{"id":20646,"date":"2023-04-17T13:09:34","date_gmt":"2023-04-17T06:09:34","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=20646"},"modified":"2023-04-18T14:45:46","modified_gmt":"2023-04-18T07:45:46","slug":"chan-doan-va-dieu-tri-xo-gan-tim","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/chan-doan-va-dieu-tri-xo-gan-tim\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh x\u01a1 gan tim"},"content":{"rendered":"<p style=\"padding-left: 40px;\"><strong>X\u01a1 gan tim (b\u1ec7nh l\u00fd gan do \u1ee9 huy\u1ebft) l\u00e0 m\u1ed9t ph\u1ed5 b\u1ec7nh c\u00e1c r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng gan trong b\u1ec7nh c\u1ea3nh suy tim ph\u1ea3i ho\u1eb7c c\u00e1c b\u1ea5t th\u01b0\u1eddng kh\u00e1c c\u1ee7a tim, g\u00e2y ra do \u1ee9 huy\u1ebft th\u1ee5 \u0111\u1ed9ng m\u1ea1n t\u00ednh \u1edf gan. B\u1ea5t k\u1ef3 nguy\u00ean nh\u00e2n g\u00e2y suy th\u1ea5t ph\u1ea3i n\u00e0o c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0a \u0111\u1ebfn \u1ee9 huy\u1ebft gan nh\u01b0 vi\u00eam m\u00e0ng ngo\u00e0i tim, h\u1edf 3 l\u00e1, h\u1eb9p 2 l\u00e1, b\u1ec7nh c\u01a1 tim, t\u00e2m ph\u1ebf m\u1ea1n. X\u01a1 gan tim c\u00f3 <\/strong><a href=\"https:\/\/www.vinmec.com\/vi\/tim-mach\/thong-tin-suc-khoe\/tim-hieu-ve-benh-suy-tim-sung-huyet\/#:~:text=Suy%20tim%20sung%20huy%E1%BA%BFt%20l%C3%A0%20t%C3%ACnh%20tr%E1%BA%A1ng%20tim%20ho%E1%BA%A1t%20%C4%91%E1%BB%99ng,c%C6%A1%20quan%20trong%20c%C6%A1%20th%E1%BB%83.\"><strong>tri\u1ec7u ch\u1ee9ng c\u1ee7a suy tim<\/strong><\/a><strong> l\u00e0 \u01b0u th\u1ebf.\u00a0 X\u01a1 gan tim c\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi vi\u00eam gan do thi\u1ebfu m\u00e1u, l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd c\u00f3 ho\u1ea1i t\u1eed gan nhi\u1ec1u g\u00e2y ra do cho\u00e1ng tim ho\u1eb7c c\u00e1c r\u1ed1i lo\u1ea1n huy\u1ebft \u0111\u1ed9ng kh\u00e1c. <\/strong><\/p>\n<p>&nbsp;<\/p>\n<h2><strong>1. Sinh b\u1ec7nh h\u1ecdc v\u00e0 nguy\u00ean nh\u00e2n g\u00e2y x\u01a1 gan tim.