Ukuqondwa kwe-Supraventricular Tachycardia: Izimpawu, Izimbangela, Nokwelashwa

I-Supraventricular tachycardia (SVT) kungenxa yokuthi inhliziyo yakho iqala ukushaya ngokushesha kakhulu ngokuzumayo, ngokuvamile ngaphezu kwezingxande eziyi-150 ngomzuzu. Cabanga ngayo njengesistimu yombane yenhliziyo yakho ehlupheka kancane futhi ithumela izibonakaliso ngokushesha kakhulu emakhameni aphezulu enhliziyo yakho.

Lesi simo siqeda izigidi zabantu futhi sivame ukwesaba lapho kwenzeka, kodwa ngokuvamile asiyingozi ekuphileni. Inhliziyo yakho ingashayela imizuzu embalwa noma amahora amaningana, bese ibuya ejwayelekile ngokwayo. Ukuqonda ukuthi kwenzekani kungakusiza uzizwe ulawula kakhulu lapho kwenzeka izigameko.

Iyini i-supraventricular tachycardia?

I-SVT iyinkinga yokuhlangana kwenhliziyo lapho inhliziyo yakho ishaya ngokushesha ngokweqile ngenxa yezibonakaliso zombane ezingalungile emakhameni aphezulu enhliziyo. Ingxenye ethi "supraventricular" isho ukuthi "ngaphezu kwe-ventricles," ebonisa amakhamera aphezulu enhliziyo ebizwa ngokuthi yi-atria.

Inhliziyo yakho inesistimu yayo yombane elawula ishaya ngalinye lenhliziyo. Ngesikhathi se-SVT, lesi sistimu yakha isikhuthazo esifushane, okubangela ukushaya kwenhliziyo okusheshayo, okujwayelekile. Izigameko eziningi ziqala futhi ziyeke ngokuzumayo, kungakho abantu abaningi bayichaza njengokuthi inhliziyo yabo "iqala" kwimodi esheshayo.

Kunezinhlobo ezintathu eziyinhloko ze-SVT, ngayinye ehilela izindlela zombane ezahlukene enhliziyweni yakho. Uhlobo oluvamile kakhulu luqeda cishe abantu abayi-2 kwabayi-1,000 ngesinye isikhathi ekuphileni kwabo.

Ziyini izimpawu ze-supraventricular tachycardia?

Isisindo esibonakalayo kakhulu ukushaya kwenhliziyo okusheshayo ngokuzumayo okubukeka sengathi inhliziyo yakho ishaya noma iduduza esifubeni sakho. Ungase uzizwe sengathi inhliziyo yakho iqhubekele ekuqhubekeni ngaphandle kokuxwayisa.

Nazi izimpawu ongazihlangabezana nazo ngesikhathi sesigameko se-SVT:

• Ukushaya kwenhliziyo okusheshayo (ngokuvamile izingxande eziyi-150-250 ngomzuzu)
• Ukushaya kwenhliziyo noma ukuzwela okududuzayo
• Ukungakhululeki noma ukubopha esifubeni
• Ukuphefumula okufushane
• Ukukhathazeka noma ukukhanya
• Ukubila
• Ukukhathala noma ubuthakathaka
• Ukuphefumula komphimbo
• Ukuhlupheka noma ukuzizwa ukhona

Abanye abantu nabo bahlangabezana nezimpawu ezingavamile njengokuphazamiseka komzimba, ukuzwa behluleka, noma isidingo esiphuthumayo sokuya emathisini. Ubukhulu bungase buhluke kumuntu ngamunye, futhi abanye abantu abaziboni kakhulu izigameko ezilula ngenkathi abanye bezithola zikhathaza kakhulu.

Ziyini izinhlobo ze-supraventricular tachycardia?

Kunezinhlobo ezintathu eziyinhloko ze-SVT, ngayinye ebangelwa yizinkinga zombane ezahlukene enhliziyweni yakho. Ukuqonda uhlobo lwakho kusiza udokotela wakho ukukhetha indlela yokwelapha engcono kakhulu.

