He aha ka nonvalvular Atrial Fibrillation?

Anter

• Nā ʻōuli o ka nonibrvular atrial fibrillation
• Kumu o ka nonvalvular atrial fibrillation
• Ke hōʻoia nei i ka fibrillation atrial nonvalvular
• Nā mālama no ka fibrillation atrial nonvalvular
• Nā Lapaʻau
• Nā Hanana
• ʻO Outlook no ka fibrillation atrial nonvalvular
• Q&A: Rivaroxaban vs. warfarin
• Q:
• A:

Hōʻike Overview

Aibrial fibrillation (AFib) ʻo ia ka huaʻōlelo olakino no kahi ritme puʻuwai kūlike ʻole. Nui nā kumu kūpono o AFib. Hoʻopili kēia i nā maʻi puʻuwai valvular, kahi i kūleʻa ʻole ai i nā kiwikā o ka puʻuwai o ke kanaka e alakaʻi ai i nā puʻuwai puʻuwai maʻamau.

Eia naʻe, nui nā poʻe me AFib ʻaʻole i loaʻa i ka maʻi puʻuwai valvular. Inā loaʻa ʻole iā ʻoe ʻo AFib e ka maʻi puʻuwai valvular, ua kapa ʻia ia he AFV ʻole nonvalvular.

ʻAʻole kahi wehewehe maʻamau o ka nonibvular AFib i kēia manawa. Ke hoʻoholo nei nā kauka i nā kumu o ka AFib e manaʻo ai he valvular a ʻo wai e manaʻo ʻia he nonvalvular.

ua hōʻike ʻia aia paha kekahi mau ʻokoʻa i ka lapaʻau ma waena o nā ʻano laulā ʻelua. Ke nānā nei nā mea noiʻi i kahi o nā hana e hana maikaʻi ai no ka AFval nonvalvular a valvular paha.

Nā ʻōuli o ka nonibrvular atrial fibrillation

Hiki iā ʻoe ke loaʻa iā AFib a loaʻa ʻole nā ​​ʻōuli. Inā ʻike ʻoe i nā ʻōuli o AFib, pili pū paha lākou:

• hōʻoluʻolu umauma
• he lele i loko o kou umauma
• palpitations puʻuwai
• ka uila a i ʻole ka maʻule ʻana
• pokole o ka hanu
• luhi luhi ʻole

Kumu o ka nonvalvular atrial fibrillation

Hiki i nā kumu nonvalvular o AFib ke hoʻopili:

• ka hōʻike ʻana i nā mea hoʻonāukiuki i ka puʻuwai, e like me ka wai ʻona, caffeine, a i ʻole paka
• ʻāpana moe
• kahe koko kiʻekiʻe
• pilikia pūpū
• hyperthyroidism, a i ʻole he thyroid gland keu
• kaumaha ma muli o ka maʻi nui, e like me ka maʻi ʻaʻai

ʻO nā kumu valvular o AFib me ka loaʻa ʻana o kahi valves puʻuwai prosthetic a i ʻole kahi kūlana i ʻike ʻia ʻo stenosis mitral valve. ʻAʻole i ʻae iki nā kauka inā pono e hoʻopili ʻia kekahi ʻano o nā maʻi puʻuwai puʻuwai i ka wehewehe ʻana o ka valvular AFib.

Ke hōʻoia nei i ka fibrillation atrial nonvalvular

Inā ʻaʻohe ou mau ʻōuli o AFib, ʻike paha kāu kauka i ka puʻuwai puʻuwai kūpono ʻole ke hoʻāʻo ʻia ʻoe no kahi ʻano pili ʻole. E hana lākou i kahi hoʻokolohua kino a nīnau iā ʻoe e pili ana i kāu mōʻaukala olakino a me kou mōʻaukala olakino ʻohana. E noi paha lākou iā ʻoe e hana hou i ka hoʻāʻo.

ʻO nā hoʻāʻo no AFib:

• uila uila
• echocardiogram
• hoʻāʻo koʻikoʻi
• umauma X-ray
• hoʻāʻo koko

Nā mālama no ka fibrillation atrial nonvalvular

Hiki i kāu kauka ke koi aku i ka lāʻau a i ʻole kekahi mau kaʻina hana e mālama ai i ka AFib nonvalvular.

Nā Lapaʻau

Inā loaʻa iā ʻoe kekahi ʻano AFib, hiki i kāu kauka ke kuhikuhi i kahi lāʻau anticoagulant. ʻO kēia no ka mea hiki i ka AFib ke hoʻonāukiuki i nā keʻena o kou puʻuwai, e pale ana i ka holo ʻana o ke koko ma waena o ka wikiwiki e like me ka maʻamau.

Ke noho mālie ke koko no ka lōʻihi loa, hiki iā ia ke hoʻomaka i ke kō ʻana. Inā kū kahi ʻōpala i loko o kou puʻuwai, hiki iā ia ke kumu i kahi blockage e alakaʻi ai i ka puʻuwai puʻuwai a i ʻole hahau. Hiki i nā Anticoagulants ke kōkua i ka hōʻemi ʻana o kou koko.

Loaʻa nā ʻano anticoagulants. Hiki i kēia mau anticoagulants ke hana i nā ʻano like ʻole e hōʻemi i ka likelike o kou koko.

