Kana panguva yekufamba kwe electrocardiogram chigadzirwa chakanyorwa zvimwe zviitiko mubasa remwoyo, saka kuongororwa "chirwere chekutanga repolarization ye ventricles". Mamiriro ezvinhu akadaro haasi nguva dzose chirwere kana chirwere, asi kuongororwa kwakaitwa nachiremba kuchave kuchidikanwa.
Syndrome of early repolarization of ventricles of the heart - chii ichocho?
Munguva pfupi yapfuura, chirwere chepakutanga ventricular repolarization (ARVD) chinowanikwa zvikuru - 8% yevarume vane hutano hwakakwana, vakadzi nevana vanodzidza nezvechiitiko chakadaro cheEGG panguva dzekuongorora zviitiko. Bhuku iri rine ngozi rinosanganisira:
- Varwere vane zvirwere nemwoyo, izvo zvinopesana nekukanganisa mubasa;
- vanhu vari kushingaira mumitambo;
- varume vatema;
- varwere vane dysplastic collagenosis.
Vakawanda vanorwara vanobvunza mubvunzo pamusoro pokuti chii chinonzi syndrome of early ventricular repolarization. Iko kushandura kusina uncharacteristic mumutsetse we electrocardiogram uye inogona kuva yekusingaperi kana yapfuura. Kakawanda, chiitiko cheEGG chinowanikwa muvecheche nevana. Kune mhando mitatu ine zvinhu zvakajairika, asi yakasiyana nehuwandu hwekuoma:
- hukuru-huri kupfuura 6 hunotungamirira;
- kuenzanisa - inosanganisira 4-5 inotungamirira;
- zvishoma - zvinoratidzwa nemitungamiri 2-3.
Izvo chirwere chekutanga kudzorerazve kwevhirikiriya hachiiti chete kune varwere vakawana kana kuberekwa kwepabonde nemoyo, asi kune avo vane:
- hypertrophic cardiomyopathy;
- dysplasia yezvinokonzera mishonga (spider finger, hyper joint movement, rinopinda mumitral canal);
- mhuri ye hyperlipidemia;
- zvirwere zvepfungwa;
- neurocircular dystonia;
- genetic predisposition.
Ndeipi ngozi yekutanga ventricular repolarization syndrome?
Pakati pezvitevedzeri zvezvidzidzo, masayendisiti akaratidza kuti chiitiko cheEGG chekutanga kutanga kwechirwere chechirwere chinogona kukonzera rufu rwechirwere chisinganzwisisiki, kana ichiendeswa nechiitiko chinokonzera syncope chepfungwa yemoyo. Chirwere chinowanzowedzera kukura kwezvirwere zvakadai se:
- heart failure;
- supraventricular arrhythmia;
- sinus tachycardia uye bradycardia;
- ischemia yemwoyo;
- atrial fibrillation;
- paroxysmal tachycardia;
- kudengenyeka kwenhemodynamics;
- kukanganisa kumidziyo yemwoyo, nezvimwewo.
Syndrome of early repolarization of ventricles in children
Kana mushure me electrocardiogram iwe unotarisana nechinetso chakadai sechirwere chekutanga kudzorerazve kwezvinyorwa zvemoyo mukati mevana, zvino unoda kuziva kuti kusimbisa kuongororwa kuti mwana achada kuongororwa zvakazara. Nokuda kweizvi, vanachiremba vanopa kupfuudza zvakadzama kuongororwa ropa (kubva mumunwe uye mutsva) uye murini, pamwe nekuita kanoverengeka e ultrasound yemwoyo. Izvo zvinowanzoenderana nemamiriro ekurapa kwehutano.
Izvi zvinorwara muhuduku hakusi kutonga. Kuongororwa kunoitwa kuitira kuti usabvisa kukanganiswa mubasa remwoyo uye rhythm. Pane zvirwere muhutatu hwemunhu, chete chiremba wezvigaro anokwanisa kutsanangura. Anogadza kugara achiongororwa nemwana ane imwe nguva yemwedzi yakawanda. Pane chirwere mune avo vana vane matambudziko ekupararira kweropa muchibereko.
Kana mwana wako akaongororwa ane chirwere chekutanga kudzoka kwemavhiriki, ipapo mune ramangwana iwe uchada:
- Deredzai kuita zvekuita uye kuderedza kushanda kwavo.
- Chengetedza mwana kubva kumarudzi ose ematambudziko.
- Chengeta kudya.
- Iva nechokwadi chokuti mwana ane mararamiro akanaka.
Syndrome of early repolarization of ventricles muvechiri kuyaruka
Vechidiki ndivo vanobatwa nemamiriro ezvinhu aya. Izvi zvinonyanya kuoneka munguva yekuyaruka. Zvinhu zvechirwere chekutanga zvekudzorera kwevhirikiriya zvinomirira kuchinja kuduku mubasa remwoyo. Vana vanofanira kuongorora zvakakwana, izvo, kunze kwezviedzo, zvinosanganisira ECHO-CG uye ECG. Kana zvirwere zvisingazivikanwi, saka hapana kurapwa kunorayirwa. Kune kuvabereki vanachiremba vanokurudzira:
- Tarisa mwana wacho mwedzi mitanhatu.
- Kupa vana mavitamini.
