Ngabe i-RBBB Inkinga?
Isigxobo segatsha lesokudla kwesigxobo sephethini engavamile esibonwa ku- electrocardiogram (ECG) , ekhombisa ukuthi impumulo yegesi yegesi ayinasakazwa ngokuvamile kuwo wonke ama -ventricles . Ngokuqondile, isikhwama segatsha esifanele esitokisini sisho ukuthi ukugqugquzela kagesi kwe-ventricle efanele kuyabambezeleka.
Yini Ebangelwa Isibopho Esifanele Segatsha?
Amagatsha amabili enqwaba (ngakwesobunxele nangakwesobunxele) yizindlela zikagesi ezivumela umqondo wokugesi wamandla kagesi ukuba usakaze ngokushesha futhi ngokulinganayo kuzo zombili izakhi, ukuze ukushaya kwenhliziyo kuhleleke kahle.
Ngesikhwama segatsha sokunene, kukhona ukuvinjelwa okuyingxenye noma okuphelele kokucindezela kagesi ku-ventricle efanele. Ukuvimba kwegatsha lesokudla kwesitoreji kuphuza ukusebenziswa kagesi kwe-ventricle efanele. Ngemuva kwalokho, i-ventricle efanele ivuselelwe ngemuva kokuba i-ventricle engakwesokunxele ivuselelwe, futhi ukuphika kwayo kubambezelekile.
Ngokuphambene nesikhwama segatsha lesobunxele esesobunxele (lapho ukugqugquzelwa kwe-ventricle kwesokunxele kubambezeleka), isikhwama segatsha esifanele segatsha asihambisani nomsebenzi jikelele wenhliziyo nganoma iyiphi indlela elinganiselwe. Ngakho-ke ibhande legatsha elungile ngokwalo livame ukubhekwa njengesimo esibuhlungu esingadingi ukwelashwa okuqondile.
Kodwa-ke, isikhwama segatsha esifanele samanje sisesekutholeni okubalulekile. Ukubaluleka kwaso kubangelwa iqiniso ukuthi kuvame ukuhlotshaniswa nesimo esithile senhliziyo noma se-pulmonary. Ngakho-ke lapho kutholakala khona ibhokisi legatsha elifanele, ukuhlolwa kwezokwelapha kuvame ukudingwa.
Ukuhlonza Isibopho Esifanele Igatsha Ukuvimba
Isigxobo segatsha lesokudla kwesokudla senza ushintsho lwesimilo ku-ECG, ngakho-ke odokotela bangasheshe bahlole lesi simo ngokuhlola i-electrocardiogram.
Ku- block block , i-QRS isakhiwo-isabelo se-ECG esimele imfucuza kagesi ehamba phakathi kwezingu-ventricles-ivulekile kunokujwayelekile, ngoba kuthatha isikhathi eside kunokujwayelekile ukuze isisakaze sisakazwe.
Esikhathini segatsha lesigatshana esifanele, kukhona iphethini lobuciko lokhu kukhulisa kuthatha izinkomba ezingu-12 (noma "ukubukwa") okuhlinzekwe yi-ECG ejwayelekile. Ngakho-ke, ngokumane nje uqaphele iphethini lokukhulisa i-QRS complex, ngokuvamile kulula ukucacisa ukuthi kukhona khona isikhwama segatsha esifanele.
Kungani Isibopho Esifanele Igatsha Livimba Okubalulekile?
Isigameko segundane legatsha elifanele likhula ngokukhula. Kubonakala kungavamile kakhulu kubantu abasha, kodwa amaphesenti angaphezu kwangu-11 abantu abaneminyaka engu-80 abanesihluthulelo segatsha esifanele.
Isigxobo segatsha lesokudla kwesokudla sivame kakhulu, futhi imithi ibaluleke kangako, kunomlingani wayo, isikhala segatsha lesishiyagalombili. Uma kutholakala igatsha legatsha elungile, ukukhathazeka okuyinhloko kufanele kube ukuhlola ukuhlola isimo sengqondo senhliziyo noma se-pulmonary.
Uma kungenjalo isimo esitholakalayo, isikhwama segatsha esifanele esivumelwaneni ngokuvamile singabhekwa njengento enobungozi ngokuphelele (engeyona eyingozi).
Igatsha Lokungena Ngesokudla Ukuvimbela Inhliziyo Nengqondo Ephansi
Igatsha lesisindo esilungile, njengoba liyizifundo ngaphakathi kwe-muscle ye-ventricle elungile, lilinganiselwe kakhulu emkhathini we-ventricular cavity. Lokhu kwenza igatsha lesisindo esifanele lithinte umonakalo nokwelula lapho noma yikuphi i-ventricle efanele ifakwe ngaphansi kokucindezeleka kwanoma yiluphi uhlobo.
Ngakho-ke, isikhwama segatsha esifanele esivumelwaneni siyovame ukuvela nanoma yisiphi isimo esithinta i-ventricle efanele. Lezi zimo zingabandakanya isifo se-coronary artery (CAD) , i- myocarditis (ukuvuvukala komzimba we-cardiac), i- atrial septal defect , i-septric defect defect, nesifo senhliziyo se-valvular .
