Cardiac arrhythmia: Zvinokonzera, Zviratidzo, Treatment

Cardiac arrhythmia (kana kutadza kwemwoyo) chirwere kumwoyo, iyo inozivikanwa nokuva chero cardiac arrhythmias. Fani chokuita nokuchinja nenguva yaakaronga kuti apote, kakawanda uye kutevedzana kwezviitiko kwemwoyo, kwemwoyo ringave kakawanda kana (kukura tachycardia) kana kunonoka (bradycardia). Zvimwe zviitiko arrhythmias kungatungamirira cardiac kusungwa. Arrhythmias kuitika chero zera, mu okumusoro Makamuri mwoyo, atria uye ventricles, ukuwo. Vamwe nemhando zvirwere hadzisi kuoneka, vamwe vari kupfuura kunoshamisa uye zvinouraya. Cardiac arrhythmia ichaongororwa chimwe chezvinhu zvakafanana zvinokonzera rufu.

The mashandiro zviri dzose mwoyo mutinhimira

Kuti tinzwisise zvinodzidziswa arrhythmia, zvikonzero zvayo chitarisiko, zvinokosha kunzwisisa kuti ndiro zvichiitika myocardial contractility. The mashandiro ari kwagara mwoyo mutinhimira cardiac conduction hurongwa inopiwa, inova sesumbu masero zvikuru unyanzvi. Masero aya kusika nemagetsi nomunhu uye nokuatakura chaiyo fibers, zvinoita kuti mwoyo tsandanyama. Pasinei nemano mumwe raiva pedyo nebundu munyika kuti vaunze nomunhu kuti mwoyo tsandanyama, pfungwa huru pano ndiyo sinus raiva pedyo nebundu, rinotaura zvinodiwa mutinhimira. It riri pamusoro rworudyi atrium. Vanowanika nokuda sinus raiva pedyo nebundu nomunhu, kufanana kupenya kwezuva, akatambanudza pairi kwose kwose. Vamwe pulses ndivo "mutoro" nokuti rutapudzo kana excitation pamusoro atria, apo vamwe kubatsira nomumugwagwa kwaitora nguva reductions kusvika atrium nguva kutumira inotevera batch mangé ropa mukati ventricles. Izvi zvinoita kuti chakaipa mutinhimira mumoyo. kutyora Its zvingava zvakafanira matambudziko maviri:

- chainetsa kupomba inotungamirwa kwacho;

- kutyora pulses zvakapararira munyika cardiac ino.

Kana matambudziko akadaro kuti rinotevera raiva pedyo nebundu iri kutenderera achipfeka "mutoro" kuti tichengete nokushanda kwemwoyo, asi zvinoderedza kakawanda kuti sunga. Saka anovandudza ane arrhythmia, zvikonzero zviri kukurukurwa pashure.

arrhythmia mhando

Vanachiremba patsanura arrhythmias, zvichienderana kwete chete nenzvimbo zvaitika (the atria kana ventricles), asi pamusoro kwemwoyo. Fast kwemwoyo nomwoyo kwemwoyo (HR) ndiro anorova kupfuura 100 paminiti inonzi tachycardia uye kunonoka kupomba nemwoyo yevanhu anorova asingasviki 60 paminiti - bradycardia. Zvinokonzera cardiac arrhythmias vari zvakananga novimba Chirwere.

Kwete nguva dzose tachycardia kana bradycardia anoreva mwoyo chirwere. Somuenzaniso, panguva yechiitwa kutsanya kwemwoyo ichaongororwa ndozvakajairwa, sezvo kuwedzera kwemwoyo anobvumira okisijeni muviri munyama. Panguva hope kana kwakadzika kutandara palpitations, muitiro kuva nomumugwagwa kwaitora nguva.

Kana tachycardia kuitika munyika atria, ipapo kutyora iri Classified sezvinotevera:

- Atrial fibrillation - a nokukurumidza kurova kwehana, kunokonzerwa runobva nemagetsi nomunhu ari atria. anonongedzera izvi kutungamirira nokukurumidza, uncoordinated kana zvinoderedza kusimba pomwoyo. Zvinokonzera atrial fibrillation komoyo sezvo convulsive runobva ventricular basa, izvo kazhinji inoitika pakanyorwa nezvimwe zvirwere zvemwoyo. Chiitiko pamusoro atrial fibrillation kunogona kukonzera matambudziko akakura, akadai sitiroko.

