda si noticeable, pamene ena yochititsa chidwi komanso amapha. Mtima arrhythmia ndi chimodzi mwa zomwe zimakonda imfa.

Limagwirira wa mungoli yachibadwa mtima

Kuti timvetsetse zimene arrhythmia, chifukwa maonekedwe ake, m'pofunika kumvetsa mmene chomwecho chikuchitika contractility m'mnyewa wamtima. Limagwirira wa yachibadwa mtima mungoli mtima dongosolo conduction amaperekedwa, umene ndi m'bulu wa maselo apadera kwambiri. Maselo amenewa kulenga zikhumbo magetsi ndi kuwanyamula ulusi wapadera, imbaenda minofu mtima. Ngakhale luso lililonse mfundo mu dongosolo kupanga zikhumbo kwa minofu mtima, mfundo yaikulu pano ndi nkusani mfundo, omwe kayendedwe ankafuna. Malowa ali pamtunda pa pamwamba pa atrium bwino. Kwaiye zilakolako nkusani mfundo, ngati kuwala kwa dzuwa, anayala kuchokera mu mbali zonse. Ena nyemba ndi "udindo" chifukwa kuchepetsa kapena malemeredwe wa atria, pamene ena amathandiza kuti kuchepetsedwa pang'onopang'ono kwa nthawi atrium kutumiza mtanda wotsatira wa magazi ventricles lapansi. Izi zipangitsa kayendedwe yachibadwa za mtima. kuphwanya Imatha chifukwa mavuto awiri:

- chisokonezo zimachitika mapangidwe ndondomeko;

- kuphwanya nyemba opangidwa mu dongosolo mtima.

Pamene mavutowa kuti mfundo yotsatira dera adzatenge ndi "udindo" tikamatsatira ntchito kugunda kwa mtima, koma amachepetsa pafupipafupi contractions. Choncho akufotokozera ndi arrhythmia, zifukwa zomwe zafotokozedwa ina.

mitundu arrhythmia

Madokotala m'kagulu arrhythmias, malingana osati pa malo pamene zidzachitika (a atria kapena ventricles), komanso pa mlingo mtima. Fast kugunda ndi kugunda kwa mtima (HR) ndi kumenyedwa woposa 100 pa mphindi amatchedwa tachycardia ndi wosakwiya zimachitika ndi kugunda kwa mtima zosakwana 60 kumenyedwa pa mphindi - bradycardia. Zimayambitsa arrhythmias mtima ndi mwachindunji amadalira mtundu wa matenda.

Osati nthawi zonse tachycardia kapena bradycardia zikutanthauza matenda a mtima. Mwachitsanzo, pa masewera olimbitsa thupi mofulumira kugunda imatengedwa ponseponse, monga kuwonjezeka kugunda kwa mtima akulola mpweya zimakhala thupi. Akagona kapena zosangalatsa kwambiri palpitations, amakonda kukhala pang'onopang'ono.

Ngati tachycardia amapezeka atria, ndiye kuphwanya kwa zimagawidwa motere:

- matenda fibrillation - ndi kugunda mofulumira, chifukwa cha zilakolako wachisokonezo magetsi mu atria lapansi. zizindikiro zimenezi zimachititsa mofulumira, uncoordinated kapena kuchepetsa minofu ofooka mtima. Zimayambitsa matenda fibrillation mtima zimaperekedwa convulsive wachisokonezo ntchito yamitsempha yamagazi, zomwe kawirikawiri amapezeka pa maziko a matenda ena mtima. Chodabwitsa fibrillation matenda kungachititse kuti mavuto aakulu, monga matenda opha ziwalo.

- matenda flutter - ofanana fibrillation matenda, zilakolako magetsi nthawi yomweyo zambiri bungwe ndi rhythmic kuposa fibrillation. Matenda flutter tidzapeze yatsoka a sitiroko ndi.

- Supraventricular tachycardia kapena supraventricular tachycardia, limene lili ndi kuchuluka kwa mitundu ya arrhythmias akuwuka pamwamba ventricles lapansi.

