{"id":29835,"date":"2023-04-30T21:26:16","date_gmt":"2023-04-30T14:26:16","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29835"},"modified":"2023-04-30T21:26:27","modified_gmt":"2023-04-30T14:26:27","slug":"phan-loai-nguon-goc-va-thoi-gian-cua-tieng-tim","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/30\/phan-loai-nguon-goc-va-thoi-gian-cua-tieng-tim\/","title":{"rendered":"Ph\u00e2n lo\u1ea1i, ngu\u1ed3n g\u1ed1c v\u00e0 th\u1eddi gian c\u1ee7a ti\u1ebfng tim"},"content":{"rendered":"


\nKhi nghe tim, \u1edf m\u1ed9t tim b\u00ecnh th\u01b0\u1eddng c\u00f3 th\u1ec3 nghe \u0111\u01b0\u1ee3c hai ti\u1ebfng, \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 l\u00e0 ti\u1ebfng tim th\u1ee9 nh\u1ea5t v\u00e0 ti\u1ebfng tim th\u1ee9 hai. C\u00e1c ti\u1ebfng tim kh\u00e1c c\u0169ng c\u00f3 th\u1ec3 nghe \u0111\u01b0\u1ee3c, \u0111\u01b0\u1ee3c \u0111\u1eb7t t\u00ean l\u00e0 ti\u1ebfng tim th\u1ee9 ba v\u00e0 th\u1ee9 t\u01b0. M\u1ed9t s\u1ed1 ti\u1ebfng th\u1ed5i c\u0169ng c\u00f3 kh\u1ea3 n\u0103ng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n khi ta ti\u1ebfn h\u00e0nh nghe tim.<\/strong><\/p>\n

1. Ti\u1ebfng tim th\u1ee9 nh\u1ea5t v\u00e0 th\u1ee9 hai<\/h2>\n

Khi c\u00e1c van tim \u0111\u00f3ng l\u1ea1i, n\u00f3 s\u1ebd t\u1ea1o ra chuy\u1ec3n \u0111\u1ed9ng rung \u2013 vibration t\u1eeb \u0111\u00f3 h\u00ecnh th\u00e0nh 2 ti\u1ebfng tim<\/p>\n

1.1 . Ti\u1ebfng tim th\u1ee9 nh\u1ea5t,<\/strong> S1, h\u00ecnh th\u00e0nh khi van nh\u0129 th\u1ea5t \u0111\u00f3ng l\u1ea1i \u2013 g\u1ed3m c\u00f3 van hai l\u00e1 v\u00e0 van ba l\u00e1 c\u1ee7a tim, S1 cho bi\u1ebft b\u1eaft \u0111\u1ea7u giai \u0111o\u1ea1n thu t\u00e2m th\u1ea5t. Van hai l\u00e1 \u0111\u00f3ng tr\u01b0\u1edbc van ba l\u00e1, tuy nhi\u00ean th\u1eddi gian \u0111\u00f3 l\u00e0 qu\u00e1 ng\u1eafn cho n\u00ean S1 th\u01b0\u1eddng nghe \u0111\u01b0\u1ee3c l\u00e0 m\u1ed9t \u00e2m \u0111\u01a1n. S1 \u0111\u01b0\u1ee3c nghe t\u1ed1t nh\u1ea5t \u1edf m\u1ecfm tim
\n1.2 Ti\u1ebfng tim th\u1ee9 hai,<\/strong> S2, h\u00ecnh th\u00e0nh khi \u0111\u00f3ng c\u00e1c van b\u00e1n nguy\u1ec7t – g\u1ed3m c\u00f3 van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i. S2 cho bi\u1ebft k\u1ebft th\u00fac th\u1eddi k\u1ef3 t\u00e2m thu c\u1ee7a th\u1ea5t v\u00e0 b\u1eaft \u0111\u1ea7u t\u00e2m tr\u01b0\u01a1ng. So v\u1edbi S1, th\u00ec S2 ng\u1eafn, \u00eam h\u01a1n v\u00e0 c\u00f3 c\u01b0\u1eddng \u0111\u1ed9 cao h\u01a1n kh\u00f4ng \u0111\u00e1ng k\u1ec3. Gi\u1ea3m ho\u1eb7c m\u1ea5t S2 g\u1ee3i \u00fd \u0111\u1ebfn b\u1ea5t th\u01b0\u1eddng van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ho\u1eb7c van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i.<\/p>\n

