{"id":31291,"date":"2023-05-04T14:40:28","date_gmt":"2023-05-04T07:40:28","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31291"},"modified":"2023-05-04T16:33:21","modified_gmt":"2023-05-04T09:33:21","slug":"cuong-nhi-va-nhung-van-de-co-ban","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/cuong-nhi-va-nhung-van-de-co-ban\/","title":{"rendered":"Cu\u1ed3ng nh\u0129 v\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 c\u01a1 b\u1ea3n"},"content":{"rendered":"

Cu\u1ed3ng nh\u0129 l\u00e0 d\u1ea1ng nh\u1ecbp nhanh nh\u0129 \u0111\u1ec1u do v\u00f2ng v\u00e0o l\u1ea1i l\u1edbn t\u1ea1i t\u00e2m nh\u0129, s\u1ef1 kh\u1eed c\u1ef1c nhanh trong t\u00e2m nh\u0129 c\u00f3 th\u1ec3 c\u00f9ng chi\u1ec1u hay ng\u01b0\u1ee3c chi\u1ec1u kim \u0111\u1ed3ng h\u1ed3 t\u1ea7n s\u1ed1 nhanh \u0111\u1ebfn 300l\/ph\u00fat. S\u1ef1 ph\u00f3ng d\u00f2ng \u0111i\u1ec7n kh\u1eed c\u1ef1c s\u1ebd t\u1ea1o ra h\u00ecnh \u1ea3nh s\u00f3ng l\u1edbn h\u00ecnh r\u0103ng c\u01b0a g\u1ecdi l\u00e0 s\u00f3ng F c\u1ee7a nh\u0129. T\u00e1c \u0111\u1ed9ng c\u1ee7a s\u00f3ng F n\u00e0y \u0111\u1ebfn t\u1ea7ng th\u1ea5t t\u00f9y thu\u1ed9c v\u00e0o \u0111\u00e1p \u1ee9ng c\u1ee7a n\u00fat nh\u0129 th\u1ea5t, th\u01b0\u1eddng s\u1ebd g\u00e2y bl\u1ed1c ch\u1ecdn l\u1ecdc 2:1, 3:1, 4:1 . Cu\u1ed3ng nh\u0129 c\u0169ng \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 b\u1eb1ng d\u1ea1ng h\u00ecnh r\u0103ng c\u01b0a tr\u00ean ECG chuy\u1ec3n \u0111\u1ea1o II, III, aVF. C\u00e1c ph\u1ee9c b\u1ed9 QRS s\u1ebd b\u1ecb thu h\u1eb9p do t\u00edn hi\u1ec7u b\u00ean ngo\u00e0i t\u00e2m nh\u0129.<\/strong><\/p>\n

1. Ph\u00e2n lo\u1ea1i cu\u1ed3ng nh\u0129<\/h2>\n


\n<\/strong>Type 1: Cu\u1ed3ng nh\u0129 ph\u1ee5 thu\u1ed9c v\u00e0o CTI (Cavo Tricuspid Isthmus) \u2013 \u0111i\u1ec3n h\u00ecnh<\/p>\n

Cu\u1ed3ng nh\u0129 “\u0111i\u1ec3n h\u00ecnh” ho\u1eb7c ph\u1ed5 bi\u1ebfn c\u00f3 t\u1ed1c \u0111\u1ed9 nh\u0129 240-340 bpm v\u00e0 t\u1ea1o ra h\u00ecnh r\u0103ng c\u01b0a \u1edf
\nchuy\u1ec3n \u0111\u1ea1o II, III, aVF tr\u00ean ECG.<\/p>\n

\uf0d8 V\u00f2ng v\u00e0o l\u1ea1i l\u1edbn ch\u1ea1y v\u00f2ng quanh van 3 l\u00e1 v\u00e0 CTI n\u1eb1m trong v\u00f2ng n\u00e0y.<\/p>\n

\uf0d8 V\u00f2ng quanh van ba l\u00e1 c\u1ee7a nh\u0129 ph\u1ea3i gi\u1ea3i ph\u1eabu \u0111\u1eb7c bi\u1ec7t t\u1ea1o ra m\u1ed9t h\u00e0ng r\u00e0o ng\u0103n c\u00e1c xung \u0111\u1ed9ng \u0111i\u1ec7n ch\u1ea1y qua v\u00e0 ch\u1ec9 xung \u0111\u1ed9ng \u0111i\u1ec7n ch\u1ea1y v\u00f2ng quanh van 3 l\u00e1<\/p>\n

