I-Arrhythmias

I-arrhythmia ukuphazamiseka kwesilinganiso senhliziyo (ishayela) noma isigqi senhliziyo. Inhliziyo ingashaya ngokushesha okukhulu (i-tachycardia), ihamba kancane kakhulu (i-bradycardia), noma ngokungajwayelekile.

I-arrhythmia ayinabungozi, uphawu lwezinye izinkinga zenhliziyo, noma ingozi esheshayo empilweni yakho.

Imvamisa, inhliziyo yakho isebenza njengompompi oletha igazi emaphashini nasemzimbeni wonke.

Ukusiza lokhu kwenzeke, inhliziyo yakho inohlelo lukagesi olwenza isiqiniseko sokuthi luyasebenzisana (luyakhama) ngendlela ehlelekile.

• Umfutho kagesi osayina inhliziyo yakho ukuthi ingene esivumelwaneni uqala endaweni yenhliziyo ebizwa nge-sinoatrial node (ebizwa nangokuthi i-sinus node noma i-SA node). Lena inhliziyo yenhliziyo yakho yemvelo.
• Isiginali ishiya i-node yaseNingizimu Afrika ihambe ngenhliziyo ihamba ngendlela kagesi esethiwe.
• Imiyalezo ehlukene yezinzwa ikhombisa inhliziyo yakho ukushaya kancane noma ngokushesha.

I-Arrhythmias idalwa yizinkinga ngohlelo lokuqhuba ugesi wenhliziyo.

• Izimpawu ezingajwayelekile (ezingeziwe) zingenzeka.
• Izimpawu zikagesi zingavinjelwa noma zehliswe.
• Amasiginali kagesi ahamba ezindleleni ezintsha noma ezihlukile enhliziyweni.

Ezinye izimbangela ezivamile zokushaya kwenhliziyo okungavamile yilezi:

• Amazinga angajwayelekile we-potassium noma ezinye izinto emzimbeni
• Ukuhlaselwa yinhliziyo, noma imisipha yenhliziyo eyonakele evela ekuhlaselweni yinhliziyo okudlule
• Isifo senhliziyo esikhona ngesikhathi sokuzalwa (esibelethweni)
• Ukwehluleka kwenhliziyo noma inhliziyo ekhulisiwe
• Indlala yegilo eyeqile

I-Arrhythmias nayo ingabangelwa ezinye izinto noma izidakamizwa, kufaka phakathi:

• Utshwala noma izidakamizwa ezivuselelayo
• Imithi ethile
• Ukubhema ugwayi (i-nicotine)

Ezinye zezigqi zenhliziyo ezejwayelekile yilezi:

• I-Atrial fibrillation noma i-flutter
• I-atrioventricular nodal reentry tachycardia (AVNRT)
• Inhliziyo block noma block atrioventricular
• I-tachycardia ye-atrial eminingi
• I-paroxysmal supraventricular tachycardia
• Isifo se-sinus syndrome
• I-ventricular fibrillation noma i-ventricular tachycardia
• Isifo se-Wolff-Parkinson-White

Uma une-arrhythmia, ukushaya kwenhliziyo yakho kungaba:

• Ukuhamba kancane (bradycardia)
• Kuyashesha kakhulu (tachycardia)
• Okungajwayelekile, okungalingani, mhlawumbe ngamabhithi engeziwe noma weqiwe

I-arrhythmia ingaba khona ngaso sonke isikhathi noma ingahle ifike idlule. Ungazizwa noma ungazizwa izimpawu lapho i-arrhythmia ikhona. Noma, ungaqaphela kuphela izimpawu uma usebenza ngokwengeziwe.

Izimpawu zingaba mnene kakhulu, noma zingaba nzima noma zisongele nokuphila.

Izimpawu ezijwayelekile ezingahle zivele lapho i-arrhythmia ikhona zingafaka:

• Ubuhlungu besifuba
• Ukuquleka
• Ubumhlophe, isiyezi
• Ukudinwa
• Ukushaya ngonyawo (ukuzwa inhliziyo yakho ishaya ngokushesha noma ngokungajwayelekile)
• Ukuphelelwa umoya
• Ukujuluka

Umhlinzeki wezokunakekelwa kwezempilo uzolalela inhliziyo yakho nge-stethoscope futhi ezwe ukushaya kwenhliziyo yakho. Umfutho wegazi wakho ungaba phansi noma ujwayelekile noma uze uphakame ngenxa yokungakhululeki.

I-ECG kuzoba ukuhlolwa kokuqala ukwenziwa.

Amadivayisi wokuqapha inhliziyo avame ukusetshenziselwa ukukhomba inkinga yesigqi, njenge:

• Ukuqapha kweHolter (lapho ugqoka khona idivayisi erekhoda futhi igcine isigqi senhliziyo yakho amahora angama-24 noma ngaphezulu)
• Ukuqapha umcimbi noma i-loop rekhoda (egqokwe amasonto ama-2 noma ngaphezulu, lapho uqopha isigqi senhliziyo yakho lapho uzizwa ngesigqi esingajwayelekile)
• Ezinye izinketho zokuqapha zesikhathi eside

Ngezinye izikhathi i-echocardiogram iyalwa ukuba ihlole ubukhulu noma ukwakheka kwenhliziyo yakho.