Van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u0111\u00f3ng tr\u01b0\u1edbc van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i. \u0110i\u1ec1u n\u00e0y l\u00e0 do \u00e1p l\u1ef1c c\u1ee7a tu\u1ea7n ho\u00e0n ph\u1ed5i th\u1ea5p h\u01a1n, cho ph\u00e9p m\u00e1u m\u00e1u ti\u1ebfp t\u1ee5c \u0111\u1ed5 v\u00e0o \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i sau khi k\u1ebft th\u00fac th\u1eddi ky t\u00e2m thu. \u1ede 70% ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh kh\u1ecfe m\u1ea1nh, s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 th\u1ec3 nghe \u0111\u01b0\u1ee3c khi m\u00e0 ti\u1ebfng tim th\u1ee9 hai b\u1ecb t\u00e1ch \u0111\u00f4i.
\nTi\u1ebfng S2 do \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i \u0111\u00f3ng t\u1ea1o n\u00ean \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 S2, trong khi \u0111\u00f3 do \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u0111\u00f3ng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 A2. Ti\u1ebfng S2 t\u00e1ch \u0111\u00f4i \u0111\u01b0\u1ee3c nghe t\u1ed1t nh\u1ea5t t\u1ea1i v\u00f9ng van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i (gian s\u01b0\u1eddn hai c\u1ea1nh b\u1edd tr\u00e1i x\u01b0\u01a1ng \u1ee9c)
\nTi\u1ebfng tim th\u1ee9 hai t\u00e1ch \u0111\u00f4i
\nS2 t\u00e1ch \u0111\u00f4i sinh l\u00fd:<\/strong>
\nKhi h\u00edt v\u00e0o s\u1ebd l\u00e0m ch\u1eadm \u0111\u00f3ng van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i kho\u1ea3ng 30-60 mili gi\u00e2y, do gia t\u0103ng h\u1ed3i l\u01b0u t\u0129nh m\u1ea1ch v\u00e0 gi\u1ea3m \u0111\u1ec1 kh\u00e1ng m\u1ea1ch ph\u1ed5i. T\u00ecnh tr\u1ea1ng n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 S2 t\u00e1ch \u0111\u00f4i sinh l\u00fd.
\nS2 t\u00e1ch \u0111\u00f4i b\u1ec7nh l\u00fd:<\/strong>
\nWide splitting of S2 \u2013 S2 t\u00e1ch \u0111\u00f4i r\u1ed9ng: gia t\u0103ng qu\u00e1 m\u1ee9c t\u00e1ch \u0111\u00f4i sinh l\u00fd, th\u01b0\u1eddng g\u1eb7p trong khi h\u00edt v\u00e0o s\u00e2u<\/p>\n

Fixed splitting of S2 \u2013 S2 t\u00e1ch \u0111\u00f4i c\u1ed1 \u0111\u1ecbnh: \u0110\u00f3ng van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i b\u1ecb tr\u00ec ho\u00e3n m\u1ed9t c\u00e1ch c\u1ed1 \u0111\u1ecbnh do gia t\u0103ng th\u1ec3 t\u00edch th\u1ea5t ph\u1ea3i (th\u00f4ng li\u00ean nh\u0129 ho\u1eb7c do suy th\u1ea5t ph\u1ea3i ti\u1ebfn tri\u1ec3n)<\/p>\n

Reversed or paradoxical splitting of S2 \u2013 S2 t\u00e1ch \u0111\u00f4i ngh\u1ecbch \u0111\u1ea3o: Khi \u0111\u00f3ng van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ecb tr\u00ec ho\u00e3n do t\u1eafc ngh\u1ebdn (AS) ho\u1eb7c b\u1ec7nh l\u00fd d\u1eabn truy\u1ec1n (block nh\u00e1nh tr\u00e1i \u2013 LBBB). Th\u1eddi gian t\u00e1ch \u0111\u00f4i h\u1eb9p khi h\u00edt v\u00e0o do \u0111\u00f3ng van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i b\u1ecb tr\u00ec ho\u00e3n khi\u1ebfn cho P2 t\u1edbi g\u1ea7n h\u01a1n v\u1edbi A2 – t\u1eeb \u0111\u00f3 t\u1ea1o ra m\u1ed9t \u00e2m \u0111\u01a1n.<\/p>\n

