I-postural orthostatic tachycardia syndrome (i-POTS) yisimo lapho izinga lentliziyo landa khona ezingeni eliphakeme uma umuntu evuka. Abantu abane-POTS bavame ukuthola izimpawu uma beqondile. Izimpawu ezijwayelekile kunazo zonke ziyizinwele ezincane futhi zinezintambo , ezingahlukahluka ngokweqile kusuka ekunciphiseni ukuze zikhubazeke.
Ngaphandle kwesilinganiso senhliziyo esisheshayo, ngezinye izikhathi bangabuye babe nehlumela ekucindezelweni kwegazi uma bemile. Kuze kube ngu-40% wabantu abathintekayo abane-POTS ekugcineni bayoba okungenani isiqephu esisodwa se- syncope (ukudlula).
I-POTS yinkinga yabantu abasha. Abaningi abanalesi simo baneminyaka ephakathi kuka-14 no-45 ubudala, futhi ngokuvamile banempilo. Abesifazane banamathuba amane kuya kwabahlanu amathuba okuthuthukisa ama-POTS kunamadoda. I-propensity ye-POTS ibonakala ikhona eminye imindeni.
Yini eyenza i-POTS?
Ochwepheshe bayavumelani ngezimbangela ze-POTS. Abanye baye bafakazela ukuthi kuncike ekutheni (njengokungemva kokulala embhedeni) noma ukuphelelwa amandla kwamanzi, kepha lezi zimiso zesikhashana futhi ziyahamba ngokushesha, kanti i-POTS ijwayele ukuqhubeka.
Kungenzeka ukuthi i-POTS ifomu le- dysautonomia , umndeni wezimo ezibangelwa ukungalingani ohlelweni lwezinzwa ezizimele - ingxenye yesimiso sezinzwa esenza imisebenzi "engazi lutho", njengokugaya, ukuphefumula nokushaya kwenhliziyo.
Uma isimiso sezinzwa ezizimele sihlelekile, zonke izimbonakaliso zingabangela, kuhilela uhlelo lwe-cardiovascular, ukuphefumula, uhlelo lokugaya , imisipha nesikhumba.
Kunama-syndromes amaningana acatshangwa ukuthi ngenxa ye-dysautonomia, kufaka phakathi i- fibromyalgia , isifo esingapheliyo sokukhathala , isifo sofuba esisathukuthela kanye nesimo esingalungile se-tachycardia .
Kodwa-ke, abantu abane-dysautonomia bavame ukuzwa izimpawu eziba phakathi kwalezi zinhlobo ezihlukahlukene ze-syndromes.
Okubangela ngempela i-POTS - noma, ngenxa yalolu daba, noma yiyiphi i-dysautonomias - ayiziwa. Kodwa-ke, njengoba kujwayelekile kuma-dysautonomias, ukuqala kwe-POTS kuvele kungazelelwe, futhi kuvame ukulandela isifo esithathelwanayo (njengesifo esibi se-influenza); isiqephu sokuhlukunyezwa (njengokuthi ithambo eliphukile, ukubeletha noma ukuhlinzwa); ukutholakala kwezidakamizwa (njenge-Agent Orange); noma ukucindezeleka kanzima ngokomzwelo (njengokucindezeleka empini noma ukucindezeleka okuthuthumayo).
Izifundo kubantu abane-POTS ziphakamisa ukuthi nazo zingase zishintshe umsebenzi wesistimu wezinzwa ezithinta kakhulu imiphetho engezansi, futhi ingaba nevolumu yegazi engapheli kunokujwayelekile.
Izimpawu nge-POTS
Abantu abane-POTS bangaba nezimpawu eziningi lapho beqondile; izimpawu ziyahlukahluka kanzima kusuka komunye nomuntu. Ezinganeni eziningi ze-POTS, izimpawu zincane. Kwabanye, izimpawu ziyakwazi ukukhubazeka.
Izimpawu ezivame ukwedlula zonke ziyizintambo, ubuhlungu obukhulu, isiyezi, umbono obonakalayo, ubuthakathaka, ukuthuthumela kanye nemizwa yokukhathazeka. Ngaphansi kancane, i-syncope ingenzeka.
