Ukuqonda iPostural Orthostatic Tachycardia Syndrome (POTS)

I-postural orthostatic tachycardia syndrome yimeko yonyango eyenza ukukhanya kunye nokubetha emva kokuma. Ngaba uhlengahlengiso lwendlela yokuphila kunye nezicwangciso zeendlela ezininzi zinokunceda ukunciphisa nokulawula iimpawu?

I-Postural Orthostatic Tachycardia Syndrome - I-POTS

I-postural orthostatic tachycardia syndrome, okanye i-POTS, yimeko eguquguqukayo ngobunzima ukusuka kwi-mild to incapacitating. NgeePOTS:

• Isantya sentliziyo sanda kakhulu ngokuma komzimba.
• Le meko idla ngokuchaphazela abantu abaselula.
• Uninzi lwabantu abane-postural orthostatic tachycardia syndrome ngabasetyhini abaphakathi kweminyaka eyi-13 kunye ne-50.
• Abanye abantu banembali yosapho lwePOTS; Abanye abantu baxela ukuba i-POTS yaqala emva kokugula okanye uxinzelelo, kwaye abanye bathi yaqala kancinci.
• Idla ngokusombulula ekuhambeni kwexesha.
• Unyango lunokuba luncedo.
• Ukuxilongwa kusekelwe ekuhloleni uxinzelelo lwegazi kunye ne-pulse / heart rate.

iimpawu

I-postural orthostatic tachycardia syndrome inokuchaphazela abantu abancinci abasempilweni kwaye inokuqala ngequbuliso. Ngokuqhelekileyo kwenzeka phakathi kweminyaka eyi-15 kunye ne-50, kwaye abasetyhini kunokwenzeka ukuba bayiphuhlise kunamadoda. Abantu banokufumana iimpawu ezahlukeneyo kwimizuzu embalwa yokuma kwindawo eleleyo okanye ehleliyo. Iimpawu zingenzeka rhoqo kwaye yonke imihla. Ezona mpawu zixhaphakileyo ziquka: (Amaziko eSizwe ezeMpilo. Iziko leSizwe lokuPhuhlisa iiNzululwazi zoGuqulelo. I-Genetic kunye neZiko loLwazi lweZifo ezinqabileyo. 2023)

• Ukuxhalabisa
• Lightheadedness
• Uziva ngathi uza kuphelelwa.
• I-Palpitations - ukuva ukubetha kwentliziyo ngokukhawuleza okanye okungaqhelekanga.
• Utywala
• Intloko
• Umbono ongezantsi
• Imilenze ijika ibebomvu-mfusa.
• Ubuthathaka
• Ukugubha
• Ukukhathala
• Iingxaki zokulala
• Ingxaki yokugxila/inkungu yengqondo.
• Abantu ngabanye banokufumana iziqendu eziphinda-phindayo zokufa isiqaqa, ngesiqhelo kungekho nasiphi na isiqhumiso ngaphandle kokuma.
• Abantu ngabanye banokufumana nayiphi na indibaniselwano yezi mpawu.
• Ngamanye amaxesha, abantu abangakwaziyo ukumelana nemidlalo okanye ukuzilolonga kwaye banokuziva beqaqadekile kwaye benesiyezi ngenxa yentshukumo ephakathi okanye ephakathi, enokuchazwa njengokunganyamezeli umthambo.

Iimpembelelo ezinxulumeneyo

• I-postural orthostatic tachycardia syndrome inokudibaniswa nezinye i-dysautonomia okanye i-syndromes ye-nervous system, njenge-neurocardiogenic syncope.
• Abantu bahlala bexilongwa kunye nezinye iimeko ezifana:
• Isifo sokunyamezela esingapheliyo
• Isifo se-Ehlers-Danlos
• Fibromyalgia
• Migraines
• Ezinye iimeko ze-autoimmune.
• Iimeko zamathumbu.

Izizathu

Ngokuqhelekileyo, ukuma kubangela ukuba igazi libaleke ukusuka kwi-torso ukuya emilenzeni. Utshintsho olukhawulezileyo luthetha ukuba lincinci igazi elikhoyo ukuze intliziyo impompe. Ukuhlawulela, inkqubo ye-nervous autonomic ithumela imiqondiso kwimithambo yegazi ukuze icinezele ukutyhala igazi elingakumbi entliziyweni kunye nokugcina uxinzelelo lwegazi kunye nesantya sentliziyo esiqhelekileyo. Uninzi lwabantu alufumani tshintsho lubalulekileyo kuxinzelelo lwegazi okanye i-pulse xa bemile. Ngamanye amaxesha, umzimba awukwazi ukwenza lo msebenzi ngokuchanekileyo.

