{"id":32250,"date":"2023-05-16T00:49:37","date_gmt":"2023-05-15T17:49:37","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=32250"},"modified":"2023-05-16T00:49:37","modified_gmt":"2023-05-15T17:49:37","slug":"chan-doan-benh-co-tim-phi-dai-do-ruou","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/16\/chan-doan-benh-co-tim-phi-dai-do-ruou\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u"},"content":{"rendered":"

\u00a0N\u00ean nghi ng\u1edd ch\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 ti\u1ec1n s\u1eed s\u1eed d\u1ee5ng r\u01b0\u1ee3u n\u1eb7ng v\u00e0 k\u00e9o d\u00e0i v\u1edbi c\u00e1c d\u1ea5u hi\u1ec7u gi\u00e3n th\u1ea5t tr\u00e1i (v\u00ed d\u1ee5, di\u1ec7n \u0111\u1eadp m\u1ecfm tim di l\u1ec7ch sang b\u00ean v\u00e0 m\u1edf r\u1ed9ng) ho\u1eb7c c\u00e1c tri\u1ec7u ch\u1ee9ng ho\u1eb7c d\u1ea5u hi\u1ec7u c\u1ee7a suy tim (HF) (v\u00ed d\u1ee5: , kh\u00f3 th\u1edf, m\u1ec7t m\u1ecfi).<\/strong><\/p>\n

1. Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u<\/strong><\/h2>\n

B\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 c\u1ea3 ba ti\u00eau chu\u1ea9n sau:<\/p>\n

    \n
  • U\u1ed1ng r\u01b0\u1ee3u n\u1eb7ng trong th\u1eddi gian d\u00e0i (th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 >80 g m\u1ed7i ng\u00e0y trong kho\u1ea3ng th\u1eddi gian \u00edt nh\u1ea5t 5 n\u0103m).<\/li>\n
  • \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i \u2013 Hai \u0111\u1eb7c \u0111i\u1ec3m sau \u0111\u00e2y th\u01b0\u1eddng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1eb1ng si\u00eau \u00e2m tim. N\u1ebfu si\u00eau \u00e2m tim kh\u00f4ng \u0111\u1ea1t m\u1ee9c t\u1ed1i \u01b0u, c\u1ed9ng h\u01b0\u1edfng t\u1eeb tim m\u1ea1ch (CMR) ho\u1eb7c ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh (CT) l\u00e0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p thay th\u1ebf \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m n\u00e0y<\/li>\n
  • Gi\u00e3n th\u1ea5t tr\u00e1i (LV) \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 th\u1ec3 t\u00edch cu\u1ed1i t\u00e2m tr\u01b0\u01a1ng LV ho\u1eb7c k\u00edch th\u01b0\u1edbc t\u00e2m tr\u01b0\u01a1ng LV (LVDD) l\u1edbn h\u01a1n 2 \u0111\u1ed9 l\u1ec7ch chu\u1ea9n so v\u1edbi b\u00ecnh th\u01b0\u1eddng (b\u1eb1ng si\u00eau \u00e2m tim, LVDD >58,4 mm \u1edf nam v\u00e0 >52,2 mm \u1edf n\u1eef).<\/li>\n<\/ul>\n

    v\u1edbi<\/p>\n

      \n
    • LVEF d\u01b0\u1edbi m\u1ee9c b\u00ecnh th\u01b0\u1eddng \u2013 M\u1eb7c d\u00f9 ph\u1ea1m vi b\u00ecnh th\u01b0\u1eddng c\u1ee7a LVEF kh\u00e1c nhau gi\u1eefa c\u00e1c ph\u01b0\u01a1ng th\u1ee9c ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh v\u00e0 d\u00e2n s\u1ed1, nh\u01b0ng LVEF <50% l\u00e0 b\u1ea5t th\u01b0\u1eddng \u0111\u1ed1i v\u1edbi c\u00e1c ph\u01b0\u01a1ng th\u1ee9c v\u00e0 l\u00e0 ng\u01b0\u1ee1ng \u0111\u01b0\u1ee3c ch\u1ea5p nh\u1eadn \u0111\u1ed1i v\u1edbi b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i<\/li>\n<\/ul>\n

