{"id":30195,"date":"2023-05-01T22:47:40","date_gmt":"2023-05-01T15:47:40","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30195"},"modified":"2023-05-01T22:47:40","modified_gmt":"2023-05-01T15:47:40","slug":"viem-co-tim-va-cac-the-lam-sang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/viem-co-tim-va-cac-the-lam-sang\/","title":{"rendered":"Vi\u00eam c\u01a1 tim v\u00e0 c\u00e1c th\u1ec3 l\u00e2m s\u00e0ng"},"content":{"rendered":"

Vi\u00eam c\u01a1 tim l\u00e0 t\u00ecnh tr\u1ea1ng vi\u00eam c\u1ee7a t\u1ebf b\u00e0o c\u01a1 tim g\u00e2y ra b\u1edfi c\u00e1c b\u1ec7nh l\u00fd nhi\u1ec5m tr\u00f9ng v\u00e0 kh\u00f4ng nhi\u1ec5m tr\u00f9ng. B\u1ec7nh c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi pha c\u1ea5p, b\u00e1n c\u1ea5p ho\u1eb7c m\u1ea1n t\u00ednh. <\/strong><\/p>\n

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

Vi\u00eam c\u01a1 tim l\u00e0 t\u00ecnh tr\u1ea1ng vi\u00eam c\u1ee7a t\u1ebf b\u00e0o c\u01a1 tim g\u00e2y ra b\u1edfi c\u00e1c b\u1ec7nh l\u00fd nhi\u1ec5m tr\u00f9ng v\u00e0 kh\u00f4ng nhi\u1ec5m tr\u00f9ng. B\u1ec7nh c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi pha c\u1ea5p, b\u00e1n c\u1ea5p ho\u1eb7c m\u1ea1n t\u00ednh. Th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a suy tim, tuy nhi\u00ean \u0111\u00f4i khi r\u1ed1i lo\u1ea1n nh\u1ecbp ho\u1eb7c \u0111\u1ed9t t\u1eed l\u00e0 bi\u1ec3u hi\u1ec7n \u0111\u1ea7u ti\u00ean c\u1ee7a b\u1ec7nh. Virus l\u00e0 nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t <\/strong>c\u1ee7a vi\u00eam c\u01a1 tim.<\/p>\n

\"Vi\u00eam<\/p>\n

Vi\u00eam c\u01a1 tim<\/strong><\/p>\n

2.Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/h2>\n

Bi\u1ec3u hi\u1ec7n c\u1ee7a b\u1ec7nh c\u00f3 th\u1ec3 t\u1eeb kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng, ch\u1ec9 bi\u1ec3u hi\u1ec7n nhi\u1ec5m khu\u1ea9n tr\u00ean c\u1eadn l\u00e2m s\u00e0ng cho \u0111\u1ebfn ti\u1ebfn tri\u1ec3n nhanh ch\u00f3ng th\u00e0nh suy tim sung huy\u1ebft n\u1eb7ng.<\/p>\n

Nh\u1eefng h\u1eadu qu\u1ea3 l\u00e2u d\u00e0i c\u0169ng r\u1ea5t \u0111a d\u1ea1ng: C\u00f3 th\u1ec3 h\u1ed3i ph\u1ee5c d\u1ea7n theo th\u1eddi gian ho\u1eb7c ti\u1ebfn tri\u1ec3n th\u00e0nh b\u1ec7nh c\u01a1 tim gi\u00e3n, suy tim.<\/p>\n

Th\u1ec3 c\u1ea5p t\u00ednh:<\/p>\n

Th\u1ec3 gi\u1ed1ng nh\u1ed3i m\u00e1u c\u01a1 tim c\u1ea5p: <\/strong>Bi\u1ec3u hi\u1ec7n c\u01a1n \u0111au ng\u1ef1c c\u1ea5p, k\u00e8m theo bi\u1ebfn \u0111\u1ed1i ST- T ch\u00eanh l\u00ean tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 b\u1ec1 m\u1eb7t, c\u00e1c ch\u1ec9 d\u1ea5u sinh h\u1ecdc nh\u01b0 Troponin, CK-MB \u0111\u1ec1u t\u0103ng.<\/p>\n

Th\u1ec3 suy tim ti\u1ebfn tri\u1ec3n: <\/strong>Bi\u1ec3u hi\u1ec7n kh\u00f3 th\u1edf, ph\u00f9, t\u1ee9c ng\u1ef1c sau m\u1ed9t nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p ho\u1eb7c ti\u00eau h\u00f3a. \u0110\u1eb7c tr\u01b0ng b\u1eb1ng suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i v\u00e0\/ho\u1eb7c th\u1ea5t ph\u1ea3i, \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 th\u00f4ng qua si\u00eau \u00e2m tim ho\u1eb7c c\u1ed9ng h\u01b0\u1edfng t\u1eeb tim.<\/p>\n

Th\u1ec3 nguy k\u1ecbch: <\/strong>Bi\u1ec3u hi\u1ec7n s\u1ed1c tim sau kho\u1ea3ng 2 tu\u1ea7n ph\u01a1i nhi\u1ec5m v\u1edbi virus, ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i gi\u1ea3m n\u1eb7ng. \u0110\u00f4i khi bi\u1ec3u hi\u1ec7n b\u1eb1ng nh\u1eefng r\u1ed1i lo\u1ea1n nh\u1ecbp nguy hi\u1ec3m li\u00ean ti\u1ebfp d\u0201n t\u1edbi t\u1eed vong.<\/p>\n

Th\u1ec3 b\u00e1n c\u1ea5p v\u00e0 th\u1ec3 m\u1ea1n t\u00ednh:<\/p>\n

C\u00e1c tri\u1ec7u ch\u1ee9ng ti\u1ebfn tri\u1ec3n tr\u00ean ba th\u00e1ng. \u0110\u1eb7c tr\u01b0ng b\u1edfi qu\u00e1 tr\u00ecnh t\u00e1i c\u1ea5u tr\u00fac th\u1ea5t tr\u00e1i v\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i.<\/p>\n