\uf0d8 C\u1ea5u tr\u00fac: xoang v\u00e0nh (CS) \u1edf ph\u00eda d\u01b0\u1edbi trong, g\u1edd van eustachi (ER) \u1edf ph\u00eda d\u01b0\u1edbi, t\u0129nh m\u1ea1ch ch\u1ee7 d\u01b0\u1edbi \u1edf ph\u00eda d\u01b0\u1edbi ngo\u00e0i, d\u1ea3i c\u01a1 CT (cristal terminalis: m\u00e0o t\u1eadn ) \u1edf th\u00e0nh b\u00ean nh\u0129 ph\u1ea3i, ti\u1ebfp theo l\u00e0 v\u00f9ng tr\u01b0\u1edbc c\u1ee7a van 3 l\u00e1 v\u00e0 v\u00e1ch li\u00ean nh\u0129.<\/p>\n

\uf0d8 V\u00f9ng d\u1eabn truy\u1ec1n ch\u1eadm l\u00e0 khu v\u1ef1c g\u1edd sau eustachi, g\u1ecdi l\u00e0 v\u00f9ng CTI (cavo tricuspid isthmus: eo gi\u1eefa t\u0129nh m\u1ea1ch ch\u1ee7 d\u01b0\u1edbi v\u00e0 van 3 l\u00e1) n\u1eb1m gi\u1eefa t\u0129nh m\u1ea1ch ch\u1ee7 d\u01b0\u1edbi v\u00e0 van ba l\u00e1. \u0110\u00e2y l\u00e0 v\u00f9ng t\u1ea1o ra c\u01a1 ch\u1ebf ch\u00ednh c\u1ee7a cu\u1ed3ng nh\u0129 \u0111i\u1ec3n h\u00ecnh.<\/p>\n

Type 2: Cu\u1ed3ng nh\u0129 kh\u00f4ng ph\u1ee5 thu\u1ed9c CTI –\u00a0 kh\u00f4ng \u0111i\u1ec3n h\u00ecnh<\/p>\n

\u0110\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi m\u1ed9t t\u1ed1c \u0111\u1ed9 nh\u0129 cao h\u01a1n l\u00e0 340-440 bpm.<\/p>\n

\uf06e C\u1ea5u tr\u00fac b\u1ea5t th\u01b0\u1eddng kh\u00e1c: s\u1eb9o, t\u0129nh m\u1ea1ch ph\u1ed5i, v\u00f2ng van 2 l\u00e1<\/p>\n

\uf06e Do ph\u1eabu thu\u1eadt b\u1ec7nh tim b\u1ea9m sinh th\u01b0\u1eddng c\u00f3 \u0111\u01b0\u1eddng v\u00e0o t\u1ea1i nh\u0129 ph\u1ea3i n\u00ean sau ph\u1eabu thu\u1eadt s\u1ebd t\u1ea1o s\u1eb9o. V\u00f2ng v\u00e0o l\u1ea1i c\u00f3 th\u1ec3 ch\u1ea1y quanh s\u1eb9o n\u00e0y ho\u1eb7c gi\u1eefa s\u1eb9o n\u00e0y v\u1edbi t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean ho\u1eb7c t\u0129nh m\u1ea1ch ch\u1ee7 d\u01b0\u1edbi. Sau ph\u1eabu thu\u1eadt thay van hai l\u00e1 t\u1ea1o s\u1eb9o v\u00e0 c\u00f3 th\u1ec3 tr\u1edf th\u00e0nh trung t\u00e2m cho v\u00f2ng v\u00e0o l\u1ea1i c\u1ee7a cu\u1ed3ng nh\u0129.<\/p>\n

\uf06e Cu\u1ed3ng nh\u0129 sau ph\u1eabu thu\u1eadt tim b\u1ea9m sinh kh\u00e1 \u0111\u1eb7c bi\u1ec7t v\u1edbi t\u1ef7 l\u1ec7 cao h\u01a1n, th\u01b0\u1eddng x\u1ea3y ra sau ph\u1eabu thu\u1eadt.<\/p>\n

