{"id":32247,"date":"2023-05-16T00:49:55","date_gmt":"2023-05-15T17:49:55","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=32247"},"modified":"2023-05-16T00:49:55","modified_gmt":"2023-05-15T17:49:55","slug":"trieu-chung-benh-co-tim-phi-dai-do-ruou","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/16\/trieu-chung-benh-co-tim-phi-dai-do-ruou\/","title":{"rendered":"Tri\u1ec7u ch\u1ee9ng b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u"},"content":{"rendered":"

U\u1ed1ng nhi\u1ec1u r\u01b0\u1ee3u trong th\u1eddi gian d\u00e0i l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u c\u1ee7a b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i th\u1ee9 ph\u00e1t. Tuy nhi\u00ean, s\u1ef1 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng tim c\u00f3 th\u1ec3 x\u1ea3y ra n\u1ebfu b\u1ec7nh \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n s\u1edbm v\u00e0 gi\u1ea3m ho\u1eb7c ng\u1eebng u\u1ed1ng r\u01b0\u1ee3u.<\/strong><\/p>\n

1. \u0110\u1ecbnh ngh\u0129a v\u00e0 t\u1ef7 l\u1ec7 b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u<\/h2>\n

B\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u l\u00e0 m\u1ed9t lo\u1ea1i b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i m\u1eafc ph\u1ea3i do u\u1ed1ng nhi\u1ec1u r\u01b0\u1ee3u trong th\u1eddi gian d\u00e0i.<\/p>\n

T\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf b\u1ec7nh nh\u00e2n suy tim (HF) ho\u1eb7c b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i r\u1ea5t kh\u00e1c nhau (v\u00ed d\u1ee5: t\u1eeb 4 \u0111\u1ebfn 40 ph\u1ea7n tr\u0103m tr\u1edf l\u00ean) v\u00e0 ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a d\u00e2n s\u1ed1 nghi\u00ean c\u1ee9u v\u00e0 ng\u01b0\u1ee1ng ti\u00eau th\u1ee5 r\u01b0\u1ee3u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh b\u1ec7nh.<\/p>\n

\"benh-co-tim-phi-dai-do-ruou\"
B\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u<\/figcaption><\/figure>\n

2. Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u<\/h2>\n

B\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 d\u1ea5u hi\u1ec7u gi\u1ed1ng nh\u01b0 \u1edf b\u1ec7nh nh\u00e2n m\u1eafc c\u00e1c d\u1ea1ng b\u1ec7nh c\u01a1 tim kh\u00e1c. Ngo\u00e0i ra, c\u00f3 th\u1ec3 quan s\u00e1t th\u1ea5y c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 d\u1ea5u hi\u1ec7u c\u1ee7a vi\u1ec7c s\u1eed d\u1ee5ng r\u01b0\u1ee3u kh\u00f4ng l\u00e0nh m\u1ea1nh.<\/p>\n

2.1. C\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 d\u1ea5u hi\u1ec7u<\/strong><\/h3>\n

C\u00e1c tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 ph\u00e1t tri\u1ec3n \u00e2m th\u1ea7m, m\u1eb7c d\u00f9 \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n, c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a suy tim tr\u00e1i c\u00f3 th\u1ec3 kh\u1edfi ph\u00e1t c\u1ea5p t\u00ednh. B\u1ec7nh nh\u00e2n th\u01b0\u1eddng kh\u00f3 th\u1edf, ch\u1ee9ng kh\u00f3 th\u1edf khi n\u1eb1m v\u00e0 kh\u00f3 th\u1edf k\u1ecbch ph\u00e1t v\u1ec1 \u0111\u00eam. \u0110au th\u1eaft ng\u1ef1c g\u1ee3i \u00fd b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh \u0111\u1ed3ng m\u1eafc (CAD; ho\u1eb7c h\u1eb9p \u0111\u1ed9ng m\u1ea1ch ch\u1ee7), m\u1eb7c d\u00f9 c\u00f3 t\u1edbi m\u1ed9t ph\u1ea7n ba s\u1ed1 b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh c\u01a1 tim kh\u00f4ng do thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 b\u1ecb \u0111au ng\u1ef1c c\u00f3 th\u1ec3 gi\u1ed1ng v\u1edbi c\u01a1n \u0111au th\u1eaft ng\u1ef1c kh\u00f4ng \u0111i\u1ec3n h\u00ecnh. \u0110\u00e1nh tr\u1ed1ng ng\u1ef1c v\u00e0 ng\u1ea5t do lo\u1ea1n nh\u1ecbp nhanh, th\u01b0\u1eddng l\u00e0 nh\u1ecbp nhanh tr\u00ean th\u1ea5t, \u0111\u00f4i khi xu\u1ea5t hi\u1ec7n.<\/p>\n

