Postural orthostatic tachycardia syndrome (POTS) inomirira umo mwoyo wekuwedzera unowedzera kusvika pakukwirira kwepamusoro kana munhu akasimuka. Vanhu vane POTS vanowanzoona zviratidzo kana vakarurama. Zvose zvinoratidza zviratidzo ndezvemusoro uye mapapita , izvo zvingasiyana zvakasiyana kubva kune zvinyoro zvishoma kuderedza.
Mukuwedzera kune kukurumidza kwepfungwa yemwoyo, dzimwe nguva vanogonawo kuva nehope muropa ravo rega pavanomira. Kusvika ku40% yevanhu vanoonekwa kuti vane POTS pakupedzisira vachave nehana imwe chiitiko che syncope (kubuda).
POTS chirwere chevechidiki. Vakawanda vane chirwere ichi chiri pakati pemakore gumi nemaviri nemakumi mana nemashanu, uye kazhinji ivo vane utano hwakanaka. Vakadzi vanowanzoita mana kana mashanu kuti vape POTS kupfuura varume. Nzvimbo yePOTS inoratidzika kuvapo mune dzimwe mhuri.
Chii chinokonzera POTS?
Nyanzvi dzinopesana nezvezvikonzero zvePOTS. Vamwe vakazvireva kuti kududzirwa (zvakadai sokunge mushure mokuvata) kana kupera simba, asi izvi zvinenge zvenguva pfupi uye zvinopera zvishoma nokukurumidza, nepo POTS inowanzoenderera mberi.
Zvichida, POTS inzira ye dysautonomia , mhuri yemamiriro ezvinhu anokonzerwa nekusawirirana mukati mehutachiona hwehutongi hwechiremera - chikamu chehurongwa hwemitsipa runotarisira "mabasa asingazivi" emumuviri, akadai sokudya, kufema uye moyo wehutano.
Apo urongwa hwehutongi hwehutongi hunenge husina kukwana, huwandu huzhinji hwezviratidzo hunogona kuguma, hune hutano hwemwoyo, kupemha, chirwere chekudya , maronda uye ganda.
Pane zvirwere zvakasiyana-siyana zvinofungidzirwa kuti zvinokonzerwa neDysautonomia, kusanganisira fibromyalgia , chisingagumi kuneta, chirwere chinosuruvarisa chewell syndrome uye zvisina kukodzera sinus tachycardia .
Zvisinei, vanhu vane dysautonomia vanowanzoona zviratidzo zvinowanikwa pakati peva syndromes dzakasiyana-siyana.
Chinonyanya kukonzera POTS - kana, nokuda kwechinhu ichocho, chero che dysautonomias - hachizivikanwi. Zvisinei, sezvinowanzoenderana nedysautonomias, kutanga kwePOTS kunowanzoerekana kwasvika, uye kazhinji kunotevera chirwere chinotapukira chinokonzera (zvakadai sechiitiko chakaipa chefivha); chiitiko chekutambudzika (zvakadai sekavhuvhuta pfupa, kuberekwa kana kuvhiyiwa); kusvibiswa kune zvinodhaka (zvakadai seAgent Orange); kana kushushikana mupfungwa (zvakadai sekuneta kuneta kana kuti kunetseka kunetseka mupfungwa).
Zvidzidzo muvanhu vane POTS zvinoratidza kuti ivowo vangave vakashandura manzwiro emagetsi emabasa ayo anonyanya kukanganisa miganhu yakaderera, uye inogona kunge ine ropa risingagumi pasi pemazuva ose.
Zviratidzo nePOTS
Vanhu vane POTS vanogona kuva nezviratidzo zvepakati pose pavanenge vakarurama; zviratidzo zvinowanzosiyana zvakanyanya mukunyanya kubva kumunhu kumunhu. Mune vakawanda vane POTS vane zvirwere, zviratidzo zvinyoro. Mune vamwe, zviratidzo zvinenge zvisingaiti.
