Te Āhuatanga O Brugada

Ko te mate Brugada (brew-GAH-dah) he āhuatanga o te ihu o te ngakau (arrhythmia) ka raru pea te ora, ka tupu mai pea i te whānau.

Kei ngā tāngata e pangia ana e te mate Brugada te tūponotanga nui ake o ngā āwangawanga o te ihu o te ngakau e tīmata ana i ngā ruma o raro o te ngakau (ventricles).

Ko te maimoatanga o te mate Brugada e whakauru ana i ngā mahi aukati pēnei i te whakaiti i te kirika me te karo i ngā rongoā ka pāngia ai te arrhythmia. He mea tika kia whakamahia e ētahi o ngā tāngata e pangia ana e te mate Brugada tētahi taputapu hauora e kiia nei ko te implantable cardioverter-defibrillator (ICD).

Ko te mate o Brugada e kore nei e tino puta he tohu e kitea ana. He tokomaha nga tangata e pangia ana e te mate o Brugada kaore e mohio kei a ratou.

Ko nga tohu me nga tohu e hono ana pea ki te mate o Brugada ko:

• Nga wiri
• Te ngaro o te mohio
• Te manawa poto me te uaua o te manawa, ina koa i te po
• Nga whiu o te ngakau, te pupuhi o te ngakau
• Te tere rawa me te koretake o te whiu o te ngakau
• Nga hopu

Ko te tohu nui o te mate o Brugada ko te hua koretake i runga i te electrocardiogram (ECG), he whakamatautau e ine ana i te mahi hiko o te ngakau.

Ko ngā tohu me ngā pūāhua o te mate Brugada e rite ana ki ētahi atu mate o te ihu o te ngakau. He mea nui kia kite koe i te kaiwhakarato hauora hei kimi mena ko te mate Brugada, tetahi atu rānei o te mate o te ihu o te ngakau te take o ngā tohu. Ki te ngaro koe i te ngākau, ā, ki te whakaaro koe pea na te āhuatanga o te ngakau, rapuhia te awhina hauora tūturu. Ki te whakatauhia tō mātua, tō teina, tō tamaiti rānei ki te mate Brugada, āta whakaaro koe ki te ui ki tō kaiwhakarato mena me whakamātau koe kia kite mena kei te tūpono koe ki te mate Brugada.

Ko te syndrome Brugada he mate ngākau te tere o te ngākau. Ka whakaohotia ia whiu o te ngākau e te tohu hiko i hangaia e ngā pūtau motuhake kei te ruma o runga o te ngākau. Ka ārahi ngā kohanga iti, e kiia nei ko ngā kaupae, kei ia o ēnei pūtau i tēnei mahi hiko, ā, ka ngākau te ngākau.

I te syndrome Brugada, ka puta he huringa i ēnei kaupae, ka tere rawa te whiu o te ngākau, ka hanga he tere ngākau kino (ventricular fibrillation).

Ko te hua, kāore te ngākau e pupū i te toto ki te toenga o te tinana. Ka taea e te tere koretake e roa ana mō te wā poto te whakangaro. Ka taea te mate ngākau ohorere ki te kore e mutu te whiu ngākau koretake.

Ka taea pea te whakaatu i te syndrome Brugada e:

• He raruraru hanganga i te ngākau, ka uaua pea te kite
• He koretake i ngā matū hei awhina i te tuku i ngā tohu hiko puta noa i te tinana (electrolytes)
• Te whakamahinga o ētahi rongoā rongoā, te kōkē

Ngā take morearea mō te mate Brugada e whai ake nei:

• Hītori whānau o te mate Brugada. I te nuinga o te wā ka tukuna tenei āhuatanga i roto i ngā whānau (kāinga). Ko te whai whānau e pangia ana e te mate Brugada ka piki ake te tūponotanga o te tangata ki te whiwhi ano hoki.
• Ko te tane. Ka kitea te mate Brugada i ngā tāne i te nuinga atu i ngā wāhine.
• Iwi. Ka puta ake te mate Brugada i ngā Āhia i te nuinga atu i ētahi atu iwi.
• Te kirika. Kāo te kirika e puta ai te mate Brugada, engari ka āwangawanga pea te ngākau, ā, ka pā te ngākau rāpoi, te mate ngākau rāpoi rānei ki ngā tāngata e pangia ana e te mate Brugada,inā, ngā tamariki.

