Zibaluleke kangakanani, futhi yini okufanele uyenze ngazo?
Phakathi kwezinhlobo eziningi ezihlukahlukene ze- arrhythmias zenhliziyo , bambalwa abadale ukudangala nokudideka phakathi kokubili odokotela neziguli njengengxenyana ye-ventricular yangaphambi kwesikhathi (i-PVCs, ebizwa nangokuthi ukuphikisana kwe-ventricular ngaphambi kwesikhathi). Emahhovisi ahlukahlukene odokotela, nasezindaweni ezihlukahlukene emlandweni, ama-PVC aye abhekwa njengama-harbingers okufa okuzayo, noma njengezinto ezibucayi ngokuphelele ezingafuneki lutho.
Impendulo enembile yindawo ethile phakathi kwalezi zinto ezimbili. Ukuze siqonde ngempela ukubaluleka kwama-PVCs, sidinga ukubuyekezwa ukuthi bangubani, ukuthi bathini ngokuchazwa kwezokwelapha, ukuthi kufanele bahlolwe kanjani nokuthi kufanele baphathwe kanjani.
Sibutsetelo
I-PVC iyisimo esiningi somfutho kagesi esivela kwesinye sezakhi ze-cardiac. Ngenxa yokuthi lesi sici esengeziwe sibonakala ngaphambi kokushaya kwenhliziyo evamile kunomathuba okwenzeka, kuthiwa "kungakabi isikhathi."
Ama-PVC atholakala ngokuwagcina e- electocardiogram . Ama-PVC ajwayelekile kakhulu. Kuphakathi kwabantu abangu-20 abajwayelekile bayoba okungenani i-PVC eyodwa emgqeni we-ECG wamaminithi amabili, futhi amaphesenti aphezulu kakhulu azoba nama-PVC ekuqapha kwehora lama-24.
Abanye abantu bazoba neziqephu zePVC eziningana ngokulandelana. Uma kukhona ama-PVC angaphezu kuka-3 olandelanayo, isiqephu sibhekwa ngokuthi i -tricycardia engekho engapheli (NSVT) .
Izimpawu
Iningi labantu abane-PVCs alinayo izimpawu nhlobo. Bamane nje abazizwa. Kodwa-ke, iningi labantu abano-PVCs lizobona amaphupho - ukuqwashisa okungavamile kwentando yenhliziyo. Lezi zindebe zivame ukuchazwa ngokuthi "izintambo ezinqanyuliwe" noma "inhliziyo ephazamisayo." Kwamanye abantu, lezi zimpawu zingaba nzima ukubekezelela.
Kungakhathaliseki ukuthi ubona noma cha yini izimpawu ezivela kuma-PVC wakho kuhlobene nezici eziningi. Abanye abantu basuke bemvelo ngokwemvelo kunoma yiziphi izenzakalo ezingavamile ezenzeka ezingxenyeni zabo zangaphakathi, kufaka phakathi i-PVCs. Abanye bajabule ngokungazi nge-PVCs yabo ngosuku lapho besebenza futhi bephazamiseka, kodwa ngokuzumayo baqala ukuzizwa lapho behlala emini ebusuku kanye nezindlela zangaphandle zisuswe. Kodwa ngenhlanhla, iningi labantu abanePVCs abazizwa nhlobo.
Ukubaluleka
Ama-PVC anesibalo sezokwelapha ngaphandle kokuthi bangakwazi ukuveza izimpawu. Kule minyaka edlule, ukukhathazeka okuyinhloko nge-PVCs umqondo wokuthi bangandisa ingozi yomuntu yokufa okungazelelwe kusuka ekuboshiwe inhliziyo . Kwaphela amashumi eminyaka, kwakukholelwa ukuthi ukutholakala kwama-PVC kwaphakamisa kakhulu leyo ngozi. Ubufakazi obamuva kakhulu buke bakhombise ukuthi ama-PVC ngokwawo angeke akhulise ingozi yokufa ngokuzumayo kakhulu (uma kunjalo), nokuthi inhlangano phakathi kwama-PVC kanye nokufa okungazelelwe kungaba yinto engacacile.
Ngokukodwa, kubonakala ukuthi abantu abanePVC abavame ukuba nabo, noma ukuthuthukisa eminyakeni embalwa, isifo senhliziyo esivelele. Futhi njengoba abantu abanezifo zenhliziyo ezibaluleke ngempela benengozi enkulu yokufa ngokuzumayo, ama-PVCs ahlobene nengozi efanayo (noma ngabe ama-PVC ngokwawo akhiqiza ingozi eyengeziwe).
Ngakho-ke ama-PVC angase ahlotshaniswe nenengozi yenhliziyo ekhulayo, kodwa cishe akuyona imbangela yangempela yengozi ekhulayo.
Ukuxilongwa
Ukuphindaphinda, ukubaluleka kokwelashwa okuyinhloko kwe-PVCs ukuthi kungase kuhlotshwe ingozi yesifo senhliziyo. Ngakho uma unama-PVC, udokotela wakho kufanele enze ukuhlolwa kwenhliziyo, afune isifo senhliziyo engaziwa ngaphambili, futhi ahlole ingozi yokuthuthukisa isifo senhliziyo esikhathini esizayo.
