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3f] / fxL, % ;fpg . nDkL l: sg / f] u lgoGq0f ug{ bfªdf Ps nfv rf/ xhf/ kf“r ;o vf] k cfjZos 5 t/ / f] u lgoGq0f ug{ lhNnfsf nflu tLg xhf/ 8f] h dfq} vf] k cfpg nfu] sf] 5 . e] 6] / ] g/ L c: ktfn tyf kz' ;] jf lj1 s] Gb| bfªdf kflnsfx?n] vf] k nufpg'kg] { kz'sf] ;+Vof %^ xhf/ kf“r ;o / x] sf] ljj/ 0f k7fP klg b'O{ xhf/ kf“r ;o %) 8f] h vf] ksf] efuaG8f nufPsf 5g\ . rf/ ;o %) 8f] h vf] k e] 6] / ] g/ L c: ktfn tyf kz' ;] jf lj1 s] Gb| bfªdf / xg] u/ L c? vf] ksf] efua08f nufOPsf] s] Gb|sf k|d'v ;'bfd e§n] hfgsf/ L lbg'eof] . pxf“n] dfu cg';f/
r6\ofª nfu] / j8f;b: osf] lgwg / f] Nkf, % ;fpg -o';_– r6\ofª nfu] / / f] Nkfdf Ps j8f;b: osf] lgwg ePsf] 5 . ;'g5x/ L ufp“kflnsf–# s'Okfwf/ fsf j8f;b: o $( jifL{o lbnaxfb'/ 3tL{ du/ sf] r6\ofª nfu] / lgwg ePsf] lhNnf k|x/ L sfof{non] hgfPsf] 5 . d[ts 3tL{ du/ cfkm\gf] sfG5f] efOsf] 3/ df ;'t] sf] a] nf r6\ofªdf k/ ] sf] pQm sfof{nosf ;"rgf clwsf/ L k|sfz e';fnn] hfgsf/ L lbg'eof] . r6\ofªdf k/ L cGo 7fp“sf s] xL JolQm klg 3fOt] ePsfn] To; : yfgtkm{ k|x/ L hf“b} u/ ] sf] pxf“n] atfpg'eof] ] .
vf] k ck'u ePsf] n] nDkL l: sg ;+qmd0f gePsf] uf] 7df dfq} vf] k nufpg] tof/ L ePsf] atfpg'eof] . kf“r xhf/ 8f] h vf] k dfu] sf] 3f] / fxL pkdxfgu/ kflnsfn] tLg ;o 8f] h vf] k kfpg] ePsf] 5 eg] rf/ xhf/ 8f] h dfu] sf] t'n;Lk'/ pkdxfgu/ kflnsfn] b'O{ ;o 8f] h kfpg] ePsf] 5 . To: t} kf“r xhf/ 8f] h vf] k dfu u/ ] sf] zflGtgu/ ufp“kflnsfsfn] b'O{ ;o %), cf7 xhf/ 8f] h dfu u/ ] sf b+uLz/ 0f / / fKtL ufp“kflnsfn] qmdzM tLg ;o / b'O{ ;o 8f] h kfpg] ePsf 5g\ . kf“r xhf/ 8f] h dfu u/ ] sf] a+unfr'nLn] b'O{ ;o %), ;ft÷;ft xhf/ 8f] h dfu u/ ] sf ndxL gu/ kflnsf / aaO{ ufp“kflnsfn] tLg÷tLg ;o 8f] h vf] k kfpg] ePsf 5g\ . To;} u/ L