I-AV nodal reentrant tachycardia (AVNRT) uhlobo oluvamile kakhulu, olukwakha cishe u-60% wazo zonke izimo ze-SVT. Lokhu kwenzeka lapho izibonakaliso zombane zibanjelwe elupeni oluzungezile i-AV node yenhliziyo yakho, evame ukusisiza ukuhlanganisa ukushaya kwenhliziyo phakathi kwamakhamera aphezulu naphansi.

I-AV reentrant tachycardia (AVRT) kwenzeka lapho une-indlela eyengeziwe yombane enhliziyweni yakho kusukela ekuzalweni. Lokhu kudala isikhulu esivumela izibonakaliso zombane ukuthi zihambe ngezigcawu, okubangela ukushaya kwenhliziyo okusheshayo. I-Wolff-Parkinson-White syndrome iyifomu elidumile kakhulu le-AVRT.

I-Atrial tachycardia ayivamile futhi kwenzeka lapho indawo eyodwa emakhameni aphezulu enhliziyo yakho ithumela izibonakaliso zombane ngokushesha kakhulu. Lolu hlobo ngezinye izikhathi luvela kubantu abanezimo zenhliziyo ezinye noma ngemuva kokuhlinzwa kwenhliziyo.

Yini ebangela i-supraventricular tachycardia?

I-SVT ngokuvamile ivela ezindleleni zombane ezingalungile enhliziyweni yakho ozalwa nazo. Lezi zindlela noma izikhulu ezingeziwe ngokuvamile azibangeli izinkinga kuze kube yilapho okuthile kuziqalisa kamuva ekuphileni.

Izici ezivamile ezingaqalisa isigameko se-SVT zifaka:

• Ukusetshenziswa kwe-caffeine noma utshwala
• Ukuhlupheka noma ukukhathazeka
• Ukungahlali kahle noma ukukhathala
• Ukuphelelwa amanzi
• Imithi ethile (njenge-decongestants)
• Ukubhema noma i-nicotine
• Ukuzivocavoca okukhulu noma ukushintsha kwesikhundla ngokuzumayo
• Ukushintsha kwamahomoni ngesikhathi sokukhulelwa noma ukuya esikhathini

Kwezinye izimo ezingavamile, izimo zenhliziyo eziyisisekelo njengokugula kwenhliziyo, izinkinga zesitho se-thyroid, noma izifo zephunga zingase zifake isandla kwi-SVT. Abanye abantu bathuthukisa i-SVT ngemuva kokuhlinzwa kwenhliziyo noma njengomphumela wecala wemithi ethile.

Abantu abaningi abane-SVT banenhliziyo ejwayelekile ngokwakhe, okusho ukuthi imisipha yenhliziyo nama-valves asebenza kahle. Inkinga iyombane kuphela, njengokuba ne-wiring issue ohlelweni oluphilile.

Nini okufanele ubona udokotela nge-supraventricular tachycardia?

Kufanele ubona udokotela uma uhlangabezana nezigameko zokushaya kwenhliziyo okusheshayo, ikakhulukazi uma kwenzeka ngokuphindaphindiwe noma kuhlala isikhathi esingaphezu kwemizuzu embalwa. Ngisho noma i-SVT ngokuvamile ayinayo ingozi, ukuthola ukuxilongwa okuhle kukusiza ukuqonda ukuthi kwenzekani futhi ufunde amasu okulawula.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uhlangabezana nalezi zibonakaliso zexwayiso ngesikhathi sesigameko sokushaya kwenhliziyo okusheshayo:

• Ubuhlungu besifuba noma ukungakhululeki okukhulu esifubeni
• Ukuphefumula okufushane kakhulu
• Ukuhluleka noma ukusondela ekuhlulekeni
• Ukukhathazeka okuqhubekayo
• Izigameko ezihlala isikhathi esingaphezu kwemizuzu engama-30
• Izibonakaliso zokwehluleka kwenhliziyo (ukuvuvukala ezinyaweni, ukwanda kwesisindo ngokuzumayo)

Shaya izinsizakalo eziphuthumayo uma unebuhlungu besifuba ngokushaya kwenhliziyo okusheshayo noma uma uzizwa sengathi ungase uhluleke. Lezi zimpawu, nakuba zingavamile nge-SVT, zidinga ukuhlolwa ngokushesha ukuze kuvinjwe ezinye izimo zenhliziyo ezinkulu.