<\/strong><\/h2>\n<p>Trong suy th\u1ea5t ph\u1ea3i ho\u1eb7c suy hai th\u1ea5t, t\u0103ng \u00e1p l\u1ef1c nh\u0129 ph\u1ea3i qua t\u0129nh m\u1ea1ch ch\u1ee7 d\u01b0\u1edbi v\u00e0 c\u00e1c t\u0129nh m\u1ea1ch gan l\u00e0m t\u0103ng \u00e1p l\u1ef1c trong gan. \u1ede c\u1ea5p \u0111\u1ed9 t\u1ebf b\u00e0o, \u1ee9 huy\u1ebft t\u0129nh m\u1ea1ch l\u00e0m c\u1ea3n tr\u1edf h\u1ed3i l\u01b0u m\u00e1u trong c\u00e1c xoang gan v\u00e0o ti\u1ec3u t\u0129nh m\u1ea1ch. \u1ee8 huy\u1ebft xoang gan g\u00e2y t\u00edch t\u1ee5 m\u00e1u ngh\u00e8o oxy, teo nhu m\u00f4, ho\u1ea1i t\u1eed, l\u1eafng \u0111\u1ecdng collagen v\u00e0 cu\u1ed1i c\u00f9ng d\u1eabn t\u1edbi x\u01a1 h\u00f3a.<\/p>\n<p>\u1ee8 huy\u1ebft g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan qua ba c\u01a1 ch\u1ebf ch\u00ednh: (1) gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng m\u00e1u \u0111\u1ebfn gan, (2) gi\u1ea3m b\u00e3o \u0111\u1ed9 b\u00e3o h\u00f2a oxy m\u00e1u \u0111\u1ed9ng m\u1ea1ch, v\u00e0 (3) t\u0103ng \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch gan. R\u1ed1i lo\u1ea1n tu\u1ea7n ho\u00e0n gan c\u0169ng g\u1eb7p trong m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd kh\u00e1c nh\u01b0 h\u1ed9i ch\u1ee9ng t\u1eafc t\u0129nh m\u1ea1ch xoang gan, huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch c\u1eeda, h\u1ed9i ch\u1ee9ng Budd-Chiari.<\/p>\n<p>Nguy\u00ean nh\u00e2n c\u1ee7a x\u01a1 gan tim l\u00e0 c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y suy th\u1ea5t ph\u1ea3i \u1ee9 huy\u1ebft nh\u01b0 b\u1ec7nh tim thi\u1ebfu m\u00e1u (31%), b\u1ec7nh c\u01a1 tim (23%), b\u1ec7nh van tim (23%), b\u1ec7nh ph\u1ed5i nguy\u00ean ph\u00e1t (15%), b\u1ec7nh m\u00e0ng ngo\u00e0i tim (8%).<\/p>\n<h2><strong>2. D\u1ecbch t\u1ec5 h\u1ecdc c\u1ee7a b\u1ec7nh x\u01a1 gan tim.<\/strong><\/h2>\n<ul>\n<li>T\u1ec9 l\u1ec7 hi\u1ec7n m\u1eafc c\u1ee7a x\u01a1 gan tim kh\u00f3 x\u00e1c \u0111\u1ecbnh do b\u1ec7nh gan c\u00f3 th\u1ec3 kh\u00f4ng tri\u1ec7u ch\u1ee9ng, ch\u1ea9n \u0111o\u00e1n b\u1ecb nh\u1ea7m v\u1edbi c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan.<\/li>\n<li>B\u1ec7nh su\u1ea5t v\u00e0 t\u1eed su\u1ea5t c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh x\u01a1 gan tim hi\u1ebfm khi do b\u1ec7nh gan g\u00e2y ra. M\u00e0 b\u1ec7nh tim n\u1ec1n s\u1ebd quy\u1ebft \u0111\u1ecbnh k\u1ebft c\u1ee5c l\u00e2m s\u00e0ng.<\/li>\n<li>Tu\u1ed5i kh\u1edfi ph\u00e1t b\u1ec7nh kh\u00f4ng r\u00f5 r\u00e0ng v\u00e0 ph\u1ee5 thu\u1ed9c v\u00e0o th\u1eddi \u0111i\u1ec3m kh\u1edfi ph\u00e1t suy tim m\u1ea5t b\u00f9. Nh\u01b0 v\u1edbi b\u1ec7nh tim, nguy c\u01a1 x\u01a1 gan tim s\u1ebd t\u0103ng theo tu\u1ed5i.