Beats - oku ... ukuphazamiseka intliziyo isingqisho - izinto. Iimpawu yesifo sentliziyo

Beats - oku kuphazamiseka eliqhelekileyo, ingakumbi xa izigulane abalupheleyo. Loo uburhulumente sikhatshwa ukuphazamiseka eziqhelekileyo intliziyo rhythm. Namhlanje, abantu abaninzi banomdla imiba yintoni na unobangela wale ngxaki, ukuba yingozi empilweni, kunokuba.

Beats - ntoni na?

Namhlanje, ingxaki efanayo abajongene iikliniki ezininzi izigulane. Ngoko ke yintoni beats? Esi sifo, nto leyo ehambisana kunye neengxaki ezithile kwisingqi kwentliziyo. Izifo ezifana waphawula ucutheko engaqhelekanga (systole), okanye yonke myocardium, okanye iinxalenye zayo ezahlukeneyo (umz, imithambo, lo ventricles).

Beats - udidi okanye isoyikiso empilweni?

Kakade ke, namhlanje, abantu abaninzi ujamelene nengxaki efanayo. Ngoko yingozi njani kuba sigulo? Enyanisweni, ukuncitshiswa engaqhelekanga lunokwenzeka kwaye, enyanisweni, zisenokuvela nanini na ubudala. Umzekelo, abantu abaselula bedla ngokuyaphula ezikhala imvakalelo yabetha akomelela, yaphakama intliziyo, oku xa ibetha. Ngaphezu koko, Ngokwezibalo, malunga nama-80% abantu abadala ngaphezu kweminyaka engamashumi amahlanu amaxesha ngamaxesha ubunzima ukusuka ngamaxesha umothuko wamva "nezingacwangciselwanga".

Yintoni na ke ukwenzeka ngenxa systole? Kwezinye ukuphazamiseka zentliziyo kunye neempahla olujikeleza itshintswa: kuyo wabumba ezitshangubeni ethunjini ekuthiwa-, iindawo chumayela. Amaninzi, isifo onjalo libonakala find the ventricles, imithambo, esiludumbo atrioventricular. Kuyinto le nakujoliso olutsha ethunjini ukujikelezisa la engabangela zisaphila indlela kwisigaba sayo kuthanjiswa (diastole). Kubonakala ngathi ibetha. Oku, ngengozi, kunokuba yingozi kakhulu.

Kakade ke, kuvela iminqweno akukho ingxaki enkulu kwimpilo yabantu. Kunjalo, balumkisa lobukho ingxaki, iingcali bacebisa izigulane ezinjalo ukuze sinikele ingqalelo ngakumbi indlela yabo yokuphila, landela idayethi enziwe bahlolwe rhoqo.

Kwelinye icala, xa ibetha rhoqo kakhulu kuchaphazela yonke eziphilayo. Ngapha koko, ngenxa yokuba ekuqaleni cuts ezininzi kunciphise umsi igazi, nto leyo ekhokelela ukuba ukuhla kwemali igazi ebuchotsheni kunye nemithambo yenhliziyo. Kwiimeko ezinjalo, xa ibetha intliziyo kuyingozi kakhulu, njengoko oko kunokubangela umonakalo myocardium, niphele okanye ukufa ngesiquphe yendoda.

Heart rhythm ukuphazamiseka: Oonobangela

Enyanisweni, kukho izinto ezininzi ezinokudala uhlaselo lwe arrhythmia zingenzeka. Ngokomzekelo, ukuphazamiseka isingqi intliziyo unako kunxulumana kunye nempembelelo kwi ephilayo iikhemikhali ezithile, kuqukwa ukutya okuthile, iziselo, iziyobisi, nkqu iti okanye ikofu olomeleleyo. Imiba yomngcipheko siyasebenza ukuba ukutshaya. beats intliziyo esebenzayo kungenzeka kwabasetyhini esexesheni.

Ukongeza, oonobangela ziquka ezinye izifo, kuquka osteochondrosis (ingakumbi umnqonqo wesibeleko), kunye DYSTONIA semithambo, nezifo ze imvelaphi ezahlukeneyo, kunye nabanye.

