He aha te Supraventricular Tachycardia? Ngā Tohutohu, Ngā Take, me te Maimoatanga

Ko te supraventricular tachycardia (SVT) te tere haere o te whiu o tō ngakau, te nuinga atu i te 150 whiu ia meneti. Whakaarohia he mea raru te pūnaha hiko o tō ngakau, ā, e tuku ana i ngā tohu tere rawa atu i ngā ruma o runga o tō ngakau.

E pā ana tenei āhuatanga ki te mano o te iwi, ā, e tino wehi ana te ahua i te wā e puta mai ana, engari ehara i te mea ngāwari te mate. Ka tere pea tō ngakau mō ngā meneti torutoru, ā, ka hoki ki te noho mārama. Ko te mārama ki te mea kei te pēhea, ka āwhina iā koe ki te whakahaere i ngā wāhanga e puta mai ana.

He aha te supraventricular tachycardia?

Ko te SVT he raruraru o te whiu o te ngakau, kei reira te tere o te whiu o tō ngakau nā te raru o ngā tohu hiko i ngā ruma o runga o te ngakau. Ko te kī 'supraventricular' he tikanga 'i runga i ngā ventricles,' e tohu ana ki ngā ruma o runga o te ngakau e kiia nei ko ngā atria.

He pūnaha hiko ake tō ngakau e whakahaere ana i ia whiu o te ngakau. I te wā o te SVT, ka hanga tēnei pūnaha he kōwhiti poto, e puta ai ngā whiu tere, ā, tika o te ngakau. Ko te nuinga o ngā wāhanga ka tīmata ka mutu ngāwari, koia te take i whakaahuatia ai e te tini o te iwi he 'whakahohe' tō ngakau ki te aratau tere.

E toru ngā momo matua o te SVT, kei ia momo ngā ara hiko rerekē i roto i tō ngakau. Ko te momo tino noa e pā ana ki te 2 i ia 1,000 o te iwi i tētahi wā o o rātou oranga.

He aha ngā tohu o te supraventricular tachycardia?

Ko te tohu tino marama ko te tere haere o te whiu o te ngakau, e rite ana ki te pupuhi, ki te rere o tō ngakau i roto i tō uma. Ka rite pea koe ki te tere haere o tō ngakau ki te tere nui kahore he whakatūpato.

Ko ēnei ngā tohu ka pā atu ki a koe i te wā o te wāhanga SVT:

• Te tere o te whiu o te ngakau (te nuinga 150-250 whiu ia meneti)
• Te pupuhi, te rere o te ngakau
• Te mamae, te pēhanga o te uma
• Te poto o te manawa
• Te māuiui, te ngāwari ki te ngaro
• Te werawera
• Te ngenge, te ngoikore
• Ngā pupuhi o te kaki
• Te manukanuka, te wehi

Ko ētahi atu o te iwi ka pā atu ki ngā tohu kahore rawa e tino kitea, penei i te ruaki, te ngāwari ki te ngaro, te hiahia nui ki te mimi. Ka rerekē te kaha mai i te tangata ki te tangata, ā, ko ētahi kaore e tino kite i ngā wāhanga ngawari, engari ko ētahi ka kite he tino raruraru.

He aha ngā momo o te supraventricular tachycardia?

E toru ngā momo matua o te SVT, kei ia momo ngā raruraru hiko rerekē i roto i tō ngakau. Ko te mārama ki tō momo ka āwhina i tō tākuta ki te whiriwhiri i te huarahi maimoatanga pai.

AV nodal reentrant tachycardia (AVNRT) ko te momo tino noa, e 60% pea o ngā take SVT katoa. Ka puta mai tēnei ina mau ngā tohu hiko i roto i te porowhita i te AV node o tō ngakau, e āwhina ana i te whakahaere i ngā whiu o te ngakau i waenganui i ngā ruma o runga me ngā ruma o raro.