      V\u00e0<\/p>\n

        \n
      • Kh\u00f4ng c\u00f3 b\u1ec7nh t\u0103ng huy\u1ebft \u00e1p, van tim v\u00e0 thi\u1ebfu m\u00e1u c\u01a1 tim c\u0169ng nh\u01b0 c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c c\u1ee7a b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i \u0111\u1ee7 \u0111\u1ec3 g\u00e2y ra r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu LV. CAD n\u00ean \u0111\u01b0\u1ee3c lo\u1ea1i tr\u1eeb.<\/li>\n<\/ul>\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. X\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n\u00a0<\/strong><\/h2>\n

        B\u1ec7nh nh\u00e2n nghi ng\u1edd m\u1eafc b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u n\u00ean \u0111\u01b0\u1ee3c si\u00eau \u00e2m tim c\u0169ng nh\u01b0 \u0111\u00e1nh gi\u00e1 CAD.<\/p>\n

        Si\u00eau \u00e2m tim \u2014<\/strong> Si\u00eau \u00e2m tim n\u00f3i chung l\u00e0 m\u1ed9t x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n quan tr\u1ecdng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u. B\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi gi\u00e3n LV r\u00f5 r\u1ec7t ho\u1eb7c gi\u00e3n hai t\u00e2m th\u1ea5t, t\u0103ng kh\u1ed1i l\u01b0\u1ee3ng LV, th\u00e0nh LV m\u1ecfng (ho\u1eb7c \u0111\u1ed9 d\u00e0y b\u00ecnh th\u01b0\u1eddng), r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m tr\u01b0\u01a1ng v\u00e0 suy t\u00e2m thu. N\u1ebfu k\u00edch th\u01b0\u1edbc LV v\u00e0 ch\u1ee9c n\u0103ng t\u00e2m thu kh\u00f4ng th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 \u0111\u1ea7y \u0111\u1ee7, n\u00ean s\u1eed d\u1ee5ng h\u00ecnh \u1ea3nh tim kh\u00f4ng x\u00e2m l\u1ea5n kh\u00e1c.<\/p>\n

        Kho\u1ea3ng m\u1ed9t n\u1eeda s\u1ed1 \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u1ec7n r\u01b0\u1ee3u kh\u00f4ng tri\u1ec7u ch\u1ee9ng c\u00f3 t\u0103ng nh\u1eb9 \u0111\u1ed9 d\u00e0y th\u00e0nh th\u1ea5t tr\u00e1i m\u00e0 kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng si\u00eau \u00e2m tim v\u1ec1 gi\u1ea3m co b\u00f3p c\u01a1 tim. So v\u1edbi c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3 th\u1ec3 ki\u1ec3m so\u00e1t r\u01b0\u1ee3u b\u00ecnh th\u01b0\u1eddng, nh\u1eefng ng\u01b0\u1eddi b\u1ecb r\u1ed1i lo\u1ea1n s\u1eed d\u1ee5ng r\u01b0\u1ee3u \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n \u0111\u00e3 t\u0103ng \u0111\u1ed9 d\u00e0y c\u1ee7a th\u00e0nh LV v\u00e0 v\u00e1ch li\u00ean th\u1ea5t v\u00e0 kh\u1ed1i l\u01b0\u1ee3ng LV. Nh\u1eefng b\u1ea5t th\u01b0\u1eddng n\u00e0y xu\u1ea5t hi\u1ec7n m\u1eb7c d\u00f9 c\u00e1c ch\u1ec9 s\u1ed1 co b\u00f3p c\u01a1 tim tr\u00ean si\u00eau \u00e2m tim b\u00ecnh th\u01b0\u1eddng bao g\u1ed3m ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u, s\u1ef1 d\u1ecbch chuy\u1ec3n th\u00e0nh tim, v\u1eadn t\u1ed1c v\u00e0 s\u1ef1 r\u00fat ng\u1eafn chu vi s\u1ee3i c\u01a1. Kho\u1ea3ng th\u1eddi gian t\u00e2m thu cho th\u1ea5y r\u00fat ng\u1eafn th\u1eddi gian t\u1ed1ng m\u00e1u v\u00e0 k\u00e9o d\u00e0i th\u1eddi gian ti\u1ec1n t\u1ed1ng m\u00e1u s\u1edbm.<\/p>\n

