Bated mpweya: zimayambitsa ndi mankhwala

Likumira za mtima - mankhwala a matenda zisakuyenda amanditenga maganizo a madokotala ambiri mtima, ndi ena "mtima" wa akatswiri. Chifukwa, zomwe ndi zizindikiro za matenda oopsa, mmene tiyenera kuchitira izo zimene - amenewa ndi nkhani zina chidwi kwa anthu athu. Si chinsinsi kuti ndithu ambiri anthu ali ndi matenda monga "mtima likumira". Zizindikiro, chithandizo cha mankhwala wowerengeka, thandizo mabungwe apadera, diagnoses - mfundo izi ayenera kufufuza kwa aliyense amene ali ndi zizindikiro za matenda. Zazikulu izi ena nkhani panopa nkhaniyi.

Bated mpweya: zimayambitsa ndi mankhwala

Chifukwa tanthauzo la "kuchepa mphamvu" mu mitima ya ntchito kungakhale zosiyanasiyana mungoli ndi conduction chisokonezo. Ena mwa limati amenewa popanda alowererepo zachipatala, ndi zina akuchedwa kudziwika ndi mankhwala chakupha. Kusiyanitsa supraventricular ndi yamitsempha yamagazi arrhythmias.

arrhythmias supraventricular

Ndi msanga magetsi ntchito za mtima. chifukwa ndi gwero kuti lili atria ndi mitsempha m'mapapo mwanga wa dzenje ndi mu mphambano atrioventricular. Pambuyo ndi kuchepetsa zapadera angathe tsankho kapena wathunthu postextrasystolic mozama. Pafupipafupi kumenyedwa msanga ndi yaitali chete kwa pambuyo kuchepetsa zapadera angapereke kumverera chimazilala, kusokonezeka kwa mtima.

Independent matenda tanthauzo la mitundu imeneyi ndi arrhythmias, kupatula milandu anthu pamene maonekedwe awo ndi kuyamba kuthamanga tachycardias supraventricular, matenda flutter kapena matenda fibrillation.

Popeza vuto kandalama mtima minofu supraventricular extrasystoles chithandizo chapadera si chofunika. Nthawi kumene limodzi ndi chidwi zotengera malingaliridwe kusapeza, beta-blockers, verapamil, mankhwala angagwiritsidwe ntchito.

Nthawi zambiri extrasystoles supraventricular ndi chiwonetsero cha matenda chachikulu (dystonia, aakulu obstructive m'mapapo mwanga matenda, electrolyte matenda), ndiye matenda amafuna kuyengedwa ndi chithandizo cha ndondomeko chimapangitsa.

Yamitsempha yamagazi fibrillation extrasystolic

Yamitsempha yamagazi extrasystoles - anticipatory magetsi ntchito za mtima poyerekezera kayendedwe yaikulu inalimbikitsa zimachitika akuwuka mu miyendo kapena kusiyana mtolo nthambi chipika, Orion kapena Purkinje ntchito myocardium. Pambuyo pasukuluyi kwambiri ndi angayambe zonse compensatory Imani, kumene monga momwe zinachitikira kumenyedwa matenda msanga, anamva mu mawonekedwe a "kuchepa mphamvu". Yamitsempha yamagazi njira popanda panopa mmene anawasiyanitsira uliwonse wa matenda organic mtima si chinthu chiopsezo cha imfa yadzidzidzi Choncho Popanda kuchitapo kanthu. Kuchotserapo ali odwala wathanzi syndromes kumtundu (kobadwa nako elongation kapena kufupikitsa vuto QT, Brugada, etc.).

Likumira mtima, chifukwa ndi zizindikiro zimene amaona kuti zidzachitika chifukwa cha kaimbidwe osowa mtima.
A mlingo yachibadwa mtima anatsimikiza mkati zodabwitsa 60 100 pa mphindi imodzi. Thupi liwiro la mtima kumachitika akagona, pamene kupuma kwambiri, mu othamanga.

Ngati kuphwanya pa siteji iliyonse ndi m'badwo wa zimachitika mtima akufotokozera pathological bradycardia, kumene kungakhale symptomatic, asymptomatic, ndipo akuvutika kwambiri mankhwala.

Zimayambitsa bradycardia

Kusiyanitsa zimayambitsa mkati ndi kunja kwa bradycardia.
The zifukwa mkati monga:

• okalamba;
• inatsekeratu matenda a mtima;
• connective minofu matenda;
• matenda obadwa nawo, kuphatikizapo kufooka kwa mfundo atrioventricular;
• akulu amyloidosis;
• mwakayakaya opaleshoni (orthotics mavavu, mtima kupatsidwa zina) ;
• matenda opatsirana (diphtheria, matenda enaake ophwanya mtima, poizoni magazi, typhoid malungo).

Ndi zinthu zina za bradycardia monga:

• thupi maphunziro;
• elektrotonus wakuthwa vagal (vasovagal mdima; supersensibly carotid nkusani);
• mankhwala (beta-blockers, calcium njira blockers, digoxin, lifiyamu, antiarrhythmic wothandizila);
• bongo;
• hypokalemia;
• hyperkalemia;
• matenda a ubongo (CNS chotupa, kuchuluka intracranial kuthamanga);
• Obstructive matenda obanika kutulo syndrome.