Ziyini izici ezingozi ze-supraventricular tachycardia?

Izici eziningi zingandisa amathuba akho okuthuthukisa i-SVT, nakuba abantu abaningi abanezi zici ezingozi abazilangabezani nezigameko. Iminyaka nobulili badlala indima, nge-SVT ngokuvamile ivela okokuqala ebusheni.

Izici ezingozi ezivamile zifaka:

• Ukuba owesifazane (abesifazane banethuba elingaphezulu kabili lokuthuthukisa i-SVT)
• Iminyaka phakathi kweminyaka engama-12-40 yokugula kokuqala
• Umlando womndeni wezinkinga zokushaya kwenhliziyo
• Ukuhlupheka noma ukuhlaselwa kokukhathazeka
• Ukukhulelwa (ukushintsha kwamahomoni kungase kuqalise izigameko)
• Izifo ze-thyroid
• I-sleep apnea
• Ukusetshenziswa okukhulu kwe-caffeine noma utshwala

Ngokungavamile, izimo zenhliziyo ezithile ezikhona kusukela ekuzalweni, ukuhlinzwa kwenhliziyo kwangaphambili, noma izifo zephunga ezingapheli zingase zikhulise ingozi ye-SVT. Noma kunjalo, abantu abaningi abathuthukisa i-SVT abanayo i-heart disease futhi ngokuvamile baphilile.

Ukuba nezici ezingozi akusho ukuthi uzokuthuthukisa ngokuqinisekile i-SVT. Abantu abaningi abanezici ezingozi eziningi abazilangabezani nezigameko, ngenkathi abanye abangenazo izici ezingozi ezicacile bathuthukisa lesi simo.

Ziyini izinkinga ezingase zenzeke nge-supraventricular tachycardia?

Abantu abaningi abane-SVT baqhuba impilo evamile ngokuphelele ngaphandle kwezinkinga ezinkulu. Lesi simo ngokuvamile sihle, okusho ukuthi aliyilimazi inhliziyo yakho noma alifinyeleli isikhathi sakho sokuphila.

Noma kunjalo, izigameko ezivamile noma ezihlala isikhathi eside ngezinye izikhathi zingabangela:

• Ukuncipha kokuphila okuhle ngenxa yokukhathazeka ngezigameko
• Ukukhathala okuvela ezigamekweni eziphindaphindayo
• Ngokungavamile, ukubuthakathaka kwemisipha yenhliziyo uma izigameko zivame kakhulu futhi zihlala isikhathi eside
• Izingozi ezingabangelwa ukuqala ngokuzumayo ngesikhathi sokushayela noma eminye imisebenzi
• Ukuvakashela e-emergency room kanye nezindleko zezempilo

Kwezinye izimo ezingavamile kakhulu, abantu abanezinye izinhlobo ze-SVT (ikakhulu labo abane-Wolff-Parkinson-White syndrome) bangase bathuthukise izinkinga zokushaya kwenhliziyo ezinkulu. Lokhu kuqeda abantu abangaphansi kuka-1% abane-SVT futhi ngokuvamile kwenzeka kuphela ngezinhlobo ezithile zezindlela ezingalungile.

Umphumela wozwela ngokuvamile ubangela izinkinga eziningi kunomphumela womzimba. Abantu abaningi bathuthukisa ukukhathazeka mayelana nokuthi isigameko esilandelayo singase senzeke nini, okungase kuqalise izigameko eziningi futhi kudale isizungu sokukhathazeka.

I-supraventricular tachycardia ingavikeleka kanjani?

Nakuba ungakwazi ukuvimbela izindlela zombane eziyisisekelo ebangela i-SVT, ngokuvamile unganciphisa ubukhulu bezigameko ngokugwema izici zakho siqu. Ukugcina idayari yaleso sikhathi lapho izigameko zenzeka kusiza ukuqonda izici zakho ezithile.