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

Ch\u1ea9n \u0111o\u00e1n d\u1ef1a v\u00e0o c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng ngh\u0129 \u0111\u1ebfn nhi\u1ec5m virus, \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 v\u00e0 men tim g\u1ee3i \u00fd t\u1ed5n th\u01b0\u01a1ng c\u01a1 tim. Sinh thi\u1ebft n\u1ed9i m\u1ea1c c\u01a1 tim c\u00f3 th\u1ec3 h\u1eefu \u00edch trong vi\u1ec7c kh\u1eb3ng \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n nh\u01b0ng th\u01b0\u1eddng \u00e2m t\u00ednh. Si\u00eau \u00e2m tim v\u00e0 ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb tim c\u00f3 vai tr\u00f2 quan tr\u1ecdng trong ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 \u1ea3nh h\u01b0\u1edfng tr\u00ean ch\u1ee9c n\u0103ng tim. L\u01b0u \u00fd c\u1ea7n lo\u1ea1i tr\u1eeb h\u1ed9i ch\u1ee9ng \u0111\u1ed9ng m\u1ea1ch v\u00e0nh c\u1ea5p.<\/p>\n

4. C\u00e1c th\u1ec3 vi\u00eam c\u01a1 tim theo nguy\u00ean nh\u00e2n<\/h2>\n

4.1 Vi\u00eam c\u01a1 tim do virus<\/strong><\/h3>\n

\u1ede nh\u1eefng n\u01b0\u1edbc ph\u01b0\u01a1ng T\u00e2y, virus \u0111\u01b0\u1eddng ru\u1ed9t \u0111\u1eb7c bi\u1ec7t l\u00e0 Coxsackie B l\u00e0 nguy\u00ean nh\u00e2n hay g\u1eb7p nh\u1ea5t g\u00e2y vi\u00eam c\u01a1 tim. Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh bao g\u1ed3m \u0111au c\u01a1, \u0111au ng\u1ef1c ki\u1ec3u m\u00e0ng ph\u1ed5i, tri\u1ec7u ch\u1ee9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean, \u0111au kh\u1edbp, \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c v\u00e0 s\u1ed1t. H\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 h\u1ed3i ph\u1ee5c kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng trong v\u00f2ng v\u00e0i tu\u1ea7n. \u0110i\u1ec1u tr\u1ecb ch\u1ee7 y\u1ebfu l\u00e0 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng.<\/p>\n

Nh\u1eefng lo\u1ea1i virus kh\u00e1c nh\u01b0 cytomegalovirus (CMV), Dengue, vi\u00eam gan, Epstein – Barr virus (EBV), c\u00fam v\u00e0 th\u1ee7y \u0111\u1eadu th\u01b0\u1eddng hi\u1ebfm khi g\u00e2y t\u1ed5n th\u01b0\u01a1ng c\u01a1 tim. Ch\u1ea9n \u0111o\u00e1n d\u1ef1a v\u00e0o thay \u0111\u1ed5i \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 v\u00e0 men tim. Vi\u00eam c\u01a1 tim do quai b\u1ecb \u00edt th\u1ea5y, nh\u00ecn chung x\u1ea3y ra trong tu\u1ea7n \u0111\u1ea7u c\u1ee7a \u0111\u1ee3t b\u1ec7nh v\u00e0 th\u01b0\u1eddng th\u1ea7m l\u1eb7ng, m\u1eb7c d\u00f9 theo b\u1ec7nh h\u1ecdc l\u00e0 th\u01b0\u1eddng g\u1eb7p.<\/p>\n

Nhi\u1ec5m Rubella trong qu\u00fd \u0111\u1ea7u thai k\u1ef3 g\u00e2y ra nh\u1eefng d\u1ecb t\u1eadt b\u1ea9m sinh <\/em>nh\u01b0 c\u00f2n \u1ed1ng \u0111\u1ed9ng m\u1ea1ch ho\u1eb7c ph\u00e1t tri\u1ec3n b\u1ea5t th\u01b0\u1eddng \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i; vi\u00eam c\u01a1 tim hi\u1ebfm g\u1eb7p nh\u01b0ng g\u00e2y suy tim b\u00e0o thai ho\u1eb7c tr\u1ebb s\u01a1 sinh.<\/p>\n

T\u1ed5n th\u01b0\u01a1ng tim ph\u1ed5 bi\u1ebfn \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n nhi\u1ec5m HIV (l\u00ean t\u1edbi 50%) nh\u01b0ng ch\u1ec9 10% c\u00f3 b\u1eb1ng ch\u1ee9ng tr\u00ean l\u00e2m s\u00e0ng. Bi\u1ec3u hi\u1ec7n th\u00f4ng th\u01b0\u1eddng l\u00e0 suy tim sung huy\u1ebft v\u00e0 b\u1ec7nh c\u01a1 tim gi\u00e3n, do t\u00e1c \u0111\u1ed9ng tr\u1ef1c ti\u1ebfp c\u1ee7a HIV l\u00ean t\u1ebf b\u00e0o c\u01a1 tim, d\u00f9 nhi\u1ec5m tr\u00f9ng c\u01a1 h\u1ed9i \u1edf b\u1ec7nh nh\u00e2n h\u1ed9i ch\u1ee9ng suy gi\u1ea3m mi\u1ec5n d\u1ecbch m\u1eafc ph\u1ea3i (AIDS) l\u00e0 m\u1ed9t nguy\u00ean nh\u00e2n quan tr\u1ecdng kh\u00e1c g\u00e2y vi\u00eam c\u01a1 tim<\/p>\n

