Ngabe I-Slow Heart Rate Rate Inkinga, Futhi Ngabe Kudinga Ukubhekwa Nini?
I-Bradycardia yigama lezokwelapha ngenani lezinhliziyo elihamba kancane kunejwayelekile. Ezincwadini zezokwelashwa, i-bradycardia ivame ukuchazwa njengezinga lokuphumula lenhliziyo elingaphansi kwezingu-60 ngomzuzu. Kodwa-ke, abaningi (mhlawumbe iningi) labantu abanempilo banesilinganiso senhliziyo sokuphumula ngaphansi kwezingu-60. Ngakho ukuba ne-bradycardia akuyona into embi, noma ngisho into engavamile.
Ngokuvamile kuyisibonakaliso sempilo enhle.
Ngakolunye uhlangothi, i-bradycardia ingaba yinkinga enkulu uma izinga lenhliziyo liba buthaka kangangokuba inhliziyo ayikwazi ukupompa igazi elanele ukunikeza izidingo zomzimba. Yilolu hlobo lwe-bradycardia engavamile oluba ukukhathazeka ngokwezokwelapha, futhi okudinga ukuhlolwa ngokucophelela nokwelashwa.
Izimpawu ZeBradycardia Engavamile
Uma izinga lenhliziyo lihamba kancane, izitho eziningana zomzimba zingase zingasebenzi ngendlela evamile, futhi izimpawu ezihlukahlukene zingase ziholele. Ngokuvamile, izimpawu ze-bradycardia ezingavamile ziba zimbi nakakhulu ngemizamo yokuzikhandla (ngoba izidingo zomzimba ziba zikhulu uma uzikhandla), kodwa izimpawu zingase zibe khona ngesikhathi sokuphumula uma i-bradycardia inzima.
Izimpawu ezingabangelwa yi-bradycardia zifaka:
- Ukuphefumula noma isizungu (ikakhulukazi ngokuzikhandla)
- Kulula ukukhathala
- I-syncope ( yokuphelelwa amandla) noma eduze-syncope
- I-Dyspnea (ukuphefumula okuncane )
- Ubuhlungu besifuba noma ukungakhululeki
- Ukudideka
Uma i-bradycardia ihlotshaniswa nanoma iyiphi yalezi zimpawu, imbangela ye-bradycardia kumele inqunywe, futhi ukwelashwa kufanele kunikezwe ukubuyisela izinga lenhliziyo evamile.
Izinhlobo zeBradycardia: I-Sinus Bradycardia
Kulezi zinhlobo ezimbili ezivamile ze-bradycardia, i-sinus bradycardia iyinto evamile kakhulu.
Ngakho-ke yini i-sinus bradycardia?
Ukushaya kwenhliziyo kukhiqizwa futhi kuhlanganiswe ukucindezela kagesi kwenhliziyo, futhi umfutho wegesi ukhiqizwa ku-node yesusus, isidleke esincane samaseli esiphezulu kwe-atrium efanele. Lapho i-node ye-sinus ikhiqiza lezi zifiso zikagesi ngesilinganiso esincishisiwe, izinga lokushaya kwenhliziyo liba buthaka, futhi kuthiwa ikhona isisindo se-sinus bradycardia.
Funda kabanzi mayelana nesistimu kagesi yenhliziyo .
Okujwayelekile ngokumelene ne-Sinus Bradycardia engavamile. Ngesikhathi sokuphumula, i-node ye-sinus idala imishanguzo kagesi ngesilinganiso esiphakathi kwama-50-60 no-100 izikhathi ngomzuzu. Ngakho isilinganiso senhliziyo sokuphumula ngaphakathi kwalolu hlu libizwa ngokuthi " isigqi sesiniso esivamile ." Lapho isilinganiso sesinono sisheshe kunama-100 ngomzuzu, kubizwa ngokuthi i- sinus tachycardia . Futhi izinga le sinus elihamba kancane kunama-60 ngomzuzu libizwa ngokuthi i-sinus bradycardia.
I-Sinus bradycardia ivame ukuvame ukujwayelekile. Umzimba onempilo uhle kakhulu ekulawuleni izinga lenhliziyo ukuba kube yilokho okudingeka kube ukusekela imisebenzi yomzimba. Futhi kaningi, lesi sivalo senhliziyo evamile silinganiselwe lokho odokotela "ngokusemthethweni" ababeka njenge-sinus bradycardia.
