Mhepo yemagetsi inotarisa kutengesa kwemoyo uye inoita kuti zvivako zvakasiyana-siyana zvepurojekiti yemwoyo zvive nenzira yakanyatsogadziriswa. Mabasa aya akaoma uye akaoma-somuenzaniso, apo chiratidzo chemagetsi chemhepo chinofamba kubva kuAria kusvika kumhepo, mutsauko munguva yegumi zvechipiri zvinogona kuita kuti zvive nehutano hwekushaya mwoyo.
Ne physiologic system inoda ichi chiyero chechinhu chakajeka uye chakaoma, pane zvakafanira kuva nhamba ipi zvayo nzira iyo inogona kuvhiringidzika kana kusagadzikana. Saka hazvifaniri kutishamisa kuti chironga chemwoyo chinogona kuguma kubva pane zvakawanda zvinokonzera zvinokonzera.
Izvi zvinoreva, pakati pezvimwe zvinhu, kuti danho rakakosha mukuongorora nekurapa munhu ane chirwere chepfungwa chinokonzera kuziva, sezvakanyatsoita, chinokonzera chinokonzera mwoyo chinetso chinetso. Kubvisa kana kuderedza chikonzero ichocho kazhinji ndiyo nzira yakanakisisa yekurapa arhythmia.
Zvimwe zvinokonzera moyo wegyidhythmias zvinogona kuiswa muzvikamu zvakasiyana. Heino tsanangudzo pfupi yezvikamu zvakakura zvezvinetso zvinowanzokonzera mashythmias, zvakanyorwa (zvishoma nezvishoma) kubva kune dzakawanda kusvika zvisinganyanyozivikanwi.
Autonomic Kusabvumirana
Izwi rinotyisa remagetsi , kazhinji, rinotungamirira mabasa emumuviri atinenge tisingafungi nezvake, kufanana nekufema, kutuka, uye kushaya mwoyo.
Bradycardias (slow slow heart rhythms) uye tachycardias (fast heart rhythms) zvinowanzoitika semugumisiro wokunyanya kupfurikidza kwe (respectively) vagal tone , kana kuti mutsa une tsitsi. Kuvhiringidzika kwevagal, uye bradycardia, inogona kubva ((somuenzaniso), chiitiko chekurutsira, kuvhiringidzwa kwakanyanya, kana kuvhiringidza urinary.
Kunyanya kunzwira tsitsi (kunyanya adrenaline) kubva pakunetseka kwakanyanya kana kutyisa kamwe kamwe kunogona kukonzera tachycardia inonakidza.
Nenzira yekurapa arrhythmias nemhaka yekusagadzikana kwezvokwadi ndeyokubvisa chikonzero chekunyanyisa vagal kana tsiye nyoro. Aya magythmias anoenda apo kusagadzikana kwezvokuzvigadzirisa kwakagadziriswa.
Chirwere chemoyo
Chero chero rudzi rwechirwere chemwoyo runogona kukanganisa mafungiro emagetsi emwoyo uye hukonzera mwoyo wegrimhythmias. Iramhythmias iyo inokonzerwa nechirwere chepfungwa inogona kutarisa yose yemutambo we cardiac arrhythmias-kubva zvachose kushaya simba pamapurisa anoremekedzwa kusvika kune yakaipa kwazvo inonzi ventricular fibrillation .
Zvisinei, chirongwa chepfungwa chepfungwa ndicho chikonzero chinonyanya kukosha chekuvhiringidza kwechokwadi chaizvo. Matambudziko emwoyo anowanzokonzera hupenyu hwehupenyu hunotyisa matambudziko matambudziko ane chirwere chetachiona , chirwere chemwoyo (musimba wechipfuva), uye chirwere chemwoyo chinonzi valve .
