Nini i-Slow Heart Rate kwiNgxaki, kwaye nini ifuna ukuba yenziwe nini?
I-Bradycardia yimizuzu yonyango ngenqanaba lentliziyo elincinci kuneliqhelekileyo. Kwiincwadi zonyango, i-bradycardia idla ngokuchazwa njengezinga lokuphumla kwentliziyo elingaphantsi kwama-60 beats ngomzuzu. Nangona kunjalo, abaninzi (mhlawumbi ininzi) yabantu abanempilo banokuphumla kweengqondo ezingaphantsi kwama-60. Ngoko ukuba i-bradycardia ayikho into embi, okanye into engafanelekanga.
Ngokuqhelekileyo ngumqondiso wempilo enhle.
Ngakolunye uhlangothi, i-bradycardia ingaba yingxaki ebalulekileyo ukuba isantya senhliziyo siphuthuma kangangokuba intliziyo ayikwazi ukupompa igazi elaneleyo ukubonelela iimfuno zomzimba. Yilolu hlobo lwe-bradycardia engavamile eyenziwa yinkxalabo yezokwelapha, kwaye oku kufuna ukuvavanya nokunyamekela unyango.
Iimpawu zeBradycardia engavumelekanga
Ukuba isantya senhliziyo sihamba ngokukhawuleza, iinxalenye ezininzi zomzimba zingasebenzi ngokuqhelekileyo, kwaye iimpawu ezahlukahlukeneyo zingabangela. Ngokuqhelekileyo, iimpawu zebradycardia ezingavamile ziba zimbi nakwiimzamo zokuzikhandla (ngenxa yokuba iimfuno zomzimba ziba zikhulu xa uzizibhokoxa), kodwa iimpawu zingaphinda zikhona ngexesha lokuphumla xa i-bradycardia ilukhuni.
Iimpawu ezinokubangelwa kwibradycardia ziquka:
- Ukugqithisa okanye utywala (ngokukodwa ngokuzama)
- Kulula ukunyaniseka
- I -syncope (ukuphelelwa amandla) okanye kufuphi-syncope
- Dyspnea (ukuphefumula okufutshane)
- Intlungu yesifuba okanye ukungahambi kakuhle
- Ukudideka
Ukuba i-bradycardia inxulumene naliphi na le mpawu, imbangela ye-bradycardia kufuneka imiswe, kwaye unyango kufuneka lunikezwe ukubuyisela izinga lentliziyo ngokuqhelekileyo.
Iintlobo zeBradycardia: iSinus Bradycardia
Kwizinto ezimbini eziqhelekileyo ze-bradycardia, i-sinus bradycardia yinto eqhelekileyo kakhulu.
Ngoko yintoni i-sinus bradycardia?
Ukubetha kwentliziyo kuveliswa kwaye kulungelelaniswa yintliziyo yomtsalane, kwaye umtsalane wombane uveliswa kwi-node yesusus, isidleke esincinane seeseli eziphezulu kwi-atrium efanelekileyo. Xa i-node ye-sinus ivelisa iziphumo zombane ngezinga elincinciweyo, izinga lentliziyo linciphisa, kwaye kuthiwa i-sinus bradycardia ikhona.
Funda kabanzi malunga nenkqubo yombane wenhliziyo .
Ngokuqhelekileyo ngokubhekiselele kwi-Sinus Bradycardia engavumelekanga. Ekuphumleni, i-node ye-sinus ivelisa iimpembelelo zombane kwisantya esiphakathi kwama-50-60 kunye nama-100 ngamaxesha ngomzuzu. Ngoko intlawulo yenhliziyo yokuphumla ngaphakathi kwesi sibizo kuthiwa " isigqithiso sesimo esivamile ." Xa izinga le sinus likhawuleza ngaphezu kwama-100 ngamazuzu ngomzuzu, libizwa ngokuba yi- sinus tachycardia . Kwaye inqanaba lesinono liye lincinci ngaphezu kwamaxesha angama-60 ngomzuzu kuthiwa yi-sinus bradycardia.
I-Sinus bradycardia idla ngokuqhelekileyo. Umzimba ophilileyo ulungile kakhulu ekulawuleni izinga lentliziyo ukuba nayiphi na into efunekayo ukuxhasa imisebenzi yomzimba. Kwaye, ngokuqhelekileyo, eli liqhelekileyo lemilinganiselo yenhliziyo lingaphakathi kwoluhlu lwabagqirha "ngokusemthethweni" luchaza njenge-sinus bradycardia.
