{"id":29971,"date":"2023-05-01T22:58:00","date_gmt":"2023-05-01T15:58:00","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29971"},"modified":"2023-05-01T22:58:00","modified_gmt":"2023-05-01T15:58:00","slug":"ho-van-dong-mach-chu-va-chan-doan-lam-sang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/ho-van-dong-mach-chu-va-chan-doan-lam-sang\/","title":{"rendered":"H\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7\u00a0v\u00e0 ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng"},"content":{"rendered":"

H\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/a>\u00a0l\u00e0 t\u00ecnh tr\u1ea1ng x\u1ea3y ra khi van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 kh\u00f4ng \u0111\u00f3ng k\u00edn. Van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 l\u00e1 van ng\u0103n c\u00e1ch gi\u1eefa \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 t\u00e2m th\u1ea5t tr\u00e1i, c\u00f3 nhi\u1ec7m v\u1ee5 \u0111\u00f3ng m\u1edf, cho ph\u00e9p m\u00e1u ch\u1ec9 \u0111i theo m\u1ed9t chi\u1ec1u nh\u1ea5t \u0111\u1ecbnh. Khi van n\u00e0y b\u1ecb h\u1edf, m\u00e1u b\u1ecb d\u1ed3n ng\u01b0\u1ee3c tr\u1edf l\u1ea1i tim thay v\u00ec \u0111\u01b0\u1ee3c b\u01a1m ra \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, l\u00e0m\u00a0t\u0103ng g\u00e1nh th\u1ea5t tr\u00e1i\u00a0v\u00e0 l\u00e2u d\u00e0i s\u1ebd d\u1eabn \u0111\u1ebfn\u00a0suy tim.<\/strong><\/p>\n

1.Nguy\u00ean nh\u00e2n<\/h2>\n

1.1 Nguy\u00ean nh\u00e2n t\u1ea1i van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/strong><\/h3>\n

Di ch\u1ee9ng b\u1ec7nh th\u1ea5p tim (th\u01b0\u1eddng k\u1ebft h\u1ee3p v\u1edbi h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 c\u0169ng nh\u01b0 h\u1eb9p ho\u1eb7c h\u1edf van hai l\u00e1), vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n, tho\u00e1i h\u00f3a v\u00e0 v\u00f4i h\u00f3a (k\u00e8m h\u1eb9p van \u0110M ch\u1ee7), van \u0110M ch\u1ee7 hai l\u00e1 van, ch\u1ea5n th\u01b0\u01a1ng.<\/p>\n

1.2 Nguy\u00ean nh\u00e2n t\u1ea1i g\u1ed1c \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/h3>\n

Do t\u0103ng huy\u1ebft \u00e1p, t\u00e1ch th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, h\u1ed9i ch\u1ee9ng Marfan. C\u00e1c nguy\u00ean nh\u00e2n hi\u1ebfm g\u1eb7p kh\u00e1c: T\u1ea1o x\u01b0\u01a1ng b\u1ea5t to\u00e0n, vi\u00eam \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 do giang mai, vi\u00eam kh\u1edbp – c\u1ed9t s\u1ed1ng (vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp, Reiter…), vi\u00eam \u0111\u1ed9ng m\u1ea1ch (Takayasu, t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3) …<\/p>\n

2.Sinh l\u00fd b\u1ec7nh<\/h2>\n

Khi van b\u1ecb h\u1edf, th\u1ec3 t\u00edch nh\u00e1t b\u00f3p t\u0103ng l\u00ean do m\u00e1u ph\u1ee5t ng\u01b0\u1ee3c tr\u1edf v\u1ec1 t\u1eeb \u0110M ch\u1ee7 v\u00e0o th\u1ea5t tr\u00e1i. Cung l\u01b0\u1ee3ng tim \u0111\u01b0\u1ee3c duy tr\u00ec b\u1eb1ng c\u00e1ch gi\u00e3n th\u1ea5t tr\u00e1i \u0111\u1ec3 t\u0103ng th\u1ec3 t\u00edch nh\u00e1t b\u00f3p nh\u01b0ng l\u00e0m t\u0103ng qu\u00e1 m\u1ee9c th\u1ec3 t\u00edch cu\u1ed1i t\u00e2m tr\u01b0\u01a1ng. Qu\u00e1 t\u1ea3i th\u1ec3 t\u00edch k\u00e9o d\u00e0i v\u00e0 ti\u1ebfn tri\u1ec3n d\u1ea7n d\u0201n t\u1edbi c\u01a1 tim gi\u00e3n l\u1edbn, suy ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i v\u00e0 h\u1eadu qu\u1ea3 cu\u1ed1i c\u00f9ng l\u00e0 suy tim bi\u1ec3u hi\u1ec7n tri\u1ec7u ch\u1ee9ng.<\/p>\n

