Isizathu sokufa okungazelelwe kubadlali abasha
I-Arrhythmogenic ye-ventricular cardiomyopathy (AVRC) yisimo sezakhi zofuzo lapho imisipha yomzimba ejwayelekile ishintshwa khona ngezintambo ezinamafutha, ezinamafutha amaningi, ikakhulukazi kwi-ventricle efanele. Isizathu esiyinhloko i-AVRC sibalulekile ukuthi singakhipha ama- arrhythmias enhliziyo engaba yingozi. (I-AVRC igama elithi "elisha" lalesi simo, esasibizwa ngokuthi "i-arrhythmogenic right ventricular dysplasia.")
I-AVRC ayivamile, kodwa ayidlangalaleni. Itholakala kunoma yimuphi umuntu oneminyaka engu-2000 kuya ku-5000 uma uyibheka. Kodwa-ke, isikhathi esisodwa esidlangalaleni ngokuvamile esizwa nge-AVRC yilapho umdlali osemusha efa ngokuzumayo, ngoba i-AVRC ingenye yezimo zenhliziyo ezihambisana nokufa okungazelelwe kubadlali abasha .
Ziyini Izimpawu Ze-AVRC?
Ngenkathi i-AVRC isifo senhliziyo - okungukuthi, isifo senhliziyo - akuvamile ukuthi kubangele izinkinga zemisipha ezinde ngokwanele ukuveza ukuhluleka kwenhliziyo . Kunalokho, ukubaluleka komtholampilo wukuthi kungabangela ukuguquka kwenhliziyo - ikakhulukazi, izakhiwo ze- ventricular zangaphambi kwesikhathi , i- ventricular tachycardia , futhi ngezinye izikhathi i- fibrication ye-ventricular .
Izimpawu ezibangelwa i-AVRC zivame ukuhlobana nama-arrhythmias angaveza. Abantu abane-AVRC bavame ukuchaza iziqephu ze- palpitations , ikhanda elikhanyayo, noma i- syncope . Ngeshwa, ukufa okungazelelwe kungase kwenzeke, futhi nakakhulu ngeshwa, ukufa okungazelelwe kungase kube uphawu lokuqala ukuthi kunenkinga yenhliziyo.
Ngenkathi i-AVRC ingabangela ukufa okungazelelwe kungenzeka nganoma isiphi isikhathi, lesi senzakalo kungenzeka kakhulu phakathi kweziqephu zokuzikhandla komzimba. Yingakho i-AVRC ingenye yezimiso ezikhiqiza ukufa okungazelelwe ezinkundleni ezibonakala ziphilile, ezincane.
Abantu abaningi abane-AVRC - kuze kube ngu-40% - ngeke babone izimpawu, futhi baxilongwa kuphela uma behlolwe ngenxa yesifo ngoba ilungu lomndeni litholakale linalo.
I-AVRC ikhonjiswe kanjani?
Ukubona i-AVRC kufezwa ngokuhlola i- electrocardiogram (okuvame ukubonisa ukucushwa okukhethekile kwe-QRS complex), kanye ne- echocardiogram (okuvame ukukhombisa ukungalingani okuphawulekayo emzimbeni we-carricac we-ventricle efanele) futhi ngezinye izikhathi nge-ventricle kwesokunxele).
Uma ukuxilongwa kuqhubeka kungabaza, ngezinye izikhathi i- MRI yomzimba ingasiza ukuphoqa izinto. Ukuhlolwa kwe-genetic kungasiza futhi ekwenzeni ukuxilongwa, futhi kunconywa kubo bonke abantu abanalesi simo.
Ngenkathi ukuhlolwa kwe-electrophysiologic kungasiza ngezikhathi ezithile ekuhlukaniseni i-tachycardia ye-ventricular ngenxa ye-AVRC esuka kwe-ventricular tachycardia ebangelwa ezinye izimo zenhliziyo, ukuhlolwa okunjalo akusizi njalo, futhi akudingeki njalo.
