ʻO Paroxysmal supraventricular tachycardia (PSVT)

ʻO Paroxysmal supraventricular tachycardia (PSVT) kahi mahele o ka wikiwiki o ka puʻuwai e hoʻomaka i kahi ʻāpana o ka puʻuwai ma luna o nā ventricle. "Paroxysmal" ʻo ia hoʻi mai kēlā me kēia manawa.

ʻO ka maʻamau, ʻo nā keʻena o ka puʻuwai (atria a me nā ventricle) kahi aelike i kahi ʻano i hoʻohui ʻia.

• Hoʻokumu ʻia nā kuʻikia e kahi hōʻailona uila e hoʻomaka i kahi o ka puʻuwai i kapa ʻia ʻo node sinoatrial (i kapa ʻia hoʻi ʻo sinus sinus a i ʻole SA node).
• Holo ka hōʻailona ma o nā keʻena puʻuwai o luna (ʻo atria) a haʻi i ka atria e ʻaelike.
• Ma hope o kēia, neʻe ka hōʻailona i lalo i ka puʻuwai a haʻi i nā keʻena haʻahaʻa (nā ventricle) e ʻaelike.

Hoʻomaka ka helu wikiwiki o ka naʻau mai PSVT me nā hanana i kū i nā wahi o ka puʻuwai ma luna o nā keʻena haʻahaʻa (ventricle).

Aia kekahi mau kumu kikoʻī o PSVT. Hiki iā ia ke hoʻomohala ke kiʻekiʻe nā lāʻau o ka naʻau, digitalis. Hiki iā ia ke hana me kahi ʻano i ʻike ʻia ʻo Wolff-Parkinson-White syndrome, ka mea i ʻike pinepine ʻia i ka poʻe ʻōpio a me nā pēpē.

Hoʻonui ka mea aʻe i kāu makaʻu no PSVT:

• Hoʻohana rama
• Hoʻohana ka cafe
• Hoʻohana lāʻau lāʻau lapaʻau
• Puhipaka

Hoʻomaka pinepine nā ʻōuli a kū koke. Hiki iā lākou ke noho no kekahi mau minuke a mau mau hola paha. Pākuʻi ʻia paha nā ʻōuli:

• Hopohopo
• Pīkī pahu
• Palpitations (kahi ʻano o ka naʻau o ka puʻuwai), pinepine me ka helu kaulike a wikiwiki paha (heihei)
• Pākuʻi wikiwiki
• Pokole o ka hanu

ʻO nā ʻōuli ʻē aʻe e hiki ke hana me kēia ʻano nā:

• Puʻupuʻu
• Mauleʻa

ʻO kahi hoʻokolohua kino i ka wā o PSVT e hōʻike i ka wikiwiki o ka puʻuwai. Hōʻike paha ia i nā puʻupuʻu ikaika i ka ʻāʻī.

ʻOi aku paha ka helu o ka naʻau ma kahi o 100, a ʻoi aku ma mua o 250 mau kani i kēlā me kēia minuke (bpm). I nā keiki, kiʻekiʻe ke kiʻekiʻe o ka naʻau. Aia paha he mau hōʻailona o ke kahe o ke koko e like me ka lightheadedness. Ma waena o nā māhele o PSVT, maʻamau ka helu o ka puʻuwai (60 a 100 bpm).

Hōʻike kahi ECG i nā hōʻailona e hōʻike iā PSVT. Pono paha kahi noiʻi electrophysiology (EPS) no kahi hōʻoia pololei a ʻike i ka lāʻau maikaʻi loa.

No ka mea hele mai ʻo PSVT a hele aku, e kuhi pono pono i ka poʻe e komo i kahi nānā Holter 24 hola. No nā wā lōʻihi, hiki ke hoʻohana ʻia i kekahi lepe o ka mīkini hoʻopaʻa leo.

ʻO PSVT e kū hoʻokahi wale nō i kekahi manawa ʻaʻole pono ka lapaʻau inā ʻaʻohe ou hōʻailona a i ʻole nā ​​pilikia puʻuwai ʻē aʻe.