Tachycardias amachokera ku ventricles ndi kugawidwa mu subtypes zotsatirazi:

- yamitsempha yamagazi Tachycardia - akuimira kudya heartbeats zonse ndi chizindikiro nthenda magetsi kuti ventricles lapansi. Zimenezi zimathandiza kudzazidwa kwathunthu kwa ventricles ndi zoletsa magazi mpope mosabvuta.

- yamitsempha yamagazi fibrillation - arrhythmia ichi, zimayambitsa amene kugona mu inefficient ikukoka magazi chifukwa kugwedezeka yamitsempha yamagazi. Izi ndi vuto wokongola kwambiri kuti nthawi zambiri itha imfa ngati mtima sangathe kubwezeretsa kayimbidwe kotani bwinobwino pakangotha mphindi zochepa. Anthu ambiri amene ali ndi yamitsempha yamagazi fibrillation, kapena ndi matenda oopsa a mtima kapena kuti anamva ululu kwambiri, monga kumenya kwa mphezi.

Si nthawi zonse kusakumvekamveka mtima kuti munthu akayamba bradycardia. Ngati muli mawonekedwe labwino, mtima umatha kupopa magazi okwanira ndi kumenyedwa 60 pa mphindi pa mpumulo. Kungachepetse mlingo mtima ndi mankhwala ena. Komabe, ngati muli ndi mtengo mtima wodekha, ndipo mtima wanu osati ikukoka magazi zokwanira, inu mukhoza kukhala mmodzi wa mitundu yambiri ya bradycardia.

- nkusani arrhythmia, zomwe zimabweretsa kufooka chifukwa cha mfundo nkusani.

- anatseka misewu malemeredwe kwa zikhumbo za magetsi pakati pa atria ndi ventricles. Pankhaniyi, wodwalayo angaganize kumenyedwa analilumpha a minofu mtima.

- masiku asanakwane chidule cha mtima - ndi ventricles kumachitika pakati kumenyedwa awiri yachibadwa.

Zimayambitsa arrhythmias mtima

A munthu wathanzi sangathe konse zowawa ndi mavuto otere. Pamene mtima arrhythmia, zifukwa chifukwa zinthu zosiyanasiyana chokhwima kwa thupi. Kungakhale kusintha mu mnofu mtima, matenda a mitima, electrolyte vutoli mu magazi, kuvulala pambuyo akuvutika kudwala mtima, lipole pambuyo opaleshoni ya mtima ndi ena. The umagunda mofulumira unakambidwanso mogwirizana ndi nkhawa, zolimbitsa thupi, utsogoleli mankhwala.

Nkofunika kudziwa kuti munthu ali ndi arrhythmia, amachititsa ndi kuchiza nthenda iliyonse gulu zaka odwala kukhala osiyana. Ana Mwachitsanzo, matenda kumachitika chifukwa cha zinthu zina akuluakulu - zina. Kwa matenda monga arrhythmia mtima, zimayambitsa ambiri tingaone pa mndandanda:

- Kupondelezedwa kwa amene kuwonongeka ndi mtima mavavu (endocarditis, myocarditis, enaake ophwanya malungo).

- Matenda a chithokomiro England.

- cholowa zinthu.

- Kuperewera kwa madzi m'thupi ndi kupanda potaziyamu mu thupi kapena electrolytes ena.

- kuwonongeka kwa mtima chifukwa vuto la mtima.

- The ndondomeko ya machiritso pambuyo opaleshoni ya mtima.

Zosavuta matenda ndi kusuta, nkhawa, mowa kwambiri ya tiyi kapena khofi kapena mowa, zaka, kuthamanga kwa magazi, matenda a impso, ndi ena.

