Mwoyo unoerekana wamira kushanda. Kana akasakurumidza kubatsirwa, anofa

Myocardial infarction uye kusungwa kwemoyo kamwe kamwe zviitiko zviviri zvemoyo. Zvose zvine ngozi kune hutano uye hupenyu, asi nzira yavo yakasiyana zvachose. Ndezvipi zvikonzero zvakasiyana-siyana, zviratidzo uye nzira yekubatsira munhu anenge atambudzwa munyaya imwe neimwe, anotsanangura Dr. Szymon Budrejko kubva kuDhipatimendi reCardiology uye Heart Electrotherapy yeMedical University yeGdańsk, nhengo yeBhodi reMoyo Rhythm Chikamu chePolish Society. yeCardiology..

1. Kurwiswa kwemoyo imamiriro ekuyerera kweropa mumidziyo ye coronary inovharika zvishoma kana kuvharika zvachose. Chiratidzo chacho kamwe kamwe uye kurwadziwa kwakanyanya kwechipfuva, asi izvi hazviwanzobatanidzwa nekurasikirwa kwekuziva
2. Kune rumwe rutivi, kamwe-kamwe kusungwa kwemwoyo ndiyo mamiriro ayo maitiro emagetsi emwoyo anomira
3. SCA ichazivikanwa zvikuru mushure mekunge munhu anenge abatwa arasikirwa nekuziva, kushayikwa kwekunzwa uye mweya wekufema - anodaro Dr. Szymon Budrejko. 
4. Ihwo hupenyu hunotyisa hunoda kupindira nokukurumidza - anowedzera cardiologist
5. Unogona kuwana dzimwe nyaya dzakadai paTvoiLokony peji repamba

Mwoyo - mechanical uye magetsi basa

- Basa remoyo ndere kupomba ropa, iro, pamwe chete neokisijeni, rinounzwa kunhengo dzese uye matishu ari mumuviri wemunhu. Kuti "pombi" yedu ishande zvakanaka, inoda kukurudzira, rudzi rwekutanga. Nzira yakarurama yekushanda kwemwoyo haina kukosha; kuchengetedza kutenderera kwakakodzera kwezvisungo zvayo uye diasters, ndiko kuti, "kutungamirira" kwakakodzera - anodaro Dr. Szymon Budrejko.

Mumwoyo, zvinhu zvose zvinotanga nechiratidzo chemagetsi - mhirizhonga iyo "inorayira" masero akakodzera kuti abvumirane uye asununguke mukutevedzana kwakarurama. Pasina rhythm yakarurama yemwoyo, ndiko kuti, kutenderera kwakarurama kwekugadzirisa uye kusununguka kwemoyo - kukurudzira kutanga atria uye ipapo mavheti, hapana kutonga kwakakodzera. Zvichitevera chiratidzo chakakodzera chekudzora, kamuri dzemwoyo dzinobata, uye dzinobudisa ropa, dzichirisundira nepakati pemwoyo uye kubva ipapo kuenda kunharaunda. Saka kune maitiro maviri akasiyana ari kushanda mumoyo: magetsi nemagetsi. Ose ari maviri akakosha zvakanyanya pakushanda kwakaringana kwenhengo uye chipenyu chose uye akabatana zvisingagoneki.

Kurwiswa kwemoyo - kuvharika mumidziyo ye coronary

- Kunyange zvazvo munhau zvinoitika kuti izwi rokuti "kurwadziwa kwemoyo" rinoonekwa, zvakakosha kuziva kuti mumutauro wePolish terminology izwi rakadaro harioneki. Iri izwi rekutaura uye bepa rekutsvaga, dudziro chaiyo yeshoko reChirungu rekurwadziwa kwemoyo. Zita rechokwadi rechiPolish rechimiro chinotsanangurwa nezwi iri ndiro myocardial infarction. Zvakakosha kuziva nezvazvo - anodaro Dr. Szymon Budrejko.

Chirwere chemoyo imamiriro ezvinhu umo ropa rinoyerera mumidziyo yekorona rinovharwa zvishoma kana zvachose, zvichiita kuti ischemia uye necrosis yemhasuru yemwoyo. Chirwere chemoyo chinoitika kakawanda nekuda kwekutsemuka uye kupatsanurwa kwechidimbu cheatherosclerotic plaque, iyo inovhara kamwe kamwe midziyo yecoronary. Izvi zvinotungamirira kukuvhara ropa uye kuvhara kwemudziyo lumen.

