{"id":30149,"date":"2023-05-01T22:50:35","date_gmt":"2023-05-01T15:50:35","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30149"},"modified":"2023-05-01T22:50:35","modified_gmt":"2023-05-01T15:50:35","slug":"chan-doan-benh-co-tim-that-phai-gay-roi-loan-nhip","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/chan-doan-benh-co-tim-that-phai-gay-roi-loan-nhip\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i g\u00e2y r\u1ed1i lo\u1ea1n nh\u1ecbp"},"content":{"rendered":"

B\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i g\u00e2y r\u1ed1i lo\u1ea1n nh\u1ecbp<\/a> (ARVC) l\u00e0 b\u1ea5t th\u01b0\u1eddng tim c\u00f3 t\u00ednh di truy\u1ec1n v\u1edbi \u0111\u1eb7c \u0111i\u1ec3m m\u00f4 c\u01a1 tim th\u1ea5t ph\u1ea3i \u0111\u01b0\u1ee3c thay th\u1ebf b\u1eb1ng m\u00f4 s\u1ee3i – m\u1ee1, l\u00e0 ti\u1ec1n \u0111\u1ec1 cho c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y t\u1eed vong.<\/strong><\/p>\n

\"B\u1ec7nh<\/p>\n

B\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i g\u00e2y r\u1ed1i lo\u1ea1n nh\u1ecbp<\/strong><\/p>\n

1.\u0110\u1ecbnh ngh\u0129a<\/h2>\n

B\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i g\u00e2y r\u1ed1i lo\u1ea1n nh\u1ecbp (ARVC) l\u00e0 b\u1ea5t th\u01b0\u1eddng tim c\u00f3 t\u00ednh di truy\u1ec1n v\u1edbi \u0111\u1eb7c \u0111i\u1ec3m m\u00f4 c\u01a1 tim th\u1ea5t ph\u1ea3i \u0111\u01b0\u1ee3c thay th\u1ebf b\u1eb1ng m\u00f4 s\u1ee3i – m\u1ee1, l\u00e0 ti\u1ec1n \u0111\u1ec1 cho c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y t\u1eed vong. C\u00e1c b\u1ea5t th\u01b0\u1eddng n\u00e0y ti\u1ebfn tri\u1ec3n g\u00e2y gi\u00e3n th\u1ea5t ph\u1ea3i v\u00e0 suy th\u1ea5t ph\u1ea3i. Trong m\u1ed9t v\u00e0i tr\u01b0\u1eddng h\u1ee3p, th\u1ea5t tr\u00e1i c\u0169ng b\u1ecb \u1ea3nh h\u01b0\u1edfng, bi\u1ec3u hi\u1ec7n tr\u00ean l\u00e2m s\u00e0ng l\u00e0 t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd th\u1ea5t tr\u00e1i \u0111\u01a1n \u0111\u1ed9c. T\u1ef7 l\u1ec7 b\u1ec7nh g\u1eb7p v\u00e0o kho\u1ea3ng t\u1eeb 1\/2000 t\u1edbi 1\/5000.<\/p>\n

2.Ch\u1ea9n \u0111o\u00e1n<\/h2>\n

Ch\u1ea9n \u0111o\u00e1n c\u00e1c c\u00e1 th\u1ec3 m\u1eafc b\u1ec7nh c\u00f3 th\u1ec3 r\u1ea5t kh\u00f3 kh\u0103n, \u0111\u1eb7c bi\u1ec7t khi s\u00e0ng l\u1ecdc c\u00e1c tr\u01b0\u1eddng h\u1ee3p m\u1eafc b\u1ec7nh c\u00f3 t\u00ednh ch\u1ea5t gia \u0111\u00ecnh, v\u00ec c\u00e1c th\u0103m d\u00f2 kh\u00f4ng x\u00e2m l\u1ea5n c\u00f3 \u0111\u1ed9 nh\u1ea1y th\u1ea5p.<\/p>\n