Kwa matenda a ntchito bradycardia kuchititsa Holter polojekiti, chochitika owerengera ndi zojambulira, zipangizo implantable, komanso pogwira kuphunzira electrophysiological.

mankhwalawa bradycardia

Sitepe yoyamba ndi kudziwa zomwe zimayambitsa ndi kuwonongedwa zotheka bradikaridii zochita zawo (discontinuation wa beta-blockers). Ngati palibe m'munsi zochotseka, mungafunike mankhwala mankhwala kapena kwa kanthawi kapena okhazikika AKUYENDA).

mankhwala

Yotithandiza kwambiri kugunda kwa mtima deceleration (masekondi yaitali kuposa 3) ntchito atropine, isoproterenol, aminophylline. Komabe, kudya mankhwala lingachititse arrhythmias, kuphatikizapo chisokonezo yamitsempha yamagazi moyo pachiswe.
Odwala ndi ischemia m'mnyewa wamtima ndi bradycardia chifukwa gwiritsirani mankhwala antiischemic ndipo biding nthawi yawo, pogwiritsa ntchito AKUYENDA ngati n'koyenera.

Odwala ndi maganizo nkusani syndrome khadi ndi chipika atrioventricular ndi ayesedwa kukhazikitsa kwa kanthawi kapena okhazikika pacemaker.
Pali anayamba zikuonetsa European kwa unsembe wa pacemakers okhazikika odwala ndi odwala nkusani syndrome, atrioventricular chipika.

zosiyanasiyana ogalamutsa

Kusiyanitsa stimulators umodzi chipinda, wapawiri-chipinda, atatu chipinda. Ndi maelekitirodi yoyamba ndi yachiwiri 1 ndi 2 (matenda ndi / kapena yamitsempha yamagazi kumanja). zipangizo atatu chipinda ntchito biventrikulyatnoy kutsegula ndi kukhala Chiongoko ndi zina kwa ventricle kumanzere.

Pamene bwino matenda kukondoweza yamitsempha yamagazi synchronism anawawidwa. The ECG pa ndondomeko izi adakhala ndi kudzipatula bwino mtolo nthambi chipika.
Pa kukondoweza kwa ventricles onse anasunga ntchito zawo synchronous, hemodynamics mtima mu nkhani iyi, bwino.

implantation

Woyamba wagawo amenewa unakhazikitsidwa mu 1958. Mu zotsatirazi ndi kusanduka awo. Tsopano ndi amakono, ochepa, mkulu zamakono zipangizo.

Panopa, pali chomera pachaka ku ogalamutsa 400 1,200 pa anthu miliyoni.

Kardiopribor amachititsa magetsi kutsegula kwa myocardium lapansi. Mbendera propagates pamodzi ndi minofu mtima anthu omwe si thupi. yaitali wake kukhudzana angachititse masinthidwe magetsi ndi makina mu myocardium lapansi. unsembe chofunika kupangidwa ndi zizindikiro stimulator kwambiri.

NKHANI kukondoweza modes

Pa yamitsempha yamagazi bwino AKUYENDA magetsi zimachitika umagwiritsidwa lamanzere yamitsempha yamagazi pamwamba ndi depolarizes medlennoprovodyaschy myocardium. The ECG chimaoneka anatseka misewu ya kumanzere mtolo chipika nthambi. odwala oterowo m'munsi ejection kachigawo kuposa odwala popanda anatseka misewu. Komanso, pamene ndondomeko izi zimachitika magetsi mtima kukonzanso. Posachedwapa, pali chizolowezi kuchepetsa zikuonetsa kuti deta unsembe ogalamutsa mogwirizana ndi nambala yaikulu ya kusintha chowawa.

Icho chinakhazikitsidwa kuti otsika ejection kachigawo anapanga pansi zochita za ventricles lapansi. Avereji - kutsegula kwa atria, ndiye ena onse a mtima. Mwapamwamba anasunga ejection kachigawo pa kukondoweza kwa atria ndi ventricles wa njira zachilengedwe.

Anatsimikizira kuti zochepa otukuka matenda fibrillation odwala ndi kutsegula matenda ndi awiri chipinda kuposa odwala ndi yamitsempha yamagazi yekha chikoka chipangizo.

The wapawiri-chipinda chipangizo, kutsimikiziridwa kafukufuku amaona, ndi bwino odwala zolimbitsa thupi.
Pacemakers panopa muyeso wa golide mu chithandizo cha odwala ndi bradycardia symptomatic. Kufunafuna akupitiriza kuti njira zambiri zokhudza thupi la Phindu pa myocardium lapansi.

Pomaliza

Choncho, likumira za mtima (tulo kapena zinthu zina) - matenda oopsa kwambiri. Pamene zizindikiro woyamba wa matenda ayenera yomweyo funsani kuchipatala kuchita mayesero onse ndi mosamala ankachitira. Liwiro chiyambi mankhwala ndi kapewedwe, ndi aluso adzakhala mankhwala.