2. Nguy\u00ean nh\u00e2n cu\u1ed3ng nh\u0129<\/h2>\n

M\u1ed9t lo\u1ea1t c\u00e1c b\u1ec7nh tim v\u00e0 ph\u1ed5i c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn cu\u1ed3ng nh\u0129. B\u1ea5t k\u1ef3 b\u1ec7nh tim d\u1eabn \u0111\u1ebfn vi\u00eam ho\u1eb7c thay \u0111\u1ed5i c\u1ea5u tr\u00fac c\u1ee7a tim c\u00f3 th\u1ec3 g\u00e2y ra cu\u1ed3ng nh\u0129, bao g\u1ed3m b\u1ec7nh c\u01a1 tim, b\u1ec7nh tim b\u1ea9m sinh, b\u1ec7nh th\u1ea5p kh\u1edbp, v\u00e0 vi\u00eam m\u00e0ng ngo\u00e0i tim. Kho\u1ea3ng 1\/3 b\u1ec7nh nh\u00e2n b\u1ecb cu\u1ed3ng nh\u0129 c\u00f3 th\u1ec3 kh\u00f4ng m\u1eafc c\u00e1c b\u1ec7nh tim m\u1ea1ch; Tuy nhi\u00ean, kho\u1ea3ng 1\/3 b\u1ec7nh nh\u00e2n cu\u1ed3ng nh\u0129 c\u00f3 b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh (\u0111au th\u1eaft ng\u1ef1c v\u00e0 nh\u1ed3i m\u00e1u c\u01a1 tim), v\u00e0 1\/3 c\u00f2n l\u1ea1i b\u1ecb t\u0103ng huy\u1ebft \u00e1p.
\nT\u00ecnh tr\u1ea1ng n\u1ec1n ph\u1ed5 bi\u1ebfn kh\u00e1c bao g\u1ed3m:
\n\u2022 COPD
\n\u2022 Thuy\u00ean t\u1eafc ph\u1ed5i
\n\u2022 M\u1ea5t c\u00e2n b\u1eb1ng \u0111i\u1ec7n gi\u1ea3i
\n\u2022 Ng\u1ed9 \u0111\u1ed9c digitalis
\n\u2022 C\u01b0\u1eddng gi\u00e1p
\n\u2022 Sau ph\u1eabu thu\u1eadt b\u1eafc c\u1ea7u
\n\u2022 B\u1ec7nh van tim
\n\u2022 Suy tim sung huy\u1ebft<\/p>\n