Kana ropa rinopihwa kune imwe nzvimbo yemoyo rakavharwa kana kutogurwa, zvidimbu zvematishu akanyimwa chikafu uye oxygen muropa zvinotanga kufa. Ichi chiitiko chinogona kuitika, pakati pezvimwe, semugumisiro wekutambudzika kwakanyanya, kurovedza muviri kana zvakasiyana-siyana zvinopisa. Ikukurumidzira uye kupindira kwekukurumidzira kunodiwa.

Kurwara kwemoyo - nzira yekubatsira?

Chiratidzo chechirwere chemoyo chiri kamwe kamwe uye kurwadziwa kwakanyanya muchipfuva. Munhu angave achiziva, achifema zvakanaka kana kuti kufema nokukurumidza, kurova kwemwoyo wake kunonzwika, uye kurova kwake kunowanzowedzera. Zvimwe zviratidzo zvechirwere chemoyo zvinogona kusanganisira kupera simba, kuchena uye kudikitira.

-Muchiitiko chekurwadziwa kwemoyo, rubatsiro rwekutanga runosanganisira kufonera amburenzi nekukurumidza, uchitevera mirairo yeanotumira uye kuenderera mberi kwekutarisa kweakabatwa. Hazvina kudikanwa kuita CPR. Muchiitiko ichi, chinangwa ndechekutakura munhu akuvara kuenda kunzvimbo ine nyanzvi yehutano hwemwoyo nekukurumidza uye kudzoreredza ropa rakakodzera kumhasuru yemoyo nekukurumidza. Mamiriro ezvinhu anoshanduka apo munhu anenge abatwa anotanga kusungwa kwemwoyo kamwe kamwe (SCA) semugumisiro wechirwere chemoyo (hachifaniri kuitika, asi zvinogoneka). SCA inogona kuzivikanwa zvikuru mushure mekunge munhu arasikirwa nehana, uye hapana kunzwika kupuruzira uye kufema. Muchiitiko chakadaro, kune ngozi yakananga kuhupenyu, uye nzira yakarurama yakasiyana zvachose - anodaro Dr. Szymon Budrejko.

Kamwe kamwe kusungwa kwemoyo - dambudziko rinouraya rearrhythmic

-Kamwe-kamwe kusungwa kwemoyo (SCA) inzvimbo iyo iyo mechanic basa remoyo inomira. Zvinogona kukonzerwa nekusashanda zvakanaka mu "control system" - semuenzaniso, arrhythmia inokonzera kuti simba remagetsi riri mumoyo ripararire nekukurumidza uye / kana mhirizhonga zvekuti moyo unobata uye unozorora asynchronously, zvichiita kuti moyo uvhiringidze kutenderera kwayo. . inova yakakomba kwazvo zvokuti “pombi” yedu haigoni kuita basa rayo zvakanaka uye kugovera ropa nenzira yakafanira. Mwoyo unomira kurova. Ndiyo mamiriro ekukurumidza kutyisidzira upenyu, inoda kupindira nokukurumidza - anotsanangura Dr. Szymon Budrejko.

Sezvo nyanzvi inotsanangura, kamwe kamwe kusungwa kwemwoyo kunogona kuitika, pakati pezvimwe zvinhu, semugumisiro we "kugurwa" neropa panguva yekurwadziwa kwemoyo. Kuora kana kupera kweropa kumusana wemwoyo kunotungamirira kukushaya simba kwe "pombi" uye kukundikana kwemagetsi kwemoyo, asi zvinogonawo kukanganisa magetsi "kutonga" kwemoyo uye kutungamirira kuhupenyu hunopisa arrhythmias. Kurwiswa kwemoyo kunogona kana kusatungamira kune arrhythmias izvo zvinogona kukonzera kamwe kamwe kusungwa kwemoyo. Panguva imwecheteyo, kamwe kamwe kusungwa kwemwoyo nekuda kwe arrhythmia kunogona kuitika kwete chete mukurwadziwa kwemoyo.

Myocardial infarction ndechimwe chezvikonzero zvinogona kukonzera ventricular fibrillation kana ventricular tachycardia, maviri anotyisa ventricular arrhythmias anogona kuita kuti mwoyo urege kurova. Aya arrhythmias anogonawo kuitika kune varwere vane mwoyo wakakuvadzwa nekuda kwekusingaperi ischemia (kureva chirwere chemwoyo chenguva refu), kunyange kana vasina kumbova nehosha yemwoyo kana kuti vakave nayo kare kare.

