{"id":30183,"date":"2023-05-01T22:48:01","date_gmt":"2023-05-01T15:48:01","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30183"},"modified":"2023-05-01T22:48:01","modified_gmt":"2023-05-01T15:48:01","slug":"benh-co-tim-chu-san-va-loan-duong-co","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-co-tim-chu-san-va-loan-duong-co\/","title":{"rendered":"B\u1ec7nh c\u01a1 tim chu s\u1ea3n v\u00e0 lo\u1ea1n d\u01b0\u1ee1ng c\u01a1"},"content":{"rendered":"

B\u1ec7nh c\u01a1 tim chu s\u1ea3n<\/a> (BCTCS), c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 b\u1ec7nh c\u01a1 tim li\u00ean quan \u0111\u1ebfn thai k\u1ef3, l\u00e0 m\u1ed9t nguy\u00ean nh\u00e2n \u00edt g\u1eb7p g\u00e2y ra suy tim \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1ee5 n\u1eef v\u00e0o cu\u1ed1i thai k\u1ef3 ho\u1eb7c trong giai \u0111o\u1ea1n s\u1edbm sau h\u1eadu s\u1ea3n.Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 l\u00e0 m\u1ed9t nh\u00f3m c\u00e1c b\u1ec7nh l\u00fd r\u1ed1i lo\u1ea1n c\u01a1 c\u00f3 kh\u1ea3 n\u0103ng di truy\u1ec1n g\u00e2y y\u1ebfu c\u01a1 ti\u1ebfn tri\u1ec3n tr\u00ean c\u01a1 th\u1ec3 ng\u01b0\u1eddi. C\u00f3 h\u01a1n 100 t\u00ecnh tr\u1ea1ng li\u00ean quan \u0111\u1ebfn lo\u1ea1n d\u01b0\u1ee1ng c\u01a1.<\/strong><\/p>\n

1. B\u1ec7nh c\u01a1 tim chu s\u1ea3n<\/h2>\n

1.1 \u0110\u1ecbnh ngh\u0129a v\u00e0 nguy\u00ean nh\u00e2n<\/h3>\n

B\u1ec7nh c\u01a1 tim chu s\u1ea3n (BCTCS), c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 b\u1ec7nh c\u01a1 tim li\u00ean quan \u0111\u1ebfn thai k\u1ef3, l\u00e0 m\u1ed9t nguy\u00ean nh\u00e2n \u00edt g\u1eb7p g\u00e2y ra suy tim \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1ee5 n\u1eef v\u00e0o cu\u1ed1i thai k\u1ef3 ho\u1eb7c trong giai \u0111o\u1ea1n s\u1edbm sau h\u1eadu s\u1ea3n.<\/p>\n

Nh\u00f3m Working Group ESC 2010 \u0111\u00e3 \u0111\u1ecbnh ngh\u0129a BCTCS l\u00e0 m\u1ed9t b\u1ec7nh c\u01a1 tim v\u00f4 c\u0103n <\/strong>v\u1edbi c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m sau:<\/p>\n

    \n
  • Xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng suy tim trong th\u00e1ng cu\u1ed1i thai k\u1ef3 ho\u1eb7c trong v\u00f2ng 5 th\u00e1ng sau khi sinh.\u00a0<\/strong><\/li>\n
  • Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng c\u1ee7a suy tim tr\u01b0\u1edbc \u0111\u00f3.<\/li>\n
  • Kh\u00f4ng c\u00f3 m\u1ed9t nguy\u00ean nh\u00e2n x\u00e1c \u0111\u1ecbnh kh\u00e1c cho suy tim.<\/li>\n
  • R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i (LV) v\u1edbi ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u (LVEF) d\u01b0\u1edbi 45%. Th\u1ea5t tr\u00e1i c\u00f3 th\u1ec3 gi\u00e3n ho\u1eb7c kh\u00f4ng.<\/li>\n<\/ul>\n

