{"id":24909,"date":"2023-04-19T17:46:33","date_gmt":"2023-04-19T10:46:33","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=24909"},"modified":"2023-04-20T16:26:26","modified_gmt":"2023-04-20T09:26:26","slug":"chan-doan-va-dieu-tri-viem-co-tim-sau-tiem-vac-xin-covid-19-bo-y-te","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/chan-doan-va-dieu-tri-viem-co-tim-sau-tiem-vac-xin-covid-19-bo-y-te\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb vi\u00eam c\u01a1 tim sau ti\u00eam v\u1eafc xin Covid-19 \u2013 B\u1ed9 Y t\u1ebf"},"content":{"rendered":"

Vi\u00eam c\u01a1 tim\/m\u00e0ng tim c\u1ea5p sau ti\u00eam v\u1eafc xin COVID-19 m\u1edbi \u0111\u01b0\u1ee3c ghi nh\u1eadn g\u1ea7n \u0111\u00e2y trong b\u00e1o c\u00e1o c\u1ee7a c\u00e1c C\u01a1 quan Ph\u00f2ng ch\u1ed1ng b\u1ec7nh t\u1eadt, c\u01a1 quan Qu\u1ea3n l\u00fd D\u01b0\u1ee3c v\u00e0 T\u1ed5 ch\u1ee9c gi\u00e1m s\u00e1t an to\u00e0n v\u1eafc xin t\u1ea1i Ch\u00e2u \u00c2u, Hoa k\u1ef3 v\u00e0 m\u1ed9t s\u1ed1 n\u01b0\u1edbc kh\u00e1c. Vi\u00eam c\u01a1 tim c\u1ea5p<\/a> (c\u00f3 ho\u1eb7c kh\u00f4ng k\u00e8m vi\u00eam m\u00e0ng ngo\u00e0i tim c\u1ea5p) l\u00e0 m\u1ed9t trong nh\u1eefng bi\u1ebfn ch\u1ee9ng quan tr\u1ecdng sau khi ti\u00eam v\u1eafc xin COVID-19, bao g\u1ed3m nh\u00f3m bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn ph\u1ea3n v\u1ec7; nh\u00f3m bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn \u0111\u00f4ng-ch\u1ea3y m\u00e1u (nh\u01b0 h\u1ed9i ch\u1ee9ng gi\u1ea3m ti\u1ec3u c\u1ea7u\/huy\u1ebft kh\u1ed1i sau ti\u00eam v\u1eafc xin) hay nh\u00f3m bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn vi\u00eam c\u01a1 tim\/m\u00e0ng tim (VCT\/VMNT).<\/strong><\/p>\n

\"minh-hoa-viem-co-tim\"<\/p>\n

1. L\u00e2m s\u00e0ng vi\u00eam c\u01a1 tim\/ m\u00e0ng ngo\u00e0i tim<\/strong><\/h2>\n

1.1. L\u00e2m s\u00e0ng<\/strong><\/p>\n

Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng xu\u1ea5t hi\u1ec7n th\u01b0\u1eddng\u00a02-4\u00a0ng\u00e0y\u00a0sau\u00a0ti\u00eam v\u1eafc\u00a0xin COVID-19,\u00a0d\u00f9 c\u00f3 th\u1ec3 g\u1eb7p s\u1edbm\u00a0(12h sau\u00a0ti\u00eam) h\u01a1n ho\u1eb7c mu\u1ed9n h\u01a1n,\u00a0bao\u00a0g\u1ed3m:<\/p>\n

–\u00a0\u0110au ng\u1ef1c: ki\u1ec3u \u0111au th\u1eaft ch\u1eb9n v\u00f9ng\u00a0sau\u00a0x\u01b0\u01a1ng \u1ee9c, ng\u1ef1c tr\u00e1i ho\u1eb7c ph\u1ea3i, ho\u1eb7c ki\u1ec3u \u0111au r\u00e1t b\u1ecfng\u00a0thay\u00a0\u0111\u1ed5i\u00a0theo\u00a0nh\u1ecbp h\u00f4 h\u1ea5p ho\u1eb7c t\u01b0 th\u1ebf.<\/p>\n

