Kumenyedwa - ichi ... matenda mtima mungoli - zimayambitsa. Zizindikiro za matenda a mtima

Ukugunda - izi ndi matenda zofala, makamaka kwa odwala okalamba. okhumudwa limodzi ndi kusokonezeka kwa mungoli yachibadwa mtima. Masiku ano, anthu ambiri ali ndi chidwi pa nkhani ya zomwe zimayambitsa vutoli, mmene oopsa thanzi, zingakhale.

Ukugunda - ndichiyani?

Lero, nayenso anakumana ndi odwala ambiri zipatala. Chotero kodi ukugunda? matenda, amene amagwirizana ndi matenda ena a kayendedwe mtima. Ndi matenda amenewa anaona chidule zapadera (systole), kapena myocardium lonse, kapena ziwalo osiyana (mwachitsanzo, wa atria, ndi ventricles).

Ukugunda - ponseponse kapena kuopseza thanzi?

Lero, anthu ambiri akukumana ndi vuto ofanana. Ndiye kodi oopsa akhoza kukhala matenda a? Ndipotu, kuchepetsa zapadera angayambe ndi zoona, amapezeka pa msinkhu uliwonse. Mwachitsanzo, achinyamata nthawi zambiri amadandaula kumverera kwa kugunda kwa mtima amphamvu, ichi ndi kumenyedwa. Komanso, malingana ndi kuwerengera, pafupifupi 80% ya anthu achikulire kuposa zaka makumi asanu nthawi akudwala nthawi zivomezi zina "unscheduled".

chifukwa pakutchulidwa wa systole chiyani? Matenda ena a mtima , ndi zotengera za dongosolo mtima lisinthike: izo anapanga otchedwa zotupa ectopic, madera kulalikira mwakhama. Nthawi zambiri, chisokonezo akuoneka m'njira ya ventricles ndi, atria, ndi mfundo atrioventricular. Ndi izi foci ectopic kupanga nyemba zimene zimachititsa heartbeats limagwirira mu zosangalatsa gawo lake (diastole). Izo zikuwoneka ngati kumenyedwa. Izi, poyamba, zikhoza kukhala zoopsa kwambiri.

Kumene, nthawi zina uka zikhumbo si loopsa kwambiri thanzi la munthu. Komabe, iwo kuchenjeza cha kukhalapo vuto, akatswiri amalangiza odwala ngati kumvetsera kwambiri kuti moyo wawo, kudya zakudya ndi kubatizidwa tizipima zonse.

Komano, kumenyedwa kwambiri kawirikawiri bwanji lonse chamoyo. Ndipotu, chifukwa cha mabala angapo oyambirira yafupika umuna magazi, imbaenda ku kuchepa magazi mu ubongo ndi mitsempha inatsekeratu. Zikatero, ndi kumenyedwa mtima ndi woopsa kwambiri, chifukwa angayambitse kuwonongeka kwa myocardium ndi kukomoka kapena mwadzidzidzi imfa ya munthu.

Mtima mungoli chosokoneza: Zoyambitsa

Ndipotu, pali zinthu zambiri zimene zingatisocheretse nkhondo ya arrhythmia angagwe. Mwachitsanzo, mtima mungoli chisokonezo zikhoza kugwirizana ndi chikoka pa chamoyo ndi mankhwala ena, kuphatikizapo kudya zakudya zina, zakumwa, mankhwala, ngakhale tiyi wamphamvu kapena khofi. Zifukwa imakhudzanso kusuta. Zinchito mtima kumenyedwa kumachitika mu akazi pa msambo.

Komanso, zoyambitsa zina matenda, kuphatikizapo osteochondrosis (makamaka msana khomo lachiberekero), ndi mtima dystonia, neuroses ya chiyambi osiyanasiyana, ndipo ena.