Ps xhf/ kf“r ;o 8f] h dfu u/ ] sf] u9jf ufp“kflnsfn] b'O{ ;o / 5 xhf/ 8f] h dfu u/ ] sf] / fhk'/ ufp“kflnsfn] tLg ;o 8f] h dfq} vf] k kfpg] ePsf 5g . o;cl3 bfªsf b'O{ kflnsf / e] 6] / ] g/ L c: ktfn tyf kz' ;] jf lj1 s] Gb| bfªaf6 Ps xhf/ Ps ;o kz'nfO{ vf] k nufO ;lsPsf] 5 . / fKtL / u9jf ufp“kflnsfn] kf“r÷kf“r ;o 8f] h / e] 6] / ] g/ L c: ktfn tyf kz' ;] jf lj1 s] Gb| bfªn] t'n;Lk'/ sf Jofj;flos kmd{df Ps ;o 8f] h vf] k nufPsf] hgfPsf] 5 . / f] lsPg ;+qmd0f e] 6] / ] g/ L c: ktfn tyf kz' ;] jf lj1 s] Gb| bfªsf cg';f/ ;+qmd0f b/ s] xL sd eP klg / f] lsPsf] 5} g . s] Gb|sf kz' lrlsT;s e/ t b] jsf] 6fn] nDkL l: sgsf sf/ 0f kmf] sf p7] sf kz'df 3fp ePsf] atfpg'eof] . …gof“ ;+qmd0f sd eP klg ;+qmldt kz'Dff p7] sf kmf] sf 3fp ag] sf 5g\Ú– pxf“n] eGg'eof] – …;a} lt/ o: t} 5 .Ú ;/ sf/ L tYof+s cg';f/ bfªsf @* xhf/ 5 ;o &# kz' nDkL l: sg ;+qmldt 5g\ . @^ xhf/ cf7 ;o &% ufO{ uf] ? / Ps xhf/ ;ft ;o (* e} ;L ;+qmldt ePsf] df ;ft ;o !^ ufO{ uf] ? / cf7j6f e} ;L u/ L ;ft ;o @$ j6f d/ ] sf 5g\ . 3f] / fxLdf !) ufO{ uf] ? / cf7 e} +;L, t'n;Lk'/ df gf} , zflGtgu/ df ^) ufO{ uf] ? d/ ] sf 5g\ . b+uLz/ 0fdf @%, / fKtLdf $(, a+unfr'nLdf !* ufO{ uf] ? d/ ] sf 5g\ . To;} u/ L ndxL gu/ kflnsfdf @%, aaO{df Ps ;o %), u9jfdf Ps ;o / / fhk'/ df Ps ;o @) ufO{ uf] ? d/ ] sf 5g\ . n'lDagL k|b] zdf *$ xhf/ 5 ;o !! kz' nDkL l: sg ;+qmd0faf6 hf] lvdk"0f{ cj: yfdf / x] sf] n'lDagL k|b] zsf] s[lif tyf e"ld Joj: yf dGqfnon] hgfPsf] 5 . dGqfnosf cg';f/ n'lDagLdf tLg xhf/ kf“r ;o *% kz' ;+qmd0faf6 d/ ] sf 5g\ .