• If uxinzelelo lwegazi luyehla ekumeni kwaye lubangele iimpawu njengokukhanya, kwaziwa ngokuba yi-orthostatic hypotension.
• ukuba Uxinzelelo lwegazi luhlala luqhelekileyo, kodwa izinga lokubetha kwentliziyo likhawuleza, ziiPOTS.
• Izinto ezichanekileyo ezibangela i-postural orthostatic tachycardia syndrome ziyahluka kubantu kodwa zihambelana notshintsho kwi:
• Inkqubo ye-nervous autonomic, amanqanaba e-adrenal hormone, umthamo wegazi elipheleleyo, kunye nokunyamezela ukunyamezela komzimba. (Robert S. Sheldon et al., 2015)

I-Autonomic Nervous System

Inkqubo ye-nervous autonomic ilawula uxinzelelo lwegazi kunye nesantya sentliziyo, eziziindawo zenkqubo ye-nervous elawula imisebenzi yangaphakathi yomzimba efana nokugaya, ukuphefumla, kunye nesantya sentliziyo. Kuqhelekile ukuba uxinzelelo lwegazi lwehle kancinci kwaye isantya sentliziyo sikhawuleze kancinci xa simile. NgePOTS, olu tshintsho lubonakala ngakumbi.

• I-POTS ithathwa njengoluhlobo lwe-dysautonomia, oluyiyo ukuncipha kolawulo kwinkqubo ye-nervous autonomic.
• Ezinye ii-syndromes ezininzi zicingelwa ukuba zihlobene ne-dysautonomia, njenge-fibromyalgia, i-bowel syndrome enomsindo, kunye nesifo esingapheliyo sokukhathala.
• Akucaci ukuba kutheni i-syndrome okanye nayiphi na enye iindidi ze-dysautonomia zikhula, kodwa kubonakala ngathi kukho i-family predisposition.

Ngamanye amaxesha isiqendu sokuqala se-POTS sibonakalisa emva kwesiganeko sezempilo esinje:

• Ukukhulelwa
• Isifo esosulelayo esiqatha, umzekelo, imeko enzima yomkhuhlane.
• Isiqendu somonzakalo okanye ukubhideka kwengqondo.
• Utyando olukhulu

Ukuqondwa

• Uvavanyo lokuxilonga luya kubandakanya imbali yezonyango, uvavanyo lomzimba, kunye neemvavanyo zokuxilonga.
• Umboneleli wezempilo uya kuthatha uxinzelelo lwegazi kunye ne-pulse ubuncinane kabini. Kanye xa ndilele kwaye kanye xa ndimile.
• Imilinganiselo yoxinzelelo lwegazi kunye nesantya sokubetha kwentliziyo ilele phantsi, ukuhlala, kunye nokuma zizinto ezibalulekileyo ze-orthostatic.
• Ngokuqhelekileyo, ukuma kwandisa izinga lokubetha kwentliziyo nge-10 beats ngomzuzu okanye ngaphantsi.
• Nge-POTS, ukubetha kwentliziyo kunyuka ngama-30 ngomzuzu ngelixa uxinzelelo lwegazi luhlala lungatshintshi. (Dysautonomia International. 2019)
• Ukubetha kwentliziyo kuhlala kunyukile ngaphezulu kwemizuzwana embalwa xa umile/udla ngokuba yimizuzu eli-10 nangaphezulu.
• Iimpawu zenzeka rhoqo.
• Ihlala ngaphezu kweentsuku ezimbalwa.

Utshintsho lwepulse yendawo ayisiyiyo kuphela ukuqwalaselwa kokuxilonga kwi-postural orthostatic tachycardia syndrome, njengoko abantu ngabanye banokufumana olu tshintsho kunye nezinye iimeko.

tests

• Ezinye iingcali zisebenzisa uvavanyo lwe-tilt-table kuxilongo lokuqala kunye nokubeka iliso kunyango. (Amaziko eSizwe ezeMpilo. Iziko leSizwe lokuPhuhlisa iiNzululwazi zoGuqulelo. I-Genetic kunye neZiko loLwazi lweZifo ezinqabileyo. 2023)
• Ngethuba lolu vavanyo, uxinzelelo lwegazi kunye ne-pulse zilinganiswa izihlandlo ezininzi xa zilele etafileni kwaye xa itafile ishukunyiswa kwindawo ethe tye.

Ukuxilongwa ngokungafani

• Kukho izizathu ezahlukeneyo ze-dysautonomia, i-syncope, kunye ne-orthostatic hypotension.
• Kulo lonke uvandlakanyo, umboneleli wezempilo unokujonga ezinye iimeko, ezifana nokuphelelwa ngamanzi emzimbeni, ukukhutshwa kwe-deconditioning ekuphumleni kwebhedi ixesha elide, kunye ne-diabetes neuropathy.
• Amayeza afana ne-diuretics okanye amayeza oxinzelelo lwegazi anokubangela iziphumo ezifanayo.

impatho

Zininzi iindlela ezisetyenziswayo ekulawuleni i-POTS, kwaye abantu ngabanye banokufuna indlela yeendlela ezininzi. Umboneleli wezempilo uya kucebisa rhoqo ukujonga uxinzelelo lwegazi kunye ne-pulse ekhaya ukuze baxoxe ngeziphumo xa besiya kuxilongo lwezonyango.