\"H\u1edf<\/p>\n

H\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/strong><\/p>\n

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

Trong h\u1edf van \u0110M ch\u1ee7 c\u1ea5p t\u00ednh, tri\u1ec7u ch\u1ee9ng kh\u00f3 th\u1edf g\u1eb7p ph\u1ed5 bi\u1ebfn, t\u0103ng cung l\u01b0\u1ee3ng tim trong tr\u1ea1ng th\u00e1i th\u1ea5t tr\u00e1i kh\u00f4ng \u0111\u00e0n h\u1ed3i, \u00e1p l\u1ef1c cu\u1ed1i t\u00e2m tr\u01b0\u01a1ng th\u1ea5t tr\u00e1i t\u0103ng d\u0201n \u0111\u1ebfn ph\u00f9 ph\u1ed5i, t\u1ee5t huy\u1ebft \u00e1p v\u00e0 s\u1ed1c tim.<\/p>\n

Trong h\u1edf van \u0110M ch\u1ee7 m\u1ea1n t\u00ednh, ban \u0111\u1ea7u kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng. \u00c1p l\u1ef1c cu\u1ed1i t\u00e2m tr\u01b0\u01a1ng th\u1ea5t tr\u00e1i th\u1ea5p do gi\u00e3n th\u1ea5t tr\u00e1i. Qu\u00e1 t\u1ea3i th\u1ec3 t\u00edch m\u00e3n t\u00ednh d\u0201n \u0111\u1ebfn suy th\u1ea5t tr\u00e1i v\u00e0 suy tim m\u1ea1n t\u00ednh.<\/p>\n

\u0110au th\u1eaft ng\u1ef1c, tri\u1ec7u ch\u1ee9ng t\u00e1ch th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 (v\u00ed d\u1ee5: \u0110au ng\u1ef1c lan ra sau l\u01b0ng).<\/p>\n

C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c.<\/p>\n

M\u1ea1ch n\u1ea3y m\u1ea1nh, ch\u00ecm s\u00e2u, d\u1ea5u hi\u1ec7u Corrigan (c\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y m\u1ea1ch c\u1ea3nh \u0111\u1eadp)<\/p>\n

D\u1ea5u hi\u1ec7u De Musset<\/u><\/strong>: \u0110\u1ea7u g\u1eadt g\u00f9 theo nh\u1ecbp \u0111\u1eadp c\u1ee7a tim.<\/p>\n

D\u1ea5u hi\u1ec7u M\u00fcller<\/u><\/strong>: L\u01b0\u1ee1i g\u00e0 \u0111\u1eadp theo nh\u1ecbp tim.<\/p>\n

D\u1ea5u hi\u1ec7u Traube<\/u><\/strong>: \u201cS\u00fang l\u1ee5c b\u1eafn v\u00e0o x\u01b0\u01a1ng \u0111\u00f9i\u201d ti\u1ebfng m\u1ea1ch \u0111\u1eadp m\u1ea1 n h nghe b\u1eb1ng \u1ed1ng nghe t\u1ea1i \u0111\u1ed9ng m\u1ea1ch \u0111\u00f9i.<\/p>\n

D\u1ea5u hi\u1ec7u Quincke<\/u><\/strong>: X ung mao m\u1ea1ch c\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y \u1edf m\u00f3ng tay.<\/p>\n

