He aha te Ahuatanga o Brugada? Tohutohu, Take, me te Maimoatanga

Ko te ahuatanga o Brugada he mate ngakau onge e pā ana ki te huarahi e neke ai ngā tohu hiko i roto i tō ngakau. Ka taea e tēnei ahuatanga ira e whakaweto ai tō ngakau kia tere rawa atu te whiti, kāore rānei i te tika, ā, ka āhei te arahi ki te ngaro o te wairua, ā, i ngā take kino, te mutu o te ngakau.

I whakaahuatia tuatahi te ahuatanga i te tau 1992 e ngā tākuta Pāniora, a Pedro rāua ko Josep Brugada. Ko te taha matau o te pūnaha hiko o tō ngakau te mea nui e pā ana. Ahakoa he wehi te ahua, ko te mārama ki te ahuatanga o Brugada ka āhei te awhina i a koe ki te mahi tahi me tō rōpū hauora hei whakahaere pai.

He aha ngā tohu o te ahuatanga o Brugada?

He tokomaha ngā tāngata e pangia ana e te ahuatanga o Brugada kāore e kitea he tohu. Ki te puta mai ngā tohu, he mea nui te hono atu ki ngā whiti ngakau kāore i te tika.

Ko ēnei ngā tohu tino noa ka kitea e koe:

• Te ngaro ohorere o te wairua, te tata rānei ki te ngaro o te wairua, inā te moe rānei te okioki.
• Te pupuhi o te ngakau, te āhua rānei o te tere o te whiti o tō ngakau, te ngaro rānei o ngā whiti.
• Te uaua ki te manawa, te poto rānei o te manawa.
• Te mamae o te uma, te kore rānei o te harikoa.
• Te māuiui, te mārama rānei o te mahunga.
• Ngā whakaaturanga rite ki te hopu i te wā e ngaro ana te wairua.

Ko te wā kawa mo te ahuatanga o Brugada ko te tino puta mai o ngā tohu i te wā e moe ana, i te wā rānei e okioki ana, kāore i te wā e whakakori tinana ana. He rerekē tēnei i ngā ahuatanga ngakau maha atu. Ka kitea e ētahi tāngata te mea e kiia nei ko te "manawa ngākau o te pō," he āhua rite ki te hamama, te uaua rānei ki te manawa i te wā e moe ana.

I ngā take onge, ko te tohu tuatahi o te ahuatanga o Brugada ko te mutu ohorere o te ngakau. Koinei te take i tino nui ai te tirotiro whānau ki te whakatauhia tētahi i roto i tō whānau me tēnei ahuatanga.

He aha ngā momo o te ahuatanga o Brugada?

Ka wehea te ahuatanga o Brugada ki ngā momo rerekē i runga i te momo whakarerekētanga ira e pā ana. Ko te momo tino noa ko te Momo 1, e whakaatu ana i te 20-25% o ngā take.

Ko te ahuatanga o Brugada Momo 1 e pā ana ki ngā whakarerekētanga i roto i te ira SCN5A, e whakahaere ana i ngā kaupapa konutai i roto i ngā pūtau ngakau. Ko tēnei momo te tino whai tikanga o te whakawhiwhinga, ā, he ngāwari ki te whakatau i roto i te whakamātautau ira.

Ko ngā Momo 2 ki te 12 e pā ana ki ngā whakarerekētanga i roto i ētahi atu ira e pā ana ki ētahi atu kaupapa ion i roto i tō ngakau. He tino onge ēnei momo, ā, he uaua pea te kimi i roto i te whakamātautau ira noa. Ka taea e ia momo te whai tohu iti me ngā taumata morearea.

Heoi, he mea nui kia mōhio kei te 70% o ngā tāngata e pangia ana e te ahuatanga o Brugada kāore he whakarerekētanga ira e taea te kitea me ngā tikanga whakamātautau o nāianei. Kāore tēnei e whakaatu ana he iti ake te pono, he kino rānei te ahuatanga – he tikanga noa iho kei te kimi tonu ngā kānaka putaiao i ngā take ira katoa e pā ana.

He aha ngā take o te ahuatanga o Brugada?

