{"id":29965,"date":"2023-05-01T22:52:15","date_gmt":"2023-05-01T15:52:15","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29965"},"modified":"2023-05-01T22:52:15","modified_gmt":"2023-05-01T15:52:15","slug":"hep-van-dong-mach-chu-va-nhung-dac-diem-quan-trong","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/hep-van-dong-mach-chu-va-nhung-dac-diem-quan-trong\/","title":{"rendered":"H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m quan tr\u1ecdng"},"content":{"rendered":"

H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/a> l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd van tim ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf c\u00e1c n\u01b0\u1edbc ph\u00e1t tri\u1ec3n, nam g\u1eb7p nhi\u1ec1u h\u01a1n n\u1eef, gia t\u0103ng theo tu\u1ed5i, t\u1ef7 l\u1ec7 m\u1eafc t\u1edbi 2% \u1edf ng\u01b0\u1eddi tr\u00ean 65 tu\u1ed5i. B\u1ec7nh ng\u00e0y c\u00e0ng tr\u1edf n\u00ean ph\u1ed5 bi\u1ebfn do m\u00f4 h\u00ecnh d\u00e2n s\u1ed1 gi\u00e0 ho\u00e1 v\u00e0 c\u00e1c ti\u1ebfn b\u1ed9 trong ch\u1ea9n \u0111o\u00e1n.<\/strong><\/p>\n

1. Nguy\u00ean nh\u00e2n<\/h2>\n
    \n
  • M\u1eafc ph\u1ea3i : H\u1eb9p van \u0110M ch\u1ee7 do v\u00f4i h\u00f3a v\u00e0 tho\u00e1i ho\u00e1 van (th \u01b0\u1eddng g\u1eb7p nh\u1ea5t), b\u1ec7nh th\u1ea5p tim, b\u1ec7nh Paget, suy th\u1eadn giai \u0111o\u1ea1n cu\u1ed1i.<\/li>\n
  • B\u1ea9m sinh: B\u1ec7nh l \u00fd van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 hai l\u00e1 van g\u1eb7p v\u1edbi t\u1ea7n su\u1ea5t 1 – 2% tr\u1ebb s\u01a1 sinh s\u1ed1ng. Van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ch\u1ec9 c\u00f3 hai l\u00e1 van s\u1ebd d\u0201n \u0111\u1ebfn b\u1ea5t th\u01b0\u1eddng d\u00f2ng ch\u1ea3y qua van \u0110M ch\u1ee7 , l\u00e2u d\u00e0i s\u1ebd l\u00e0m c\u00e1c l\u00e1 van x\u01a1 v\u00e0 v\u00f4i h\u00f3a, cu\u1ed1i c\u00f9ng l\u00e0 gi\u1ea3m di\u1ec7n t\u00edch l\u1ed7 van.<\/li>\n<\/ul>\n

    2. B\u1ec7nh sinh<\/h2>\n

    H\u1eb9p van \u0110M ch\u1ee7 d\u0201n \u0111\u1ebfn t\u0103ng tr\u1edf kh\u00e1ng t\u1ed1ng m\u00e1u c\u1ee7a th\u1ea5t tr\u00e1i. H\u1eb9p van ng\u00e0y c\u00e0ng ti\u1ebfn tri\u1ec3n theo th\u1eddi gian d\u0201n t\u1edbi nh\u1eefng bi\u1ebfn \u0111\u1ed5i c\u1ea5u tr\u00fac th\u1ea5t tr\u00e1i \u0111\u1ec3 th\u00edch nghi. C\u01a1 t\u00e2m th\u1ea5t tr\u00e1i ng\u00e0y c\u00e0ng d\u00e0y l\u00ean \u0111\u1ec3 duy tr\u00ec th\u1ec3 t\u00edch nh\u00e1t b\u00f3p, ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u v\u00e0 th\u1ec3 t\u00edch cu\u1ed1i t\u00e2m tr\u01b0\u01a1ng, m\u1eb7c d\u00f9 ch\u00eanh \u00e1p th\u00ec t\u00e2m thu gi\u1eefa t\u00e2m th\u1ea5t tr\u00e1i v\u00e0 \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean ng\u00e0y c\u00e0ng gia t\u0103ng.<\/p>\n