Amasu okuphuza impilo angasiza ekuvimbeni izigameko afaka:

• Ukulinganisela ukusetshenziswa kwe-caffeine (ikhofi, itiye, amanzi amandla)
• Ukuncipha kokusetshenziswa kotshwala
• Ukuthola ukulala okwanele (amahora angu-7-9 ebusuku)
• Ukulawula ukucindezeleka ngezindlela zokupumula
• Ukugcina umzimba unamanzi
• Ukugwema ukubhema nemikhiqizo ye-nicotine
• Ukufunda imibhalo yemithi ye-stimulants
• Ukushintsha kwesikhundla kancane kancane (ikakhulukazi ukuvuka kancane)

Ukuzivocavoca okuvamile kuzuzisa impilo yenhliziyo, kodwa abanye abantu bathola ukuthi ukuzivocavoca okukhulu kuqalisa izigameko. Ungase udinga ukulungisa ubukhulu bakho bokuzivocavoca noma isikhathi ngokususelwa ekuphenduleni kwakho.

Amathuluzi okulawula ukucindezeleka njengokuphefumula okujulile, ukucamngca, noma i-yoga angaba usizo kakhulu ngoba ukucindezeleka nokukhathazeka kuyizici ezivamile. Abanye abantu bathola ukuthi ukuphumula okuvamile kunciphisa kokubili ubukhulu besigameko nokukhathazeka ngokuba nezigameko.

I-supraventricular tachycardia ixilongwa kanjani?

Ukuxilongwa kwe-SVT kuqala ngodokotela wakho olalela izimpawu zakho nomlando wakho wezokwelapha. Inselelo iwukuthi izigameko ngokuvamile ziyeka ngesikhathi ufika ehhovisi lika-dokotela, ngakho ukushaya kwenhliziyo yakho kubonakala kujwayelekile ngesikhathi sokuvakasha.

Udokotela wakho cishe uzosebenzisa ukuhlolwa okuhlukene ukuze abambe isigameko noma abuke izibonakaliso ze-SVT:

• I-Electrocardiogram (ECG) ngesikhathi sesigameko ibonisa ukushaya okusheshayo, okujwayelekile
• I-Holter monitor (ukurekhoda ukushaya kwenhliziyo kwamahora angu-24-48)
• I-Event monitor (egqokwe amasonto ambalwa ukuze ibambe izigameko ezingekho njalo)
• Ukuhlolwa kokucindezeleka ukuze kubonwe ukuthi ukuzivocavoca kuqalisa yini i-SVT
• Isifundo se-Electrophysiology (ukuhlonzwa okukhethekile okuqopha uhlelo lombane lenhliziyo)

Ukuxilongwa okuqinisekile kakhulu kuvela ekuqoshweni kokushaya kwenhliziyo yakho ngesikhathi sesigameko esiqinisekile. Kungakho udokotela wakho engase akucele ukuba uqambe i-monitor izinsuku ezimbalwa noma amasonto ambalwa kuze kube yilapho isigameko senzeka.

Ukuhlolwa kwegazi kungase kwenziwe ukuze kuhlolwe umsebenzi we-thyroid noma kubukele ezinye izimo ezingase zifake isandla ekuhambeni okusheshayo kwenhliziyo. I-echocardiogram (i-ultrasound yenhliziyo) iqinisekisa ukuthi isakhiwo senhliziyo yakho sijwayelekile.

Iyini ukwelashwa kwe-supraventricular tachycardia?

Ukwelashwa kwe-SVT kugxile ekuyekiseni izigameko ezikhona nokunciphisa ezizayo. Indlela ixhomeke ekutheni uba nezigameko kangakanani, ukuthi zikhathaza kangakanani, kanye nempilo yakho jikelele.

Ukuyekisa isigameko esisebenzayo, odokotela ngokuvamile bancoma ukuzama okuqondile kwe-vagal kuqala. Lena yindlela elula ehlukanisa inzwa yakho ye-vagus futhi ngezinye izikhathi ingase iyeke izigameko ze-SVT ngokwemvelo. I-Valsalva maneuver (ukuhlala phansi njengokungathi uya emathisini) isebenza kubantu abaningi.