4.2 Vi\u00eam c\u01a1 tim do Rickettsia<\/h3>\n
    \n
  • S\u1ed1t Q do R. burnetii <\/strong>g\u00e2y vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c \u0111i\u1ec3n h\u00ecnh; vi\u00eam m\u00e0ng ngo\u00e0i tim c\u0169ng ph\u1ed5 bi\u1ebfn. Vi\u00eam c\u01a1 tim kh\u00f4ng th\u01b0\u1eddng g\u1eb7p v\u00e0 t\u1ea1o ra nh\u1eefng bi\u1ebfn \u0111\u1ed1i nh\u1ea5t th\u1eddi c\u1ee7a ST-T.<\/li>\n
  • S\u1ed1t ph\u00e1t ban v\u00f9ng n\u00fai \u0111\u00e1 (Rocky Mountain spotted fever) <\/strong>do R. rickettsia g\u00e2y ra vi\u00eam m\u1ea1ch lan t\u1ecfa, sau \u0111\u00f3 g\u00e2y vi\u00eam c\u01a1 tim. Si\u00eau \u00e2m tim c\u00f3 th\u1ec3 th\u1ea5y r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i, \u0111i\u1ec1u n\u00e0y th\u1eadm ch\u00ed c\u00f3 th\u1ec3 t\u1ed3n t\u1ea1i sau khi nhi\u1ec5m tr\u00f9ng \u0111\u00e3 h\u1ebft.<\/li>\n
  • S\u1ed1t m\u00f2 (T. t sutsugamushi) <\/strong>g\u00e2y ra c\u1ea3 vi\u00eam m\u00e0ng \u0111\u00e1y mao m\u1ea1ch c\u00f3 th\u1ec3 d\u0201n \u0111\u1ebfn vi\u00eam c\u01a1 tim, g\u00e2y ch\u1ea3y m\u00e1u trong c\u01a1 v\u00e0 ch\u1ea5m xu\u1ea5t huy\u1ebft d\u01b0\u1edbi ngo\u1ea1i t\u00e2m m\u1ea1c. Th\u01b0\u01a1ng t\u1ed5n l\u00e2u d\u00e0i th\u01b0\u1eddng hi\u1ebfm g\u1eb7p.<\/li>\n<\/ul>\n

    4.3 Vi\u00eam c\u01a1 tim do vi khu\u1ea9n<\/h3>\n
      \n
    • N\u00e3o m\u00f4 c\u1ea7u (N. meningitidis): <\/strong>Vi\u00eam c\u01a1 tim do n\u00e3o m\u00f4 c\u1ea7u l\u00e0m t\u0103ng t\u1ef7 l\u1ec7 t\u1eed vong chung, l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a c\u00e1c xu\u1ea5t huy\u1ebft b\u00ean ngo\u00e0i ho\u1eb7c b\u00ean trong c\u00e1c c\u01a1 quan. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng bao g\u1ed3m suy tim xung huy\u1ebft, tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim, tr\u00e0n kh\u00ed m\u00e0ng ngo\u00e0i tim. C\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 nhi\u1ec5m khu\u1ea9n huy\u1ebft n\u00ean \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd, \u0111\u1eb7c bi\u1ec7t nh\u1eefng tr\u01b0\u1eddng h\u1ee3p c\u00f3 b\u1ea5t th\u01b0\u1eddng tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3.<\/li>\n
    • Mycoplasma: <\/strong>L\u00e0 vi khu\u1ea9n nh\u1ecf nh\u1ea5t kh\u00f4ng c\u00f3 v\u00e1ch t\u1ebf b\u00e0o n\u00ean kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c nhu\u1ed9m gram th\u00f4ng th\u01b0\u1eddng v\u00e0 kh\u00f4ng nh\u1ea1y v\u1edbi c\u00e1c lo\u1ea1i kh\u00e1c sinh th\u01b0\u1eddng d\u00f9ng. Mycoplasma th\u01b0\u1eddng c\u00f3 \u1edf b\u1ec1 m\u1eb7t da, ni\u00eam m\u1ea1c. Khi c\u01a1 th\u1ec3 b\u1ecb suy gi\u1ea3m mi\u1ec5n d\u1ecbch, vi khu\u1ea9n s\u1ebd x\u00e2m nh\u1eadp v\u00e0o m\u00e1u v\u00e0 \u0111\u1ebfn g\u00e2y b\u1ec7nh \u1edf c\u00e1c c\u01a1 quan. Mycoplasma pneumoniae th\u01b0\u1eddng g\u00e2y t\u1ed5n th\u01b0\u01a1ng tim nh\u1ea5t trong 4 type ch\u00ednh, t\u1ed5n th\u01b0\u01a1ng bao g\u1ed3m vi\u00eam m\u00e0ng ngo\u00e0i tim v\u00e0 suy tim sung huy\u1ebft. C\u00e1c bi\u1ebfn \u0111\u1ed5i tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 kh\u00f4ng \u0111i\u1ec3n h\u00ecnh trong nhi\u1ec5m Mycoplasma pneumoniae. B\u1ec7nh kh\u00f4ng c\u00f3 \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u.<\/li>\n
    • B\u1ec7nh Whipple (g\u00e2y b\u1ec7nh b\u1edfi vi khu\u1ea9n Tropheryma whippelii): <\/strong>B\u1ec7nh g\u00e2y r\u1ed1i lo\u1ea1n h\u1ea5p thu ch\u1ea5t b\u00e9o v\u00e0 carbohydrate v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng ch\u00ednh nh\u01b0 n\u00f4n, bu\u1ed3n n\u00f4n, \u0111au b\u1ee5ng, ti\u00eau ch\u1ea3y, g\u1ea7y s\u00fat c\u00e2n. C\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n \u1edf c\u00e1c c\u01a1 quan kh\u00e1c nh\u01b0 n\u00e3o, tim, kh\u1edbp, m\u1eaft. T\u1ed5n th\u01b0\u01a1ng tim \u0111\u01b0\u1ee3c ghi nh\u1eadn v\u1edbi s\u1ef1 th\u00e2m nhi\u1ec5m c\u01a1 tim b\u1edfi \u0111\u1ea1i th\u1ef1c b\u00e0o nhu\u1ed9m periodic acid-Schiff (PAS) d\u01b0\u01a1ng t\u00ednh. C\u00e1c bi\u1ebfn c\u1ed1 \u0111\u1ed9ng m\u1ea1ch v\u00e0nh hay t\u0103ng \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i c\u00f3 th\u1ec3 g\u1eb7p. T\u1ed5n th\u01b0\u01a1ng x\u01a1 h\u00f3a g\u00e2y h\u1edf van hai l\u00e1 v\u00e0 van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7. Li\u1ec7u ph\u00e1p kh\u00e1ng sinh c\u00f3 hi\u1ec7u qu\u1ea3 trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb, b\u1ec7nh \u00edt khi t\u00e1i ph\u00e1t.<\/li>\n
    • C\u00e1c vi khu\u1ea9n kh\u00e1c: <\/strong>Legionella, Salmonella, Psittacosis, Streptococcus, vi\u00eam c\u01a1 tim do lao hi\u1ebfm g\u1eb7p (th\u01b0\u1eddng g\u1eb7p vi\u00eam m\u00e0ng ngo\u00e0i tim h\u01a1n,<\/li>\n<\/ul>\n