Kukho ezinye izinto ezinokudala intliziyo isingqisho ukuphazamiseka waphawula. Kusenokwenzeka ukuba ezinxulumene amanxeba somgquba myocardium kunye nenkqubo Uhanjiso. Umzekelo, uhlaselo akholisa ukubakho izigulane abakhubazekileyo ezahlukeneyo, kwakunye kwisiqalo Cardiosclerosis, cardiomyopathy, isifo kwemithambo, izifo ukudumba (myocarditis, pericarditis). Imiba yomngcipheko nazo zibandakanya izifo ezifana hemochromatosis, sarcoidosis, amyloidosis, ngokuba ukwimeko enjalo komngcipheko ophezulu umonakalo intliziyo.

Attack of arrhythmia kaninzi kwenzeka sizoku lwisana ngumkhuhlane olomeleleyo. Ukongeza, isiphumo esifanayo kunokukhokelela iziyobisi ezithile, kuquka ezo iziyobisi eziqulathe caffeine, ephedrine, aminophylline, novodrin, kunye nemithi yokunciphisa tricyclic, iziyobisi umchamo kunye corticosteroids.

luxinzelelo olungamandla, uxinzelelo emzimbeni, ukuphazamiseka isiqulatho izimbiwa kwizisele engabalulekanga - konke oku kungakhokelela ekubeni umntu ucutheko enomfutho kwemisipha kwentliziyo.

ngezigaba zokuphula

Kakade ke, namhlanje kukho iinkqubo zokuhlelwa ezininzi, ukuqonda ukuba kwenzeka ntoni na xa ibetha - umzekelo, kuxhomekeke lethu le nakujoliso olutsha ethunjini. Kakhulu sivame izinga ukungaphumeleli kwi ventricles, ngaphezulu kwama-60% ezigulane beze ugqirha unesifo onjalo.

Ngowe-25% xa ibetha kokubona atrial. Kakhulu alufane ukuphazamiseka isingqisho kwenzeka kwipokotho woxhulumaniso atrioventricular, kwiimeko ezinjalo, zibizwa atrioventricular. Ukongeza, kukho imidibaniso ezahlukeneyo iifom ngasentla.

Kwezinye iimeko, isingqisho sinus oyinhloko igcinwa ngaxeshanye kunye nokusekwa nakujoliso olutsha ethunjini, lunyhasho eso kuthiwa parasystole. Ukunyhashwa zihlelwa kunye nenani nakujoliso olutsha lwe excitation, ukuze babe zombini mono- kunye polytopic.

Ukuba beats ezimbini ngokulandelelana, zibizwa nesithandwa sakhe. Ukuba ukuncitshiswa enkulu balandela scheme "ngaphezulu kwe ezimbini ngokulandelelana," oko kukuthi - ibetha ivolibholi. Ukongeza, komgomo ezinjalo yahlulwe amaqela kuxhomekeke xa zithe zenzeka ngexesha yindibanisela intliziyo (oku kwangethuba, phakathi kunye kade). Ukuba uthathe ingqalelo thina nezihlandlo iziganeko extrasystoles, basenokuba kunqabile (ngaphantsi kwe-5 engaqhelekanga cuts ngomzuzu), eliphakathi (6 ukuya ku-15) okanye rhoqo (ventricular umz rhoqo extrasystole ephelekwa izishunqulelo ngaphezulu kwe-15 ngokugqithiseleyo ventricular ngomzuzu).

Ngokuqhelekileyo, kukho inkqubo apho arrhythmia zihlelwe ngohlobo imvelaphi yayo. Umzekelo, ukuphazamiseka isingqisho kwentliziyo esinxulunyaniswa kunye izilonda eziyityhefu eziphilayo okanye izihlunu, ukuphazamiseka nokomzimba.

Njengoko beats kubonisiwe?

Enyanisweni, iimpawu zesifo sentliziyo akhoyo zonke izigulane, maxa wambi arrhythmia ugqibe ngengozi ngexesha electrocardiogram lwesiqhelo. Ngaphezu koko, zininzi izinto ezinokuthi ezichaphazela imali kunye nobushushu iimpawu abakhoyo. Umzekelo, izigulane izilonda somgquba myocardium kunokuba lula kakhulu ukuba athwale iziqephu arrhythmia, ngoxa umfanekiso lwezonyango ngayo abantu DYSTONIA nemithambo kukhangeleka kakhulu nzima.

Amaninzi extrasystole subjectively njengoko push nkqi, nkqu yabetha intliziyo isifuba ngaphakathi. Kwezinye iimeko, izigulane ingxelo yokuba baziva ngathi intliziyo "flips" okanye "somersaults". neemvakalelo ezinjalo ezinxulumene ne unciphiso nkqi, ehlokomayo elibukhali kwi myocardium.

