Uhlelo lwegesi lwenhliziyo lulawula isilinganiso senhliziyo futhi luqinisekisa ukuthi amakamelo ahlukahlukene enkontileka yenhliziyo ngendlela ehlelekile ngokuphelele. Lezi zinkimbinkimbi zinkimbinkimbi futhi zinkimbinkimbi-isibonelo, lapho isibonakaliso sogesi senhliziyo sisuka e-atria kuya e-ventricles, umehluko ngesikhathi sokufunda okweshumi kwesigamu kungenza umthelela omkhulu ekusebenzeni kwenhliziyo.
Ngesistimu ye-physiologic edinga lelizinga lokuchaneka nokuyinkimbinkimbi, kuzomele kube nanoma iyiphi inamba yezindlela ezingaphazanyiswa ngazo noma eziphazamisekile. Ngakho akufanele kusimangaze ukuthi ama-arrhythmiya enhliziyo angabangelwa yizimbangela eziyinhloko.
Lokhu kusho, phakathi kwezinye izinto, ukuthi isinyathelo esibucayi ekuhloleni nasekuphatheni umuntu one-arrhythmia yenhliziyo ukukhomba, njengoba kungenzeka ngangokunokwenzeka, imbangela eyinhloko yenkinga yenhliziyo yenhliziyo. Ukuqeda noma ukunciphisa leso sizathu ngokuvamile kuyindlela engcono kakhulu yokwelapha i-arrhythmia.
Izimbangela ze-arrhythmias zenhliziyo zingenziwa ngezigaba eziningana. Nansi incazelo emfushane yezigaba eziyinhloko zezinkinga ezivame ukudala ama-arrhythmias, afakwe kuhlu (cishe) ukusuka kokubili kuya kokungavamile.
Ukungalingani kokuzenzekelayo
Isistimu ye- neon autonomic , ngokujwayelekile, ilawula imisebenzi yomzimba esingajwayelekile ngokucabanga ngayo, njengokuphefumula, ukujuluka, nokushaya kwenhliziyo.
I-Bradycardias (izinhliziyo ezincishiswe kancane) kanye ne- tachycardias (imizwa yenhliziyo esheshayo) ivame ukuvela ngenxa yokugqithisa (ngokulandelana) ithoni ye-vagal , noma ithoni yokuzwelana. I-Vagal overstimulation, ne-bradycardia, ingase ibangele (isibonelo), isiqephu sokuhlanza, ukuqothuka okukhulu, noma ukuvimbela umchamo.
Izwi elizwakalayo elizwelayo (kakhulu kakhulu i-adrenaline) kusukela ekucindezelekeni okucindezelayo noma ukwesaba okungazelelwe kungabangela i-tachycardia engathandekayo.
Inkohliso yokwelapha ama-arrhythmias ngenxa yokungalingani kokuzimela ukukhipha imbangela ye-vagal ngokweqile noma ithoni yokuzwelana. Lawa ma-arrhythmias ahamba lapho ukungalingani kokuzimela kuxazululwa.
Isifo senhliziyo
Noma yiluphi uhlobo lwesifo senhliziyo lungathinta uhlelo lwegesi lwenhliziyo futhi lubangele ukuhlelwa kwe-cardiac arrhythmias. Ama-arrhythmias avela esifo senhliziyo angakwazi ukufaka yonke i-arrutthmias ye-cardiac-kusukela ekubunjweni okubulalayo kokuqala kwe-atrial kuya ku -fibrillation eyingozi kakhulu ye-ventricular .
Kodwa-ke, isifo senhliziyo esisodwa yisisusa esivame kakhulu sokuphazamiseka kwesigungu esiyingozi ngempela. Izifo zenhliziyo ezivame ukhiqiza izinkinga zezinhliziyo ezisongela ukuphila ziyisifo se-artery coronary , isifo senhliziyo (isifo senhliziyo), nesifo se-valve senhliziyo .
Eqinisweni, ingozi yokufa okungazelelwe iphakeme kakhulu kubantu abaye bahlaselwa yinhliziyo noma ukuhluleka kwenhliziyo ukuthi enye yemigomo emikhulu kadokotela lapho ukwelapha lezi ziguli kufanele ithathe izinyathelo ezidingekayo ukuze kunciphise kakhulu leyo ngozi .