Ko te take nui o te ahuatanga o Brugada ko ngā whakarerekētanga ira e pā ana ki te huarahi e neke ai ngā tohu hiko i roto i te uaua ngakau. Ka whakakorekore ēnei whakarerekētanga i te rere noa o ngā ion konutai, kārīhiuma, kāore rānei i roto i ngā pūtau ngakau.

Whakaarohia te pūnaha hiko o tō ngakau me te wāea i roto i tō whare. Ki te pēhea te "wāea" nā ngā huringa ira, ka taea te whakaweto hiko e arahi ana ki ngā whiti ngakau kino.

Ka whakawhiwhia te ahuatanga i roto i te tauira e kiia nei e ngā tākuta he tauira rangatira autosomal. Ko te tikanga mena kei tetahi o ō mātua te ahuatanga o Brugada, he 50% te tūponotanga o te whakawhiwhinga i te whakarerekētanga ira. Heoi, ko te whai i te whakarerekētanga kāore e whakamana ana ka puta mai ngā tohu.

Ka taea e ētahi take te whakaoho i ngā tohu i ngā tāngata e whai ana i te whakaaro ira:

• Te kirika, inā ngā kirika nui ake i te 102°F (39°C).
• Ētahi rongoā, inā ētahi rongoā antiarrhythmic, antidepressants, me ngā anesthetics.
• Ngā koretake o te electrolyte, inā te iti o te pāhare pāporo, te nui rānei o te kārīhiuma.
• Te inu nui o te waiū.
• Te whakamahinga o te kokain.
• Ngā kai nui, te maroke rānei i ētahi wā.

He mea whakamīharo, kāore i rite ki ngā ahuatanga ngakau maha, kāore te whakakori tinana e whakaoho noa i ngā tohu o te ahuatanga o Brugada. Ko te tikanga, ka tino puta mai ngā tohu i te wā e okioki ana, e moe ana rānei, ina he iti ake te tere o tō ngakau.

Nōhea te haere ki te tākuta mō te ahuatanga o Brugada?

Me rapu wawe koe i te tiaki hauora mena ka pāngia koe e ngā whakaaturanga o te ngaro o te wairua, inā te moe rānei te okioki. Me arotake wawe tetahi whakaaturanga o te ngaro ohorere o te mohio.

Karangahia te 911, haere rānei ki te rūma urupare inaianei mena ka pāngia koe e te mamae o te uma, te uaua nui ki te manawa, ki te kitea rānei koe e tetahi e ngaro ana te mohio. Ka taea e ēnei te tohu o te raruraru nui o te whiti ngakau e hiahia ana ki te maimoatanga wawe.

Whakaritea he hui me tō tākuta mena ka kitea e koe ngā pupuhi ngakau e puta ana, te māuiui maha, te whakaaro rānei o te mate ohorere o te ngakau i roto i tō whānau, inā ngā tāngata kei raro i te 50. Ahakoa he ngawari te ahua o ō tohu, he pai ake te tirotiro.

Me kite hoki koe i te tākuta mena kei te inu koe i ngā rongoā, ka kitea rānei e koe ngā tohu ngakau hou. Ka taea e ētahi rongoā te whakaiti i te ahuatanga o Brugada, ā, me whakarereke pea e tō tākuta tō mahere maimoatanga.

He aha ngā take morearea mō te ahuatanga o Brugada?

Ka taea e ngā take maha te whakanui ake i tō tūponotanga ki te whai i te ahuatanga o Brugada, ki te wheako rānei i ngā tohu mena kei a koe te ahuatanga. Ko te mārama ki ēnei take morearea ka āhei te awhina i a koe me tō tākuta ki te aromatawai pai ake i tō āhuatanga.

Ko ngā take morearea matua ko ēnei:

• Te hītori whānau o te ahuatanga o Brugada, te mate ohorere o te ngakau kāore i te whakamārama.
• Ko te tane (he 8-10 wā te tūponotanga o ngā tāne ki te whai tohu i ngā wāhine).
• Te tīpuna Āhia, inā te tīpuna o te Tonga-tāwhaki Āhia, te tīpuna o Hapani.
• Te tau i waenga i te 30-50 tau (ina te tino puta mai o ngā tohu).
• Te whai i ētahi atu ahuatanga whiti ngakau.
• Te inu i ētahi rongoā e pā ana ki te whiti ngakau.