    M\u1eb7c d\u00f9 nguy\u00ean nh\u00e2n c\u1ee7a BCTCS v\u0201n ch\u01b0a r\u00f5 r\u00e0ng, th\u01b0\u1eddng do r\u1ea5t nhi\u1ec1u y\u1ebfu t\u1ed1 b\u1ec7nh sinh k\u1ebft h\u1ee3p v\u1edbi nhau, nh\u01b0ng sau \u0111\u00e2y l\u00e0 m\u1ed9t trong nh\u1eefng y\u1ebfu t\u1ed1 li\u00ean quan \u0111\u1ebfn t\u0103ng nguy c\u01a1 BCTCS:<\/p>\n

      \n
    • Tu\u1ed5i l\u1edbn h\u01a1n 30 n\u0103m<\/li>\n
    • Ng\u01b0\u1eddi Ch\u00e2u \u00c1 v\u00e0 ng\u01b0\u1eddi g\u1ed1c Phi<\/li>\n
    • \u0110a thai<\/li>\n
    • Ti\u1ec1n s\u1eed ti\u1ec1n s\u1ea3n gi\u1eadt, s\u1ea3n gi\u1eadt ho\u1eb7c t\u0103ng huy\u1ebft \u00e1p sau sinh L\u1ea1m d\u1ee5ng cocain<\/li>\n
    • \u0110i\u1ec1u tr\u1ecb thu\u1ed1c gi\u1ea3m co t\u1eed cung k\u00e9o d\u00e0i \u0111\u01b0\u1eddng u\u1ed1ng (> 4 tu\u1ea7n) v\u1edbi thu\u1ed1c \u0111\u1ed3ng v\u1eadn beta adrenergic nh\u01b0 terbutaline.<\/li>\n<\/ul>\n

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

      B\u1ec7nh c\u01a1 tim chu s\u1ea3n<\/strong><\/p>\n

       <\/p>\n

      1.2 Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/h3>\n

      Tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh c\u01a1 tim chu s\u1ea3n c\u0169ng bi\u1ec3u hi\u1ec7n gi\u1ed1ng nh\u01b0 trong c\u00e1c b\u1ec7nh c\u1ea3nh suy tim kh\u00e1c. B\u1ec7nh nh\u00e2n th\u01b0\u1eddng c\u00f3 bi\u1ec3u hi\u1ec7n m\u1ec7t m\u1ecfi, kh\u00f3 th\u1edf khi g\u1eafng s\u1ee9c, kh\u00f3 th\u1edf k\u1ecbch ph\u00e1t v\u1ec1 \u0111\u00eam, ph\u00f9 ch\u00e2n. Tuy nhi\u00ean nh\u1eefng tri\u1ec7u ch\u1ee9ng n\u00e0y d\u1ec5 b\u1ecb nh\u1ea7m l\u0201n \u0111\u1ed1i v\u1edbi nh\u1eefng bi\u1ec3u hi\u1ec7n th\u00f4ng th\u01b0\u1eddng kh\u00e1c khi b\u1ec7nh nh\u00e2n mang thai nh\u1eefng th\u00e1ng cu\u1ed1i, do \u0111\u00f3 c\u00f3 th\u1ec3 l\u00e0m vi\u1ec7c ch\u1ea9n \u0111o\u00e1n b\u1ecb ch\u1eadm tr\u1ec5.<\/p>\n

      Tri\u1ec7u ch\u1ee9ng thuy\u00ean t\u1eafc \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i v\u00e0 thuy\u00ean t\u1eafc m\u1ea1ch h\u1ec7 th\u1ed1ng c\u0169ng th\u01b0\u1eddng g\u1eb7p. \u0110\u1eb7c bi\u1ec7t trong tr\u01b0\u1eddng h\u1ee3p th\u1ea5t tr\u00e1i gi\u00e3n l\u1edbn, k\u00e8m theo ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i gi\u1ea3m < 35% l\u00e0 nh\u1eefng y\u1ebfu t\u1ed1 nguy c\u01a1 g\u00e2y huy\u1ebft kh\u1ed1i trong bu\u1ed3ng th\u1ea5t tr\u00e1i.<\/p>\n

