Tako Tsubo syndrome ama wadnaha oo jabay

Tako Tsubo syndrome ama wadnaha oo jabay

 

Tako Tsubo syndrome waa cudur ku dhaca muruqa wadnaha oo lagu garto cillad ku meel gaadh ah oo ah halbowlaha bidix. Tan iyo sharaxaadii ugu horeysay ee Japan 1990, Tako Tsubo syndrome waxay heshay aqoonsi caalami ah. Si kastaba ha ahaatee, ka dib 30 sano oo dadaal badan oo lagu doonayay in si fiican loo fahmo cudurkan, aqoonta hadda jirta ayaa weli xaddidan.

Qeexida xanuunka wadnaha ee jabay

Tako Tsubo syndrome waa cudur ku dhaca muruqa wadnaha oo lagu garto cillad ku meel gaadh ah oo ah halbowlaha bidix.

Wadnaxanuunku wuxuu magaciisa ka qaataa Jabbaan "dabinka octopus", iyadoo ay ugu wacan tahay qaabka uu halbowlaha bidix u qaato xaaladaha badankooda: barar xagga sare ee wadnaha iyo cidhiidhiga salkeeda. Cudurka Takotsubo waxaa sidoo kale loo yaqaannaa "xannuunnada wadnaha ee jaban" iyo "apical ballooning syndrome".

Yaa dan ka leh?

Cudurka 'Takotsubo syndrome' wuxuu xisaabiyaa qiyaastii 1 ilaa 3% dhammaan bukaannada adduunka oo dhan. Sida laga soo xigtay suugaanta, qiyaastii 90% bukaanada qaba cilladda waa haweenka da'doodu u dhaxayso 67 iyo 70 sano. Haweenka da'doodu ka weyn tahay 55 sano ayaa shan jeer ka badan khatarta ah inay cudurka qaadaan haweenka ka yar 55 sano waxayna toban jeer ka badan yihiin ragga.

Calaamadaha cudurka Tako Tsubo

Calaamadaha ugu caansan ee Tako Tsubo syndrome waa:

  • Xabad xanuun fiiqan;
  • Dyspnea: dhib ama neefsashada oo ku adkaata;
  • A syncope: miyir beelid degdeg ah.

Muujinta bukaan-socodka ee Takotsubo syndrome oo ay keentay cadaadis jireed oo daran ayaa laga yaabaa in ay u badan tahay muujinta cudurka ba'an ee hoose. Bukaannada qaba istaroogga ischaemic ama suuxdin, Takotsubo syndrome ayaa inta badan la socota xanuunka laabta. Taas bedelkeeda, bukaanada qaba walaaca shucuureed waxay leeyihiin barar sare oo xanuunka laabta iyo garaaca wadnaha.

Waxaa muhiim ah in la ogaado in qayb ka mid ah bukaannada qaba cudurka 'Takotsubo syndrome' ay soo bandhigi karaan calaamado ka dhashay dhibaatooyinkooda:

  • Wadnaha oo istaaga;
  • Bararka sambabada;
  • Shil maskaxda maskaxda ah;
  • shoog Wadnaha: fashilka bamka wadnaha;
  • Wadnaha istagay ;

Cudurka loo yaqaan 'diagnostic du syndrome' de Takotsubo

Ogaanshaha cudurka Takotsubo syndrome badanaa way adagtahay in la kala saaro wadnaxanuun myocardial ba'an. Si kastaba ha ahaatee, bukaanada qaarkood waxa lagu ogaan karaa si lama filaan ah isbeddelada ku yimaadda electrocardiogram (ECG) ama kor u kaca degdega ah ee biomarkers wadnaha - alaabooyinka lagu sii daayo dhiigga marka wadnuhu dhaawacmo.

Angiography ee wadnaha oo leh ventriculography bidix - tayada tayada iyo tirada ee shaqada ventricular bidix - waxaa loo tixgeliyaa qalabka ogaanshaha heerka dahabka si meesha looga saaro ama loo xaqiijiyo cudurka.

Qalab, oo loo yaqaan dhibcaha InterTAK, ayaa sidoo kale si dhakhso ah u hagi kara ogaanshaha cudurka Takotsubo. Lagu qiimeeyay 100 dhibcood, buundada InterTAK waxay ku salaysan tahay todoba xuduud: 

  • Galmada dumarka (25 dhibcood);
  • Jiritaanka cadaadiska nafsaaniga ah (24 dhibcood);
  • Jiritaanka cadaadiska jirka (13 dhibcood);
  • Maqnaanshaha niyad-jabka ee qaybta ST ee wadnaha wadnaha (12 dhibcood);
  • Taariikhda dhimirka (11 dhibcood);
  • Taariikhda neerfaha (9 dhibcood);
  • Kordhinta muddada QT ee wadnaha wadnaha (6 dhibcood).

Dhibcaha ka weyn 70 waxay la xiriirtaa itimaalka cudurka oo u dhigma 90%.

Sababaha xanuunka wadnaha ee jabay

Inta badan Takotsubo syndromes waxaa keena dhacdooyin walaac leh. Kiciyeyaasha jirka ayaa ka badan kuwa dareenka dareenka. Dhanka kale, bukaanada labka ah ayaa inta badan saameeya dhacdo cadaadis jireed, halka haweenka ku jira kicinta shucuureed inta badan la arko. Ugu dambeyntii, kiisasku waxay sidoo kale dhacaan maqnaanshaha cadaadis cad.

