Tachycardia hāhā

ʻO ka tachycardia Ventricular (VT) kahi puʻuwai wikiwiki e hoʻomaka i nā keʻena haʻahaʻa o ka puʻuwai (ventricles).

ʻO VT kahi helu pālū ma mua o 100 mau paʻi i kēlā me kēia minuke, me 3 mau puʻuwai puʻuwai i kū ʻole i ka lālani.

Hiki i ke ʻano ke ulu ma ke ʻano he kakahiaka a i ʻole lohi paha o ka hopena o ka puʻuwai. Hiki paha i nā poʻe me:

• Cardiomyopathy
• Hewa puʻuwai
• ʻOki kino puʻuwai
• Myocarditis
• Maʻi maʻi valvular

Hiki i ka VT ke hana me ka ʻole o ka maʻi puʻuwai.

Hiki ke hana i nāʻiʻo scar i ka mākala o nā lā ventricle, mau mahina, a i ʻole mau makahiki ma hope o ka puʻuwai puʻuwai. Hiki i kēia ke alakaʻi i ka tachycardia ventricular.

Hiki ke kumu ʻia ʻo VT e:

• Anati-arrhythmic ai '(hoʻohana e hana i ka abnormal naau puʻuwai)
• Nā loli i ke kemika o ke koko (e like me ka pae potassium haʻahaʻa)
• Nā hoʻololi i ka pH (acid-base)
• Ka nele o ka nui o ka oxygen

"Torsade de pointes" kahi ʻano kikoʻī o VT. ʻO ia pinepine ma muli o ka maʻi puʻuwai congenital a i ʻole ka hoʻohana ʻana o kekahi mau lāʻau.

Hiki paha iā ʻoe ke loaʻa nā ʻōuli inā wikiwiki ka puʻuwai i ka wā o ka māhele VT a ʻoi aku paha ka lōʻihi ma mua o kekahi mau kekona. Pākuʻi ʻia paha nā ʻōuli:

• Hōʻoluʻolu o ka umauma (angina)
• Pahu (sinkope)
• Lightheadedness a ʻūpā paha
• ʻO ka manaʻo o ka naʻau e kuʻi ka puʻuwai (palpitations)
• Pokole o ka hanu

E hoʻomaka paha nā ʻōuli a kū koke. I kekahi mau hihia, ʻaʻohe hōʻailona.

E nānā ka mea mālama ola:

• Pulse pau ʻole
• Ka nalowale o ka ʻike
• ʻO ke kaomi maʻamau a haʻahaʻa paha
• Pākuʻi wikiwiki

Hiki ke hoʻohana ʻia nā hoʻokolohua e ʻike ai i ka tachycardia ventricular:

• Luna nānā Holter
• ECG
• Ke aʻo electracsiac Intracardiac (EPS)
• Nānā i ka ritme me kahi mea hoʻopaʻa loop a i ʻole hāmeʻa

Loaʻa paha iā ʻoe nā chemistries koko a me nā hoʻokolohua ʻē aʻe.

Pili ka mālama ʻana i nā ʻōuli, a me ke ʻano o ka maʻi puʻuwai.

Inā pilikia kekahi me VT, koi paha lākou:

• CPR
• Cardioversion (uila uila)
• Nā lāʻau lapaʻau (e like me ka lidocaine, procainamide, sotalol, a i ʻole amiodarone) i hāʻawi ʻia ma o ke aa

Ma hope o kahi ʻāpana o VT, lawe ʻia nā ʻanuʻu i nā hanana hou aʻe.

• Pono paha nā lāʻau i lawe ʻia e ka waha no ka mālama wā lōʻihi. Eia nō naʻe, hiki i kēia mau lāʻau ke loaʻa nā hopena ʻino. Hoʻohana pinepine ʻia lākou e like me ka hoʻomohala ʻia ʻana o nā lāʻau ʻē aʻe.
• ʻO ke kaʻina hana e luku ai i ka puʻuwai puʻuwai e hoʻokumu ana i ka puʻuwai abnormal (i kapa ʻia ʻo ablasi) hiki ke hana ʻia.
• Kākoʻo ʻia kahi defibrillator cardioverter implantable (ICD). He mea hūnā ia e ʻike i nā mea hoʻoweliweli ʻino, kuʻi wikiwiki. Kapa ʻia kēia kuʻi puʻuwai maʻamau he arrhythmia. Inā kū ia, hoʻouna koke ka ICD i kahi haʻalulu uila i ka puʻuwai e hoʻololi i ka mele i ka maʻamau. Kapa ʻia kēia defibrillation.

Pili ka hopena i ke ʻano o ka naʻau a me nā ʻōuli.

ʻAʻole hiki i ka tachycardia Ventricular ke kumu i nā ʻōuli i kekahi poʻe. Eia naʻe, hiki ke make. He kumu nui ia o ka make koke ʻana o ka naʻau.

E hele i ka lumi pilikia a kāhea paha i ka helu pilikia kūloko (e like me 911) inā loaʻa iā ʻoe kahi wikiwiki, kūleʻa ʻole ʻole, maʻule, a ʻeha hoʻi ka umauma. ʻO kēia mau mea a pau he hōʻailona paha o ka tachycardia ventricular.

I kekahi mau hihia, ʻaʻole hiki ke pale ʻia ka maʻi. I nā hihia ʻē aʻe, hiki ke pale ʻia e ka mālama ʻana i nā pilikia o ka puʻuwai a me ka hōʻalo ʻana i kekahi mau lāʻau.

ʻO ka tachycardia ākea; V tach; Tachycardia - ventricular

• Imibrable cardioverter defibrillator - hoʻokuʻu

• Imi i ka cardioverter-defibrillator
• Defibrillator puʻuwai hiki ʻole ke kanu ʻia

Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. ʻO 2017 AHA / ACC / HRS Alakaʻi no ka mālama ʻana i nā mea maʻi me nā arrhythmia ventricular a me ka pale ʻana i ka make o ka puʻuwai hikiwawe: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force e pili ana i nā kulekele hana lapaʻau a me ka Heart Rhythm Society [paʻi ʻia ka hoʻoponopono i paʻi ʻia. ʻO J Am Coll Cardiol. 2018; 72 (14): 1760]. ʻO J Am Coll Cardiol. 2018; 72 (14): 1677-1749. PMID: 29097294 pubmed.ncbi.nlm.nih.gov/29097294/.

Epstein EF, DiMarco JP, Ellenbogen KA, Estes NA 3rd, et al. 2012 ACCF / AHA / HRS i hoʻomohala i hoʻohui ʻia i loko o ka ACCF / AHA / HRS 2008 mau alakaʻi no ka hoʻomaʻamaʻa ʻana i nā manaʻo o nā ʻano like ʻole o ka puʻuwai puʻuwai: kahi hōʻike o ka American College of Cardiology Foundation / American Heart Association Task Force e pili ana i nā kulekele hana a me ka puʻuwai Heart. ʻAhahui. ʻO J Am Coll Cardiol. 2013; 661 (3): e6-75. PMID: 23265327 pubmed.ncbi.nlm.nih.gov/23265327/.

ʻO Garan H. Ventricular arrhythmia. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 59.

ʻO Olgin JE, ʻo Tomaselli GF, ʻo Zipe DP. ʻO Ventricular Arrhythmias. 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 39.