C\u00e1c ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n d\u1ef1a v\u00e0o tri\u1ec7u ch\u1ee9ng, ti\u1ec1n s\u1eed gia \u0111\u00ecnh c\u00f3 ng\u01b0\u1eddi m\u1eafc b\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i sinh r\u1ed1i lo\u1ea1n nh\u1ecbp, \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 b\u1ea5t th\u01b0\u1eddng v\u00e0 c\u00e1c bi\u1ebfn \u0111\u1ed5i c\u1ea5u tr\u00fac khi th\u0103m d\u00f2 h\u00ecnh th\u00e1i th\u1ea5t ph\u1ea3i.<\/p>\n

Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh khi c\u00f3 2 ti\u00eau chu\u1ea9n ch\u00ednh; ho\u1eb7c 1 ti\u00eau chu\u1ea9n ch\u00ednh v\u00e0 2 ti\u00eau chu\u1ea9n ph\u1ee5; ho\u1eb7c 4 ti\u00eau chu\u1ea9n ph\u1ee5 (theo ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n Task Force)<\/strong><\/p>\n

Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n B\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i sinh r\u1ed1i lo\u1ea1n nh\u1ecbp<\/p>\n\n\n\n\n\n\n
Ti\u00eau chu\u1ea9n g\u1ed1c<\/strong><\/td>\nTi\u00eau chu\u1ea9n s\u1eeda \u0111\u1ed5i<\/strong><\/td>\n<\/tr>\n
I. R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng khu tr\u00fa\/to\u00e0n b\u1ed9 v\u00e0 bi\u1ebfn \u0111\u1ed5i c\u1ea5u tr\u00fac<\/strong><\/td>\n<\/tr>\n
Ti\u00eau chu\u1ea9n ch\u00ednh.<\/em><\/strong><\/td>\n<\/tr>\n
–\u00a0 Bu\u1ed3ng th\u1ea5t ph\u1ea3i gi\u00e3n nhi\u1ec1u, ch\u1ee9c n\u0103ng co b\u00f3p th\u1ea5t ph\u1ea3i gi\u1ea3m nhi\u1ec1u; ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i kh\u00f4ng gi\u1ea3m ho\u1eb7c gi\u1ea3m nh\u1eb9.<\/p>\n

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

–\u00a0 Ph\u00ecnh th\u1ea5t ph\u1ea3i khu tr\u00fa (v\u00f9ng kh\u00f4ng v\u1eadn \u0111\u1ed9ng ho\u1eb7c gi\u1ea3m v\u1eadn \u0111\u1ed9ng ph\u00ecnh ra trong th\u00ec t\u00e2m tr\u01b0\u01a1ng.<\/td>\n

Si\u00eau \u00e2m tim 2D<\/strong>:<\/p>\n

–\u00a0 M\u1ea5t v\u1eadn \u0111\u1ed9ng, gi\u1ea3m v\u1eadn \u0111\u1ed9ng v\u00f9ng ho\u1eb7c ph\u00ecnh th\u1ea5t ph\u1ea3i<\/p>\n

–\u00a0 v\u00e0 1 trong s\u1ed1 c\u00e1c d\u1ea5u hi\u1ec7u sau (cu\u1ed1i t\u00e2m<\/p>\n

tr\u01b0\u01a1ng):<\/p>\n

*\u0110K \u0110RTP tr\u1ee5c d\u1ecdc >32 mm (\/BSA >19 mm\/m 2 )<\/em><\/p>\n

*\u0110K \u0110RTP tr\u1ee5c ng\u1eafn >36 mm (\/BSA > 21 mm\/m2)<\/em><\/p>\n

*FAC \u2264 33%<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n\n\n\n\n\n\n\n\n\n
<\/td>\nMRI tim<\/strong>:<\/p>\n

–\u00a0 Kh\u00f4ng v\u1eadn \u0111\u1ed9ng ho\u1eb7c gi\u1ea3m v\u1eadn \u0111\u1ed9ng v\u00f9ng th\u1ea5t ph\u1ea3i ho\u1eb7c th\u1ea5t ph\u1ea3i co b\u00f3p kh\u00f4ng \u0111\u1ed3ng b\u1ed9<\/p>\n

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

–\u00a0 v\u00e0 1 trong s\u1ed1 c\u00e1c d\u1ea5u hi\u1ec7u sau:<\/p>\n

* Th\u1ec3 t\u00edch th\u1ea5t ph\u1ea3i cu\u1ed1i t\u00e2m tr\u01b0\u01a1ng\/BSA > 110 mL\/m 2 (nam gi\u1edbi) ho\u1eb7c > 100 mL\/m 2 (n\u1eef gi\u1edbi)<\/em><\/p>\n