2. C\u00e1c ti\u1ebfng tim kh\u00e1c<\/h2>\n

2.1 Ti\u1ebfng tim th\u1ee9 ba (S3)
\n<\/strong>C\u00e1c ti\u1ebfng tim kh\u00e1c bao g\u1ed3m c\u00f3 ti\u1ebfng tim th\u1ee9 ba v\u00e0 ti\u1ebfng tim th\u1ee9 t\u01b0. Ti\u1ebfng tim
\n<\/strong>th\u1ee9 ba (S3) l\u00e0 ti\u1ebfng c\u00f3 c\u01b0\u1eddng \u0111\u1ed9 th\u1ea5p, nghe \u0111\u01b0\u1ee3c \u1edf gi\u1eefa t\u00e2m tr\u01b0\u01a1ng. Khi c\u00f3 s\u01b0 hi\u1ec7n di\u1ec7n c\u1ee7a S3, ti\u1ebfng tim \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 nh\u01b0 c\u00f3 m\u1ed9t nh\u1ecbp ng\u1ef1a phi \u2013 gallop rhythm<\/em><\/strong>, \u0111\u01a1n gi\u1ea3n l\u00e0 khi th\u00eam ti\u1ebfng S3 b\u00ean c\u1ea1nh S1 v\u00e0 S2 s\u1ebd t\u1ea1o ra m\u1ed9t \u00e2m thanh nghe nh\u01b0 ti\u1ebfng ng\u1ef1a phi. S3 nghe \u0111\u01b0\u1ee3c sau S2, trong su\u1ed1t th\u1eddi k\u1ef3 \u0111\u1ed5 \u0111\u1ea7y t\u00e2m th\u1ea5t th\u1ee5 \u0111\u1ed9ng
\nS3 sinh l\u00fd, do s\u1ef1 \u0111\u1ed5 \u0111\u1ea7y th\u1ea5t nhanh v\u00e0 th\u1ee5 \u0111\u1ed9ng trong th\u1eddi k\u1ef3 t\u00e2m tr\u01b0\u01a1ng, c\u00f3 th\u1ec3 x\u1ea3y ra trong m\u1ed9t s\u1ed1 t\u00ecnh tr\u1ea1ng c\u00f3 kh\u1ea3 n\u0103ng gia t\u0103ng cung l\u01b0\u1ee3ng tim nh\u01b0 nhi\u1ec5m \u0111\u1ed9c gi\u00e1p v\u00e0 mang thai, c\u0169ng c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t bi\u1ec3u hi\u1ec7n trong \u0111\u1ed9 tu\u1ed5i tr\u1ebb em.
\nM\u1eb7t kh\u00e1c, S3 b\u1ec7nh l\u00fd l\u00e0 do gi\u1ea3m \u0111\u1ed9 gi\u00e3n \u2013 compliance c\u1ee7a t\u00e2m th\u1ea5t (do d\u00e3n ho\u1eb7c qu\u00e1 t\u1ea3i th\u1ec3 t\u00edch), g\u00e2y ra ti\u1ebfng \u0111\u1ed5 \u0111\u1ea7y th\u1ea5t. C\u00e1c nguy\u00ean nh\u00e2n g\u00e2y ra ti\u1ebfng S3 b\u1ec7nh l\u00fd bao g\u1ed3m c\u00e1c t\u00ecnh tr\u1ea1ng gi\u1ea3m t\u00ednh \u0111\u00e0n h\u1ed3i c\u1ee7a th\u1ea5t tr\u00e1i, nh\u01b0 suy th\u1ea5t tr\u00e1i, d\u00e3n th\u1ea5t tr\u00e1i, h\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 – aortic
\nregurgitation<\/em><\/strong>, h\u1edf hai l\u00e1, c\u00f2n \u1ed1ng \u0111\u1ed9ng m\u1ea1ch, v\u00e0 th\u00f4ng li\u00ean th\u1ea5t. C\u00e1c b\u1ec7nh l\u00fd l\u00e0m gi\u1ea3m t\u00ednh \u0111\u00e0n h\u1ed3i c\u1ee7a th\u1ea5t ph\u1ea3i c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra ti\u1ebfng S3 b\u1ec7nh l\u00fd. Bao g\u1ed3m c\u00f3 suy th\u1ea5t ph\u1ea3i v\u00e0 vi\u00eam m\u00e0ng ngo\u00e0i tim co th\u1eaft \u2013 constrictive pericarditis<\/em><\/strong>.<\/p>\n