        R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng tim nh\u1eb9 th\u01b0\u1eddng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n \u1edf b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n s\u1eed d\u1ee5ng r\u01b0\u1ee3u m\u1ea1n t\u00ednh tr\u01b0\u1edbc khi gi\u1ea3m ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u tr\u1edf th\u00e0nh bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng. R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m tr\u01b0\u01a1ng th\u01b0\u1eddng x\u1ea3y ra tr\u01b0\u1edbc r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu v\u00e0 x\u1ea3y ra th\u01b0\u1eddng xuy\u00ean h\u01a1n khi suy ch\u1ee9c n\u0103ng t\u00e2m thu tr\u1edf n\u00ean r\u00f5 rang.<\/p>\n

        \u0110\u00e1nh gi\u00e1 CAD \u2014 <\/strong>CAD \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb \u0111\u00e1nh gi\u00e1 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc suy tim (HF) m\u1edbi v\u00e0\/ho\u1eb7c b\u1ec7nh c\u01a1 tim gi\u00e3n l\u00e0 nh\u1eefng \u1ee9ng c\u1eed vi\u00ean ti\u1ec1m n\u0103ng cho t\u00e1i th\u00f4ng m\u1ea1ch m\u00e1u. Th\u1eed nghi\u1ec7m g\u1eafng s\u1ee9c kh\u00f4ng x\u00e2m l\u1ea5n l\u00e0 b\u01b0\u1edbc \u0111\u1ea7u ti\u00ean h\u1ee3p l\u00fd, \u0111\u1ec3 cung c\u1ea5p th\u00f4ng tin \u0111\u1ec3 ph\u00e2n t\u1ea7ng r\u1ee7i ro v\u00e0 ti\u00ean l\u01b0\u1ee3ng. Tuy nhi\u00ean, ch\u1ee5p \u0111\u1ed9ng m\u1ea1ch v\u00e0nh l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p thay th\u1ebf cho nghi\u1ec7m ph\u00e1p g\u1eafng s\u1ee9c \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao l\u00e0 nh\u1eefng \u1ee9ng c\u1eed vi\u00ean ti\u1ec1m n\u0103ng cho t\u00e1i th\u00f4ng m\u1ea1ch v\u00e0nh (v\u00e0 c\u0169ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m nguy c\u01a1 trung b\u00ecnh ho\u1eb7c cao trong nghi\u1ec7m ph\u00e1p g\u1eafng s\u1ee9c v\u00e0 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng LV). Ch\u1ee5p m\u1ea1ch v\u00e0nh kh\u00f4ng x\u00e2m l\u1ea5n s\u1eed d\u1ee5ng CMR ho\u1eb7c CT l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn ti\u1ec1m n\u0103ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 CAD \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh c\u01a1 tim gi\u00e3n kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n.<\/p>\n