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

Ph\u1ed5 bi\u1ebfn nh\u1ea5t, cu\u1ed3ng nh\u0129 lo\u1ea1i 1, \u0111\u01b0\u1ee3c g\u00e2y ra b\u1edfi m\u1ed9t v\u00f2ng v\u00e0o l\u1ea1i l\u00e0m r\u1ed1i lo\u1ea1n nh\u1ecbp tim c\u00f3 ngu\u1ed3n g\u1ed1c \u1edf t\u00e2m nh\u0129 ph\u1ea3i \u0111i v\u00f2ng quanh van ba l\u00e1. Cu\u1ed3ng nh\u0129 lo\u1ea1i 2 c\u00f3 th\u1ec3 c\u00f3 ngu\u1ed3n g\u1ed1c \u1edf t\u00e2m nh\u0129 tr\u00e1i ho\u1eb7c ph\u1ea3i, t\u0129nh m\u1ea1ch ph\u1ed5i (t\u01b0\u01a1ng t\u1ef1 nh\u01b0 rung nh\u0129), ho\u1eb7c van hai l\u00e1.
\nM\u1ed9t v\u00f2ng v\u00e0o l\u1ea1i l\u00e0m r\u1ed1i lo\u1ea1n nh\u1ecbp tim \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 nh\u01b0 l\u00e0 m\u1ed9t t\u00edn hi\u1ec7u kh\u1eed c\u1ef1c m\u00e0 di chuy\u1ec3n trong m\u1ed9t v\u00f2ng tr\u00f2n ch\u1eb7t ch\u1ebd th\u00f4ng qua c\u00e1c s\u1ee3i d\u1eabn truy\u1ec1n c\u1ee7a tim, d\u1eabn \u0111\u1ebfn co th\u1eaft nhanh kh\u00f4ng c\u00f3 ki\u1ec3m so\u00e1t.
\nTrong cu\u1ed3ng nh\u0129, v\u00f2ng v\u00e0o l\u1ea1i n\u00e0y gi\u1edbi h\u1ea1n \u1edf t\u00e2m nh\u0129. C\u1ea3 hai lo\u1ea1i cu\u1ed3ng nh\u0129 lo\u1ea1i 1 v\u00e0 lo\u1ea1i 2 t\u00e2m nh\u0129 \u0111\u00f2i h\u1ecfi block d\u1eabn truy\u1ec1n; ch\u1ec9 1 trong m\u1ed7i 2 ho\u1eb7c 3 t\u00edn hi\u1ec7u co \u0111i qua n\u00fat nh\u0129 th\u1ea5t, d\u1eabn \u0111\u1ebfn co t\u00e2m th\u1ea5t.
\n\u0110\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng
\n<\/strong>C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ea5p t\u00ednh c\u1ee7a cu\u1ed3ng nh\u0129 l\u00e0 \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c th\u01b0\u1eddng xuy\u00ean. \u0110i\u1ec1u n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c dung n\u1ea1p t\u1ed1t tr\u00ean m\u1ed9t tr\u00e1i tim kh\u1ecfe m\u1ea1nh \u1edf m\u1ed9t b\u1ec7nh nh\u00e2n kh\u1ecfe m\u1ea1nh. Tuy nhi\u00ean, n\u1ebfu b\u1ec7nh nh\u00e2n l\u00e0 “deconditioned” ho\u1eb7c c\u00f3 b\u1ec7nh tim ti\u1ec1m \u1ea9n c\u00f3 th\u1ec3 c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng bao g\u1ed3m:
\n\u2022 Kh\u00f3 th\u1edf
\n\u2022 \u0110au ng\u1ef1c
\n\u2022 X\u00e2y x\u1ea9m
\n\u2022 Ch\u00f3ng m\u1eb7t
\n\u2022 Bu\u1ed3n n\u00f4n
\n\u2022 Lo \u00e2u qu\u00e1 m\u1ee9c
\nM\u1ed9t qu\u00e1 tr\u00ecnh cu\u1ed3ng nh\u0129 k\u00e9o d\u00e0i c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn suy tim. C\u00e1c tri\u1ec7u ch\u1ee9ng bao g\u1ed3m:
\n<\/strong>\u2022 Kh\u00f3 th\u1edf khi g\u1eafng s\u1ee9c
\n\u2022 Ph\u00f9
\n\u2022 Kh\u00f3 th\u1edf khi n\u1eb1m
\n\u2022 \u0110au ng\u1ef1c<\/p>\n