Izidakamizwa
Ikakhulukazi kubantu abangase babe nesimo esincane sokuthuthukisa ama-arrhythmias enhliziyo (isibonelo, ngenxa yesifo senhliziyo esiyinkimbinkimbi noma udaba lwezakhi zofuzo), izidakamizwa ezihlukahlukene zingaba yisici esibangela ukuba i-arrhythmia ivele ngempela.
Uhlu lwezidakamizwa ezingabangela i-arrhythmias mkhulu kakhulu.
Izinhlobo zezidakamizwa ezivame ukuhlotshaniswa nama-arrhythmiya enhliziyo zihlanganisa:
- Digoxin .
- Izidakamizwa ze-antiarrythmic , ikakhulukazi i-quinidine, i-disopyramide, i-procainamide, i-sotalol, ne-do-e-mail.
- I-Cocaine.
- Utshwala , ikakhulukazi emva kokuphuza ngokweqile.
- Ama-antibiotics , kuhlanganise i-erythromycin, i-azithromycin, i-clarithromycin, ne-ciprofloxacin.
- Ama- antihistamine angenalutho, afana ne-terfenadine ne-astemizole.
- Izidakamizwa ze-Psychotropic, ikakhulukazi i-haloperidol, i-thorazine, ne-methadone.
Izifo Zomzimba
Kusukela ngo-2000, abacwaningi baye baqhamuka ukushintshashintsha kwezakhi zofuzo ezichaza manje ama-arrhythmias amaningi angakaqondakali we-cardiac.
Nasi uhlu lwe-arrhythmias ye-cardiac ejwayelekile manje eyaziwa ukuthi isetshenziselwa izakhi zofuzo.
Njengoba ucwaningo luqhubeka, kuqinisekile ukuthi amanye ama-arrhythmias azofakwa kulolu hlu:
- I-Long QT syndrome .
- I-Brugada syndrome .
- Ezinye izinhlobo ze- block block nesigatshana segatsha .
- Isifo se-sinus esigulayo kubantu abasha.
- Izinhlobo ezithile ze -fibrillation e-atrial .
- Izinhlobo ezithile ze -tachycardia ye- ventricular .
Ukuguga
Ngenxa yezizathu ezingacacile, ukuguga ngokwayo kuhlotshaniswa nesimo se-fibrosis esasakazekayo (ubuchopho) ngaphakathi kwesisu senhliziyo esingase sikholele kwisifo se-sinus syndrome, i-heart block noma i-fibrillation ye-atrial. I-fibrosis ye-cardiac yokuguga iyisizathu esivame kakhulu kubantu asebekhulile ukufuna i- pacemaker .
I-Electrolyte ne-Metabolic Disorders
Ukuphazamiseka okuhlukahlukene kwe-serum electrolytes, kanye ne-acidity yegazi, kungabangela ama-arrhythmias enhliziyo. Lezi ziphazamiso zivame ukubonakala kubantu abanesifo sezinso, isifo sikashukela, bathatha izidakamizwa ezithile (ikakhulukazi izidakamizwa ), ziphelelwa amanzi, noma ziyagula.
I-electrolyte kanye nezinkinga zemetaboli ezivame ukudala izi-arrhythmias kufaka:
- I-Hypokalemia (amazinga aphansi e-potassium).
- I-Hyperkalemia (amazinga aphezulu e-potassium).
- I-Hypomagnesemia (amazinga aphansi we-magnesium).
- I-Hypocalcemia (amazinga aphansi e-calcium).
- I-Acidosis (i-blood too acidic).
- I-alkalosis (i-alkaline negazi).
Anesthesia
I-arrhythmias ye-cardiac isivamile kakhulu kubantu ababhekene ne-anesthesia jikelele. Nakuba iningi lala ma-arrhythmias libheke futhi lilawulwa kalula, amanye angaba yingozi futhi kunzima ukuphatha.
I-anesthesia ihlotshaniswa nama-arrhythmias enhliziyo ngezizathu eziningana, kufaka phakathi:
- Ama-anesthetic agents ngokwabo.
- Ama-electrolyte nezinkinga zemetaboli ezingase zenzeke ngesikhathi se-anesthesia.