Zviratidzo zvinowanzoitika ndezvekuputika, kuchena kwepfungwa, chirungu, zviratidzo zvakashata, utera, kudedera uye manzwiro ekuzvidya mwoyo. Pashoma kakawanda, syncope inogona kuitika.
POTS dzimwe nguva inoputirana nedysautonomia syndromes , saka vanhu vane POTS vanogonawo kuwana zviratidzo zvakadai sekuputika mumimba, kubvongodza, kurara, kuvhara muviri, aches uye kurwadziwa uye kuneta zvakanyanya.
Kubudirira kubudirira kwekutsvaga kwemoyo kunowanikwa kana ukamira hazvivimbisi kuti aya "mamwe" zviratidzo (kana chero) achaendawo.
POTS Inozivikanwa sei?
Vanachiremba vanogona kukwanisa kuongororwa POTS nekutora nhoroondo yezvokurapa uye kunyatsoongorora. Chinokosha chekuongororwa ndiko kuratidza kuti kuwedzera kwemoyo kunowedzera zvisina kukodzera mumamiriro ekururama. Izvi zvinoreva kuti kana iwe uine zviratidzo zvinoratidzira POTS, chiremba wako anofanira kutora ropa rako rinenge kaviri - kamwechete paunenge urere pasi uye kamwe paunenge wakamira.
Kazhinji, kana munhu akasimuka, mwoyo wepamusoro unowedzera ne 10 kurova pamaminiti kana pasi.
NePOTS, kuwedzera kunowanzove kwakanyanya kukura - kazhinji 30 kurohwa paminiti kana kupfuura. Dzimwe nguva kuwedzerwa kusinganzwisisiki kwehutano hwemoyo kunongowanikwa mushure mokunge murwere amira kwemaminitsi mashomanana.
Nokuda kwechikonzero ichi, kana POTS ichifungidzirwa kuti kuongorora kwemafura kunogona kubatsira pakuita kuti kuongororwa.
Kana kuwedzerwa kusinganzwisisiki kwepfungwa yemuviri paunenge wakamira unowanikwa, chiremba wako anofanirwa kutarisa zvimwe zvinokonzera zvinokonzera, zvakadai sekudonha mvura, kudonhedzera kubva pakugara kwenguva refu, chirwere cheshuga chirwere cheropa kana mishonga yakasiyana-siyana (kunyanya diuretics kana ropa remishonga yemishonga ). Kana pasina chimwe chezvikonzero izvi zviripo, ipapo kuongororwa kwePOTS kunogona kuitwa neine chivimbo.
Ichokwadi kuti POTS inobereka chinangwa ichi, kuwanikwazve (ndiko kuti, kuwedzerwa kwepfungwa yemwoyo pakamira), kunopa vanhu vane POTS zvakasarudzwa pane vanhu vane mamwe maitiro eDysautonomia, umo maitiro avo anowanzowedzera zvishomanana (kana chero) chinangwa chinowanikwa. Vanhu vakawanda varombo vane dysautonomia vanoudzwa vanopfuura chiremba mumwe chete kuti vanongova "nehanya". Kuti vanachiremba varasikirwa nehutachiona zvachose havafaniri kuva vashoma kune vanhu vane POTS.
POTS Inotorwa Sei?
Sezvakaitwa nedysautonomias yose, kurapa POTS kunowanzova nyaya yekuedza-uye-kukanganisa, kuedza nzira dzakasiyana-siyana dzokurapa kusvikira zviratidzo zvichisvikwa pasi pekutonga kwakanaka - kazhinji nzira inogona kutora mavhiki kana mwedzi. Zvisinei, chero bedzi chiremba uye murwere varamba vachiramba varipo, zviratidzo zvinogona kudzorwa munzvimbo zhinji yevanhu vane POTS.
Kune maitiro matatu maitiro ekurapa - kuwedzerwa ropa, kushandisa maitiro, uye zvinodhaka.