4. Ch\u1ea9n \u0111o\u00e1n b\u1eb1ng h\u00ecnh \u1ea3nh h\u1ecdc<\/h2>\n

4.1 ECG
\n<\/strong>M\u1ed9t \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 th\u01b0\u1eddng l\u00e0 \u0111\u1ee7 \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n cu\u1ed3ng nh\u0129. Tr\u00ean ECG, nh\u1ecbp nh\u0129 kho\u1ea3ng 250-350 bpm (lo\u1ea1i 1) ho\u1eb7c 350-450 bpm (lo\u1ea1i 2) \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n b\u1edfi c\u00e1c s\u00f3ng P. S\u00f3ng P s\u1ebd c\u00f3 m\u1ed9t h\u00ecnh d\u1ea1ng r\u0103ng c\u01b0a kh\u00e1c bi\u1ec7t v\u00e0 \u0111\u00f4i khi \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 s\u00f3ng f hay “s\u00f3ng cu\u1ed3ng nh\u0129”. S\u00f3ng cu\u1ed3ng nh\u0129 h\u00ecnh r\u0103ng c\u01b0a tr\u00ean ECG \u1edf chuy\u1ec3n \u0111\u1ea1o II, III, aVF l\u00e0 \u0111\u1ee7 \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n lo\u1ea1i rung nh\u0129 lo\u1ea1i 1. N\u1ebfu s\u00f3ng cu\u1ed3ng nh\u0129 h\u01b0\u1edbng l\u00ean, v\u00f2ng v\u00e0o l\u1ea1i s\u1ebd ch\u1ea1y theo chi\u1ec1u kim \u0111\u1ed3ng h\u1ed3. N\u1ebfu s\u00f3ng cu\u1ed3ng nh\u0129 \u0111\u1ea3o ng\u01b0\u1ee3c, v\u00f2ng v\u00e0o l\u1ea1i s\u1ebd ch\u1ea1y ng\u01b0\u1ee3c chi\u1ec1u kim \u0111\u1ed3ng (ph\u1ed5 bi\u1ebfn h\u01a1n). Th\u00eam v\u00e0o \u0111\u00f3, ph\u1ee9c b\u1ed9 QRS h\u1eb9p khi m\u00e0 nh\u1ecbp b\u1eaft ngu\u1ed3n t\u1eeb b\u00ean ngo\u00e0i t\u00e2m nh\u0129.
\nCu\u1ed1i c\u00f9ng, nh\u1ecbp nh\u0129 v\u00e0 nh\u1ecbp th\u1ea5t s\u1ebd c\u00f3 m\u1ed9t t\u1ec9 l\u1ec7 kh\u00f4ng \u0111\u1ed5i. T\u1ec9 l\u1ec7 2:1 ho\u1eb7c 3:1 c\u1ee7a s\u00f3ng P \u0111\u1ebfn ph\u1ee9c b\u1ed9 QRS l\u00e0 ph\u1ed5 bi\u1ebfn. \u0110\u00f4i khi nh\u1ecbp tim l\u00e0 qu\u00e1 nhanh \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh s\u00f3ng h\u00ecnh r\u0103ng c\u01b0a. Truy\u1ec1n adenosine s\u1ebd l\u00e0m ch\u1eadm t\u1ed1c \u0111\u1ed9 d\u1eabn truy\u1ec1n t\u1ea1i n\u00fat AV, gi\u1ea3m nh\u1ecbp th\u1ea5t v\u00e0 t\u0103ng s\u1ed1 l\u01b0\u1ee3ng s\u00f3ng P l\u1eb7p \u0111i l\u1eb7p l\u1ea1i quan s\u00e1t \u0111\u01b0\u1ee3c. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 gi\u00fap ch\u1ea9n \u0111o\u00e1n d\u1ec5 d\u00e0ng. Ngo\u00e0i ra, m\u1ed9t nghi\u1ec7m ph\u00e1p ph\u1ebf b\u1ecb c\u00f3 th\u1ec3 cung c\u1ea5p h\u1ed7 tr\u1ee3 ch\u1ea9n \u0111o\u00e1n. Nghi\u1ec7m ph\u00e1p ph\u1ed5 bi\u1ebfn nh\u1ea5t \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong b\u1ed1i c\u1ea3nh l\u00e2m s\u00e0ng l\u00e0 nghi\u1ec7m ph\u00e1p Valsalva.<\/p>\n

\"cuong-nhi\"
H\u00ecnh \u1ea3nh \u0111i\u1ec3n h\u00ecnh<\/figcaption><\/figure>\n

4.2 Si\u00eau \u00e2m tim
\n<\/strong>Si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c s\u1ebd l\u00e0 m\u1ed9t ph\u1ea7n ch\u1ea9n \u0111o\u00e1n ti\u00eau chu\u1ea9n cho rung nh\u0129. Th\u1ee7 thu\u1eadt n\u00e0y s\u1ebd \u0111\u00e1nh gi\u00e1 nh\u0129 tr\u00e1i v\u00e0 nh\u0129 ph\u1ea3i v\u00e0 gi\u00fap lo\u1ea1i tr\u1eeb b\u1ec7nh c\u01a1 tim, vi\u00eam m\u00e0ng ngo\u00e0i tim, v\u00e0 b\u1ec7nh van tim. Th\u00eam v\u00e0o \u0111\u00f3, si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n c\u00f3 th\u1ec3 s\u1ebd \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 ph\u00e1t hi\u1ec7n s\u1ef1 h\u00ecnh th\u00e0nh huy\u1ebft kh\u1ed1i trong t\u00e2m nh\u0129 tr\u00e1i.<\/p>\n

T\u00e0i li\u1ec7u tham kh\u1ea3o:\u00a0<\/strong><\/p>\n

    \n
  • B\u00e0i gi\u1ea3ng Cu\u1ed3ng Nh\u0129, TS TR\u01af\u01a0NG QUANG KHANH, BV Th\u1ed1ng Nh\u1ea5t<\/li>\n
  • \u00a0B\u1ec7nh H\u1ecdc Tim M\u1ea1ch Lecturio<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