<\/li>\n<li>Kh\u00f4ng c\u00f3 nghi\u00ean c\u1ee9u so s\u00e1nh t\u1ec9 l\u1ec7 nam\/n\u1eef trong x\u01a1 gan tim, nh\u01b0ng nam g\u1eb7p nhi\u1ec1u h\u01a1n n\u1eef do suy tim sung huy\u1ebft g\u1eb7p nhi\u1ec1u \u1edf nam h\u01a1n.<\/li>\n<\/ul>\n<h2><strong>3. \u0110\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng v\u00e0 c\u1eadn l\u00e2m s\u00e0ng.<\/strong><\/h2>\n<p>Giai \u0111o\u1ea1n b\u1ec7nh gan kh\u00f4ng tri\u1ec7u ch\u1ee9ng: b\u1ec7nh nh\u00e2n ch\u1ec9 c\u00f3 <a href=\"https:\/\/vinmec.com\/vi\/tim-mach\/thong-tin-suc-khoe\/cac-trieu-chung-lam-sang-cua-hoi-chung-suy-tim-phai\/\">tri\u1ec7u ch\u1ee9ng suy tim sung huy\u1ebft<\/a> v\u00e0 b\u1ea5t th\u01b0\u1eddng ch\u1ee9c n\u0103ng gan tr\u00ean x\u00e9t nghi\u1ec7m. Tri\u1ec7u ch\u1ee9ng di\u1ec5n ti\u1ebfn t\u1eeb t\u1eeb nh\u01b0ng c\u0169ng c\u00f3 th\u1ec3 kh\u1edfi ph\u00e1t \u0111\u1ed9t ng\u1ed9t trong vi\u00eam m\u00e0ng ngo\u00e0i tim h\u1ea1n ch\u1ebf ho\u1eb7c suy tim ph\u1ea3i m\u1ea5t b\u00f9 c\u1ea5p.<\/p>\n<ul>\n<li>C\u00e1c <strong><a href=\"https:\/\/vinmec.com\/vi\/tieu-hoa-gan-mat\/thong-tin-suc-khoe\/cac-bat-thuong-benh-ly-o-gan\/?link_type=related_posts\">b\u1ea5t th\u01b0\u1eddng ch\u1ee9c n\u0103ng gan<\/a><\/strong> c\u00f3 th\u1ec3 g\u1eb7p nh\u01b0: t\u0103ng transaminase t\u1eeb 2 \u2013 3 l\u1ea7n gi\u1edbi h\u1ea1n tr\u00ean, c\u00f3 th\u1ec3 t\u0103ng bilirubin gi\u00e1n ti\u1ebfp, bilirubin to\u00e0n ph\u1ea7n hi\u1ebfm khi qu\u00e1 3mg\/dL; h\u1ea1 albumin m\u00e1u c\u00f3 th\u1ec3 chi\u1ebfm 30 \u2013 50% b\u1ec7nh nh\u00e2n v\u00e0 th\u01b0\u1eddng l\u00e0 nh\u1eb9. Nh\u1eefng b\u1ea5t th\u01b0\u1eddng n\u00e0y kh\u00f4ng li\u00ean quan m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng gan tr\u00ean m\u00f4 h\u1ecdc v\u00e0 c\u0169ng c\u00f3 th\u1ec3 do suy dinh d\u01b0\u1ee1ng ho\u1eb7c m\u1ea5t protein do b\u1ec7nh l\u00fd ru\u1ed9t.<\/li>\n<li>Giai \u0111o\u1ea1n c\u00f3 tri\u1ec7u ch\u1ee9ng b\u1ec7nh gan: ng\u01b0\u1eddi b\u1ec7nh c\u00f3 c\u1ea3m gi\u00e1c c\u0103ng t\u1ee9c h\u1ea1 s\u01b0\u1eddn ph\u1ea3i do c\u0103ng bao gan, v\u00e0ng da (\u00edt g\u1eb7p h\u01a1n). X\u00e9t nghi\u1ec7m th\u1ea5y phosphatase ki\u1ec1m b\u00ecnh th\u01b0\u1eddng ho\u1eb7c t\u0103ng nh\u1eb9 c\u00f3 th\u1ec3 gi\u00fap ph\u00e2n bi\u1ec7t x\u01a1 gan do tim v\u1edbi c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c.