Kauoha paha nā kauka i nā lāʻau anticoagulant i ʻike ʻia ma ke ʻano he lāʻau antagonists K no ka poʻe me ka AFib valvular. Paʻa ka poʻe antagonists ʻo Wikamina K i ka hiki i kou kino ke hoʻohana i ka lāʻau K. No ka mea pono i kou kino i ka wikamina K e hana i kahi ʻōpala, ke ālai ia hiki ke hōʻemi i kou koko. ʻO Warfarin (Coumadin) kahi ʻano wikamina K antagonist.

Eia nō naʻe, ʻo ka lawe ʻana i kahi antagonist vitamin K pono i nā kipa kauka mau e nānā i ke ʻano o ka hana a ka anticoagulant. Pono nō ʻoe e mālama i nā ʻano papaʻai pono ʻole no laila ʻaʻole ʻoe e lawe i ka lāʻau K nui loa mai kāu papaʻai.

ʻO nā lāʻau hou, i koi ʻia i kēia manawa ma luna o warfarin, hana i nā ʻano like ʻole e hōʻemi ai i ke kāpili ʻana o ke koko i koi ʻole i kēia nānā. Hana paha kēia iā lākou e ʻoi aku i ka poʻe antagonists ʻo ka wikamina K no ka poʻe me ka AFib nonvalvular.

Kapa ʻia kēia mau lāʻau hou he non-vitamin K oral anticoagulants (NOACs). Hana lākou ma ka pāpā ʻana i ka thrombin, kahi mea e pono ai i kou koko e ʻūlū. ʻO nā laʻana o NOACs:

• dabigatran (Pradaxa)
• rivaroxaban (Xarelto)
• apixaban (Eliquis)

Ma waho aʻe o nā anticoagulants, hiki i ke kauka ke kuhikuhi i nā lāʻau e kōkua i ka mālama ʻana i kou puʻuwai. Pākuʻi ʻia kēia mau mea:

• dofetilide (Tikosyn)
• amiodarone (Cordarone)
• sotalol (Betapace)

Nā Hanana

Hiki paha i kāu kauka ke koi aku i nā kaʻina hana i hiki ke kōkua i ka "hoʻonohonoho" ʻana i kou puʻuwai no laila e kuʻi ia i ke mele. ʻO kēia mau kaʻina hana:

• Cardioversion. I ka cardioversion, hāʻawi ʻia i kēia manawa kahi uila i kou puʻuwai e hoʻāʻo e hoʻihoʻi i ka mele i ka sinus sinus maʻamau, kahi maʻamau, a me ke kuʻi puʻuwai.
• Hoʻomaha. Hoʻopili kēia i ka scarring a hōʻino ʻana paha i nā ʻāpana o kou puʻuwai e hoʻouna nei i nā hōʻailona uila uila ʻole i mea e kuʻi hou ai kou puʻuwai i ke mele.

ʻO Outlook no ka fibrillation atrial nonvalvular

ʻOi aku ka makaʻu o ka poʻe me ka AFib valvular no ke kahe koko. Eia nō naʻe, ʻoi aku ka makaʻu o nā kānaka āpau me ka AFib no nā kahe koko ma mua o ka poʻe i loaʻa ʻole ka AFib.

Inā manaʻo ʻoe hiki iā ʻoe ke loaʻa iā AFib, e kamaʻilio me kāu kauka. Hiki iā lākou ke hoʻohana maʻamau i kahi electrocardiogram e loiloi ai i kou puʻuwai puʻuwai. Mai laila, hiki iā lākou ke hana e hoʻoholo inā he valvular a nonvalvular paha kāu AFib a hoʻokumu i kahi hoʻolālā lapaʻau e ʻoi aku ka maikaʻi iā ʻoe.

Q&A: Rivaroxaban vs. warfarin

Q:

Loaʻa wau iā AFib nonvalvular. ʻO wai ka anticoagulant ʻoi aku ka maikaʻi, rivaroxaban a i ʻole warfarin?

A:

ʻOkoʻa ka hana a Warfarin a me rivaroxaban, a loaʻa i kēlā me kēia mea nā pros a me nā cons. ʻO nā mea maikaʻi o nā lāʻau e like me rivaroxaban ʻaʻole pono ʻoe e nānā i kāu kōkō koko a i ʻole kaohi i kāu papaʻai, ʻoi aku ka liʻiliʻi o kā lākou launa lāʻau ʻana, a hele wikiwiki lākou e hana. Ua loaʻa ʻo Rivaroxaban e hana a ʻo warfarin hoʻi no ka pale ʻana i ka hahau a me ke kāpili ʻana o ke koko. ʻO ka lalo i rivaroxaban ka mea hiki ke kumu i ke kahe o ka gastrointestinal ma mua o warfarin. Ua hōʻike ʻia kahi loiloi o nā hoʻokolohua lāʻau hou e hōʻike ana i ka NOAC e hoʻemi ana i nā make āpau āpau ma kahi o 10 pakeneka.

ʻOi aku ka nui o ka poʻe me ka AFib valvular i ka loaʻa o ke koko ma mua o ka poʻe i loaʻa i ka maʻi puʻuwai nonvalvular.