Ko ngā raruraru o te mate Brugada e hiahia ana ki te tiaki hauora tūturu. Ko ngā raruraru o te mate Brugada e whai ake nei:

• Te mutu o te ngakau ohorere. Ki te kore e tukatuka wawe, ko tēnei ngaro ohorere o te mahi o te ngakau, te manawa me te mohio, e tupu ana i te wa e moe ana, he mate. Mā te tiaki hauora tere, tika, ka taea te ora.
• Te ngaro o te mohio. Ki te mate Brugada, ko te ngaro o te mohio e hiahia ana ki te tiaki hauora tūturu.

Mēnā kei te whānau koe he mate Brugada syndrome tetahi, ka taea te whakamātautau ira ki te whakatau mena kei a koe, kei te tūpono rānei koe ki te āhuatanga.

Ko te nuinga o te wā ka taea te whakatau i te mate Brugada i roto i te hunga pakeke, ā, i etahi wā, i roto i ngā taitamariki. He iti rawa te whakatau i roto i ngā tamariki nohinohi, nā te mea ka kore e kitea ngā tohu.

Hei whakatau i te mate Brugada, ka mahi te kaiwhakarato hauora i te whakamātautau tinana, ā, ka whakarongo ki te ngākau mā te stethoscope. Ka mahia ngā whakamātautau hei tirotiro i te tukunga o te ngākau, ā, hei whakatau, hei whakau rānei i te mate Brugada.

Electrocardiogram (ECG) me te rongoā, kāore rānei. He whakamātautau tere, ngāwari te electrocardiogram (ECG), e tuhi ana i ngā tohu hiko i roto i te ngākau. I te wā o te whakamātautau, ka honoa ngā pūoko (electrodes) ki te uma, ā, i etahi wā ki ngā waewae. Ka taea e te whakamātautau te awhina i te kimi i ngā raruraru ki te tukunga me te hanganga o te ngākau.

Ki te pai te tukunga o te ngākau i te wā o te whakamātautau, ko te mahi e whai ake nei pea ko te kakahu i te taputapu kawe-a-ringa mō te rā katoa me te pō. Ko te momo whakamātautau tēnei e kiia nei ko te whakamātautau 24-hāora Holter monitor.

He maha ngā tāngata e whai tohu ana i te mate Brugada, engari kei roto i te tawhiti noa ngā hua o ō rātou electrocardiograms (ECGs) tuatahi me ngā whakamātautau 24-hāora Holter. Ka taea e ēnei tāngata te whai electrocardiograms atu e whakauru ana i ngā rongoā e hoatu ana mā te IV, ka taea te whakaohooho i te tukunga ngākau kore-pai.

Whakamātautau me te whakaraupapa Electrophysiological (EP). Ka taea te mahi i tēnei whakamātautau, e kiia ana hoki ko te ako electrophysiologic (EP), i ētahi tāngata e whakapae ana he mate Brugada.

I roto i tēnei whakamātautau, ka whakauru te kaiwhakarato hauora i ngā pūpoipoi angiangi, ngāwari te whakamahi (catheters) e whakaoti ana ki ngā electrodes, mā ngā oko toto ki ngā wāhi rerekē i roto i te ngākau. Kia oti te whakanoho, ka taea e ngā electrodes te whakaatu i te hora o ngā tohu hiko puta noa i te ngākau.

• Electrocardiogram (ECG) me te rongoā, kāore rānei. He whakamātautau tere, ngāwari te electrocardiogram (ECG), e tuhi ana i ngā tohu hiko i roto i te ngākau. I te wā o te whakamātautau, ka honoa ngā pūoko (electrodes) ki te uma, ā, i etahi wā ki ngā waewae. Ka taea e te whakamātautau te awhina i te kimi i ngā rararu ki te tukunga me te hanganga o te ngākau.