Ezimweni ezikhethiwe, i-coronary angiography ingenziwa ukubona ukuthi igazi ligeleza kanjani emithanjeni esenhliziyweni yakho.

Isivivinyo esikhethekile, esibizwa nge-electrophysiology Study (EPS), kwesinye isikhathi senziwa ukubhekisisa uhlelo lukagesi lwenhliziyo.

Lapho i-arrhythmia ibucayi, ungadinga ukwelashwa okuphuthumayo ukubuyisela isigqi esijwayelekile. Lokhu kungafaka:

• Ukwelashwa kagesi (defibrillation noma i-cardioversion)
• Ukufaka i-pacemaker yenhliziyo yesikhashana
• Imithi enikezwa ngomthambo noma ngomlomo

Kwesinye isikhathi, ukwelashwa okungcono kwe-angina yakho noma ukwehluleka kwenhliziyo kuzokwehlisa amathuba akho okuba ne-arrhythmia.

Imithi ebizwa ngemithi elwa nokuhleleka ingasetshenziswa:

• Ukuvimbela i-arrhythmia ukuthi ingenzeki futhi
• Ukugcina izinga lokushaya kwenhliziyo yakho lingasheshi noma lihambe kancane

Eminye yale mithi ingaba nemiphumela engemihle. Thatha njengoba kuchazwe umhlinzeki wakho. Ungayeki ukuthatha umuthi noma ushintshe umthamo ngaphandle kokukhuluma kuqala nomhlinzeki wakho.

Ezinye izindlela zokwelapha ukuvimbela noma ukwelapha isigqi senhliziyo esingajwayelekile zihlanganisa:

• Ukususwa kwenhliziyo, okusetshenziselwa ukukhomba izindawo ezisenhliziyweni yakho ezingadala izinkinga zesigqi senhliziyo yakho
• I-cardioverter defibrillator efakwe ngaphakathi, efakwa kubantu abasengozini enkulu yokufa okungazelelwe kwenhliziyo
• I-Pemerman pacemaker, idivaysi ezwa lapho inhliziyo yakho ishaya kancane kakhulu. Ithumela isignali enhliziyweni yakho eyenza inhliziyo yakho ishaye ngejubane elifanele.

Umphumela uncike ezintweni eziningana:

• Uhlobo lwe-arrhythmia onalo.
• Noma ngabe unesifo semithambo yenhliziyo, ukwehluleka kwenhliziyo, noma isifo senhliziyo se-valvular.

Shayela umhlinzeki wakho uma:

• Uthuthukisa noma yiziphi izimpawu ze-arrhythmia engenzeka.
• Utholwe ukuthi une-arrhythmia futhi izimpawu zakho ziba zimbi noma UNGATHUTHUKI ngokwelashwa.

Ukuthatha izinyathelo zokuvimbela isifo semithambo yegazi kunganciphisa amathuba okuba ube ne-arrhythmia.

Isigqi senhliziyo esingajwayelekile; IBradycardia; Tachycardia; I-Fibrillation

• I-Atrial fibrillation - ukukhishwa
• Inhliziyo pacemaker - ukukhipha
• Ukuthatha i-warfarin (Coumadin, Jantoven) - okufanele ubuze udokotela wakho

• Inhliziyo - isigaba phakathi nendawo
• Inhliziyo - ukubuka kwangaphambili
• Isigqi senhliziyo esijwayelekile
• I-Bradycardia
• I-tachycardia evundlile
• I-Atrioventricular block - ukulandelwa kwe-ECG
• Uhlelo lokuqhuba kwenhliziyo

U-Al-Khatib SM, uStevenson WG, u-Ackerman MJ, et al. Umhlahlandlela we-2017 AHA / ACC / HRS wokuphathwa kweziguli ezine-ventricular arrhythmias kanye nokuvimbela ukufa kwenhliziyo okungazelelwe: Isifinyezo Esiphezulu: Umbiko We-American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Isigqi senhliziyo. I-2018; 15 (10): e190-e252. I-PMID: 29097320 kushicilelwe.ncbi.nlm.nih.gov/29097320/.

Olgin JE. Sondela esigulini nge-arrhythmia esolwayo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 56.

UTomaselli GF, uRubart M, uZipes DP. Izindlela ze-arrhythmias yenhliziyo. 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 34.

UTracy CM, u-Epstein AE, uDarbar D, et al. Ukubuyekezwa okugxile kwe-ACCF / AHA / HRS kuka-2012 kwemihlahlandlela yango-2008 yokwelashwa okusekelwe kudivayisi kokungajwayelekile kwesigqi senhliziyo: umbiko we-American College of Cardiology Foundation / American Heart Association Task Force on Guidelines Practice. UJ Am Coll Cardiol. 2012; 60 (14): 1297-1313. I-PMID: 22975230 pubmed.ncbi.nlm.nih.gov/22975230/.