Dzimwe nguva maSCA anoitika semugumisiro wezvimwe zvisizvo kana zvirwere. Izvi zvinosanganisira, semuenzaniso, zvirwere zvemoyo zvemajini izvo, nekuda kwekuvhiringidzika kweionic, zvinokanganisa basa remagetsi emwoyo uye zvinobatsira kutanga kwearrhythmias. Izvo zvinoitika kuti zviratidzo zverudzi urwu rwechirwere zvinoonekwa pane ECG yekutevera, asi izvi hazvisi nguva dzose. Nhoroondo yezvirwere zvakasiyana-siyana zvemwoyo mumhuri yepedyo yemurwere inogona kubatsira. Kana mumwe munhu ari pedyo newe akamutswa kana kuti akaiswa cardioverter defibrillator (ICD), ichi chinhu chinokosha chekuongorora.

Kamwe kamwe kusungwa kwemwoyo kunogonawo kuitika semugumisiro we dilated cardiomyopathy-inoenderana nekutadza kwemoyo. Muchiitiko ichi, mwoyo wakakuvadzwa zvakanyanya semugumisiro wechirwere uye basa rayo rinokanganisa. Zvisinei, zvinoitikawo kuti kusungwa kwemwoyo kunoitika mumoyo wehutano hwakanaka - mune vechidiki, kusanganisira vatambi. Mhosva yega yega inoda kuongororwa kwakadzama kwakanangana nekubvisa chikonzero chekuitika kweSCA uye kudzivirira zvinogona kuitika mune ramangwana.

Kamwe kamwe kusungwa kwemoyo - nzira yekubatsira?

Chiratidzo chinonyanya kukosha chekusungwa kwemwoyo kurasikirwa kwekuziva. Mukusungwa kwemoyo, mukusiyana nekupfupi syncope, murwere haadzokezve kuziva pakarepo mushure mechinguva. Murwere ane kurova kwemwoyo kusingaonekwe uye haasi kufema zvakanaka.

Mukusungwa kwemoyo, nzira chete yekubatsira munhu anenge abatwa ndeyekufona nekukurumidza kuti ubatsirwe uye kutora kumutsidzira. Zvakaitika uye tsvakiridzo yesainzi inoratidza kuti kukurumidza kuita kwakadai kunoitwa (chinhu chikuru chayo chinodaidzwa kuti kunze kwemoyo masaja, kureva rhythmic compression ye sternum nechipfuva), inowedzera mikana yekupona kwevanhu vakakuvara (saka izvozvo zvakakosha kudzidzisa vanhu vakawanda sezvinobvira munharaunda iyi pese pazvinogoneka).

Pamusoro pazvo, defibrillation ingave iri madikanwa, kureva kuendesa simba remagetsi rinozodzoreredza rhythm yemwoyo yemurwere. Zvakakodzera kuyeuka kuti defibrillation inogona kuitwa nehunyanzvi mabasa ekukurumidzira, asiwo neAED (Automated External Defibrillator) - an otomatiki ekunze defibrillator. Ichi chishandiso, chinowanikwa munhamba inowedzera yeruzhinji uye isiri yeruzhinji mapoinzi, mushure mekubatanidza kune akabatwa, achazvimiririra kuongorora moyo wake mutinhimira, kuraira vanhu vachipa rubatsiro uye kuita defibrillation kana zvichidikanwa, nokudaro kuchengetedza munhu akabatwa kusvika ambulensi yasvika.

- Iyo AED saka, chekutanga pane zvese, zvakakosha kuziva nezve mudziyo uyu. Zvadaro reflex yepanyama ichave yekuitsvaga muchiitiko chechiitiko chinosanganisira munhu akakuvadzwa semugumisiro wekusungwa kwemoyo kamwe kamwe. Chechipiri, gara wakadzikama, svika kune marongerwo, uye uverenge mirairo. Chigadzirwa chacho chichatitungamirira nhanho nhanho; Sezvo isu tichipa rubatsiro rweAED, tinodzidza zvekuita zvinotevera. Zvakakosha kuziva kuti defibrillation ichaitwa nehurongwa chete kana mudziyo ukaona zvakakodzera zvichienderana nekuongorora kwayo. Zvikasadaro, ichakuudza zvekuita zvinotevera. Chero nzira, kushandiswa kweAED kune munhu anobatwa nemoyo wekusungwa hakuzokuvadzi - yeuka izvozvo uye usatya kushandisa iyi system. SCA inzvimbo yekutyisidzira hupenyu nekukurumidza. Pakarepo defibrillation uye kudzorerwa kwekurova kwemoyo kazhinji ndiyo chete mukana wekurarama uye kudzivirira kuremara, kuremara! – anokwidza Dr. Szymon Budrejko.