  Ki te pai te tukunga o te ngākau i te wā o te whakamātautau, ko te mahi e whai ake nei pea ko te kakahu i te taputapu kawe-a-ringa mō te rā katoa me te pō. Ko te momo whakamātautau tēnei e kiia nei ko te whakamātautau 24-hāora Holter monitor.

  He maha ngā tāngata e whai tohu ana i te mate Brugada, engari kei roto i te tawhiti noa ngā hua o ō rātou electrocardiograms (ECGs) tuatahi me ngā whakamātautau 24-hāora Holter. Ka taea e ēnei tāngata te whai electrocardiograms atu e whakauru ana i ngā rongoā e hoatu ana mā te IV, ka taea te whakaohooho i te tukunga ngākau kore-pai.

• Echocardiogram. Ka whakamahi te echocardiogram i ngā ngaru oro hei hanga i ngā whakaahua o te ngākau. Kāore tēnei whakamātautau e taea te whakatau i te mate Brugada anake, engari ka taea te awhina i te kimi i ngā raruraru hanganga ki te ngākau.

• Whakamātautau me te whakaraupapa Electrophysiological (EP). Ka taea te mahi i tēnei whakamātautau, e kiia ana hoki ko te ako electrophysiologic (EP), i ētahi tāngata e whakapae ana he mate Brugada.

  I roto i tēnei whakamātautau, ka whakauru te kaiwhakarato hauora i ngā pūpoipoi angiangi, ngāwari te whakamahi (catheters) e whakaoti ana ki ngā electrodes, mā ngā oko toto ki ngā wāhi rerekē i roto i te ngākau. Kia oti te whakanoho, ka taea e ngā electrodes te whakaatu i te hora o ngā tohu hiko puta noa i te ngākau.

Ko ngā tikanga rongoā mō te mate Brugada pea ka uru mai te rongoā, ngā mahi whakamahi ngongo rānei, te pokanga rānei hei tāpiri i te taputapu e whakahaere ana i te tukunga o te ngakau. Ko te rongoā mō te mate Brugada e whakawhirinaki ana ki te tūponotanga o te tukunga o te ngakau koretake (arrhythmia).

Ko te tūponotanga teitei e whakauru ana:

Ki te pēhea koe te mate Brugada engari kāore he tohu, pea kāore koe e hiahia ki te rongoā motuhake, no te mea ko te tūponotanga o te tukunga o te ngakau koretake pea ka iti. Heoi, pea ka tūtohu te kaiwhakarongo hauora kia tangohia ngā mahi hei whakaiti i te tūponotanga o ngā tukunga o te ngakau koretake.

Kaua e inu i ngā rongoā ka taea te whakaoho i te tukunga o te ngakau koretake. He maha ngā rongoā ka taea te whakapiki ake i te tūponotanga o te tukunga o te ngakau koretake, tae atu ki ētahi rongoā ngakau me ngā rongoā whakaiti mate pouri. Ko te inu waipiro nui rawa ka taea hoki te whakapiki ake i te tūponotanga.

Korero atu ki tō kaiwhakarongo hauora mō ngā rongoā e inu ana koe, tae atu ki ngā rongoā me ngā taapiri i hokona kaore he tohutohu.

Ko ētahi o ngā tāngata e mate ana i te mate Brugada ka tukuna ngā rongoā, pēnei i te quinidine, hei ārai i te tukunga o te ngakau kino pea. Pea ka tukuna ēnei rongoā anake, te taputapu hauora rānei – e kiia nei ko te implantable cardioverter-defibrillator (ICD) – e whakahaere ana i te tukunga o te ngakau.

Ko ngā tāngata e mate ana i te mate Brugada kua mate ngakau rānei, kua ngaro ngākau rānei, pea ka hiahia ki te pokanga, ki te mahi whakamahi ngongo rānei.