Izinketho zemithi zifaka:

• I-Adenosine (inikezwa esibhedlela ukuze iyeke izigameko ezibuhlungu)
• I-Beta-blockers (ivimbela izigameko futhi inciphisa ukushaya kwenhliziyo)
• I-Calcium channel blockers (imiphumela efanayo ne-beta-blockers)
• Imithi ye-Anti-arrhythmic (yezimo ezinzima)

Kubantu abanezibonakaliso ezivamile, ezikhathazayo, i-catheter ablation inikeza ukwelashwa okungenzeka. Lolu hlelo lusebenzisa amandla okushisa noma ukubanda ukuze lubhubhise izindlela zombane ezingalungile ebangela i-SVT. Amanani okuphumelela aphezulu kakhulu (ngaphezu kuka-95% wezinye izinhlobo), futhi abantu abaningi abasabi isigameko esilandelayo ngemuva kokwelashwa kwe-ablation.

Isinqumo mayelana nobukhulu bokuwelapha sixhomeke ekupheleni kwakho. Abanye abantu banezigameko ezimbalwa, ezifushane futhi bakhetha ukungelaphi, ngenkathi abanye abanezibonakaliso ezivamile bazuza kakhulu ngemithi noma i-ablation.

Indlela yokwelapha ekhaya ngesikhathi se-supraventricular tachycardia?

Ukufunda amasu okuyeka izigameko ze-SVT ekhaya kungakunika ukuzethemba futhi kunciphisa ukukhathazeka ngalesi simo. Lezi zindlela zisebenza ngokuqalisa inzwa yakho ye-vagus, engase iphazamise isikhulu esingalungile sombane.

Amathuluzi asebenzayo ekhaya afaka:

• I-Valsalva maneuver: Bambani umoya wakho bese uhlala phansi imizuzwana engama-10-15
• Amanzi abandayo ebusweni noma i-ice pack ebusweni nasekhoneni
• Ukukhokha ngamandla izikhathi eziningi
• I-Carotid massage (uma ufundeke udokotela wakho kuphela)
• Ukuzivocavoca kokuphefumula okujulile
• Ukulala phansi ngezinyawo eziphakanyisiwe

Hlala uzolile ngesikhathi sezibonakaliso, ngoba ukukhathazeka kungase kubenze bahlale isikhathi eside. Hlala noma ulale phansi endaweni enhle bese uzama enye ye-vagal maneuvers. Izibonakaliso eziningi ziyeka ngaphakathi kwemizuzu embalwa ngalezi zindlela.

Gcina irekhodi lezigameko zakho, kufaka phakathi izici, ubude, nokuthi yini esisize ukuyeka. Lolu lwazi lusiza udokotela wakho ukulungisa uhlelo lwakho lokwelapha futhi lukusiza ukuqonda izici esimweni sakho.

Kufanele ulungiselele kanjani i-appointment yakho yodokotela?

Ukulungiselela kahle i-appointment yakho kusiza udokotela wakho ukuqonda kahle isimo sakho futhi athuthukise uhlelo lokwelapha oluphumelelayo kakhulu. Njengoba izigameko ze-SVT ngokuvamile zifushane futhi azikwazi ukubikezelwa, ulwazi oluqondile oluvela kuwe lubalulekile.

Ngaphambi kokuvakasha kwakho, bhala phansi:

• Inkulumo eningiliziwe yezimpawu zakho ngesikhathi sezibonakaliso
• Ukuthi izigameko zenzeka kangakanani nokuthi zihlala isikhathi esingakanani
• Izici ezingase uziqaphele
• Yini esiza ukuyeka izigameko
• Yonke imithi kanye nezinhlanganisela ozithathayo
• Umlando womndeni wezinkinga zenhliziyo
• Imibuzo mayelana nesimo sakho kanye nezinketho zokwelapha

Uma kungenzeka, zama ukurekhoda i-pulse yakho ngesikhathi sesigameko noma ube nomuntu oyibala imizuzwana engama-15 bese uyaluphindaphinda ngokune.

Letha uhlu lwabo bonke abahlinzeki bezempilo obabona kanye nanoma yikuphi ukuhlolwa kwenhliziyo kwangaphambili okwenzile. Uma ubelokhu uya e-emergency room ngezigameko, letha lezo zirekhodi uma zitholakala.

