Funda kabanzi Ngalesi Sibonelo se-ECG esingavamile
Uma utshelwe udokotela ukuthi unesihluthulelo segatsha, kusho ukuthi i- electrocardiogram yakho (ECG) ibonisa iphethini ehlukile, engavamile. Kulesi sihloko sizoxoxa ngalokho okushiwo yi-branch block, futhi yimiphi imibuzo ongase ufune ukuyibuza udokotela wakho.
I-Standard Cardiac Electrical System
Amagatsha amasheya ayiyingxenye ebalulekile yesistimu kagesi yomzimba , uhlelo olulawula isigqi senhliziyo futhi luxhumanisa isenzo senhliziyo.
Inhliziyo iyabulala ngokuphendula isignali kagesi kagesi. Njengoba isignali kagesi isakazwa kuyo yonke inhliziyo, izinkontileka zezinhliziyo zenhliziyo. Ngakho ukusatshalaliswa okuhleliwe, okwesikhathi esifike ngesikhathi somfutho kagesi kubaluleke kakhulu ekusebenzeni kahle kwenhliziyo.
Isignali kagesi yenhliziyo isuka ku- node ye-sinus e-atrium engenhla kwesokudla, isakazeka kuwo wonke ama-atria (okwenza ukuba i-atria ishaye), bese idlula ku- node ye - AV . Ukushiya i-AV node, umfutho wegesi ufinyelela ema-ventricles nge-band of fibers cardiac ebizwa ngokuthi i-Bundle Yakhe. Kusukela esitokisini sakhe, umfutho wegesi ungena emagatsheni amabili enqwaba: igatsha lesigungu lesokudla kanye negatsha lesobunxele. Amagatsha okuhamba kwesokudla nangakwesobunxele asakaza umfutho wegesi kuwo wonke ama-ventricle angakwesokudla nangakwesokunxele, ngokubambisana, okwenza abashaye. Lapho amagatsha asezintweni esebenza ngendlela evamile, i-ventricles engakwesokudla neyesokunxele iyavumelana cishe kanyekanye.
I-ECG iyimifanekiso ebonakalayo yethonya lokugesi njengoba lihamba ngenhliziyo. I-QRS eyinkimbinkimbi yilokho izazi ze-cardiologists zibiza ingxenye ethile ye-ECG, ingxenye ebonisa ukucindezela kagesi njengoba isatshalaliswa yisistimu yegatsha yesikhwama kuwo wonke ama-ventricles.
Kule nhla ngenhla, i-Panel A ibonisa ukuthi inkimbinkimbi evamile ye-QRS ibonakala kanjani ku-ECG evamile.
(Kwalabo abanesithakazelo, lesi sibalo sibonisa ukuhola mina kusuka ku-ECG ehamba phambili engu-12.) Njengoba kokubili ama-ventricles athola amandla okugesi ngesikhathi esisodwa, isakhiwo esijwayelekile se-QRS sincane kakhulu (ngokuvamile singaphansi kwesigamu esingu-0.1 ngesikhathi.) Ukugqugquzela ngesikhathi esisodwa kokubili kwe-ventricles kuncike ekutheni amandla kagesi ahambe phansi kokubili amagatsha angakwesokunxele nesokunxele esivumelwaneni esisheshayo.
Ukuvinjelwa Kwegatsha Legatsha: Incazelo
Umsebenzi wamagatsha ezinqwaba ukusabalalisa ukusabalalisa kwe-cardiac electrical impulse kuwo wonke ama-ventricles ngendlela efanayo, ukuze lapho isivumelwano se- ventricles (ukukhipha igazi enhliziyweni), senza ngendlela ehlelekile futhi ehlelekile. Igatsha lesigungu lesokudla linikeza umfutho kagesi ku-ventricle efanele, futhi igatsha lesobunxele lesokunxele linikeza umfutho ku-ventricle kwesokunxele.
Esigatsheni segatsha lesigatshana, eyodwa noma kokubili amagatsha amabili esitolo ayisayithumeli imiqondo kagesi ngokuvamile. Lokhu kuvame ukuvela ngenxa yesifo noma ukulimala kwelinye lamagatsha ezinqwaba, njengoba kungenzeka nge- infarction ye-myocardial (ukushaya kwenhliziyo) noma ngokushaya inhliziyo .
Kodwa-ke, isikhwama segatsha lesigxobo singase senzeke ngenxa yesizathu esicacile kubantu abanempilo enhle.