Kutaura zvazviri, njodzi yekufa kamwe-kamwe inokwana zvakanyanya kune vanhu vane mwoyo yekurwadziwa kana mwoyo kusakundikana kuti chimwe chezvinangwa zvechiremba pavanenge vachirapa varwere vanofanira kunge vatora matanho anodiwa kuti vaderedze dambudziko iroro .
Zvinodhaka
Kunyanya muvanhu vanogona kunge vane chinangwa chekuita chimiro chechimiro (zvichiitika, nekuda kwechirwere chepfungwa chepfungwa kana kuti genetic issue), zvinodhaka zvakasiyana-siyana zvinogona kuva izvo zvinokonzera izvo zvinogadzirisa chirmiti.
Urongwa hwezvinodhaka zvinogona kukonzera arrhythmias zvakakura zvikuru.
Mhando dzemishonga inowanzobatanidzwa nemoyo wegymythmias dzinosanganisira:
- Digoxin .
- Antiarrythmic zvinodhaka , kunyanya quinidine, disopyramide, procainamide, sotalol, uye dofetilide.
- Cocaine.
- Doro , kunyanya mushure mekudhakwa.
- Antibiotics , kusanganisira erythromycin, azithromycin, clarithromycin, uye ciprofloxacin.
- Kwete-sedating antihistamine , yakadai sedfenadine uye astemizole.
- Psychotropic zvinodhaka, kunyanya haloperidol, thorazine, uye methadone.
Genetic Disorders
Kubvira muna 2000, vatsvakurudzi vakaona mazita emarudzi akasiyana-siyana akashandura mafungiro emagetsi anoshandiswa zvino anotsanangura maitiro akawanda akareruka ekutenda mwoyo.
Heino urongwa hwemaparidhemias anovhiringidzika mukati mehupenyu iye zvino anozivikanwa kuti ane chimiro.
Sezvo kutsvakurudza kuchifambira mberi, ndeyechokwadi kuti mamwe arrhythmias achawedzerwa kune urongwa urwu:
- Long QT syndrome .
- Brugada syndrome .
- Mamwe maitiro e mwoyo block uye bundle branch block .
- Kurwara sinus syndrome kune vechidiki.
- Mimwe mhando dzehutachiona hwemagetsi .
- Mimwe mhando dze tricycardia ye ventricular .
Kukwegura
Pamusana pezvikonzero zvisingave pachena, kukwegura kunobatanidza nehuwandu hwekuparara kwe fibrosis (kupora) mukati memutsipa wemwoyo unogona kutungamirira kune chirwere sinus syndrome, moyo block kana chirwere chetrial fibrillation. Chirwere chemwoyo chinokwegura ndicho chikonzero chikuru kune vakwegura kuti vatsvake pacemaker .
Electrolyte uye Metabolic Disorders
Kusiyana kwakasiyana-siyana kwe-serum electrolytes, uye ye acidity yeropa, kunogona kukonzera chironga chemwoyo. Matambudziko aya anowanzoonekwa kuvanhu vane zvirwere zvepfungwa, chirwere cheshuga, vari kutora mamwe mishonga (kunyanya diuretics ), yakasvibiswa, kana ari kurwara.
I electrolyte uye zvinetso zvemagetsi zvinonyanya kukonzera arrhythmias dzinosanganisira:
- Hypokalemia (low potassium levels).
- Hyperkalemia (high potassium levels).
- Hypomagnesemia (low magnesium levels).
- Hypocalcemia (low calcium levels).
- Acidosis (neropa pia acidic).
- Alkalosis (neropa pia alkaline).
Anesthesia
Cardiac arrhythmias yakajairika kune vanhu vari kuwirirana anesthesia. Nepo huzhinji hwemagirthmiyasi huine hutano uye huri nyore nyore, humwe hunogona kuve hune ngozi uye hwakaoma kurapa.
Anesthesia inobatanidza nemwoyo wegadzirisiti pamusana pezvikonzero zvakasiyana, kusanganisira:
- Anesthetic agents ivo pachavo.