Ezinye izigulane ukuhlasela arrhythmia thile efanayo iimpawu kwemithambo okanye angina. Arrythmia, lu dityanisiwe utshintsho ezisebenzayo soloko ilandelwa lutshintsho lwemithetho nezinye iimpawu. Umzekelo, izigulane akhalaze eyandileyo ukubila, ukuziva elifutshane umoya, ukufikelwa, wavele ziyenzeka womelele, ubuthathaka, ubuhlungu. Ngamanye amaxesha kukho kwaye kunzima nokuziva ixhala, nokuba ukoyika.

Kukho nezinye iimpawu zesifo sentliziyo. Ezifana nesiyezi. ventricular rhoqo beats ngaphambi kwexesha okanye atrial kunye ukuhla imveliso kwegazi, nto leyo ebangela le uphawu. Xa izigulane semithambo palsy yamafutha arrhythmias ezinjalo kunokukhokelela ukuphazamiseka yokumpompoza kwegazi, ephelekwa paresis, syncope, nezinye izifo kunye aphasia. Kuyo nayiphi na imeko, ngokubonakala ezinjalo ithi kufuneka ngoko nangoko udibane nogqirha, kuba imiphumo inokuba yingozi kakhulu kwaye kunzima.

Iam ebuntwaneni

Enyanisweni, ibetha ebantwaneni sivame ukuxilongwa. Oku bangaphathwa umntwana na ubudala, maxa wambi ukuphazamiseka libhaliswe naxa Palsy. Ngokobalo manani ngaphezu kwama-75% abantwana ngamaqondo ahlukahlukeneyo, ubunzima okuthile entliziyweni isingqisho. Ke kwiminyaka elishumi edlulileyo inani labantwana nala ukuphazamiseka liye landa kakhulu.

Ziziphi izizathu eziphambili arrhythmias kwentliziyo ebantwaneni? Okokuqala kufanele kuphawulwe Iziphene zokuzalwa cardiomyopathy. Ukongeza, i-common kakhulu ziquka myocarditis ezosulelayo, isifo sentliziyo samathambo, zemfuza isifo ezimisele.

Kwezinye iimeko, esi sifo lu dityanisiwe neengxaki ezithile ezidalwe kunye neenkqubo luvo. Umzekelo, imbonakalo extrasystole kunokubangela hypothyroidism okanye isifo seswekile. Kwelinye icala, ukubaluleka kweenkqubo ezingapheliyo ukudumba kwaye ezasulelayo, ngokunjalo nezifo ukushiyeka kunye nokungabikho kwezinye izinto, emzimbeni okanye emphefumlweni ntshikilelo kakhulu. Nakowuphi na umzekelo, isifo onjalo abadinga unyango olufanelekileyo. Ke ukuba iingqikelelo, xa ibetha avareji okanye ezinqabileyo, nto leyo ezingahambi amanxeba somgquba intliziyo, uthathwa uhlobo ekhuselekileyo ngokwentelekiso sifo.

iindlela Modern loxilongo

Ngokuqhelekileyo, zininzi iindlela ukuxilonga, kuquka ECG. Extrasystole xa isifundo efanayo, ngokuqhelekileyo zibonakala ngokucacileyo. Nangona kunjalo, inkqubo diagnostic awuqali oku. Okokuqala, ugqirha kufuneka kuqhuba uviwo ngokucokisekileyo, oqala zokuqokelelwa kolwazi. Isigulane kufuneka azise yingcali leyo ubonakele iimpawu, indlela enamandla ngayo uhlasela, kaninzi kangakanani ukuba zenzeke.

Kubaluleke kakhulu ukuba ukukhangela unobangela arrhythmias inhliziyo. Ukuza kuthi ga ngoku, ukuya imbali yezonyango, ugqirha kufuneka bazazi phambi nezinye izifo, iziyobisi. Into yokuba imvelaphi kunye nohlobo izitshanguba kwenkqubo Uhanjiso kwentliziyo kuxhomekeke kakhulu ukhetho unyango olusebenzayo.

Emva koko ugqirha kudla uqhuba ukubetha Ngokucofa kwi kwemithambo iphiramidi. Xa arrhythmia specialist buyisela lencinibakazi ukubetha okwenzeka ngaphambi kwexesha. Maxa wambi, phezu koko, ephelekwa izigigaba arrythmia of 'ukuwa' ukubetha ukuba kwenzeka xa kukho ukugcwaliswa zaneleyo le ventricles ngexesha diastole.