Kh\u00e1m th\u1ef1c th\u1ec3 th\u01b0\u1eddng cho th\u1ea5y c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a suy tim<\/a> tr\u00e1i v\u00e0 ph\u1ea3i<\/strong> bao g\u1ed3m huy\u1ebft \u00e1p k\u1eb9p, th\u01b0\u1eddng k\u00e8m theo t\u0103ng huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch h\u1ec7 th\u1ed1ng th\u1ee9 ph\u00e1t do co m\u1ea1ch ngo\u1ea1i bi\u00ean qu\u00e1 m\u1ee9c. Tim to (bi\u1ec3u hi\u1ec7n l\u00e0 di\u1ec7n \u0111\u1eadp \u1edf \u0111\u1ec9nh m\u1edf r\u1ed9ng v\u00e0 l\u1ec7ch sang m\u1ed9t b\u00ean), ti\u1ebfng ng\u1ef1a phi ti\u1ec1n t\u00e2m tr\u01b0\u01a1ng (S3) v\u00e0 ti\u1ec1n t\u00e2m thu (S4) ph\u1ed5 bi\u1ebfn. Th\u01b0\u1eddng th\u1ea5y ti\u1ebfng th\u1ed5i t\u00e2m thu \u1edf m\u1ecfm c\u1ee7a h\u1edf van hai l\u00e1 th\u1ee9 ph\u00e1t. M\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a suy tim ph\u1ea3i kh\u00e1c nhau, nh\u01b0ng t\u0129nh m\u1ea1ch c\u1ed5 n\u1ed5i, c\u1ed5 tr\u01b0\u1edbng v\u00e0 ph\u00f9 ngo\u1ea1i vi th\u01b0\u1eddng g\u1eb7p \u1edf b\u1ec7nh ti\u1ebfn tri\u1ec3n.<\/p>\n

\u0110o \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch c\u1ea3nh<\/strong> c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t \u0111\u1eb7c \u0111i\u1ec3m ph\u00e2n bi\u1ec7t quan tr\u1ecdng trong vi\u1ec7c x\u00e1c \u0111\u1ecbnh c\u1ed5 tr\u01b0\u1edbng l\u00e0 do b\u1ec7nh c\u01a1 tim do r\u01b0\u1ee3u hay x\u01a1 gan. \u00c1p l\u1ef1c t\u0129nh m\u1ea1ch c\u1ed5 \u0111i\u1ec3n h\u00ecnh b\u00ecnh th\u01b0\u1eddng ho\u1eb7c th\u1ea5p trong x\u01a1 gan, tr\u1eeb khi c\u00f3 c\u1ed5 tr\u01b0\u1edbng c\u0103ng, th\u00f4ng qua \u00e1p l\u1ef1c l\u00ean c\u01a1 ho\u00e0nh, c\u00f3 th\u1ec3 l\u00e0m t\u0103ng \u00e1p l\u1ef1c trong l\u1ed3ng ng\u1ef1c. Do \u0111\u00f3, trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 c\u1ed5 tr\u01b0\u1edbng c\u0103ng, \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch c\u1ed5 t\u0103ng cao g\u1ee3i \u00fd \u00edt nh\u1ea5t l\u00e0 do r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng tim. M\u1eb7t kh\u00e1c, \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch c\u1ed5 b\u00ecnh th\u01b0\u1eddng th\u1ea5p l\u00e0m cho suy tim \u00edt c\u00f3 kh\u1ea3 n\u0103ng l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ra c\u1ed5 tr\u01b0\u1edbng<\/p>\n