Lapho sekutholakala ukuxilongwa, ukuhlolisiswa kwezakhi zofuzo nakho kunconywa ngezihlobo zokuqala. Ngesinye sezihlobo ezintathu zezinga lokuqala lomuntu onesigungu se-AVRC sizogcina nesimo.
Ukwelapha i-AVRC
Umgomo oyinhloko ekwelapheni i-AVRC ukuvimbela ukufa okungazelelwe kwe-cardiac kusuka kwi-ventricular tachycardia noma i-fibrillation.
Ngenxa yokuthi ukufa ngokuzumayo kuvame ukuhlotshaniswa nokuzivocavoca kule nkinga, abagijimi abane-AVRC kufanele bagweme kuzo zonke imidlalo ezincintisanayo, ngaphandle kokungabikho kwemisebenzi encane efana negalufu noma i-bowling.
Ngaphezu kwalokho, kufanele bagweme noma yikuphi umsebenzi oveza amaphupho amakhulu.
I-arrhythmias ehlobene ne-AVRC ibonakala ikhutshwe ngokugqugquzela ukuzwelana - ingxenye yesimiso se- autonomic senzwa esandisa amazinga e-adrenaline, futhi iyabangela ukulwa noma impendulo yezindiza. Yingakho ukuzivocavoca kuyinkinga nge-AVRC. Ngakho-ke, izazi ze-cardiologists eziningi zincoma ukusetshenziswa kwe- blocka blockers kule nkinga, ukungafani nomphumela we-adrenaline enhliziyweni.
Izidakamizwa ezifakwe ngaphakathi zikhuthazwa kakhulu kubantu abaningi abane-AVRC, ikakhulukazi, noma ubani oye waba nesiqephu sokuboshwa komzimba, isiqephu se-tachycardia eqhubekayo, okuyi-episode ye-syncope engaqondakali, noma o-echocardiogram obonisa ukuzibandakanya okukhulu komsila wenhliziyo.
Kubantu abane-AVRC abangenayo yalezi zimo, ingozi yokufa okungazelelwe ibonakala sengathi iphansi - uma nje ilandela imingcele yokuzivocavoca umzimba futhi ithatha izivimbela zabo ze-beta.
Kubantu abano-AVRC abaye baqhubeka nokugcina ama-arrhythmias, i-prognosis ehlala isikhathi eside ibonakala inhle kakhulu uma igwema ukuzivocavoca umzimba, ithatha i-beta blockers, ithole i-defibrillator engenawo umuthi , futhi (kwezinye izimo) ithathe izidakamizwa eziphikisayo .
Izwi elivela
I-arhyhythmogenic ye-ventricular cardiomyopathy yimizimba yezakhi zofuzo ezingabangela ama-arrhythmias abulalayo angase abulale, futhi ingenye yezimbangela zokufa kungazelelwe kubadlali abasha. Ngokwelashwa okunonya, abantu abanezimo bavame ukwenza kahle.
> Imithombo:
> Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. Umhlahlandlela we-AHA / ACC / HRS we-2017 wokuphathwa kweziguli ezine-Arrhythmias ezinamandla kanye Nokuvimbela Ukufa Kwegazi Lokufa Kwegazi: Isifinyezo Esiphezulu: Umbiko We-American College of Cardiology / American Heart Association Task Force Emitholampilo Yokuzivocavoca Yomtholampilo kanye ne-Heart Rhythm Society. I-Heart Rhythm 2017.
> Ruwald AC, Marcus F, Estes NA 3rd, et al. Umhlangano Wokuncintisana Nezemidlalo Yokuzilibazisa Ukubamba iqhaza Ngezehlakalo Zezinhliziyo Ezigulini Nge-Arrhythmogenic Right Ventricular Cardiomyopathy: Imiphumela Evela eNyakatho Melika I-Multidisciplinary Study Of Arrhythmogenic Right Ventricular Cardiomyopathy. I-Eur Heart J 2015; 36: 1735.