AV reentrant tachycardia (AVRT) ka puta mai ina he ara hiko atu koe i te whānau. Ka hanga tēnei i te porowhita e taea ai te haere o ngā tohu hiko i roto i ngā porowhita, e puta ai ngā whiu tere o te ngakau. Ko te Wolff-Parkinson-White syndrome te ahua tino mohiotia o te AVRT.

Atrial tachycardia ehara i te mea noa, ā, ka puta mai ina tere rawa te pupuhi o tetahi wāhi i ngā ruma o runga o tō ngakau i ngā tohu hiko. Ka puta mai tēnei momo i ētahi wā i ngā tāngata kei a rātou ētahi atu āhuatanga o te ngakau, i muri rānei i te pokanga ngakau.

He aha ngā take o te supraventricular tachycardia?

Ko te SVT te tikanga he hua mai i ngā ara hiko raru i roto i tō ngakau i whānau mai koe. Ko ēnei ara atu, porowhita rānei kaore e tino pākia kia tae rawa ki tetahi mea e whakaoho ana i a rātou i muri mai i te oranga.

Ko ngā mea whakaoho noa e taea te tīmata i te wāhanga SVT:

• Te inu kofeine, waipiro rānei
• Te ahotea, te manukanuka rānei
• Te kore moe, te ngenge rānei
• Te ngauwai
• Ētahi rongoā (penei i ngā decongestants)
• Te kai hikareti, te nikotini rānei
• Te whakapakari tinana, te huri o te tu rānei
• Ngā huringa homoni i te wā hapu, i te wā o te meneti rānei

I ngā take onge, ko ngā āhuatanga o te ngakau penei i te mate ngakau, ngā raruraru tairoirōiti, ngā mate pūkahukahu rānei ka āwhina ki te SVT. Ka puta mai te SVT i ētahi wā i muri i te pokanga ngakau, i te pānga rānei o ētahi rongoā.

Ko te nuinga o te iwi kei a rātou te SVT he ngakau noa te hanganga, ko te tikanga ko te uaua ngakau me ngā pereti e mahi pai ana. Ko te raruraru he hiko noa iho, penei i te raruraru waea i roto i te pūnaha hauora.

Nōhea te haere ki te tākuta mō te supraventricular tachycardia?

Me haere koe ki te tākuta mena ka pā atu ki a koe ngā wāhanga o te tere o te whiu o te ngakau, ina koa mena ka puta mai anō rātou, ka roa atu rānei i ngā meneti torutoru. Ahakoa ehara i te mea kino te SVT, ko te whiwhi i te tautuhi tika ka āwhina iā koe ki te mārama ki te mea kei te pēhea, ā, ka ako i ngā rautaki whakahaere.

Rapua te awhina hauora tūturu mena ka pā atu ki a koe ēnei tohu whakatūpato i te wā o te wāhanga whiu tere o te ngakau:

• Te mamae o te uma, te kore ngāwari nui rānei o te uma
• Te poto nui o te manawa
• Te ngaro, te tata ki te ngaro rānei
• Te māuiui tonu
• Ngā wāhanga e roa atu ana i te 30 meneti
• Ngā tohu o te ngoikore o te ngakau (te pupuhi o ngā waewae, te piki o te taumaha)

Karangahia ngā ratonga āwhina tūturu mena he mamae o te uma me te tere o te whiu o te ngakau, mena ka rite koe ki te ngaro. Ko ēnei tohu, ahakoa onge ki te SVT, me whakamātautau tūturu kia kore ai e puta mai ētahi atu āhuatanga kino o te ngakau.

He aha ngā take morearea mō te supraventricular tachycardia?

He maha ngā take ka piki ake ai tō tūponotanga ki te whanake i te SVT, ahakoa ko te tini o te iwi kei a rātou ēnei take morearea kaore e pā atu ki ngā wāhanga. Ko te tau me te ira tangata e mahi ana, ā, ko te SVT te nuinga o te wā ka puta tuatahi i te taitamarikitanga.

