I-paroxysmal supraventricular tachycardia (PSVT)

I-paroxysmal supraventricular tachycardia (PSVT) iziqephu zokushaya kwenhliziyo okusheshayo eziqala engxenyeni yenhliziyo ngaphezu kwama-ventricles. "I-Paroxysmal" isho njalo ngezikhathi ezithile.

Imvamisa, amakamelo enhliziyo (i-atria nama-ventricles) enza isivumelwano ngendlela ehambisanayo.

• Ukuphambana kubangelwa yisiginali kagesi eqala endaweni yenhliziyo ebizwa nge-sinoatrial node (ebizwa nangokuthi i-sinus node noma i-SA node).
• Isiginali ihamba ngamakamelo aphezulu enhliziyo (i-atria) bese itshela i-atria ukuthi isebenze.
• Ngemuva kwalokhu, isignali yehla iye enhliziyweni futhi itshele amakamelo aphansi (ama-ventricles) ukuthi asebenze.

Isilinganiso senhliziyo esheshayo esivela ku-PSVT singaqala ngemicimbi eyenzeka ezindaweni zenhliziyo ngaphezu kwamakamelo aphansi (ama-ventricles).

Kunezimbangela ezithile ze-PSVT. Ingakhula lapho imithamo yemithi yenhliziyo, i-digitalis, iphakeme kakhulu. Kungenzeka futhi ngesimo esaziwa nge-Wolff-Parkinson-White syndrome, esivame ukubonakala kubantu abasha nasezinsaneni.

Lokhu okulandelayo kwandisa ubungozi bakho be-PSVT:

• Ukusetshenziswa kotshwala
• Ukusetshenziswa kwe-caffeine
• Ukusetshenziswa kwezidakamizwa ezingekho emthethweni
• Ukubhema

Izimpawu zivame ukuqala futhi zime ngokungazelelwe. Zingahlala imizuzu embalwa noma amahora ambalwa. Izimpawu zingafaka:

• Ukukhathazeka
• Ukuqina kwesifuba
• Ukushaya ngonyawo (umuzwa wokuzwa ukushaya kwenhliziyo), imvamisa ngesilinganiso esingajwayelekile noma esisheshayo (umjaho)
• Ukushaya ngamandla okusheshayo
• Ukuphelelwa umoya

Ezinye izimpawu ezingenzeka ngalesi simo zifaka:

• Isiyezi
• Ukuquleka

Ukuhlolwa ngokomzimba ngesikhathi sesiqephu se-PSVT kuzobonisa ukushaya kwenhliziyo okusheshayo. Kungakhombisa nokudonsa okunamandla entanyeni.

Ukushaya kwenhliziyo kungahle kube ngaphezu kwe-100, futhi kushaye ngisho nangaphezu kwama-250 beats ngomzuzu (bpm). Ezinganeni, izinga lokushaya kwenhliziyo livame ukuba phezulu kakhulu. Kungaba nezimpawu zokuhamba kwegazi okungalungile njengokukhanya okukhanyayo. Phakathi kweziqephu ze-PSVT, isilinganiso senhliziyo sijwayelekile (60 kuya ku-100 bpm).

I-ECG ngesikhathi sezimpawu ikhombisa i-PSVT. Ucwaningo lwe-electrophysiology (EPS) lungadingeka ukuthola ukuxilongwa okunembile nokuthola ukwelashwa okuhle kakhulu.

Ngoba i-PSVT ifika idlule, ukuze uyihlolisise abantu kungadingeka ukuthi bagqoke i-Holter monitor yamahora angama-24. Isikhathi eside, enye ithephu yedivayisi yokuqopha isigqi ingasetshenziswa.

I-PSVT eyenzeka kanye kuphela ngesikhathi ingase ingadingi ukwelashwa uma ungenazo izimpawu noma ezinye izinkinga zenhliziyo.

Ungazama amasu alandelayo ukuphazamisa ukushaya kwenhliziyo okusheshayo ngesikhathi sesiqephu se-PSVT:

• Ukuhamba kweValsalva. Ukuze wenze lokhu, ubamba umoya nokuphefumula kwakho, njengokungathi uzama ukunyakaza amathumbu.
• Ukukhwehlela ngenkathi uhleli nomzimba wakho ophezulu ugobile phambili.
• Ukuchitha amanzi eqhwa ebusweni bakho

Kufanele ugweme ukubhema, i-caffeine, utshwala, nezidakamizwa ezingekho emthethweni.

Ukwelashwa okuphuthumayo ukwehlisa ukushaya kwenhliziyo kubuyele kokujwayelekile kungafaka:

• Ukuphefumula kukagesi, ukusetshenziswa kokushaqeka kagesi
• Imithi ngomthambo

Ukwelashwa kwesikhathi eside kubantu abaphindaphinde iziqephu ze-PSVT, noma abanesifo senhliziyo, kungafaka:

• Ukukhishwa kwenhliziyo, inqubo esetshenziselwa ukubhubhisa izindawo ezincane enhliziyweni yakho ezingadala ukushaya kwenhliziyo okusheshayo (njengamanje ukwelashwa okukhethwa kukho kuma-PSVTs amaningi)
• Imithi yansuku zonke yokuvikela iziqephu eziphindiwe
• Ama-pacemaker anqamula ukushaya kwenhliziyo okusheshayo (kwesinye isikhathi angasetshenziswa ezinganeni ezine-PSVT ezingaphendulanga kolunye ukwelashwa)
• Ukuhlinzwa ukushintsha izindlela ezisenhliziyweni ezithumela amasiginali kagesi (lokhu kunganconywa kwezinye izimo kubantu abadinga okunye ukuhlinzwa kwenhliziyo)

I-PSVT ngokuvamile ayisongeli impilo. Uma kukhona ezinye izinkinga zenhliziyo, zingaholela ekuhlulekeni kwenhliziyo noma i-angina.

Shayela umhlinzeki wakho wezempilo uma:

• Unomuzwa wokuthi inhliziyo yakho ishaya ngokushesha futhi izimpawu azipheli zodwa ngemizuzu embalwa.
• Unomlando we-PSVT futhi isiqephu asisuki kumjikelezo weValsalva noma ngokukhwehlela.
• Unezinye izimpawu ngokushaya kwenhliziyo okusheshayo.
• Izimpawu zibuya kaningi.
• Izimpawu ezintsha ziyakhula.

Kubaluleke kakhulu ukuxhumana nomhlinzeki wakho uma unezinye izinkinga zenhliziyo.

I-PSVT; I-tachycardia engaphezulu; Isigqi senhliziyo esingajwayelekile - i-PSVT; I-Arrhythmia - i-PSVT; Ukushaya kwenhliziyo okusheshayo - i-PSVT; Ukushaya kwenhliziyo okusheshayo - i-PSVT

• Uhlelo lokuqhuba kwenhliziyo
• Ukuqapha kwenhliziyo kaHolter

UDalal AS, uVan Hare GF. Ukuphazamiseka kwesilinganiso nesigqi senhliziyo. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 462.

Olgin JE, Zipes DP. Ama-arrhythmias aphezulu. 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 37.

Ikhasi RL, Joglar JA, Caldwell MA, et al. Umhlahlandlela we-2015 ACC / AHA / HRS wokuphathwa kweziguli ezindala ezine-tachycardia engaphezulu kwamandla: umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice Guidelines kanye ne-Heart Rhythm Society. Ukujikeleza. 2016; 133 (14); e471-e505. I-PMID: 26399662 pubmed.ncbi.nlm.nih.gov/26399662/.

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.