Ngakho-ke abantu abasha abanempilo, ngisho nabantu asebekhulile uma besesimweni esihle, bayohlala bephumula amazinga enhliziyo kuma-40 noma ama-50.
Kuyinto evamile (futhi evamile) kubantu abaningi ukuba babe namazinga enhliziyo kuleli bubanzi ngenkathi belele. Nakuba lokhu kuyingxenye ye-sinus bradycardia, kuyindlela ye-physiologic ye-sinus bradycardia-okusho ukuthi isilinganiso senhliziyo sifanele izidingo zomzimba, futhi ngaleyo ndlela, i-sinus bradycardia iyinto evamile.
I-Sinus bradycardia ibhekwa njengenkinga uma izinga lenhliziyo lincane kakhulu ukuhlangabezana nezidingo zomzimba. Uma izinga lenhliziyo liba buthaka kangangokuthi hhayi igazi elinyathelisiwe ngenhliziyo, izimpawu zingathuthuka. Uma i-sinus bradycardia ikhiqiza izimpawu, ayijwayelekile futhi idinga ukuphathwa.
Yini Ebangela Ukungajwayelekile KweSinus Bradycardia? Lapho i-sinus bradycardia ikhiqiza izimpawu, kubhekwa njengento engavamile.
I-sinus bradycardia engavamile ingaba yesikhashana noma iphikelela.
I- sinus bradycardia yesikhashana evame ukubangelwa ithoni ekhulayo emgodini we- vagus . Ukukhuthazwa kwe-vagus nerve kuzonciphisa i-node yesusus, okubangela ukuncipha kwenhliziyo. Ukuvuselela kwe-Vagal nerve kuvame ukukhiqizwa ngezinkinga ezihlukahlukene zamathumbu (ikakhulukazi izinhlanzi noma ukuhlanza), noma ukuphendula ubuhlungu obukhulu noma ukucindezeleka ngokomzwelo.
I-Sinus bradycardia ebangelwa i-vagus nerve stimulation ibhekwa ngokuthi "umzimba" (ngokuphambene ne-pathological), ngoba kuyindlela evamile yokuphendula, futhi iyanyamalala ngokushesha nje lapho ithoni ephakeme ye-vagal iphela.
I-sinus bradycardia engavamile ephikisanayo ivame ukubangelwa yisifo se-sinus se-intrinsic-isifo ngaphakathi kwe-node node ngokwayo. Ngokuvamile, isifo se-sinus se-intrinsic sinomphumela wehlobo lwe-fibrosis (ukukhwabanisa) ngaphakathi kwe-node ye-sinus, okuwukubonakaliswa okuvamile kokuguga. Ngakho-ke isifo se-sinus se-intrinsic ngokuvamile sibonakala kubantu abaneminyaka engu-70 ubudala noma ngaphezulu.
Kubantu abanesifo se-sinus se-intrinsic, izinga lokushaya kwenhliziyo livame ukuphumula kokubili kokuphumula, futhi ngesikhathi sokuzikhandla. Abantu abanezifo zesifo se-sinus zangaphakathi ezivame ukubonisa ukuthi banesifo " sinus syndrome ".
Ngaphandle kwesifo se-sinus se-intrinsic, ezinye izimo zezokwelapha eziningana zingabangela i-sinus bradycardia. (Lokhu kuzofakwa ohlwini ngokushesha) Kodwa kungakhathaliseki ukuthi kungani imbangela, ngenkathi i-sinus bradycardia ingaveza izimpawu eziphawulekayo, ingozi yokufa kwayo iphansi kakhulu.
Izinhlobo zeBradycardia: I-Heart Block
Uhlobo lwesibili olujwayelekile lwe-bradycardia yi-heart block. Ngokuphambene ne-sinus bradycardia, okuyinto kubantu abaningi empeleni ejwayelekile, i-heart block isiso sonke isimo esingavamile.