He mea whakamīharo, ahakoa ka taea e ngā wāhine te whakawhiwhi me te kawe i te whakarerekētanga ira o Brugada, he iti rawa te tūponotanga ki te whāngainga i ngā tohu. E whakaaro ana ngā kānaka putaiao ko ngā homoni, inā te estrogen, ka taea te tiaki i ētahi wāhi mai i ngā pānga o te ahuatanga.

He wāhi ano te wāhi whenua. He tino noa te ahuatanga o Brugada i ētahi wāhi o te ao, inā te Tonga-tāwhaki Āhia. I ētahi wāhi o Tai, Laos, e kiia ana ko te "Mate ohorere o te pō kāore i te whakamārama," ā, ko te take matua o te mate i ngā tāne taitamariki.

He aha ngā raruraru pea o te ahuatanga o Brugada?

Ko te raruraru tino kino o te ahuatanga o Brugada ko te mutu ohorere o te ngakau, e taea te whakamate mena kāore i te maimoatia wawe. Ka puta mai tēnei ina ka whāngaia tō ngakau i te whiti tere rawa atu, e kore ai e taea te pupuhi i te toto.

Ka pāngia ngā tāngata e te ahuatanga o Brugada e ngā raruraru pea:

• Te fibrillation ventricular (he whiti ngakau kino, koretake).
• Te mate ohorere o te ngakau, inā te moe rānei te okioki.
• Ngā whakaaturanga ngaro o te wairua e taea te arahi ki ngā whara mai i ngā hinga.
• Te fibrillation atrial (te whiti koretake i ngā ruma o runga o te ngakau).
• Te kore o te ngakau i ngā take onge me ngā whakaaturanga e puta ana.
• Te pānga hinengaro mai i te noho me te ahuatanga e taea te whakamate.

He rerekē te morearea o ēnei raruraru mai i te tangata ki te tangata. Kāore ētahi tāngata e pangia ana e te ahuatanga o Brugada e kitea he tohu, engari ka taea e ētahi atu te whai whakaaturanga e taea te whakamate. Ka taea e tō tākuta te awhina i te aromatawai i tō morearea takitahi i runga i tō āhuatanga motuhake me ngā hua whakamātautau.

He mea tika te kōrero, me te whakahaere hauora tika, he tokomaha ngā tāngata e pangia ana e te ahuatanga o Brugada e ora ana i ngā oranga noa, mahi. Ko te mea nui ko te mahi tata me te tohunga whiti ngakau hei tirotiro i tō ahuatanga me te tango i ngā whakaritenga tika.

Me pēhea te whakatau i te ahuatanga o Brugada?

Ko te whakatau i te ahuatanga o Brugada e hiahia ana ki te whakakotahitanga o ngā whakamātautau me te arotake tika e te tohunga ngakau. Kāore te whakatau i te tino tika no te mea ka taea te whakaweto o te ahuatanga, ka haere mai ngā tohu, ka haere atu.

Ka tīmata tō tākuta me te hītori hauora taipitopito me te whakamātautau tinana. Ka ui rātou ki ō tohu, te hītori whānau, me ētahi rongoā kei te inu koe. Ka āhei tēnei mōhio ki te āwhina i a rātou ki te mārama ki ō take morearea me te whakatau i ngā whakamātautau e hiahiatia ana.

Ko ngā whakamātautau whakatau matua ko ēnei:

• Electrocardiogram (ECG) ki te titiro ki ngā tauira whiti ngakau.
• Te whakamātautau wero rongoā me ngā rongoā penei i te flecainide, te procainamide rānei.
• Te whakamātautau a Holter, te kai rekoata mahi rānei hei hopu i ngā whiti ngakau i te wā.
• Te ako electrophysiology hei aromatawai i te pūnaha hiko o tō ngakau.
• Te whakamātautau ira ki te titiro ki ngā whakarerekētanga e mohiotia ana.
• Te tirotiro whānau mena kei a koe ngā whānau e pangia ana e te ahuatanga.

He mea nui te ECG no te mea ka taea te whakaatu i te tauira motuhake e kiia nei ko te "tauira Brugada." Heoi, kāore tēnei tauira e puta mai i ia whakamātautau, koinei te take i tūtohutia ai e tō tākuta ngā ECG maha, te tirotiro tonu rānei.