<\/li>\n<\/ul>\n<p>B\u1ec7nh gan \u1ee9 huy\u1ebft do suy th\u1ea5t ph\u1ea3i m\u1ea5t b\u00f9 c\u1ea5p c\u00f3 th\u1ec3 kh\u1edfi ph\u00e1t \u0111\u1ed9t ng\u1ed9t v\u00e0ng da v\u00e0 t\u0103ng cao men gan, bilirubin. C\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a t\u0103ng \u00e1p c\u1eeda v\u00e0 shut c\u1eeda \u2013 ch\u1ee7 ch\u1ec9 x\u1ea3y ra khi b\u1ec7nh gan \u1ee9 huy\u1ebft ti\u1ebfn tri\u1ec3n \u0111\u1ebfn x\u01a1 gan m\u1ea5t b\u00f9.<\/p>\n<h3><strong>3.1. C\u00e1c tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng c\u1ee7a x\u01a1 gan tim.<\/strong><\/h3>\n<p>C\u00e1c tri\u1ec7u ch\u1ee9ng do suy tim ph\u1ea3i: ph\u00f9 ph\u1ee5 thu\u1ed9c l\u01b0\u1ee3ng n\u01b0\u1edbc nh\u1eadp, t\u0103ng c\u00e2n, t\u0103ng v\u00f2ng b\u1ee5ng; \u0111au h\u1ea1 s\u01b0\u1eddn ph\u1ea3i; ti\u1ec3u \u0111\u00eam; m\u1ec7t ng\u00e0y c\u00e0ng t\u0103ng; ch\u00e1n \u0103n, bu\u1ed3n n\u00f4n. Ng\u01b0\u1eddi b\u1ec7nh c\u00f2n c\u00f3 th\u1ec3 c\u00f3 tri\u1ec7u ch\u1ee9ng do suy tim to\u00e0n b\u1ed9: kh\u00f3 th\u1edf ti\u1ebfn tri\u1ec3n, kh\u00f3 th\u1edf khi n\u1eb1m, kh\u00f3 th\u1edf k\u1ecbch ph\u00e1t v\u1ec1 \u0111\u00eam; ho, kh\u00f2 kh\u00e8 (c\u01a1n hen tim); lo \u00e2u.<\/p>\n<h3><strong>3.2. Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3.<\/strong><\/h3>\n<ul>\n<li>Ph\u00f9 chi d\u01b0\u1edbi, v\u00f9ng th\u1ea5p, c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n \u0111\u1ebfn c\u1ed5 tr\u01b0\u1edbng trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh gan ti\u1ebfn tri\u1ec3n v\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb. Ph\u00f9 m\u1ea1n c\u00f3 th\u1ec3 k\u00e8m t\u0103ng s\u1eafc t\u1ed1 da, d\u00e0y c\u1ee9ng da v\u00e0 vi\u00eam m\u00f4 t\u1ebf b\u00e0o.<\/li>\n<li>T\u0129nh m\u1ea1ch c\u1ed5 n\u1ed5i, ph\u1ea3n h\u1ed3i gan t\u0129nh m\u1ea1ch c\u1ed5 d\u01b0\u01a1ng t\u00ednh.<\/li>\n<li>D\u1ea5u hi\u1ec7u Kussmaul: t\u0129nh m\u1ea1ch c\u1ed5 n\u1ed5i trong th\u00ec h\u00edt v\u00e0o c\u00f3 th\u1ec3 g\u1ee3i \u00fd vi\u00eam ngo\u1ea1i t\u00e2m m\u1ea1c h\u1ea1n ch\u1ebf, suy th\u1ea5t ph\u1ea3i, h\u1eb9p 3 l\u00e1, t\u00e2m ph\u1ebf m\u1ea1n.