Maʻi maʻi sinus

ʻO ka maʻamau, hoʻomaka ka puʻuwai i kahi ma nā keʻena kiʻekiʻe o ka puʻuwai (atria). ʻO kēia wahi ka mea mālama i ka naʻau. Kāhea ʻia ka node sinoatrial, sinus node a i ʻole SA node. ʻO kāna kuleana e mālama i ka puʻuwai e kuʻi mau a maʻa mau.

ʻO ka maʻi maʻi sinus kahi hui o nā pilikia o ka puʻuwai puʻuwai ma muli o nā pilikia me ka piko sinus, e like me:

• Lohi loa ka wikiwiki o ka puʻuwai, i kapa ʻia sinus bradycardia
• Hoʻomaha a kū paha ke kuʻi puʻuwai, i kapa ʻia ʻo sinus sinus a i ʻole ka hopu sinus
• Episodes o ka wikiwiki o ka naʻau
• Pākuʻi ka puʻuwai lohi e hoʻololi me nā puʻuwai puʻuwai wikiwiki, i kapa ʻia ʻo bradycardia-tachycardia a i ʻole "tachy-brady syndrome"

Kū pinepine ka maʻi maʻi sinus i nā poʻe ma mua o 50 mau makahiki. Ma muli o ka hōʻino ʻia e like me ka ʻeha i nā ala uila i ka puʻuwai puʻuwai puʻuwai.

I nā keiki, ʻoki ʻia ka puʻuwai ma nā keʻena ma luna kahi kumu maʻamau o ka maʻi sinus sinus.

Hiki ke loaʻa nā maʻi puʻuwai coronary, ke koko kiʻekiʻe, a me nā maʻi aorta a me mitral me nā maʻi sinus sinus. Eia naʻe, ʻaʻohe pili iki kēia mau maʻi me ka maʻi maʻi.

ʻAʻole maʻamau ka maʻi maʻi sinus, akā ʻaʻole kakaikahi. ʻO ia ke kumu maʻamau loa e pono ai i ka poʻe e hana i kahi pacemaker hana. Kū pinepine ʻo Sinus bradycardia ma mua o nā ʻano o ke ʻano.

ʻO Tachycardias (nā puʻuwai puʻuwai wikiwiki) e hoʻomaka i nā keʻena o luna o ka puʻuwai mahele paha o ka maʻi maʻi. Hoʻopili kēia i ka fibrillation atrial, flutter atrial, tachycardia atrial. ʻO ka manawa o ka helu wikiwiki o ka puʻuwai e ukali pinepine ʻia e nā helu puʻuwai lohi loa. Ke loaʻa nā manawa o ka lohi a me ka wikiwiki o ka puʻuwai (rhythm) e kapa pinepine ʻia ke ʻano he tachy-brady syndrome.

Hiki i kekahi mau lāʻau ke hana i nā puʻuwai puʻuwai maikaʻi ʻole, keu hoʻi ke kiʻekiʻe nā lāʻau. Hoʻopili kēia i nā digitalis, nā blockers calcium, beta-blockers, a me antiarrhythmics.

ʻO ka hapanui o ka manawa, ʻaʻohe ʻōuli.

Hiki ke hoʻohālikelike nā ʻōuli i hana ʻia i nā ʻano maʻi ʻē aʻe.

Pākuʻi ʻia paha nā ʻōuli:

• ʻEha ʻeha a angina paha
• Huikau a i ʻole nā ​​hoʻololi ʻē aʻe i ke kūlana noʻonoʻo
• Maule ʻaule a maule paha
• Ka luhi
• ʻO ka puʻupuʻu a i ʻole ka uila
• ʻO ka manaʻo o ka naʻau e kuʻi ka puʻuwai (palpitations)
• Ka hanu ʻana o ka hanu, malia paha me ka hoʻoikaika kino e like me ka hele wāwae

Lohi paha ka wikiwiki o ka puʻuwai i kēlā me kēia manawa. Kūleʻa a haʻahaʻa paha ke kahe o ke koko.

ʻO ka maʻi maʻi sinus paha ke kumu a hoʻomaka a maikaʻi ʻole paha nā ʻōuli o ka puʻuwai. ʻIke ʻia ka maʻi maʻi sinus inā loaʻa nā ʻōuli ma nā hanana o ka arrhythmia wale nō. Eia naʻe, paʻakikī pinepine ka loulou e hōʻoia.