Ko ngā take morearea noa:

• Ko te wahine (e rua te tupono o ngā wāhine ki te whanake i te SVT)
• Te tau i waenganui i te 12-40 tau mō ngā wāhanga tuatahi
• Te hītori whānau o ngā raruraru whiu ngakau
• Ngā mate manukanuka, ngā whakaeke manukanuka rānei
• Te hapu (ka taea e ngā huringa homoni te whakaoho i ngā wāhanga)
• Ngā mate tairoirōiti
• Te moe apnea
• Te nui o te inu kofeine, waipiro rānei

Kaore e tino kitea, ko ētahi āhuatanga o te ngakau e puta mai ana i te whānau, te pokanga ngakau o mua, ngā mate pūkahukahu roa rānei ka piki ake ai te morearea SVT. Engari, ko te nuinga o te iwi e whanake ana i te SVT kahore he mate ngakau kei raro, ā, he hauora.

Ko te whai i ngā take morearea kaore e tikanga ka whanake koe i te SVT. Ko te tini o te iwi kei a rātou ngā take morearea maha kaore e pā atu ki ngā wāhanga, ā, ko ētahi atu kahore he take morearea marama ka whanake i te āhuatanga.

He aha ngā raruraru pea o te supraventricular tachycardia?

Ko te nuinga o te iwi kei a rātou te SVT e ora ana i te oranga noa kahore he raruraru kino. Ko te āhuatanga he pai te tikanga, ko te tikanga kaore e pakaru tō ngakau, kāore hoki e poto tō oranga.

Engari, ko ngā wāhanga maha, roa rānei ka taea pea te puta mai:

• Te heke o te kounga o te oranga nā te manukanuka mō ngā wāhanga
• Te ngenge mai i ngā wāhanga maha
• Kaore e tino kitea, te ngoikore o te uaua ngakau mena he tino maha, he roa ngā wāhanga
• Ngā aituā nā te tīmatanga ohorere i te wā e taraiwa ana, i ētahi atu mahi rānei
• Ngā haerenga ki te ruma āwhina tūturu me ngā utu hauora

I ngā take onge rawa, ko te iwi kei a rātou ētahi momo SVT (inā koa rātou kei a rātou te Wolff-Parkinson-White syndrome) ka taea pea te whanake i ngā raruraru whiu nui atu. E pā ana tenei ki te kore atu i te 1% o te iwi kei a rātou te SVT, ā, ko te nuinga o te wā ka puta mai anake ki ngā momo ara raru motuhake.

Ko te pānga hinengaro te nuinga o te wā e puta mai ana ngā raruraru atu i ngā pānga tinana. Ko te tini o te iwi e whanake ana i te manukanuka mō te wā e puta mai ai te wāhanga e whai ake nei, ka taea pea te whakaoho i ngā wāhanga atu, ā, ka hanga he porowhita o te manukanuka.

Me pēhea te aukati i te supraventricular tachycardia?

Ahakoa kaore e taea e koe te aukati i ngā ara hiko kei raro e puta ai te SVT, ka taea pea e koe te whakaiti i te maha o ngā wāhanga mā te karo i ō whakaoho whaiaro. Ko te pupuri i te tātai o te wā e puta mai ana ngā wāhanga ka āwhina ki te kimi i ō tauira motuhake.

Ngā rautaki noho e taea te āwhina i te aukati i ngā wāhanga:

• Te whakaiti i te inu kofeine (kofe, tii, inu kaha)
• Te whakaiti i te inu waipiro
• Te whiwhi i te moe tika (7-9 haora ia pō)
• Te whakahaere i te ahotea mā ngā tikanga whakamahinga
• Te noho pai te wai
• Te karo i te kai hikareti me ngā hua nikotini
• Te pānui i ngā tohu rongoā mō ngā mea whakaoho
• Ngā huringa tu ngawari (inā koa te whakatikatika i te tere)

Ko te whakapakari tinana he pai te tikanga mō te hauora o te ngakau, engari ko ētahi ka kite he whakaoho ngā wāhi mahi kaha i ngā wāhanga. Ka hiahia pea koe ki te whakarite i tō kaha whakapakari tinana, i tō wā rānei i runga i tō whakautu.