Pali zinthu zina zimene zingatisocheretse anaona mtima mungoli chisokonezo. zifukwa kugwirizana ndi zotupa organic wa myocardium ndi dongosolo conduction. Mwachitsanzo, kuukira amayambira odwala ndi olumala osiyana, komanso pa maziko Cardiosclerosis, cardiomyopathy, inatsekeratu mtsempha wamagazi matenda, matenda yotupa (myocarditis, pericarditis). Zifukwa mulinso matenda monga hemochromatosis, sarcoidosis, amyloidosis, chifukwa mu chikhalidwe ngati cha chiopsezo kuwonongeka mtima.

Kuukira kwa arrhythmia zambiri amapezeka ndi limakhala malungo amphamvu. Komanso, zotsatira chomwecho kungachititse kumwa mankhwala ena, kuphatikizapo mankhwala amene muli tiyi kapena khofi, ephedrine, aminophylline novodrin, ndi antidepressants tricyclic, mankhwala diuretic ndi corticosteroids.

kupanikizika kwambiri, nkhawa thupi, chosokoneza cha okhutira mchere maselo m'mnyewa wamtima - zonse zimene zimachititsa kuti itakula chidule cha minofu mtima.

gulu la kuyan'anila

Kumene, lero pali zambiri gulu machitidwe, zomwe n'zotheka kumvetsa zimene ndi kumenyedwa - mwachitsanzo, malinga ndi kutanthauzira kwa foci ectopic. Nthawi zambiri anati mlingo kulephera ventricles ndi oposa 60% odwala kubwera kwa dokotala ndi matenda amenewa.

25% ya ananena kumenyedwa matenda. Kwambiri kamodzikamodzi chisokonezo mungoli zimachitika mu matumba kugwirizana atrioventricular, mu Zikatero, iwo amatchedwa atrioventricular. Komanso pali ma zosiyanasiyana mitundu pamwambapa.

Nthawi zina, Woyambirira nkusani mungoli anakhalabe imodzi ndi mapangidwe foci ectopic, ngati kulakwila ndi amatchedwa parasystole. Kuphwanya anawagawira ndi chiwerengero cha foci wa malemeredwe, angakhale onse mono- ndi polytopic.

Ngati kumenyedwa ndi awiri mu mzere, iwo amatchedwa wophatikizidwa. Ngati kuchepetsa zapadera anatsatira chiwembu "oposa awiri mu mzere," kutanthauza - ananyoza kumenyedwa. Komanso, kuyan'anila amenewa anawagawa m'magulu malinga akapezeka pa chidule mtima (ichi oyambirira, pakati ndi mochedwa). Ngati ife kuganizira zochitika za kumenyedwa msanga, angakhale osowa (osachepera 5 contractions chisanadze akuti pa mphindi), sing'anga (6 mpaka 15), kapena kawirikawiri (mwachitsanzo pafupipafupi yamitsempha yamagazi kumenyedwa msanga limodzi ndi oposa 15 zapadera contractions yamitsempha yamagazi pamphindi).

Mwachibadwa, pali dongosolo lomwe arrhythmia zimagawidwa monga chiyambi chake. Mwachitsanzo, matenda mtima mungoli akhoza kugwirizana ndi organic kapena minofu zotupa poizoni, matenda thupi.

Monga kumenyedwa wasonyeza?

Ndipotu, zizindikiro za matenda a mtima pano odwala onse nthawi zina arrhythmia anatsimikiza mwangozi pa electrocardiogram chizolowezi. Komanso pali zinthu zambiri zimene zingakhudze kuchuluka ndi mphamvu ya zizindikiro pano. Mwachitsanzo, odwala ndi zotupa organic wa myocardium kungakhale N'zosavuta kunyamula zinthu zochititsa arrhythmia, pamene chithunzi matenda mu anthu ndi dystonia mtima amayang'ana kwambiri kovuta.

Nthawi zambiri extrasystole subjectively achitanji Kankhani amphamvu, ngakhale kugunda kwa mtima wa pachifuwa kuchokera mkati. Nthawi zina, odwala ananena kuti kumva ngati mtima wa "flips" kapena "somersaults". ndi maganizo kugwirizana ndi amphamvu, amphamvu ndi lakuthwa kuchepetsa myocardium lapansi.

