Kungakhathaliseki ukuthi umuntu onenhliziyo inhliziyo udinga i-pacemaker incike ezintweni eziningana
"I-Heart block" yinkinga evamile ephazamisa uhlelo lwegesi lwenhliziyo. I-Heart block-ebizwa nangokuthi i-atrioventric block, noma i-AV block-ingenye yezimbangela ezimbili ezibalulekile ze- bradycardia (izinga lentliziyo elincane).
Sibutsetelo
E-block block, izinhliziyo zikagesi zengqondo zivinjelwe noma zivinjelwe ngokuphelele njengoba zizama ukuhamba ezinkampanini ezingenasifo senhliziyo kuya ekamelweni lokuvotela.
Ngenxa yokuthi lezi zifiso zikagesi zivumela inhliziyo ukuba ikwazi uma kufanele ishaywe, uma i-heart block ibanzi ngokwanele inganciphisa izinga lokushaya kwenhliziyo emazingeni aphansi.
Uma une-block block, nansi izici eziyinhloko ezizocacisa ukuthi udinga i-pacemaker:
- Uma i-heart block yakho ibangelwe ukukhuphuka kwesikhashana kwezwi le-vagal, i-pacemaker cishe ayidingi.
- Uma une-degree ye-first block block, i-pacemaker ayidingekile ngaphandle kokuthi ibhulogi ihlukaniswe.
- Uma une-block yesibili ye-block block okungenzeka ukuthi iveza izimpawu noma i-distal, kuyadingeka i-pacemaker. I-block degree yesibili engeke ibangele izimpawu futhi ihamba phambili ngokuvamile ayidingi i-pacemaker.
- Uma unesibindi senhliziyo ye-third degree, ke uma kungenjalo ngenxa yokwanda okwesikhashana kwezwi le-vagal, i-pacemaker ihlale idingeka njalo.
Izimbangela
Izigcawu ezincane ze block block akuzona neze eziyingozi noma ezingavamile. I-heart heart block ngokuvamile ibonakala kubantu abasha, abanempilo abathola ukwanda okungazelelwe kwezwi lezinzwa zabo.
Leli gama le-vagal landa kakhulu livela nge-nausea, ukuhlanza, noma ekuphenduleni ubuhlungu, ukwesaba, noma ukucindezeleka okungazelelwe. Leli fomu lebhokisi lezinhliziyo alisongela impilo futhi alibonakali noma iyiphi inkinga ebalulekile ngenqubo kagesi yenhliziyo. Iyanyamalala masinyane lapho umcimbi oshukumisayo usuphelile futhi cishe awudingi ukungena kwe-pacemaker.
Ngakolunye uhlangothi, i-heart block ingase ivele nezifo ezihlukahlukene zenhliziyo, ikakhulukazi isifo se-coronary , isifo senhliziyo , noma i- myocarditis . Kukhona nezinhlobo zomndeni zebhokisi lezinhliziyo.
Ngokuvamile, lapho i-heart block ikhiqizwa yisifo senhliziyo, kusho ukuthi kukhona ukuphazamiseka okungapheli kwesistimu kagesi yomzimba. Lolu hlobo lwebhokisi lezinhliziyo luyaqhubeka luba lubi nakakhulu ngokuhamba kwesikhathi, ngakho-ke kudingeke ukuba abacindezeli bezinhlungu zomoya babe nezidakamizwa.
Izimpawu
Ngokuya ngobukhulu bayo, i-heart block ingaveza izimpawu eziningi, kusukela kunoma yikuphi kuya kwesinye isizungu , i- syncope (ukulahlekelwa kokuqonda), noma ngisho nokufa. I-Heart block ebaluleke ngokwanele ukuveza izimpawu, noma lokho okusongela ukuba yileyo enzima, ingaphathwa ngempumelelo nge- pacemaker . Ngakho-ke uma unesifo senhliziyo, ingqinamba enkulu kuwe nodokotela wakho kuyoba ukuthi unqume ukuthi inhliziyo yakho ibhekile ngokwanele ukufuna i-pacemaker.
I-Heart block engeke ikhiqize noma yiziphi izimpawu okuvamile akudingi i-pacemaker, ngaphandle uma i-heart degree yesithathu noma i-distal inhliziyo block. Uma i-heart block ikhiqiza izimpawu-ikakhulukazi ugozi noma i-syncope-ke ukuyiphatha nge-pacemaker kuvame ukudingeka. Okuhlukile lapho i-heart block iyaziwa yesikhashana-ngokwesibonelo, uma kwenzeka ngenxa yokwanda okwesikhashana kwezwi lesigalo.
I-Degree
I-heart block ihlukaniswe odokotela ibe yiyodwa ye "degrees" ezintathu. Udokotela wakho anganquma izinga lebhokisi lenhliziyo yakho nge- electrocardiogram (ECG) .
- I-block degree yokuqala kusho ukuthi umfutho ngamunye we-cardiac ekugcineni uwenza ube yi-atria kuya kuma-ventricles, kodwa ukuqhutshwa komfutho kuyashesha.
- I-block degree yesibili ichaza ukuthi ezinye zezimpendulo zenziwa ngempumelelo kuma-ventricles, kodwa ezinye azikho.