Ibambe auscultation intliziyo. Ngoxa ukuphulaphula, ungaphawula ubukho njengokuzalwa mna II abanzi. Hi ndlela leyi, sisifo enjalo, ithowuni lokuqala luyomelezwa, nto leyo ehambisana iziseko kancinane le ventricles. Kodwa ke ilizwi okwesibini, phezu koko, buthathaka, njengoko ezincinane kakhulu ejection igazi kulo aorta kunye pulmonary.

Emva koko ugqirha uza kuthumela isigulane ukuba uqinisekise cardiogram intliziyo. Le yenye yeendlela ezininzi echanekileyo uphando. Kwezinye iimeko, i-ebizwa ngokuba Holter ECG. Yintoni le nkqubo? emzimbeni wakhe na isixhobo ekhethekileyo ephathekayo ubhala isingqisho intliziyo ngaphezu kweentsuku 1-2 apha. Ukongeza, isigulana ugcina idayari umsebenzi, apho uchaza iimvakalelo zakhe enze iintshukumo. Esinjalo isifundo isetyenziswa xa ufuna ukufumana oko kwenza i arrhythmia.

Ukuba arrhythmias wentliziyo zange kwenzeke nokuphumla, kuqhuba iimvavanyo ezongezelelweyo - a ergometry ibhayisekile kunye novavanyo treadmill. Ezi zifundo zenza kube lula ukuba umlinganiselo parameters (uxinzelelo lwegazi) kwaye wenze electrocardiogram ngexesha umthambo (ezifana ehamba Ungabambiseki, umthambo kwi ibhayisekile emileyo). Ukuba ukrokrela ukuba umonakalo engabalulekanga eziphilayo izigulane kucetyiswa ukuba wenze ultrasound kunye MRI intliziyo.

Indlela yokuphatha arrhythmia?

Njengoko sele kukhankanyiwe, unyango arrhythmia kwentliziyo kuxhomekeke ityala layo. Umzekelo, ukuba arrhythmias ezinxulumene ne ngokuthatha amayeza, ngoko, Kakade ke, kufuneka ukuba irhoxiswe. Ukuba izizathu belele ukuphazamiseka sokugaya kwaye yemithambo iinkqubo, kwimfuno yokuphatha nabo kwindawo yokuqala, yaye extrasystoles uhlaselo uza kutshitsha kunye sifo ephambili.

Kwezinye iimeko uxilongo kunceda ukuqonda oko kwavela ukuphazamiseka nesingqi sizoku lwisana overstrain luvo. izigulane ezinjalo uthunyelwe luvo ngenxa uthethwano, njengoko umthetho, zabelwe ukufumana nadlamkisayo qatha okanye iimali imifuno umthomalalisi.

arrhythmias manqapha rarely uhlasela musa kufuna unyango oluthile unyango, izigulane kucetyiswa ukuba bathobele kuphela ngemigaqo indlela yokuphila esempilweni, yaye kumaxesha ngamaxesha abangalupasanga uviwo ngokuphindaphindiweyo.

Ukuba bamelwa rhoqo, ekhatshwa ukuphelelwa umoya, ubuthathaka kunye izithonga womelele, ngoko, mhlawumbi, ugqirha aya kuyinyula amachiza afanelekileyo. Njengomthetho jikelele, ukuze kupheliswe ukunyhashwa ekuthiwa emiselweyo amachiza antiarrhythmic, kuquka lidocaine, sotalol, procainamide hydrochloride, diltiazem, quinidine, Cordarone, mexyl. Xa kungekho tyala ayikwazi ukusetyenziswa yedwa, la machiza, njengoko idosi nokufumana indlela ongqala ngqo kumntu omnye. Ngaphezu koko, maxa wambi ichiza ilawulwa ngexesha esweni Holter ECG, oko kusenza siqonde ukuba ingaba ichiza esebenza ngokwenene njengoko kufuneka, yaye akayi kubangela umzimba ukuba unalo umonakalo omkhulu.

Xa iyeza ekstrasistoliyah elihle ukuthatha nje zawahlasela bemkile ngokupheleleyo, okanye ubuncinane inani labo aya kuncitshiswa abe ubuncinane. Emva koko, isixa iziyobisi kuqala ukunciphisa ngokuthe ngcembe emva koko ukusirhoxisa ngokupheleleyo. Ngokuqhelekileyo, impatho enjalo sihlala iinyanga eziliqela. Kodwa iintlobo amabi kwephulwa izigulane ezithatha antiarrhythmics ubomi.