I-POTS ngezinye izikhathi igqoke ezinye izidakamizwa ze- dysautonomia , ngakho-ke abantu abane-POTS bangase babone izimpawu ezengeziwe ezifana neziqhwa zesisu, ukubhuka, isifo sohudo, ukuqothulwa, ama-aches nezinhlungu nokukhathala okwedlulele.
Ukwelapha ngokuphumelelayo izinga lokushaya kwenhliziyo elikwenzekayo lapho ukuma akuqinisekisi ukuthi lezi "ezinye" izimpawu (uma zikhona) nazo zizohamba.
I-POTS ihlolwe kanjani?
Odokotela kufanele bakwazi ukuxilonga i-POTS ngokuthatha umlando wezokwelapha ngokucophelela nokwenza ukuhlolwa okuphelele ngokomzimba. Isihluthulelo sokuxilongwa sibonisa ukuthi izinga lenhliziyo landa ngokungavamile ekuhambeni okuqondile. Lokhu kusho ukuthi uma unezimpawu ezibonisa ukuthi i-POTS, udokotela wakho kufanele athathe ingcindezi yakho yegazi okungenani kabili - kanye kanye ngenkathi ulele futhi kanye ngenkathi umile.
Ngokuvamile, lapho umuntu ephakama, izinga lenhliziyo landa ngamabhere angu-10 ngomzuzu noma ngaphansi.
Nge-POTS, ukwanda ngokuvamile kuvame kakhulu - ngokuvamile ukushaya okungu-30 ngomzuzu noma ngaphezulu. Ngezinye izikhathi lokhu kwanda okungavamile kwenani lenhliziyo kwenzeka kuphela ngemva kokuba isiguli simile imizuzu embalwa.
Ngenxa yalesi sizathu, uma ngabe i-POTS icatshangwa ukuthi ukuhlolwa kwetafula e-tilt kungaba usizo ekwenzeni ukuxilongwa.
Uma ukwanda okungavamile kwentengo yenhliziyo ngenkathi kumile, udokotela wakho kufanele abheke ezinye izimbangela ezingase zibe khona, njengokungcoliswa kwemvelo, ukuyeka ukulala embhedeni wesikhathi eside, ukuphelelwa yisifo sikashukela noma izidakamizwa ezihlukahlukene (ikakhulukazi imithi ye- diuretics noma imithi yegazi ). Uma engekho kulezi ezinye izimbangela ezikhona, ukuxilongwa kwe-POTS kungenziwa ngokuqiniseka.
Ukuthi i-POTS ikhiqiza le njongo, ukutholakala ngokuphindaphindiwe (okungukuthi, ukwenyuka kwentengo yenhliziyo uma ikhona), kunika abantu abane-POTS inzuzo enhle phezu kwabantu abanezinhlobo eziningi ze-dysautonomia, lapho isimo sabo ngokuvamile siveza ambalwa (uma noma yikuphi) okutholakele. Abantu abaningi abampofu abane-dysautonomia batjelwa udokotela abangaphezu kweyodwa ukuthi bavele "banenkinga." Ukuze odokotela baphuthelwe ukuxilongwa ngokuphelele kufanele kube okungajwayelekile kubantu abanePOTS.
I-POTS iphatheke kanjani?
Njengawo wonke ama-dysautonomias, ukuphatha i-POTS ngokuvamile kuyinkinga yokulinga-nephutha, ukuzama izinketho ezahlukene zokwelashwa kuze kube yilapho izimpawu zilethwa ngaphansi kokulawula okufanele - ngokuvamile inqubo engathatha amasonto noma izinyanga. Noma kunjalo, uma nje udokotela nesiguli behlala bephikelela, izimpawu zingalawulwa kuningi labantu abanePOTS.
Kunezindlela ezintathu ezijwayelekile zokwelashwa - ukwandisa ivolumu yegazi, ukuvivinya umzimba, kanye nezidakamizwa.
