{"id":33753,"date":"2023-05-13T20:57:36","date_gmt":"2023-05-13T13:57:36","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=33753"},"modified":"2024-11-05T23:52:25","modified_gmt":"2024-11-05T16:52:25","slug":"benh-co-tim-chu-sinh-peripartum-cardiomyopathy-ppcm","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/13\/benh-co-tim-chu-sinh-peripartum-cardiomyopathy-ppcm\/","title":{"rendered":"B\u1ec7nh c\u01a1 tim chu sinh Peripartum cardiomyopathy (PPCM)"},"content":{"rendered":"<div><strong>B\u1ec7nh c\u01a1 tim chu sinh (PPCM) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 th\u1ed1ng tim m\u1ea1ch, g\u00e2y ra s\u1ef1 suy y\u1ebfu ho\u1eb7c m\u1ea5t ch\u1ee9c n\u0103ng c\u1ee7a c\u01a1 tim chu. Trong b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang ta s\u1ebd t\u00ecm hi\u1ec3u v\u1ec1 b\u1ec7nh c\u01a1 tim chu sinh, c\u00e1c nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng v\u00e0 c\u00e1ch \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 gi\u00fap c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a nh\u1eefng ng\u01b0\u1eddi b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi b\u1ec7nh n\u00e0y.\u00a0<\/strong><\/div>\n<div>\n<figure style=\"width: 629px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/i.imgur.com\/yljCUp2.png\" alt=\"Ngu\u1ed3n: Vinmec\" width=\"629\" height=\"433\" \/><figcaption class=\"wp-caption-text\">Ngu\u1ed3n: Vinmec<\/figcaption><\/figure>\n<\/div>\n<div><\/div>\n<h2><strong>1. \u0110\u1ecbnh ngh\u0129a <\/strong><strong>b\u1ec7nh c\u01a1 tim chu sinh<\/strong><strong>:<\/strong><\/h2>\n<div>Hi\u1ec7p h\u1ed9i Tim m\u1ea1ch ch\u00e2u \u00c2u (ESC) \u0111\u00e3 \u0111\u1ecbnh ngh\u0129a v\u1ec1 PPCM l\u00e0 b\u1ec7nh c\u01a1 tim v\u1edbi gi\u1ea3m EF, th\u01b0\u1eddng &lt; 45%, xu\u1ea5t hi\u1ec7n v\u00e0o cu\u1ed1i thai k\u1ef3 ho\u1eb7c trong nh\u1eefng th\u00e1ng sau khi sinh \u1edf m\u1ed9t ph\u1ee5 n\u1eef kh\u00f4ng c\u00f3 b\u1ec7nh tim c\u1ea5u tr\u00fac tr\u01b0\u1edbc \u0111\u00f3.<\/div>\n<h2><strong>2. Nguy\u00ean nh\u00e2n<\/strong><strong>b\u1ec7nh c\u01a1 tim chu sinh<\/strong><strong>:<\/strong><\/h2>\n<div>+ Thay \u0111\u1ed5i hormone prolactin: nh\u1eefng th\u00e1ng cu\u1ed1i v\u00e0 sau sinh c\u00f3 n\u1ed3ng \u0111\u1ed9 hormone prolactin cao. \u0110\u00e2y l\u00e0 hormone c\u00f3 vai tr\u00f2 quan tr\u1ecdng trong \u0111i\u1ec1u h\u00f2a h\u1ec7 mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3. S\u1ef1 gia t\u0103ng hormon n\u00e0y l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch v\u00e0 g\u00e2y ph\u1ea3n \u1ee9ng, t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn t\u1ebf b\u00e0o c\u01a1 tim.<\/div>\n<div>+ Vi\u00eam c\u01a1 tim do virus: Vi\u00eam c\u01a1 tim do virus l\u00e0m c\u01a1 tim b\u1ecb ho\u1ea1i t\u1eed, x\u01a1 h\u00f3a, ch\u1ee9c n\u0103ng tim gi\u1ea3m.