Paroxysmal tachycardia supraventricular (PSVT)

Paroxysmal supraventricular tachycardia (PSVT) waa dhacdooyin xaddiga garaaca wadnaha oo degdeg ah oo ka bilaabma qayb ka mid ah wadnaha oo ka sarreysa marinnada. "Paroxysmal" waxaa loola jeedaa waqti ka waqti.

Caadi ahaan, qolalka wadnaha (atria iyo ventricles) waxay ku qandaraasyaan qaab isku duuban.

• Maroojisyada waxaa sababa calaamadda korantada oo ka bilaabata meel wadnaha ka mid ah oo loo yaqaan 'sinoatrial node' (oo sidoo kale loo yaqaanno sinus node ama SA node).
• Calaamaddu waxay ku dhex socotaa qolalka sare ee wadnaha (atria) waxayna u sheegaysaa atria inay is qabsato.
• Taas ka dib, calaamaddu waxay hoos ugu degtaa wadnaha waxayna u sheegtaa qolalka hoose (ventricles) inay qandaraas galaan.

Qiyaasta wadnaha ee degdegga ah ee ka timaadda PSVT waxay ku bilaaban kartaa dhacdooyinka ka dhaca meelaha wadnaha ka sarreeya qolalka hoose (ventricles).

Waxaa jira dhowr sababo gaar ah oo keena PSVT. Waxay horumarin kartaa marka qiyaasaha daawada wadnaha, dijitaalku, ay aad u sarreeyaan. Waxay sidoo kale ku dhici kartaa xaalad loo yaqaan 'Wolff-Parkinson-White syndrome', oo inta badan lagu arko dhalinyarada iyo dhallaanka.

Waxyaabaha soo socda ayaa kordhiya halista aad ugu jirto PSVT:

• Isticmaalka khamriga
• Isticmaalka kaafiinka
• Isticmaalka daroogada sharci darrada ah
• Sigaar cabid

Astaamuhu badanaa waxay u bilowdaan una istaagaan si lama filaan ah. Waxay socon karaan dhowr daqiiqo ama dhowr saacadood. Calaamadaha waxaa ka mid noqon kara:

• Walaac
• Laab adag
• Jasbado (dareen ah dareemidda garaaca wadnaha), oo inta badan leh qaddarin aan caadi ahayn ama dhakhso ah (tartanka)
• Garaaca wadnaha
• Neefta oo kugu yaraata

Calaamadaha kale ee ku dhici kara xaaladdan waxaa ka mid ah:

• Dawakhaad
• Suuxdin

Baadhitaan jireed inta lagu jiro dhacdada PSVT wuxuu muujin doonaa garaaca wadnaha oo deg deg ah. Waxa kale oo laga yaabaa inay ku tusto garaac xoog leh qoorta.

Qiyaasta wadnaha ayaa laga yaabaa inay ka sarreyso 100, iyo xitaa in ka badan 250 garaac daqiiqaddii (bpm). Carruurta, garaaca wadnaha ayaa u muuqda mid aad u sarreeya. Waxaa jiri kara calaamado wareega dhiigga oo liita sida madax-xanuun. Inta udhaxeysa dhacdooyinka PSVT, garaaca wadnaha waa caadi (60 ilaa 100 bpm).

ECG inta lagu jiro astaamaha waxay muujineysaa PSVT. Daraasad elektirojiyadeed (EPS) ayaa loo baahan karaa si loo helo cilad sax ah iyo in la helo daaweynta ugu fiican.

Sababtoo ah PSVT way timaaddaa oo tagtaa, si loo baaro dadku waxay u baahan karaan inay xirtaan 24-saacadood oo ah Holter monitor. Muddo dheer, cajalad kale oo aaladda wax lagu duubo laxanka ah ayaa la isticmaali karaa.

PSVT-da oo dhacda kaliya hal mar inyar uma baahnid daaweyn haddii aadan lahayn astaamo ama dhibaatooyin kale oo wadnaha ah.