      4.4 Vi\u00eam c\u01a1 tim do xo\u1eafn khu\u1ea9n<\/h3>\n

      Kho\u1ea3ng 10% b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh Lyme c\u00f3 t\u1ed5n th\u01b0\u01a1ng tim (b\u1ec7nh g\u00e2y ra do ve c\u1eafn) do s\u1ef1 x\u00e2m nh\u1eadp tr\u1ef1c ti\u1ebfp v\u00e0o c\u01a1 tim c\u1ee7a xo\u1eafn khu\u1ea9n Borrelia burgdorferi c\u00f9ng v\u1edbi c\u00e1c t\u00e1c nh\u00e2n mi\u1ec5n d\u1ecbch trung gian. C\u00e1c t\u1ed5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 g\u1eb7p nh\u01b0 r\u1ed1i lo\u1ea1n d\u0201n truy\u1ec1n nh\u0129 th\u1ea5t, suy ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i. Ch\u1ee5p CLVT v\u1edbi gallium ho\u1eb7c indium c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c c\u00e1c t\u1ed5n th\u01b0\u01a1ng c\u01a1 tim.<\/p>\n

        \n
      • B\u1ec7nh Weil <\/strong>(g\u00e2y ra do xo\u1eafn khu\u1ea9n v\u00e0ng da Leptospira): L\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00e2y truy\u1ec1n t\u1eeb \u0111\u1ed9ng v\u1eadt sang ng\u01b0\u1eddi khi da, ni\u00eam m\u1ea1c ti\u1ebfp x\u00fac v\u1edbi \u0111\u1ea5t v\u00e0 n\u01b0\u1edbc nhi\u1ec5m n\u01b0\u1edbc ti\u1ec3u c\u1ee7a \u0111\u1ed9ng v\u1eadt mang xo\u1eafn khu\u1ea9n. C\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p nh\u01b0 s\u1ed1t cao, \u0111au \u0111\u1ea7u d\u1eef d\u1ed9i, n\u00f4n m\u1eeda, \u0111au nh\u1ee9c c\u01a1, giai \u0111o\u1ea1n sau c\u00f3 th\u1ec3 d\u0201n \u0111\u1ebfn vi\u00eam m\u00e0ng n\u00e3o, suy gan, suy th\u1eadn… C\u00e1c t\u1ed5n th\u01b0\u01a1ng tim m\u1ea1ch t\u01b0\u01a1ng \u0111\u1ed1i n\u1eb7ng bao g\u1ed3m: Vi\u00eam m\u00f4 k\u1ebd c\u01a1 tim, r\u1ed1i lo\u1ea1n d\u0201n truy\u1ec1n, vi\u00eam \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, \u0111\u1ed9ng m\u1ea1ch v\u00e0nh. C\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh: ELISA, PCR, x\u00e9t nghi\u1ec7m huy\u1ebft thanh h\u1ecdc MAT (ng\u01b0ng k\u1ebft vi l\u01b0\u1ee3ng tr\u00ean k\u00ednh hi\u1ec3n vi).<\/li>\n
      • Giang mai <\/strong>(do xo\u1eafn khu\u1ea9n Treponema pallidum): L\u00e0 t\u00e1c nh\u00e2n ph\u1ed5 bi\u1ebfn g\u00e2y vi\u00eam th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, t\u1ed5n th\u01b0\u01a1ng c\u01a1 tim hi\u1ebfm g\u1eb7p<\/li>\n<\/ul>\n

        4.5 Vi\u00eam c\u01a1 tim do k\u00fd sinh tr\u00f9ng<\/h3>\n

        \u1ede v\u00f9ng Nam M\u1ef9, k\u00fd sinh tr\u00f9ng (tr\u00f9ng roi) Trypanosoma cruzi g\u00e2y ra b\u1ec7nh vi\u00eam c\u01a1 tim Chagas<\/p>\n