Izinhlungu zezinhliziyo ezivamise ukuhlanganiswa nama-PVC zihlanganisa izifo ze- coronary artery (CAD) nokuhluleka kwenhliziyo ngenxa ye-cardiomyopathy ehlanjululwe . Ama-PVC nawo avame ukubonwa ne- hypertrophic cardiomyopathy , kanye nesifo se-valve senhliziyo .
Ngokuvamile, i- echocardiogram iyindlela enhle yokuhlola izimo eziningi zenhliziyo, nakuba udokotela wakho angase futhi afune ukwenza ukuhlolwa kwe-thallium yokucindezeleka ukuze ahlole kabanzi nge-CAD.
Ngaphezu kwalokho, wena nodokotela wakho kufanele nibheke ukuhlola okusemthethweni kokufaka ingozi kuhlanganise nokuhlola ukudla kwakho, isisindo, umlando wokubhema, imikhuba yokuzivocavoca, ama- cholesterol namazinga e- triglyceride , ukucindezelwa kwegazi nokuhlola kwegazi kwegazi.
Izinga leNengozi
Ulwazi olungcono kakhulu esinalo namhlanje luphakamisa ukuthi ama-PVC ngokwawo akwenzeki neze ayingozi. Eqinisweni, ucwaningo luye lwabonisa ukuthi ukucindezela ama-PVC ngezidakamizwa ezithintekayo akugcini nje ukwehluleka ukunciphisa ingozi yokufa, kodwa eqinisweni (kuye ngokuthi yisiphi isisetshenziswa esisetshenziswayo), kungandisa leyo ngozi.
Lo mbuzo, noma kunjalo, awukaxazululwa. Ucwaningo olwenziwe ngo-2015 lwabonisa ubudlelwane obukhona phakathi kobukhona be-PVC kanye nentuthuko elandelayo yokuhluleka kwenhliziyo ngaphezu kweminyaka engu-10. Ingabe i-PVC ngokwayo yenza okuthile ukukhiqiza ukuhluleka kwenhliziyo, noma ingabe iyisibonakaliso sokuthi inkinga ye-muscle yangaphambili ingaba khona? Ucwaningo olwengeziwe luzodingeka ukuthi luqaphele lokhu.
Kuleli qophelo, kuphela okungajwayelekile ukuthi kunesidingo sempilo, noma ngisho efiselekayo, ukuzama ukuvimbela ama-PVC ngemithi.
Ukwelapha
Njengoba i-PVC ngokwayo ingacabangi ukuthi ingabi yingozi, akufanele kube isimanga ukuthi ukwelapha i-PVC akuyona yonke into eqondile. Eqinisweni, odokotela bavame ukudideka kancane ngokuthi yini okufanele bayenze lapho omunye weziguli zabo enePVC, ikakhulu uma lezo PVC ziveza izimpawu eziningi.
Ngokuvamile, ukwelashwa kwama-PVC kuhlose ukwenza izinto ezimbili. Umgomo wokuqala nokubaluleke kakhulu ukunciphisa ingozi enkulu yokuthuthukisa isifo senhliziyo, mhlawumbe kufaka phakathi ingozi yokufa kungazelelwe. Ngempela, umgomo wesibili ukunciphisa izimpawu (uma zikhona) zibangelwa yi-PVCs. Lezi imigomo emibili ehluke ngokuphelele, futhi njengoba odokotela neziguli benza izinqumo mayelana nokuphatha ama-PVC, ngamunye wale migomo yokwelashwa udinga ukubhekwa ngokuzimela. Ungafunda kabanzi lapha mayelana nokwelashwa kwama-PVC.
Izwi elivela
Ama-PVC ajwayelekile kakhulu, ngisho naphakathi kwabantu abaphilile ngokuphelele. Noma kunjalo, ama-PVC angabangela izimpawu, futhi angase akhombise ukuthi uhlobo oluthile lwezifo zenhliziyo ezingatholakali lukhona. Ngakho-ke, ukuthola ama-PVC kufanele, kungenani, kubangele ukuhlolwa kwenhliziyo.
> Imithombo:
> Ama-Dukes JW, uDewland TA, uVittinghoff E, et al. I-Ectopy ye-Ventricular njenge-Predictor of Heart Failure and Death. J Am Col Cardiol 2015; 66: 101-109.
> Priori SG, Blomström-Lundqvist C, i-Mazzanti A, et al. Imikhombandlela ye-ESC ka-2015 yokuphathwa kweziguli ezine-Arrhythmias ezinamandla kanye Nokuvimbela Ukufa Kwezinhliziyo Zama-Sudden: I-Task Force for the Management of Iziguli ezine-Ventricular Arrhythmias kanye Nokuvimbela Ukufa Kwezinhliziyo Ze-Cardiac Death of the European Society of Cardiology (ESC). Kuvunyelwe yi: Association of European Pediatric and Congenital Cardiology (AEPC). I-Eur Heart J 2015; 36: 2793.
> Lamba J, Redfearn DP, Michael KA, et al. I-Radiofrequency Catheter Ablation ye-Treatment ye-Idiopathic Isandulela se-Ventricular Contractions Isuka ku-Right Ventricular Outflow Tract: Ukubuyekezwa Okuhlelekile nokuhlaziywa kwe-Meta. I-Pacing Clin Electrophysiol 2014; 37:73.