Tachycardia atrial multifocal

ʻO ka tachycardia atrial multifocal atrial (MAT) kahi wikiwiki wikiwiki o ka naʻau. Hiki ia ke hoʻouna ʻia nā hōʻailona (uila impulses) mai ka puʻuwai o luna (atria) i ka puʻuwai o lalo (ventricle).

Hāʻawi ka puʻuwai kanaka i nā impulses uila, a i ʻole nā ​​hōʻailona, ​​e haʻi iā ia e kuʻi. ʻO ka maʻamau, hoʻomaka kēia mau hōʻailona ma kahi o ke keʻena ʻākau i luna i kapa ʻia ʻo ka pona sinoatrial (sinus sinus a i ʻole SA node). Kuhi ʻia kēia piko i ka "pacemaker maoli." Kōkua ia i ka mālama ʻana i ka puʻuwai puʻuwai. Ke ʻike ka naʻau i kahi hōʻailona, ​​ʻaelike ia (a i ʻole nā ​​paʻi).

ʻO ka helu puʻuwai maʻamau i nā mākua ma kahi o 60 a 100 mau kani i kēlā me kēia minuke. ʻOi aku ka wikiwiki o ka helu o ka puʻuwai maʻamau i nā keiki.

I ka MAT, nā wahi he nui i nā hōʻailona ahi atria i ka manawa like. Nui loa nā hōʻailona e alakaʻi i ka wikiwiki o ka puʻuwai. Kū pinepine pinepine ia ma waena o 100 a 130 mau pā i kēlā me kēia minuke a ʻoi paha i nā mākua. ʻO ka wikiwiki o ka puʻuwai e hana i ka puʻuwai e hana ʻoi loa a neʻe ʻole i ke koko. Inā wikiwiki loa ka puʻuwai, aia ka liʻiliʻi o ka manawa no ka piha o ka puʻuwai e hoʻopiha i ke koko ma waena o nā paʻi. No laila, ʻaʻole lawa ka pauma koko i ka lolo a me ke koena o ke kino me kēlā me kēia contraction.

ʻO ka MAT ka mea maʻamau i nā makahiki 50 a ʻoi. ʻIke pinepine ʻia i ka poʻe me nā kūlana e hoʻohaʻahaʻa i ka nui o ka oxygen i loko o ke koko. Loaʻa kēia mau ʻano:

• Pulumonia koʻohune
• ʻO ka maʻi pulmonary obstructive maʻi (COPD)
• Hoka puʻuwai Congestive
• Kanesa maʻi ʻaʻai
• Hoka maikaʻi ʻole
• Emperorism pulmonary

Hiki paha iā ʻoe ke makaʻu kiʻekiʻe aʻe no MAT inā loaʻa iā ʻoe:

• Maʻi maʻi coronary
• Diabetes
• Ua ʻoki ʻia i loko o nā pule he 6 i hala
• Overdosed ma ka lāʻau theofylline
• Sepsis

Ke emi ka helu o ka puʻuwai ma mua o 100 mau kani i kēlā me kēia minuke, ua kapa ʻia ka arrhythmia "holoholo atrial pacemaker."

ʻAʻohe o kekahi hōʻailona i kekahi poʻe. Ke kū nā hōʻailona, ​​hiki iā lākou ke hoʻopili:

• Pīkī pahu
• ʻĀlohilohi
• Mauleʻa
• ʻO ka manaʻo o ka puʻuwai e kuʻi maʻamau a wikiwiki paha (palpitations)
• Pokole o ka hanu
• ʻO ka hōʻemi kaumaha a me ka holomua ʻole i nā pēpē

Nā ʻōuli ʻē aʻe i hiki ke hana ʻia me kēia maʻi.

• Ka pilikia o ka hanu ke moe i lalo
• Puʻupuʻu

Hōʻike kahi hoʻokolohua kino i kahi puʻuwai puʻuwai kūwaho ʻole o 100 mau paʻi i kēlā me kēia minuke. He maʻamau a haʻahaʻa paha ke kahe o ke koko. Aia paha he hōʻailona o ka maikaʻi o ka holo ʻana.

ʻO nā hoʻokolohua e kuhikuhi iā MAT me:

• ECG
• Ke aʻo electrophysiologic (EPS)

Hoʻohana ʻia nā mea nānā puʻuwai e hoʻopaʻa i ka puʻuwai wikiwiki. Pākuʻi ʻia kēia mau mea:

• Nānā Holter 24 hola
• ʻO nā mea hoʻopaʻa loop loop lōʻihi e ʻae iā ʻoe e hoʻomaka i ka hoʻopaʻa ʻana inā loaʻa nā ʻōuli

Inā ʻoe ma ka haukapila, e kiaʻi ʻia ka puʻuwai o kou naʻau 24 mau hola i ka lā, ma ka liʻiliʻi ma ka mua.

Inā loaʻa iā ʻoe kahi ʻano i hiki ke alakaʻi iā MAT, pono e mālama mua ʻia kēlā ʻano.

Hoʻomaʻo no ka MAT me:

• Ke hoʻomaikaʻi nei i nā pae o ke koko
• Ke hāʻawi nei i ka magnesium a i ʻole ka potassium ma o kahi aa
• Ke kū nei i nā lāʻau, e like me ka theophylline, hiki ke hoʻonui i ka helu o ka puʻuwai
• Lawe i nā lāʻau e hoʻōlohi i ka helu o ka puʻuwai (inā wikiwiki ka wikiwiki o ka puʻuwai), e like me nā kahakaha kanal o ka maʻi (verapamil, diltiazem) a i ʻole beta-blockers

Hiki ke kāohi ʻia ʻo MAT inā mālama ʻia a kāohi ʻia ke ʻano e kumu i ka puʻuwai wikiwiki.

Komo pū nā pilikia:

• Cardiomyopathy
• Hoka puʻuwai Congestive
• Hoʻoemi i ka hana pumping o ka puʻuwai

Kāhea i kāu kahu mālama ola inā:

• Loaʻa iā ʻoe kahi puʻuwai wikiwiki a i ʻole kaulike me nā ʻōuli MAT ʻē aʻe
• Loaʻa iā ʻoe ka MAT a ʻoi aku ka maikaʻi o kāu mau ʻōuli, mai hoʻomaikaʻi me ka mālama ʻana, a i ʻole e hoʻomohala i nā ʻōuli hou

I mea e hōʻemi ai i ka makaʻu o ka hoʻomohala ʻana iā MAT, e mālama koke i nā maʻi e kū koke iā ia.

ʻO ka chaachcardia atrial chaotic

• Puʻuwai - ʻāpana ma waena o ka waena
• Puʻuwai - ʻike mua
• ʻŌnaehana hoʻoneʻe o ka puʻuwai

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.

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.