<\/li>\n<li>Ran ph\u1ed5i: c\u00f3 ran ph\u1ed5i n\u1ebfu c\u00f3 suy tim to\u00e0n b\u1ed9. Gi\u1ea3m ph\u1ebf \u00e2m 2 \u0111\u00e1y do tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i.<\/li>\n<li>B\u1ea5t th\u01b0\u1eddng \u1edf tim: ti\u1ebfng T3 v\u00e0 T4 \u1edf th\u1ea5t ph\u1ea3i g\u1ee3i \u00fd suy th\u1ea5t ph\u1ea3i. Ti\u1ebfng th\u1ed5i to\u00e0n t\u00e2m thu, \u00e2m s\u1eafc cao c\u1ee7a h\u1edf 3 l\u00e1. D\u1ea5u hi\u1ec7u t\u0103ng \u00e1p ph\u1ed5i: T2 t\u00e1ch \u0111\u00f4i v\u1edbi P2 l\u1edbn. \u00c2m ph\u1ed5i Graham Steell c\u1ee7a h\u1edf van ph\u1ed5i c\u00f3 t\u0103ng \u00e1p ph\u1ed5i.<\/li>\n<li>Gan to: ch\u1eafc, c\u1ee9ng. L\u00e1ch to c\u00f3 th\u1ec3 s\u1edd ch\u1ea1m.<\/li>\n<li>Suy m\u00f2n: ch\u00e1n \u0103n, s\u1ee5t c\u00e2n, suy dinh d\u01b0\u1ee1ng do b\u1ec7nh tim ti\u1ebfn tri\u1ec3n.<\/li>\n<\/ul>\n<h2><strong>4. X\u1eed tr\u00ed v\u00e0 qu\u1ea3n l\u00fd ng\u01b0\u1eddi b\u1ec7nh x\u01a1 gan tim.<\/strong><\/h2>\n<ul>\n<li>\u1ede ph\u1ea7n l\u1edbn tr\u01b0\u1eddng h\u1ee3p, l\u1ee3i ti\u1ec3u l\u00e0 c\u1ed1t l\u00f5i trong \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng.<\/li>\n<\/ul>\n<p>+ Furosemide n\u00ean ti\u00eam m\u1ea1ch \u0111\u1ec3 tr\u00e1nh h\u1ea5p thu k\u00e9m \u1edf ru\u1ed9t, d\u00f9ng li\u1ec1u th\u1ea5p v\u00e0 t\u0103ng li\u1ec1u \u0111\u1ec3 \u0111\u1ea1t m\u1ee9c l\u1ee3i ti\u1ec3u mong mu\u1ed1n v\u00e0 m\u1ee5c ti\u00eau. M\u1ee5c ti\u00eau l\u00e2m s\u00e0ng l\u00e0 \u0111\u01b0a c\u00e2n n\u1eb7ng b\u1ec7nh nh\u00e2n v\u1ec1 m\u1ee9c n\u1ec1n. T\u0103ng BUN v\u00e0 creatinin cho th\u1ea5y suy th\u1eadn c\u1ea5p tr\u01b0\u1edbc th\u1eadn v\u00e0 \u0111\u00e3 l\u1ee3i ni\u1ec7u t\u1ed1i \u0111a.<\/p>\n<p>+ Spironolacton c\u00f3 th\u1ec3 th\u00eam v\u00e0o n\u1ebfu c\u00f3 c\u01b0\u1eddng aldosteron th\u1ee9 ph\u00e1t.<\/p>\n<ul>\n<li>Khi b\u1ec7nh nh\u00e2n \u0111\u1ee7 d\u1ecbch, ch\u1eb9n beta v\u00e0 \u1ee9c ch\u1ebf men chuy\u1ec3n c\u00f3 th\u1ec3 th\u00eam v\u00e0o n\u1ebfu b\u1ec7nh n\u1ec1n l\u00e0 suy th\u1ea5t tr\u00e1i.<\/li>\n<\/ul>\n<ul>\n<li>Spironolacton c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc, n\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 suy tim NYHA III ho\u1eb7c IV.