Isifo sesinus

Ngokwesiqhelo, ukubetha kwentliziyo kuqala kwindawo yamagumbi aphezulu entliziyo (atria). Le ndawo yintliziyo yentliziyo. Ibizwa ngokuba yi-sinoatrial node, sinus node okanye SA node. Indima yayo kukugcina ukubetha kwentliziyo kuzinzile kwaye kuhleli rhoqo.

Isifo sesinus esigulayo liqela leengxaki zesingqisho sentliziyo ngenxa yeengxaki zesinus node, njenge:

• Inqanaba lokubetha kwentliziyo licotha kakhulu, elibizwa ngokuba yi-sinus bradycardia
• Ukubetha kwentliziyo kuyanqumama okanye kuyeke, okubizwa ngokuba yisinus kuyanqumama okanye ukubanjwa kwesono
• Iziqendu zenqanaba lentliziyo elikhawulezayo
• Isingqi sentliziyo esicothayo esitshintsha nesingqi sentliziyo esikhawulezayo, esibizwa ngokuba yi-bradycardia-tachycardia okanye "tachy-brady syndrome"

Isifo sesinus esigula kakhulu sivela kubantu abadala kuneminyaka yobudala engama-50. Oku kusoloko kusenzeka ngenxa yokonakala okunjengokubala kweendlela zombane kwinyama yezihlunu zentliziyo.

Kubantwana, utyando lwentliziyo kumagumbi aphezulu ngumba oqhelekileyo wesifo se-sinus syndrome.

Isifo sentliziyo esisifo sentliziyo, uxinzelelo lwegazi kunye nezifo zevalvu ze-aortic kunye ne-mitral zinokubakho nesifo sesinus. Nangona kunjalo, ezi zifo azinakwenza nto nesifo.

Isifo sesinus esigulayo asiqhelekanga, kodwa kunqabile. Esona sizathu sixhaphakileyo sabantu kufuneka ukuba kufakelwe pacemaker eyenziweyo. I-Sinus bradycardia yenzeka rhoqo ngakumbi kunezinye iimeko zeli meko.

I-Tachycardias (izingqisho zentliziyo ekhawulezayo) eziqala kumagumbi aphezulu entliziyo zinokuba yinxalenye yesifo. Oku kubandakanya i-atrial fibrillation, atrial flutter, atrial tachycardia. Ixesha lokukhawuleza kwentliziyo lihlala lilandelwa kukucotha kwenhliziyo. Xa kukho amaxesha okubini okuhamba kancinci kunye nokukhawuleza kwentliziyo (isingqisho) imeko ihlala ibizwa ngokuba yi-tachy-brady syndrome.

Amanye amayeza anokwenza isingqisho sentliziyo esingaqhelekanga sibe nzima ngakumbi, ngakumbi xa idosi ziphezulu. Oku kubandakanya i-digitalis, i-calcium channel blockers, i-beta-blockers, kunye ne-antiarrhythmics.

Uninzi lwexesha, akukho zimpawu.

Iimpawu ezenzekayo zinokulinganisa ezinye iingxaki.

Iimpawu zingabandakanya:

• Intlungu yesifuba okanye i-angina
• Ukudideka okanye olunye utshintsho kubume bengqondo
• Ukuphela amandla okanye ukusondela kufutshane
• Ukudinwa
• Utywala okanye intloko
• Imvakalelo yokuziva ukubetha kwentliziyo (ukubetha kwentliziyo)
• Ukuphefumla okufutshane, kunokwenzeka kuphela ngokwenza imisebenzi yomzimba njengokuhamba

Inqanaba lentliziyo linokucotha nangaliphi na ixesha. Uxinzelelo lwegazi lunokuba yinto eqhelekileyo okanye ephantsi.