        B\u1ec7nh l\u00e2y truy\u1ec1n qua ch\u1ee7 t\u00fac trung gian l\u00e0 b\u1ecd r\u1ec7p thu\u1ed9c lo\u00e0i Triatoma. Trong giai \u0111o\u1ea1n c\u1ea5p, n\u00f3 c\u00f3 th\u1ec3 g\u00e2y ra vi\u00eam c\u01a1 tim n\u1eb7ng d\u0201n \u0111\u1ebfn suy tim v\u00e0 t\u1eed vong. Nh\u1eefng ng\u01b0\u1eddi tr\u1ebb hay g\u1eb7p t\u00ecnh tr\u1ea1ng ti\u1ebfn tri\u1ec3n b\u1ec7nh c\u1ea5p t\u00ednh v\u00e0 th\u01b0\u1eddng n\u1eb7ng h\u01a1n ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh. Sau kho\u1ea3ng 20 n\u0103m, g\u1ea7n 30% b\u1ec7nh nh\u00e2n ti\u1ebfn tri\u1ec3n th\u00e0nh b\u1ec7nh Chagas m\u1ea1n t\u00ednh. C\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng r\u1ea5t kh\u00e1c nhau t\u1eeb kh\u00f4ng tri\u1ec7u ch\u1ee9ng (ch\u1ea9n \u0111o\u00e1n b\u1eb1ng huy\u1ebft thanh d\u01b0\u01a1ng t\u00ednh) \u0111\u1ebfn ti\u1ebfn tri\u1ec3n th\u00e0nh suy tim sung huy\u1ebft g\u00e2y gi\u00e3n c\u00e1c bu\u1ed3ng tim.<\/p>\n

        4.6 Vi\u00eam c\u01a1 tim do n\u1ea5m<\/h3>\n

        Vi\u00eam c\u01a1 tim do n\u1ea5m kh\u00e1 hi\u1ebfm g\u1eb7p v\u00e0 th\u01b0\u1eddng g\u1eb7p \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh l\u00fd \u00e1c t\u00ednh, nh\u1eefng ng\u01b0\u1eddi \u0111ang \u0111i\u1ec1u tr\u1ecb h\u00f3a ch\u1ea5t, steroid, ho\u1eb7c c\u00e1c li\u1ec7u ph\u00e1p \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch kh\u00e1c. C\u00e1c y\u1ebfu t\u1ed1 thu\u1eadn l\u1ee3i d\u0201n \u0111\u1ebfn b\u1ec7nh bao g\u1ed3m c\u00e1c ph\u0201u thu\u1eadt tim, nhi\u1ec5m HIV, v\u00e0 s\u1eed d\u1ee5ng thu\u1ed1c truy\u1ec1n t\u0129nh m\u1ea1ch.<\/p>\n

        C\u00e1c c\u0103n nguy\u00ean li\u00ean quan bao g\u1ed3m Actinomyces, Aspergillus, Candida, Cryptococcus, and Histoplasma. Nhi\u1ec5m c\u00e1c lo\u00e0i n\u1ea5m coccidiodes th\u01b0\u1eddng g\u00e2y t\u1ed5n th\u01b0\u01a1ng m\u00e0ng ngo\u00e0i tim v\u1edbi vi\u00eam m\u00e0ng ngo\u00e0i tim, ti\u1ebfn \u0111\u1ebfn vi\u00eam m\u00e0ng ngo\u00e0i tim co th\u1eaft<\/p>\n

        Vi\u00eam c\u01a1 tim do n\u1ea5m th\u01b0\u1eddng ch\u1ec9 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n qua sinh thi\u1ebft c\u01a1 tim. Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c do n\u1ea5m ch\u1ea9n \u0111o\u00e1n b\u1eb1ng k\u1ebft qu\u1ea3 c\u1ea5y m\u00e1u.<\/p>\n

        4.7 Vi\u00eam c\u01a1 tim do nhi\u1ec5m \u0111\u1ed9c v\u00e0 chuy\u1ec3n h\u00f3a<\/h3>\n

        R\u1ea5t nhi\u1ec1u lo\u1ea1i thu\u1ed1c, t\u00e1c nh\u00e2n h\u00f3a h\u1ecdc v\u00e0 v\u1eadt l\u00fd (nhi\u1ec7t, ph\u00f3ng x\u1ea1) c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng c\u01a1 tim.<\/p>\n

        Anthracyclines (daunorubicin v\u00e0 adriamycin)<\/strong>: Nh\u1eefng lo\u1ea1i thu\u1ed1c n\u00e0y \u1ee9c ch\u1ebf t\u1ed5ng h\u1ee3p acid nucleic v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra nhi \u1ec5 m \u0111\u1ed9c s\u1edbm ho\u1eb7c mu\u1ed9n. Nhi\u1ec5m \u0111\u1ed9c c\u01a1 tim c\u1ea5p bao g\u1ed3m c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp, r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i c\u1ea5p, h\u1ed9i ch\u1ee9ng vi\u00eam m\u00e0ng ngo\u00e0i tim – c\u01a1 tim c\u1ea5p, nh\u1ed3i m\u00e1u c\u01a1 tim v\u00e0 \u0111\u1ed9t t\u1eed do tim. Nhi\u1ec5m \u0111\u1ed9c c\u01a1 tim mu\u1ed9n l\u00e0 do c\u00e1c b\u1ec7nh c\u01a1 tim tho\u00e1i h\u00f3a ph\u1ee5 thu\u1ed9c li\u1ec1u c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n b\u1ea5t c\u1ee9 l\u00fac n\u00e0o sau v\u00e0i tu\u1ea7n \u0111\u1ebfn v\u00e0i th\u00e1ng k\u1ec3 t\u1eeb li\u1ec1u cu\u1ed1i c\u00f9ng. Tri\u1ec7u ch\u1ee9ng c\u00f3 th \u1ec3 kh\u00f3 ki\u1ec3m so\u00e1t v\u00e0 gh\u00e9p tim \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p khi m\u00e0 tr\u1ecb li\u1ec7u ung th\u01b0 \u0111\u00e3 \u0111\u1ea1t \u0111\u01b0\u1ee3c.<\/p>\n