        H\u00ecnh \u1ea3nh tim kh\u00e1c \u2014<\/strong> N\u1ebfu h\u00ecnh \u1ea3nh si\u00eau \u00e2m tim kh\u00f4ng t\u1ed1i \u01b0u \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a b\u1ec7nh c\u01a1 tim gi\u00e3n, th\u00ec h\u00ecnh \u1ea3nh tim kh\u00e1c \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 k\u00edch th\u01b0\u1edbc bu\u1ed3ng t\u00e2m th\u1ea5t, \u0111\u1ed9 d\u00e0y th\u00e0nh th\u1ea5t v\u00e0 ch\u1ee9c n\u0103ng t\u00e2m thu \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t. CMR th\u01b0\u1eddng cung c\u1ea5p ch\u1ea5t l\u01b0\u1ee3ng h\u00ecnh \u1ea3nh v\u00e0 \u0111\u1ed9 n\u00e9t cao h\u01a1n so v\u1edbi si\u00eau \u00e2m tim, m\u1eb7c d\u00f9 kh\u00f4ng c\u00f3 \u0111\u1eb7c \u0111i\u1ec3m CMR \u0111\u1eb7c bi\u1ec7t n\u00e0o \u0111\u1ec3 ph\u00e2n bi\u1ec7t b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u v\u1edbi c\u00e1c lo\u1ea1i b\u1ec7nh c\u01a1 tim kh\u00e1c. M\u1ed9t l\u1ee3i \u00edch b\u1ed5 sung c\u1ee7a CMR l\u00e0 t\u00ednh thu\u1eadn ti\u1ec7n c\u1ee7a n\u00f3 trong vi\u1ec7c x\u00e1c \u0111\u1ecbnh c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m g\u1ee3i \u00fd c\u00e1c nguy\u00ean nh\u00e2n c\u1ee5 th\u1ec3 kh\u00e1c c\u1ee7a HF v\u00e0 b\u1ec7nh c\u01a1 tim, ch\u1eb3ng h\u1ea1n nh\u01b0 b\u1ec7nh tim thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9, b\u1ec7nh amyloidosis v\u00e0 qu\u00e1 t\u1ea3i s\u1eaft. CT l\u00e0 m\u1ed9t thay th\u1ebf kh\u00e1c cho si\u00eau \u00e2m tim c\u00f3 th\u1ec3 k\u1ebft h\u1ee3p h\u00ecnh \u1ea3nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh v\u00e0 t\u00e2m th\u1ea5t.<\/p>\n

        Sinh thi\u1ebft n\u1ed9i m\u1ea1c c\u01a1 tim <\/strong>\u2014 Sinh thi\u1ebft n\u1ed9i m\u1ea1c c\u01a1 tim th\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh khi nghi ng\u1edd b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u, v\u00ec nh\u1eefng thay \u0111\u1ed5i m\u00f4 h\u1ecdc \u1edf b\u1ec7nh c\u01a1 tim do r\u01b0\u1ee3u t\u01b0\u01a1ng t\u1ef1 nh\u01b0 \u1edf b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i v\u00f4 c\u0103n. Tuy nhi\u00ean, sinh thi\u1ebft n\u1ed9i m\u1ea1c c\u01a1 tim \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p khi c\u00e1c ch\u1ea9n \u0111o\u00e1n kh\u00e1c (v\u00ed d\u1ee5: b\u1ec7nh amyloidosis) \u0111\u01b0\u1ee3c nghi ng\u1edd d\u1ef1a tr\u00ean \u0111\u00e1nh gi\u00e1 kh\u00f4ng x\u00e2m l\u1ea5n v\u00e0 c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n kh\u00e1c \u0111\u1ec3 x\u00e1c nh\u1eadn ch\u1ea9n \u0111o\u00e1n kh\u00f4ng c\u00f3 s\u1eb5n.<\/p>\n","protected":false},"excerpt":{"rendered":"

        \u00a0N\u00ean nghi ng\u1edd ch\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 ti\u1ec1n s\u1eed s\u1eed d\u1ee5ng r\u01b0\u1ee3u n\u1eb7ng v\u00e0 k\u00e9o d\u00e0i v\u1edbi c\u00e1c d\u1ea5u hi\u1ec7u gi\u00e3n th\u1ea5t tr\u00e1i (v\u00ed d\u1ee5, di\u1ec7n \u0111\u1eadp m\u1ecfm tim di l\u1ec7ch sang b\u00ean v\u00e0 m\u1edf r\u1ed9ng) ho\u1eb7c c\u00e1c tri\u1ec7u ch\u1ee9ng ho\u1eb7c d\u1ea5u hi\u1ec7u c\u1ee7a suy tim […]<\/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":"\nCh\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u - Vinmec<\/title>\n<meta name=\"description\" content=\"N\u00ean nghi ng\u1edd ch\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 ti\u1ec1n s\u1eed s\u1eed d\u1ee5ng r\u01b0\u1ee3u n\u1eb7ng v\u00e0 k\u00e9o d\u00e0i v\u1edbi c\u00e1c d\u1ea5u hi\u1ec7u b\u1ec7nh tim m\u1ea1ch.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i do r\u01b0\u1ee3u - 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