      1.3 Ch\u1ea9n \u0111o\u00e1n<\/h3>\n

      Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u01a1 tim chu s\u1ea3n d\u1ef1a v\u00e0o \u0111\u1ecbnh ngh\u0129a c\u1ee7a b\u1ec7nh, g\u1ed3m 3 y\u1ebfu t\u1ed1 :<\/p>\n

        \n
      • Suy tim ti\u1ebfn tri\u1ec3n trong th\u00e1ng cu\u1ed1i thai k\u00ec ho\u1eb7c trong v\u00f2ng 5 th\u00e1ng sau khi sinh. Kh\u00f4ng c\u00f3 nguy\u00ean nh\u00e2n kh\u00e1c g\u00e2y suy tim.<\/li>\n
      • Ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i gi\u1ea3m, EF < 45%<\/li>\n<\/ul>\n

        1.4 \u0110i\u1ec1u tr\u1ecb<\/h3>\n

        M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb b\u1ec7nh c\u01a1 tim chu s\u1ea3n c\u0169ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 \u0111\u1ed1i v\u1edbi \u0111i\u1ec1u tr\u1ecb suy tim c\u1ea5p v\u00e0 suy tim m\u1ea1n t\u00ednh c\u00f3 gi\u1ea3m ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u, bao g\u1ed3m:<\/p>\n

          \n
        • Cung c\u1ea5p O2 v\u00e0 h\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p n\u1ebfu c\u1ea7n. T\u1ed1i \u01b0u ti\u1ec1n g\u00e1nh.<\/li>\n
        • H\u1ed7 tr\u1ee3 huy\u1ebft \u0111\u1ed9ng b\u1eb1ng c\u00e1c thu\u1ed1c v\u1eadn m\u1ea1ch.<\/li>\n
        • \u0110i\u1ec1u tr\u1ecb gi\u1ea3m tri\u1ec7u ch\u1ee9ng<\/li>\n
        • B\u1eaft \u0111\u1ea7u c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u k\u00e9o d\u00e0i gi\u00fap c\u1ea3i thi\u1ec7n ti\u00ean l\u01b0\u1ee3ng.<\/li>\n<\/ul>\n

          \u0110i\u1ec1u tr\u1ecb suy tim v\u1edbi c\u00e1c thi\u1ebft b\u1ecb h\u1ed7 tr\u1ee3 kh\u00e1c nh\u01b0 ICD hay CRT c\u1ea7n h\u1ebft s\u1ee9c c\u00e2n nh\u1eafc. Hi\u1ec7n nay ch\u01b0a c\u00f3 d\u1eef li\u1ec7u l\u00e2m s\u00e0ng \u1ee7ng h\u1ed9 c\u1ea5y c\u00e1c thi\u1ebft b\u1ecb n\u00e0y trong \u0111i\u1ec1u tr\u1ecb suy tim do b\u1ec7nh c\u01a1 tim chu s\u1ea3n th\u01b0\u1eddng quy, do kh\u1ea3 n\u0103ng ti\u1ec1m t\u00e0ng h\u1ed3i ph\u1ee5c ch\u1ee9c n\u0103ng tim sau n\u00e0y. M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u theo d\u00f5i cho th\u1ea5y ch\u1ee9c n\u0103ng tim c\u00f3 th\u1ec3 ph\u1ee5c h\u1ed3i v\u1ec1 b\u00ecnh th\u01b0\u1eddng sau 6 th\u00e1ng \u0111\u1ebfn 5 n\u0103m.<\/p>\n