Iyini into ebalulekile mayelana ne-supraventricular tachycardia?

I-SVT iyisimo sokushaya kwenhliziyo esivamile, esivame ukuba sihle esibangela izigameko zokushaya kwenhliziyo okusheshayo. Nakuba lezi zigameko zingase zibe ukwesaba, ngokuvamile azibangeli izinkinga ezinkulu zezempilo futhi azilimazi inhliziyo yakho.

Abantu abaningi abane-SVT bangalawula isimo sabo ngokuphumelelayo ngokulungisa impilo, amathuluzi ekhaya, noma imithi uma kudingeka. Kulabo abanezibonakaliso ezivamile, ezikhathazayo, i-catheter ablation inikeza ithuba elihle lokwelashwa ngengozi encane.

Okubalulekile ukusebenzisana nodokotela wakho ukuthuthukisa uhlelo lokulawula oluhambisana nesimo sakho esithile. Ngokuqonda okuhle nokwelashwa, abantu abane-SVT ngokuvamile baqhuba impilo evamile, esebenzayo ngaphandle kokulinganiselwa.

Imibuzo evamile ebuzwa mayelana ne-supraventricular tachycardia

Q.1 Ingakwelashwa ngokuphelele yini i-supraventricular tachycardia?

Yebo, i-SVT ngokuvamile ingalashwa ngokuphelele ngenqubo ebizwa ngokuthi i-catheter ablation. Lolu hlelo lokwelapha olukhulu luncane lubhubhisa izindlela zombane ezingalungile ebangela i-SVT yakho, ngamanani okuphumelela angaphezu kuka-95% wezinye izinhlobo. Abantu abaningi abasabi isigameko esilandelayo ngemuva kokwelashwa okuphumelelayo kwe-ablation.

Q.2 Kuphephile yini ukuzivocavoca nge-supraventricular tachycardia?

Abantu abaningi abane-SVT bangazivocavoca ngokuphephile, nakuba ungase udinga ukulungisa uhlelo lwakho ngokususelwa ezicini zakho. Abanye abantu bathola ukuthi ukuzivocavoca okukhulu kuqalisa izigameko, ngenkathi abanye abanawo amaphutha. Qala kancane, gcina umzimba unamanzi, bese uyeka uma uzwa isigameko siqala. Xoxani ngezinhlelo zakho zokuzivocavoca nodokotela wakho.

Q.3 Ingabe ukukhulelwa kungathinta i-supraventricular tachycardia?

Ukukhulelwa kungase kukhulise ubukhulu bezigameko ze-SVT ngenxa yokushintsha kwamahomoni, ukwanda kwamagama egazi, nokucindezeleka komzimba enhliziyweni. Noma kunjalo, i-SVT ngesikhathi sokukhulelwa ngokuvamile ilawuleka futhi ngokuvamile ayilimazi ingane. Udokotela wakho angalungisa imithi ukuze aqinisekise ukuphepha kokubili wena nengane yakho.

Q.4 Ingabe i-supraventricular tachycardia izoba mbi ngokuhamba kwesikhathi?

I-SVT ngokuvamile ayibi ngokuhamba kwesikhathi noma ibingelisi ukulimala kwenhliziyo okuqhubekayo. Abanye abantu bahlangabezana nezibonakaliso ngokuphindaphindiwe njengoba bekhula, ngenkathi abanye bathola ukuthi ziya nciphisa. Isimo ngokwalo aliholeli kwezinye izinkinga zenhliziyo ezinkulu kubantu abaningi.

Q.5 Ingabe ukucindezeleka kudala izigameko ze-supraventricular tachycardia?

Ukucindezeleka nokukhathazeka kuyizici ezivamile kakhulu zezigameko ze-SVT, kodwa azibangeli isimo esiyisisekelo. Izindlela zombane ezingalungile ngokuvamile zikhona kusukela ekuzalweni, futhi ukucindezeleka kuziqalisa nje ukuthi zisebenze. Ukulawula ukucindezeleka ngezindlela zokupumula, ukulala okwanele, kanye nokushintsha impilo kunganciphisa kakhulu ubukhulu besigameko.