Ngaphezu kwalokho, isikhwama segatsha esifanele singabonakala nanoma yisiphi isimo sephaphu esibangela ukuphakama okungapheli ezinkingeni ngaphakathi kwe-ventricle efanele, ikakhulukazi yomshuwalense we-pulmonary . I-hypertension ye-pulmonary, nayo, ingabangelwa ukuhlukana kwezifo ezihlukahlukene zamaphaphu, kuhlanganise nesifo esingenasifo se-pulmonary chronic obstructive (COPD) nokuphefumula okuphazamisayo kokulala .
Ukuze uqaphele, isikhwama segatsha esifanele esivumelwaneni sivame nanoma yisiphi isimo esivusa kakhulu izingcindezi ku-ventricle efanele. Isimo esivame kakhulu esenza lokhu kuhlanganiswa kwe- pulmonary .
Ngenxa yalokho, noma ngubani otholakala ukuthi unesihluthulelo segatsha esifanele esifundeni udinga ukuhlolwa kwezokwelapha okugxila ezimpawu zesifo senhliziyo noma sephaphu. I-x-ray yesifuba kanye ne- echocardiogram amathuluzi okuhlola ajwayelekile-asetshenziswa ngale njongo.
Ngenxa yokuthi igatsha lesisindo esifanele lithinteka kunoma yini engayikhiqiza ngisho nokuhlukunyezwa okuncane ku-ventricle efanele, igatsha lesigatshana lesiguquko sokuhamba kwesigamu lwenzeka cishe cishe ngamaphesenti angu-5 weziguli ezithinta ukuphazamiseka kwenhliziyo . Lesi sikhwama segatsha lesokunene lesigxobo sokunene senzeke lapho umcengezi uphazamisa igatsha lesisindo esifanele. Lesi sikhwama segatsha esithatha isikhathi eside sixazulula masinyane (kungakapheli amaminithi) uma isithwathwa sisuswa.
Kodwa-ke, kubantu abaye bashiya isikhwama segatsha esisele, kubangele ngisho nalesi sikhwama segatsha lesiguquko sangakwesokudla singase sibe nesibindi senhliziyo esiphelele , futhi inhliziyo ingayeka ukushaya. Ngakho-ke, kubantu abanesihluthulelo segatsha lesokunxele abanesisindo sokungena komzimba, ngezinye izikhathi i- pacemaker yesikhashana ifakwe phakathi nenqubo, ukuqinisekisa ukuthi isigqi senhliziyo sizoqhubeka singaphazanyiswa ngesikhathi sesifundo.
Igatsha Lokunene Elivinjiwe Nokuvimbela I-Heartbeat
With block block kwesokudla noma kwesokunxele igatsha, izinhliziyo ezimbili ventricle ziyakhuthazwa ngokulandelana (eyodwa emva komunye) esikhundleni esisodwa. Lokhu kulahlekelwa kokusebenzisana okuvamile phakathi kwama-ventricles amabili kunganciphisa ukusebenza kahle kwenhliziyo.
Kodwa-ke, ukunciphisa ukusebenza kahle kwenhliziyo kuyinto encane futhi akukho mphumela esigodini segatsha elifanele. Ngakho-ke, isibonelo, ukusetshenziswa kokwelashwa kabusha kwe-cardiac (CRT) akunconywa kubantu abanesikhwama segatsha esifanele, ngisho noma benesifo senhliziyo .
Ingabe Isivuno Sesegatsha Esifanele Sifuna I-Pacemaker?
Isivimbe segatsha lesokudla kwesokudla, ngokwalo, asidingi ukwelashwa nge-pacemaker engunaphakade. Kodwa-ke, kwabanye abantu abakhiphe isitifiketi segatsha esifanele asikwenzeki ngokwayo, kepha kunalokho kubonisa ukubonakaliswa okukodwa kwenkinga ejwayelekile ngenqubo yokucubungula kagesi. Ezimweni ezinjalo i-pacemaker ingagcina isadingeka uma isifo se-sinus syndrome noma i-heart block kufanele ikhule.
Izwi elivela
Isigatshana segatsha sokunene ngokwalo isimo esibucayi esingadingi ukwelashwa. Noma kunjalo, noma ubani otholakala ukuthi unayo kufanele abe nokuhlolwa kokuhlola ukulawula ngaphandle kwesifo senhliziyo noma sephaphu. Uma kungatholakali nhlobo, khona-ke isikhwama segatsha esifanele esivumelwaneni ngokuvamile singabhalwa njengento yokuthola engafanele, ngaphandle kokubaluleka kwezokwelapha okubalulekile.
> Imithombo:
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> Barsheshet A, Goldenberg I, Garty M, et al. Ukuxhunyaniswa Kwegatsha Legatsha Ukuvimbela Ukufa Kwesikhathi Eside (iminyaka Emine) Ezilwaneni Ezibelethwe Izibhedlela Ezihlulekayo Nge-Systolic Feart. Am J Cardiol 2011; 107: 540.
> Bussink BE, Holst AG, uJespersen L, et al. Isibopho sokungena kwesigatshana segatsha: Ukuvama, izici ze-Fisk, nomphumela ku-General Population: Imiphumela Kusuka eSifundweni Senhliziyo YaseCopenhagen City. I-Eur Heart J 2013; 34: 138.
> Zhang ZM, Rautaharju PM, Soliman EZ, et al. Ingozi Yokufa Ehlanganiswe Nesibopho Segatsha Amagatsha kanye Nokubuyiselwa Okuhlobene Okungafani (Kusukela ku-Women's Health Initiative WHI). Am J Cardiol 2012; 110: 1489.