* FAC \u2264 40%<\/em><\/p>\n

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

Ch\u1ee5p bu\u1ed3ng th\u1ea5t ph\u1ea3i<\/strong>:<\/p>\n

– M\u1ea5t v\u1eadn \u0111\u1ed9ng, gi\u1ea3m v\u1eadn \u0111\u1ed9ng v\u00f9ng ho\u1eb7c ph\u00ecnh th\u1ea5t ph\u1ea3i<\/td>\n<\/tr>\n

Ti\u00eau chu\u1ea9n ph\u1ee5<\/em><\/strong><\/td>\n<\/tr>\n
\u00a0<\/strong><\/p>\n

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

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

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

–\u00a0 Gi\u00e3n nh\u1eb9 to\u00e0n b\u1ed9 th\u1ea5t ph\u1ea3i v\u00e0\/ho\u1eb7c gi\u1ea3m ch\u1ee9c n\u0103ng co b\u00f3p th\u1ea5t ph\u1ea3i v\u1edbi th\u1ea5t tr\u00e1i b\u00ecnh<\/p>\n

th\u01b0\u1eddng<\/p>\n

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

–\u00a0 Gi\u00e3n nh\u1eb9 t\u1eebng \u0111o\u1ea1n th\u1ea5t ph\u1ea3i.<\/p>\n

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

–\u00a0 Gi\u1ea3m v\u1eadn \u0111\u1ed9ng v\u00f9ng th\u1ea5t ph\u1ea3i.<\/td>\n

Si\u00eau \u00e2m tim 2D:<\/p>\n

–\u00a0\u00a0 Kh\u00f4ng v\u1eadn \u0111\u1ed9ng, gi\u1ea3m v\u1eadn \u0111\u1ed9ng v\u00f9ng th\u1ea5t ph\u1ea3i<\/p>\n

–\u00a0\u00a0 v\u00e0 1 trong s\u1ed1 c\u00e1c d\u1ea5u hi\u1ec7u sau (cu\u1ed1i t\u00e2m tr\u01b0\u01a1ng):<\/p>\n

*\u00a0\u00a0 \u0110K \u0110RTP tr\u1ee5c d\u1ecdc: 29 – 32 mm (\/BSA: 16 – 19 mm\/m 2 )<\/em><\/p>\n

*\u00a0\u00a0 \u0110K \u0110RTP tr\u1ee5c ng\u1eafn: 32 – 36 mm (\/BSA: 18 – 21 mm\/m2)<\/em><\/p>\n

* FAC > 33 \u0111\u1ebfn \u2264 40%<\/em><\/p>\n

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

C\u1ed9ng h\u01b0\u1edfng t\u1eeb tim:<\/p>\n

–\u00a0 Kh\u00f4ng v\u1eadn \u0111\u1ed9ng ho\u1eb7c gi\u1ea3m v\u1eadn \u0111\u1ed9ng v\u00f9ng th\u1ea5t ph\u1ea3i ho\u1eb7c<\/p>\n

th\u1ea5t ph\u1ea3i co b\u00f3p kh\u00f4ng \u0111\u1ed3ng b\u1ed9<\/p>\n

–\u00a0 v\u00e0 1 trong s\u1ed1 c\u00e1c d\u1ea5u hi\u1ec7u sau:<\/p>\n

* Th\u1ec3 t\u00edch th\u1ea5t ph\u1ea3i cu\u1ed1i t\u00e2m tr\u01b0\u01a1ng\/BSA: 100 – 110 mL\/m2 (nam gi\u1edbi) ho\u1eb7c 90 – 100 mL\/m 2 (n\u1eef gi\u1edbi)<\/em><\/p>\n

* FAC > 40 \u0111\u1ebfn \u2264 45%<\/em><\/td>\n<\/tr>\n

II. T\u00ednh ch\u1ea5t m\u00f4 c\u01a1 tim<\/strong><\/td>\n<\/tr>\n
Ti\u00eau chu\u1ea9n ch\u00ednh<\/em><\/strong><\/td>\n<\/tr>\n
– Sinh thi\u1ebft c\u01a1 tim: Th\u00e2m nhi\u1ec5m m\u00f4 s\u1ee3i-m\u1ee1 thay th\u1ebf m\u00f4 c\u01a1 tim<\/td>\n– Ph\u00e2n t\u00edch h\u00ecnh th\u00e1i h\u1ecdc: M\u00f4 c\u01a1 tim c\u00f2n ch\u00edm<\/p>\n