Kiciyeyaasha jirka

Kiciyeyaasha jirka waxaa ka mid ah:

  • Dhaqdhaqaaqa jireed: beero ama isboorti degdeg ah;
  • Xaalado caafimaad oo kala duwan ama xaalado shil ah: neefsasho degdeg ah oo degdeg ah (xiiqda, xanuunka sambabada ee daba-dheeraada), pankreatitis, cholecystitis (caabuqa xameetida), pneumothorax, dhaawacyada traumatic, sepsis, chemotherapy, radiotherapy, uurka, qaybta qalliinka, hillaaca, qarqidda u dhow, hypothermia, kokain, aalkolo ama ka-noqoshada opioid, sumowga carbon monoxide, iwm.
  • Daawooyinka qaarkood, oo ay ku jiraan tijaabooyinka cadaadiska dobutamine, tijaabooyinka elektiroonigga ah (isoproterenol ama epinephrine), iyo beta-agonists ee neefta ama cudurrada sambabada xanniba ee joogtada ah;
  • Xiritaanka degdega ah ee halbowlayaasha wadnaha;
  • Saamaynta habdhiska dareenka: istaroog, dhaawac madaxa, dhiig-baxa intracerebral ama gariir;

Kiciyeyaasha nafsiga ah

Kiciyeyaasha nafsiga ah waxaa ka mid ah:

  • Murugo: dhimashada xubin qoyska ka mid ah, saaxiib ama xayawaan rabaayad ah;
  • Isku dhacyada dadka dhexdooda: furiinka ama kala tagga qoyska;
  • Cabsi iyo argagax: tuugo, weerar ama hadal fagaare ah;
  • Cadho: muran xubin qoys ama milkiile;
  • Walaaca: jirro gaar ah, daryeel caruur ama guri la'aan;
  • Dhibaatooyinka dhaqaale ama xirfadeed: Khamaarka khamaarka, kacitaanka ganacsiga ama shaqo la'aanta;
  • Kuwo kale: dacwooyinka, gaalnimada, xidhitaanka xubin qoyska ka mid ah, khasaare xagga sharciga ah, iwm.
  • Masiibooyinka dabiiciga ah sida dhulgariirrada iyo daadadka.

Ugu dambeyntii, waa in la ogaadaa in kiciyeyaasha shucuureed ee syndrome-ka aysan had iyo jeer ahayn kuwa xun: dhacdooyinka shucuurta wanaagsan waxay sidoo kale keeni karaan cudurka: xaflad dhalasho oo la yaab leh, xaqiiqda ku guuleysiga Ghanna iyo wareysi shaqo oo wanaagsan, iwm. lagu tilmaamay sida "Happy Heart Syndrome".

Daawaynta Takotsubo syndrome

Ka dib kiiskii ugu horreeyay ee cudurka 'Takotsubo syndrome', bukaanku waxay halis ugu jiraan soo noqoshada, xitaa sannado ka dib. Maaddooyinka qaarkood waxay u muuqdaan inay muujinayaan horumarka badbaadada hal sano iyo hoos u dhaca heerkan soo noqnoqda:

  • Xakameeyayaasha ACE: waxay joojiyaan beddelka angiotensin I ilaa angiotensin II - enzim sababa xididdada dhiigga inay ciriiri galaan - waxayna kordhiyaan heerarka bradykinin, enzyme leh saameyn vasodilating;
  • Angiotensin II reseptor antagonists (ARA II): waxay xannibaan ficilka enzyme eponymous.
  • Daawada ka hortagga platelet (APA) ayaa laga yaabaa in loo tixgeliyo xaalad-kiis ka dib isbitaalka la dhigo haddii ay dhacdo cillad daran oo xagga bidixda ah oo la xiriirta dibiro joogto ah.

Doorka suurtagalka ah ee catecholamines-ka xad-dhaafka ah - xeryahooda organic ee laga sameeyay tyrosine oo u dhaqma sida hoormoonka ama neurotransmitter, kuwa ugu caansan kuwaas oo ah adrenaline, norepinephrine iyo dopamine - horumarinta wadnaha wadnaha ee Takotsubo ayaa laga dooday muddo dheer, iyo sida, beta-blockers ayaa loo soo jeediyay istaraatiijiyad daweyn ahaan. Si kastaba ha ahaatee, uma muuqdaan kuwo waxtar leh mustaqbalka fog: heerka soo noqnoqda ee 30% ayaa lagu arkay bukaanada lagu daaweeyay beta-blockers.

Wadooyin kale oo daweyn ah ayaa weli ah in la sahamiyo, sida daawada xinjirowga lidka ku ah, daawaynta hoormoonka ee menopause ama daaweynta nafsaaniga ah.

Waxyaabaha khatarta

Qodobbada halista ah ee cudurka Takotsubo syndrome waxaa loo kala saari karaa saddex nooc oo waaweyn:

  • Waxyaalaha hormoonnada: ka-hortagga muuqda ee haweenka postmenopausal waxay soo jeedinayaan saameyn hormoon ah. Heerarka estrogen ee hoose ka dib menopause waxay suurtogal u tahay inay kordhiyaan u nuglaanta haweenka ee Takotsubo syndrome, laakiin xogta habaysan ee muujinaysa xidhiidh cad oo u dhexeeya labadooda ayaa ka maqan ilaa hadda;
  • Qodobbada hidda-socodka: waxaa suurtogal ah in u-fiirsiga hidde-sidaha ay la falgalaan arrimaha deegaanka si ay u door bidaan bilawga cudurka, laakiin halkan sidoo kale, daraasado u oggolaanaya caddayntan in la soo koobo ayaa ka maqan;
  • Xanuunada Dhimirka iyo Dareemaha: Baahsanaanta sare ee dhimirka - walaaca, niyad-jabka, xannibaadda - iyo xanuunka neerfaha ayaa lagu soo warramey bukaanada qaba cudurka Takotsubo.

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