        Cocain: <\/strong>C\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p l\u00e0 \u0111au ng\u1ef1c, v\u00e3 m\u1ed3 h\u00f4i, h\u1ed3i h\u1ed9p tr\u1ed1ng ng\u1ef1c. \u1ede s\u1ed1 \u00edt tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 g\u1eb7p thi\u1ebfu m\u00e1u c\u01a1 tim do co th\u1eaft m\u1ea1ch v\u00e0nh ho\u1eb7c huy\u1ebft kh\u1ed1i trong l\u00f2ng \u0110MV. C\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t v\u00e0 \u0111\u1ed9t t\u1eed c\u0169ng c\u00f3 th\u1ec3 g\u1eb7p. \u0110i\u1ec1u tr\u1ecb b\u1eb1ng ch\u1eb9n beta giao c\u1ea3m v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3.<\/p>\n

        Catecholamine: <\/strong>B\u1ec7nh c\u01a1 tim gi\u00e3n c\u00f3 h\u1ed3i ph\u1ee5c \u0111\u00e3 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 c\u00f9ng v\u1edbi u t\u1ee7y th\u01b0\u1ee3ng th\u1eadn do \u0111i\u1ec1u tr\u1ecb li\u1ec1u cao c\u00e1c catecholamine v\u00e0 li\u1ec1u cao c\u01b0\u1eddng beta trong \u0111\u1ee3t b\u1ec7nh ph\u1ed5i m\u1ea1n t\u00ednh m\u1ea5t b\u00f9. Aspirin v\u00e0 dipyridamole c\u00f3 th\u1ec3 c\u00f3 m\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng, \u0111i\u1ec1u n\u00e0y g\u1ee3i \u00fd \u0111\u1ebfn vai tr\u00f2 c\u1ee7a ti\u1ec3u c\u1ea7u trong c\u01a1 ch\u1ebf sinh b\u1ec7nh h\u1ecdc.<\/p>\n

        S\u1ef1 thi\u1ebfu h\u1ee5t taurine v\u00e0 carnitine: <\/strong>L i\u00ean quan \u0111\u1ebfn b\u1ec7nh c\u01a1 tim gi\u00e3n; trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p thi\u1ebfu carnitine, b\u1ed5 sung \u0111\u1ea7y \u0111\u1ee7 c\u00f3 th\u1ec3 gi\u00fap c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng v\u00e0 ch\u1ee9c n\u0103ng tim. M\u1ee9c carnitine c\u01a1 tim gi\u1ea3m \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh c\u01a1 tim gi\u00e3n nh\u01b0ng ch\u01b0a r\u00f5 r\u00e0ng.<\/p>\n

        4.8 B\u1ec7nh vi\u00eam c\u01a1 tim qu\u00e1 m\u1eabn (HSM)<\/h3>\n

        L\u00e0 m\u1ed9t ph\u1ea3n \u1ee9ng t\u1ef1 mi\u1ec5n d\u1ecbch c\u1ee7a tim li\u00ean quan \u0111\u1ebfn d\u00f9ng thu\u1ed1c \u0111\u1eb7c tr\u01b0ng b\u1edfi t\u00ecnh tr\u1ea1ng s\u1ed1t, ph\u00e1t ban c\u1ea5p t\u00ednh, t\u0103ng b\u1ea1ch c\u1ea7u \u00e1i toan trong m\u00e1u ngo\u1ea1i vi v\u00e0 c\u00e1c b\u1ea5t th\u01b0\u1eddng tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 nh\u01b0 bi\u1ebfn \u0111\u1ed5i \u0111o\u1ea1n ST ho\u1eb7c c\u00e1c bi\u1ec3u hi\u1ec7n gi\u1ed1ng nh\u1ed3i m\u00e1u c\u01a1 tim. M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u00f3 suy tim ti\u1ebfn tri\u1ec3n nhanh, th\u1eadm ch\u00ed t\u1eed vong. Tuy nhi\u00ean, kh\u00f4ng ph\u1ea3i HSM n\u00e0o c\u0169ng xu\u1ea5t hi\u1ec7n s\u1edbm trong qu\u00e1 tr\u00ecnh d\u00f9ng thu\u1ed1c, c\u00f3 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p h\u00e0ng n\u0103m sau m\u1edbi bi\u1ec3u hi\u1ec7n b\u1ec7nh.<\/p>\n

        V\u1ec1 m\u00f4 h\u1ecdc, HSM \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 th\u00e2m nhi\u1ec5m c\u00e1c b\u1ea1ch c\u1ea7u \u00e1i toan, t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3, \u00edt g\u1eb7p t\u1ebf b\u00e0o c\u01a1 ho\u1ea1i t\u1eed.<\/p>\n

        C\u00e1c lo\u1ea1i thu\u1ed1c g\u00e2y b\u1ec7nh kh\u00e1c nhau bao g\u1ed3m c\u00e1c lo\u1ea1i kh\u00e1ng sinh (penicillin, amphotericin, chloramphenicol, tetracycline, sulphonamide), thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh (phenytoin, carbamazepine), thu\u1ed1c ch\u1ed1ng lao (isoniazid), c\u00e1c thu\u1ed1c gi\u1ea3m \u0111au ch\u1ed1ng vi\u00eam kh\u00f4ng steroid (NSAIDs; indomethacin, phenylbutazone), l\u1ee3i ti\u1ec3u, methyldopa, sulphonylurea, v\u00e0 amitriptyline.<\/p>\n

        B\u1ec7nh hi\u1ebfm g\u1eb7p tr\u00ean l\u00e2m s\u00e0ng. N\u00ean ng\u01b0ng s\u1eed d\u1ee5ng thu\u1ed1c g\u00e2y vi\u00eam c\u01a1 tim qu\u00e1 m\u0201n v\u00e0 c\u00f3 th\u1ec3 d\u00f9ng steroid \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng.<\/p>\n

