Wolff-Parkinson-White chirwere (WPW)

Wolff-Parkinson-White (WPW) chirwere mamiriro ezvinhu mune imwe nzira yemagetsi mumoyo inotungamira kunguva dzekukurumidza kwemoyo (tachycardia).

WPW syndrome ndechimwe chezvinhu zvinowanzoitika zvinokonzeresa kukurumidza kwemoyo matambudziko muvacheche nevana.

Kazhinji, zviratidzo zvemagetsi zvinotevera imwe nzira kuburikidza nemoyo. Izvi zvinobatsira moyo kurova nguva dzose. Izvi zvinodzivirira moyo kubva pakuwedzera kurova kana kurova zvichiitika nekukurumidza.

Muvanhu vane chirwere cheWPW, mamwe emagetsi emagetsi anoenda pasi neimwe nzira. Izvi zvinogona kukonzera kukurumidza kwemoyo kuroora kunodaidzwa kunzi supraventricular tachycardia.

Vazhinji vanhu vane WPW syndrome havana mamwe matambudziko emoyo. Zvisinei, ichi chiitiko chakabatanidzwa nemamwe mamiriro emwoyo, senge Ebstein anomaly. Chimiro chechimiro chinomhanyawo mumhuri.

Kakawanda sei kukurumidza kwemoyo kurovera kunoitika kunosiyana zvichienderana nemunhu. Vamwe vanhu vane WPW syndrome vane zvikamu zvishoma chete zvekukurumidza kwemoyo. Vamwe vanogona kukurumidza kurovera kwemoyo kamwe kana kaviri pasvondo kana kupfuura. Zvakare, panogona kunge pasina zviratidzo zvachose, saka mamiriro acho anowanikwa kana kuongororwa kwemoyo kuchiitwa kune chimwe chikonzero.

Munhu ane chirwere ichi anogona kunge aine:

• Kurwadziwa pachifuva kana kuomesa pachipfuva
• Dzungu
• Musoro wakareruka
• Kufenda
• Palpitations (kunzwa kwekunzwa moyo wako uchirova, kazhinji nekukurumidza kana zvisina kujairika)
• Kufema kwekufema

Kuongorora kwepanyama kunoitwa panguva yetachycardia episode kunoratidza kurovera kwemoyo nekukurumidza kupfuura zana kurova paminiti. Kurova kwemoyo kwakajairika kurova makumi matanhatu kusvika zana paminiti muvakuru, uye pasi pemakumi mashanu nemakumi mashanu paminiti muvacheche, vacheche, uye vana vadiki. Kuwedzera kweropa kunowanzoitika kana kushomeka muzviitiko zvakawanda.

Kana munhu wacho asina tachycardia panguva yemubvunzo, mhedzisiro yacho inogona kunge yakajairika. Mamiriro acho anogona kuongororwa aine ECG kana neamburenzi ECG yekutarisa, senge Holter yekutarisa.

Chiyero chinonzi electrophysiologic kudzidza (EPS) chinoitwa kuchishandiswa makateti anoiswa mumoyo. Muedzo uyu unogona kubatsira kuziva nzvimbo yenzira yemagetsi yekuwedzera.

Mishonga, kunyanya antiarrhythmic zvinodhaka senge procainamide kana amiodarone, inogona kushandiswa kudzora kana kudzivirira kurovera kwemoyo nekukurumidza.

Kana kurova kwemoyo kusingadzokere kune zvakajairwa nekurapwa, vanachiremba vanogona kushandisa imwe mhando yekurapa inonzi yemagetsi cardioversion (kuvhunduka).

Iyo yekurapa kwenguva refu yeWPW syndrome inowanzo kuve catheter ablation. Maitiro aya anosanganisira kupinza chubhu (catheter) mutsinga kuburikidza nekamucheka kadiki padhuze nemupendero kusvika panharaunda yemoyo. Kana iyo tipi yasvika pamoyo, iyo diki nzvimbo iri kukonzera iyo inokurumidza kurova kwemoyo inoparadzwa uchishandisa yakasarudzika mhando mhando yesimba inonzi radiofrequency kana nekuitisa iyo (cryoablation). Izvi zvinoitwa sechikamu cheiyo electrophysiologic kudzidza (EPS).

Vhura kuvhiyiwa kwemoyo kuti upise kana kuomesa nzira yekuwedzera inogona kupawo mushonga wekusingaperi weWPW syndrome. Muzviitiko zvakawanda, maitiro aya anoitwa chete kana iwe uchida kuvhiyiwa kwemoyo kune zvimwe zvikonzero.

Catheter ablation inorapa kusagadzikana uku muvanhu vazhinji. Kubudirira kwehuwandu hwemaitiro kunoitika pakati pe85% kusvika 95%. Kubudirira kwehuwandu kuchasiyana zvichienderana nenzvimbo uye huwandu hwedzimwe nzira.

Zvinetso zvinogona kusanganisira:

• Matambudziko ekuvhiyiwa
• Kutadza kwemoyo
• Yakaderedzwa BP (inokonzerwa nekukurumidza kwemoyo)
• Migumisiro yechirwere yemishonga

Mhando yakanyanya kukurumidza yekurova kwemoyo ndeye ventricular fibrillation (VF), iyo inogona kukurumidza kukonzeresa kuvhunduka kana kufa. Iyo dzimwe nguva inogona kuitika kune vanhu vane WPW, kunyanya kana ivo zvakare vane atrial fibrillation (AF), iri imwe mhando yeasina kujairika moyo mutinhimira. Rudzi urwu rwekukurumidza kwemoyo kurova kunoda kurapwa kwechimbichimbi uye maitiro anonzi cardioversion.

Fonera wako mupi wezvehutano kana:

• Iwe une zviratidzo zveWPW syndrome.
• Iwe une kusagadzikana uku uye zviratidzo zvinowedzera kuwedzera kana kusavandudza nemushonga.

Taura nemupi wako nezvekuti nhengo dzemhuri yako dzinofanirwa kuongororwa mafomu akagarwa nhaka eichi chiitiko.

Preexcitation chirwere; WPW; Tachycardia - Wolff-Parkinson-White chirwere; Arrhythmia - WPW; Hwakajairika moyo mutinhimira - WPW; Kukurumidza kurova kwemoyo - WPW

• Kusanzwisisika kwaEbstein
• Holter moyo kuongorora
• Kuitisa system yemoyo

Dalal AS, Van Hare GF. Kukanganiswa kwehuremu uye mutinhimira wemwoyo. Mune: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chap 462.

Tomaselli GF, Zipes DP. Kusvika kune murwere ane moyo arrhythmias. Mune: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Chirwere Chemwoyo cheBraunwald: A Chinyorwa cheCardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019: chitsuwa 32.

Zimetbaum P. Supraventricular yemoyo arrhythmias. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 58.