<60% (ho\u1eb7c <50% n\u1ebfu l\u00e0 \u01b0\u1edbc t\u00ednh), th\u00e2m nhi\u1ec5m m\u00f4 s\u1ee3i – m\u1ee1 thay th\u1ebf m\u00f4 c\u01a1 tim th\u00e0nh t\u1ef1 do th\u1ea5t ph\u1ea3i \u1edf > 1 m\u0201u b\u1ec7nh ph\u1ea9m; c\u00f3\/kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng th\u00e2m nhi\u1ec5m m\u00f4 s\u1ee3i – m\u1ee1 tr\u00ean sinh thi\u1ebft m\u00f4 c\u01a1 tim.<\/td>\n<\/tr>\n

Ti\u00eau chu\u1ea9n ph\u1ee5<\/em><\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
<\/td>\n– Ph\u00e2n t\u00edch h\u00ecnh th\u00e1i h\u1ecdc: M\u00f4 c\u01a1 tim c\u00f2n chi\u1ebfm 60 – 75% (ho\u1eb7c < 65% n\u1ebfu l\u00e0 \u01b0\u1edbc t\u00ednh), th\u00e2m nhi\u1ec5m m\u00f4 s\u1ee3i – m\u1ee1 thay th\u1ebf m\u00f4 c\u01a1 tim th\u00e0nh t\u1ef1 do th\u1ea5t ph\u1ea3i \u1edf > 1 m\u0201u b\u1ec7nh ph\u1ea9m; c\u00f3\/kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng th\u00e2m nhi\u1ec5m m\u00f4 s\u1ee3i – m\u1ee1 tr\u00ean sinh thi\u1ebft m\u00f4 c\u01a1 tim.<\/td>\n<\/tr>\n
II. B\u1ea5t th\u01b0\u1eddng t\u00e1i c\u1ef1c<\/strong><\/td>\n<\/tr>\n
Ti\u00eau chu\u1ea9n ch\u00ednh<\/em><\/strong><\/td>\n<\/tr>\n
<\/td>\n– S\u00f3ng T \u0111\u1ea3o ng\u01b0\u1ee3c \u1edf c\u00e1c chuy\u1ec3n \u0111\u1ea1o tr\u01b0\u1edbc tim ph\u1ea3i (V1 – V3) ho\u1eb7c c\u00e1c chuy\u1ec3n \u0111\u1ea1o V4 – V6 \u1edf ng\u01b0\u1eddi<\/p>\n

> 14 tu\u1ed5i (kh\u00f4ng k\u00e8m block nh\u00e1nh ph\u1ea3i ho\u00e0n to\u00e0n QRS > 120 ms)<\/td>\n<\/tr>\n

Ti\u00eau chu\u1ea9n ph\u1ee5<\/em><\/strong><\/td>\n<\/tr>\n
– S\u00f3ng T \u0111\u1ea3o ng\u01b0\u1ee3c \u1edf c\u00e1c chuy\u1ec3n \u0111\u1ea1o tr\u01b0\u1edbc tim ph\u1ea3i (V2 v\u00e0 V3) (ng\u01b0\u1eddi > 12 tu\u1ed5i, kh\u00f4ng k\u00e8m block nh\u00e1nh ph\u1ea3i).<\/td>\n–\u00a0\u00a0 S\u00f3ng T \u0111\u1ea3o ng\u01b0\u1ee3c \u1edf c\u00e1c chuy\u1ec3n \u0111\u1ea1o V1 v\u00e0 V2 \u1edf ng\u01b0\u1eddi > 14 tu\u1ed5i (kh\u00f4ng k\u00e8m block nh\u00e1nh ph\u1ea3i ho\u00e0n to\u00e0n) ho\u1eb7c \u1edf c\u00e1c chuy\u1ec3n \u0111\u1ea1o V4 – V6.<\/p>\n