- Ukushintshashintsha kwemithwalo yemithwalo yegazi okungenzeka ngesikhathi se-anesthesia.
- Ukungalingani kokuzenzekelayo ngesikhathi se-anesthesia.
- Izinguquko ekucindezelweni kwegazi ngesikhathi se-anesthesia.
- Ukulimala kwenhliziyo ngesikhathi sokuhlinzwa, ikakhulukazi ukuhlinzwa kwenhliziyo.
I-Cardiac Trauma
Ukuhlukunyezwa kwenhliziyo kusuka kunoma yikuphi ukulimala kwesifuba, noma ngenxa yokuhlinzwa kwenhliziyo, kungenza ama-arrhythmias cishe noma yiluphi uhlobo.
Idiopathic
"Idiopathic" yigama lezokwelapha ngoba, "Asazi ukuthi yini eyabangela." I-arrhythmia ye-cardiac ibhekwa njenge-idiopathic uma, ngemuva kokuphenyisisa okukhulu, imbangela eyimbangela ingabe ingaziwa.
Eminyakeni yamuva, ama-arrhythmias amaningi ayejwayele ukuhlukaniswa njenge-idiopathic manje ayaziwa ukuthi abezofuzo ezivela emvelaphi.
Izingozi Zezingozi
Indlela engcono yokunciphisa ingozi yokuthuthukisa ama-arrhythmias enhliziyo ukwenza konke ongakwenza ukuze ugweme isifo senhliziyo. Lokhu kungesizathu esilula: iningi lama-arrhythmias enhliziyo eliyingozi noma eliphazamisayo empilweni yomuntu ngenxa yesifo senhliziyo esingase sikwazi ukuvimbela.
Ukunciphisa ingozi yesifo senhliziyo kungaba yinselele kubantu abaningi, kodwa kuwufanele umzamo-hhayi kuphela ukunciphisa ingozi ye-arrhythmias kodwa (okubaluleke nakakhulu) ukunciphisa ingozi yesifo senhliziyo esibangele ama-arrhythmias ekuqaleni indawo.
Izinto zokuphila eziyinhloko ezinganciphisa ingozi yesifo senhliziyo zihlanganisa:
- Ukungabhemi, noma ukuyeka uma wenza .
- Ukuphatha i- cholesterol ephakeme kanye / noma i-triglycerides .
- Ukuthola okuningi kokuzivocavoca .
- Ukugwema noma ukwelapha umfutho wegazi ophakeme .
- Ukuphatha isifo sikashukela .
- Gwema ukukhuluphala, noma ukulahlekelwa isisindo.
Nakuba izi-arrhythmiya eziningi manje seziyaziwa ngokuthi zakhiwe ngezakhi zofuzo, i-genetics ye-arrhythmias yenhliziyo ivame ukuba yinkimbinkimbi kakhulu. Ukuvivinya ngezifo ze-arrhythmias zenhliziyo akukhuthazwa ngokuvamile ngoba ukuhumusha imiphumela yokuhlola iseluleko esiwusizo ngokuvamile akunakwenzeka.
Kodwa-ke, amalungu omndeni oseduze wabantu abaye bahlala ne-QT syndrome ende, i-Brugada syndrome, noma ama-arrhythmias ahlobene ne- cardiomyopathy ye-hypertrophic , ukuhlolwa kwezakhi zofuzo kungase kube yinzuzo ekunqumeni ukuthi ukwelashwa kwe-prophylactic kufanele kucatshangelwe.
> Imithombo:
> Fogoros RN, Mandrola JM. Ukuhlolwa kwe-Electrophysiologic Ngombono: Ukuhlolwa Nokuphathwa Kwe-Cardiac Arrhythmias. Ku: Ukuhlolwa kwe-Electrophysiolgic kaFogoros. UWiley Blackwell: 2017.
> I-Fu DG, i-Cardiac Arrhythmia: Ukuxilongwa, Izimpawu Nezokwelapha. I-Cell Biochem Biophys. 2015 Nov; 73 (2): 291-296.
> Wilde AAM, Bezzina CR. I-Genetics ye-Cardiac Arrhythmias. Inhliziyo. 2005 Oct; 91 (10): 1352-1358.