Bvunza general practitioner Maarten: Kunetswa ne cardiac arrhythmias uye kunonoka kwemoyo

Maarten Vasbinder anogara kuIsaan. Basa rake ndere general practitioner, basa raainyanya kudzidzira kuSpain. PaThailandblog anopindura mibvunzo kubva kuvaverengi vanogara muThailand uye anonyora nezvechokwadi chezvekurapa.

Iwe une mubvunzo kuna Maarten uye unogara muThailand here? Tumira izvi kumupepeti: www.thailandblog.nl/contact/ Zvakakosha kuti upe ruzivo rwakakwana se:

• Zera
• Zvichemo)
• Nhoroondo
• Kushandiswa kwemishonga, kusanganisira kuwedzera, nezvimwewo.
• Kusvuta, doro
• kufuta
• Optional: mhedzisiro yerabhoritari uye kumwe bvunzo
• Zvinogoneka BP

Unogona kutumira mafoto ku [email inodzivirirwa] zvese zvinogona kuitwa zvisingazivikanwe, zvakavanzika zvako zvinovimbiswa.

Cherechedzo: Sarudzo yekupindura inovharwa nekusarudzika kudzivirira kuvhiringika nemazano asina kutsigirwa nemishonga nevaverengi vane vavariro yakanaka.

Wadiwa Martin,

Ndanga ndiine heart rhythm disorder kubva 2000. Ndakashandisa tambocor kupesana neizvi uye kubvira 2013 concor 2.5 mg. Izvi mushure mekuongororwa muchipatara cheBangkok.

Semwedzi mishoma yapfuura ndakave nekurova kwemoyo kwakaderera zvakanyanya. Pakuzorora kwakapoteredza 40, kamwe chete svondo rino 35. Nekushanda kwemazuva ose kusvika makumi matanhatu. Kuwanda kweropa kunosiyana zvikuru, kubva pa60/100 pakuzorora kusvika pa60/120. Idzi shanduko dzimwe nguva dzinoitika mukati memaminitsi mashoma. Kurova kwemoyo kunenge kusingaite asi hakumbokwikwi panguva iyoyo. Zvinoita senge kutyora mutsindo.

Kurova kwemoyo kwekupedzisira (6 months ago) firimu rakaburitsa mufananidzo wakajairika. Zviratidzo zvemuviri:

• dzimwe nguva kurwadziwa kuduku kuruoko rworuboshwe, kunopera pashure penguva yakati. Inoitika kakawanda pavhiki.
• hapana kurwadziwa muchipfuva.
• zuva rakatevera kudzidziswa kwebhasikoro, kunzwa kusingafadzi zvishoma kune rumwe rutivi rworuboshwe rwechipfuva, asi pasina kurwadziwa.
• hapana dzungu, asi kazhinji musoro wakapfava zvikuru.

Huremu 82 kilos, kureba 189cm. Age 77 years. Hapana doro, hapana kuputa. Hapana mimwe mishonga. Hapana nhoroondo yemhuri yematambudziko emwoyo. Akaita mitambo yekutsungirira kusvika pazera re65. Iye zvino tenderera 4 kanomwe pavhiki nekumhanya, dzidzira nezviyereso ka2 pasvondo. Zvose kwemaminitsi makumi mana nemashanu.

Please advice.

Kwazisai,

K.

*****

Zvinotsanangurwa,

Tambocor neConcor marudzi akasiyana emishonga. Tambocor (flecainide) iKirasi IC inorwisa-arrhythmic, ine mhedzisiro pamwoyo mutinhimira. Semuenzaniso, unogona kuona rhythm semutambo wekutamba, waltz iri ¾, foxtrot 4/4, tango 3+3+2 nezvimwe.

Inowanzopihwa kurova kwemoyo kusingaite uye ine chepfu. Dzimwe nguva zviri nani kutora aspirin kana imwe anticoagulant, asi izvi zvinoenderana nerudzi rwearrhythmia.

Concor (bisoprololol) is beta-blocker, iyo inodzora mwero (kumhanya) kwekurova kwemoyo, mune iyi kesi zvichidzika. Iko kuderera kwemoyo kungangodaro kunokonzerwa neConcor.

Saka iwe unofanirwa kumira kutora Concor uye shanyira chiremba wemwoyo nekukurumidza, zviri nani svondo rino.

Pachokwadi,

Martin Vasbinder