Isifo se-sinus syndrome

Imvamisa, ukushaya kwenhliziyo kuqala endaweni esemagumbini aphezulu enhliziyo (atria). Le ndawo i-pacemaker yenhliziyo. Ibizwa ngokuthi i-sinoatrial node, i-sinus node noma i-SA node. Indima yalo ukugcina ukushaya kwenhliziyo kuqinile futhi kujwayelekile.

I-Sick sinus syndrome iyiqembu lezinkinga zesigqi senhliziyo ngenxa yezinkinga zenodi yesono, efana nale:

• Izinga lokushaya kwenhliziyo lihamba kancane, elibizwa nge-sinus bradycardia
• Ukushaya kwenhliziyo kuyama noma kuyeke, okubizwa ngokuthi ama-sinus ikhefu noma ukuboshwa kwesinus
• Iziqephu zokushaya kwenhliziyo okusheshayo
• Isigqi senhliziyo esihamba kancane esishintshana nesigqi senhliziyo esisheshayo, esibizwa nge-bradycardia-tachycardia noma i- "tachy-brady syndrome"

I-Sick sinus syndrome ivame ukwenzeka kubantu abadala kuneminyaka yobudala engama-50. Imvamisa kungenxa yokulimala okunjengokubanda ezindleleni zikagesi ezicutshini zomzimba zenhliziyo.

Ezinganeni, ukuhlinzwa kwenhliziyo emakamelweni aphezulu kuyimbangela ejwayelekile yesifo se-sinus syndrome.

Isifo senhliziyo, umfutho wegazi ophakeme, kanye nezifo ze-aortic kanye ne-mitral valve kungenzeka nge-sick sinus syndrome. Kodwa-ke, lezi zifo kungenzeka ukuthi azihlangene nesifo.

Ukugula kwesinus syndrome akuvamile, kodwa akuvamile. Yisona sizathu esivame kakhulu ukuthi abantu badinge ukufakelwa isibophezelo sokwakha pacemaker. I-Sinus bradycardia yenzeka kaningi kunezinye izinhlobo zesimo.

Ama-tachycardias (isigqi senhliziyo esisheshayo) aqala emakamelweni aphezulu enhliziyo angaba yingxenye yesifo. Lokhu kufaka phakathi i-atrial fibrillation, i-atrial flutter, i-atrial tachycardia. Isikhathi samanani asheshayo enhliziyo kuvame ukulandelwa ngamanani wenhliziyo ahamba kancane kakhulu. Lapho kunezikhathi zokushaya kwenhliziyo okuhamba kancane nokusheshayo (isigqi) isimo ngokuvamile sizobizwa nge-tachy-brady syndrome.

Eminye imithi ingenza isigqi senhliziyo esingajwayelekile sibe sibi kakhulu, ikakhulukazi uma imithamo iphakeme. Lokhu kufaka phakathi i-digitalis, i-calcium block blockers, i-beta-blockers, ne-antiarrhythmics.

Isikhathi esiningi, azikho izimpawu.

Izimpawu ezenzekayo zingalingisa ezinye izifo.

Izimpawu zingafaka:

• Ubuhlungu besifuba noma i-angina
• Ukudideka noma ezinye izinguquko esimweni sengqondo
• Ukuquleka noma ukusondela kokuquleka
• Ukukhathala
• Isiyezi noma ikhanda elikhanyayo
• Ukuzwa kokuzwa ukushaya kwenhliziyo (ukushaya kwenhliziyo)
• Ukuphefumula okuncane, mhlawumbe kuphela ngomsebenzi womzimba njengokuhamba

Ukushaya kwenhliziyo kungahle kuhamba kancane nganoma yisiphi isikhathi. Umfutho wegazi ungajwayelekile noma uphansi.

Ukugula kwesinus syndrome kungadala ukuthi izimpawu zokuhluleka kwenhliziyo ziqale noma zibe zimbi kakhulu. Ukugula kwesinus syndrome kutholakala lapho izimpawu zenzeka kuphela phakathi kweziqephu ze-arrhythmia. Noma kunjalo, isixhumanisi kaningi kunzima ukufakazela.