Mtima arrhythmia ana

Ana, nthendayi zimagawidwa monga kugunda kufala matenda malo, mwachitsanzo mu ventricles kapena atria. Ngati arrhythmia ana, amachititsa tiyenera kuyang'ana mosamala kwambiri mwayi mwanayo kuchira. Ana matenda arrhythmias zikuphatikizapo kuyan'anila zotsatirazi:

- msanga matenda chidule;

- supraventricular tachycardia;

- matenda fibrillation;

- matenda flutter;

- chapamimba tachycardia;

- Wolff-Parkinson-White (a boma limene zimachitika magetsi akhoza kufika mofulumira ku ventricle a).

Yamitsempha yamagazi kugunda kwa mtima matenda ana monga:

- msanga yamitsempha yamagazi contractions (oyambirira kapena owonjezera kugunda);

- yamitsempha yamagazi tachycardia (a chikhalidwe moyo pachiswe amene chizindikiro magetsi amalandira ventricles awo variable mlingo);

- yamitsempha yamagazi fibrillation (osasamba, yosalongosoka kugunda).

Pakuti matenda ana yodziwika ndi bradycardia zotsatirazi:

- nkusani mfundo kukanika (arrhythmias mtima ana, chifukwa kamene kamayambitsa mungoli wozengereza contractions mtima);

- mtima chipika (wathunthu chipika kapena sachedwa kugunda magetsi ku mfundo sinoatrial kuti ventricles a).

Zizindikiro za arrhythmias zimadalira kukhwima kwa mwanayo. Ana okulirapo akhoza kundiuza za maganizo awo kumva chizungulire kapena kuwala flutter za mtima. Makanda kapena aang'ono amalembedwa irritability, wotumbululuka khungu, kusafuna kudya. Ena zizindikiro zosonyeza arrhythmias monga:

- kufooka, kutopa;

- osasamba kugunda ndi zimachitika;

- chizungulire, kukomoka kapena boma presyncopal ;

- wotumbululuka khungu;

- ululu chifuwa;

- kufupika kwa mpweya, thukuta;

- kusafuna kudya;

- irritability.

Ngati ana anayamba mtima arrhythmia, zimayambitsa matenda chifukwa cha zinthu zotsatirazi :, mukumwa mankhwala, malungo, matenda malungo. Zambiri zimayambitsa kwambiri monga malformations kobadwa nako. Nthawi zambiri vuto lililonse arrhythmias ana. Komabe, pamene pali kusintha kugunda kwa mtima mu chikhalidwe mwana wa mpumulo, ndi masewero kapena zolimbitsa thupi, makolo ayenera kupeza thandizo dokotala bungwe lina la zachipatala.

Mtima arrhythmia mu achinyamata

Ngati arrhythmia mwa achinyamata, amachititsa kuti zingasiyane malingana ndi nkusani mungoli. Wachinyamata, thupi poyera kuti kusintha angapo, zomwe zimayambitsa zosiyanasiyana matenda. A chodabwitsa ofanana ndi kaŵirikaŵiri kudwala, kusintha mwina zimachitika pa mlingo thupi, ndi m'tsogolo. Komabe, izi sizikutanthauza kuti arrhythmia mu achinyamata sayenera kuperekedwa kufunika. Pa siteji yoyamba ya mwana matenda amafuna zonse kuyendera dokotala amene kuwunika mphamvu ya arrhythmia. Ngati zizindikiro za chiyani kutha pasanathe zaka 1-2, mtsikana ndithudi thandizo la mankhwala.

Mtundu ambiri arrhythmia mu unyamata ndi bradycardia. Matendawa chiopsezo kuti ubongo wake si kupeza chofunika kuchuluka kwa mpweya, zomwe zimachititsa kuwonongeka luso aluntha, ntchito maphunziro, zochita pang'onopang'ono, kulephera kuchita mokwanira masewera ndi mavuto ena.

Zimayambitsa arrhythmia mu m'badwo uwu si nthawi zonse kugwirizana ndi matenda a dongosolo mtima. Zoyambitsa matenda angakhale matenda endocrine, nkhawa, mantha nkhawa, kusintha m'thupi mwa achinyamata, m'mapapo kapena bronchial matenda, chimfine, limodzi ndi malungo ndi zina zotero. Pamene vegetative-mtima dystonia, matenda nthawi zambiri ndi khalidwe malodza, choncho mankhwala a ana awa n'kofunika utsogoleli wa mankhwala ndi zamaganizo uphungu.