    Khi t\u00ecnh tr\u1ea1ng h\u1eb9p van ti\u1ebfp t\u1ee5c ti\u1ebfn tri\u1ec3n ho\u1eb7c kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, qu\u00e1 tr\u00ecnh ph\u00ec \u0111\u1ea1i c\u01a1 tim ti\u1ebfp t\u1ee5c ti\u1ebfn tri\u1ec3n, c\u01a1 tim dung n\u1ea1p ng\u00e0y c\u00e0ng k\u00e9m, th\u1ec3 t\u00edch cu\u1ed1i t\u00e2m tr\u01b0\u01a1ng t\u0103ng l\u00ean m\u1eb7c d\u00f9 k\u00edch th\u01b0\u1edbc bu\u1ed3ng tim ch\u01b0a thay \u0111\u1ed5i. R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m tr\u01b0\u01a1ng th\u1ea5t tr\u00e1i g\u00f3p ph\u1ea7n d\u0201n \u0111\u1ebfn bi\u1ec3u hi\u1ec7n tri\u1ec7u ch\u1ee9ng \u0111\u1ea7u ti\u00ean. B\u00ean c\u1ea1nh \u0111\u00f3 qu\u00e1 tr\u00ecnh t\u00e1i c\u1ea5u tr\u00fac, x\u01a1 h\u00f3a, thi\u1ebfu m\u00e1u c\u01a1 tim khi\u1ebfn cho co b\u00f3p kh\u00f4ng c\u00f2n hi\u1ec7u qu\u1ea3.<\/p>\n

    \"H\u1eb9p<\/p>\n

    H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/strong><\/p>\n

    3.\u0110\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng<\/h2>\n

    Tam ch\u1ee9ng kinh \u0111i\u1ec3n: \u0110au ng\u1ef1c, kh\u00f3 th\u1edf, ng\u1ea5t<\/strong>. Th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n khi h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 n\u1eb7ng.<\/p>\n

    C\u01a1n \u0111au th\u1eaft ng\u1ef1c<\/strong>: L\u00e0 do hi\u1ec7n t\u01b0\u1ee3ng m\u1ea5t c\u00e2n b\u1eb1ng cung c\u1ea7u oxy g\u00e2y ra b\u1edfi s\u1ef1 t\u0103ng kh\u1ed1i l\u01b0\u1ee3ng v\u00e0 t\u0103ng s\u1ee9c c\u0103ng c\u01a1 th\u1ea5t tr\u00e1i (gi\u1ea3m \u00e1p l\u1ef1c t\u01b0\u1edbi m\u00e1u d\u01b0\u1edbi n\u1ed9i t\u00e2m m\u1ea1c). C\u01a1n \u0111au ng\u1ef1c x\u1ea3y ra \u1edf 2\/3 b\u1ec7nh nh\u00e2n c\u00f3 h\u1eb9p van \u0110M ch\u1ee7 nh\u01b0ng ch\u1ec9 c\u00f3 1\/2 trong s\u1ed1 n\u00e0y c\u00f3 h\u1eb9p \u0111\u1ed9ng m\u1ea1ch v\u00e0nh.<\/p>\n

    Ng\u1ea5t: <\/strong>Do h\u1eadu qu\u1ea3 c\u1ee7a h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 kh\u00edt, cung l\u01b0\u1ee3ng tim kh\u00f4ng t\u0103ng \u0111\u01b0\u1ee3c \u0111\u1ec3 \u0111\u00e1p \u1ee9ng nhu c\u1ea7u g\u1eafng s\u1ee9c g\u00e2y gi\u00e3n m\u1ea1ch ngo\u1ea1i vi v\u00e0 gi\u1ea3m \u00e1p l\u1ef1c t\u01b0\u1edbi m\u00e1u n\u00e3o.<\/p>\n

    Kh\u00f3 th\u1edf: <\/strong>suy tim, ph\u00f9 ph\u1ed5i (khi b\u1ec7nh nh\u00e2n c\u00f3 xu\u1ea5t hi\u1ec7n rung nh\u0129 th\u00ec tri\u1ec7u ch\u1ee9ng kh\u00f3 th\u1edf th\u01b0\u1eddng tr\u1ea7m tr\u1ecdng h\u01a1n). C\u00f3 th\u1ec3 x\u1ea3y ra \u0111\u1ed9t t\u1eed do r \u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t.<\/p>\n

    Kh\u00e1m l\u00e2m s\u00e0ng<\/u><\/strong><\/p>\n

    M\u1ea1ch nh\u1ecf, n\u1ea3y ch\u1eadm (r\u00f5 nh\u1ea5t \u1edf \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh), huy\u1ebft \u00e1p k\u1eb9t , \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n h\u1eb9p van \u0110M ch\u1ee7 n\u1eb7ng huy\u1ebft \u00e1p t\u00e2m thu s\u1ebd gi\u1ea3m . Giai \u0111o\u1ea1n \u0111\u1ea7u, di\u1ec7n \u0111\u1eadp m\u1ecfm tim s\u1ebd b\u1ecb k\u00e9o l\u00ean cao. Giai \u0111o\u1ea1n sau khi suy tim ti\u1ebfn tri\u1ec3n, bu\u1ed3ng th\u1ea5t tr\u00e1i gi\u00e3n, m\u1ecfm tim \u1edf d\u01b0\u1edbi v\u00e0 ra ngo\u00e0i. Rung miu th\u1ea5y \u1edf \u1ed5 van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 (khoang li\u00ean s\u01b0\u1eddn 2 b\u00ean ph\u1ea3i).<\/p>\n