–\u00a0\u00a0\u00a0 S\u00f3ng T \u0111\u1ea3o ng\u01b0\u1ee3c \u1edf c\u00e1c chuy\u1ec3n \u0111\u1ea1o V1 – V4 \u1edf ng\u01b0\u1eddi > 14 tu\u1ed5i c\u00f3 k\u00e8m block nh\u00e1nh ph\u1ea3i ho\u00e0n to\u00e0n.<\/td>\n<\/tr>\n

IV. B\u1ea5t th\u01b0\u1eddng kh\u1eed c\u1ef1c\/ d\u1eabn truy\u1ec1n<\/strong><\/td>\n<\/tr>\n
Ti\u00eau chu\u1ea9n ch\u00ednh<\/em><\/strong><\/td>\n<\/tr>\n
\u00a0<\/strong><\/p>\n

– S\u00f3ng Epsilon ho\u1eb7c QRS k\u00e9o d\u00e0i<\/p>\n

> 110 ms khu tr\u00fa \u1edf c\u00e1c chuy\u1ec3n<\/p>\n

\u0111\u1ea1o tr\u01b0\u1edbc tim ph\u1ea3i (V1 v\u00e0 V2)<\/td>\n

– S\u00f3ng Epsilon (s\u00f3ng \u0111i\u1ec7n th\u1ebf th\u1ea5p xu\u1ea5t hi\u1ec7n \u1edf kho\u1ea3ng gi\u1eefa k\u1ebft th\u00fac ph\u1ee9c b\u1ed9 QRS t\u1edbi \u0111i\u1ec3m b\u1eaft \u0111\u1ea7u c\u1ee7a s\u00f3ng T) \u1edf c\u00e1c chuy\u1ec3n \u0111\u1ea1o tr\u01b0\u1edbc tim ph\u1ea3i (V1 – V3)<\/td>\n<\/tr>\n
Ti\u00eau chu\u1ea9n ph\u1ee5<\/em><\/strong><\/td>\n<\/tr>\n
– \u0110i\u1ec7n t\u00e2m \u0111\u1ed3 t\u00edn hi\u1ec7u trung<\/p>\n

b\u00ecnh: \u0110i\u1ec7n th\u1ebf tr\u1ec5<\/td>\n

–\u00a0\u00a0\u00a0\u00a0 N\u1ebfu ph\u1ee9c b\u1ed9 QRS < 110 ms \u1edf \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 th\u01b0\u1eddng, \u0111\u00e1nh gi\u00e1 \u0111i\u1ec7n th\u1ebf tr\u1ec5 tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 t\u00edn hi\u1ec7u trung b\u00ecnh th\u1ecfa m\u00e3n > 2\/3 ti\u00eau chu\u1ea9n sau:<\/p>\n

–\u00a0 fQRS (QRS ph\u00e2n \u0111o\u1ea1n) > 114 ms.<\/p>\n

–\u00a0\u00a0\u00a0 Th\u1eddi gian \u0111i\u1ec7n th\u1ebf th\u1ea5p c\u1ee7a ph\u1ee9c b\u1ed9 QRS (\u0111i\u1ec7n th\u1ebf < 40 pV) > 38 ms.<\/p>\n

–\u00a0\u00a0 Gi\u00e1 tr\u1ecb hi\u1ec7u d\u1ee5ng c\u1ee7a \u0111i\u1ec7n th\u1ec3 \u1edf 40 ms cu\u1ed1i c\u1ee7a<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
<\/td>\nph\u1ee9c b\u1ed9 QRS < 20 gV.<\/p>\n

– Th\u1eddi gian k\u1ebft th\u00fac ho\u1ea1t \u0111\u1ed9ng c\u1ee7a ph\u1ee9c b\u1ed9 QRS > 55 ms (\u0111o t\u1eeb \u0111i\u1ec3m th\u1ea5p nh\u1ea5t c\u1ee7a s\u00f3ng S \u0111\u1ebfn cu\u1ed1i ph\u1ee9c b\u1ed9 QRS, bao g\u1ed3m c\u1ea3 s\u00f3ng R’, \u1edf chuy\u1ec3n \u0111\u1ea1o V1, V2 ho\u1eb7c V3, trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 block nh\u00e1nh ph\u1ea3i ho\u00e0n to\u00e0n).<\/td>\n<\/tr>\n