Mtima arrhythmia mu akazi

Akazi, monga gulu, kuimira chidwi ya mavuto kwa cardiologist amene imakhazikika mu chisokonezo mtima mungoli. Pali kusintha pamwezi mu arrhythmias zina, zimene mtima ndi gwero la ululu komanso nkhawa odwala wamkazi, ndipo pali ngozi mkazi amawapeza mtima arrhythmia. Zoyambitsa, chithandizo cha matenda ndi zizindikiro zake zimadalira zinthu zosiyanasiyana kuganizira.

Akazi ndi kufala kwa odwala nkusani syndrome, nkusani tachycardia, atrioventricular nodal tachycardia ndi mitundu ina matenda. Zimayambitsa arrhythmias mu akazi imakhudzana ndi mlingo chakhungu mtima:

- yamitsempha yamagazi tachycardia (kupita ku zipinda m'munsi kwa mtima);

- supraventricular tachycardia (amapezeka mu zipinda chapamwamba kwa mtima);

- msanga matenda contractions (akupezeka zipinda chapamwamba ndipo m'munsi kwa mtima).

Nkofunika kukumbukira kuti mtima wosweka ndi chizindikiro, si matenda. Nthawi zina, pamene pali arrhythmia, chifukwa cha mwina zokhudza zinthu monga nkhawa, chisangalalo mantha, maganizo kukhumudwa. Komabe, mu milandu, ndi matenda mokwanira za matenda, kuthetsa kuthekera zifukwa yaikulu kwambiri.

Arrhythmias pa mimba zambiri kumachitika chifukwa cha m'thupi amasintha mkazi. Kuchuluka milingo timafunika ndi anthu chorionic gonadotropin makhalidwe mawu a ngalande ion mu mtima, kusintha hemodynamic yodziwika ndi kuwonjezeka mu buku magazi ndi mtima awiriawiri linanena bungwe. Komanso, mimba kumawonjezera kamvekedwe chisoni. Zonsezi mu thupi mkazi amathandiza kuti chitukuko cha arrhythmia.

Mtima arrhythmia anthu

Anthu, matenda a mtima zimachitika nthawi 2 zambiri kuposa akazi. Mitundu ambiri matenda ndi atrioventricular chipika, syndrome carotid nkusani, matenda fibrillation, supraventricular tachycardia, matenda Wolf-Parkinson-White, kobwereza yamitsempha yamagazi tachycardia, fibrillation yamitsempha yamagazi ndi imfa yadzidzidzi, ndi matenda Brugada. Zimayambitsa arrhythmias anthu amaganizira ndi kukhala onenepa kwambiri, kumwa mowa mwauchidakwa, kusuta fodya, wongokhala, zakudya osauka, nkhawa, mukumwa mankhwala.

Amuna ndi matenda a mtima makamaka sachedwa osauka arrhythmias, kuyambira monyanyira mu mnofu mtima zingachititse mtima wolephera kapena kuchedwa kwa mbendera magetsi ku nkusani mfundo kuti ventricles lapansi. Ngati pali arrhythmia pambuyo chakudya, zimayambitsa chikhalidwe ichi imakhudzana ndi kuthamanga kwa m'mimba kwa chifundamtima. Choncho pali psinjika a sternum, ndi kuthamanga pa mtima. Zimayambitsa arrhythmia mwa amuna unakambidwanso mogwirizana ndi kuthamanga kwa magazi, overactive chithokomiro England, amene kumawonjezera chiopsezo.