    Cu\u1ed3ng nh\u0129 l\u00e0 d\u1ea1ng nh\u1ecbp nhanh nh\u0129 \u0111\u1ec1u do v\u00f2ng v\u00e0o l\u1ea1i l\u1edbn t\u1ea1i t\u00e2m nh\u0129, s\u1ef1 kh\u1eed c\u1ef1c nhanh trong t\u00e2m nh\u0129 c\u00f3 th\u1ec3 c\u00f9ng chi\u1ec1u hay ng\u01b0\u1ee3c chi\u1ec1u kim \u0111\u1ed3ng h\u1ed3 t\u1ea7n s\u1ed1 nhanh \u0111\u1ebfn 300l\/ph\u00fat. S\u1ef1 ph\u00f3ng d\u00f2ng \u0111i\u1ec7n kh\u1eed c\u1ef1c s\u1ebd t\u1ea1o ra h\u00ecnh \u1ea3nh s\u00f3ng l\u1edbn h\u00ecnh r\u0103ng c\u01b0a g\u1ecdi […]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\nCu\u1ed3ng nh\u0129 v\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 c\u01a1 b\u1ea3n - Vinmec<\/title>\n<meta name=\"description\" content=\"Cu\u1ed3ng nh\u0129 l\u00e0 d\u1ea1ng nh\u1ecbp nhanh nh\u0129 \u0111\u1ec1u do v\u00f2ng v\u00e0o l\u1ea1i l\u1edbn t\u1ea1i t\u00e2m nh\u0129, kh\u1eed c\u1ef1c nhanh t\u1ea1i t\u00e2m nh\u0129 c\u00f3 th\u1ec3 c\u00f9ng chi\u1ec1u hay ng\u01b0\u1ee3c chi\u1ec1u kim \u0111\u1ed3ng h\u1ed3.\" \/>\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=\"Cu\u1ed3ng nh\u0129 v\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 c\u01a1 b\u1ea3n - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Cu\u1ed3ng nh\u0129 l\u00e0 d\u1ea1ng nh\u1ecbp nhanh nh\u0129 \u0111\u1ec1u do v\u00f2ng v\u00e0o l\u1ea1i l\u1edbn t\u1ea1i t\u00e2m nh\u0129, kh\u1eed c\u1ef1c nhanh t\u1ea1i t\u00e2m nh\u0129 c\u00f3 th\u1ec3 c\u00f9ng chi\u1ec1u hay ng\u01b0\u1ee3c chi\u1ec1u kim \u0111\u1ed3ng h\u1ed3.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/cuong-nhi-va-nhung-van-de-co-ban\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-05-04T07:40:28+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-05-04T09:33:21+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/atrial_flutter_21349464229752-300x113.webp\" \/>\n<meta name=\"author\" content=\"Dai Tran Van\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Dai Tran Van\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 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\/04\/cuong-nhi-va-nhung-van-de-co-ban\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/cuong-nhi-va-nhung-van-de-co-ban\/\",\"name\":\"Cu\u1ed3ng nh\u0129 v\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 c\u01a1 b\u1ea3n - Vinmec\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-05-04T07:40:28+00:00\",\"dateModified\":\"2023-05-04T09:33:21+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b99bd843f29d91903ec9b6d18e47b0e2\"},\"description\":\"Cu\u1ed3ng nh\u0129 l\u00e0 d\u1ea1ng nh\u1ecbp nhanh nh\u0129 \u0111\u1ec1u do v\u00f2ng v\u00e0o l\u1ea1i l\u1edbn t\u1ea1i t\u00e2m nh\u0129, kh\u1eed c\u1ef1c nhanh t\u1ea1i t\u00e2m nh\u0129 c\u00f3 th\u1ec3 c\u00f9ng chi\u1ec1u hay ng\u01b0\u1ee3c chi\u1ec1u kim \u0111\u1ed3ng h\u1ed3.\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/cuong-nhi-va-nhung-van-de-co-ban\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/cuong-nhi-va-nhung-van-de-co-ban\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/cuong-nhi-va-nhung-van-de-co-ban\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Cu\u1ed3ng nh\u0129 v\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 c\u01a1 b\u1ea3n\"}]},{\"@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\/b99bd843f29d91903ec9b6d18e47b0e2\",\"name\":\"Dai Tran Van\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/1.gravatar.com\/avatar\/104f3ddcb78816cdc9f1340c38ade413?