I-Heart block iyenzeka lapho izinhliziyo zikagesi zithinta ingxenye noma zivinjelwe ngokuphelele njengoba zihamba zisuka e-atria yenhliziyo kuya ezingweni ze-ventricles. Ngenxa yokuthi akuyona yonke imishanguzo kagesi efinyelela ezingxenyeni ze-ventricles, isilinganiso senhliziyo siba sihamba kancane kunalokho okufanele sibe khona. Funda kabanzi mayelana ne-heart block .
Njengoba kunjalo nge-sinus bradycardias engavamile, i-heart block ingaba yesikhashana noma iphikelela.
I- heart heart block ingenzeka (njengokungathi sinus bradycardia engapheli) ngeziqephu zethoni ye-vagal eyanda. Lolu hlobo lwe-heart block elivame ukubonakala luvame kubantu abancane, abantu abanempilo ephikisanayo ngenxa yezinyosi, ukuhlukunyezwa okungazelelwe, noma ukucindezeleka okungazelelwe. Leli bhulogi lenhliziyo libhekwa njengeliyingozi, futhi cishe alingeke lidinga ukwelashwa okungaphezu kokwelashwa (noma ukugwema) izenzakalo ezibangele ithoni ephakeme ye-vagal.
I- heart block eqhubekayo yindaba eyingozi kakhulu ngoba ivame ukubi kakhulu (futhi ingabe isongela ukuphila) njengoba isikhathi sihamba. Nge-block yezinhliziyo, noma kunjalo, ngisho nalapho isimo esibucayi siqhubeka, i-bradycardia ngokwayo ingaba phakathi. Lokhu kusho ukuthi ngezinye izikhathi, kungase kube ngisho nesikhathi esiningi, izinga lokushaya kwenhliziyo empeleni libubanzi obuvamile; kodwa izinga lokushaya kwenhliziyo lingahle liphumele kumazinga okukhiqiza izibonakaliso ngaphandle kwesizathu esicacile noma umcibisholo (ngoba isimo esibucayi siqhubeka). Leli qiniso livame ukwenza inhliziyo ivimbele okunzima kakhulu ukuxilonga kune-sinus bradycardia. Kungakhathaliseki ukuthi i-bradycardia ikhona ngaso sonke isikhathi noma iphakathi, noma kunjalo, ukuphika inhliziyo okuphikelela cishe njalo kudinga ukwelashwa.
Izimbangela zeBradycardia
Njengoba sibonile, i-sinus bradycardia yangasese kanye ne-heart block block ivame ukubangelwa ukwanda okungazelelwe kwethoni yangasese. Uma ithoni ye-vagal ibuyiselwe evamile, izinga lokushaya kwenhliziyo libuyele evamile - ngakho akukho ukuphathwa okuqhubekayo kwe-bradycardia ngokwayo okudingekayo.
Ngakolunye uhlangothi, i-bradycardia engavamile engapheli ingabangela izimo ezihlukahlukene zezokwelapha. Lokhu kufaka:
- Isifo se-artery Coronary
- I-Pericarditis
- I-Myocarditis
- Ukuhlukumeza inhliziyo ngenxa yokulimala noma ukuhlinzwa komzimba
- Ama-Amyloidosis
- I-Hypothyroidism
- I-Dysautonomia
- Izinhlobo ezihlukahlukene zokutheleleka, kuhlanganise nesifo seLyme , isifo seCasgas , ne- Rocky Mountain
- Izinkinga zobungqingili, ikakhulukazi lezo ezihlobene nokucindezeleka okungeyona ingcindezi noma isifo sohlangothi
- I-Hypoxia (amazinga aphansi e-oksijeni egazi), ngokuvamile okwenzeka nge- apnea yokuvimbela ukulala
- Izidakamizwa ezihlukahlukene, kuhlanganise nezivimbela ze-beta , izivimbela ze- calcium , izidakamizwa ezihlukunyezwayo , i- opioids , i-lithium, nezidakamizwa ezihlukahlukene ze-chemotherapy
I-Bradycardia Kufanele Ihlolwe Kanjani?
Ukuhlolwa kwe-bradycardia ngokuvamile kuqondakala kahle. Okokuqala, udokotela udinga ukuhlola i- electrocardiogram (ECG) kuyilapho i-bradycardia ikhona, ukucacisa ukuthi kungenxa yokuthi sinus bradycardia noma i-heart block.