d'2f lkmtf{ lng] k|fjwfgk|lt dfgj clwsf/ cfof]usf] cfklQ o'uaf] w ;dfrf/ bftf sf7df8f} +, % ;fpg . / fli6«o dfgj clwsf/ cfof] un] / fhgLlts ;Demf} tfaf6 ePsf ;xdltsf cfwf/ df h'g;'s} k|sf/ sf d'2f lkmtf{ lng ;Sg] Joj: yfk|lt cfklQ hgfp“b} ;+;bdf ljrf/ fwLg ljw] os ;Rofpg'kg{] wf/ 0ff cl3 ;f/ ] sf] 5 . o: tf] k|fjwfgn] d'n'sdf dfgj clwsf/ pNn+3g / b08xLgtf df} nfpg] eGb} cfof] un] uDeL/ cfklQ hgfPsf] 5. cfof] un] z'qmaf/ kqsf/ ;Dd] ng ub{} k|ltlglw;efaf6 kfl/ t eO{ xfn / fli6«o;efdf ljrf/ fwLg / x] sf] s] xL g] kfn P] g ;+zf] wg
ug{ ag] sf] ljw] os, @)*) k|fjwfgk|lt cfkm\gf] wf/ 0ff cl3 ;f/ ] sf] xf] . pQm ljw] ossf] bkmf ^$ df / x] sf] d'n'sL kmf} hbf/ L sfo{ljlw ;+lxtf, @)&$ sf] bkmf !!^ kl5 bkmf !!^ …sÚ yk u/ L zflGtk"0f{ / fhgLltsf] d"nwf/ df Nofpg d'2f lkmtf{ lng ;lsg] k|fjwfg / flvPsf] 5 . pQm bkmfdf s'g} / fhgLlts bn jf ;d"xn] d'n'ssf] / fhgLlts k|0ffnL;“u c;xdt / xL lx+;fTds lqmofsnfk ;~rfng ul/ / x] sf] df To: tf] / fhgLlts bn jf ;d"x zflGtk"0f{ / fhgLlts d"nwf/ df cfpg g] kfnsf] ;+ljwfg / k|rlnt sfg'gsf] cwLgdf
/ xL zflGtk"0f{ / fhgLlts lqmofsnfk ;~rfng ug{] k|lta4tf hgfO{ g] kfn ;/ sf/ / / fhgLlts bn jf ;d"xaLr / fhgLlts k|s[ltsf ;Demf} tfsf] dfWodaf6 g] kfn ;/ sf/ jfbL eO{ bfo/ ePsf d'2f lkmtf{ lng] u/ L ;xdlt ePsf] df To: tf] ;Demf} tfadf] lhd To: tf / fhgLlts bn jf ;d"xsf g] tf tyf sfo{stf{sf lj?4df g] kfn ;/ sf/ jfbL eO{ rnfOPsf h'g;'s} d'2f h'g;'s} txsf] cbfntdf ljrf/ fwLg / x] sf] eP klg lkmtf{ lng afwf kg{] 5} g eGg] pNn] v 5 . of] k|fjwfgn] cfof] usf] l;kmfl/ ; / ;+qmd0fsfnLg Gofodf k|efj kfg{] cfof] usf]
wf/ 0ff 5 . …plNnlvt sfg'gL k|fjwfgn] h'g;'s} / fhgLlts bn jf ;d"xn] lx+;fTds tyf uDeL/ k|s[ltsf kmf} hbf/ L ck/ fw u/ ] sf] v08df ;d] t / fhgLlts bn jf ;d"xsf g] tf, sfo{stf{x? / fhgLlts ;xdltdfkm{t sfg'gL sf/ jfxLsf] bfo/ faf6 pDsg ;Sg] b] lvG5Ú– cfof] usf] kqsf/ ;Dd] ngdf cWoIf tkaxfb'/ du/ n] eGg'eof] –cbfntaf6 Goflos k/ LIf0f x'g gkfpg] jf Goflos k/ LIf0f eO;s] sf] cj: yfdf d'2f lkmtf{ lng] sfo{n] bf] ifLn] pGd'lQm kfpg] / cfdhg;fwf/ 0fdf Gofo k|0ffnLk|ltsf] ljZj;gLotdf x|f; x'“b} hfg] vt/ f x'G5 .Ú