D\u1ea5u hi\u1ec7u Duroziez<\/u><\/strong>: T i\u1ebfng th \u1ed5i t\u00e2m thu v\u00e0 t\u00e2m tr\u01b0\u01a1ng nghe th\u1ea5y tr\u00ean \u0111\u1ed9ng m\u1ea1ch \u0111\u00f9i khi \u0111\u1ed9ng m\u1ea1ch \u0111\u01b0\u1ee3c n\u00e9n b\u1eb1ng ng\u00f3n tay.<\/p>\n

M\u1ecfm tim di l\u1ec7ch v\u1ec1 d\u01b0\u1edbi b\u00ean, \u0111\u1eadp m\u1ea1nh v\u00e0 lan r\u1ed9ng h\u01a1n. C\u00f3 th\u1ec3 c\u1ea3m th\u1ea5y rung miu v\u00f9ng m\u1ecfm.<\/p>\n

Nghe tim<\/u><\/em><\/strong><\/p>\n

    \n
  • Ti\u1ebfng T2 c\u00f3 th\u1ec3 b\u00ecnh th\u01b0\u1eddng (ho\u1eb7c to h\u01a1n) n\u1ebfu h\u1edf van do b\u1ec7nh l\u00fd g\u1ed1c \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 c\u00f3 th\u1ec3 \u00eam nh\u1eb9 ho\u1eb7c m\u1ea5t n\u1ebfu h\u1edf van do b\u1ec7nh l\u00fd van. Ti\u1ebfng T3 c\u00f3 th\u1ec3 nghe th\u1ea5y khi th\u1ea5t tr\u00e1i gi\u00e3n ho\u1eb7c suy tim giai \u0111o\u1ea1n s\u1edbm.<\/li>\n
  • Ti\u1ebfng th\u1ed5i t\u00e2m thu t\u1ed1ng m\u00e1u t\u01b0\u01a1ng t\u1ef1 nh\u01b0 h\u1eb9p van \u0110M ch\u1ee7 c\u00f3 th\u1ec3 nghe th\u1ea5y (nguy\u00ean nh\u00e2n h\u1ed7n h\u1ee3p c\u1ee7a h\u1eb9p\/ h\u1edf van \u0110M ch\u1ee7 ho\u1eb7c do d\u00f2ng m\u00e1u cu\u1ed9n khi th\u1ec3 t\u00edch nh\u00e1t b\u00f3p t\u0103ng).<\/li>\n
  • Ti\u1ebfng th\u1ed5i c\u1ee7a h\u1edf van \u0110M ch\u1ee7 c\u00f3 \u00e2m s\u1eafc cao, th\u00ec t\u00e2m tr\u01b0\u01a1ng s\u1edbm ngay sau ti\u1ebfng T2. Ti\u1ebfng n\u00e0y nghe r\u00f5 nh\u1ea5t khi b\u1ec7nh nh\u00e2n t\u01b0 th\u1ebf ng\u1ed3i v\u00e0 ng\u1ea3 ra tr\u01b0\u1edbc trong th\u00ec th\u1edf ra. Nghe r\u00f5 nh\u1ea5t d\u1ecdc theo b\u1edd tr\u00e1i tr\u00ean x\u01b0\u01a1ng \u1ee9c (\u0111\u00f4i khi d\u1ecdc theo b\u1edd ph\u1ea3i n\u1ebfu gi\u00e3n g\u1ed1c \u0111\u1ed9ng m\u1ea1ch ch\u1ee7). Th\u1eddi gian c\u1ee7a ti\u1ebfng th\u1ed5i t\u00e2m tr\u01b0\u01a1ng t\u01b0\u01a1ng quan v\u1edbi m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a h\u1edf van \u0110M ch\u1ee7.<\/li>\n
  • Ti\u1ebfng rung Austin Flint nghe \u0111\u01b0\u1ee3c \u1edf gi\u1eefa t\u00e2m tr\u01b0\u01a1ng v\u00f9ng m\u1ecfm tim g\u00e2y b\u1edfi d\u00f2ng m\u00e1u xu\u00f4i chi\u1ec1u qua l\u1ed7 van hai l\u00e1 b\u1ecb h\u1eb9p khi \u00e1p l\u1ef1c th\u1ea5t tr\u00e1i t\u0103ng v\u00e0 d\u00f2ng h\u1edf van \u0110M ch\u1ee7 tr\u00e0o ng\u01b0\u1ee3c h\u01b0\u1edbng tr\u1ef1c ti\u1ebfp v\u1ec1 l\u00e1 tr\u01b0\u1edbc van hai l\u00e1.<\/li>\n<\/ul>\n