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/1.gravatar.com\/avatar\/104f3ddcb78816cdc9f1340c38ade413?s=96&d=mm&r=g\",\"caption\":\"Dai Tran Van\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/tranvandai2791995gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Cu\u1ed3ng nh\u0129 v\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 c\u01a1 b\u1ea3n - Vinmec","description":"Cu\u1ed3ng nh\u0129 l\u00e0 d\u1ea1ng nh\u1ecbp nhanh nh\u0129 \u0111\u1ec1u do v\u00f2ng v\u00e0o l\u1ea1i l\u1edbn t\u1ea1i t\u00e2m nh\u0129, kh\u1eed c\u1ef1c nhanh t\u1ea1i t\u00e2m nh\u0129 c\u00f3 th\u1ec3 c\u00f9ng chi\u1ec1u hay ng\u01b0\u1ee3c chi\u1ec1u kim \u0111\u1ed3ng h\u1ed3.","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":"Cu\u1ed3ng nh\u0129 v\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 c\u01a1 b\u1ea3n - Vinmec","og_description":"Cu\u1ed3ng nh\u0129 l\u00e0 d\u1ea1ng nh\u1ecbp nhanh nh\u0129 \u0111\u1ec1u do v\u00f2ng v\u00e0o l\u1ea1i l\u1edbn t\u1ea1i t\u00e2m nh\u0129, kh\u1eed c\u1ef1c nhanh t\u1ea1i t\u00e2m nh\u0129 c\u00f3 th\u1ec3 c\u00f9ng chi\u1ec1u hay ng\u01b0\u1ee3c chi\u1ec1u kim \u0111\u1ed3ng h\u1ed3.","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/cuong-nhi-va-nhung-van-de-co-ban\/","og_site_name":"Vinmec","article_published_time":"2023-05-04T07:40:28+00:00","article_modified_time":"2023-05-04T09:33:21+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/atrial_flutter_21349464229752-300x113.webp"}],"author":"Dai Tran Van","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Dai Tran Van","Est. reading time":"6 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/cuong-nhi-va-nhung-van-de-co-ban\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/cuong-nhi-va-nhung-van-de-co-ban\/","name":"Cu\u1ed3ng nh\u0129 v\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 c\u01a1 b\u1ea3n - Vinmec","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-05-04T07:40:28+00:00","dateModified":"2023-05-04T09:33:21+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b99bd843f29d91903ec9b6d18e47b0e2"},"description":"Cu\u1ed3ng nh\u0129 l\u00e0 d\u1ea1ng nh\u1ecbp nhanh nh\u0129 \u0111\u1ec1u do v\u00f2ng v\u00e0o l\u1ea1i l\u1edbn t\u1ea1i t\u00e2m nh\u0129, kh\u1eed c\u1ef1c nhanh t\u1ea1i t\u00e2m nh\u0129 c\u00f3 th\u1ec3 c\u00f9ng chi\u1ec1u hay ng\u01b0\u1ee3c chi\u1ec1u kim \u0111\u1ed3ng h\u1ed3.","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/cuong-nhi-va-nhung-van-de-co-ban\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/cuong-nhi-va-nhung-van-de-co-ban\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/cuong-nhi-va-nhung-van-de-co-ban\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Cu\u1ed3ng nh\u0129 v\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 c\u01a1 b\u1ea3n"}]},{"@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\/b99bd843f29d91903ec9b6d18e47b0e2","name":"Dai Tran Van","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/1.gravatar.com\/avatar\/104f3ddcb78816cdc9f1340c38ade413?s=96&d=mm&r=g","contentUrl":"http:\/\/1.gravatar.com\/avatar\/104f3ddcb78816cdc9f1340c38ade413?s=96&d=mm&r=g","caption":"Dai Tran Van"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/tranvandai2791995gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/31291"}],"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\/16"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=31291"}],"version-history":[{"count":2,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/31291\/revisions"}],"predecessor-version":[{"id":31763,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/31291\/revisions\/31763"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=31291"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=31291"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=31291"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}