I ētahi wā, ka whakamahi ngā tākuta i te whakamātautau wero rongoā i te wā e hoatu ana e rātou he rongoā e taea te whakaatu i te tauira Brugada mena kei a koe te ahuatanga. Ka mahia tēnei whakamātautau i roto i te whare hauora me te tirotiro tika no te mea ka taea te whakaoho i ngā whiti kino i ngā tāngata e pangia ana e te ahuatanga.

He aha te maimoatanga mō te ahuatanga o Brugada?

Ko te maimoatanga mō te ahuatanga o Brugada e aro ana ki te aukati i ngā whiti ngakau kino me te whakahaere i ngā tohu. Ko te mahere maimoatanga motuhake e whakawhirinaki ana ki tō taumata morearea, ngā tohu, me ngā hua whakamātautau.

Mō ngā tāngata e tino morearea ana ki te mutu ohorere o te ngakau, ko te maimoatanga matua ko te implantable cardioverter defibrillator (ICD). Ko tēnei taputapu iti e tirotiro ana i tō whiti ngakau, ka tuku i te whakakiki hiko mena ka kitea e ia he whiti kino. Ahakoa ka taea te kore harikoa o te whakakiki, ka taea te whakaora i te ora.

Ko ngā whiringa maimoatanga ko ēnei:

• Te tāpiringa ICD mō ngā turoro morearea nui.
• Ngā rongoā penei i te quinidine hei awhina i te whakaū i ngā whiti ngakau.
• Te karo i ngā whakaoho penei i ētahi rongoā me ngā kirika nui.
• Te tirotiro tonu me te tiaki whai muri.
• Ngā whakarerekētanga oranga hei whakaiti i te morearea.
• Te tohutohu whānau me te whakamātautau ira.

Kāore te katoa e pangia ana e te ahuatanga o Brugada e hiahia ana ki te ICD. Ka aromatawai e tō tākuta tō morearea takitahi i runga i ngā take penei i te whai tohu, ō hua whakamātautau, me tō hītori whānau. Ka taea te whakahaere i ētahi tāngata me te tirotiro tika me te karo i ngā whakaoho e mohiotia ana.

He mea nui hoki te whakahaere rongoā. Ka arotake tō rōpū hauora i ō rongoā katoa kia kore ai tetahi o rātou e whakaiti i tō ahuatanga. Ka hoatu ano e rātou ki a koe tētahi rārangi o ngā rongoā hei karo, kia mōhiotia ai e ō kaiwhakarato hauora katoa tō ahuatanga.

Me pēhea te whakahaere i te ahuatanga o Brugada i te kāinga?

Ko te whakahaere i te ahuatanga o Brugada i te kāinga e pā ana ki te tango i ngā mahi hei karo i ngā whakaoho me te whakarite mō ngā urupare. Ahakoa ka āhua wehi tēnei, he tokomaha ngā tāngata e whakahaere pai ana i tō rātou ahuatanga me ētahi whakarerekētanga oranga.

He mea nui te whakahaere kirika no te mea ka taea e ngā kirika nui te whakaoho i ngā whiti kino. Pupurihia ngā rongoā whakaiti kirika penei i te acetaminophen, te ibuprofen rānei i te kāinga, whakapā atu ki tō tākuta mena ka piki ake tō kirika i te 101°F (38.3°C). Kaua e ngana ki te "whakakake" i te kirika mena kei a koe te ahuatanga o Brugada.

Ko ēnei ngā rautaki whakahaere kāinga matua:

• Tirohia tō pāmahana ina pangia koe e te mate, ā, whakahaeretia ngā kirika wawe.
• Kawehia he kāri putea, kākahu whakatūpato hauora rānei me tō whakatau.
• Pupurihia he rārangi hou o ngā rongoā hei karo.
• Noho maroke, pupuri i te kai pai.
• Whiwhi moe tika, whakahaerehia te ahotea.
• Karohia te nui o te waiū me ngā rongoā whakangahau.