- Atrial flutter - akafanana atrial fibrillation, magetsi nomunhu panguva yakawanda vakarongeka uye mutinhimira pane fibrillation. Atrial flutter zvakare kunoita kuti panowanikwa sitiroko.

- Supraventricular tachycardia kana supraventricular tachycardia, rinosanganisira muzvizhinji siyana arrhythmias yomuka pamusoro ventricles.

Tachycardias kunobuda ventricles akakamurwa inotevera subtypes:

- Ventricular Tachycardia - chinomiririra kutsanya dzose heartbeats vane mwero zviratidzo zvemagetsi kuna ventricles. Kanoita zvekupfakira yakazara ventricles uye chinonditadzisa pombi ropa zvakanaka.

- Ventricular fibrillation - arrhythmia ichi, zvinokonzera iyo vanovandira va neudhadha kupomba ropa nemhaka ventricular kuzununguka. Iri dambudziko wakanaka chakakomba kuti kazhinji kunoguma murufu kana mwoyo haakwanisi kudzorera hwandaiva mutinhimira mukati maminitsi mashoma. Vanhu vazhinji vanoona ventricular fibrillation, kana vane zvakakomba mwoyo chirwere kana dzakaona chakakomba kunotevera, zvakadai somunhu semheni ranwa.

Hazvina nguva dzose pasi kwemwoyo zvinoreva kuti munhu ave bradycardia. Kana uri utano chimiro, mwoyo unogona kupomba zvakakwana ropa uye 60 anorova paminiti pa zororo. Anogona kuderedza kwemwoyo uye nemimwe mishonga. Zvisinei, kana une anonoke kwemwoyo, uye mwoyo wako haasi kupomba ropa zvakakwana, unogona kuva mumwe pakubhadhara anoverengeka bradycardia.

- sinus arrhythmia, izvo chinoita utera anokonzerwa sinus raiva pedyo nebundu.

- Blockade excitation pamusoro nemagetsi nomunhu pakati atria uye ventricles. Panyaya iyi, murwere vanganzwa akapembera anorova mwoyo tsandanyama.

- Kukurumidza marwadzo mwoyo - the ventricles kunoitika pakati maviri kwomuzvarirwo anorova.

Zvinokonzera cardiac arrhythmias

Munhu utano anogona kashoma kutambura nezvinetso zvakafanana. Kana cardiac arrhythmia, zvikonzero zvayo chikonzero siyana yaivhuvhuta zvikonzero muviri. Zvingava nokuchinja mwoyo tsandanyama, nechirwere chemwoyo, electrolyte kusaenzana muropa, kukuvara pashure kutambura mwoyo kurwisa, apore pashure Kuvhiya mwoyo uye vamwe. The kupomba zvazvingava kunewo chokuita mwoyo, kurovedza muviri, zvinodhaka kutarisira.

Zvakakosha kunzwisisa kuti kana munhu aine arrhythmia, zvinokonzera uye pakurapa chirwere rimwe zera chikamu wevarwere zvichava zvakasiyana. In vana Somuenzaniso, chirwere kunoitika somugumisiro zvimwe zvinhu nedzevakuru - mamwe. Nokuti chirwere akadai cardiac arrhythmia, mukuru zvinokonzera vangazivikanwa pachikwata:

- kutyorwa kwekodzero dzokuremekedza kuti kukuvara uye mwoyo mavharuvhu (endocarditis, myocarditis, rheumatic fivha).

- Akakomba of thyroid shwanu.

- nhaka zvinhu.

- Kushaya mvura mumuviri uye kushayikwa potassium pamuviri kana zvimwe electrolytes.

- kuvadza mwoyo nokuda chomwoyo.

- The urongwa chokuporesa pashure kuvhiya mwoyo.