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t'n;Lk'/ , % ;fpg . b] zs} pTs[i6 eg] / k|rf/ ul/ Psf] a;kfs{ . : df6{ elgg] a;kfs{, t'n;Lk'/ a;kfs{ . g t o;df sDkfp08 ul/ Psf] 5, g / ftsf] ;dodf aQL aN5, g t oxf“ ;'/ Iffsf] s'g} ljlw g} ckgfOPsf] 5 . ljutsf lbgdf klg t'n;Lk'/ a;kfs{ If] q cf;kf;df ePsf cfk/ flws 36gfx?n] t'n;Lk'/ ;'/ Iffsf lx;fan] sdhf] / 5 eGg] k|i6\ofPs} 5g\ . oBlk laxLaf/ / flt a;kfs{leq} ePsf] 36gfn] oxf“leq x'g] s's[To aflxl/ Psf] 5 eg] t'n;Lk'/ a;kfs{df dlxnfx? ;'/ lIft 5} gg\ eGg] ;Gb] z uPsf] 5 . laxLaf/ / flt : ju{åf/ L gu/ kflnsfsL &# jifL{of dlxnf anfTs[t x'g'eof] . a;kfs{af6 uf8L lg: sg] 7fp“g] / sf] 36gf: ynaf6 t'n;Lk'/ –!% sf k': s/ k|tLIffnodf ;'Tg'ePsf] / x] 5 . To;kl5 / f] sf / s'dfv ufp“kflnsf–& ;Nofgsf pgLx?n] kmsfO km'nfO{ Toxf“ nu] sf @) jifL{o / ] zd lasnfO{ k|x/ Ln] gf $ / x] 5g\ . kl5 ToxL k|tLIffnodf ;'t] sf v &*$* gDa/ sf] a;af6 kqmfp u¥of] . csf] {n] k|x/ LnfO{ b] v] / va/ u/ ] sf / x] 5g\ . pgLx? b'a} hgf oftfoft dhb'/ x'g\ . To;nuQ} a;kfs{d} / x] sf] k|x/ L 6f] nLn] kLl8tsf cg';f/ a'waf/ dfgj sNof0f kLl8tsf] p4f/ u/ ] sf] xf] Ú– pxf“n] eGg'eof] – ;dfh ;] jf3/ af6 lg: s] sf] / laxLaf/ …cf“vf sd b] Vg'x'“bf] / x] 5 . pxf“ s;/ L t'n;Lk'/ cfPsf] atfpg'ePsf] Onfsf oxf“;Dd cfOk'Ug'eof] eGg] af/ ] cg';Gwfg k|x/ L sfof{nosf k|d'v l8P;kL k'ik/ fh ub} { 5f} + .Ú : jf: Yo k/ LIf0f eO;s] sf] 5 . dNnn] atfpg'eof] . …a] n'sf pxf“ t'n;Lk'/ kLl8tsf] dfgl;s cj: yf 7Ls} / x] sf] 5 . CMYK
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b] pv'/ L, % ;fpg . df] xDdb cfl/ km cG;f/ Lsf] hGd bfª t'n;Lk'/ df eof] . t'n;Lk'/ d} x'ls{g'eof] , ToxL+ a9\g' eof] . k9fO n] vfO klg t'n;Lk'/ d} rNof] . pxf“sf] ljjfx ;Nofgaf6 eof] . pxf“sf a'jfx? lj=;+= @)#@ ;fnlt/ sf] Onfjf;df a;fO yfNg' ePsf] lyof] . df] xDdbn] @)^# ;fndf hGdsf] cfwf/ df gful/ stf lng'eof] . clxn] pxf“sL 5f] / L ;flxjf dG;'/ L !^ jif{ k'Ug'eof] . h;n] xfn;fn} Onfsf k|zf;g sfof{no t'n;Lk'/ af6 j+zhsf] gful/ stfsf] k|df0fkq kfpg'ePsf] 5 . …d hlGdPsf] oxL df6f] df xf] , oxL+ x'ls{P“, oxL+ 7"nf] eP“Ú– df] xDdbn] eGg'eof] – …@)^# ;fndf hGdsf] cfwf/ df d] / f] gful/ stf aGof] . clxn] 5f] / Lsf] pd] / klg k'Uof] . lgod klg cfof] . 