–\u00a0Kh\u00f3 th\u1edf: \u1edf c\u00e1c m\u1ee9c \u0111\u1ed9 kh\u00e1c\u00a0nhau,\u00a0t\u1eeb kh\u00f3 th\u1edf nh\u1eb9\u00a0khi\u00a0g\u1eafng s\u1ee9c \u0111\u1ebfn kh\u00f3 th\u1edf th\u01b0\u1eddng xuy\u00ean ho\u1eb7c kh\u00f3 th\u1edf d\u1eef d\u1ed9i, t\u01b0\u01a1ng \u1ee9ng v\u1edbi m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a\u00a0suy tim.<\/p>\n

–\u00a0R\u1ed1i lo\u1ea1n nh\u1ecbp\u00a0tim:\u00a0c\u1ea3m gi\u00e1c\u00a0tim\u00a0\u0111\u1eadp nhanh\/ch\u1eadm b\u1ea5t th\u01b0\u1eddng, ho\u1eb7c h\u1ed3i h\u1ed9p tr\u1ed1ng ng\u1ef1c\u00a0do\u00a0c\u00e1c d\u1ea1ng r\u1ed1i lo\u1ea1n nh\u1ecbp\u00a0tim\u00a0kh\u00e1c\u00a0nhau.<\/p>\n

–\u00a0Kh\u00e1m l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 kh\u00f4ng th\u1ea5y d\u1ea5u hi\u1ec7u g\u00ec \u0111\u1eb7c bi\u1ec7t ho\u1eb7c ch\u1ec9 c\u00f3 ti\u1ebfng c\u1ecd m\u00e0ng ngo\u00e0i\u00a0tim.\u00a0C\u00f3 th\u1ec3 c\u00f3 s\u1ed1t ho\u1eb7c kh\u00f4ng.<\/p>\n

–\u00a0Vi\u00eam c\u01a1 tim\/m\u00e0ng ngo\u00e0i\u00a0tim\u00a0c\u1ea5p th\u01b0\u1eddng \u0111\u00e1p \u1ee9ng t\u1ed1t v\u1edbi \u0111i\u1ec1u tr\u1ecb v\u00e0 tho\u00e1i tri\u1ec3n\u00a0sau 3-5\u00a0ng\u00e0y,\u00a0song\u00a0c\u0169ng c\u00f3 th\u1ec3 tr\u1edf n\u1eb7ng th\u1eadm ch\u00ed\u00a0nguy\u00a0k\u1ecbch b\u1ea5t th\u01b0\u1eddng.<\/p>\n

–\u00a0D\u1ea5u hi\u1ec7u n\u1eb7ng\/nguy k\u1ecbch\u00a0bao\u00a0g\u1ed3m nh\u1eefng bi\u1ec3u hi\u1ec7n c\u1ee7a c\u00e1c t\u00ecnh tr\u1ea1ng nh\u01b0 ph\u00f9 ph\u1ed5i c\u1ea5p,\u00a0suy tim\u00a0c\u1ea5p, tr\u00e0n d\u1ecbch m\u00e0ng\u00a0tim\u00a0g\u00e2y \u00e9p\u00a0tim,\u00a0s\u1ed1c\u00a0tim,\u00a0c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp nhanh\/ch\u1eadm ph\u1ee9c t\u1ea1p, ng\u1ea5t\/th\u1ec9u th\u1eadm ch\u00ed \u0111\u1ed9t t\u1eed.\u00a0Khi\u00a0\u0111\u00f3 s\u1ebd c\u00f3 c\u00e1c bi\u1ec3u hi\u1ec7n t\u01b0\u01a1ng \u1ee9ng v\u1edbi\u00a0suy tim\u00a0ho\u1eb7c r\u1ed1i lo\u1ea1n nh\u1ecbp\u00a0tim\u00a0\u1edf c\u00e1c m\u1ee9c \u0111\u1ed9 v\u1eeba-n\u1eb7ng nh\u01b0 m\u1ea1ch\u00a0nhanh,\u00a0kh\u00f4ng \u0111\u1ec1u ho\u1eb7c r\u1ea5t ch\u1eadm,\u00a0nghe tim\u00a0c\u00f3 ti\u1ebfng\u00a0tim\u00a0m\u1edd, ti\u1ebfng ng\u1ef1a\u00a0phi T3, ran\u00a0\u1ea9m \u1edf ph\u1ed5i,\u00a0gan to,\u00a0t\u0129nh m\u1ea1ch c\u1ed5 n\u1ed5i, huy\u1ebft \u00e1p t\u1ee5t\/k\u1eb9t, \u0111\u1ea7u\u00a0chi\u00a0l\u1ea1nh \u1ea9m n\u1ed5i v\u00e2n t\u00edm\u00a0(khi\u00a0c\u00f3 s\u1ed1c tim…)…<\/p>\n