Ena odwala arrhythmia kuukira kungafanane ndi zizindikiro za matenda mtsempha wamagazi kapena angina. Arrythmia, amagwirizana ndi kusintha zinchito nthawi zambiri limodzi ndi zizindikiro zina. Mwachitsanzo, odwala amadandaula kuchuluka thukuta, kumverera yochepa mpweya otentha amatuluka, wamphamvu, mwadzidzidzi zikuchitika kufooka, nkhawa. Nthawi zina kuli zosamvetsetseka kumverera nkhawa, ngakhale mantha.

Pali zizindikiro zina matenda a mtima. Monga chizungulire. Pafupipafupi yamitsempha yamagazi kumenyedwa msanga kapena matenda limodzi ndi kuchepa linanena bungwe magazi, zomwe zimabweretsa chizindikiro ichi. Odwala ndi oziziritsa mtima atherosclerosis arrhythmias amenewa kungachititse kuti kusokonezeka kwa magazi, limodzi ndi paresis, syncope, matenda ena ndi aphasia. Mulimonsemo, mawonetseredwe a limati ayenera yomweyo dokotala, chifukwa zotsatira zake zikhoza kukhala zoopsa kwambiri ndi zovuta.

Kumenyedwa paubwana

Ndipotu, kumenyedwa ana nthawi zambiri matenda. Iwo akudwala mwana wa msinkhu uliwonse, zina za matendawa m'kaundula ngakhale pa chitukuko yoopsa. Malinga ndi kafukufuku, oposa 75% ya ana amakhala osiyana, amadwala matenda mtima mungoli. Ndipo pa khumi zapitazi chiwerengero cha ana ndi matenda amenewa chawonjezeka kwambiri.

Kodi chikuchititsa mavuto a arrhythmias mtima ana chiyani? Choyamba tisaiwale kubadwa zopindika ndipo cardiomyopathy. Komanso, ambiri monga matenda myocarditis, matenda enaake ophwanya mtima, chibadwa matenda wotsimikiza.

Nthawi zina, matenda amagwirizana ndi matenda ena a endocrine ndi machitidwe mantha. Mwachitsanzo, maonekedwe a extrasystole zingachititse hypothyroidism kapena shuga. Komano, tanthauzo la njira aakulu yotupa ndi matenda, komanso matenda akusowa ndi kusowa kwa ena zinthu, kwambiri thupi kapena maganizo nkhawa. Mulimonsemo, ndi chisokonezo akufunika mankhwalawa. Monga zonenera, ambiri kapena osowa kumenyedwa, amene si limodzi ndi zotupa organic mtima, imatengedwa mawonekedwe ndi abwino matenda.

njira zamakono za matenda

Mwachibadwa, pali njira zambiri matenda, kuphatikizapo ECG. Extrasystole pamene kuphunzira zofanana, kawirikawiri kuoneka bwino. Komabe, njira yodziwira sayamba ndi ichi. Kuyamba, dokotala ayenera kuchititsa bwinobwino, limene limayamba ndi kutolera mfundo. Wodwala ayenera kudziŵitsa katswiri zomwe zizindikiro anaonekera, momwe kwambiri kuti akuukira, kangati zidzachitika.

Nkofunika kwambiri kudziwa chifukwa cha arrhythmias mtima. Kuti zimenezi zitheke, ati mbiri zachipatala, dokotala ayenera kudziwa pamaso pa matenda ena, mankhwala osokoneza bongo. Popeza kuti chiyambi ndi chikhalidwe cha zotupa za dongosolo mtima conduction kumadalira kusankha mankhwala ogwira.

Pambuyo kuti dokotala zambiri amachita zimachitika palpation pa mtsempha wamagazi ndi zozungulira. Pamene arrhythmia katswiri akhoza m'malo zimachitika yoweyula amenewa amapezeka asanakalambe. Nthawi zina, m'malo mwake, limodzi ndi nkhani arrythmia a "kugwa" Kugunda kuti kumachitika pamene pali osakwanira kudzazidwa ventricles pa diastole.