Zizindikiro za matenda akuluakulu

Mu matenda amenewa, monga arrhythmia mtima, zizindikiro, zimayambitsa matenda n'zogwirizana. Mwachitsanzo, pamene mtima kumenya mofulumira kuposa wabwinobwino, zizindikiro za matenda monga chifuwa kusapeza, palpitations, chizungulire, kupweteka kwa mutu, matenda oopsa. Ngati bradycardia nthawi anachititsa kufooka, chizungulire, kukomoka kapena boma presyncopal, kutsitsa magazi.

Zizindikiro za arrhythmias akuluakulu monga kufooka ambiri, kuchuluka kutopa, osasamba kugunda ndiponso kugunda kwa mtima. Mu heartbeats pang'onopang'ono ubongo osazindikira kuchuluka kwa mpweya, kotero kuti odwala lipoti pafupipafupi chizungulire, kukomoka, kapena predobmoroki, ali ndi kufupika kwa mpweya ndi kuchuluka thukuta. Khungu wotumbululuka, yokutidwa ndi thukuta. Pamene tachycardia pafupipafupi ululu chifuwa, kuchulukitsidwa irritability,

Ngati chifuwa flutter ndi mwachisawawa, palibe choopsa, iwo Musatenge. Koma ngati kupweteka mtima wake akukhala wamba monga munthu mowirikiza pali kumverera cha kufooka, adzionere amakhala osasamba, ndi nthawi kuwona dotolo.

arrhythmia chithandizo

Zimakhala zopweteka kwambiri matenda a mtima amaonedwa kukhala zabwinobwino ndipo safuna chithandizo. Ngati munthu ali ndi arrhythmia mtima osiyanasiyana, chithandizo cha matenda zambiri osadalira pa wina ndi mzake, chifukwa madokotala kusankha mankhwala njira yochokera za zinthu zimene zinayambitsa matenda. Chithandizo cha matenda a nthawi amalandira kupewa magazi kuundana mu m'magazi kuteteza kufala kwa matenda opha ziwalo, kubwezeretsa yachibadwa mtima mungoli, kugunda kwa mtima kulamulira mu zosiyanasiyana zachilendo, kuchepetsa zinthu za chiopsezo cha matenda a mtima.

Ngati bradycardia zayamba kufotokoza zifukwa, madokotala nthawi zambiri amachita ntchito pacemakers. pacemaker ndi chipangizo yaing'ono, amene anapereka pafupi phewa lapansi. maelekitirodi chimodzi kapena zingapo ndi nsonga, akubwera kuchokera chida cha, kutumiza nyemba magetsi kudzera ziwiya magazi mtima ndipo motero yotithandiza mtengo wokhazikika mtima anthu.

Pakuti zosiyanasiyana tachycardia, wodwalayo mwina akuchipatala mankhwala, amene amalola kulamulira kugunda kwa mtima kapena kubwezeretsa yachibadwa mtima mungoli. mankhwala amenewa kungathandize kuchepetsa mavuto n'kotheka. Mu fibrillation matenda, dokotala n'kukulemberani mankhwala, thinners magazi kuti kuteteza mapangidwe magazi kuundana mu m'magazi. Pamene matenda fibrillation mtima Kwalamulidwa mankhwala ntchito cardioversion, amene amalola kuti abwezeretse yachibadwa nkusani mungoli.

Nthawi zina, wodwala akhoza yovomereza chithandizo opaleshoni ya arrhythmia. Mu milandu yoopsa inatsekeratu mtsempha wamagazi matenda mtima kutsatsa kwa inatsekeratu opaleshoni kulambalala. Ndondomeko amathandiza kusintha otaya magazi mtima. Radiofrequency ablation imagwiridwa mu nkhani ya kochulukira kugunda kwa mtima ndi zimachitika osakwanira. Pa ntchito, adokotala akupanga puncture mu minofu yovulazidwa kuti sangathe kuchititsa zikhumbo magetsi.

kupewa

Pofuna kupewa matenda a mtima, arrhythmias, makamaka, ayenera kukhala moyo wathanzi, potsatira malangizo okhudza zakudya, kusiya zizolowezi zoipa, kupewa mavuto, kuchita masewera olimbitsa thupi.