1<\/strong>.<\/strong>2. C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/p>\n

1.2.1. C\u00e1c x\u00e9t nghi\u1ec7m c\u1ea7n th\u1ef1c hi\u1ec7n:<\/em><\/strong><\/p>\n

– C\u00f4ng th\u1ee9c m\u00e1u c\u00f3 th\u1ec3 t\u0103ng b\u1ea1ch c\u1ea7u (\u00edt t\u0103ng b\u1ea1ch c\u1ea7u \u00e1i toan), t\u0103ng hsCRP.<\/p>\n

– Ch\u1ec9 \u0111i\u1ec3m sinh h\u1ecdc: CK-MB, Troponin T ho\u1eb7c Troponin I th\u01b0\u1eddng t\u0103ng r\u00f5, NT- proBNP\/BNP t\u0103ng theo m\u1ee9c \u0111\u1ed9 suy tim.<\/p>\n

– \u0110i\u1ec7n t\u00e2m \u0111\u1ed3 bi\u1ebfn \u0111\u1ed5i b\u1ea5t th\u01b0\u1eddng so v\u1edbi tr\u01b0\u1edbc \u0111\u00f3: bi\u1ebfn \u0111\u1ed5i \u0111o\u1ea1n ST-T, s\u00f3ng T \u0111\u1ea3o chi\u1ec1u, ho\u1eb7c c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp \u0111a d\u1ea1ng (r\u1ed1i lo\u1ea1n nh\u1ecbp nhanh nh\u0129, nh\u1ecbp nhanh th\u1ea5t k\u1ecbch ph\u00e1t ho\u1eb7c k\u00e9o d\u00e0i; r\u1ed1i lo\u1ea1n nh\u1ecbp ch\u1eadm, bl\u1ed1c nh\u0129 th\u1ea5t, bl\u1ed1c ph\u00e2n nh\u00e1nh; ngo\u1ea1i t\u00e2m thu nh\u0129\/th\u1ea5t xu\u1ea5t hi\u1ec7n th\u01b0\u1eddng xuy\u00ean).<\/p>\n

– Ch\u1ee5p Xquang tim ph\u1ed5i: c\u00f3 th\u1ec3 g\u1eb7p b\u00f3ng tim to, ph\u1ed5i m\u1edd, c\u00e1c \u0111\u01b0\u1eddng Kerley B\u0085<\/p>\n

–\u00a0Si\u00eau \u00e2m\u00a0tim:\u00a0c\u00f3 th\u1ec3 th\u1ea5y gi\u1ea3m ch\u1ee9c n\u0103ng\u00a0co\u00a0b\u00f3p c\u01a1\u00a0tim,\u00a0r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng v\u00f9ng c\u01a1 tim kh\u01b0 tr\u00fa ho\u1eb7c to\u00e0n th\u1ec3, d\u1ecbch m\u00e0ng tim (\u00edt ho\u1eb7c nhi\u1ec1u g\u00e2y \u00e9p tim)…<\/p>\n

1.2.2. C\u00e1c x\u00e9t nghi\u1ec7m chuy\u00ean s\u00e2u<\/em><\/strong>:<\/p>\n

– Ch\u1ee5p \u0111\u1ed9ng m\u1ea1ch v\u00e0nh ch\u1ecdn l\u1ecdc qua \u1ed1ng th\u00f4ng gi\u00fap lo\u1ea1i tr\u1eeb h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh c\u1ea3nh gi\u1ed1ng vi\u00eam c\u01a1 tim c\u1ea5p.<\/p>\n

– Ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb tim hay sinh thi\u1ebft c\u01a1 tim gi\u00fap ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh.<\/p>\n