Komanso unachitikira mtima auscultation. Pamene akumvetsera, mungaone pamaso pa masiku asanakwane Ine ndi II wa malankhulidwe. Mwa njira, ndi matenda amenewa, kamvekedwe woyamba umalimba, amene amagwirizana ndi kudzazidwa pang'ono ventricles lapansi. Koma kamvekedwe chachiwiri, pa mwake, wofooka, monga ejection magazi mu msempha ndi mtsempha wamagazi m'mapapo mwanga ndi laling'ono kwambiri.

Pambuyo kuti dokotala adzatumiza wodwalayo onetsetsani cardiogram mtima. Ichi ndi chimodzi mwa njira yolondola kwambiri za kafukufuku. Nthawi zina, otchedwa Holter ECG. Kodi ndondomeko? thupi wodwalayo amamangiriridwa wapadera kunyamula chipangizo kuti akulemba mtima kayendedwe pa masiku 1-2. Komanso wodwalayo amasunga tsikulo kuchita zimene anafotokoza maganizo ake ndi kuchita ntchito. phunziro limeneli ntchito ngati mukufuna kupeza zimene akapsa ndi arrhythmia.

Ngati arrhythmias mtima sizinkachitika pa mpumulo, kuchititsa mayesero zina - njinga ergometry komanso matayala mayeso. Maphunziro awa n'zotheka kuti kuyeza magawo (magazi) ndi kupanga electrocardiogram pa masewera olimbitsa thupi (monga kuyenda pa matayala ndi thupi pa njinga yosasuntha). Ngati mukukayikira kuti organic m'mnyewa wamtima kuwonongeka odwala akulimbikitsidwa kuchita ultrasound ndi Kujambula mtima.

Kodi kuchitira arrhythmia?

Monga tanenera kale, mankhwalawa arrhythmia mtima zimadalira mavutowo. Mwachitsanzo, ngati arrhythmias kugwirizana ndi kumwa mankhwala, ndiye, ndithudi, ayenera zimafika. Ngati zifukwa kugona mu matenda m'mimba ndi mtima kachitidwe, kufunika kuwachitira mu malo oyamba, ndipo extrasystoles kuukira idzapita pamodzi ndi matenda choyambirira.

Nthawi zina matendawa kumathandiza kumvetsa zimene mungoli chisokonezo choukira limakhala la overstrain mantha. odwala amenewa amatchedwa ndi katswiriyu kwa mokambilana ndi, monga ulamuliro, amapatsidwa kulandira mankhwala wofatsa kapena sedative chindapusa zitsamba.

Ayi ndipo kawirikawiri akuukira arrhythmias musati amafuna chithandizo chamankhwala, odwala analimbikitsa okha kutsatira mfundo za moyo wathanzi, ndipo nthawi pochitika kuona mobwerezabwereza.

Ngati kuukira zimachitika kawirikawiri, limodzi ndi kufupika kwa mpweya, kufooka ndi kumumenya amphamvu, ndiye, osalephera, adokotala kusankha mankhwala oyenera. Tinganene, kuthetsa kuyan'anila za otchedwa akuchipatala mankhwala antiarrhythmic, kuphatikizapo lidocaine wa, sotalol, procainamide hydrochloride, diltiazem, quinidine, Cordarone, mexyl. Palibe sangathe ntchito nokha, mankhwala, monga mlingo ndi kulandira mode kwambiri payekha. Komanso, nthawi zina mankhwala chikuyendetsedwera pa Holter ECG polojekiti, izo limatithandiza kumvetsa ngati mankhwala othandiza monga kuyenera, ndipo si chifukwa thupi ngati ali zoipa kwambiri.

Mu mankhwala chosaopsa ekstrasistoliyah kutenga bola kuukira kwathunthu atapita, kapena chiwerengero chawo chidzakhala kuchepetsedwa yochepa. Kenako, kuchuluka kwa mankhwala kuyamba pang'onopang'ono kuchepetsa kenako kuletsa izo palimodzi. Childs, zimenezi kumatenga miyezi ingapo. Koma m'njira zilonda za kuyan'anila za odwala kutenga antiarrhythmics moyo.