Risk zvirwere inowedzera nokusvuta, kushushikana, kunyanya kudyiwa zvine caffeine kana doro, zera, BP, chirwere cheitsvo, uye vamwe.

Cardiac arrhythmia muvana

In vana, maperembudzi Classified maererano zvechivhurumukira hutachiwana zvinetso nzvimbo, kureva ari ventricles kana atria. Kana arrhythmia nevana, anoita izvozvo zvinofanira nyatsotarira chaizvo kuwedzera mwana wacho mikana kupora. Vana atrial arrhythmias zvinosanganisira zvinotevera kutyorwa:

- vakurumidze atrial marwadzo;

- supraventricular tachycardia;

- atrial fibrillation;

- atrial flutter;

- gastric tachycardia;

- Wolff-Parkinson-White (ezvinhu umo yemagetsi kupomba anogona kusvika nokukurumidza kupinda ventricle).

Ventricular kwemwoyo zvirwere muvana dzinosanganisira:

- vakurumidze ventricular sunga (mangwanani kana zvimwe kwemwoyo);

- ventricular tachycardia (chirwere chinouraya umo zviratidzo zvemagetsi tinogamuchirwa ventricles yavo shanduka zvazvingava);

- ventricular fibrillation (kwemashifiti, vasina kurongeka kwemwoyo).

For zvinetso zvevana vanoonekwa ne bradycardia zvinotevera:

- sinus raiva pedyo nebundu dysfunction (cardiac arrhythmias kuvana, nokuda hunokonzera kunonoka mutinhimira kubva cardiac sunga);

- mwoyo nechigumbuso (wakakwana chinogumbura kana kunonotsa magetsi chido kubva sinoatrial raiva pedyo nebundu kusvika ventricles).

Zviratidzo arrhythmias kunoenderana kukura mwana. Vana vakura vanogona kuudza pamusoro pachavo kunzwa nzwa dzungu kana chiedza flutter mwoyo. In vacheche kana nendumure anozivikanwa kushatirwa, ganda rakachenuruka, kushaya kudya. Zvimwe zviratidzo zvinowanzovapo arrhythmias dzinosanganisira:

- muutera, nekuneta;

- mugari kwemwoyo uye kufamba kweropa;

- dzungu, kufenda kana presyncopal mamiriro ;

- hapana ganda;

- kurwadziwa muchipfuva;

- kupfupika mweya, vangadikitira;

- kushaya havi;

- kugumbuka.

Kana yomwana yakatanga cardiac arrhythmia, zvinokonzera chirwere zvinokonzerwa zvinhu zvinotevera :, uchirapwa nemimwe mishonga, kupisa, fivhiri zvirwere. Kuti uwane chakakomba zvinokonzera zvinosanganisira vachiberekwa malformations. Muzviitiko zvizhinji hakukuvadzi arrhythmias vana. Zvisinei, kana paine kuchinja mwoyo mwero nomwana mamiriro rokuzorora, ndiwo mutambo kana kurovedza muviri, vabereki vanofanira kutsvaka nyanzvi dzokurapa mu sangano kuchipatara.

Cardiac arrhythmia mu kuyaruka

Kana arrhythmia pakati kuyaruka, anoita izvozvo dzingasiyana zvichienderana sinus mutinhimira. Munguva yokuyaruka, muviri pachena kuti vakawanda kuchinja, izvo kunowanzokonzera zvakasiyana siyana zvirwere. A yakafanana chinoshamisa kusanganisira zvokurwara, kuchinja zvimwe kuitika panguva vasiri vanochiva uye pakupedzisira kunyangarika. Zvisinei, izvi hazvirevi kuti arrhythmia iri kuyaruka havafaniri kupiwa kukosha. Panguva kutanga pavaipfuura chirwere kuyaruka kunoda nguva rokuongorora chiremba ndiani kuongorora simba pamusoro arrhythmia. Kana zviratidzo regai inonyangarika mukati mumakore 1-2, iyo kuyaruka ndechimwe vanoda kurapwa.