<\/li>\n<\/ul>\n<ul>\n<li>Ph\u1eabu thu\u1eadt: b\u1eaft c\u1ea7u m\u1ea1ch v\u00e0nh; s\u1eeda van 3 l\u00e1; c\u1eaft m\u00e0ng ngo\u00e0i tim trong vi\u00eam ngo\u1ea1i t\u00e2m m\u1ea1c h\u1ea1n ch\u1ebf; m\u1ed5 t\u1ea1o shunt c\u1eeda ch\u1ee7: ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh; gh\u00e9p tim v\u1edbi b\u1ec7nh c\u01a1 tim giai \u0111o\u1ea1n cu\u1ed1i.<\/li>\n<li>Ch\u1ebf \u0111\u1ed9 \u0103n: gi\u1ea3m mu\u1ed1i &lt;2g\/d.<\/li>\n<\/ul>\n<ul>\n<li>V\u1eadn \u0111\u1ed9ng: ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh t\u1eadp luy\u1ec7n ph\u00f9 h\u1ee3p sau khi suy tim \u1ed5n \u0111\u1ecbnh.<\/li>\n<\/ul>\n<ul>\n<li>Theo d\u00f5i: h\u01b0\u1edbng d\u1eabn b\u1ec7nh nh\u00e2n duy tr\u00ec c\u00e2n n\u1eb7ng. H\u01b0\u1edbng d\u1eabn t\u0103ng li\u1ec1u l\u1ee3i ti\u1ec3u n\u1ebfu c\u00e2n n\u1eb7ng qu\u00e1 1kg\/ng\u00e0y. Theo d\u00f5i K m\u00e1u, BUN, creatinin huy\u1ebft thanh, AST, ATL, phosphotase ki\u1ec1m v\u00e0 bilirubin.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/p>\n<p>Mansoor Arif, Kyle K Pond, Cardiac Cirrhosis and Congestive Hepatopathy, Medscape 2020.<\/p>\n<p>Xanthopoulos A, Starling RC, Kitai T, Triposkiadis F. Heart Failure and Liver Disease: Cardiohepatic Interactions. JACC Heart Fail. 2019 Feb;7(2):87-97.<\/p>\n<p>Hilscher M, Sanchez W. Congestive hepatopathy. Clin Liver Dis (Hoboken). 2016 Oct 2;8(3):68-71.<\/p>\n<p>Rodriguez Ziccardi M, Pendela VS, Singhal M. Cardiac Cirrhosis. [Updated 2023 Feb 7]. In: StatPearls<\/p>\n","protected":false},"excerpt":{"rendered":"<p>X\u01a1 gan tim (b\u1ec7nh l\u00fd gan do \u1ee9 huy\u1ebft) l\u00e0 m\u1ed9t ph\u1ed5 b\u1ec7nh c\u00e1c r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng gan trong b\u1ec7nh c\u1ea3nh suy tim ph\u1ea3i ho\u1eb7c c\u00e1c b\u1ea5t th\u01b0\u1eddng kh\u00e1c c\u1ee7a tim, g\u00e2y ra do \u1ee9 huy\u1ebft th\u1ee5 \u0111\u1ed9ng m\u1ea1n t\u00ednh \u1edf gan. B\u1ea5t k\u1ef3 nguy\u00ean nh\u00e2n g\u00e2y suy th\u1ea5t ph\u1ea3i n\u00e0o c\u0169ng c\u00f3 th\u1ec3 [&hellip;]<\/p>\n","protected":false},"author":69,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh x\u01a1 gan tim - Vinmec<\/title>\n<meta name=\"description\" content=\"X\u01a1 gan tim l\u00e0 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng gan trong b\u1ec7nh c\u1ea3nh suy tim ph\u1ea3i. 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