Pa nthawi imene mankhwala sizikugwira ntchito, kapena wodwala anaulula tsankho awo, gwiritsani ntchito njira zina zochizira, makamaka radiofrequency ablation za mtima. Mwa njira, chizindikiro chosonyeza kuti mtundu uwu wa mankhwala ndi mawonekedwe arrhythmia yamitsempha yamagazi, omwe limodzi ndi zikwi kuukira 20-30 tsiku. Izi ndi opaleshoni imene ikugwirizana ndi asang'ambe njira olanda. Iwo ikuchitika ntchito yapadera endovascular catheter amene chikutumiza mafunde mkulu-pafupipafupi. Choncho, dontho elekitirodi mtima amakhudza mbali kumene wosweka madutsidwe. Ndi mwambo umenewo, inu akhoza kuletsa kufala kwa pathological, "cholakwika" Kugunda n'kuyambiranso yachibadwa nkusani mungoli.

Zotsatira za arrhythmias mtima, ndipo odziŵa za odwala

Kuti madokotala ananena zawo odwala mwachindunji zimadalira matenda ndi pamaso pa matenda concomitant. Mwachitsanzo, owopsa ndi kumenyedwa kuti kukhala pa maziko a matenda a mtima, cardiomyopathy ndi organic m'mnyewa wamtima kuwonongeka.

Mulimonsemo, pakalibe chithandizo choyenera yake kungachititse kuti kulemera vuto. Ngakhale kuti ambiri a kumenyedwa ndi mtima wabwino, nthawi zina amatuluka pa maziko ake ndi matenda ena owopsa, kuphatikizapo tachycardia paroxysmal, matenda fibrillation ndi matenda flutter. zinthu zimenezi kungachititse kuti imfa wodwalayo mwadzidzidzi.

Pali ena mavuto ena kuti ayende pa kumenyedwa. Ndi choyamba, mavuto ndi magazi ndi zakudya za zimakhala. Ndipotu, pamene mobwerezabwereza extrasystoles buku la magazi ejected ndi mtima yafupika kwambiri. Zimenezi zimabweretsa mpweya njala komanso kusokonezeka kwa makope yachibadwa. Nthawi zambiri ukugunda kumabweretsa chitukuko cha kulephera aakulu aimpso, inatsekeratu ndi oziziritsa mitsempha, imbaenda mavuto kwambiri.

njira zopewera

Kumene, wodwala ndi mavuto ofanana ayenera mayina ndi cardiologist ndi kukumana anayendera zonse. The njira yaikulu yopewera mavuto oopsa arrythmia ndi mankhwalawa matenda choyambirira. anthu odwala muyenera kuonetsetsa kumwa mankhwala zotchulidwa katswiri, komanso kutsatira ndandanda ndi chakudya. Komanso kugunda kwa mtima maphunziro zonse zifunika, popeza amapereka dokotala mwayi kutsatira mayendedwe a chitukuko cha matenda ndi zotsatira za mankhwala akuchipatala.

Ndithudi odwala amafunika ukasintha kupendanso moyo. matenda aliwonse mtima amafuna zakudya zapadera. Kusiya kusuta, kumwa mowa ndi tiyi kapena khofi chofunika. Ndipo, ndithudi, ntchito ya dongosolo mtima adzakhala zothandiza kuchita masewera olimbitsa thupi nthawi zonse, kuyenda mu mpweya wabwino.

Tiyenera kulankhula za thandizo. Kuukira ukugunda zambiri umafika mwadzidzidzi. Wodwala ayenera pogona ndi kumasuka. Izo analimbikitsanso chochotsa mabatani pamwamba pa mkanjo wake, anamasuka tayi wake ndi lamba, mawu, kuchotsa zotchinga zonse zotheka kuti kusokoneza kupuma. Ngati kuukira chinali chifukwa cha nkhawa, izo amaloledwa kutenga pang'ono mankhwala sedative. Ndi bwino itanani ambulansi, chifukwa zotsatira zake zingakhale zowopsa arrhythmia.