Vakawanda mhando arrhythmia mu kuyaruka bradycardia. The chirwere pamutanhiko kuti uropi wemwana haana kuwana inodiwa okisijeni, chinoguma kudzikira mune zvedzidzo mano, zvedzidzo kuita, anononoka siyana, kutadza kuita zvizere zvemitambo uye nezvimwe zvinetso.

The zvinokonzera arrhythmia muchizvarwa ichi hakusi chokuita zvirwere kumwoyo. Kutsamwisa chirwere zvinogona kwemakemikari anobudiswa zvinetso, kushushikana, huta kushushikana, hormone kuchinja kuyaruka, zvemapapu kana Árbol zvirwere, chikosoro, achiperekedzwa nefivha uye zvichingodaro. Apo vegetative-vascular dystonia, chirwere kazhinji ari phantom hunhu, saka mishonga vana ava zvakakosha kwokubatsira sedatives uye mazano vanachiremba.

Cardiac arrhythmia vakadzi

Women, seboka, zvinomiririra inonakidza seti nematambudziko nokuti cardiologist uyo ane unyanzvi mumwoyo mutinhimira vachivavhiringidza. Pane pamwedzi kuchinja kwemamwe arrhythmias, umo mwoyo itsime kusanzwa uye kufunganya wevarwere munhukadzi, uye pane dzimwe ngozi kana mukadzi ari chirwere cardiac arrhythmia. Zvinokonzera, pakurapa chirwere chacho zviratidzo kuvimba dzakawanda dzakasiyana zvinhu kuti funga.

Vakadzi vane yepamusoro hwakapararira sinus sick urwere, sinus tachycardia, atrioventricular nodal tachycardia nezvimwe siyana zvirwere. Zvinokonzera arrhythmias vakadzi chokuita vasingadzoreki mwoyo rate:

- ventricular tachycardia (kuenda apasi Makamuri mwoyo);

- supraventricular tachycardia (kumbowanikwa makamuri okumusoro mumoyo);

- vakurumidze atrial sunga (kumbowanikwa okumusoro Makamuri mwoyo).

Zvakakosha kuyeuka kuti mwoyo uri chiratidzo, kwete chirwere. Dzimwe nguva, apo pane arrhythmia, mhaka zvinganzi chokuita zvinhu zvakadai kushushikana, huta mafaro, epfungwa. Zvisinei, mune zviitiko izvi, kumbonyatsoongorora chirwere kwechirwere chacho, kubvisa mukana zvikuru zvikonzero.

Arrhythmias panguva pamuviri Kazhinji kunoitika pamusana hormone anochinja mukadzi. Vakawedzera kwevari inonzi estrogen uye hwevanhu chorionic nezvinhu gonadotropin kutaura Ion migero mumwoyo, hemodynamic kuchinjai ichazivikanwa noku kuwedzera ropa vhoriyamu uye cardiac goho Paarismängud. Uyezve, pamuviri inowedzera tsitsi matauriro. kuchinja zvose izvi iri hadzi muviri kungawedzera kukura arrhythmia.

Cardiac arrhythmia nevanhu

Varume, mwoyo chirwere kuitika muna 2 nguva kakawanda kupfuura vakadzi. Vakawanda siyana chirwere vari atrioventricular mufurati, carotid sinus chirwere, atrial fibrillation, supraventricular tachycardia, Wolf-Parkinson-White urwere, idzokororo ventricular tachycardia, ventricular fibrillation pakarepo rufu, uye Brugada syndrome. Zvinokonzera arrhythmias nevanhu runowanzotaurwa nezvarwo kufuta, doro, kusvuta, nokusarovedza muviri, murombo zvokudya, kushushikana, uchirapwa nemimwe mishonga.

Varume vane mwoyo chirwere anonyanya kuita dzichiri arrhythmias, sezvo hadzina kufambiswa zvakanaka mumwoyo tsandanyama unogona kukonzera mwoyo nokukundikana kana kunonoka kuti magetsi chiratidzo kubva sinus raiva pedyo nebundu kusvika ventricles. Kana pane arrhythmia pashure zvokudya, zvinokonzera ichi chokuita aomerwa mudumbu kusvikira diaphragm. Saka pane compression pakati sternum, kwokudzvinyirira pamwoyo. The zvinokonzera arrhythmia nevanhu vari chokuita cheBP, overactive thyroid shwanu, iyo kunowedzera ngozi.