Ngoko abantu abatsha abasempilweni, kunye nabantu abadala xa besesimweni esifanelekileyo, baya kuhlala behlaziya ixabiso lentliziyo kwi-40s okanye kwi-50s.
Kuqhelekile (kunye nokuqhelekileyo) kubantu abaninzi ukuba babe nemilinganiselo yeenhliziyo kule ndlela xa belele. Nangona le nto ibandakanya i-sinus bradycardia, yindlela ye-physiologic ye-sinus bradycardia-oko kuthetha ukuba izinga lentliziyo lifanelekileyo kwiimfuno zomzimba, kwaye ngoko ke, i-sinus bradycardia iyinto eqhelekileyo.
I-Sinus bradycardia ithathwa njengengxaki ukuba izinga lentliziyo lincinci ukuhlangabezana neemfuno zomzimba. Ukuba isantya senhliziyo siphuthuma kangangokuthi ingekho igazi elaneleyo eliqhutyelwa yintliziyo, iimpawu ziyakhula. Ukuba i-sinus bradycardia iveza iimpawu, ayiqhelekanga kwaye kufuneka iphathwe.
Yintoni Edala Ubunzima beSinus Bradycardia? Xa i-sinus bradycardia ivelisa iimpawu, ihlala icingwa njengeyinto engavamile.
Sinus bradycardia engavumelekanga ingaba yintsuku, okanye iyaqhubeka.
I- sinus bradycardia emfutshane idla ngokubakho ngenxa yethoni eyongeziweyo kwi- vagus nererve . Ukukhuthazwa kwe-vagus nererve kuya kunciphisa i-node ye-sinus, kubangela ukuphuculwa kwenani lentliziyo. I-Vagal ye-stimulation ye-nerve ivame ukuveliswa ngeengxaki ezahlukeneyo zesisu (ikakhulukazi isicupunu okanye ukuhlanza), okanye ukuphendula intlungu ebuhlungu okanye ukuxinezeleka kwengcinezelo.
I-Sinus bradycardia ebangelwa yi-vagus nerve stimulation ibhekwa ngokuthi "umzimba" (ngokuchasene ne-pathological), kuba iyimpendulo evamile, kwaye iyanyamalala ngokukhawuleza nje ukuba ithoni ephakamileyo ye-vagal iyancipha.
I-sinus bradycardia engavumelekanga ihlala ibangelwa yi-sinus node disease - isifo ngaphakathi kwe-node node ngokwayo. Ngokuqhelekileyo, isifo se-sinus se-intrinsic sisifo ngenxa yoluhlobo lwe-fibrosis (ulwaphulo) ngaphakathi kwinqanaba le-sinus, olubonakaliso oluqhelekileyo lokuguga. Ngoko isifo se-sinus se-intrinsic sibonakala kubantu abaneminyaka engama-70 ubudala okanye ngaphezulu.
Kubantu abanesifo se-sinus se-intrinsic, isantya senhliziyo sisoloko singasetyenziswanga phantsi kokubili, kwaye ngexesha lokuqhuba. Abantu abanesifo se-sinus se-symptomatic often "bathi sinesifo se-sinus syndrome ".
Ukongeza kwi-sinus disease node disease, ezinye iimeko zonyango zingabangela isono sinus bradycardia. (Ezi ziza kubalwa ngokukhawuleza.) Kodwa kungakhathaliseki ukuba yiyiphi imbangela, ngelixa i-sinus bradycardia inokuvelisa iimpawu ezibalulekileyo, umngcipheko wokufa kwayo uncinci.
Iintlobo zeBradycardia: I-Heart Block
Uhlobo lwesibini oluqhelekileyo lwe-bradycardia lukhuseleko lwenhliziyo. Ngokuchasene ne-sinus bradycardia, ebantwini abaninzi ngokwenene, isithintelo senhliziyo sihlala sisimo esingavamile.