1.3. Ch\u1ea9n \u0111o\u00e1n<\/strong><\/p>\n

1.3.1. Ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng<\/em><\/strong>\u00a0d\u1ef1a tr\u00ean 4 ti\u00eau chu\u1ea9n<\/p>\n

– B\u1ec7nh c\u1ea3nh g\u1ee3i \u00fd: xu\u1ea5t hi\u1ec7n sau ti\u00eam v\u1eafc xin COVID-19, th\u01b0\u1eddng 2-4 ng\u00e0y.<\/p>\n

– C\u00f3 \u00edt nh\u1ea5t 1 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng (\u0111au ng\u1ef1c\/kh\u00f3 th\u1edf\/r\u1ed1i lo\u1ea1n nh\u1ecbp tim) v\u00e0 2 thay \u0111\u1ed5i c\u1eadn l\u00e2m s\u00e0ng (ch\u1ec9 \u0111i\u1ec3m sinh h\u1ecdc: t\u0103ng CK-MB, Troponin T ho\u1eb7c I; \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 bi\u1ebfn \u0111\u1ed5i; si\u00eau \u00e2m tim c\u00f3 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng\/v\u1eadn \u0111\u1ed9ng th\u00e0nh tim ho\u1eb7c tr\u00e0n d\u1ecbch m\u00e0ng tim).<\/p>\n

– Kh\u00f4ng m\u1edbi nhi\u1ec5m COVID-19 (x\u00e9t nghi\u1ec7m realtime PCR \u00e2m t\u00ednh).<\/p>\n

– Lo\u1ea1i tr\u1eeb c\u00e1c c\u00e1c nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng t\u01b0\u01a1ng t\u1ef1 (nh\u01b0 h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p, nhi\u1ec5m tr\u00f9ng, suy tim do nguy\u00ean nh\u00e2n kh\u00e1c.).<\/p>\n

1.3.2. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/em><\/strong>\u00a0v\u1edbi c\u1ed9ng h\u01b0\u1edfng t\u1eeb tim ho\u1eb7c sinh thi\u1ebft c\u01a1 tim, nh\u01b0ng ch\u1ec9 n\u00ean th\u1ef1c hi\u1ec7n khi v\u1eabn r\u1ea5t nghi ng\u1edd song c\u1ea7n l\u01b0u \u00fd to\u00e0n tr\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh c\u00f3 cho ph\u00e9p kh\u00f4ng, kh\u1ea3 n\u0103ng c\u1ee7a c\u01a1 s\u1edf y t\u1ebf c\u00f3 th\u1ec3 ti\u1ebfn h\u00e0nh v\u00e0 phi\u00ean gi\u1ea3i k\u1ebft qu\u1ea3 kh\u00f4ng.<\/p>\n

2. \u0110i\u1ec1u tr\u1ecb<\/strong><\/h2>\n

– T\u1ea5t c\u1ea3 ng\u01b0\u1eddi d\u00e2n sau ti\u00eam v\u1eafc xin COVID-19 c\u00f3 m\u1ed9t trong s\u1ed1 c\u00e1c d\u1ea5u hi\u1ec7u nghi ng\u1edd (\u0111au ng\u1ef1c, kh\u00f3 th\u1edf, r\u1ed1i lo\u1ea1n nh\u1ecbp) c\u1ea7n \u0111\u01b0\u1ee3c th\u0103m kh\u00e1m \u0111\u1ec3 lo\u1ea1i tr\u1eeb vi\u00eam c\u01a1 tim v\u00e0\/ho\u1eb7c vi\u00eam m\u00e0ng tim c\u1ea5p (VCT\/VMNT). Ng\u01b0\u1eddi d\u00e2n c\u1ea7n th\u00f4ng b\u00e1o t\u1edbi \u0111\u01b0\u1eddng d\u00e2y n\u00f3ng, ho\u1eb7c \u0111\u1ebfn b\u1ec7nh vi\u1ec7n g\u1ea7n nh\u1ea5t \u0111\u1ec3 \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn v\u00e0 th\u0103m kh\u00e1m.<\/p>\n

– Ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n VCT\/VMNT c\u1ea5p c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u00e0 theo d\u00f5i s\u00e1t (\u0111\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c b\u1ec7nh c\u1ea3nh n\u1eb7ng\/nguy k\u1ecbch) t\u1ea1i c\u01a1 s\u1edf y t\u1ebf c\u00f3 \u0111\u1ee7 kh\u1ea3 n\u0103ng h\u1ed3i s\u1ee9c c\u1ea5p c\u1ee9u tim m\u1ea1ch.<\/p>\n

– C\u1ea7n chuy\u1ec3n tuy\u1ebfn \u0111\u1ebfn c\u00e1c b\u1ec7nh vi\u1ec7n chuy\u00ean khoa tim m\u1ea1ch khi c\u00f3 c\u00e1c bi\u1ec3u hi\u1ec7n n\u1eb7ng\/nguy k\u1ecbch (nh\u01b0 ph\u1ea7n 2.1).<\/p>\n

– Hi\u1ec7n ch\u01b0a c\u00f3 \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u cho vi\u00eam c\u01a1 tim\/vi\u00eam m\u00e0ng ngo\u00e0i tim c\u1ea5p sau ti\u00eam v\u1eafc xin COVID-19, ch\u1ee7 y\u1ebfu l\u00e0 gi\u1ea3m \u0111au ch\u1ed1ng vi\u00eam, s\u1eb5n s\u00e0ng \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p-tu\u1ea7n ho\u00e0n khi c\u00f3 c\u00e1c di\u1ec5n bi\u1ebfn n\u1eb7ng ho\u1eb7c nguy k\u1ecbch nh\u01b0 ph\u00f9 ph\u1ed5i c\u1ea5p, suy tim c\u1ea5p, r\u1ed1i lo\u1ea1n nh\u1ecbp tim ph\u1ee9c t\u1ea1p, s\u1ed1c tim hay tr\u00e0n d\u1ecbch m\u00e0ng tim \u00e9p tim..<\/p>\n

– \u0110i\u1ec1u tr\u1ecb gi\u1ea3m \u0111au ch\u1ed1ng vi\u00eam b\u1eb1ng:<\/p>\n

* Thu\u1ed1c gi\u1ea3m \u0111au ch\u1ed1ng vi\u00eam kh\u00f4ng steroids (NSAIDs): \u0111\u1ebfn khi h\u1ebft tri\u1ec7u ch\u1ee9ng, c\u00f3 th\u1ec3 l\u1ef1a ch\u1ecdn m\u1ed9t trong s\u1ed1 c\u00e1c thu\u1ed1c:<\/p>\n

+ Aspirin\u00a0li\u1ec1u\u00a0500-1000mg * 1-3\u00a0l\u1ea7n\/ng\u00e0y.<\/p>\n

+ Ibuprofen 600mg * 1-3\u00a0l\u1ea7n\/ng\u00e0y.<\/p>\n

+ Indomethacin 25-50mg * 1-3\u00a0l\u1ea7n\/ng\u00e0y.<\/p>\n

* Colchicine:\u00a0c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng\u00a0colchicine thay\u00a0th\u1ebf ho\u1eb7c b\u1ed5 tr\u1ee3\u00a0cho NSAIDs\u00a0v\u1edbi li\u1ec1u\u00a00,5mg * 1-2\u00a0l\u1ea7n\/ng\u00e0y \u0111\u1ebfn\u00a0khi\u00a0h\u1ebft tri\u1ec7u ch\u1ee9ng.<\/p>\n

* Corticoid\u00a0ho\u1eb7c\u00a0IVIG\u00a0ch\u01b0a ho\u00e0n to\u00e0n th\u1ed1ng nh\u1ea5t, \u01b0u ti\u00ean\u00a0cho\u00a0nh\u00f3m c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng r\u1ea7m r\u1ed9, suy tim n\u1eb7ng, r\u1ed1i lo\u1ea1n nh\u1ecbp tim ph\u1ee9c t\u1ea1p.<\/p>\n

+ N\u1ebfu d\u00f9ng corticoid th\u00ec n\u00ean d\u00f9ng s\u1edbm, li\u1ec1u cao, ng\u1eafn ng\u00e0y: methyl prednisolon 1-2 mg\/kg\/ng\u00e0y (t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi prednisolon 0,8 – Img\/kg\/ng\u00e0y) trong 2-3 ng\u00e0y.<\/p>\n