V. R\u1ed1i lo\u1ea1n nh\u1ecbp<\/strong><\/td>\n<\/tr>\n
Ti\u00eau chu\u1ea9n ch\u00ednh<\/em><\/strong><\/td>\n<\/tr>\n
<\/td>\n– Nh\u1ecbp nhanh th\u1ea5t b\u1ec1n b\u1ec9 ho\u1eb7c kh\u00f4ng b\u1ec1n b\u1ec9 v\u1edbi d\u1ea1ng block nh\u00e1nh tr\u00e1i, tr\u1ee5c h\u01b0\u1edbng l\u00ean tr\u00ean (QRS \u00e2m ho\u1eb7c kh\u00f4ng x\u00e1c \u0111\u1ecbnh \u1edf chuy\u1ec3n \u0111\u1ea1o DII, DIII, aVF v\u00e0 d\u01b0\u01a1ng \u1edf chuy\u1ec3n \u0111\u1ea1o aVL).<\/td>\n<\/tr>\n
Ti\u00eau chu\u1ea9n ph\u1ee5<\/em><\/strong><\/td>\n<\/tr>\n
–\u00a0\u00a0\u00a0\u00a0 Nh\u1ecbp nhanh th\u1ea5t d\u1ea1ng block nh\u00e1nh tr\u00e1i (b\u1ec1n b\u1ec9 ho\u1eb7c kh\u00f4ng b\u1ec1n b\u1ec9) tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3, holter \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 ho\u1eb7c test g\u1eafng s\u1ee9c<\/p>\n

–\u00a0\u00a0\u00a0\u00a0 Ngo\u1ea1i t\u00e2m thu th\u1ea5t m\u1ee9c \u0111\u1ed9 nhi\u1ec1u (> 1.000\/24 gi\u1edd tr\u00ean holter \u0111i\u1ec7n t\u00e2m \u0111\u1ed3).<\/td>\n

–\u00a0\u00a0\u00a0 Nh\u1ecbp nhanh th\u1ea5t kh\u00f4ng b\u1ec1n b\u1ec9 ho\u1eb7c b\u1ec1n b\u1ec9 kh\u1edfi ph\u00e1t v\u1ecb tr\u00ed \u0111\u01b0\u1eddng ra th\u1ea5t ph\u1ea3i, d\u1ea1ng block nh\u00e1nh tr\u00e1i, tr\u1ee5c h\u01b0\u1edbng xu\u1ed1ng d\u01b0\u1edbi (QRS d\u01b0\u01a1ng \u1edf chuy\u1ec3n \u0111\u1ea1o DII, DIII, aVF v\u00e0 \u00e2m \u1edf chuy\u1ec3n \u0111\u1ea1o aVL) ho\u1eb7c tr\u1ee5c kh\u00f4ng x\u00e1c \u0111\u1ecbnh.<\/p>\n

–\u00a0\u00a0 > 500 ngo\u1ea1i t\u00e2m thu th\u1ea5t\/24 gi\u1edd tr\u00ean Holter \u0111i\u1ec7n t\u00e2m \u0111\u1ed3.<\/td>\n<\/tr>\n

VI. Ti\u1ec1n s\u1eed gia \u0111\u00ecnh<\/strong><\/td>\n<\/tr>\n
Ti\u00eau chu\u1ea9n ch\u00ednh<\/em><\/strong><\/td>\n<\/tr>\n
– B\u1ec7nh gia \u0111\u00ecnh \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh b\u1eb1ng sinh thi\u1ebft c\u01a1 tim ho\u1eb7c ph\u0201u thu\u1eadt.<\/td>\n–\u00a0\u00a0\u00a0 B\u1ec7nh \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u1edf h\u1ecd h\u00e0ng b\u1eadc 1 v\u1edbi ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n n\u00e0y<\/p>\n