Mena kei a koe te ICD, akohia te tirotiro i tōna mahi, kia mōhiotia ai te mahi mena ka pupuhi. Ka whakaako atu tō rōpū taputapu ki a koe me pēhea te tirotiro, me te wā hei rapu awhina. Ko te nuinga o ngā tāngata e whakarite pai ana ki te whai ICD, ka taea te hoki ki ngā mahi noa.

Whakaarohia te ako i te CPR, kia mōhiotia ai e ngā mema whānau me pēhea te mahi. Ahakoa kei te tumanako koe ki te kore e hiahiatia, ko te whai i ngā tāngata e tata ana ki a koe e mōhio ana ki te CPR ka taea te whakamarie me te whakaora pea i te ora.

Me pēhea te whakarite mō tō hui tākuta?

Ko te whakarite mō tō hui ka āhei te whakarite kia whiwhi koe i te nuinga o tō haerenga, ka hoatu ki tō tākuta ngā mōhiohio e hiahia ana rātou ki te awhina i a koe. Tīmatahia ma te kohikohi mōhiohio mō ō tohu me te hītori whānau i mua i tō haerenga.

Tuhia ō tohu katoa, ahakoa kaore e rite ki tō ngakau. Tākina te wā e puta mai ana, te roa o te noho, me te mahi i te wā e puta mai ana. Ka āhei tēnei mōhio ki te āwhina i tō tākuta ki te mārama pai ake ki tō ahuatanga.

I mua i tō hui, whakaritea:

• He rārangi katoa o ō rongoā o nāianei, tae atu ki ngā taapiri.
• Tō hītori hauora whānau, inā ngā raruraru ngakau, ngā mate ohorere rānei.
• He whakaahuatanga taipitopito o ō tohu me te wā e puta mai ana.
• Ngā pātai e hiahia ana koe ki te ui ki tō tākuta.
• Ngā hua whakamātautau o mua, ngā rekoata hauora rānei.
• Mōhiohio mō tō oranga, tae atu ki ngā tikanga whakakori me ngā taumata ahotea.

Whakaarohia te kawe mai i te mema whānau, te hoa rānei ki tō hui. Ka taea e rātou te awhina i a koe ki te mahara ki te kōrero a te tākuta, ka whakarato i te tautoko i te wā pea he haerenga ahotea. Ka taea hoki te awhina o tetahi i reira mena ka hiahia koe ki te kōrero mō te tirotiro whānau.

Kaua e whakaroa ki te ui i ngā pātai i tō haerenga. Koinei tō wā ki te mārama ki tō ahuatanga me ngā whiringa maimoatanga. Uihia mō tetahi mea e awangawanga ana koe, tae atu ki ngā mahi e ora ana, me ngā tohu e hiahia ana ki te tiaki hauora wawe.

He aha te mea nui mō te ahuatanga o Brugada?

Ko te ahuatanga o Brugada he ahuatanga whiti ngakau kino engari e taea te whakahaere, e pā ana ki te pūnaha hiko o tō ngakau. Ahakoa ka taea te whakamate, he tokomaha ngā tāngata e pangia ana e te ahuatanga e ora ana i ngā oranga tino, mahi me te tiaki hauora tika me te whakahaere oranga.

Ko te mea nui kia mahara ko te whakatau wawe me te maimoatanga tika ka taea te whakaiti i tō morearea o ngā raruraru. Mena kei a koe ngā tohu, te hītori whānau rānei o te ahuatanga, kaua e tatari ki te rapu aromatawai hauora.

Ko te mahi tahi me te tohunga whiti ngakau he mea nui mō te whakahaere pai i te ahuatanga o Brugada. Ka taea e rātou te awhina i te whakatau i tō taumata morearea takitahi me te whakawhanake i te mahere maimoatanga e tika ana mōu. Ko te tiaki whai muri tonu me te noho mōhiohio mō tō ahuatanga he mea nui mō te whakahaere angitu.

Kia mahara ko te whai i te ahuatanga o Brugada kāore e whakaatu ana kaore e taea e koe te ora i te oranga noa. Me ngā whakaritenga tika me te tiaki hauora, ka taea e te nuinga o ngā tāngata e pangia ana e te ahuatanga te mahi, te whakakori, te koa hoki ki ō rātou mahi noa. Ko te mea nui ko te noho mōhiohio, te whai i tō mahere maimoatanga, me te pupuri i te kōrero whakatuwhera me tō rōpū hauora.