    4.C\u1eadn l\u00e2m s\u00e0ng<\/h2>\n
      \n
    • \u0110i\u1ec7n t\u00e2m \u0111\u1ed3<\/strong>: Ph\u00ec \u0111\u1ea1i th\u1ea5t tr\u00e1i, tr\u1ee5c tr\u00e1i.<\/li>\n
    • X-qua ng ng\u1ef1c th\u1eb3ng<\/strong>: Trong h\u1edf van \u0110M ch\u1ee7 m\u1ea1n t\u00ednh c\u00f3 b\u00f3ng tim to. Gi\u00e3n \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean trong b\u1ec7nh l\u00fd g\u1ed1c \u0110M ch\u1ee7.<\/li>\n
    • Si\u00eau \u00e2m tim: <\/strong>Doppler m\u00e0u v\u00e0 Doppler xung kh\u1eb3ng \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n v\u00e0 m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a h\u1edf van \u0110M ch\u1ee7. Si\u00eau \u00e2m M-mode cho ph\u00e9p \u0111o \u0111\u01b0\u1eddng k\u00ednh g\u1ed1c \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, th\u1ea5t tr\u00e1i v\u00e0 ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u.<\/li>\n
    • Th\u00f4ng tim<\/strong>: \u0110\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u01b0\u1edbc khi ph\u0201u thu\u1eadt thay van hay g\u1ed1c \u0110M ch\u1ee7. Ch\u1ee5p \u0110M ch\u1ee7 t\u01b0 th\u1ebf nghi\u00eang tr\u00e1i gi\u00fap \u0111\u00e1nh gi\u00e1 g\u1ed1c \u0110M ch\u1ee7 v\u00e0 m\u1ee9c \u0111\u1ed9 h\u1edf.<\/li>\n<\/ul>\n

      C\u00e1c giai \u0111o\u1ea1n h\u1edf van \u0110M ch\u1ee7 theo AHA\/ACC 2017<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
      Ph\u00e2n<\/strong><\/p>\n

      \u0111\u1ed9<\/strong><\/td>\n

      		\u0110\u1ecbnh ngh\u0129a<\/strong><\/td>\n\u00a0<\/strong><\/p>\n

      Gi\u1ea3i ph\u1eabu van<\/strong><\/td>\n

      		\u00a0<\/strong><\/p>\n

      Huy\u1ebft \u0111\u1ed9ng<\/strong><\/td>\n

      		H\u1eadu qu\u1ea3 huy\u1ebft \u0111\u1ed9ng<\/strong><\/td>\nTri\u1ec7u ch\u1ee9ng<\/strong><\/td>\n<\/tr>\n
      A<\/strong><\/td>\nC\u00f3 nguy c\u01a1 h\u1edf van \u0110M<\/strong><\/p>\n

      ch\u1ee7<\/strong><\/td>\n

      		–\u00a0 Van \u0110M ch\u1ee7 hai l\u00e1 van ho\u1eb7c c\u00e1c d\u1ecb t\u1eadt van b\u1ea9m sinh kh\u00e1c.<\/p>\n

      –\u00a0 X\u01a1 c\u1ee9ng van \u0110M ch\u1ee7.<\/p>\n

      –\u00a0 B\u1ec7nh l\u00fd xoang \u0110M ch\u1ee7 ho\u1eb7c \u0110M ch\u1ee7 l\u00ean.<\/p>\n