–\u00a0\u00a0\u00a0 B\u1ec7nh ch\u1ea9n \u0111o\u00e1n kh\u1eb3ng \u0111\u1ecbnh b\u1eb1ng sinh thi\u1ebft c\u01a1<\/p>\n

tim ho\u1eb7c ph\u0201u thu\u1eadt<\/p>\n

–\u00a0\u00a0 C\u00e1c \u0111\u1ecbnh \u0111\u1ed9t bi\u1ebfn gen c\u00f3 li\u00ean quan \u0111\u1ebfn b\u1ec7nh c\u01a1<\/p>\n

tim th\u1ea5t ph\u1ea3i sinh r\u1ed1i lo\u1ea1n nh\u1ecbp.<\/td>\n<\/tr>\n

Ti\u00eau chu\u1ea9n ph\u1ee5<\/em><\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n\n\n\n
–\u00a0\u00a0 Ti\u1ec1n s\u1eed gia \u0111\u00ecnh c\u00f3 \u0111\u1ed9t t\u1eed s\u1edbm (< 35 tu\u1ed5i) do nghi ng\u1edd b\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i sinh r\u1ed1i lo\u1ea1n nh\u1ecbp<\/p>\n

–\u00a0\u00a0 Ti\u1ec1n s\u1eed gia \u0111\u00ecnh (d\u1ef1a v\u00e0o ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng theo ti\u00eau chu\u1ea9n n\u00e0y).<\/td>\n

–\u00a0\u00a0 Ti\u1ec1n s\u1eed b\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i sinh r\u1ed1i lo\u1ea1n nh\u1ecbp<\/p>\n

kh\u00f4ng \u0111\u1ee7 \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh<\/p>\n

–\u00a0\u00a0 \u0110\u1ed9t t\u1eed s\u1edbm (< 35 tu\u1ed5i) do nghi ng\u1edd b\u1ec7nh c\u01a1 tim<\/p>\n

th\u1ea5t ph\u1ea3i sinh r\u1ed1i lo\u1ea1n nh\u1ecbp \u1edf h\u1ecd h\u00e0ng b\u1eadc 1<\/p>\n

–\u00a0\u00a0\u00a0 B\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i sinh r\u1ed1i lo\u1ea1n nh\u1ecbp kh\u1eb3ng \u0111\u1ecbnh b\u1eb1ng gi\u1ea3i ph\u0201u b\u1ec7nh ho\u1eb7c ti\u00eau chu\u1ea9n n\u00e0y \u1edf h\u1ecd h\u00e0ng b\u1eadc 2.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Ch\u00fa th\u00edch:<\/u><\/em> \u0110K \u0110RTP: \u0110\u01b0\u1eddng k\u00ednh \u0111\u01b0\u1eddng ra th\u1ea5t ph\u1ea3i, FAC: Ph\u00e2n s\u1ed1 di\u1ec7n t\u00edch th\u1ea5t ph\u1ea3i; BSA: Di\u1ec7n t\u00edch b\u1ec1 m\u1eb7t c\u01a1 th\u1ec3.<\/em><\/p>\n

\u00a0<\/em>Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n theo ti\u00eau chu\u1ea9n g\u1ed1c:<\/p>\n

Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh khi c\u00f3 2 ti\u00eau chu\u1ea9n ch\u00ednh, ho\u1eb7c 1 ti\u00eau chu\u1ea9n ch\u00ednh v\u00e0 2 ti\u00eau chu\u1ea9n ph\u1ee5, ho\u1eb7c 4 ti\u00eau chu\u1ea9n ph\u1ee5 t\u1eeb c\u00e1c nh\u00f3m tri\u1ec7u ch\u1ee9ng kh\u00e1c nhau.<\/p>\n

Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n theo ti\u00eau chu\u1ea9n s\u1eeda \u0111\u1ed5i:<\/p>\n

Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh khi c\u00f3 2 ti\u00eau chu\u1ea9n ch\u00ednh, ho\u1eb7c 1 ti\u00eau chu\u1ea9n ch\u00ednh v\u00e0 2 ti\u00eau chu\u1ea9n ph\u1ee5, ho\u1eb7c 4 ti\u00eau chu\u1ea9n ph\u1ee5 t\u1eeb c\u00e1c nh\u00f3m tri\u1ec7u ch\u1ee9ng kh\u00e1c nhau<\/p>\n

Ranh gi\u1edbi: 1 ti\u00eau chu\u1ea9n ch\u00ednh v\u00e0 1 ti\u00eau chu\u1ea9n ph\u1ee5 ho\u1eb7c 3 ti\u00eau chu\u1ea9n ph\u1ee5 t\u1eeb c\u00e1c nh\u00f3m tri\u1ec7u ch\u1ee9ng kh\u00e1c nhau<\/p>\n