- I-block degree yesithathu kusho ukuthi zonke izimo zivaliwe. I-block degree ye-third degree ibizwa nangokuthi "i-heart block block".
Kumuntu one-block degree ye-heart block, ukusinda kuxhomeke ekubeni khona kwamaseli we-pacemaker aphansi ngaphansi kwesayithi le-block.
Lokhu kungukuthi, amangqamuzana enza izifiso zawo kagesi ezivumela inhliziyo ukuba iqhubeke ishaya.
Ingqikithi yenhliziyo ekhishwe yilawa maseli we-pacemaker ezinconywayo ibizwa ngokuthi "isigqi sokuphunyuka." Ngokuvamile, lezi zingoma zokuphunyuka ziyazi ukuthi zingathembeki futhi zibuthakathaka. Ngezinye izikhathi ukuba khona kwesigqi sokuphunyuka kuthathwa njengesimo esiphuthumayo sezokwelapha.
Ngokuvamile, izinga eliphezulu le-block block, cishe kunesidingo se-pacemaker. Ama-packemaker ahlale edingekayo nge-block degree yesithathu, ngokuvamile nge-block degree yesibili, kodwa kuphela okungajwayelekile nge-degree yokuqala ye-block.
Indawo
Ngesikhathi sesigqi senhliziyo evamile, ukucindezeleka kwenhliziyo kagesi kufanele kudlule ngaphesheya kwe-atria kanye ne-ventricles (AV junction). Le junction AV inezinhlaka ezimbili:
- I- node ye-AV
- Isibopho Sakhe (ukucatshangwa ngokuthi "ikhebula" elihambelanayo lamafayili enza izimpendulo zikagesi kusukela ku-AV node kuya emazwini asebenzayo)
Ekunqumeni ubukhulu bebhokisi lezinhliziyo, kubalulekile ukwazi ukuthi ukuphikisana kwe-AV kubonakala kuphi. Okungukuthi, ingabe i-block ngaphakathi kwe-AV node noma ingaphansi kwesikhwama saKhe (noma amagatsha enqwaba avela esiswini sakhe)?
Ezimweni eziningi, udokotela anganquma indawo yebhokisi lenhliziyo nje ngokuhlola i-ECG. Ngezinye izikhathi, kunesidingo sokufundwa kwe-electrophysiology .
I-Heart block eyenzeka ngaphakathi kwe-AV node ("i-proximal" block block) ivame ukuba yinhle futhi ngokuvamile ayidingi i-pacemaker engunaphakade. Lokhu kungenxa yokuthi uma ibhulogi lwenzeka ngaphakathi kwe-AV node, amaseli we-pacemaker ezinsizayo ku-node ye-AV ngaphesheya kwesayithi ye-block ngokuvamile athatha isigqi senhliziyo. Lokhu okubizwa ngokuthi "isigqi sokuphunyuka kwama-junctional" kuvame ukuba nesimo esifanele futhi akuyona ingozi empilweni.
Ngakolunye uhlangothi, nge-block "distal" yenhliziyo, lapho ibhokisi livela khona noma ngaphasi kwesigxobo saKhe, noma yiliphi amaseli we-pacemaker ezincane angatholakala kuphela emagatsheni ezinqwaba noma nge-ventricles. Ingqikithi yenhliziyo ephumela ekutheni ibizwa ngokuthi "i-ventricular rythmhy rhythm." Ngenxa yokuthi lezi zinsizakalo ze-pacemaker ezixhasayo ziyaziwa ukuthi zingathembeki futhi zijwayele ukuyeka ngokungazelelwe, isigqi sokuphunyuka kwe-ventricular kubhekwa njengesimo esiyingozi.
I-distal heart block ivame ukwedlula isikhathi. Ngakho-ke ngisho nasezindaweni lapho okwamanje kubangelwa khona kuphela i-block yokuqala noma yesibili i-degree block, i-distal heart block ibhekwa njengengozi futhi cishe njalo idinga ukwelashwa nge-pacemaker.
Izwi elivela
Uma utshelwe ukuthi unesivimbe senhliziyo noma i-AV block, wena nodokotela wakho kuzodinga ukucabangela zonke lezi zinto ukuze unqume ukuthi udinga i-pacemaker. Ngenhlanhla, ukuqoqa ulwazi oludingekayo ngokuvamile kuyindlela esheshayo futhi eqondile futhi nje ngezinye izikhathi kudinga ukuhlola okungahleliwe kwe-electrophysiology.
> Umthombo:
> Epstein AE, DiMarco JP, Ellenbogen KA, et al. I-ACC / AHA / HRS 2008 Izinkombandlela zokwelashwa okusekelwe ngeDivaysi ye-Cardiac Rhythm Okungajwayelekile: Umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice (Ikomidi Lokubhala Ukubuyekeza I-ACC / AHA / NASPE 2002 Isiqondiso Sokuqondisa Ukufakwa Kwentuthuko of Pacemakers Cardiac and Antiarrhythmia Devices): athuthukiswe ngokubambisana ne-American Association for Thoracic Surgery kanye neNhlangano Yezintatheli Zezintambo. Ukujikeleza ngo-2008; 117: e350.