- Electrolyte uye zvinetso zvemagetsi zvinogona kuitika munguva yeanesthesia.
- Kusiyana kwepfungwa yeropa inogona kuitika panguva yeanesthesia.
- Kusiyanisa kwezvivimbiso panguva yeanesthesia.
- Kuchinja kweropa mukati meanesesthesia.
- Utano hwemwoyo panguva yekuvhiyiwa, kunyanya kuvhiyiwa kwemoyo.
Cardiac Trauma
Kushungurudzika kwemapfupa kubva kune chero chigumbuso chechipfuva, kana sechikonzero chekuvhiya kwepfungwa, kunogona kubudisa arrhythmias inenge chero ipi zvayo.
Idiopathic
"Idiopathic" ndiyo izwi rezvokurapa rokuti, "Hatizivi kuti chii chakakonzera." Chirwere chepfungwa chinonzi idiopathic kana, pashure pekutsvakurudza zvakadzama, chinokonzera chikonzero chinoramba chisingazivikanwi.
Mumakore achangobva kupfuura, akawanda arrhythmias ayo aisarudzwa kuti idiopathic iye zvino anozivikanwa kuva mazita ekuberekwa.
Risk Factors
Nzira yakanakisisa yekuderedza dambudziko rako rekuvandudza chironga chemwoyo ndekuita zvose zvaunogona kuti urege kurwara nemwoyo. Izvi ndezvechikonzero chakareruka: huwandu hwemaridymiasi ehupenyu hune ngozi kana hunovhiringidza hupenyu hwomunhu hunobva kune chirwere chemwoyo chinogona kudzivirirwa zvikuru.
Kuderedza dambudziko rako rechirwere chepfungwa kunogona kuva dambudziko kune vanhu vakawanda, asi zvakakosha kuedza-kwete kungoita kuti padzivirire dambudziko re arrhythmias asi (kunyanya kunyanya kukosha) kuderedza dambudziko rehutano hwemoyo hunokonzera arrhythmias mukutanga nzvimbo.
Maitiro makuru ekurarama maitiro anokwanisa kuderedza ngozi yako yepfungwa yemwoyo inosanganisira:
- Kwete kusvuta, kana kumira kana iwe uchidaro .
- Kutarisira cholesterol yakakwirira uye / kana triglycerides .
- Kuwana zvakawanda zvekurovedza muviri .
- Kudzivisa kana kubata chirwere chepfungwa .
- Kutarisa chirwere cheshuga .
- Kudzivisa kukwegura, kana kuora muviri.
Kunyange zvazvo akawanda uye akawanda arhythmias iye zvino anozivikanwa kuti ane mazita emagetsi, genetics yemaridythmias inowanzova yakaoma kwazvo. Kuongorora zvirwere zvepachiviri pamagetsi hazviwanzokurudzirwa nokuti kushandura migumisiro yekuongororwa mazano anobatsira kazhinji hazvibviri.
Zvisinei, kune vemhuri dzepedyo dzevanhu vane kwenguva yakareba yeHT syndrome, brugada syndrome, kana arrhythmias inosangana ne hypertrophic cardiomyopathy , maitiro ekuongorora maitiro angave anokosha pakusarudza kana mushonga weprophylactic unofanirwa kuonekwa.
> Sources:
> Fogoros RN, Mandrola JM. Electrophysiologic Kuedza Mukufungidzira: Kuongorora nekurapa kweCardiac Arrhythmias. Muna: Fogoros 'Electrophysiolgic Testing. Wiley Blackwell: 2017.
> Fu DG, Cardiac Arrhythmia: Kuziva, zviratidzo uye mishonga. Cell Biochem Biophys. 2015 Nov; 73 (2): 291-296.
> Wilde AAM, Bezzina CR. Genetics of Cardiac Arrhythmias. Moyo. 2005 Oct; 91 (10): 1352-1358.