      –\u00a0 Ti\u1ec1n s\u1eed th\u1ea5p kh\u1edbp ho\u1eb7c th\u1ea5p tim.<\/p>\n

      –\u00a0 Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n.<\/td>\n

      		Kh\u00f4ng c\u00f3 h\u1edf van \u0110M ch\u1ee7 ho\u1eb7c h\u1edf r\u1ea5t nh\u1eb9<\/strong><\/td>\nKh\u00f4ng<\/td>\nKh\u00f4ng<\/td>\n<\/tr>\n
      B<\/strong><\/td>\nH\u1edf van \u0110M<\/strong><\/p>\n

      ch\u1ee7 nh\u1eb9 – v\u1eeba<\/strong><\/td>\n

      		\u00a0<\/strong><\/p>\n

      \u00a0<\/strong><\/p>\n

      – V\u00f4i h\u00f3a nh\u1eb9 \u0111\u1ebfn v\u1eeba \u1edf van \u0110M ch\u1ee7 ba l\u00e1 ho\u1eb7c hai l\u00e1 ho\u1eb7c d\u1ea1ng d\u1ecb t\u1eadt<\/p>\n

      b\u1ea9m sinh kh\u00e1c.<\/td>\n

      		H\u1edf van \u0110M ch\u1ee7 nh\u1eb9:<\/strong><\/p>\n

      –\u00a0 \u0110\u1ed9 r\u1ed9ng d\u00f2ng h\u1edf < 25% \u0111\u01b0\u1eddng ra th\u1ea5t tr\u00e1i<\/p>\n

      –\u00a0 \u0110\u01b0\u1eddng k\u00ednh d\u00f2ng h\u1edf t\u1ea1i g\u1ed1c < 0,3 cm<\/td>\n

      		\u00a0<\/strong><\/p>\n

      \u00a0<\/strong><\/p>\n

      – Ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i b\u00ecnh<\/p>\n

      th\u01b0\u1eddng.<\/td>\n

      		\u00a0<\/strong><\/p>\n

      \u00a0<\/strong><\/p>\n

      \u00a0<\/strong><\/p>\n

      Kh\u00f4ng<\/td>\n<\/tr>\n

      <\/td>\n<\/td>\n\u00a0<\/strong><\/p>\n

      –\u00a0 Gi\u00e3n xoang Valsalva.<\/p>\n

      \u00a0<\/strong><\/p>\n

      –\u00a0 T\u1ed5n th\u01b0\u01a1ng van<\/p>\n

      do th\u1ea5p.<\/td>\n

      		–\u00a0 Th\u1ec3 t\u00edch h\u1edf < 30 mL\/nh\u1ecbp<\/p>\n

      –\u00a0 Ph\u00e2n su\u1ea5t h\u1edf <30%<\/p>\n

      – ERO < 0.10 cm2.<\/p>\n

      –\u00a0 \u0110\u1ed9 tr\u00ean ch\u1ee5p bu\u1ed3ng tim<\/p>\n

      1+.<\/td>\n

      		– Th\u1ec3 t\u00edch th\u1ea5t<\/p>\n

      tr\u00e1i<\/p>\n

      b\u00ecnh th\u01b0\u1eddng ho\u1eb7c<\/p>\n

      th\u1ea5t tr\u00e1i gi\u00e3n nh\u1eb9.<\/td>\n

      		<\/td>\n<\/tr>\n
      <\/td>\n<\/td>\n– Ti\u1ec1n s\u1eed vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m<\/p>\n

      khu\u1ea9n.<\/td>\n

      		H\u1edf van \u0110M ch\u1ee7 v\u1eeba:<\/strong><\/p>\n

      – \u0110\u1ed9 r\u1ed9ng d\u00f2ng h\u1edf 25 – 64%<\/p>\n

      \u0111\u01b0\u1eddng ra th\u1ea5t tr\u00e1i.<\/td>\n

      		<\/td>\n<\/td>\n<\/tr>\n
      <\/td>\n<\/td>\n<\/td>\n– \u0110\u1ed9 r\u1ed9ng d\u00f2ng h\u1edf t\u1ea1i g\u1ed1c<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
      <\/td>\n<\/td>\n<\/td>\n0,3 – 0,6 cm<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
      <\/td>\n<\/td>\n<\/td>\n– Th\u1ec3 t\u00edch h\u1edf 30 – 59<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
      <\/td>\n<\/td>\n<\/td>\nmL\/nh\u1ecbp.<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
      <\/td>\n<\/td>\n<\/td>\n– Ph\u00e2n su\u1ea5t h\u1edf 30 – 49%.<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
      <\/td>\n<\/td>\n<\/td>\n– ERO 0,10 – 0,29 cm2.<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
      <\/td>\n<\/td>\n<\/td>\n– \u0110\u1ed9 tr\u00ean ch\u1ee5p bu\u1ed3ng tim<\/td>\n<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