          M\u1ed9t s\u1ed1 \u0111i\u1ec1u tr\u1ecb b\u1ed5 tr\u1ee3 kh\u00e1c nh\u01b0 c\u00e1c thu\u1ed1c ch\u1ed1ng r\u1ed1i lo\u1ea1n nh\u1ecbp, thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng d\u1ef1 ph\u00f2ng huy\u1ebft kh\u1ed1i, li\u1ec7u ph\u00e1p Bromocriptin, c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch, hay c\u00e1c globulin mi\u1ec5n d\u1ecbch kh\u00f4ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u01b0\u1eddng quy trong \u0111i\u1ec1u tr\u1ecb v\u00e0 c\u00f2n \u0111ang tranh c\u00e3i, ch\u1ec9 s\u1eed d\u1ee5ng \u1edf m\u1ed9t s\u1ed1 nh\u00f3m b\u1ec7nh nh\u00e2n nh\u1ea5t \u0111\u1ecbnh.<\/p>\n

          1.5 Ti\u00ean l\u01b0\u1ee3ng<\/h3>\n

          Kho\u1ea3ng m\u1ed9t n\u1eeda s\u1ed1 b\u1ec7nh nh\u00e2n s\u1ebd tr\u1edf v\u1ec1 b\u00ecnh th\u01b0\u1eddng ho\u1eb7c g\u1ea7n nh\u01b0 b\u00ecnh th\u01b0\u1eddng trong v\u00f2ng 6 th\u00e1ng \u0111\u1ea7u sau sinh. Ph\u1ea7n c\u00f2n l\u1ea1i, m\u1ed9t s\u1ed1 s\u1ebd ti\u1ebfp t\u1ee5c x\u1ea5u \u0111i v\u00e0 c\u00f3 th\u1ec3 d\u0201n \u0111\u1ebfn t\u1eed vong ho\u1eb7c c\u1ea7n gh\u00e9p tim, trong khi nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00e1c ti\u1ebfp t\u1ee5c tr\u1ea3i qua suy tim sung huy\u1ebft m\u1ea1n t\u00ednh.<\/p>\n

          2. Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1<\/h2>\n

          Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 l\u00e0 m\u1ed9t nh\u00f3m c\u00e1c b\u1ec7nh l\u00fd r\u1ed1i lo\u1ea1n c\u01a1 c\u00f3 kh\u1ea3 n\u0103ng di truy\u1ec1n g\u00e2y y\u1ebfu c\u01a1 ti\u1ebfn tri\u1ec3n tr\u00ean c\u01a1 th\u1ec3 ng\u01b0\u1eddi. C\u00f3 h\u01a1n 100 t\u00ecnh tr\u1ea1ng li\u00ean quan \u0111\u1ebfn lo\u1ea1n d\u01b0\u1ee1ng c\u01a1, nh\u01b0ng ch\u1ee7 y\u1ebfu bao g\u1ed3m lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 Duchenne v\u00e0 Becker, lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 th\u1eaft l\u01b0ng<\/p>\n

          – chi d\u01b0\u1edbi, lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 m\u1eb7t – b\u1ea3 vai – c\u00e1nh tay, c\u01a1 nh\u0201n h\u1ea7u – thanh qu\u1ea3n, c\u01a1 ngo\u1ea1i bi\u00ean, v\u00e0 Emery – Dreifuss.<\/p>\n