- Iva nechokwadi chokuti mwana ane mararamiro anoraramira (pasina kushushikana uye kushanda nesimba kwakasimba).
- Kupa vana zvokudya zvakakosha uye zvakasiyana.
Syndrome of early repolarization of ventricles muvatambi
Munguva yezvidzidzo, izvo zvaive mukutarisa kwevatambi vezvenyanzvi, zvakawanikwa kuti vanenge 80 muzana yavo vane bradycardia (mwoyo wepakati muminiti 1 inosvikira 60). Chirwere chekutanga kugadzirisa kwemavhirikiti emwoyo chinoratidzwa mune zvinotakura zve vagal influences uye kukurudzirwa mubhokisi rekusiya kuruboshwe rwekugadzirisa rusvingo. Vanhu vakadaro vanofanira:
- Deredza mutoro.
- Kuchengetedza kugara uchigamuchira mishonga (dope).
- Cherechedza nechiremba.
Syndrome of early repolarization of ventricles during pregnancy
Apo amai vamangwana vanowanikwa vane chirwere chekurumidza kudzorera myocardium ye ventricular, anotanga kunetseka, ane hanya uye mubvunzo unomuka pamusoro pekuti izvi zvichaitika sei kumwana nekuita gumbo. Masayendisiti akaratidza kuti chiitiko cheEGG hachina kukanganisa kukura kwe fetal uye hutano nenzira ipi zvayo, kana mukadzi ane pamuviri asina zvimwe zvirwere zvakakomba (semuenzaniso, arrhythmia).
Syndrome of early repolarization ye ventricles - zviratidzo
Kazhinji ECG-phenomenon inowanikwa zvisina kuitika munguva yekuongorora mune dzimwe zvirwere. Varwere vangave vasina mhere-mhere kana kuti vane hukama nehutano hwepfungwa. Zviratidzo zvehutano hwekutanga kugadzirisa zvevhirikiri zvinoratidzwa nenzira dzakasiyana-siyana, izvo zvinoonekwa sechinhu chinotyisa kuhutano uye zvinogona kutungamirira kurufu (ventricular fibrillation).
Vakawanda varwere vane:
- kusagadzikana kwemwoyo, zvichikonzera kushungurudzika kwehemodynamic;
- pulmonary edema ;
- kupfupika kwemhepo ;
- cardiogenic shock ;
- hypertensive crisis .
Kuongorora kwevanhu vakuru kunosanganisira kuongorora:
- ECG kutarisa mukati mezuva kana kupfuura;
- kuiswa kwevavocainamide inopisa, kuitira kuti pazvibvumirano zviratidze zviratidzo zvekusaly;
- sampuli ne potassium, apo murwere akatora mushonga (iyo inonzi 2 g) yekuratidzwa kwezviratidzo;
- biochemical blood test;
- lipidogram.
Syndrome of early repolarization of ventricles on ECG
Kana pane kusava nechokwadi kwekuva nemararamiro epamwoyo, chirwere chemwoyo chinogara chichigadzirwa, chirwere chekutanga kudzorerazve kwevhirikiriya chinogona kuzviratidza pane zvishonga nenzira ye:
- kuonekwa kwechimwe chizunguro J muQRS yakaoma;
- kuchinja muT T kana iine nzvimbo yakakura;
- kushandiswa kwemaxiki emagetsi kuruboshwe;
- shandura chimiro chechidimbu ST, iyo inofamba pasi, mushure mokunge mucheche unomuka;
- Kurema (pseudo-coronary uplift) ye ST sekamu mumutungamiri we thoracic kumusoro kweega (kusvika kusvika 3 mm).
Zviratidzo zveanoraly zvinogona kuonekwa panzvimbo yekutora thoracic muEECG. Zvakakosha kubhadhara zino S, nokuti rinogona kuderera zvikuru muhukuru kana kuti tsvina kubva kumatavi anonzi thoracic kuruboshwe. Ichi chinoratidzira kuvanachiremba kuti mwoyo wemunhu yakashandura mararamiro ekureba kwenguva yakareba. Munyaya iyi, yakaoma QRS (gwaro qR) munharaunda yeV5 neV6 ichaumbwa.
Syndrome of early repolarization of ventricles paECHO
Panguva yekuongororwa, vanachiremba vanokwanisa kurondedzera maitiro ekuzorora (ECHO) uye ECG, chirwere chekudzoka kwepakutanga kwezvinyorwa mumwana zvinonyatsoratidzwa nenzira dzakadaro. Vanobatsira kuziva chakavanzika chisina kumira mumoyo, kupa pfungwa yehutano, rhythm uye basa remuviri mukuru. Kutarisa kwakadaro kwakachengeteka kwehutano hwevana.
Syndrome of early repolarization ye ventricles - kurapa
Kuchengetedza kweEECG-phenomenon haina kuita pfungwa, nokuti haina zviratidzo uye haisi chirwere. Kuti chirwere chekurumidza kugadzirisa marocardium ye ventricular muvana nevakuru vasati vauye kuva dambudziko guru, vanachiremba vanoti:
- Uyai kunovaona mwedzi mitanhatu yese.
- Zvinyatsobatanidzwa mune zvakasiyana-siyana.
- Kutora nguva mumhepo itsva.
- Zvakanaka kudya.
- Bvisa tsika dzose dzakaipa.