2.2 Ti\u1ebfng tim th\u1ee9 t\u01b0 (S4)
\n<\/strong>Ti\u1ebfng tim th\u1ee9 t\u01b0 l\u00e0 ti\u1ebfng cu\u1ed1i k\u1ef3 t\u00e2m tr\u01b0\u01a1ng. C\u00f3 c\u01b0\u1eddng \u0111\u1ed9 cao h\u01a1n S3 kh\u00f4ng \u0111\u00e1ng k\u1ec3, S4 c\u0169ng l\u00e0 \u00e2m t\u01b0\u01a1ng t\u1ef1 nh\u01b0 ti\u1ebfng ng\u1ef1a phi c\u1ee7a S3 \u2013 triple gallop rhythm. S4 tr\u01b0\u1edbc S1 v\u00e0 c\u00f3 li\u00ean quan \u0111\u1ebfn co th\u1eaft nh\u0129 v\u00e0 \u0111\u1ed5 \u0111\u1ea7y th\u1ea5t nhanh ch\u1ee7 \u0111\u1ed9ng.
\nS4 do gi\u1ea3m t\u00ednh \u0111\u00e0n h\u1ed3i c\u1ee7a t\u00e2m th\u1ea5t. Gi\u1ea3m t\u00ednh \u0111\u00e0n h\u1ed3i c\u1ee7a th\u1ea5t tr\u00e1i, nh\u01b0 trong h\u1eb9p \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, h\u1edf van hai l\u00e1, t\u0103ng huy\u1ebft \u00e1p, \u0111au th\u1eaft ng\u1ef1c, nh\u1ed3i m\u00e1u c\u01a1 tim, v\u00e0 l\u1edbn tu\u1ed5i c\u00f3 th\u1ec3 t\u1ea1o S4 khi nghe tim. Gi\u1ea3m t\u00ednh \u0111\u00e0n h\u1ed3i th\u1ea5t ph\u1ea3i, nh\u01b0 trong t\u0103ng \u00e1p ph\u1ed5i, h\u1eb9p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i, t\u01b0\u01a1ng t\u1ef1 c\u0169ng c\u00f3 th\u1ec3 t\u1ea1o S4
\nC\u00f3 kh\u1ea3 n\u0103ng ti\u1ebfng tim th\u1ee9 ba v\u00e0 th\u1ee9 t\u01b0 c\u00f9ng t\u1ed3n t\u1ea1i, trong tr\u01b0\u1eddng h\u1ee3p \u0111\u00f3 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 nh\u1ecbp b\u1ed1n \u2013 quadruple rhythm. G\u1ee3i \u00fd kh\u1ea3 n\u0103ng suy gi\u1ea3m ch\u1ee9c n\u0103ng t\u00e2m th\u1ea5t. N\u1ebfu S3 v\u00e0 S4 \u0111\u01b0\u1ee3c th\u00eam v\u00e0o khi m\u1ea1ch nhanh, th\u00ec t\u1ea1o ra ti\u1ebfng ng\u1ef1a phi t\u1ed5ng h\u1ee3p \u2013 summation gallop.<\/p>\n