       <\/p>\n\n\n\n\n\n\n\n\n\n
      <\/td>\n<\/td>\n<\/td>\n2+.<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
      C<\/strong><\/td>\nH\u1edf van \u0110M<\/strong><\/p>\n

      ch\u1ee7 n\u1eb7ng<\/strong><\/p>\n

      kh\u00f4ng tri\u1ec7u ch\u1ee9ng<\/strong><\/td>\n

      		–\u00a0 Van \u0110M ch\u1ee7 v\u00f4i h\u00f3a.<\/p>\n

      \u00a0<\/strong><\/p>\n

      –\u00a0 Van \u0110M ch\u1ee7 hai l\u00e1 ho\u1eb7c d\u1ea1ng d\u1ecb t\u1eadt<\/p>\n

      b\u1ea9m sinh kh\u00e1c.<\/p>\n

      \u00a0<\/strong><\/p>\n

      –\u00a0 Gi\u00e3n ph\u00ecnh xoang<\/p>\n

      ho\u1eb7c \u0110M ch\u1ee7 l\u00ean.<\/td>\n

      		H\u1edf van \u0110M ch\u1ee7 n\u1eb7ng:<\/strong><\/p>\n

      –\u00a0 \u0110\u1ed9 r\u1ed9ng d\u00f2ng h\u1edf \u2265 65% \u0111\u01b0\u1eddng ra th\u1ea5t tr\u00e1i.<\/p>\n

      –\u00a0 \u0110\u1ed9 r\u1ed9ng d\u00f2ng h\u1edf t\u1ea1i g\u1ed1c ><\/p>\n

      0,6 cm.<\/p>\n

      –\u00a0 D\u00f2ng tr\u00e0o ng\u01b0\u1ee3c to\u00e0n t\u00e2m tr\u01b0\u01a1ng.<\/p>\n

      –\u00a0 Th\u1ec3 t\u00edch h\u1edf \u2265 60 mL\/nh\u1ecbp.<\/td>\n

      		C1: <\/strong>Ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i b\u00ecnh th\u01b0\u1eddng (\u2265 50 v\u00e0 th\u1ea5t tr\u00e1i gi\u00e3n nh\u1eb9 \u0111\u1ebfn v\u1eeba (LVESD \u2264 50<\/p>\n

      mm).<\/p>\n

      \u00a0<\/strong><\/p>\n

      C2: <\/strong>Gi\u1ea3m ch\u1ee9c n\u0103ng t\u00e2m thu<\/p>\n

      th\u1ea5t tr\u00e1i (< 50%) ho\u1eb7c gi\u00e3n n\u1eb7ng th\u1ea5t tr\u00e1i (LVEDSD ><\/p>\n

      50 mm ho\u1eb7c ch\u1ec9 s\u1ed1 LVESD > 25<\/p>\n

      mm\/m2).<\/td>\n

      		Kh\u00f4ng C\u1ea7n c\u00f3 test<\/p>\n

      g\u1eafng s\u1ee9c \u0111\u1ec3 kh\u1eb3ng \u0111\u1ecbnh t\u00ecnh<\/p>\n

      tr\u1ea1ng tri\u1ec7u ch\u1ee9ng.<\/td>\n<\/tr>\n

      <\/td>\n<\/td>\n– Bi\u1ebfn \u0111\u1ed5i van do<\/p>\n

      th\u1ea5p.<\/td>\n

      		– Ph\u00e2n su\u1ea5t h\u1edf \u2265 50%<\/p>\n

      – ERO \u2265 0,3 cm2.<\/td>\n

      		<\/td>\n<\/tr>\n
      <\/td>\n<\/td>\n<\/td>\n– \u0110\u1ed9 tr\u00ean ch\u1ee5p bu\u1ed3ng<\/td>\n<\/td>\n<\/tr>\n
      <\/td>\n<\/td>\n– Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c<\/p>\n

      nhi\u1ec5m khu\u1ea9n g\u00e2y \u0111\u00f3ng kh\u00f4ng k\u00edn v\u00e0 th\u1ee7ng van.<\/td>\n

      		tim 3+ t\u1edbi 4+.<\/p>\n

      – \u0110\u1ec3 ch\u1ea9n \u0111o\u00e1n h\u1edf van \u0110M ch\u1ee7 m\u1ea1n c\u1ea7n c\u00f3 ti\u00eau chu\u1ea9n<\/td>\n