Ibloko yenhliziyo ivela xa iinjongo zombane zentliziyo zincinci okanye zivaliwe ngokupheleleyo njengoko zihamba ukusuka kwi-atria yentliziyo ukuya kuma-ventricles. Ngenxa yokuba kungekhona zonke iimpembelelo zombane ezifikelela kwii-ventricles, izinga lentliziyo liba ludlulileyo kunokuba limele libe lide. Funda kabanzi malunga nebhokisi leentliziyo .
Njengoko kunjalo nge-sinus bradycardias engavumelekanga, ibhloko yenhliziyo ingaba yintsuku okanye iqhubeka.
Isibilini senhliziyo esilulayo sinokuvela (njengokuba sinus bradycardia yangasemva) kunye neepisodes zokunyuka kwetalal tone. Olu hlobo lwesithintelo senhliziyo esilawuleza lubonakala lubonakala kubantu abancinci, abantu abanempiliso abanesithongweni se-vagal ephakanyisiwe ngenxa yeentlanzi, intlungu, okanye ukuxinezeleka ngokukhawuleza. Le bhloko yeentliziyo ibonwa njengobunono, kwaye phantse akufuneki unyango olungaphaya (okanye ukuphepha) iziganeko ezibangele ithoni ephakamileyo ye-vagal.
Ubomi bentliziyo engapheliyo yinto ebaluleke kakhulu kuba ithambekele ekugqithiseni (kwaye ingasongela ubomi) njengoko ixesha lihamba. Nangona iibhloko zentliziyo, nangona kunjalo, nangona imeko eqhubekayo, i-bradycardia ngokwayo ingaba phakathi. Oku kuthetha ukuba ngamanye amaxesha, unokuba luninzi lwangexesha, inqanaba lentliziyo ephumayo ngokwenene kuluhlu oluqhelekileyo; kodwa isantya senhliziyo sinokungqubuzana ngokukhawuleza kumanqanaba okuvelisa izibonakaliso ngaphandle kwesizathu esicacileyo okanye esichukumisayo (kuba imeko ephantsi iqhubekayo). Eli qiniso lisoloko lenza intliziyo ibambe ingxaki kunzima ukuxilonga kune-sinus bradycardia. Ingaba i bradycardia ikhona kuyo yonke ixesha okanye iphakathi, nangona kunjalo, ukuqhubeka kwintliziyo yebhokisi ngokukhawuleza idinga unyango rhoqo.
Izizathu zeBradycardia
Njengoko sibonile, i-sinus bradycardia yangasemva kunye ne-heart heart block ibangelwa kukunyuka ngokukhawuleza kwithethini ye-vagal. Xa ithoni ye-vagal ibuyiselwe kwinto eqhelekileyo, intlawulo yenhliziyo iphinda ibuyele kwizinto eziqhelekileyo - ngoko akukho unyango olungapheliyo lwe-bradycardia ngokwayo.
Ngakolunye uhlangothi, i-bradycardia engapheliyo ingabangela izifo ezahlukeneyo zonyango. Ezi ziquka:
- Izifo ze-coronary
- Pericarditis
- Myocarditis
- Ukuxhatshazwa kwenhliziyo ngenxa yokulimala okanye ukuhlinzwa komzimba
- Amyloidosis
- Hypothyroidism
- IDysautonomia
- Zininzi iintlobo zezifo, eziquka isifo seLyme, isifo seCasgas kunye ne- Rocky Mountain
- Iintlungu zesibindi, ngakumbi ezo zihambelana nokunyuka kwengcinezelo okanye ukushaywa kwesifo
- I-Hypoxia (amanqanaba e-oxygen ephantsi), ngokuqhelekileyo kwenzeka nge- obnea obstructive sleep apnea
- Iziyobisi ezahlukeneyo, kubandakanywa ne- beta blockers , i- calcium channel blockers , i- antiarrhymic drugs , i- opioids , i-lithium, kunye neyeza ezahlukeneyo zamachiza
I-Bradycardia Kufanele Ihlolwe Njani?
Ukuvavanywa kwe-bradycardia kudla ngokuthe ngqo. Okokuqala, ugqirha kufuneka ahlolisise i- electrocardiogram (ECG) ngelixa i-bradycardia ikhoyo, ukuchonga ukuba ngaba ngenxa ye-sinus bradycardia okanye i-heart block.