Kwiimeko apho la machiza azisebenzi, okanye isigulane kutyhilwa ukubanyamezela abo, sebenzisa ezinye iindlela zonyango, ingakumbi, radiofrequency ablation kwentliziyo. Hi ndlela leyi, ibonisa kule fomu unyango kwakhona uhlobo ventricular arrhythmia, nto leyo sikhatshwa amawaka zokuhlaselwa-20-30 ngosuku. Le yinkqubo yotyando enokuthanani kancinane amacebo ezonakalisayo. Kuliwa usebenzisa i catheter ekhethekileyo endovascular leyo sithumela kwemisinga eliphezulu-rhoqo. Ngoko ke, lo dot electrode intliziyo kuchaphazela iinxalenye apho kwaphulwa conductivity. Ngokwenkqubo enjalo, usenokucima usasazeko lwezidumbu, ukubetha "ephosakeleyo," ziqhubeke sinus isingqisho eqhelekileyo.

Imiphumo arrhythmias, imithambo kunye noqikelelo abagulayo

I-ALS ukuba izigulane zixhomekeke ngqo kwi sifo kunye ubukho ukuphazamiseka ezihamba. Umzekelo, kuyingozi uninzi ibetha ephuhlisa kwisiqalo ngenxa yesifo sentliziyo, cardiomyopathy nomonakalo organic engabalulekanga.

Kuyo nayiphi na imeko, ukungabikho koncedo abaqeqeshiweyo kunye kwangexesha kungakhokelela inkinga ubunzima. Nangona uninzi ibetha kuba nabungozi, maxa wambi ukuphuhlisa kwi imvelaphi yayo kunye nezinye izifo eziyingozi, kuquka tachycardia paroxysmal, fibrillation atrial enomoya atrial. iimeko ezinjalo kunokukhokelela ekufeni ngesiquphe yesigulana.

Kukho ezinye iingxaki ezihamba kunye ne-extrasystole. Oku, kwindawo yokuqala, iingxaki zokujikeleza kwegazi kunye nesondlo sokutya. Enyanisweni, ngamaxesha angaphezulu okuphindaphindiweyo, umthamo wegazi owenziwe yintliziyo uncitshiswa kakhulu. Oku kukukhokelela kwindlala ye-oksijini kunye nokuphazamiseka kwegazi eliqhelekileyo. Ngokuqhelekileyo, i-extrasystole ikhokelela ekuphuhliseni ukungapheli kwimizimba yengqumbo, i-coronary kunye ne-cerebral vessels, ebandakanya ubunzima obukhulu.

Izindlela zokuthintela

Enyanisweni, isigulane esinengxaki ezifanayo kufuneka sibhaliswe kunye ne-cardiologist kwaye sihlale sihlolwa. Indlela ephambili yokuthintela iingxaki ezinobungozi zesicrosystole yonyango oluchanekileyo lwezifo eziphambili. Izigulane kufuneka zisoloko zithabatha iziyobisi ezichazwe yicutshulwa, kwaye zigcine neshedyuli kunye neyonyango. Ukongezelela, uvavanyo oluqhelekileyo lwezinga lentliziyo liyimfuneko, njengoko oku kunika ugqirha ithuba lokulandela isantya sesi sifo kunye nemiphumo yemithi enqunyiwe.

Ngokuqinisekileyo, izigulane ziya kufuneka zihlolisise kwakhona indlela yokuphila. Nasiphi na isifo senhliziyo sidinga ukutya okhethekileyo. Ukwenqaba ukutshaya, ukusela utywala kunye ne-cafeine kuyimfuneko. Kwaye, ke, ukuba umsebenzi we-cardiovascular system iya kuba luncedo ngokulinganayo, kodwa usebenze rhoqo, uhamba emoyeni omtsha.

Ngokwahlukileyo kuyimfuneko ukuthetha ngoncedo lokuqala. Ukuhlasela i-extrasystole, ngokuqhelekileyo kuvela ngokukhawuleza. Isigulana kufuneka silale kwaye sizinciphe. Kukwacetyiswa kwakhona ukuba udibanise amaqhosha aphezulu ekhati, ukhulule umtya kunye nebhande, ngelizwi, ususe zonke izithintelo ezinokuthintela ukuphefumla. Ukuba ukuhlaselwa kubangelwa ukuxinezeleka, ngoko kuyavunyelwa ukuthatha inani elincinci lokukhusela. Kungcono ukubiza i-ambulensi, kuba imiphumo ye-extrasystole ingaba yingozi.