      		<\/td>\n<\/tr>\n
      <\/td>\n<\/td>\n<\/td>\ngi\u00e3n th\u1ea5t tr\u00e1i.<\/td>\n<\/td>\n<\/tr>\n
      D<\/strong><\/td>\nH\u1edf van \u0110M<\/strong><\/p>\n

      ch\u1ee7 n\u1eb7ng c\u00f3 tri\u1ec7u<\/strong><\/p>\n

      ch\u1ee9ng<\/strong><\/td>\n

      		–\u00a0 Van \u0110M ch\u1ee7 v\u00f4i<\/p>\n

      h\u00f3a<\/p>\n

      \u00a0<\/strong><\/p>\n

      –\u00a0 Van \u0110M ch\u1ee7 hai l\u00e1 ho\u1eb7c d\u1ea1ng d\u1ecb t\u1eadt<\/p>\n

      b\u1ea9m sinh kh\u00e1c.<\/p>\n

      \u00a0<\/strong><\/p>\n

      –\u00a0 Gi\u00e3n ph\u00ecnh xoang<\/p>\n

      ho\u1eb7c \u0110M ch\u1ee7 l\u00ean<\/p>\n

      \u00a0<\/strong><\/p>\n

      –\u00a0 Bi\u1ebfn \u0111\u1ed5i van do th\u1ea5p.<\/p>\n

      \u00a0<\/strong><\/p>\n

      –\u00a0 Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n g\u00e2y \u0111\u00f3ng kh\u00f4ng k\u00edn ho\u1eb7c th\u1ee7ng van.<\/td>\n

      		H\u1edf van \u0110M ch\u1ee7 n\u1eb7ng:<\/strong><\/p>\n

      –\u00a0 \u0110\u1ed9 r\u1ed9ng d\u00f2ng h\u1edf \u2265 65% \u0111\u01b0\u1eddng ra th\u1ea5t tr\u00e1i<\/p>\n

      –\u00a0 \u0110\u1ed9 r\u1ed9ng d\u00f2ng h\u1edf t\u1ea1i g\u1ed1c ><\/p>\n

      0,6 cm.<\/p>\n

      –\u00a0 D\u00f2ng tr\u00e0o ng\u01b0\u1ee3c to\u00e0n t\u00e2m tr\u01b0\u01a1ng.<\/p>\n

      –\u00a0 Th\u1ec3 t\u00edch h\u1edf \u2265 60 mL\/nh\u1ecbp.<\/p>\n

      –\u00a0 Ph\u00e2n su\u1ea5t h\u1edf \u2265 50%<\/p>\n

      – ERO \u2265 0,3 cm2.<\/p>\n

      –\u00a0 \u0110\u1ed9 tr\u00ean ch\u1ee5p bu\u1ed3ng tim 3+<\/p>\n

      t\u1edbi 4+.<\/p>\n

      –\u00a0 \u0110\u1ec3 ch\u1ea9n \u0111o\u00e1n h\u1edf van \u0110M ch\u1ee7 m\u1ea1n c\u1ea7n c\u00f3 ti\u00eau chu\u1ea9n gi\u00e3n th\u1ea5t tr\u00e1i.<\/td>\n

      		–\u00a0 H\u1edf van \u0110M ch\u1ee7 n\u1eb7ng c\u00f3<\/p>\n

      tri\u1ec7u ch\u1ee9ng v\u1edbi ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i b\u00ecnh th\u01b0\u1eddng (LVEF \u2265 50%),<\/p>\n

      gi\u1ea3m nh\u1eb9-v\u1eeba<\/p>\n

      (LVEF 40 – 50 %)<\/p>\n

      ho\u1eb7c gi\u1ea3m n\u1eb7ng (LVEF < 40%).<\/p>\n

      \u00a0<\/strong><\/p>\n

      –\u00a0 Th\u1ea5t tr\u00e1i gi\u00e3n v\u1eeba\/<\/p>\n

      nhi\u1ec1u<\/td>\n

      		Kh\u00f3 th\u1edf khi<\/p>\n

      g\u1eafng s\u1ee9c, \u0111au ng\u1ef1c ho\u1eb7c c\u00e1c<\/p>\n

      tri\u1ec7u ch\u1ee9ng suy tim n\u1eb7ng.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