Umthamo wegazi ungakulungiswa ngokugqugquzela ukudla okuneziphuzo, ukondla uketshezi oluningi, kanye / noma ukuthatha i-fludrocortisone, imithi yokwelashwa eyanciphisa ikhono lezinso ukuze lenze i-sodium. Ngenxa yokuthi ukushisa amanzi ngokweqile kujwayelekile, kubaluleke kakhulu ukuthatha uketshezi kokuqala ekuseni - ngaphambi kokuphuma embhedeni, uma kungenzeka.
Ubufakazi bubonisa ukuthi ukuqeqeshwa kokuvivinya umzimba okude isikhathi eside kungathuthukisa kakhulu i-POTS. Ngenxa yokuthi kungaba nzima kakhulu kubantu abane-POTS ukwenza umsebenzi wokuzivocavoca okudinga ukuba baqonde, uhlelo lokuzivocavoca oluhlelekile ngaphansi kokuqondisa lungadingeka. Ngokuvamile, lezi zinhlelo zokuzivocavoca zizoqala ngokubhukuda noma ukusebenzisa imishini yokudonsa, engadingi ukuma okuqondile. Ngokuvamile, ngemva kwenyanga noma amabili, umuntu onama-POTS uyakwazi ukushintsha ukuhamba, ukugijima noma ukuhamba ngebhayisikili. Uma une-POTS, kuzodingeka uqhubeke uhlelo lwakho lokuzivocavoca kuze kube phakade ukuze ugcine izimpawu zakho zingabuyeli.
Izidakamizwa ezisetshenziswe okungenani impumelelo ethile ukuphatha i-POTS zihlanganisa i-midodrine ne- beta blockers . Eminye imibiko isikisela ukuthi i-pyridostigmine (i-Mestinon) ingaba usizo. Ngokungafani nezinye izinhlobo zama-dysautonomia, i-serotonin reuptake inhibitors (SSRIs) ekhethiwe ayibonakali inoma iyiphi inzuzo ku-POTS.
U-Ivabradine (umuthi osetshenziswa kubantu abane-sinus tachycardia engalungile), uye wasebenzisa ngokuphumelelayo kwabanye abantu abane-POTS, kanti izifundo ezisemthethweni ziyaqhubeka zihlola izidakamizwa kule njongo.
Odokotela abaningi abaphatha i-POTS zama zonke izindlela ezintathu ngaphandle kwe-bat. Ukwelashwa sekuqale ukuthuthukisa ivolumu yamanzi, uhlelo lokuzivocavoca lubekiwe, futhi ukwelapha izidakamizwa (ngokuvamile nge-midodrine) sekuqalile. Ikakhulukazi uma uhlelo lokuzivocavoca lwesikhathi eside lungasungulwa, ukwelashwa kwezidakamizwa ngokuvamile kungaqedwa ekugcineni.
Izwi elivela
I-POTS yisimo esingasiphazamisa kakhulu futhi sikhungathekise abantu abancane abancane, abanempilo enhle abahluphekayo. Izindaba ezinhle ukuthi, lapho kutholakala ukuxilongwa, umuntu ophethe i-POTS kufanele alindele ukufeza ukulawula okunethezeka kwezibonakaliso zabo, uma nje yena nodokotela babo bengapheli ekutholeni inhlanganisela efanele yezokwelapha ezizobasebenzela .
> Imithombo:
> Arnold AC, Okamoto LE, Diedrich A, et al. I-Low-Dose Propranolol ne-Exercise Capacity ku-Postural Tachycardia Syndrome: Isifundo Esihleliwe. I-Neurology 2013; 80: 1927.
> Freeman R, Wieling W, Axelrod FB, et al. Isitatimende sokubambisana mayelana nencazelo ye-Orthostatic Hypotension, i-Syncope engokwemvelo ne-Postural Tachycardia Syndrome. I-Auton Neurosci 2011; 161: 46.
> Kimpinski K, Figueroa JJ, Singer W, et al. I-Prospective, 1-year Study-Up of Postural Tachycardia Syndrome. I-Mayo Clin Proc 2012; 87: 746.
> Thieben MJ, uSandroni P, uSletten DM, et al. I-Postural Orthostatic Tachycardia Syndrome: I-Mayo Clinic Experience. I-Mayo Clin Proc 2007; 82: 308.