    Nghe: Ti\u1ebfng T1 b\u00ecnh th\u01b0\u1eddng ho\u1eb7c nh\u1eb9. \u1ede b\u1ec7nh nh\u00e2n h\u1eb9p van \u0110M ch\u1ee7 nh\u1eb9, ti\u1ebfng T2 b\u00ecnh th\u01b0\u1eddng (ti\u1ebfng \u0111\u00f3ng van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 tr\u01b0\u1edbc ti\u1ebfng \u0111\u00f3ng van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i). H\u1eb9p van \u0110M ch\u1ee7 v\u1eeba, ti\u1ebfng T2 \u0111anh (ti\u1ebfng \u0111\u00f3ng van \u0110M ch\u1ee7 v\u00e0 van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i h\u1ee3p nh\u1ea5 t). Ti\u1ebfng T3 l\u00e0 d\u1ea5u hi\u1ec7u ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i k\u00e9m. Ti\u1ebfng T4 xu\u1ea5t hi\u1ec7n do nh\u0129 tr\u00e1i co b\u00f3p t\u1ed1ng m\u00e1u v\u00e0o bu\u1ed3ng th\u1ea5t tr\u00e1i c\u00f3 \u0111\u1ed9 gi \u00e3n k\u00e9m khi h\u1eb9p van \u0110M ch\u1ee7 kh\u00edt.<\/p>\n

    Th\u1ed5i t\u00e2m thu t\u1ed1ng m\u00e1u \u1edf ph\u00eda tr\u00ean b\u00ean ph\u1ea3i x\u01b0\u01a1ng \u1ee9c, lan l\u00ean c\u1ed5, \u0111\u1ea1t c\u01b0\u1eddng \u0111\u1ed9 cao nh\u1ea5t v\u00e0o \u0111\u1ea7u \u0111\u1ebfn gi\u1eefa t\u00e2m thu. M\u1ee9c \u0111\u1ed9 h\u1eb9p van \u0110M ch\u1ee7 c\u00e0ng n\u1eb7ng, ti\u1ebfng th\u1ed5i c\u00e0ng d\u00e0i h\u01a1n, m\u1ea1nh h\u01a1n v\u00e0 \u0111\u1ea1t c\u1ef1c \u0111\u1ea1i ch\u1eadm h\u01a1n (cu\u1ed1i k\u1ef3 t\u00e2m thu). Tuy nhi\u00ean c\u01b0\u1eddng \u0111\u1ed9 ti\u1ebfng th\u1ed5i kh\u00f4ng li\u00ean quan ch\u1eb7t ch \u1ebd v\u1edbi m\u1ee9c \u0111\u1ed9 h\u1eb9p do c\u01b0\u1eddng \u0111\u1ed9 ti\u1ebfng th\u1ed5i c\u00f3 th\u1ec3 gi\u1ea3m nh\u1eb9 \u0111i n\u1ebfu cung l\u01b0\u1ee3ng tim gi\u1ea3m nhi\u1ec1u ho\u1eb7c ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i gi\u1ea3m n\u1eb7ng.<\/p>\n

    4.C\u1eadn l\u00e2m s\u00e0ng<\/h2>\n

    \u0110i\u1ec7n t\u00e2m \u0111\u1ed3<\/strong>: Ph\u00ec \u0111\u1ea1i nh\u0129 tr\u00e1i, ph\u00ec \u0111\u1ea1i t h\u1ea5t tr\u00e1i, block nh\u00e1nh tr\u00e1i th\u01b0\u1eddng c\u00f3. R\u1ed1i lo\u1ea1n nh\u1ecbp tim \u00edt khi x\u1ea3y ra, th\u01b0\u1eddng g\u1eb7p \u1edf giai \u0111o\u1ea1n mu\u1ed9n c\u1ee7a b\u1ec7nh, ch\u1ee7 y\u1ebfu l\u00e0 rung nh\u0129.<\/p>\n

    X – quang ng\u1ef1c: <\/strong>C\u00f3 th\u1ec3 th\u1ea5y d\u1ea5u hi\u1ec7u v\u00f4i ho\u00e1 van v\u00e0 g\u1ed1c \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, gi\u00e3n sau ch\u1ed7 h\u1eb9p t\u1ea1i \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean.<\/p>\n

    Si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c: <\/strong>V an \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ecb v\u00f4i ho\u00e1 v\u00e0 h\u1ea1n ch\u1ebf bi\u00ean \u0111\u1ed9 m\u1edf. Si\u00eau \u00e2m Doppler m\u00e0u \u0111\u1ec3 ph\u00e1t hi\u1ec7n h\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ph\u1ed1i h\u1ee3p. Si\u00eau \u00e2m Doppler xung li\u00ean t\u1ee5c \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 v\u1eadn t\u1ed1c v\u00e0 ch\u00eanh \u00e1p qua van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7. X\u00e1c \u0111\u1ecbnh di\u1ec7n t\u00edch l\u1ed7 van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u.<\/p>\n