Kh\u1ea3 n\u0103ng m\u1eafc b\u1ec7nh: 1 ti\u00eau chu\u1ea9n ch\u00ednh ho\u1eb7c 2 ti\u00eau chu\u1ea9n ph\u1ee5 t\u1eeb c\u00e1c nh\u00f3m tri\u1ec7u ch\u1ee9ng kh\u00e1c nhau.<\/p>\n

3. Ph\u00e2n t\u1ea7ng nguy c\u01a1<\/h2>\n

M\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 gi\u00fap b\u00e1c s\u0129 l\u00e2m s\u00e0ng \u0111\u00e1nh gi\u00e1 v\u00e0 ph\u00e2n t\u1ea7ng nguy c\u01a1 \u0111\u1ed9t t\u1eed \u1edf b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i do lo\u1ea1n nh\u1ecbp: Sau c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n<\/p>\n

Ng\u1ea5t kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n ho\u1eb7c \u0111\u01b0\u1ee3c cho l\u00e0 do r\u1ed1i lo\u1ea1n nh\u1ecbp.<\/p>\n

R\u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t: C\u01a1n nh\u1ecbp nhanh th\u1ea5t b\u1ec1n b\u1ec9, c\u01a1n nh\u1ecbp nhanh th\u1ea5t kh\u00f4ng b\u1ec1n b\u1ec9, nhi\u1ec1u h\u01a1n 1000 ngo\u1ea1i t\u00e2m thu th\u1ea5t khi theo d\u00f5i b\u1eb1ng Holter \u0111i\u1ec7n t\u00e2m \u0111\u1ed3.<\/p>\n

Th\u0103m d\u00f2 \u0111i\u1ec7n sinh l\u00fd g\u00e2y \u0111\u01b0\u1ee3c c\u00e1c c\u01a1n nh\u1ecbp nhanh th\u1ea5t. Suy ch\u1ee9c n\u0103ng th\u1ea5t ph\u1ea3i ho\u1eb7c th\u1ea5t tr\u00e1i t\u1eeb v\u1eeba \u0111\u1ebfn n\u1eb7ng. C\u00f3 t\u1eeb 2 b\u1ec7nh li\u00ean quan \u0111\u1ebfn \u0111\u1ed9t bi\u1ebfn gen tr\u1edf l\u00ean \u0111i k\u00e8m. Ng\u01b0\u1eddi \u0111\u1ea7u ti\u00ean trong th\u1ebf h\u1ec7 gia \u0111\u00ecnh m\u1eafc b\u1ec7nh.<\/p>\n

Gi\u1edbi t\u00ednh nam.<\/p>\n","protected":false},"excerpt":{"rendered":"

B\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i g\u00e2y r\u1ed1i lo\u1ea1n nh\u1ecbp (ARVC) l\u00e0 b\u1ea5t th\u01b0\u1eddng tim c\u00f3 t\u00ednh di truy\u1ec1n v\u1edbi \u0111\u1eb7c \u0111i\u1ec3m m\u00f4 c\u01a1 tim th\u1ea5t ph\u1ea3i \u0111\u01b0\u1ee3c thay th\u1ebf b\u1eb1ng m\u00f4 s\u1ee3i – m\u1ee1, l\u00e0 ti\u1ec1n \u0111\u1ec1 cho c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y t\u1eed vong. B\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i g\u00e2y […]<\/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":"\nCh\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i g\u00e2y r\u1ed1i lo\u1ea1n nh\u1ecbp - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i g\u00e2y r\u1ed1i lo\u1ea1n nh\u1ecbp c\u00f3 t\u00ednh di truy\u1ec1n v\u1edbi \u0111\u1eb7c \u0111i\u1ec3m m\u00f4 c\u01a1 tim th\u1ea5t ph\u1ea3i thay th\u1ebf b\u1eb1ng m\u00f4 s\u1ee3i - m\u1ee1, c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y t\u1eed vong.\" \/>\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 b\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i g\u00e2y r\u1ed1i lo\u1ea1n nh\u1ecbp - 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