Ko ngā tikanga whakahaere ahotea penei i te manawa hohonu, te whakaaroaro, te yoga rānei ka tino āwhina, nā te mea ko te ahotea me te manukanuka ngā whakaoho noa. Ko ētahi ka kite he whakaiti i te maha o ngā wāhanga me te manukanuka mō te whai wāhanga ngā mahi whakamahinga noa.

Me pēhea te tautuhi i te supraventricular tachycardia?

Ko te tautuhi i te SVT ka tīmata mā tō tākuta e whakarongo ana ki ō tohu me tō hītori hauora. Ko te wero ko te mutunga o ngā wāhanga i te wā e tae atu ana koe ki te tari o te tākuta, no reira ka rite te whiu o tō ngakau i te wā o te haerenga.

Ka whakamahi pea tō tākuta i ngā whakamātautau maha hei hopu i te wāhanga, hei titiro rānei ki ngā tohu o te SVT:

• Electrocardiogram (ECG) i te wā o te wāhanga e whakaatu ana i te whiu tere, tika
• Holter monitor (te tuhi whiu ngakau 24-48 haora)
• Event monitor (e mau ana mō ngā wiki hei hopu i ngā wāhanga onge)
• Te whakamātautau ahotea hei tiro mena ka whakaoho te whakapakari tinana i te SVT
• Electrophysiology study (te whakamātautau motuhake e whakaahua ana i te pūnaha hiko o te ngakau)

Ko te tautuhi tino tika mai i te tuhi i te whiu o tō ngakau i te wā o te wāhanga. Koia te take ka tono pea tō tākuta kia mau koe i te mataara mō ngā rā, wiki rānei kia puta mai rawa te wāhanga.

Ka taea te mahi i ngā whakamātautau toto hei tirotiro i te mahi tairoirōiti, hei titiro rānei ki ētahi atu āhuatanga e taea te āwhina ki ngā whiu tere o te ngakau. Ko te echocardiogram (te ultrasound ngakau) e whakarite ana he noa te hanganga o tō ngakau.

He aha te maimoatanga mō te supraventricular tachycardia?

Ko te maimoatanga mō te SVT e aro ana ki te mutu i ngā wāhanga o nāianei, ki te aukati rānei i ngā wāhanga e whai ake nei. Ko te huarahi e whakawhirinaki ana ki te maha o ngā wāhanga e whai ana koe, ki te āwangawanga rānei, ki tō hauora whānui.

Mō te mutu i te wāhanga e mahi ana, ko ngā tākuta te nuinga o te wā e tūtohutia ana ngā mahi vagal tuatahi. Ko ēnei ngā tikanga ngāwari e whakaoho ana i tō ngakau vagus, ā, ka taea pea te mutu i ngā wāhanga SVT ngāwari. Ko te mahi Valsalva (te pupuri i tō manawa, te pēhi iho rānei penei i te mimi) e mahi ana mō te tini o te iwi.

Ko ngā whiringa rongoā:

• Adenosine (e hoatu ana i te hōhipera hei mutu i ngā wāhanga pakari)
• Beta-blockers (e aukati ana i ngā wāhanga, e whakaiti ana i te tere o te ngakau)
• Calcium channel blockers (ngā pānga rite ki ngā beta-blockers)
• Ngā rongoā anti-arrhythmic (mō ngā take uaua)

Mō te iwi kei a rātou ngā wāhanga maha, āwangawanga rānei, ko te catheter ablation e tuku ana i te rongoā pea. Ko tēnei tukanga e whakamahi ana i te wera, i te makariri rānei hei whakangaro i ngā ara hiko raru e puta ai te SVT. Ko ngā reiti angitu he tino teitei (atu i te 95% mō te nuinga o ngā momo), ā, ko te tini o te iwi kaore e whai wāhanga atu i muri i te ablation.