I-ECG ingakhombisa isigqi senhliziyo esingajwayelekile esihlobene nalesi sifo.

Abaqaphi beHolter noma besikhathi eside besikhathi eside bangamathuluzi asebenzayo wokuthola isifo se-sinus syndrome. Bangase bathathe amanani enhliziyo ahamba kancane kakhulu kanye nokuhlaba ikhefu okude, kanye neziqephu ze-atach tcardiacardias. Izinhlobo zabaqaphi zifaka iziqaphi zemicimbi, ama-loop rekhoda, kanye ne-telemetry yeselula.

Isifundo se-intracardiac electrophysiology (EPS) yisivivinyo esikhetheke kakhulu salesi sifo. Kodwa-ke, akudingeki kaningi futhi kungenzeka kungaqinisekisi ukuxilongwa.

Kwezinye izimo, izinga lokushaya kwenhliziyo yomuntu liyabonakala lapho ehamba noma ezivocavoca umzimba ukuze abone ukuthi lenyuka ngokwanele yini.

Ungahle ungadingi ukwelashwa uma ungenazo izimpawu. Umhlinzeki wakho wezokunakekelwa kwempilo uzobuyekeza imishanguzo oyisebenzisayo ukuqinisekisa ukuthi ayenzi isimo sakho sibe sibi kakhulu. Ungayeki ukuthatha noma imiphi imithi yakho ngaphandle uma umhlinzeki wakho ekutshela ukuthi wenze kanjalo.

Ungadinga i-pacemaker efakwe unomphela uma izimpawu zakho zihlobene ne-bradycardia (ukushaya kwenhliziyo okuhamba kancane).

Ukushaya kwenhliziyo okusheshayo (tachycardia) kungalashwa ngomuthi. Ngezinye izikhathi, inqubo ebizwa ngokuthi i-radiofrequency ablation isetshenziselwa ukwelapha i-tachycardia.

Kwezinye izimo, imithi esetshenziselwa ukulawula izikhathi zokushaya kwenhliziyo okusheshayo ihlanganiswe nokusetshenziswa kwe-pacemaker, evikela izikhathi zokushaya kwenhliziyo okuhamba kancane.

I-syndrome ivame ukuqhubeka. Lokhu kusho ukuthi kuya kuba kubi ngokuhamba kwesikhathi ezimweni eziningi.

Umbono wesikhathi eside muhle kakhulu kubantu abane-pacemaker ehlala njalo efakiwe.

Izinkinga zingafaka:

• Angina
• Ukwehla kwamandla okuzivocavoca umzimba
• Ukuquleka (i-syncope)
• Ukuwa noma ukulimala okubangelwa ukuquleka
• Ukwehluleka kwenhliziyo
• Ukumpompa kwenhliziyo okubi

Shayela umhlinzeki wakho uma une:

• Ubumhlophe
• Ukuquleka
• Ukushaya kancane
• Ezinye izimpawu zalesi simo

Ukugcina inhliziyo yakho iphilile ngokudla ukudla okunomsoco nokuzivocavoca umzimba kungavimbela izinhlobo eziningi zesifo senhliziyo.

Ungadinga ukugwema ezinye izinhlobo zemithi. Izikhathi eziningi, isimo asivikeleki.

Isifo se-Bradycardia-tachycardia; Ukungasebenzi kahle kwesinus node; Ukushaya kwenhliziyo okuhamba kancane - isinus egulayo; I-Tachy-brady syndrome; Ikhefu le-sinus - isinus egulayo; Ukuboshwa kweSinus - isifo sokugula

• Inhliziyo pacemaker - ukukhipha

• I-Pacemaker

Olgin JE, Zipes DP. I-Bradyarrhythmias kanye ne-atrioventricular block. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 40.

I-Zimetbaum P. Supraventricular arrhythmias yenhliziyo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 58.