Hōʻike paha kahi ECG i nā puʻuwai puʻuwai e pili ʻole i kēia maʻi.

ʻO nā mea nānā ʻo Holter a ʻoi aku ka lōʻihi ʻoi aku ka maikaʻi o nā mea hana no ke kuhikuhi ʻana i ka maʻi sinus sinus. Hiki iā lākou ke hāpai i nā helu puʻuwai lohi loa a hoʻomaha iki, a me nā ʻāpana o nā tachycardias atrial. ʻO nā ʻano o nā mea nānā me nā kahu hanana, nā mea hoʻopaʻa leo, a me nā telemetry pūnaewele.

ʻO kahi noi intracardiac electrophysiology study (EPS) kahi hōʻike kikoʻī loa no kēia maʻi. Eia naʻe, ʻaʻole pono pinepine ia a ʻaʻole paha e hōʻoia i ka ʻike.

I kekahi mau hihia, ʻike ʻia ka nui o ka naʻau o ke kanaka ke hele a hoʻomaʻamaʻa paha e ʻike inā hoʻonui ʻia ka lawa.

ʻAʻole paha ʻoe e pono ke mālama inā ʻaʻohe ou ʻōuli. E loiloi kāu mea mālama ola i nā lāʻau āu e lawe ai e hōʻoia ʻaʻole lākou e hōʻeha i kou kūlana. Mai hōʻoki i ka lawe ʻana i kekahi o kāu lāʻau inā ʻaʻole haʻi ʻia ka mea lawelawe iā ʻoe e hana pēlā.

Pono ʻoe i pacemaker i hoʻokomo mau ʻia inā pili kāu mau ʻōuli i ka bradycardia (ka puʻuwai puʻuwai).

Hiki ke mālama ʻia kahi helu puʻuwai wikiwiki (tachycardia) me ka lāʻau. I kekahi manawa, hoʻohana ʻia kahi hana e kapa ʻia ʻo radiofrequency ablasi e hoʻōla i ka tachycardia.

I kekahi mau hihia, hoʻohui ʻia nā lāʻau e kāohi ai i nā manawa o ka wikiwiki o ka puʻuwai wikiwiki me ka hoʻohana ʻana i kahi pacemaker, nā kiaʻi e kūʻē i nā wā o ka wikiwiki o ka puʻuwai.

Holomua pinepine ka maʻi maʻi. ʻO kēia ka mea eʻoi aku ka maikaʻi ma mua o ka manawa i ka nui o nā manawa.

ʻO ke kuanaʻike wā lōʻihi he maikaʻi loa ia no nā poʻe i loaʻa kahi pacemaker paʻa mau.

Komo pū nā pilikia:

• Angina
• Ka emi o ka hana hoʻoikaika kino
• Pahu (sinkope)
• Hāʻule a hōʻeha ʻia paha e ka maule ʻana
• Hewa puʻuwai
• Pauma puʻuwai maikaʻi ʻole

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe:

• ʻĀlohilohi
• Mauleʻa
• Palpitations
• Nā ʻōuli ʻē aʻe o ke ʻano

Mālama i kou puʻuwai olakino ma ka ʻai ʻana i ka papaʻai kaulike a me ka hoʻoikaika kino ʻana hiki ke pale aku i nā ʻano maʻi maʻi puʻuwai.

Pono paha ʻoe e hōʻalo i kekahi ʻano o nā lāʻau. I nā manawa he nui, ʻaʻole hiki ke pale ʻia ke ʻano.

Maʻi maʻi Bradycardia-tachycardia; Hewa ka hopena Sinus; Pāloli ka helu o ka puʻuwai - sinus sinus; Maʻi Tachy-brady; Hoʻomaha iki ka hewa - sinus sinus; Hopu hewa - maʻi sinus

• Hoʻomaʻamaʻa i ka puʻuwai - hoʻokuʻu

• Pāʻalāʻau

ʻO Olgin JE, ʻo Zipe DP. Bradyarrhythmias a me atrioventricular poloka. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 40.

Zimetbaum P. Supraventricular cardiac arrhythmia. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 58.