          Ph\u1ea7n l\u1edbn c\u00e1c lo\u1ea1i lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 l\u00e0 r\u1ed1i lo\u1ea1n h\u1ec7 th\u1ed1ng v\u1edbi \u1ea3nh h\u01b0\u1edfng l\u00ean c\u01a1 tr\u01a1n v\u00e0 c\u01a1 tim c\u0169ng nh\u01b0 c\u01a1 x\u01b0\u01a1ng. Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 c\u00f3 th\u1ec3 di truy\u1ec1n tr\u1ed9i tr\u00ean nhi\u1ec5m s\u1eafc th\u1ec3 th\u01b0\u1eddng, l\u1eb7n nhi\u1ec5m s\u1eafc th\u1ec3 th\u01b0\u1eddng ho\u1eb7c di truy\u1ec1n li\u00ean k\u1ebft tr\u00ean nhi\u1ec5m s\u1eafc th\u1ec3 X. B\u1ec7nh \u1ea3nh h\u01b0\u1edfng l\u00ean c\u01a1 tim v\u00e0 ch\u1ee7 y\u1ebfu l\u00e0 c\u00e1c m\u00f4 d\u0201n truy\u1ec1n, v\u00ec v\u1eady g\u00e2y ra r\u1ed1i lo\u1ea1n d\u0201n truy\u1ec1n nh\u0129 th\u1ea5t nhi\u1ec1u m\u1ee9c \u0111\u1ed9, r\u1ed1i lo\u1ea1n nh\u1ecbp nhanh v\u00e0 suy tim.<\/p>\n

          C\u00e1c tri\u1ec7u ch\u1ee9ng s\u1ebd r\u1ea5t kh\u00f3 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1, v\u00ec b\u1ec7nh nh\u00e2n b\u1ecb h\u1ea1n ch\u1ebf b\u1edfi t\u00ecnh tr\u1ea1ng khuy\u1ebft t\u1eadt tr\u1ea7m tr\u1ecdng. C\u1ea7n theo d\u00f5i \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 12 chuy\u1ec3n \u0111\u1ea1o v\u00e0 si\u00eau \u00e2m tim<\/u> <\/em>v\u00ec \u0111\u00e2y l\u00e0 hai c\u1eadn l\u00e2m s\u00e0ng r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh nh\u1eefng \u1ea3nh h\u01b0\u1edfng s\u1edbm l\u00ean tim. M\u1ed9t khi \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u01a1 tim, \u0111i\u1ec1u tr\u1ecb theo ph\u00e1c \u0111\u1ed3 suy tim v\u1edbi l\u1ee3i ti\u1ec3u, \u1ee9c ch\u1ebf men chuy\u1ec3n v\u00e0 ch\u1eb9n beta giao c\u1ea3m. C\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp v\u00e0 tri\u1ec7u ch\u1ee9ng c\u1ee7a suy tim m\u1ea1n t\u00ednh th\u1ee9 ph\u00e1t do b\u1ec7nh c\u01a1 tim gi\u00e3n l\u00e0 nguy\u00ean nh\u00e2n ch\u00ednh l\u00e0m n\u1eb7ng b\u1ec7nh v\u00e0 g\u00e2y t\u1eed vong trong c\u00e1c ca b\u1ec7nh c\u01a1 tim.<\/p>\n

          Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 Duchenne (DMD) v\u00e0 lo\u1ea1n d\u01b0\u1ee1ng Becker (BMD) <\/strong>l\u00e0 nh\u1eefng r\u1ed1i lo\u1ea1n c\u1ee7a gen m\u00e3 h\u00f3a protein dystrophin li\u00ean k\u1ebft v\u1edbi nhi\u1ec5m s\u1eafc th\u1ec3 X.<\/p>\n

          Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 Duchenne <\/strong>bi\u1ec3u hi\u1ec7n t\u1eeb nh\u1ecf v\u00e0 l\u00e0 ki\u1ec3u lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 di truy\u1ec1n ph\u1ed5 bi\u1ebfn nh\u1ea5t, v\u1edbi s\u1ef1 v\u1eafng m\u1eb7t g\u1ea7n nh\u01b0 ho\u00e0n to\u00e0n c\u1ee7a protein dystrophin \u1edf m\u00e0ng bao c\u01a1.<\/p>\n