Lapho umfutho wegesi uphuze ukufinyeleleka kwe-ventricle yayo, ukulibaziseka kubonakala njengendlela ehlukile e-ECG ebizwa ngokuthi igatsha legatsha. Umthelela omkhulu wesikhwama segatsha lesigxobo yilokhu okuphazamisa ukukhishwa okukodwa kwamagciwane amabili. Ukukhishwa kwe-ventricle eyodwa (leyo enegatsha "elivinjiwe") kwenzeka kancane ngemva kokukhishwa komunye, kunokuba ngesikhathi esifanayo.
Qaphela ukuthi ngenkathi igatsha lesigatshana segama elithi "block" lisetshenzisiwe, igatsha elisithintekayo lingase libe "lingavinjelwe." Ezimweni eziningi, igatsha lesitolo alivinjelwe ngokuphelele, kodwa kunalokho nje kumane uqhube umfutho wegesi kancane kancane igatsha eliphambene nesikhwama.
Yeka ukuthi i-Bundle Block Block ibheka kanjani njenge-ECG
Abantu abanesivinini segatsha ngokuvamile banesibindi segatsha (RBBB) noma i-block bundle branch block (LBBB), kuye ngokuthi yiyiphi yamagatsha amabili esithintekayo. Ama-Panels B no-C kulesi sibalo sibonisa izinguquko zesici ezenzeka ku-QRS complex uma umuntu eshiye noma kwesokudla ibhande legatsha. Kuzo zombili izimo, inkimbinkimbi ye-QRS iba mkhulu kunokujwayelekile, ngoba kuthatha isikhathi eside ukuthi isignali kagesi isakazwe ngokuphelele kuwo wonke ama-ventricles. Ukuma kwenkimbinkimbi ye-QRS kwembula ukuthi yiliphi igatsha lesisindo (ngakwesokudla noma kwesobunxele) eliqhuba ukugcizelela kagesi ngokungavamile.
Ngesinye isikhathi, amagatsha omabili athintekile, kanti iphethini yegatsha legatsha e-ECG ayibonakali ngokucacile njengesikhwama segatsha lesigunxele noma kwesokunxele. Kulesi simo, ibhulogi legatsha libizwa ngokuthi "ukubambezeleka kokuqhutshwa kwezingcingo."
Izimpawu Nezinkinga
Ezimweni eziningi, isikhwama segatsha lesigxobo asiveza izimpawu. Kodwa-ke, esakhiweni esinzima esivinini sikhwameni ikhono lokufakela amandla kagesi ukuze ufinyelele noma yi-ventricle ingase ibe yinto enamandla kakhulu. Kulezi zimo, umfutho ungase uvinjelwe ngokuphelele ekufinyeleleni ama-ventricles, okuholela ekuqedeni i-heart block - engabangela ukuvumelanisa kwe-syncope noma ukufa okungazelelwe komzimba .
Ngezinye izikhathi ukutholakala kwesigatshana segatsha kungabonisa ukuthi kukhona inkinga yenhliziyo engaphansi. Ngakho-ke lapho kutholakala ibhokisi legatsha, abaningi odokotela bayasincoma ukuhlolwa kwenhliziyo okungavumelekile (ngokuvamile, i- echocardiogram ).
Indlela Yegatsha Yegatsha Elibhekwa Ngayo
Esikhathini esiningi, isikhwama segatsha ngokwabo asidingi ukwelashwa. Kodwa-ke, kwezinye izimo abantu abanebhokisi legatsha lesokunxele kufanele bathole i- pacemaker , ikakhulukazi, eliphinde liphinde livuselele ukuhlanganiswa kwama-ventricles abo .
Izwi elivela
Isigatshana segatsha lesigceme ukutholakala okuvamile kwi-ECG. Ngenkathi abantu abanezicabha zamagatsha kumele bazuze ukuhlolwa kwenhliziyo okungabonakali ukuze babheke isifo senhliziyo esisezingeni eliphansi, ezimweni eziningi igatsha lezinhlamvu ngokwayo aliyona inkinga ebalulekile.
> Umthombo:
> Surawicz B, Childers R, Deal BJ, et al. Izincomo ze-AHA / ACCF / HRS ye-Standardization kanye nokuchazwa kwe-Electrocardiogram: Ingxenye III: Ukuphazamiseka Okuqhutshwa Ngokwemvelo: Isitatimende Sosayensi esivela ku-American Heart Association Electrocardiography neKomiti Ye-Arrhythmias, uMkhandlu Wezokwelapha I-Cardiology; i-American College of Cardiology Foundation; kanye ne-Heart Rhythm Society. Kuvunywe yiNhlangano Yomhlaba Wonke Ye-Electrocardiology Ye-Computerized. J Am Coll Cardiol 2009; 53: 976.