Ngā pātai e ui pinepinetia ana mō te ahuatanga o Brugada

Ka taea e ngā tāngata e pangia ana e te ahuatanga o Brugada te whakakori haumaru?

Ae, ka taea e te nuinga o ngā tāngata e pangia ana e te ahuatanga o Brugada te whakakori haumaru. Kāore i rite ki ngā ahuatanga ngakau maha atu, kāore ngā tohu o te ahuatanga o Brugada e puta mai i te wā e mahi tinana ana. Heoi, me kōrero koe mō ō mahere whakakori me tō kaitiaki ngakau kia tika ai mō tō āhuatanga motuhake.

Ka tūtohu pea tō tākuta ki te karo i ngā mahi tino uaua, ngā hākinakina rānei he morearea nui o te whara mena kei a koe te ICD. Ka āhei te awhina i a koe ki te whakawhanake i te mahere whakakori e pupuri ana i a koe i te hauora, i te whakaiti i ngā morearea.

He ira te ahuatanga o Brugada?

Ae, ko te ahuatanga o Brugada he ahuatanga ira e taea te whakawhiwhi mai i ngā mātua ki ngā tamariki. He 50% te tūponotanga o ia tamaiti o te tangata e pangia ana e te ahuatanga o Brugada ki te whakawhiwhi i te whakarerekētanga ira. Heoi, ko te whai i te whakarerekētanga kāore e whakamana ana ka puta mai ngā tohu.

Ko te tirotiro whānau te mea e tūtohutia ana ina whakatauhia tētahi me te ahuatanga o Brugada. Ka āhei tēnei ki te kimi i ētahi atu mema whānau pea e whai ana i te ahuatanga, e hiahia ana ki te tirotiro, ki te maimoatanga rānei.

Ka taea e ngā rongoā te whakaoho i ngā tohu o te ahuatanga o Brugada?

Ae, ka taea e ētahi rongoā te whakaoho i ngā whiti ngakau kino i ngā tāngata e pangia ana e te ahuatanga o Brugada. Kei roto i ēnei ētahi rongoā antiarrhythmic, tricyclic antidepressants, me ētahi anesthetics. Ka hoatu e tō tākuta ki a koe tētahi rārangi katoa o ngā rongoā hei karo.

Whakamōhiotia tonu tetahi kaiwhakarato hauora mō tō whakatau o te ahuatanga o Brugada i mua i te whakahau i ngā rongoā hou. Kei roto i ēnei ngā niho, ngā taote, me ētahi atu tohunga pea kāore e mōhio ki tō ahuatanga.

Me pēhea taku mahi mena ka pupuhi taku ICD?

Mena ka tuku tō ICD i te whakakiki, ngana ki te noho mārie, noho rānei i raro tonu. Ko te tikanga o te whakakiki kua kitea, kua maimoatia e tō taputapu he whiti ngakau kino. Whakapā atu ki tō tākuta, ki tō pokapū taputapu rānei inaianei hei whakamōhio i te whakakiki, whakaritea he hui whai muri.

Mena ka whiwhi koe i ngā whakakiki maha, kaore rānei e pai to ahua i muri i te whakakiki, rapu wawe i te tiaki hauora. Ka arotake tō rōpū taputapu i ngā raraunga mai i tō ICD hei mārama ki te mea i puta, kia whakatau rānei mena he whakarerekētanga e hiahiatia ana.

Ka taea e ngā wāhine e pangia ana e te ahuatanga o Brugada te whānau tamariki haumaru?

Ae, ka taea e ngā wāhine maha e pangia ana e te ahuatanga o Brugada te whānau tamariki haumaru, engari ko te hapu e hiahia ana ki te tirotiro tika e tō kaitiaki ngakau me tō tohunga whānau. Ko ngā huringa homoni i te wā hapu ka taea te tiaki i ētahi wāhi mai i ngā tohu o te ahuatanga o Brugada.

Ka tirotiro tika koe e tō rōpū hauora i te wā hapu me te whānau. Ka kōrero hoki rātou mō te tohutohu ira hei awhina i a koe ki te mārama ki ngā morearea o te whakawhiwhi i te ahuatanga ki ō tamariki me ngā whiringa whakamātautau.