2.2. K\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m ban \u0111\u1ea7u <\/strong><\/h3>\n

C\u00e1c x\u00e9t nghi\u1ec7m th\u00f4ng th\u01b0\u1eddng c\u00f3 th\u1ec3 cho th\u1ea5y nh\u1eefng ph\u00e1t hi\u1ec7n to\u00e0n th\u00e2n g\u1ee3i \u00fd v\u1ec1 vi\u1ec7c l\u1ea1m d\u1ee5ng r\u01b0\u1ee3u \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i. Ch\u00fang bao g\u1ed3m\u00a0 th\u1ec3 t\u00edch h\u1ed3ng c\u1ea7u trung b\u00ecnh v\u00e0 huy\u1ebft s\u1eafc t\u1ed1 t\u0103ng cao, gi\u1ea3m ti\u1ec3u c\u1ea7u nh\u1eb9 v\u00e0 t\u0103ng n\u1ed3ng \u0111\u1ed9 gamma-glutamyl transpeptidase v\u00e0 aspartate aminotransferase (AST) trong huy\u1ebft thanh. T\u1ef7 l\u1ec7 AST so v\u1edbi alanine aminotransferase (ALT) >2 r\u1ea5t g\u1ee3i \u00fd b\u1ec7nh gan do r\u01b0\u1ee3u.<\/p>\n

\u0110i\u1ec7n t\u00e2m \u0111\u1ed3 (ECG)<\/strong> th\u01b0\u1eddng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n nghi ng\u1edd m\u1eafc b\u1ec7nh, m\u1eb7c d\u00f9 c\u00e1c ph\u00e1t hi\u1ec7n kh\u00f4ng \u0111\u1eb7c hi\u1ec7u. \u1ede nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh, c\u00e1c d\u1ea5u hi\u1ec7u tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 c\u00f3 th\u1ec3 bao g\u1ed3m r\u1ed1i lo\u1ea1n nh\u1ecbp tim (\u0111\u1eb7c bi\u1ec7t l\u00e0 rung nh\u0129), kho\u1ea3ng QT \u0111\u01b0\u1ee3c k\u00e9o d\u00e0i (QTc), th\u1eddi gian QRS k\u00e9o d\u00e0i (l\u00e0 m\u1ed9t ch\u1ec9 b\u00e1o ti\u00ean l\u01b0\u1ee3ng b\u1ea5t l\u1ee3i), b\u1ea5t th\u01b0\u1eddng d\u1eabn truy\u1ec1n (v\u00ed d\u1ee5: r\u1ed1i lo\u1ea1n nh\u1ecbp tim tr\u00e1i). block nh\u00e1nh ho\u1eb7c ch\u1eadm d\u1eabn truy\u1ec1n trong th\u1ea5t), v\u00e0 thay \u0111\u1ed5i s\u00f3ng ST v\u00e0 s\u00f3ng T.<\/p>\n

Ch\u1ee5p X quang ph\u1ed5i kh\u00f4ng chu\u1ea9n b\u1ecb<\/strong> \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u01a1 tim nh\u01b0ng th\u01b0\u1eddng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n nghi ng\u1edd m\u1eafc b\u1ec7nh suy tim \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh c\u00e1c d\u1ea5u hi\u1ec7u ph\u00f9 ph\u1ed5i v\u00e0 lo\u1ea1i tr\u1eeb c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y kh\u00f3 th\u1edf kh\u00e1c. M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh c\u01a1 tim do r\u01b0\u1ee3u c\u00f3 tim to (t\u0103ng t\u1ef7 l\u1ec7 tim tr\u00ean l\u1ed3ng ng\u1ef1c), nh\u01b0ng ph\u00e1t hi\u1ec7n n\u00e0y c\u00f3 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u v\u00e0 \u0111\u1ed9 nh\u1ea1y h\u1ea1n ch\u1ebf \u0111\u1ed1i v\u1edbi s\u1ef1 ph\u00ec \u0111\u1ea1i c\u1ee7a LV so v\u1edbi si\u00eau \u00e2m tim.<\/p>\n