Emva koko, ugqirha kufuneka amisele ukuba ngaba i-bradycardia iyakwazi ukuqhubeka, okanye nokuba kunokuba ingaba sisiganeko esiphucukileyo ngenxa yokwanda kwetayalini. Oku kuphantse kufezekiswe ngokuthatha nje imbali yonyango.
Uvavanyo loxinzelelo lunokuba luncedo ekukhutsheni isifo sesifo se-sinus okanye ibhloko yenhliziyo ebonakalayo kuphela ngexesha lokuzikhandla. Ukubekwa kweliso kwe-ECG olude ixesha elide lingaba luncedo ekufumaneni i-bradycardias eyenzeka kuphela ngokukhawuleza. Ucwaningo lwe- electrophysiology lunokuba luchanekileyo ekufumaneni izifo zesifo se-sinus kunye ne-heart block, kodwa akusoloko kuyimfuneko ukwenza njalo.
I-Bradycardia Kufanele Yenziwe Njani?
Ukunyangwa kwe-bradycardia kuxhomekeke ekubeni ingaba sinus bradycardia okanye ibhloko yenhliziyo, kwaye ingaba iyayibuyiswa okanye ayikho.
I-bradycardias ebuyiswayo ingakho ngenxa yokuphakama kwexesha lesantya kwisitimu se-vagal esiye sithethe ngaso. Kwiimeko ezinjalo, unyango lubandakanya ukuphepha iintlobo zeemeko ezibangela ukuba i-vagal tone ithwale.
I-bradycardia eqhubekayo inokuphinda iguquke xa ibangelwa unyango lweziyobisi, isifo esithathelwanayo, i-pericarditis, i-myocarditis okanye i-hypothyroidism. Kule meko, ukunyanga ngokugqithiseleyo ingxaki engundoqo isoloko ijongana nenqanaba lentliziyo elincinci.
Ukuba i-sinus bradycardia iguqulwa, okanye ayivelanga impawu, iyakwazi ukulawulwa kuphela ngokuvavanya ngokulandelelana. Nangona kunjalo, ngamanye amaxesha abantu asebekhulile isifo se-node sinode kuphela evelisa iimpawu ngexesha lokuzikhandla, xa isantya senhliziyo esiphumeli njengokuba kufanelekile. Ngoko uvavanyo loxinzelelo luya kuba luncedo kakhulu ekunqumeni ukuba isifo se-node sisifo siphuhlisa impawu okanye cha.
I-Sinus bradycardia engaphendulwanga kwaye ivelisa iimpawu kufuneka iphathwe nge- pacemaker esigxina .
I-block block yeyona nto ibaluleke kakhulu, kuba ibhloko yenhliziyo ihamba phambili, kwaye inokubangela ukufa. Ngoko, ngaphandle kokuba ibhloko yenhliziyo ibangelwa imeko eguquguqukayo, unyango nge-pacemaker esisigxina luhlala lufunekayo.
ILizwi
I-Bradycardia ivame ukuba yinto eqhelekileyo engafuneki uvavanyo olunzulu lwezokwelapha, okanye unyango oluthile.
Kodwa ukuba unayo i-sinus bradycardia eveza iimpawu, okanye i-heart block block ingaba kukho impawu okanye ayikho, kuya kufuneka usebenze nodokotela wakho ukucacisa ukuba kutheni unayo, kwaye unqume ukuba ngaba i-pacemaker ingafuneka.
> Imithombo:
> Epstein AE, DiMarco JP, Ellenbogen KA, et al. Ukuhlaziywa kwe-ACCF / i-AHA / HRS ka-2012 ihlanganiswe kwi-ACCF / AHA / HRS 2008 Izikhokelo zonyango oluxhomekeke kwiNkcukacha yeRhythm yePardium Okungaqhelekanga: Ingxelo ye-American College of Cardiology Foundation / i-American Heart Association Umsebenzi wamaKhokelo kwiZiCwangciso zeNkqubo kunye neNtliziyo yeRhythm UMbutho. J Am Coll Cardiol 2013; 61: e6.
> Fogoros RN, Mandrola JM. Ucwaningo lwe-Electrophysiology kuVavanyo lweBradycardia: I-Node yase-SA, i-AV Node kunye ne-His-Purkinje System. Ku: Uvavanyo lwe-Fogoros 'Electrophysiologic Testing, I-Sixth Edition. Wiley Blackwell, ngo-2017.