5f] / Ln] j+zhsf] gful/ stf agfPsL 5g\ . xfdL w] / } v'zL 5f} + .Ú P;OO{ k/ LIffdf / fd|f] u|] 8 lnP/ pQL0f{ ePsL 5f] / LnfO{ dflyNnf] sIffsf] k9fOsf nflu ;lhnf] x'g] cfl/ kmn] atfpg'eof] . g] kfnsf] gful/ stf klxnf] ;+;f] wg P] g @)&( sf] sfof{Gjog ub{} hGdsf cfwf/ df gful/ stf lnPsf JolQmx?sf ;GtfgnfO{ j+zhsf] g] kfnL gful/ stf k|bfg ul/ Psf] 5 . dG;'/ L;lxt bfª lhNnfdf Ps ;o ^* hgfn] g] kfnL gful/ stfsf] k|df0fkq k|fKt u/ ] sf 5g\ . ;a} eGbf a9L gful/ stf Onfsf k|zf;g sfof{no ndxLn] ljt/ 0f u/ ] sf] 5 . Onfsf k|zf;g sfof{no ndxLn] ^* j6f gful/ stf ljt/ 0f u/ ] sf] 5 eg] Onfsf k|zf;g sfof{no t'n;Lk'/ n] %# / lhNnf k|zf;g sfof{no 3f] / fxLaf6 $& hgfn] j+zhsf] gful/ stf lnPsf
5g\ . lhNnf k|zf;g sfof{no bfªn] c;f/ * ut] ;"rgf hf/ L ub{} g] kfnL gful/ stfsf] k|df0fkq k|fKt ug{ !! k|sf/ sf] k|df0fx? k] z ug{ cg'/ f] w u/ ] sf] lyof] . h;cGtu{t c;f/ !) ut] af6 lhNnfdf gful/ stf ljt/ 0fsf] sfd z'? ePsf] lyof] . Onfsf k|zf;g sfof{no ndxLn] c;f/ !! ut] b] lv xfn;Dd ^* j6f j+zhsf] gful/ stf ljt/ 0f u/ ] sf] hgfPsf] 5 . lgldQ sfof{no k|d'v O{Zj/ L ef/ tLsf cg';f/ hGdsf] cfwf/ df gful/ stf k|fKt u/ ] sfx?sf] ;Gtfgn] j+zhsf] cfwf/ df gful/ stf k|fKt u/ ] sf] atfpg'eof] . …z'? z'?df lgs} eL8 nfUof] . slt a'em\gsf] nflu cfpg'eof] . kl5 sfuhkq k'u] sfx?nfO{ j+zhsf] gful/ stf ljt/ 0f u¥of} +Ú– pxf“n] eGg'eof] – … cfhef] ln rfk sd 5 .Ú Onfsf k|zf;g sfof{no t'n;Lk'/ af6 %# hgfn] j+zhsf] cfwf/ df gful/ stf k|fKt u/ ] sf] sfof{no k|d'v o1 a'9fn] hfgsf/ L lbg'eof] . …gof“ lgod nfu' ePkl5 k|lqmof k"/ f u/ ] / gful/ stf lbOPsf] 5 . a'jfn] hGdsf] cfwf/ df gful/ stf agfO;s] sf] t/ cfkm\gf 5f] / f5f] / LnfO{ gful/ stf agfOlbg g;s] sf]
v08df clxn] sf] lgodn] ;Daf] wg u/ ] kl5 gful/ stfsf] k|df0fkq hf/ L u/ ] sf 5f} +Ú– sfof{no k|d'v a'9fn] eGg'eof] – …sfof{nodf gful/ stf agfpg cfpg] sf] ;+Vof kmf6\6 km'6\6 5 .