          Lo\u1ea1n d\u01b0\u1ee1ng Becker <\/strong>bi\u1ec3u hi\u1ec7n \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh v\u00e0 li\u00ean quan \u00edt h\u01a1n t\u1edbi c\u01a1 x\u01b0\u01a1ng nh\u01b0ng th\u01b0\u1eddng r\u1ed1i lo\u1ea1n n\u1eb7ng h\u01a1n v\u1edbi c\u01a1 tim. S\u1ef1 b\u1ea5t th\u01b0\u1eddng c\u1ee7a tim bao g\u1ed3m b\u1ea5t th\u01b0\u1eddng d\u0201n truy\u1ec1n c\u1ee7a n\u00fat nh\u0129 th\u1ea5t, v\u00e0 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n m\u1ed9t c\u00e1ch nhanh ch\u00f3ng.<\/p>\n

          Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 th\u1eaft l\u01b0ng – chi d\u01b0\u1edbi (LGMD) <\/strong>\u1ea3nh h\u01b0\u1edfng l\u00ean c\u01a1 vai v\u00e0 c\u01a1 th\u1eaft l\u01b0ng ch\u1eadu v\u00e0 c\u00f3 th\u1ec3 di truy\u1ec1n tr\u1ed9i ho\u1eb7c l\u1eb7n tr\u00ean nhi\u1ec5m s\u1eafc th\u1ec3 th\u01b0\u1eddng. \u0110\u1ed9t bi\u1ebfn x\u1ea3y ra \u1edf gen m\u00e3 h\u00f3a protein c\u1ee7a m\u00e0ng ngo\u00e0i nh\u00e2n trong c\u01a1 v\u00e2n. Nh\u1eefng r\u1ed1i lo\u1ea1n c\u1ee7a tim chi\u1ebfm \u01b0u th\u1ebf h\u01a1n h\u1eb3n trong c\u00e1c ki\u1ec3u lo\u1ea1n d\u01b0\u1ee1ng LGMD type 1B, 1D, 2E, v\u00e0 2I; bao g\u1ed3m b\u1ec7nh c\u01a1 tim v\u00e0 b\u1ec7nh c\u1ee7a h\u1ec7 th\u1ed1ng d\u0201n truy\u1ec1n.<\/p>\n

          Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 m\u1eb7t – b\u1ea3 vai – c\u00e1nh tay (FSHD) <\/strong>l\u00e0 m\u1ed9t b\u1ec7nh di truy\u1ec1n tr\u1ed9i nhi\u1ec5m s\u1eafc th\u1ec3 th\u01b0\u1eddng v\u1edbi s\u1ef1 r\u1ed1i lo\u1ea1n ti\u1ebfn tri\u1ec3n c\u1ee7a c\u01a1 m\u1eb7t, vai v\u00e0 c\u01a1 c\u00e1nh tay. Nh\u1eefng bi\u1ec3u hi\u1ec7n ch\u00ednh c\u1ee7a tim bao g\u1ed3m b\u1ea5t th\u01b0\u1eddng s\u00f3ng P, ch\u1eadm d\u0201n truy\u1ec1n trong th\u1ea5t v\u00e0 r\u1ed1i lo\u1ea1n nh\u1ecbp tr\u00ean th\u1ea5t.<\/p>\n

          Lo\u1ea1n d\u01b0\u1ee1ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1 <\/strong>l\u00e0 m\u1ed9t b\u1ec7nh h\u1ec7 th\u1ed1ng di truy\u1ec1n nhi\u1ec5m s\u1eafc th\u1ec3 th\u01b0\u1eddng g\u00e2y ra b\u1edfi s\u1ef1 thi\u1ebfu l\u1eb7p l\u1ea1i b\u1ed9 ba nucleotide \u1edf gen m\u00e3 h\u00f3a myotonin. B\u1ec7nh li\u00ean quan \u0111\u1ebfn b\u1ea5t th\u01b0\u1eddng d\u0201n truy\u1ec1n nh\u0129 th\u1ea5t, r\u1ed1i lo\u1ea1n nh\u1ecbp nh\u0129 v\u00e0 th\u1ea5t, hay g\u1eb7p h\u01a1n b\u1ec7nh c\u01a1 tim trong 10% s\u1ed1 tr\u01b0\u1eddng h\u1ee3p. \u0110\u1ed9t t\u1eed do tim do b\u1ea5t k\u1ef3 nguy\u00ean nh\u00e2n n\u00e0o chi\u1ebfm t\u1edbi 30% tr\u01b0\u1eddng h\u1ee3p t\u1eed vong \u1edf c\u00e1c b\u1ec7nh nh\u00e2n b\u1ecb lo\u1ea1n d\u01b0\u1ee1ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1.<\/p>\n

          Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 Emery – Dreifus <\/strong>c\u00f3 nhi\u1ec1u ki\u1ec3u di truy\u1ec1n kh\u00e1c nhau v\u00e0 b\u1ecb g\u00e2y ra b\u1edfi \u0111\u1ed9t bi\u1ebfn lamin A v\u00e0 C (protein c\u1ee7a m\u00e0ng nh\u00e2n). \u0110\u1eb7c \u0111i\u1ec3m chung l\u00e0 y\u1ebfu c\u01a1 c\u00e1nh tay v\u00e0 c\u01a1 m\u00e1c do s\u1ef1 co c\u1ee9ng. Bi\u1ec3u hi\u1ec7n ch\u00ednh \u1edf tim bao g\u1ed3m b\u1ea5t th\u01b0\u1eddng d\u0201n truy\u1ec1n nh\u0129 th\u1ea5t v\u00e0 c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp nh\u0129. \u0110\u1ed9t t\u1eed do c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t c\u00f3 th\u1ec3 x\u1ea3y ra.<\/p>\n","protected":false},"excerpt":{"rendered":"

          B\u1ec7nh c\u01a1 tim chu s\u1ea3n (BCTCS), c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 b\u1ec7nh c\u01a1 tim li\u00ean quan \u0111\u1ebfn thai k\u1ef3, l\u00e0 m\u1ed9t nguy\u00ean nh\u00e2n \u00edt g\u1eb7p g\u00e2y ra suy tim \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1ee5 n\u1eef v\u00e0o cu\u1ed1i thai k\u1ef3 ho\u1eb7c trong giai \u0111o\u1ea1n s\u1edbm sau h\u1eadu s\u1ea3n.Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 l\u00e0 m\u1ed9t nh\u00f3m c\u00e1c b\u1ec7nh l\u00fd r\u1ed1i lo\u1ea1n […]<\/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":"\nB\u1ec7nh c\u01a1 tim chu s\u1ea3n v\u00e0 lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh c\u01a1 tim chu s\u1ea3n g\u00e2y ra suy tim \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1ee5 n\u1eef v\u00e0o cu\u1ed1i thai k\u1ef3. Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 g\u00e2y y\u1ebfu c\u01a1 ti\u1ebfn tri\u1ec3n tr\u00ean c\u01a1 th\u1ec3 ng\u01b0\u1eddi.\" \/>\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=\"B\u1ec7nh c\u01a1 tim chu s\u1ea3n v\u00e0 lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 - Vinmec\" \/>\n<meta property=\"og:description\" content=\"B\u1ec7nh c\u01a1 tim chu s\u1ea3n g\u00e2y ra suy tim \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1ee5 n\u1eef v\u00e0o cu\u1ed1i thai k\u1ef3. Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 g\u00e2y y\u1ebfu c\u01a1 ti\u1ebfn tri\u1ec3n tr\u00ean c\u01a1 th\u1ec3 ng\u01b0\u1eddi.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-co-tim-chu-san-va-loan-duong-co\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-05-01T15:48:01+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/sota_peripartum_cardiomyopathy-300x194.jpg\" \/>\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\/benh-co-tim-chu-san-va-loan-duong-co\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-co-tim-chu-san-va-loan-duong-co\/\",\"name\":\"B\u1ec7nh c\u01a1 tim chu s\u1ea3n v\u00e0 lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 - Vinmec\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-05-01T15:48:01+00:00\",\"dateModified\":\"2023-05-01T15:48:01+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629\"},\"description\":\"B\u1ec7nh c\u01a1 tim chu s\u1ea3n g\u00e2y ra suy tim \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1ee5 n\u1eef v\u00e0o cu\u1ed1i thai k\u1ef3. Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 g\u00e2y y\u1ebfu c\u01a1 ti\u1ebfn tri\u1ec3n tr\u00ean c\u01a1 th\u1ec3 ng\u01b0\u1eddi.