    Th\u00f4ng tim: <\/strong>C h\u1ee7 y\u1ebfu \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch v\u00e0nh ph\u1ed1i h\u1ee3p tr\u01b0\u1edbc khi ph\u0201u thu\u1eadt thay van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7. Do nguy c\u01a1 thuy\u00ean t\u1eafc m\u1ea1ch, th\u00f4ng tim kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u00eanh \u00e1p qua van, \u0111\u1eb7c bi\u1ec7t khi k \u1ef9 thu\u1eadt si\u00eau \u00e2m D opple r \u0111\u00e3 c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u00ednh x\u00e1c ch\u00eanh \u00e1p qua van v\u00e0 ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i.<\/p>\n

    Si\u00eau \u00e2m tim g\u1eafng s\u1ee9c v\u1edbi Dobutamine: <\/strong>\u0110\u01b0\u1ee3c ti\u1ebfn h\u00e0nh \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n h\u1eb9p van \u0110M ch\u1ee7 kh\u00edt c\u00f3 ph\u00e2n s\u1ed1 t\u1ed1ng m\u00e1u th\u1ea5p, ch\u00eanh \u00e1p qua van th\u1ea5p \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 d\u1ef1 tr\u1eef l \u01b0u l\u01b0\u1ee3ng\/co b\u00f3p c\u1ee7a c\u01a1 tim. Ho\u1eb7c gi\u00fap c h\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 h\u1eb9p van \u0110M ch\u1ee7 m\u1ee9c \u0111\u1ed9 nhi\u1ec1u v\u00e0 c\u00f3 gi\u1ea3m ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i th\u1ee9 ph\u00e1t v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n gi\u1ea3 h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7. \u1ede nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y di\u1ec7n t\u00edch van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 s\u1ebd t\u0103ng l\u00ean khi d\u00f9ng D obutamine.<\/p>\n

    5.Ti\u00ean l\u01b0\u1ee3ng<\/h2>\n
      \n
    • Ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh thay \u0111\u1ed5i theo t\u1eebng c\u00e1 th\u1ec3. B\u1ec7nh nh\u00e2n th\u01b0\u1eddng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng cho \u0111\u1ebfn khi h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 n\u1eb7ng. Khi \u0111\u00e3 xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng, ti\u00ean l\u01b0\u1ee3ng x\u1ea5u \u0111i \u0111\u00e1ng k\u1ec3 n\u1ebfu kh\u00f4ng can thi\u1ec7p ph\u0201u thu\u1eadt.<\/li>\n
    • B\u1ec7nh nh\u00e2n b\u1ecb \u0111au th\u1eaft ng\u1ef1c c\u00f3 kh\u1ea3 n\u0103ng s\u1ed1ng c\u00f2n ch\u1ec9 \u0111\u1ea1t 50% sau 5 n\u0103m.<\/li>\n
    • B\u1ec7nh nh\u00e2n b\u1ecb ng\u1ea5t c\u00f3 th\u1eddi gian s\u1ed1ng c\u00f2n ch\u1ec9 \u0111\u1ea1t 50% sau 3 n\u0103m.<\/li>\n
    • B\u1ec7nh nh\u00e2n b\u1ecb kh\u00f3 th\u1edf do suy tim th \u1eddi gian s\u1ed1ng trung b\u00ecnh c\u00f2n < 2 n\u0103m.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

      H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd van tim ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf c\u00e1c n\u01b0\u1edbc ph\u00e1t tri\u1ec3n, nam g\u1eb7p nhi\u1ec1u h\u01a1n n\u1eef, gia t\u0103ng theo tu\u1ed5i, t\u1ef7 l\u1ec7 m\u1eafc t\u1edbi 2% \u1edf ng\u01b0\u1eddi tr\u00ean 65 tu\u1ed5i. B\u1ec7nh ng\u00e0y c\u00e0ng tr\u1edf n\u00ean ph\u1ed5 bi\u1ebfn do m\u00f4 h\u00ecnh d\u00e2n s\u1ed1 gi\u00e0 ho\u00e1 v\u00e0 […]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\nH\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m quan tr\u1ecdng - Vinmec<\/title>\n<meta name=\"description\" content=\"H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd van tim ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf c\u00e1c n\u01b0\u1edbc ph\u00e1t tri\u1ec3n, nam g\u1eb7p nhi\u1ec1u h\u01a1n n\u1eef, gia t\u0103ng theo tu\u1ed5i.\" \/>\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=\"H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m quan tr\u1ecdng - 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