<\/div>\n<div><\/div>\n<div>+ \u0110\u1ed9t bi\u1ebfn gene di truy\u1ec1n: M\u1ed9t s\u1ed1 lo\u1ea1i b\u1ec7nh c\u01a1 tim chu sinh l\u00e0 do c\u00e1c \u0111\u1ed9t bi\u1ebfn gene di truy\u1ec1n t\u1eeb b\u1ed1 m\u1eb9. C\u00e1c \u0111\u1ed9t bi\u1ebfn n\u00e0y c\u00f3 th\u1ec3 l\u00e0 do m\u1ed9t ho\u1eb7c nhi\u1ec1u gene b\u1ecb \u1ea3nh h\u01b0\u1edfng.<\/div>\n<div><\/div>\n<div>+ Y\u1ebfu t\u1ed1 m\u00f4i tr\u01b0\u1eddng: M\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 m\u00f4i tr\u01b0\u1eddng trong qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n c\u1ee7a thai nhi nh\u01b0 thu\u1ed1c l\u00e1, r\u01b0\u1ee3u, ma t\u00fay, c\u00e1c ch\u1ea5t \u0111\u1ed9c h\u1ea1i, v\u00e0 nhi\u1ec5m virus rubella c\u00f3 th\u1ec3 g\u00e2y ra b\u1ec7nh c\u01a1 tim chu sinh.<\/div>\n<div><\/div>\n<div>+ S\u1ef1 ph\u00e1t tri\u1ec3n kh\u00f4ng \u0111\u1ea7y \u0111\u1ee7 c\u1ee7a c\u01a1 tim: Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, c\u01a1 tim c\u1ee7a thai nhi kh\u00f4ng ph\u00e1t tri\u1ec3n \u0111\u1ea7y \u0111\u1ee7, d\u1eabn \u0111\u1ebfn c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 c\u01a1 tim v\u00e0 c\u00e1c m\u00f4 xung quanh.<\/div>\n<div><\/div>\n<div>+ T\u1ed5n th\u01b0\u01a1ng do b\u1ec7nh l\u00fd m\u1eb9: M\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd m\u1eb9 nh\u01b0 b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, b\u1ec7nh th\u1ee7y \u0111\u1eadu v\u00e0 b\u1ec7nh t\u1ef1 mi\u1ec5n d\u1ecbch c\u00f3 th\u1ec3 g\u00e2y ra t\u1ed5n th\u01b0\u01a1ng cho thai nhi, d\u1eabn \u0111\u1ebfn b\u1ec7nh c\u01a1 tim chu sinh.<\/div>\n<div><\/div>\n<div>+ Y\u1ebfu t\u1ed1 kh\u00e1c: Nhi\u1ec1u y\u1ebfu t\u1ed1 kh\u00e1c nh\u01b0 tu\u1ed5i c\u1ee7a m\u1eb9, th\u00f3i quen \u0103n u\u1ed1ng v\u00e0 m\u1ee9c \u0111\u1ed9 ho\u1ea1t \u0111\u1ed9ng c\u1ee7a thai nhi c\u0169ng c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u01a1 tim v\u00e0 d\u1eabn \u0111\u1ebfn b\u1ec7nh c\u01a1 tim chu sinh.<\/div>\n<h2><strong>3. Tri\u1ec7u ch\u1ee9ng:<\/strong><\/h2>\n<div>\u00a0Tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh c\u01a1 tim chu sinh c\u00f3 th\u1ec3 kh\u00e1c nhau t\u00f9y thu\u1ed9c v\u00e0o lo\u1ea1i b\u1ec7nh v\u00e0 m\u1ee9c \u0111\u1ed9 n\u1eb7ng. Tuy nhi\u00ean, m\u1ed9t s\u1ed1 tri\u1ec7u ch\u1ee9ng chung c\u1ee7a b\u1ec7nh c\u01a1 tim chu sinh bao g\u1ed3m:<\/div>\n<div>+ Th\u1edf kh\u00f2 kh\u00e8 ho\u1eb7c kh\u00f3 th\u1edf.<\/div>\n<div>+ \u0110au ng\u1ef1c ho\u1eb7c kh\u00f3 ch\u1ecbu trong v\u00f9ng ng\u1ef1c.<\/div>\n<div>+ M\u1ec7t m\u1ecfi nhanh ch\u00f3ng khi tham gia c\u00e1c ho\u1ea1t \u0111\u1ed9ng.<\/div>\n<div>+ Ch\u00f3ng m\u1eb7t ho\u1eb7c ng\u1ea5t khi v\u1eadn \u0111\u1ed9ng.<\/div>\n<div>+ S\u1ef1 ph\u00e1t tri\u1ec3n ch\u1eadm so v\u1edbi nh\u1eefng tr\u1ebb em c\u00f9ng tu\u1ed5i.<\/div>\n<div>+ M\u00e0u da xanh ho\u1eb7c nh\u1ee3t nh\u1ea1t.<\/div>\n<h2><strong>4. Bi\u1ebfn ch\u1ee9ng:<\/strong><\/h2>\n<div>&#8211; Suy tim l\u00e0 bi\u1ebfn ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t.<\/div>\n<div>&#8211; R\u1ed1i lo\u1ea1n nh\u1ecbp tim x\u1ea3y ra \u1edf 18,7% tr\u01b0\u1eddng h\u1ee3p, nh\u1ecbp nhanh th\u1ea5t x\u1ea3y ra \u1edf 4,2%.