        5. \u0110i\u1ec1u tr\u1ecb<\/h2>\n

        H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng th\u1ec3 l\u1ef1c. Tr\u00e1nh l\u1ea1m d\u1ee5ng r\u01b0\u1ee3u hay \u0111\u1ed3 u\u1ed1ng c\u00f3 c\u1ed3n do nguy c\u01a1 l\u00e0m n\u1eb7ng th\u00eam t\u00ecnh tr\u1ea1ng vi\u00eam c\u01a1 tim.<\/p>\n

        \u0110i\u1ec1u tr\u1ecb suy tim sung huy\u1ebft v\u00e0 nguy\u00ean nh\u00e2n nhi\u1ec5m tr\u00f9ng l\u00e0 2 \u0111i\u1ec3m ch\u00ednh trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh.<\/p>\n

        C\u00e1c thu\u1ed1c \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o l\u00e0 nh\u00f3m \u1ee9c ch\u1ebf men chuy\u1ec3n ho\u1eb7c \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3, nh\u00f3m ch\u1eb9n beta giao c\u1ea3m v\u00e0 nh\u00f3m l\u1ee3i ti\u1ec3u kh\u00e1ng aldosterone.<\/p>\n

        Digoxin \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o trong \u0111i\u1ec1u tr\u1ecb suy tim c\u01a1 b\u1ea3n v\u1edbi \u00fd ngh\u0129a l\u00e0m c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng suy tim, tuy nhi\u00ean trong vi\u00eam c\u01a1 tim c\u1ea5p, Digoxin c\u00f3 th\u1ec3 l\u00e0m t\u0103ng t\u1ef7 l\u1ec7 t\u1eed vong v\u00e0 r\u1ed1i lo\u1ea1n nh\u1ecbp.<\/p>\n

        Ki\u1ec3m so\u00e1t nh\u1eefng r\u1ed1i lo\u1ea1n nh\u1ecbp g\u00e2y tri\u1ec7u ch\u1ee9ng:<\/p>\n

          \n
        • C\u00e2n nh\u1eafc c\u00e1c thu\u1ed1c ch\u1ed1ng r\u1ed1i lo\u1ea1n nh\u1ecbp nh\u01b0 Amiodarone, ch\u1eb9n beta giao c\u1ea3m trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p d\u1ef1 ph\u00f2ng t\u00e1i ph\u00e1t c\u00e1c c\u01a1n nh\u1ecbp nhanh th\u1ea5t ho\u1eb7c tr\u00ean th\u1ea5t.<\/li>\n
        • Nh\u1eefng c\u01a1n nh\u1ecbp nhanh th\u1ea5t v\u00e0 tr\u00ean th\u1ea5t v\u1edbi t\u1ea7n s\u1ed1 th\u1ea5t cao c\u0169ng c\u1ea7n \u0111\u01b0\u1ee3c s\u1edbm chuy\u1ec3n nh\u1ecbp xoang \u0111\u1ec3 duy tr\u00ec huy\u1ebft \u0111\u1ed9ng \u1ed5n \u0111\u1ecbnh. C\u00f3 th\u1ec3 c\u1ea7n s\u1ed1c \u0111i\u1ec7n chuy\u1ec3n nh\u1ecbp n\u1ebfu \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa kh\u00f4ng hi\u1ec7u qu\u1ea3.<\/li>\n
        • T\u00ecnh tr\u1ea1ng block nh\u0129 th\u1ea5t c\u0169ng th\u01b0\u1eddng g\u1eb7p trong b\u1ec7nh c\u1ea3nh vi\u00eam c\u01a1 tim. T\u1ea1o nh\u1ecbp t\u1ea1m th\u1eddi qua da l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ed1i v\u1edbi nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nh\u1ecbp ch\u1eadm, block nh\u0129 th\u1ea5t \u0111\u1ed9 cao, ho\u1eb7c ph\u1ed1i h\u1ee3p nhi\u1ec1u d\u1ea1ng r\u1ed1i lo\u1ea1n nh\u1ecbp ph\u1ee9c t\u1ea1p.<\/li>\n
        • C\u00e1c thi\u1ebft b\u1ecb h\u1ed7 tr\u1ee3 tu\u1ea7n ho\u00e0n ngo\u00e0i c\u01a1 th\u1ec3 (ECMO) \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ed1i v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p vi\u00eam c\u01a1 tim c\u1ea5p s\u1ed1c tim v\u00e0 kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa c\u01a1 b\u1ea3n. H\u1ed7 tr\u1ee3 tu\u1ea7n ho\u00e0n c\u01a1 h\u1ecdc gi\u00fap c\u1ea3i thi\u1ec7n t\u1ef7 l\u1ec7 t\u1eed vong \u1edf nh\u00f3m b\u1ec7nh nh\u00e2n n\u00e0y.<\/li>\n
        • Nh\u1eefng th\u1eed nghi\u1ec7m v\u1ec1 li\u1ec7u ph\u00e1p \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch \u1edf b\u1ec7nh nh\u00e2n vi\u00eam c\u01a1 tim kh\u00f4ng mang l\u1ea1i hy v\u1ecdng l\u1edbn. S\u1eed d\u1ee5ng steroid \u1edf b\u1ec7nh nh\u00e2n trong giai \u0111o\u1ea1n c\u1ea5p t\u00ednh c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc nh\u01b0ng ch\u01b0a ch\u1ee9ng minh \u0111\u01b0\u1ee3c nhi\u1ec1u l\u1ee3i \u00edch trong c\u1ea3i thi\u1ec7n ti\u00ean l\u01b0\u1ee3ng<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