\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-co-tim-chu-san-va-loan-duong-co\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-co-tim-chu-san-va-loan-duong-co\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-co-tim-chu-san-va-loan-duong-co\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"B\u1ec7nh c\u01a1 tim chu s\u1ea3n v\u00e0 lo\u1ea1n d\u01b0\u1ee1ng c\u01a1\"}]},{\"@type\":\"WebSite\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629\",\"name\":\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g\",\"caption\":\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/viettai304-304gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"B\u1ec7nh c\u01a1 tim chu s\u1ea3n v\u00e0 lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 - Vinmec","description":"B\u1ec7nh c\u01a1 tim chu s\u1ea3n g\u00e2y ra suy tim \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1ee5 n\u1eef v\u00e0o cu\u1ed1i thai k\u1ef3. Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 g\u00e2y y\u1ebfu c\u01a1 ti\u1ebfn tri\u1ec3n tr\u00ean c\u01a1 th\u1ec3 ng\u01b0\u1eddi.","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"B\u1ec7nh c\u01a1 tim chu s\u1ea3n v\u00e0 lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 - Vinmec","og_description":"B\u1ec7nh c\u01a1 tim chu s\u1ea3n g\u00e2y ra suy tim \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1ee5 n\u1eef v\u00e0o cu\u1ed1i thai k\u1ef3. Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 g\u00e2y y\u1ebfu c\u01a1 ti\u1ebfn tri\u1ec3n tr\u00ean c\u01a1 th\u1ec3 ng\u01b0\u1eddi.","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-co-tim-chu-san-va-loan-duong-co\/","og_site_name":"Vinmec","article_published_time":"2023-05-01T15:48:01+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/sota_peripartum_cardiomyopathy-300x194.jpg"}],"author":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i","twitter_card":"summary_large_image","twitter_misc":{"Written by":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i","Est. reading time":"7 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-co-tim-chu-san-va-loan-duong-co\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-co-tim-chu-san-va-loan-duong-co\/","name":"B\u1ec7nh c\u01a1 tim chu s\u1ea3n v\u00e0 lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 - Vinmec","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-05-01T15:48:01+00:00","dateModified":"2023-05-01T15:48:01+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629"},"description":"B\u1ec7nh c\u01a1 tim chu s\u1ea3n g\u00e2y ra suy tim \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1ee5 n\u1eef v\u00e0o cu\u1ed1i thai k\u1ef3. Lo\u1ea1n d\u01b0\u1ee1ng c\u01a1 g\u00e2y y\u1ebfu c\u01a1 ti\u1ebfn tri\u1ec3n tr\u00ean c\u01a1 th\u1ec3 ng\u01b0\u1eddi.","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-co-tim-chu-san-va-loan-duong-co\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-co-tim-chu-san-va-loan-duong-co\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-co-tim-chu-san-va-loan-duong-co\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"B\u1ec7nh c\u01a1 tim chu s\u1ea3n v\u00e0 lo\u1ea1n d\u01b0\u1ee1ng c\u01a1"}]},{"@type":"WebSite","@id":"http:\/\/noithathoaphat.in\/ctv\/#website","url":"http:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629","name":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g","contentUrl":"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g","caption":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/viettai304-304gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/30183"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=30183"}],"version-history":[{"count":1,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/30183\/revisions"}],"predecessor-version":[{"id":30193,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/30183\/revisions\/30193"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=30183"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=30183"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=30183"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}