\"tieng-tim\"<\/p>\n

3. C\u00e1c ti\u1ebfng th\u1ed5i<\/h2>\n


\n<\/strong>Ti\u1ebfng th\u1ed5i l\u00e0 \u00e2m thanh \u0111\u01b0\u1ee3c t\u1ea1o ra do d\u00f2ng ch\u1ea3y h\u1ed7n lo\u1ea1n \u2013 turbulent c\u1ee7a m\u00e1u \u0111i qua c\u00e1c van tim. D\u00f2ng ch\u1ea3y h\u1ed7n lo\u1ea1n c\u1ee7a m\u00e1u c\u00f3 th\u1ec3 do 2 l\u00fd do sau: \u0111\u1ea7u ti\u00ean, khi d\u00f2ng m\u00e1u \u0111i qua m\u1ed9t van tim b\u1ea5t th\u01b0\u1eddng, th\u1ee9 hai khi gia t\u0103ng l\u01b0\u1ee3ng m\u00e1u \u0111i qua m\u1ed9t van tim b\u00ecnh th\u01b0\u1eddng. Ti\u1ebfng th\u1ed5i c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i th\u00e0nh sinh l\u00fd, b\u1ec7nh l\u00fd d\u1ef1a v\u00e0o nguy\u00ean nh\u00e2n g\u00e2y ra.
\n3.1 Ti\u1ebfng th\u1ed5i sinh l\u00fd<\/strong><\/p>\n

\u0110\u01b0\u1ee3c nghe khi c\u00f3 gia t\u0103ng t\u00ecnh tr\u1ea1ng h\u1ed7n lo\u1ea1n c\u1ee7a d\u00f2ng m\u00e1u \u0111i qua m\u1ed9t van tim b\u00ecnh th\u01b0\u1eddng, c\u00f3 th\u1ec3 x\u1ea3y ra trong c\u00e1c t\u00ecnh tr\u1ea1ng nh\u01b0 nhi\u1ec5m \u0111\u1ed9c gi\u00e1p, thi\u1ebfu m\u00e1u c\u0169ng nh\u01b0 s\u1ed1t v\u00e0 g\u1eafng s\u1ee9c. Ti\u1ebfng th\u1ed5i sinh l\u00fd lu\u00f4n l\u00e0 ti\u1ebfng th\u1ed5i t\u00e2m thu, do gia t\u0103ng d\u00f2ng m\u00e1u x\u1ea3y ra trong su\u1ed1t th\u1eddi k\u1ef3 thu t\u00e2m th\u1ea5t. Th\u01b0\u1eddng g\u1eb7p \u1edf ng\u01b0\u1eddi tr\u1ebb tu\u1ed5i. Ti\u1ebfng th\u1ed5i sinh l\u00fd c\u00f3 nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m nh\u01b0 nh\u1eb9, ng\u1eafn, early peaking, h\u1ea7u h\u1ebft khu tr\u00fa \u1edf \u0111\u00e1y tim, c\u00f3 ti\u1ebfng tim th\u1ee9 hai b\u00ecnh th\u01b0\u1eddng, th\u01b0\u1eddng bi\u1ebfn m\u1ea5t khi thay \u0111\u1ed5i t\u01b0 th\u1ebf. C\u00e1c ph\u1ea7n th\u0103m kh\u00e1m c\u00f2n l\u1ea1i c\u1ee7a tim m\u1ea1ch b\u00ecnh th\u01b0\u1eddng trong tr\u01b0\u1eddng h\u1ee3p bi\u1ec3u hi\u1ec7n ti\u1ebfng th\u1ed5i sinh l\u00fd.
\n3.2 Ti\u1ebfng th\u1ed5i b\u1ec7nh l\u00fd<\/strong><\/p>\n