Waxaad isku dayi kartaa farsamooyinka soo socda si aad u hakiso garaaca wadnaha degdegga ah inta lagu jiro dhacdo PSVT:

• Manhajka Valsalva. Si tan loo sameeyo, waxaad haysaa neeftaada iyo culeyskaaga, sidii aad isku dayeyso inaad saxarooto.
• Qufac adoo fadhiya iyadoo jirkaaga kore uu foorarsanayo.
• Ku daadinta biyaha barafka wajigaaga

Waa inaad iska ilaalisaa sigaar cabista, kafeega, aalkolada, iyo daroogooyinka sharci darrada ah.

Daaweynta degdegga ah si loo yareeyo garaaca wadnaha oo loogu celiyo sidii caadiga ahayd waxaa ka mid noqon kara:

• Kala-baxa korantada, isticmaalka shoogga korantada
• Daawada xididka la mariyo

Daaweynta muddada-dheer ee loogu talagalay dadka ku soo noqnoqda dhacdooyinka PSVT, ama sidoo kale leh cudur wadne, waxaa ka mid noqon kara:

• Kala-bixidda Wadnaha, waa nidaam loo isticmaalo in lagu baabi'iyo aagag yar oo wadnahaaga ka mid ah oo laga yaabo inuu sababo garaaca wadnaha oo deg deg ah (xilliganna ah daaweynta xulashada inta badan PSVTs)
• Daawooyinka maalinlaha ah si looga hortago dhacdooyinka soo noqnoqda
• Kiciyeyaasha si looga takhaluso garaaca wadnaha degdegga ah (mararka qaarkood waxaa loo isticmaali karaa carruurta qaba PSVT ee aan ka jawaabin daaweyn kale)
• Qalliin lagu beddelayo waddooyinka wadnaha ee soo dira calaamadaha korantada (tan waxaa lagula talin karaa mararka qaarkood dadka u baahan qalliinka kale ee wadnaha)

PSVT guud ahaan halis ma aha nolosha. Haddii jirrooyinka kale ee wadnuhu ay jiraan, waxay u horseedi kartaa wadnaha oo isku ciriiriya ama angina.

Wac daryeel caafimaad bixiyaha haddii:

• Waxaad dareemaysaa dareen ah in wadnahaagu si dhakhso leh u garaacayo astaamuhuna iskood kuma dhammaanayaan daqiiqado yar gudahood.
• Waxaad taariikh ku leedahay PSVT oo dhacdo kama baxdo mansabka Valsalva ama qufac.
• Waxaad leedahay astaamo kale oo leh garaaca wadnaha oo degdeg ah.
• Astaamuhu badanaa way soo noqdaan.
• Calaamado cusub ayaa soo kordha.

Gaar ahaan waa muhiim inaad la xiriirto takhtarkaaga haddii aad sidoo kale leedahay dhibaatooyin kale oo wadnaha ah.

PSVT; Tachycardia supraventricular; Wadna garaac aan caadi ahayn - PSVT; Arrhythmia - PSVT; Qiyaasta wadnaha oo deg deg ah - PSVT; Qiyaasta garaaca wadnaha - PSVT

• Nidaamka wadista wadnaha
• Holter kormeerka wadnaha

Dalal AS, Van Hare GF. Khalkhal gelinta heerka iyo laxanka wadnaha. Gudaha: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Buugga Buugga Caafimaadka Caruurta. 21aad ed. Philadelphia, PA: Elsevier; 2020: baab 462.

Olgin JE, Zipes DP. Xanuunka 'Supraventricular arrhythmias'. Gudaha: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Cudurka Wadnaha ee Braunwald: Buugga Buugta Daawada Wadnaha iyo Xididdada. 11aad. Philadelphia, PA: Elsevier; 2019: cutubka 37.

Bogga RL, Joglar JA, Caldwell MA, et al. Tilmaamaha 2015 ACC / AHA / HRS ee maaraynta bukaanka qaangaarka ah ee leh tachycardia supraventricular: warbixin ka socota Kuleejka American College of Cardiology / Kooxda Wadnaha ee Wadnaha Mareykanka ee Tilmaamaha Tababarka Caafimaadka iyo Bulshada Wadnaha. Wareegga. 2016; 133 (14); e471-e505. PMID: 26399662 pubmed.ncbi.nlm.nih.gov/26399662/.

Zimetbaum P. Wadna xanuunka wadnaha ee 'Supraventricular arrhythmias'. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 26aad. Philadelphia, PA: Elsevier; 2020: baab 58.