Ulwelo kunye nokutya

• Ukusela i-non-caffeinated fluids kunokugcina umzimba umanzi.
• Umboneleli wezempilo unako ukubala umlinganiselo ochanekileyo wolwelo olufunekayo ngosuku ngalunye.
• Ukuphelelwa ngamanzi emzimbeni kuqhelekileyo, ngoko kubaluleke kakhulu ukusela amanzi kuqala ekuseni, ngokukhethekileyo ngaphambi kokuba uphume ebhedini kwaye ume.
• Kwakhona kubalulekile ukugcina amanqanaba afanelekileyo e-sodium. (Amaziko eSizwe ezeMpilo. Iziko leSizwe lokuPhuhlisa iiNzululwazi zoGuqulelo. I-Genetic kunye neZiko loLwazi lweZifo ezinqabileyo. 2023)

Ukunyanga kwamayeza

• Ukuzivocavoca kunye ulungiso lwenyama inokunceda umzimba ufunde ukuziqhelanisa nokuma nkqo.
• Kuba kunokuba ngumceli mngeni ukwenza umthambo xa usebenza ne-POTS, inkqubo yokuzivocavoca ekujoliswe kuyo phantsi kolawulo inokufuneka.
• Ucwangciso lokuzilolonga lusenokuqalwa ngokuqubha okanye ngokusebenzisa oomatshini bokubhexa, abangafuni ukuma nkqo. (Dysautonomia International. 2019)
• Emva kwenyanga okanye ezimbini, ukuhamba, ukubaleka, okanye ukukhwela ibhayisekile kunokongezwa.
• Uphononongo lubonise ukuba abantu abane-POTS, ngokomndilili, banamagumbi amancinci entliziyo kunabantu abangenayo le meko.
• Ukuzilolonga rhoqo kwe-aerobic kubonakaliswe ukwandisa ubungakanani begumbi lentliziyo, ukubetha kwentliziyo ecothayo, kunye nokuphucula iimpawu. (Qi Fu, uBenjamin D. Levine. 2018)
• Abantu ngabanye kufuneka baqhubeke nenkqubo yokuzilolonga ixesha elide ukugcina iimpawu zingabuyi.

Amachiza

• Amayeza amiselweyo okulawula i-POTS abandakanya i-midorine, i-beta-blockers, i-pyridostigmine - i-Mestinon, kunye ne-fludrocortisone. (Dysautonomia International. 2019)
• I-Ivabradine, esetyenziselwa imeko yentliziyo ye-sinus tachycardia, isetyenziswe ngokufanelekileyo kwabanye abantu.

Ungenelelo lolondolozo

Ezinye iindlela zokuthintela iimpawu ziquka:

• Ukulala kwindawo yentloko-phezulu ngokuphakamisa intloko yebhedi ukusuka emhlabeni 4 ukuya kwi-intshi ezi-6 usebenzisa ibhedi ehlengahlengiswayo, iibhloko zomthi, okanye iziphakamisi.
• Oku kwandisa umthamo wegazi elijikelezayo.
• Ukwenza iindlela zokumelana nokuthintela njengoku squatting, ukukhama ibhola, okanye ukunqumla imilenze. (Qi Fu, uBenjamin D. Levine. 2018)
• Ukunxiba iikawusi zokucinezela ukuthintela igazi elininzi ukuba lingaphumi emilenzeni xa umile kunokunceda ukuphepha i-orthostatic hypotension. (Dysautonomia International. 2019)

---

Ukoyisa ukungaphumeleli kweNtliziyo eCandekileyo

---

Ucaphulo

AmaZiko eSizwe ezeMpilo. Iziko leSizwe lokuPhuhlisa iiNzululwazi zoGuqulelo. Iziko loLwazi lweGenetic kunye neZifo ezinqabileyo (GARD). (2023). I-postural orthostatic tachycardia syndrome.

Sheldon, R. S., Grubb, B. P., 2nd, Olshansky, B., Shen, W. K., Calkins, H., Brignole, M., Raj, S. R., Krahn, A. D., Morillo, C. A., Stewart, J. M., Sutton, R., Sandroni, P., Friday, K. J., Hachul, D. T., Cohen, M. I., Lau, D. H., Mayuga, K. A., Moak, J. P., Sandhu, R. K., & Kanjwal, K. (2015). I-2015 ye-heart rhythm yoluntu inkcazo yokuvumelana malunga nokuxilongwa kunye nokunyangwa kwe-postural tachycardia syndrome, i-sinus tachycardia engafanelekanga, kunye ne-vasovagal syncope. Isingqisho sentliziyo, 12(6), e41–e63. doi.org/10.1016/j.hrthm.2015.03.029

Dysautonomia International. (2019). I-Postural Orthostatic Tachycardia Syndrome

UFu, Q., & Levine, B. D. (2018). Ukuzivocavoca kunye nokunyangwa kwe-pharmacological ye-POTS. I-Autonomic neuroscience : isiseko kunye neklinikhi, 215, 20-27. doi.org/10.1016/j.autneu.2018.07.001