Ngokungafani ne-puzzle ye-diagnostic eyenziwa yizimo eziningi zezokwelapha, kukhona imfihlakalo encane yokuthola i-fibrillation ye-atrial. Ukuthola ukuxilongwa ngokuqinile kumane nje kuyindaba yokubona i-arrhythmia kwi- electrocardiogram (ECG) .
Izivivinyo zokuthola i-A-Fib
Uma une-fibrillation ye-atrial uma uqala ukuthola usizo lwezokwelapha, ukuxilongwa kuyobonakala ngokushesha ngokushesha nje uma i-ECG isenziwa.
Ngakolunye uhlangothi, ungase ube ne- paroxysmal (intermittent) fibrillation ye-atrial , enezimpawu eziza futhi zihambe, futhi i-ECG ehhovisi likadokotela ingaba evamile. Lapha, ukuqapha kwe-ambulatory (ukugqoka umculi we-ECG ngezinsuku ezimbalwa noma amasonto ambalwa) kuzogcina ekudaluleni inkinga. Iqhinga lokuqinisekisa ukuthi ukuqapha okuqhubekayo kuyaqhubeka kuze kube yilapho okungenani isiqephu esisodwa sezimpawu sithathwe.
Kungenzeka nokuba ungenayo izimpawu ezingacacile, futhi i-arrhythmia ingase itholakale njengokuthola "okungaqondakali" okungalindelekile, ku-ECG yehhovisi, noma ngesikhathi sokuhlolwa kokucindezeleka noma isifundo sokuqapha sokuqapha esenziwa kwezinye izizathu.
Kodwa ngenye indlela, ukuxilongwa kwe-fibrillation ye-atrial kuyindaba yokuthatha i-arrhythmia ku-ECG.
Ukuhlola I-Fibrillation Yase-Atrial
Uma sekutholakala ukuthi i-fibrillation ye-atrial iyatholakala, umsebenzi wangempela uqala.
Njengesinyathelo esilandelayo, udokotela wakho uzokwenza ukuhlolwa okuphelele kwezokwelapha ukuveza ukuhlelwa kwakho kwe-arrhythmia kanye nezimbangela zayo ezingase zibe khona ngokugcwele ngangokunokwenzeka.
Kuzodingeka uqiniseke ngokutshela udokotela wakho ngomlando wakho wezokwelapha. Qinisekisa ukumtshela nganoma yiziphi izimpawu ozitholile ezingahlotshaniswa ne-frictional -rial-palpitations, ukuphelelwa amandla okulula, ukuphefumula, ukungahambi kahle esifubeni, noma iziqephu zokuphefumula noma ukuphuma.
Zama ukukhumbula noma yiziphi izenzakalo noma izimo ezibonakala ziletha izimpawu zakho-njengokuzivocavoca, ukucasuka ngokomzwelo, ukulala kabi, noma ukuphuza utshwala.
Udokotela wakho uzokubuza nganoma yiziphi izimpawu ezingase ziphakamise izifo zesifo senhliziyo noma isifo samaphaphu, futhi zizohlola ngokucophelela ngokomzimba zifuna noma yiziphi izinkomba ezengeziwe (isibonelo, ukutholakala komfutho wegazi ophezulu). Udokotela wakho kufanele aqaphele ngokucophelela ukuhlola izimbangela eziguquguqukayo ze-fibrillation ye-atrial, ngoba ukuphatha lezi zimo kungase kugcine ukuhleleka kokuphindaphindiwe. Izimbangela ezibuyiselwayo zihlanganisa hyperthyroidism , i-pulmonary embolus, pericarditis , kanye nezinqubo zokuhlinzwa zakamuva.
Futhi ungathukutheli uma udokotela wakho ekubuza okungaphezu kwesisodwa ngotshwala. I-fibrillation ye-atrial ingabangelwa uketshezi utshwala-kwabanye abantu, ngisho nemali encane yotshwala ingayenza. Ngenxa yokuthi utshwala ngenye yezinto ezimbalwa ezibangelwa ukuguqulwa kwe-atrial fibrillation, kubalulekile ukuthi udokotela wakho ahlole ngalokhu umlando wakho ngokucophelela.
Okunye ukuhlolwa
Ukuhlolwa kwegazi: Ngaphezu kokuhlolwa kwegazi okujwayelekile (kufaka phakathi ushukela wegazi lokuzila ukudla ukuze ubheke izibonakaliso zesifo sikashukela), kubalulekile kudokotela wakho ukuthola izivivinyo zomsebenzi wegciwane.
Ikakhulukazi kubantu asebekhulile, izinkinga ze-thyroid zingaba khona ngaphandle kwezimpawu zakudala.
I-ECG: Ngaphandle kokuhlinzekwa ukuxilongwa kwe-fibrillation e-atrial, i-ECG inganikeza izinkomba ezibalulekile mayelana nokuba khona noma ukungabikho kwesifo senhliziyo esingaphansi.
I-Echocardiogram: I- echocardiogram kufanele yenziwe ukuze ihlolwe amagagasi ezinhliziyo namagumbi, iphinda iphinde ibuke izibonakaliso zesifo senhliziyo esingaphansi. Kungadingeka futhi ukuba wenze i- echocardiogram ye-transesophageal (i-TEE), lapho i-transducer ye-echo idluliselwa khona (ukugwinya ithubhu) ngqo ngemuva kwenhliziyo. I-TEE ingaba usizo ekubhekeni ama-clots egazi ku-atrium yangakwesokunxele ngaphambi kokwenza i-cardioversion.
(Sizokhuluma nge-cardioversion kamuva.)
Isivivinyo sokucindezeleka : Isivivinyo sokucindezeleka ngokuvamile asidingekile ekuhlolweni kwe-fibrillation ye-atrial, kodwa kungasiza uma umlando wakho wezokwelapha noma izimpawu zakho kubonisa ukuba khona kwe-coronary artery disease.
Uma konke lokhu kuhlanganisiwe, sekuyisikhathi sokuba wena nodokotela wakho baqale ukuxoxa ngemithi yokwelashwa kwe-atrial fibrillation .
> Imithombo:
> January CT, Wann LS, Alpert JS, et al. Umhlahlandlela we-AHA / ACC / HRS wokuphatha iziguli ezine-fibrillation e-atrial: umbiko we-American College of Cardiology / American Heart Association Task Force emithethweni yokuziphatha kanye ne-Heart Rhythm Society. Ukujikeleza 2014; 130: e199.