Implantable cardioverter-defibrillator (ICD). Ko tēnei taputapu iti, e whakahaerehia ana e te pākahiko, ka whakanohoia ki te uma hei tirotiro tonu i te tukunga o te ngakau. Ka tuku ia i ngā hiko hiko ina hiahiatia hei whakahaere i ngā tukunga o te ngakau koretake. Ko te whakanoho i te implantable cardioverter-defibrillator (ICD) te nuinga o te wā e hiahia ana ki te noho i te whare hauora mo te pō kotahi.

Pea ka tuku ngā implantable cardioverter-defibrillators (ICDs) i ngā hiko hiko ina kore e hiahiatia, na reira he mea nui kia kōrerohia ngā painga me ngā tūponotanga o ēnei taputapu ki te kaiwhakarongo hauora.

Ki te pēhea koe te mate Brugada, me whai koe i ngā tirotiro hauora ā-wā hei whakarite kua whakahaeretia tika te mate tukunga o te ngakau koretake, kua whakahaeretia. Ka taea e ngā tirotiro ā-wā te āwhina i tō kaiwhakarongo kia kite i ngā raruraru i te tīmatanga, kia whakatau rānei mēnā ka hiahiatia te huringa rongoā.

• He hītori whaiaro mō ngā arrhythmias kino

• Ngā wā ngaro ngakau

• Kua ora mai i te mate ngakau ohorere

• Whakaora i te kirika nui. Ko te kirika he mea whakaoho rongonui mō ngā tukunga o te ngakau koretake ki ngā tāngata e mate ana i te mate Brugada. Whakamahia ngā rongoā whakaiti kirika i te tohu tuatahi o te kirika.

• Kaua e inu i ngā rongoā ka taea te whakaoho i te tukunga o te ngakau koretake. He maha ngā rongoā ka taea te whakapiki ake i te tūponotanga o te tukunga o te ngakau koretake, tae atu ki ētahi rongoā ngakau me ngā rongoā whakaiti mate pouri. Ko te inu waipiro nui rawa ka taea hoki te whakapiki ake i te tūponotanga.

  Korero atu ki tō kaiwhakarongo hauora mō ngā rongoā e inu ana koe, tae atu ki ngā rongoā me ngā taapiri i hokona kaore he tohutohu.

• Kaua e takaro i ngā hākinakina whakataetae. Pea ka pā tēnei ki ngā tāngata kei te tūponotanga teitei o te tukunga o te ngakau koretake kino. Pātai atu ki tō kaiwhakarongo hauora mēnā me karo koe i aua mahi hākinakina.

• Implantable cardioverter-defibrillator (ICD). Ko tēnei taputapu iti, e whakahaerehia ana e te pākahiko, ka whakanohoia ki te uma hei tirotiro tonu i te tukunga o te ngakau. Ka tuku ia i ngā hiko hiko ina hiahiatia hei whakahaere i ngā tukunga o te ngakau koretake. Ko te whakanoho i te implantable cardioverter-defibrillator (ICD) te nuinga o te wā e hiahia ana ki te noho i te whare hauora mo te pō kotahi.

  Pea ka tuku ngā implantable cardioverter-defibrillators (ICDs) i ngā hiko hiko ina kore e hiahiatia, na reira he mea nui kia kōrerohia ngā painga me ngā tūponotanga o ēnei taputapu ki te kaiwhakarongo hauora.

• Catheter ablation. Ki te kore te ICD e whakahaere tika, me te ora, i ngā tohu o te mate Brugada, pea ka taea te mahi e kiia nei ko te radiofrequency catheter ablation. Ka whakauruhia he ngongo roa, ngawari (catheter) i roto i te oko toto, ka whakatārewatia ki te ngakau. Ka tuku te ngongo i te kaha nui e whakapoka ana, e whakangaro ana rānei i te kiko ngakau e whakahaere ana i te tukunga o te ngakau koretake.

Kaore he uauatanga