Ukugula kwesinus syndrome kunokubangela ukuba iimpawu zokungaphumeleli kwentliziyo ziqale okanye zibe mandundu. Isifo sesinus syndrome sifunyanwa xa iimpawu zivela kuphela ngexesha leziqendu ze-arrhythmia. Nangona kunjalo, ikhonkco kuhlala kunzima ukubonakalisa.

I-ECG inokubonisa izingqisho zentliziyo engaqhelekanga ezinxulumene nesi sifo.

I-Holter okanye i-term rhythm monitors zixhobo ezifanelekileyo zokufumanisa isifo se-sinus syndrome. Banokuthatha kancinci kakhulu ukubetha kwentliziyo kunye nokuma kancinci, kunye neziqendu ze-tachycardias ze-atrial. Iindidi zokubek'iliso zibandakanya ukubekwa kweliso kumnyhadala, irekhoda, kunye nefowuni yokuhambisa umnxeba.

Isifundo se-intracardiac electrophysiology (EPS) luvavanyo oluthile kwesi sifo. Nangona kunjalo, ayisoloko ifuneka kwaye ayinakuqinisekisa ukuxilongwa.

Ngamanye amaxesha, ukubetha kwentliziyo yomntu kuyajongwa xa ehamba okanye esenza imithambo ukubona ukuba inyusa ngokwaneleyo na.

Awunakufuna unyango ukuba awunazo iimpawu. Umboneleli wakho wezempilo uya kuwajonga kwakhona amayeza owathathayo ukuqinisekisa ukuba ayenzi mandundu imeko yakho. Sukuyeka ukuthatha nawaphi na amayeza akho ngaphandle kokuba umboneleli wakho ukuxelele ukuba wenze njalo.

Unokufuna i-pacemaker efakwe ngokusisigxina ukuba iimpawu zakho zinxulumene ne-bradycardia (ukubetha kwentliziyo kancinci).

Inqanaba lentliziyo elikhawulezayo (i-tachycardia) linokunyangwa ngamayeza. Ngamanye amaxesha, inkqubo ebizwa ngokuba yi-radiofrequency ablation isetyenziselwa ukunyanga i-tachycardia.

Ngamanye amaxesha, amayeza asetyenziselwa ukulawula amaxesha okubetha kwentliziyo akhawulezayo adityaniswa nokusetyenziswa kwesincedisi-ntliziyo, esigcina ixesha lokuhamba kancinci kwentliziyo.

Isifo sesifo sihlala siqhubeka. Oku kuthetha ukuba iya isiba mandundu ngokuhamba kwexesha kwiimeko ezininzi.

Umbono wexesha elide ubalasele kubantu abane-pacemaker esisigxina.

Iingxaki zinokubandakanya:

• UAngina
• Ukwehla kwamandla omthambo
• Ukuphelelwa amandla (syncope)
• Ukuwa okanye ukwenzakala okubangelwa kukufa isiqaqa
• Ukumelwa yintliziyo
• Impompo yentliziyo engalunganga

Fowunela umnikezeli wakho ukuba unayo:

• Ubumhlophe
• Ukufa isiqaqa
• Iipalpitations
• Ezinye iimpawu zale meko

Ukugcina intliziyo yakho isempilweni ngokutya ukutya okunezondlo kunye nokuzilolonga kunokuthintela iintlobo ezininzi zesifo sentliziyo.

Kuya kufuneka uphephe ezinye iintlobo zamayeza. Amaxesha amaninzi, imeko ayinakuthinteleka.

Isifo seBradycardia-tachycardia; Ukungasebenzi kwesinus node; Ukubetha kwentliziyo kancinci - isifo sokugula; Isifo seTachy-brady; Sinus ikhefu - sinus egulayo; Sinus ukubanjwa - sinus ogulayo

• Intliziyo pacemaker - ukubhobhoza

• Umenzi wePacemaker

I-Olgin JE, iZipes DP. I-Bradyarrhythmias kunye nebhloko ye-atrioventricular. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 40.

I-Zimetbaum P. Supraventricular arrhythmias yentliziyo. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 58.