Zviratidzo zviri chirwere nedzevakuru

In chirwere chakadai, zvakadai cardiac arrhythmia, zviratidzo, zvinokonzera chirwere vari titsigire. Somuenzaniso, kana mwoyo kurova dzichimhanya kupfuura dzose, zviratidzo chirwere zvinosanganisira chipfuva kusanzwa, palpitations, dzungu, nomusoro, BP. Kana bradycardia ari kwaikonzera kurukutika, dzungu, kufenda, kana presyncopal mamiriro, richikwidibira pamusoro BP.

Zviratidzo arrhythmias nedzevakuru zvinosanganisira vakawanda simba, wakawedzera kuneta, mugari kurova kwehana uye kwemwoyo. In anononoka heartbeats uropi asingadi kuwana kodzero okisijeni, saka kuti varwere akashuma kakawanda dzungu, kufenda, kana predobmoroki, vane kupfupika mweya uye yakawedzera vangadikitira. Skin rakachenuruka, akafukidza ziya. Kana tachycardia kazhinji marwadzo ari mubhokisi, vakawedzera kugumbuka,

Kana chipfuva flutter vari asingashumbi, hapana ngozi, havaiti kutakura. Asi kana nokurwadziwa mumwoyo make vari kuramba vachiwanda somunhu nguva pane kunzwa simba, kurova kwemwoyo inova kwemashifiti, inguva kuona chiremba.

arrhythmia kurapwa

Most mhando chemwoyo vanoonekwa kuti haukuvadzi uye havafaniri kurapwa. Kana munhu ane cardiac arrhythmia, hunokonzera, kurapwa chirwere kazhinji yakazvimirira mumwe, sezvo vanachiremba vanosarudza kurapa nzira kwakavakirwa avo zvinhu akaparirwa chirwere. Pakurapa chirwere inowanzopiwa kutaurirwa kudzivirira ropa clots iri muropa kudzivirira ngozi sitiroko, kudzorera hwandaiva mwoyo mutinhimira, mwoyo mwero rokudzora kuipa-siyana, kuderedza zvinhu ngozi zvemwoyo.

Kana bradycardia kwamuka haana kutaura zvikonzero, vanachiremba kazhinji kuita kushandisa pacemakers. Chinodzora kurova iri mudziyo duku, inosidzikwa pedyo bondo. Mumwe kana kupfuura electrodes vane mazano, achibva chiridzwa, tumai nemagetsi pulses kuburikidza neropa midziyo mwoyo uye nokudaro kukurudzira mwoyo nguva dzose mwero muvanhu.

Nokuti marudzi mazhinji tachycardia, murwere anogona kuva nemishonga waakaudzwa, izvo anobvumira kudzora kwemwoyo kana kudzorera chakaipa mwoyo mutinhimira. kurapa kwakadaro kunogona kuderedza zvose zvinobvira matambudziko. In atrial fibrillation, chiremba mushonga, ropa thinners kuti kutadzisa paumbwe ropa clots zviri muropa. Kana atrial fibrillation murwere ushandiswe zvinodhaka vachishandisa cardioversion, izvo anobvumira kudzorera chakaipa sinus mutinhimira.

Mune zvimwe zviitiko, murwere anogona varumbidzwa kuvhiya dambudziko arrhythmia. Muzviitiko zvokuva coronary tsinga chirwere murefu ubayire coronary ndavhiyiwa. nzira iyi kunobatsira kuvandudza ropa riyerere pamwoyo. Radiofrequency ablation rinoitwa mu nyaya yakawedzera kwemwoyo pamwe kukwana kufamba kweropa. Munguva oparesheni, chiremba anoita ponji iri vanga rinenge isingagoni kuitisa magetsi nomunhu.

dziviriro

Kuitira kudzivirira mwoyo chirwere, arrhythmias, uye ndivo vanofanira kutungamirira mararamiro utano, tevera kunenge maererano muviri, regedza tsika dzakaipa, kudzivisa zvinokangaidza, kutamba mitambo.