Ko te whakatau mō te kaha o te maimoatanga e whakawhirinaki ana ki tō kounga o te oranga. Ko ētahi kei a rātou ngā wāhanga onge, poto, ā, e pai ana ki te kore maimoatanga, ā, ko ētahi atu kei a rātou ngā wāhanga maha e tino pai ana i te rongoā, i te ablation rānei.

Me pēhea te tango i te maimoatanga kāinga i te wā o te supraventricular tachycardia?

Ko te ako i ngā tikanga hei mutu i ngā wāhanga SVT i te kāinga ka taea te hoatu i te whakawhirinaki, te whakaiti rānei i te manukanuka mō te āhuatanga. Ko ēnei tikanga e mahi ana mā te whakaoho i tō ngakau vagus, e taea ai te whakakore i te porowhita hiko raru.

Ngā tikanga kāinga whai hua:

• Mahi Valsalva: Pupuri i tō manawa, pēhi iho mō ngā 10-15 hēkona
• Wai makariri ki runga i te mata, i te putea huka rānei ki runga i te mata me te kaki
• Te mare mare i ngā wā maha
• Te mirimiri carotid (mena kua whakaakona e tō tākuta)
• Ngā mahi manawa hohonu
• Te takoto ki raro me ngā waewae teitei

Noho mārama i te wā o ngā wāhanga, nā te mea ka taea e te manukanuka te whakaroa i a rātou. Noho, takoto rānei i te tūnga ngāwari, ā, whakamātautau i tētahi o ngā mahi vagal. Ko te tini o ngā wāhanga e mutu ana i roto i ngā meneti torutoru me ēnei tikanga.

Pupuri i te tuhi o ō wāhanga, tae atu ki ngā whakaoho, te roa, me te mea i āwhina ki te mutu i a rātou. Ko tēnei mōhiohio ka āwhina i tō tākuta ki te whakarite i tō mahere maimoatanga, ā, ka āwhina iā koe ki te kimi i ngā tauira i roto i tō āhuatanga.

Me pēhea te whakarite mō tō hui tākuta?

Ko te whakarite pai mō tō hui ka āwhina i tō tākuta ki te mārama pai ake ki tō āhuatanga, ki te whakawhanake rānei i te mahere maimoatanga tino whai hua. Nā te mea ko ngā wāhanga SVT he poto, he kore e mōhiotia, ko ngā mōhiohio taipitopito mai i a koe he tino nui.

I mua i tō haerenga, tuhia:

• Te whakaahuatanga taipitopito o ō tohu i ngā wāhanga
• Te maha o ngā wāhanga e puta mai ana me te roa o rātou
• Ngā whakaoho pea kua kitea e koe
• Te mea e āwhina ana ki te mutu i ngā wāhanga
• Ngā rongoā me ngā taapiri katoa e inu ana koe
• Te hītori whānau o ngā raruraru ngakau
• Ngā pātai mō tō āhuatanga me ngā whiringa maimoatanga

Mena e taea ana, ngana ki te tuhi i tō pupuhi i te wā o te wāhanga, ki te whakatau rānei tētahi mō ngā 15 hēkona, ka whakararu ki te whā. Ko ētahi taupānga waea atamai ka āwhina ki te mataara i te tere o te ngakau, ahakoa ehara i te mea tika i ngā whiu tere rawa.

Mau mai he rārangi o ngā kaiwhakarato hauora katoa e kite ana koe, me ētahi whakamātautau ngakau o mua kua whai koe. Mena kua haere koe ki te ruma āwhina tūturu mō ngā wāhanga, mau mai aua rēkōta mena e wātea ana.