+ IVIG 1-1,5g\/kg \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00e1ng \u0111i\u1ec1u tr\u1ecb v\u1edbi corticoid.<\/p>\n

– \u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p-tu\u1ea7n ho\u00e0n trong c\u00e1c b\u1ec7nh c\u1ea3nh n\u1eb7ng\/nguy k\u1ecbch<\/p>\n

+ C\u00f3 suy tim, huy\u1ebft \u0111\u1ed9ng \u1ed5n \u0111\u1ecbnh: theo c\u00e1c h\u01b0\u1edbng d\u1eabn hi\u1ec7n t\u1ea1i s\u1eed d\u1ee5ng l\u1ee3i ti\u1ec3u quai theo m\u1ee9c \u0111\u1ed9 \u1ee9 tr\u1ec7 tu\u1ea7n ho\u00e0n, thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n, thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m li\u1ec1u th\u1ea5p.<\/p>\n

+ Suy tim c\u00f3 ph\u00f9 ph\u1ed5i: \u01b0u ti\u00ean l\u1ee3i ti\u1ec3u quai \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch, th\u1edf oxy, th\u00f4ng kh\u00ed h\u1ed7 tr\u1ee3 (kh\u00f4ng x\u00e2m l\u1ea5n ho\u1eb7c qua n\u1ed9i kh\u00ed qu\u1ea3n) .<\/p>\n

+ Suy tim c\u00f3 suy s\u1ee5p huy\u1ebft \u0111\u1ed9ng, s\u1ed1c tim: \u01b0u ti\u00ean c\u00e1c thu\u1ed1c v\u1eadn m\u1ea1ch \u0111\u1ec3 ki\u1ec3m so\u00e1t huy\u1ebft \u0111\u1ed9ng, s\u1eed d\u1ee5ng s\u1edbm c\u00e1c thi\u1ebft b\u1ecb c\u01a1 h\u1ecdc h\u1ed7 tr\u1ee3 tu\u1ea7n ho\u00e0n (ECMO, LVAID)…<\/p>\n

+ C\u00f3 r\u1ed1i lo\u1ea1n nh\u1ecbp ch\u1eadm: c\u1ea7n \u0111\u1eb7t m\u00e1y t\u1ea1p nh\u1ecbp t\u1ea1m th\u1eddi.<\/p>\n

+ C\u00f3 r\u1ed1i lo\u1ea1n nh\u1ecbp nh\u0129 ho\u1eb7c th\u1ea5t tr\u1ea7m tr\u1ecdng (ngo\u1ea1i t\u00e2m thu th\u1ea5t d\u1ea7y, nh\u1ecbp nhanh th\u1ea5t, rung nh\u0129 nhanh) \u01b0u ti\u00ean s\u1eed d\u1ee5ng amiodarone.<\/p>\n

+ C\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp nhanh xoang ho\u1eb7c ngo\u1ea1i t\u00e2m thu nh\u0129 kh\u00f4ng c\u1ea7n can thi\u1ec7p thu\u1ed1c lo\u1ea1n nh\u1ecbp. C\u1ea7n l\u01b0u \u00fd b\u1ec7nh nh\u00e2n VCT c\u1ea5p hay c\u00f3 r\u1ed1i lo\u1ea1n xen k\u1ebd l\u00fac nhanh l\u00fac ch\u1eadm, c\u1ea7n theo d\u00f5i v\u00e0 \u0111i\u1ec1u ch\u1ec9nh k\u1ecbp th\u1eddi, k\u1ebft h\u1ee3p thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp v\u00e0 m\u00e1y t\u1ea1o nh\u1ecbp ho\u1eb7c c\u00e1c thi\u1ebft b\u1ecb c\u01a1 h\u1ecdc h\u1ed7 tr\u1ee3 tu\u1ea7n ho\u00e0n khi c\u00f3 suy s\u1ee5p huy\u1ebft \u0111\u1ed9ng.<\/p>\n

+ Tr\u00e0n d\u1ecbch m\u00e0ng tim \u00e9p tim: d\u1eabn l\u01b0u khoang m\u00e0ng ngo\u00e0i tim.<\/p>\n