Khona-ke, udokotela kufanele anqume ukuthi ngabe i-bradycardia cishe iyaphika, noma esikhundleni sayo ukuthi iyisenzakalo esithatha isikhathi eside ngenxa yokwanda kwethala le-vagal. Lokhu kungaba njalo njalo ngokufeza umlando wezokwelapha ngokucophelela.
Isivivinyo sokucindezeleka singasiza ekukhipheni isifo se-sinus noma i-heart block esibonakalayo kuphela ngesikhathi sokuzikhandla. Ukuqapha kwe-ECG okwesikhashana kungaba usizo ekuhloleni amabhondicardias okwenzeka kuphela ngokulandelana. Ukutadisha kwe-electrophysiology kungaba yinto eqondile ekuhloleni kokubili isifo se-node nesibindi senhliziyo, kodwa akudingekile ukwenza njalo.
I-Bradycardia Kufanele Iphathwe Kanjani?
Ukwelashwa kwe-bradycardia kuncike ekutheni kuyisinus bradycardia noma i-heart block, nokuthi ngabe iyabuyiselwa yini noma cha.
Ama-bradycardias avuselelwe angabangelwa ukuphakama okuhamba kwesikhathi kwezwi lesigcawu esesixoxile kakade. Ezimweni ezinjalo, ukwelashwa kuqukethe ukugwema izinhlobo zezimiso ezibangelwa ithoni ye-vagal.
I-bradycardia eqhubekayo ingabuyekezwa uma ibangelwa ukwelapha izidakamizwa, isifo esithathelwanayo, i-pericarditis, i-myocarditis noma i-hypothyroidism. Kulezi zimo, ukwelapha ngokweqile inkinga ebalulekile ngokuvamile inakekela izinga lentliziyo elincane.
Uma i-sinus bradycardia ingaguquguquka, noma ingabonakali izimpawu, ngokuvamile ingenziwa ilawulwe kalula ngokuhlolwa okulandelwayo okulandelwayo. Kodwa-ke, ngesinye isikhathi kubantu asebekhulile isifo se-sinus node senza kuphela izimpawu ngesikhathi sokuzikhandla, lapho izinga lokushaya kwenhliziyo lihluleka ukukhula njengoba kufanele lizivocavoca. Ngakho ukuhlolwa kokucindezeleka kungasiza kakhulu ekunqumeni ukuthi isifo se-node sinus empeleni sikhiqiza izimpawu noma cha.
I-Sinus bradycardia engaguquki futhi eveza izimpawu kufanele iphathwe nge- pacemaker ehlala njalo .
I-Heart block iyindaba ebaluleke kakhulu, ngoba i-heart block ivame ukuqhubeka, futhi ingase ibangele ukufa. Ngakho-ke, ngaphandle kokuthi i-heart block ibangelwa isimo esiphenduka kalula, ukwelashwa nge-pacemaker okuhlala njalo kudingeke njalo.
Izwi elivela
I-Bradycardia ivame ukuba yinto evamile engadingi ukuhlolwa okunzulu kwezokwelapha, noma ukwelashwa okuqondile.
Kodwa uma une-sinus bradycardia eveza izimpawu, noma inhliziyo ibambe ukuthi kunezibonakaliso noma cha, kuzodingeka usebenze nodokotela wakho ukuthola ukuthi kungani unakho, futhi unqume ukuthi ngabe i-pacemaker ingadingeka yini.
> Imithombo:
> Epstein AE, DiMarco JP, Ellenbogen KA, et al. Ukubuyekezwa okugcizelele kwe-ACCF / AHA / HRS kuhlanganiswe ne-ACCF / AHA / HRS 2008 Izinkombandlela zokwelapha okusekelwe kudivayisi ye-Cardiac Rhythm Okungajwayelekile: Umbiko we-American College of Cardiology Foundation / i-American Heart Association Task Force on Guidelines Practice kanye ne-Heart Rhythm Umphakathi. J Am Coll Cardiol 2013; 61: e6.
> Fogoros RN, Mandrola JM. Ucwaningo lwe-Electrophysiology ekuhlolweni kweBradycardia: I-SA Node, i-AV Node, ne-His-Purkinje System. Ku: Ukuhlolwa kwe-Electrophysiologic kaFogoros, Ukushicilelwa Kwesithupha. UWiley Blackwell, ngo-2017.