Ú lhNnf k|zf;g sfof{no bfªaf6 z'qmaf/ ;Dd $& hgfn] j+zhsf] cfwf/ df g] kfnL gful/ stfsf] k|df0fkq k|fKt u/ ] sf 5g\ . clws[t bnaxfb'/ a: g] tsf cg';f/ a'jfn] hGdsf] cfwf/ df gful/ stf lnPsf] , cfdfsf] j} jflxs c+lus[t cyjf hGdsf] cfwf/ df gful/ stf lnPsfx?sf ;GtfgnfO{ j+zhsf] gful/ stf lbOPsf] 5 . lhNnf k|zf;g sfof{non] j+zhsf] gful/ stf k|flKtsf nflu a'jf / cfdfsf] ;Ssn g] kfnL gful/ stfsf] k|df0fkq, ;Ssn hGdbtf{sf] k|df0fkq, hUufwgL k|df0fk"hf{ h;df ;Gtfgsf] cfdf÷a'jf jf Psf3/ ;uf] nsf JolQmsf] gfddf ePsf] hUufsf] x'g'kg{] pNn] v u/ ] sf] 5 . o: t} z} lIfs k|df0fkq, : yfgLo txn] g] kfnd} hGd eO{ lg/ Gt/ g] kfndf a;f] jf; u/ ] sf] egL ul/ lbPsf] l;kmfl/ ;, kfl/ jfl/ s ljj/ 0f, a'jf / cfdfaLrsf] ljjfx btf{ k|df0fkq, af“sL clGtd k]hdf:
dd{t ug{ g;Sbf e]lG6n]6/ uf]bfddf ylGsP o'uaf] w ;dfrf/ bftf af“s], % ;fpg . dd{t ug{ g;Sbf af“s] sf] g] kfnu~hl: yt e] / L c: ktfndf !@ j6f e] lG6n] 6/ uf] bfddf ylGsPsf 5g\ . sf] le8–!( sf] ;dodf ;/ sf/ / ljleGg bftfn] tL e] lG6n] 6/ ;xof] u u/ ] sf x'g\ . e] lG6n] 6/ lalu|Pkl5 uf] bfddf yGSofOPsf] e] / L c: ktfnsf lrlsT;s 8f= kf/ ; kf08] n] atfpg'eof] . …e] lG6n] 6/ cefjdf sf] le8– !( sf la/ fdLsf] pkrf/ df ;d: of ePkl5 ljleGg bftfn] kf“rj6f pknAw u/ fPsf lyP .
dd{t ug{ g;Sbf uf] bfddf ylGsPsf 5g\ .Ú ;/ sf/ n] vl/ b u/ ] sf @) dWo] ;ftj6f e] lG6n] 6/ klg lalu|Psf] pxf“n] atfpg'eof] . c: ktfnl;t af“sL / x] sf !# e] lG6n] 6/ df klg Aof6«Lsf] ;d: of b] lvPsf] 8f= kf08] n] atfpg'eof] . …dd{tsf nflu / sdsf] vf“rf] 5, pknAw x'gf;fy dd{t u5f} {+Ú– pxf“n] eGg'eof] . l5gl5gdf aQL cfpg] hfg] x'“bf e] lG6n] 6/ lalu|Psf x'g\ . e] / L c: ktfnsf k|d'v d] l8sn ;'kl/ 6] G8] G6 8f= ab|L rfkfufO“n] b} lgs 5j6f e] lG6n] 6/ ;~rfngdf NofPsf]
atfpg'eof] . hgzlQm / z} øof cefjn] la/ fdLnfO{ ;] jf lbg g;lsPsf] pxf“sf] egfO 5 . …k|To] s lbg () k|ltzt z} øof el/ e/ fp x'G5g\ . gof“ la/ fdLn] z} øof kfpg ls k'/ fgf lgsf] x'g'k¥of] , ls l;kmfl/ ; eP/ cGoq hfg'kg] { x'G5 .Ú 8f= rfkfufO“n] ;3g / f] usf la/ fdLnfO{ dfq cfO;Lo'df / fv] / pkrf/ ul/ g] hfgsf/ L lbg'eof] . cfO;Lo'df prf/ / t la/ fdLnfO{ : jf; km] g{ ufx|f] ePkl5 e] lG6n] 6/ sf] cfjZostf k5{ . e] / L c: ktfnsf] cfO;Lo'df !% j6f dfq a] 8 5g\ .
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ECG / ECHO
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MBBS, MD Internal Medicine DM Cardiology
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