          Vi\u00eam c\u01a1 tim l\u00e0 t\u00ecnh tr\u1ea1ng vi\u00eam c\u1ee7a t\u1ebf b\u00e0o c\u01a1 tim g\u00e2y ra b\u1edfi c\u00e1c b\u1ec7nh l\u00fd nhi\u1ec5m tr\u00f9ng v\u00e0 kh\u00f4ng nhi\u1ec5m tr\u00f9ng. B\u1ec7nh c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi pha c\u1ea5p, b\u00e1n c\u1ea5p ho\u1eb7c m\u1ea1n t\u00ednh. 1.\u0110\u1ecbnh ngh\u0129a Vi\u00eam c\u01a1 tim l\u00e0 t\u00ecnh tr\u1ea1ng vi\u00eam c\u1ee7a t\u1ebf b\u00e0o c\u01a1 tim g\u00e2y ra b\u1edfi c\u00e1c […]<\/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":"\nVi\u00eam c\u01a1 tim v\u00e0 c\u00e1c th\u1ec3 l\u00e2m s\u00e0ng - Vinmec<\/title>\n<meta name=\"description\" content=\"Vi\u00eam c\u01a1 tim g\u00e2y ra b\u1edfi c\u00e1c b\u1ec7nh l\u00fd nhi\u1ec5m tr\u00f9ng v\u00e0 kh\u00f4ng nhi\u1ec5m tr\u00f9ng. B\u1ec7nh c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi pha c\u1ea5p, b\u00e1n c\u1ea5p ho\u1eb7c m\u1ea1n t\u00ednh.\" \/>\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=\"Vi\u00eam c\u01a1 tim v\u00e0 c\u00e1c th\u1ec3 l\u00e2m s\u00e0ng - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Vi\u00eam c\u01a1 tim g\u00e2y ra b\u1edfi c\u00e1c b\u1ec7nh l\u00fd nhi\u1ec5m tr\u00f9ng v\u00e0 kh\u00f4ng nhi\u1ec5m tr\u00f9ng. B\u1ec7nh c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi pha c\u1ea5p, b\u00e1n c\u1ea5p ho\u1eb7c m\u1ea1n t\u00ednh.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/viem-co-tim-va-cac-the-lam-sang\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-05-01T15:47:40+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/tai-xuong-2-1.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=\"12 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\/viem-co-tim-va-cac-the-lam-sang\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/viem-co-tim-va-cac-the-lam-sang\/\",\"name\":\"Vi\u00eam c\u01a1 tim v\u00e0 c\u00e1c th\u1ec3 l\u00e2m s\u00e0ng - Vinmec\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-05-01T15:47:40+00:00\",\"dateModified\":\"2023-05-01T15:47:40+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629\"},\"description\":\"Vi\u00eam c\u01a1 tim g\u00e2y ra b\u1edfi c\u00e1c b\u1ec7nh l\u00fd nhi\u1ec5m tr\u00f9ng v\u00e0 kh\u00f4ng nhi\u1ec5m tr\u00f9ng. B\u1ec7nh c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi pha c\u1ea5p, b\u00e1n c\u1ea5p ho\u1eb7c m\u1ea1n t\u00ednh.\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/viem-co-tim-va-cac-the-lam-sang\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/viem-co-tim-va-cac-the-lam-sang\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/viem-co-tim-va-cac-the-lam-sang\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Vi\u00eam c\u01a1 tim v\u00e0 c\u00e1c th\u1ec3 l\u00e2m s\u00e0ng\"}]},{\"@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":"Vi\u00eam c\u01a1 tim v\u00e0 c\u00e1c th\u1ec3 l\u00e2m s\u00e0ng - Vinmec","description":"Vi\u00eam c\u01a1 tim g\u00e2y ra b\u1edfi c\u00e1c b\u1ec7nh l\u00fd nhi\u1ec5m tr\u00f9ng v\u00e0 kh\u00f4ng nhi\u1ec5m tr\u00f9ng. B\u1ec7nh c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi pha c\u1ea5p, b\u00e1n c\u1ea5p ho\u1eb7c m\u1ea1n t\u00ednh.","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":"Vi\u00eam c\u01a1 tim v\u00e0 c\u00e1c th\u1ec3 l\u00e2m s\u00e0ng - Vinmec","og_description":"Vi\u00eam c\u01a1 tim g\u00e2y ra b\u1edfi c\u00e1c b\u1ec7nh l\u00fd nhi\u1ec5m tr\u00f9ng v\u00e0 kh\u00f4ng nhi\u1ec5m tr\u00f9ng. B\u1ec7nh c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi pha c\u1ea5p, b\u00e1n c\u1ea5p ho\u1eb7c m\u1ea1n t\u00ednh.","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/viem-co-tim-va-cac-the-lam-sang\/","og_site_name":"Vinmec","article_published_time":"2023-05-01T15:47:40+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/tai-xuong-2-1.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":"12 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/viem-co-tim-va-cac-the-lam-sang\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/viem-co-tim-va-cac-the-lam-sang\/","name":"Vi\u00eam c\u01a1 tim v\u00e0 c\u00e1c th\u1ec3 l\u00e2m s\u00e0ng - Vinmec","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-05-01T15:47:40+00:00","dateModified":"2023-05-01T15:47:40+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629"},"description":"Vi\u00eam c\u01a1 tim g\u00e2y ra b\u1edfi c\u00e1c b\u1ec7nh l\u00fd nhi\u1ec5m tr\u00f9ng v\u00e0 kh\u00f4ng nhi\u1ec5m tr\u00f9ng. B\u1ec7nh c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi pha c\u1ea5p, b\u00e1n c\u1ea5p ho\u1eb7c m\u1ea1n t\u00ednh.","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/viem-co-tim-va-cac-the-lam-sang\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/viem-co-tim-va-cac-the-lam-sang\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/viem-co-tim-va-cac-the-lam-sang\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Vi\u00eam c\u01a1 tim v\u00e0 c\u00e1c th\u1ec3 l\u00e2m s\u00e0ng"}]},{"@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\/30195"}],"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=30195"}],"version-history":[{"count":1,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/30195\/revisions"}],"predecessor-version":[{"id":30199,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/30195\/revisions\/30199"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=30195"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=30195"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=30195"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}