He aha te mea nui mō te supraventricular tachycardia?

Ko te SVT he āhuatanga whiu ngakau noa, pai te tikanga e puta ai ngā wāhanga o te tere o te whiu o te ngakau. Ahakoa ka wehi te ahua o ēnei wāhanga, kaore e tino pākia ngā raruraru hauora nui, kāore hoki e pakaru tō ngakau.

Ko te nuinga o te iwi kei a rātou te SVT ka taea te whakahaere i tō āhuatanga mā ngā whakaritenga noho, ngā tikanga kāinga, ngā rongoā rānei ina hiahiatia. Mō te hunga kei a rātou ngā wāhanga maha, āwangawanga rānei, ko te catheter ablation e tuku ana i te tupono pai o te rongoā me te iti o te morearea.

Ko te mea nui ko te mahi tahi me tō tākuta hei whakawhanake i te mahere whakahaere e rite ana ki tō tūāhua motuhake. Mā te mārama me te maimoatanga tika, ko te iwi kei a rātou te SVT te nuinga o te wā e ora ana i te oranga noa, kaha kahore he whakatau.

Ngā pātai e ui pinepinetia ana mō te supraventricular tachycardia

Q.1 Ka taea te rongoā tonu te supraventricular tachycardia?

Ae, ka taea te rongoā tonu te SVT mā te tukanga e kiia nei ko te catheter ablation. Ko tēnei maimoatanga iti te whakangaro i ngā ara hiko raru e puta ai tō SVT, me ngā reiti angitu e pā atu ana ki te 95% mō te nuinga o ngā momo. Ko te tini o te iwi kaore e whai wāhanga atu i muri i te ablation angitu.

Q.2 He haumaru te whakapakari tinana me te supraventricular tachycardia?

Ko te nuinga o te iwi kei a rātou te SVT ka taea te whakapakari tinana haumaru, ahakoa ka hiahia pea koe ki te whakarite i tō mahi i runga i ō whakaoho. Ko ētahi ka kite he whakaoho ngā wāhi mahi kaha i ngā wāhanga, ā, ko ētahi kahore he raruraru. Tīmata ngāwari, noho pai te wai, mutu hoki mena ka kite koe i te wāhanga e tīmata ana. Kōrerohia ō mahere whakapakari tinana ki tō tākuta.

Q.3 Ka pā te hapu ki te supraventricular tachycardia?

Ka taea e te hapu te piki ake i te maha o ngā wāhanga SVT nā ngā huringa homoni, te nui o te toto, te ahotea tinana rānei ki te ngakau. Engari, ko te SVT i te wā hapu te nuinga o te wā ka taea te whakahaere, kāore hoki e kino ki te pēpi. Ka taea e tō tākuta te whakarite i ngā rongoā hei whakarite i te haumaru mōu me tō pēpi.

Q.4 Ka kino ake te supraventricular tachycardia i te wā?

Ko te SVT te tikanga kaore e kino ake i te wā, kāore hoki e puta mai te pakaru o te ngakau. Ko ētahi ka whai wāhanga maha ake i te wā e koroheke ana, ā, ko ētahi ka kite he iti ake te maha. Ko te āhuatanga anō kaore e ārahi ki ētahi atu raruraru kino o te ngakau i te nuinga o te iwi.

Q.5 Ka taea e te ahotea anake te whakaoho i ngā wāhanga supraventricular tachycardia?

Ko te ahotea me te manukanuka kei roto i ngā whakaoho tino noa mō ngā wāhanga SVT, engari kaore e puta mai te āhuatanga kei raro. Ko ngā ara hiko raru te nuinga o te wā e puta mai ana i te whānau, ā, ko te ahotea anake te whakaoho i a rātou ki te whakahohe. Ko te whakahaere i te ahotea mā ngā tikanga whakamahinga, te moe tika, me ngā whakaritenga noho ka taea te whakaiti nui i te maha o ngā wāhanga.