      \u00a0<\/strong><\/p>\n

      *ERO: Di\u1ec7n t\u00edch d\u00f2ng h\u1edf hi\u1ec7u d\u1ee5ng<\/em><\/p>\n

      5.Ti\u00ean l\u01b0\u1ee3ng<\/h2>\n

      H\u1edf van \u0110M ch\u1ee7 m\u1ea1n t\u00ednh c\u00f3 th\u1ec3 dung n\u1ea1p trong nhi\u1ec1u n\u0103m. T\u1ef7 l\u1ec7 s\u1ed1ng 5 n\u0103m kho\u1ea3ng 75%, t\u1ef7 l\u1ec7 s\u1ed1ng 10 n\u0103m kho\u1ea3ng 50%. Ti\u00ean l\u01b0\u1ee3ng x\u1ea5u \u0111i khi c\u00e1c tri\u1ec7u ch\u1ee9ng xu\u1ea5t hi\u1ec7n. Tuy nhi\u00ean, h\u1edf van \u0110M ch\u1ee7 n\u1eb7ng c\u1ea5p t\u00ednh c\u00f3 t\u1ef7 l\u1ec7 t\u1eed vong cao do suy tim, do \u0111\u00f3 c\u1ea7n ch\u1ec9 \u0111\u1ecbnh can thi\u1ec7p s\u1edbm.<\/p>\n","protected":false},"excerpt":{"rendered":"

      H\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7\u00a0l\u00e0 t\u00ecnh tr\u1ea1ng x\u1ea3y ra khi van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 kh\u00f4ng \u0111\u00f3ng k\u00edn. Van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 l\u00e1 van ng\u0103n c\u00e1ch gi\u1eefa \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 t\u00e2m th\u1ea5t tr\u00e1i, c\u00f3 nhi\u1ec7m v\u1ee5 \u0111\u00f3ng m\u1edf, cho ph\u00e9p m\u00e1u ch\u1ec9 \u0111i theo m\u1ed9t chi\u1ec1u nh\u1ea5t \u0111\u1ecbnh. Khi van n\u00e0y b\u1ecb h\u1edf, m\u00e1u […]<\/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\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7\u00a0v\u00e0 ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng - Vinmec<\/title>\n<meta name=\"description\" content=\"H\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 x\u1ea3y ra khi van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 kh\u00f4ng \u0111\u00f3ng k\u00edn. B\u00e0i vi\u1ebft cung c\u1ea5p n\u1ed9i dung v\u1ec1 nguy\u00ean nh\u00e2n c\u0169ng nh\u01b0 ch\u1ea9n \u0111o\u00e1n.\" \/>\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\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7\u00a0v\u00e0 ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng - Vinmec\" \/>\n<meta property=\"og:description\" content=\"H\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 x\u1ea3y ra khi van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 kh\u00f4ng \u0111\u00f3ng k\u00edn. B\u00e0i vi\u1ebft cung c\u1ea5p n\u1ed9i dung v\u1ec1 nguy\u00ean nh\u00e2n c\u0169ng nh\u01b0 ch\u1ea9n \u0111o\u00e1n.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/ho-van-dong-mach-chu-va-chan-doan-lam-sang\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-05-01T15:58:00+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Blausen_0039_AorticRegurgitation-225x300.png\" \/>\n<meta name=\"author\" content=\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/ho-van-dong-mach-chu-va-chan-doan-lam-sang\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/ho-van-dong-mach-chu-va-chan-doan-lam-sang\/\",\"name\":\"H\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7\u00a0v\u00e0 ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng - Vinmec\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-05-01T15:58:00+00:00\",\"dateModified\":\"2023-05-01T15:58:00+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629\"},\"description\":\"H\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 x\u1ea3y ra khi van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 kh\u00f4ng \u0111\u00f3ng k\u00edn. 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