Cardiogenic ujo

Ajọ Cardiogenic na-eme mgbe obi mebiri emebi nke ukwuu nke na ọ nweghị ike iweta ọbara zuru oke na akụkụ ahụ.

Ihe na-akpatakarị ya bụ ọnọdụ obi siri ike. Ọtụtụ n'ime ndị a na-eme n'oge ma ọ bụ mgbe nkụchi obi (infarction myocardial). Nsogbu ndị a gụnyere:

• Akụkụ buru ibu nke akwara obi nke na-adịghịzi agagharị nke ọma ma ọ bụ na ọ naghị agagharị ma ọlị
• Gbaji (mgbapu) nke akwara obi n'ihi mmebi sitere na nkụchi obi
• Rda ụda obi dị egwu, dịka ventricular tachycardia, ventricular fibrillation, ma ọ bụ supraventricular tachycardia
• Nrụgide na obi n'ihi mmụba nke mmiri gburugburu ya (pericardial tamponade)
• Na-akwa ma ọ bụ gbawara nke uru ma ọ bụ akwara nke na-akwado valvụ obi, ọkachasị mitral valve
• Anya mmiri ma ọ bụ gbawara mgbidi (septum) n'etiti etiti aka ekpe na aka nri (obere ime ụlọ obi)
• Ọkpụkpụ obi dị nwayọ (bradycardia) ma ọ bụ nsogbu sistemụ eletriki nke obi (mkpụrụ obi)

Ujo Cardiogenic na-eme mgbe obi enweghi ike ịmịcha ọbara dịka ahụ chọrọ. O nwere ike ime ọbụlagodi ma ọ bụrụ na enwebeghị nkụchi obi ma ọ bụrụ na otu n'ime nsogbu ndị a emee ma ọrụ obi gị na-ada na mberede.

Mgbaàmà gụnyere:

• Obi mgbu ma ọ bụ nrụgide
• Coma
• Mbelata nke mamịrị
• Iku ume ngwa ngwa
• Ọsọ ọsọ
• Arọ sweating, ooh anụahụ
• Igwe ọkụ
• Enweghi nche anya na ike itinye uche
• Restgha aghara, mkpasu iwe, mgbagwoju anya
• Iku ume ọkụ ọkụ
• Akpụkpọ ahụ nke dị jụụ na aka
• Agba dị ọcha dị n’ahụ́ ma ọ bụ nke nwere mmachi
• Na-adịghị ike (thready) usu

Otu ule ga-egosi:

• Ọbara mgbali elu (nke na-adịkarịkarị erughị 90 systolic)
• Ọbara nke na-ada karịa 10 isi mgbe ị biliri mgbe ị dina ala (orthostatic hypotension)
• Na-adịghị ike (thready) usu
• Oyi na akpụkpọ

Iji chọpụta ihe ịma jijiji nke cardiogenic, a ga-etinye catheter (tube) na akwara ngụgụ (ezi mkpụrụ obi catheterization). Nyocha nwere ike igosi na ọbara na-akwado ume na ngụgụ na obi anaghị agbapụta nke ọma.

Ule gụnyere:

• Cardiac catheterization
• Igbe x-ray
• Ọkpụkpụ akwara
• Ihe omumu
• Igwe ọkụ
• Nyocha nuklia nke obi

Enwere ike ime nyocha ndị ọzọ iji chọpụta ihe kpatara obi anaghị arụ ọrụ nke ọma.

Nyocha ụlọ nyocha gụnyere:

• Ọbara ọbara ọbara
• Ọbara ọbara (chem-7, chem-20, electrolytes)
• Cardiac enzymes (troponin, CKMB)
• Ọnụọgụ ọbara zuru ezu (CBC)
• Thyroid na-akpali akpali hormone (TSH)

Cardiogenic ujo bu ihe mberede nke ahuike. Kwesịrị ịnọ n'ụlọ ọgwụ, ọtụtụ mgbe na Intensive Care Unit (ICU). Ebumnuche nke ọgwụgwọ bụ ịchọta na ịgwọ ihe kpatara ụjọ iji chebe ndụ gị.

Nwere ike ịchọ ọgwụ iji mee ka ọbara mgbali elu ma melite ọrụ obi, gụnyere:

• Dobutamine
• Dopamine
• Epinephrine
• Levosimendan
• Milrinone
• Norepinephrine
• Vasopressin

Ọgwụ ndị a nwere ike inye aka na obere oge. Ha anaghị ejikarị ya ogologo oge.

Mgbe nsogbu ụda obi (dysrhythmia) dị njọ, ọgwụgwọ ngwa ngwa nwere ike ịdị mkpa iji weghachite ụda obi nkịtị. Nke a nwere ike ịgụnye:

• Ọdụdọ "ujo" eletriki (defibrillation ma ọ bụ cardioversion)
• Lantkụnye ihe mgbochi obi nwa oge
• Ọgwụ e nyere site na akwara (IV)

Inwere ike inata:

• Ọgwụ mgbu
• Oxygen
• Mmiri, ọbara, na ngwaahịa ọbara site na akwara (IV)

Usoro ọgwụgwọ ndị ọzọ maka ujo nwere ike ịgụnye:

• Cardiac catheterization na akwara obi angioplasty na stenting
• Nyocha obi iji duzie ọgwụgwọ
• Surgerywa ahụ nke obi (ịwa ahụ akwara akwara obi, mgbanwe ume obi, aka aka aka aka ekpe)
• Intra-aortic balloon depulsation (IABP) iji nyere obi aka rụọ ọrụ nke ọma
• Onye mmebe
• Ngwa enyemaka aka ikuku ma ọ bụ nkwado ngwaọrụ ndị ọzọ

N'oge gara aga, ọnụọgụ ọnwụ site na ụjọ cardiogenic sitere na 80% gaa 90%. N'ọmụmụ ihe na-adịbeghị anya, ọnụego a agbadala na 50% na 75%.

Mgbe a naghị agwọ ujo nke cardiogenic, ele ihe anya dị ezigbo njọ.

Nsogbu nwere ike ịgụnye:

• Mbibi ụbụrụ
• Akụrụ mmebi
• Imebi emebi

Gaa na ụlọ mberede ma ọ bụ kpọọ nọmba mberede mpaghara (dịka 911) ma ọ bụrụ na ị nwere mgbaàmà nke ujọ cardiogenic. Cardiogenic ujo bu ihe mberede nke ahuike.

May nwere ike belata ihe ize ndụ nke ịmepe ujo cardiogenic site na:

• Na-agwọ ngwa ngwa ya (dịka nkụchi obi ma ọ bụ nsogbu valvụ obi)
• Na-egbochi na ịgwọ ihe ndị na-akpata ọrịa obi, dịka ọrịa shuga, ọbara mgbali elu, cholesterol dị elu na triglycerides, ma ọ bụ ụtaba

Ujo - cardiogenic

• Obi - ngalaba site n'etiti

Felker GM, Teerlink JR. Nchoputa na njikwa nke oke obi. Na: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Ọrịa Obi Braunwald: Akwụkwọ ọgụgụ nke Ọgwụ Ọrịa Cardiovascular. Nke 11. Philadelphia, PA: Elsevier; 2019: isi 24.

Hollenberg SM. Cardiogenic ujo. Na: Goldman L, Schafer AI, eds. Ọgwụ Goldman-Cecil. Nke 26th. Philadelphia, PA: Elsevier; 2020: isi nke 99.