Hiki iā ʻoe ke hoʻāʻo i nā ʻenehana aʻe e keʻakeʻa i kahi puʻuwai wikiwiki i ka wā o PSVT:

• Manuahi ʻo Valsalva. E hana ai i kēia, paʻa ʻoe i kou hanu a me ke kanana, me he mea lā e hoʻāʻo ana ʻoe e neʻe i kou ʻōpū.
• ʻO Coughing ʻoiai e noho ana me kou kino kiʻekiʻe e kūlou i mua.
• Ke pīpī nei i ka wai hau i kou alo

Pono ʻoe e hōʻalo i ka puhipaka, caffeine, ʻalekohola, a me nā lāʻau lapaʻau kūpono ʻole.

ʻO ka mālama ulia pōpō ʻana e hoʻolohi i ke kuʻi o ka puʻuwai i ka maʻamau e komo pū paha:

• Uila cardioversion, ka hoʻohana ʻana o ka uila uila
• Nā lāʻau i loko o kahi aa

ʻO ka mālama wā lōʻihi no ka poʻe i loaʻa nā hanana hou o PSVT, a i ʻole he maʻi puʻuwai paha, e hoʻopili pū ʻia:

• Hoʻomaha Cardiac, kahi hana i hoʻohana ʻia e luku i nā wahi liʻiliʻi i kou puʻuwai e hiki ai ke kumu i ka puʻuwai wikiwiki (i kēia manawa ka mālama ʻana i kahi koho no ka hapa nui o PSVT)
• ʻO nā lāʻau i kēlā me kēia lā e pale i nā ʻāpana hou
• Pacemakers e hoʻokahuli i ka puʻuwai wikiwiki (i kekahi manawa hiki ke hoʻohana ʻia i nā keiki me PSVT i pane ʻole i nā ʻano lāʻau ʻē aʻe)
• Ke ʻoki e hoʻololi i nā ala i loko o ka puʻuwai e hoʻouna i nā hōʻailona uila (e koi ʻia kēia i kekahi mau hihia no ka poʻe e pono i kahi ʻoki puʻuwai ʻē aʻe)

ʻAʻole hoʻoweliweli nui ʻo PSVT. Inā loaʻa nā maʻi puʻuwai ʻē aʻe, hiki iā ia ke alakaʻi i ka puʻuwai puʻuwai kongestive a i ʻole angina.

Kāhea i kāu kahu mālama ola inā:

• He manaʻo kou e kuʻi wikiwiki nei kou puʻuwai a ʻaʻole pau nā ʻōuli iā lākou iho i loko o kekahi mau minuke.
• Loaʻa iā ʻoe kahi moʻolelo o PSVT a ʻaʻole hele kahi ʻāpana me ka maneuver Valsalva a i ʻole ke kaʻe ʻana.
• He mau hōʻailona ʻē aʻe kāu me ka wikiwiki o ka naʻau.
• Hoʻi pinepine nā ʻōuli.
• Kūkulu nā ʻōuli hou.

He mea nui ia e kāhea aku i kāu mea hāʻawi inā loaʻa iā ʻoe nā pilikia puʻuwai ʻē aʻe.

PSVT; Kāleka Supraventricular; Pāʻina puʻuwai maikaʻi ʻole - PSVT; Arrhythmia - PSVT; Hōʻemi puʻuwai wikiwiki - PSVT; Hōʻemi puʻuwai wikiwiki - PSVT

• ʻŌnaehana hoʻoneʻe o ka puʻuwai
• Holter puʻuwai nānā

ʻO Dalal AS, ʻo Van Hare GF. Hoʻopilikia i ka helu a me ke mele o ka puʻuwai. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 462.

ʻO Olgin JE, ʻo Zipe DP. Nā arrhythmia supraventricular. 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 37.

ʻAoʻao RL, Joglar JA, Caldwell MA, et al. ʻO 2015 ACC / AHA / HRS kulekele no ka mālama ʻana i nā mea maʻi makua me ka tachycardia supraventricular: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force e pili ana i nā Clinical Practice Guide a me ka Heart Rhythm Society. Kaapuni. 2016; 133 (14); e471-e505. PMID: 26399662 pubmed.ncbi.nlm.nih.gov/26399662/.

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.