– C\u00e1c \u0111i\u1ec1u tr\u1ecb b\u1ed5 sung kh\u00e1c tu\u1ef3 theo b\u1ec7nh c\u1ea3nh l\u00e2m s\u00e0ng nh\u01b0 c\u00e2n b\u1eb1ng d\u1ecbch, \u0111i\u1ec7n gi\u1ea3i, dinh d\u01b0\u1ee1ng, thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng (khi c\u00f3 nguy c\u01a1 t\u1eafc m\u1ea1ch cao, b\u1eb1ng ch\u1ee9ng t\u0103ng \u0111\u00f4ng), thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton (khi c\u00f3 k\u00edch \u1ee9ng d\u1ea1 d\u00e0y), kh\u00e1ng sinh (khi c\u00f3 b\u1ed9i nhi\u1ec5m…).<\/p>\n

– Ng\u01b0\u1eddi b\u1ec7nh khi xu\u1ea5t vi\u1ec7n, c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i \u0111\u1ecbnh k\u1ef3 b\u1edfi c\u00e1c b\u00e1c s\u1ef9 chuy\u00ean khoa tim m\u1ea1ch 3-6 th\u00e1ng\/l\u1ea7n \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ti\u1ebfn tri\u1ec3n c\u1ee7a ch\u1ee9c n\u0103ng tim v\u00e0 t\u00ecnh tr\u1ea1ng suy tim (n\u1ebfu c\u00f3).<\/p>\n

– \u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi \u0111\u00e3 vi\u00eam c\u01a1 tim\/m\u00e0ng ngo\u00e0i tim sau ti\u00eam v\u1eafc xin COVID-19, n\u1ebfu c\u1ea7n ti\u00eam v\u1eafc xin COVID-19 th\u00ec n\u00ean l\u1ef1a ch\u1ecdn lo\u1ea1i kh\u00e1c c\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng.<\/p>\n

 <\/p>\n

Ngu\u1ed3n: QUY\u1ebeT \u0110\u1ecaNH 3348\/Q\u0110-BYT BAN H\u00c0NH H\u01af\u1edaNG D\u1eaaN CH\u1ea8N \u0110O\u00c1N, \u0110I\u1ec0U TR\u1eca VI\u00caM C\u01a0 TIM SAU TI\u00caM CH\u1ee6NG V\u1eaeC XIN PH\u00d2NG COVID-19<\/em>. <\/em><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Vi\u00eam c\u01a1 tim\/m\u00e0ng tim c\u1ea5p sau ti\u00eam v\u1eafc xin COVID-19 m\u1edbi \u0111\u01b0\u1ee3c ghi nh\u1eadn g\u1ea7n \u0111\u00e2y trong b\u00e1o c\u00e1o c\u1ee7a c\u00e1c C\u01a1 quan Ph\u00f2ng ch\u1ed1ng b\u1ec7nh t\u1eadt, c\u01a1 quan Qu\u1ea3n l\u00fd D\u01b0\u1ee3c v\u00e0 T\u1ed5 ch\u1ee9c gi\u00e1m s\u00e1t an to\u00e0n v\u1eafc xin t\u1ea1i Ch\u00e2u \u00c2u, Hoa k\u1ef3 v\u00e0 m\u1ed9t s\u1ed1 n\u01b0\u1edbc kh\u00e1c. Vi\u00eam c\u01a1 tim c\u1ea5p […]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[3],"yoast_head":"\nCh\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb vi\u00eam c\u01a1 tim sau ti\u00eam v\u1eafc xin Covid-19 \u2013 B\u1ed9 Y t\u1ebf - Vinmec<\/title>\n<meta name=\"description\" content=\"Vi\u00eam c\u01a1 tim\/m\u00e0ng tim c\u1ea5p sau ti\u00eam v\u1eafc xin COVID-19 m\u1edbi \u0111\u01b0\u1ee3c ghi nh\u1eadn g\u1ea7n \u0111\u00e2y trong b\u00e1o c\u00e1o t\u1ea1i Ch\u00e2u \u00c2u, Hoa k\u1ef3 v\u00e0 m\u1ed9t s\u1ed1 n\u01b0\u1edbc kh\u00e1c.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb vi\u00eam c\u01a1 tim sau ti\u00eam v\u1eafc xin Covid-19 \u2013 B\u1ed9 Y t\u1ebf - 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