Si\u00eau \u00e2m tim<\/strong> l\u00e0 m\u1ed9t x\u00e9t nghi\u1ec7m quan tr\u1ecdng trong ch\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u01a1 tim do r\u01b0\u1ee3u g\u00e2y ra.<\/p>\n

Lo\u1ea1n nh\u1ecbp tim \u2014<\/strong> B\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u c\u00f3 t\u1ef7 l\u1ec7 lo\u1ea1n nh\u1ecbp nh\u0129 v\u00e0 th\u1ea5t t\u01b0\u01a1ng t\u1ef1 nh\u01b0 b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i v\u00f4 c\u0103n. Bi\u1ec3u hi\u1ec7n ph\u1ed5 bi\u1ebfn nh\u1ea5t l\u00e0 r\u1ed1i lo\u1ea1n nh\u1ecbp nh\u0129 k\u1ecbch ph\u00e1t, \u0111\u1eb7c bi\u1ec7t l\u00e0 rung nh\u0129, nh\u01b0ng r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra. Kho\u1ea3ng QTc k\u00e9o d\u00e0i nh\u1eb9 tr\u00ean ECG (QTc), m\u1ed9t y\u1ebfu t\u1ed1 nguy c\u01a1 g\u00e2y r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t, \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y \u1edf b\u1ec7nh nh\u00e2n m\u1eafc ch\u1ee9ng r\u1ed1i lo\u1ea1n s\u1eed d\u1ee5ng r\u01b0\u1ee3u v\u1edbi t\u1ef7 l\u1ec7 cao h\u01a1n so v\u1edbi b\u1ec7nh nh\u00e2n kh\u00f4ng b\u1ecb r\u1ed1i lo\u1ea1n s\u1eed d\u1ee5ng r\u01b0\u1ee3u. H\u1ea1 magie m\u00e1u v\u00e0 h\u1ea1 kali m\u00e1u, x\u1ea3y ra v\u1edbi t\u1ea7n su\u1ea5t gia t\u0103ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n nghi\u1ec7n r\u01b0\u1ee3u, c\u00f3 th\u1ec3 l\u00e0 nh\u1eefng y\u1ebfu t\u1ed1 g\u00f3p ph\u1ea7n . Vi\u1ec7c ki\u00eang khem d\u01b0\u1eddng nh\u01b0 l\u00e0m gi\u1ea3m t\u1ea7n su\u1ea5t c\u00e1c bi\u1ebfn c\u1ed1 lo\u1ea1n nh\u1ecbp tim .<\/p>\n","protected":false},"excerpt":{"rendered":"

U\u1ed1ng nhi\u1ec1u r\u01b0\u1ee3u trong th\u1eddi gian d\u00e0i l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u c\u1ee7a b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i th\u1ee9 ph\u00e1t. Tuy nhi\u00ean, s\u1ef1 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng tim c\u00f3 th\u1ec3 x\u1ea3y ra n\u1ebfu b\u1ec7nh \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n s\u1edbm v\u00e0 gi\u1ea3m ho\u1eb7c ng\u1eebng u\u1ed1ng r\u01b0\u1ee3u. 1. \u0110\u1ecbnh ngh\u0129a v\u00e0 t\u1ef7 l\u1ec7 b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i […]<\/p>\n","protected":false},"author":60,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\nTri\u1ec7u ch\u1ee9ng b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u - Vinmec<\/title>\n<meta name=\"description\" content=\"S\u1ef1 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng tim trong b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u c\u00f3 th\u1ec3 x\u1ea3y ra n\u1ebfu b\u1ec7nh \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n s\u1edbm v\u00e0 gi\u1ea3m ho\u1eb7c ng\u1eebng u\u1ed1ng r\u01b0\u1ee3u.\" \/>\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=\"Tri\u1ec7u ch\u1ee9ng b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u - 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