Ropa redu rinokwanisa kugadziriswa nokukurudzira kudya kwemanyowa, kupedza yakawanda yemunyu, uye / kana kutora fludrocortisone, mishonga inorayirirwa iyo inoderedza kukwanisa kwetsvo kuisa sodium. Nemhaka yekuti usiku hunoita kuti mvura isanyanya kuitika, zvinokosha zvikuru kunyanya kunwa mvura mvura yekutanga-mangwanani asati abva pamubhedha, kana zvichibvira.
Uchapupu hunoratidza iye zvino kuti kwenguva yakareba aerobic kurovedza muviri inogona kuvandudza zvikuru POTS. Nemhaka yokuti inogona kuva yakaoma zvikuru kune avo vane POTS kuita basa rinoda kuti vave vakarurama, chirongwa chekuita zvepurogiramu chinotungamirirwa pasi chinogona kudiwa. Kakawanda, mapurogiramu aya ekutanga anotanga nekushambira kana kushandisa michina yekugadzira, iyo isingadyi kumira kwakarurama. Kazhinji, mushure memwedzi kana maviri, munhu ane POTS anokwanisa kushandura kuenda, kumhanya kana kuti mabhasikoro. Kana uine POTS, iwe unoda kuramba uchiita chirongwa chako zvekuita nekusingaperi kuitira kuti zvirwere zvako zvisadzoke.
Zvinodhaka izvo zvakashandiswa pamwe nemamwe kubudirira kubata POTS zvinosanganisira midodrine uye beta blockers . Mimwe mitsara inoratidza kuti pyridostigmine (Mestinon) inogonawo kubatsira. Kusiyana nedzimwe maitiro eDysautonomia, serotonin reuptake inhibitors (SSRIs) inosarudzwa haina kuonekwa kuva yerimwe ruzivo muPOTS.
Ivabradine (mushonga unoshandiswa kune vanhu vane sinus tachycardia isina kukodzera), wakashandiswawo zvakajeka mune vamwe vanhu vane POTS, uye zvidzidzo zvepamutemo zviri kuedza kuongorora mushonga wechinangwa ichi.
Vanachiremba vakawanda vanobata POTS vanoedza nzira dzose nhatu kubva pari. Mishonga inotanga kuvandudza kutinhira kwemvura, chirongwa chekuvhiya chinorayirwa, uye remishonga inodhaka (kazhinji ne midodrine) yatanga. Kunyanya kana chirongwa chekudzidzira kwenguva refu chingasimbiswa, chirwere chinodhaka chinowanzogadziriswa pakupedzisira.
Shoko Rinobva
POTS mamiriro ezvinhu anogona kunge akavhiringidza uye achishungurudza avo vechidiki vaduku, vangave vane utano hwakanaka vanotambura nazvo. Nhau dzakanaka ndeyokuti, kana chirwere ichi chikaitwa, munhu ane POTS anofanira kutarisira kuzadzikisa kugutsikana kwezviratidzo zvavo, chero bedzi ivo navanachiremba vavo vasinganeti pavanowana kubatanidzwa kwakarurama kwerapa inoshanda kwavari .
> Sources:
> Arnold AC, Okamoto LE, Diedrich A, et al. Low-Dose Propranolol uye Kuedza Kudzidzira Kuita mu Postural Tachycardia Syndrome: Randomized Yokudzidza. Neurology 2013; 80: 1927.
> Freeman R, Wieling W, Axelrod FB, et al. Kubvumirana Nhoroondo pamusoro peDonstatic Hypotension, Neurally Mediated Syncope uye Postural Tachycardia Syndrome. Auton Neurosci 2011; 161: 46.
> Kimpinski K, Figueroa JJ, Singer W, et al. Anotarisira, 1-Kuongorora-Kudzidza kwe Postural Tachycardia Syndrome. Mayo Clin Proc 2012; 87: 746.
> Thieben MJ, Sandroni P, Sletten DM, et al. Postural Orthostatic Tachycardia Syndrome: iyo Mayo Clinic Experience. Mayo Clin Proc 2007; 82: 308.