X\u1ea3y ra khi c\u00f3 d\u00f2ng m\u00e1u h\u1ed7n lo\u1ea1n \u0111i qua m\u1ed9t van tim b\u1ea5t th\u01b0\u1eddng. C\u00f3 th\u1ec3 do h\u1eb9p ho\u1eb7c h\u1edf c\u00e1c van tim
\nH\u1eb9p
\n<\/strong>L\u00e0 nh\u1eefng b\u1ea5t th\u01b0\u1eddng l\u00e0m h\u1eb9p \u0111i l\u1ed7 van. T\u00ecnh tr\u1ea1ng n\u00e0y l\u00e0m cho van tim kh\u00f4ng th\u1ec3 m\u1edf ra ho\u00e0n to\u00e0n, v\u00ec l\u00ed do \u0111\u00f3 m\u00e0 ti\u1ebfng th\u1ed5i do h\u1eb9p van ch\u1ec9 c\u00f3 th\u1ec3 x\u1ea3y ra khi van n\u00e0y m\u1edf m\u00e0 th\u00f4i.
\nH\u1edf
\n<\/strong>L\u00e0 nh\u1eefng b\u1ea5t th\u01b0\u1eddng khi\u1ebfn m\u00e1u \u0111\u1ed5 ng\u01b0\u1ee3c \u1edf l\u1ea1i t\u1eeb n\u01a1i c\u00f3 \u00e1p l\u1ef1c cao \u0111\u1ebfn v\u1ecb tr\u00ed c\u00f3 \u00e1p l\u1ef1c th\u1ea5p h\u01a1n, th\u01b0\u1eddng do van \u0111\u00f3ng kh\u00f4ng k\u00edn l\u1ed7 van
\nTi\u1ebfng th\u1ed5i t\u00e2m thu
\n<\/strong>Ti\u1ebfng th\u1ed5i t\u00e2m thu l\u00e0 nh\u1eefng ti\u1ebfng th\u1ed5i h\u00ecnh th\u00e0nh trong th\u1eddi k\u1ef3 t\u00e2m thu c\u1ee7a t\u00e2m th\u1ea5t, gi\u1eefa S1 v\u00e0 S2.
\nNh\u1eefng ti\u1ebfng th\u1ed5i n\u00e0y c\u00f3 th\u1ec3 x\u1ea3y ra gi\u1eefa t\u00e2m thu (ti\u1ebfng th\u1ed5i t\u1ed1ng m\u00e1u), cu\u1ed1i t\u00e2m thu, v\u00e0 to\u00e0n b\u1ed9 t\u00e2m thu \u2013 pansystolic. Ti\u1ebfng th\u1ed5i t\u00e2m thu c\u00f3 th\u1ec3 l\u00e0 b\u00ecnh th\u01b0\u1eddng ho\u1eb7c b\u1ea5t th\u01b0\u1eddng.
\nTh\u1ed5i t\u00e2m tr\u01b0\u01a1ng<\/strong>
\n<\/span>Nh\u01b0 t\u00ean g\u1ecdi, x\u1ea3y ra trong su\u1ed1t th\u1eddi k\u1ef3 t\u00e2m tr\u01b0\u01a1ng c\u1ee7a th\u1ea5t. Lu\u00f4n l\u00e0 b\u1ec7nh l\u00fd. Khi so v\u1edbi ti\u1ebfng th\u1ed5i t\u00e2m thu th\u00ec th\u1ed5i t\u00e2m tr\u01b0\u01a1ng nh\u1eb9 v\u00e0 kh\u00f3 nghe h\u01a1n.\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Khi nghe tim, \u1edf m\u1ed9t tim b\u00ecnh th\u01b0\u1eddng c\u00f3 th\u1ec3 nghe \u0111\u01b0\u1ee3c hai ti\u1ebfng, \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 l\u00e0 ti\u1ebfng tim th\u1ee9 nh\u1ea5t v\u00e0 ti\u1ebfng tim th\u1ee9 hai. C\u00e1c ti\u1ebfng tim kh\u00e1c c\u0169ng c\u00f3 th\u1ec3 nghe \u0111\u01b0\u1ee3c, \u0111\u01b0\u1ee3c \u0111\u1eb7t t\u00ean l\u00e0 ti\u1ebfng tim th\u1ee9 ba v\u00e0 th\u1ee9 t\u01b0. M\u1ed9t s\u1ed1 ti\u1ebfng th\u1ed5i c\u0169ng c\u00f3 kh\u1ea3 n\u0103ng […]<\/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":[],"yoast_head":"\nPh\u00e2n lo\u1ea1i, ngu\u1ed3n g\u1ed1c v\u00e0 th\u1eddi gian c\u1ee7a ti\u1ebfng tim - Vinmec<\/title>\n<meta name=\"description\" content=\"Khi nghe tim, \u1edf m\u1ed9t tim b\u00ecnh th\u01b0\u1eddng c\u00f3 th\u1ec3 nghe \u0111\u01b0\u1ee3c hai ti\u1ebfng, \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 l\u00e0 ti\u1ebfng tim th\u1ee9 nh\u1ea5t v\u00e0 th\u1ee9 hai.\" \/>\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=\"Ph\u00e2n lo\u1ea1i, ngu\u1ed3n g\u1ed1c v\u00e0 th\u1eddi gian c\u1ee7a ti\u1ebfng tim - 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