<\/div>\n<div>&#8211; Huy\u1ebft kh\u1ed1i l\u00e0 bi\u1ebfn ch\u1ee9ng n\u1eb7ng ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a PPCM, chi\u1ebfm 6,6% ph\u1ee5 n\u1eef b\u1ecb PPCM \u1edf Hoa K\u1ef3. Mang thai l\u00e0m t\u0103ng c\u00e1c y\u1ebfu t\u1ed1 VII, VIII, X, fibrinogen v\u00e0 y\u1ebfu t\u1ed1 von Willebrand; gi\u1ea3m ho\u1ea1t \u0111\u1ed9ng c\u1ee7a protein C v\u00e0 S; v\u00e0 gi\u1ea3m fibrinolysis. Nh\u1eefng thay \u0111\u1ed5i n\u00e0y tr\u1edf l\u1ea1i b\u00ecnh th\u01b0\u1eddng trong s\u00e1u \u0111\u1ebfn t\u00e1m tu\u1ea7n sau khi sinh.<\/div>\n<h2><strong>5. \u0110i\u1ec1u tr\u1ecb:<\/strong><\/h2>\n<div>\u00a0 \u00a0 \u00a0C\u00e1ch \u0111i\u1ec1u tr\u1ecb b\u1ec7nh c\u01a1 tim chu sinh ph\u1ee5 thu\u1ed9c v\u00e0o lo\u1ea1i b\u1ec7nh, m\u1ee9c \u0111\u1ed9 n\u1eb7ng v\u00e0 tu\u1ed5i c\u1ee7a b\u1ec7nh nh\u00e2n. M\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb bao g\u1ed3m:<\/div>\n<div><\/div>\n<div><strong>a. D\u00f9ng thu\u1ed1c:<\/strong> Thu\u1ed1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u00fap t\u0103ng c\u01b0\u1eddng ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u01a1 tim ho\u1eb7c gi\u1ea3m thi\u1ec3u c\u00e1c tri\u1ec7u ch\u1ee9ng li\u00ean quan \u0111\u1ebfn b\u1ec7nh c\u01a1 tim chu sinh. C\u00e1c lo\u1ea1i thu\u1ed1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng bao g\u1ed3m beta-blocker, digoxin v\u00e0 ACE inhibitor<\/div>\n<div>\u00a0 \u0110i\u1ec1u tr\u1ecb suy tim:<\/div>\n<div>&#8211; H\u1ea1n ch\u1ebf d\u1ecbch &lt; 2 l\u00edt\/ng\u00e0y, h\u1ea1n ch\u1ebf mu\u1ed1i 2-4 g\/ng\u00e0y, h\u1ea1n ch\u1ebf g\u1eafng s\u1ee9c<\/div>\n<div>&#8211; C\u00e1c thu\u1ed1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng: Digoxin, ch\u1eb9n beta, l\u1ee3i ti\u1ec3u quai, hydralazine, nitrates: an to\u00e0n v\u00e0 l\u00e0 nh\u1eefng thu\u1ed1c ch\u00ednh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb suy tim cho s\u1ea3n ph\u1ee5.<\/div>\n<div>&#8211; Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n (ACE) v\u00e0 \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 AT1 (ARBs): ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh trong th\u1eddi gian mang thai v\u00ec c\u00f3 th\u1ec3 g\u00e2y ra d\u1ecb d\u1ea1ng thai nhi.<\/div>\n<div>\u00a0Ch\u1ed1ng \u0111\u00f4ng: Heparin ch\u1ec9 \u0111\u1ecbnh, kh\u00e1ng vit K ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh khi mang thai c\u00f3 th\u1ec3 cho sau sinh.<\/div>\n<div><\/div>\n<div><strong>b. Ph\u1eabu thu\u1eadt:<\/strong> N\u1ebfu b\u1ec7nh c\u01a1 tim chu sinh l\u00e0 nghi\u00eam tr\u1ecdng, ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 s\u1eeda ch\u1eefa c\u01a1 tim v\u00e0 c\u00e1c m\u00f4 xung quanh. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt bao g\u1ed3m kh\u00e2u l\u1ea1i c\u00e1c v\u00e1ch trong c\u01a1 tim, thay th\u1ebf c\u00e1c c\u01a1 tim b\u1ecb h\u1ecfng, ho\u1eb7c t\u1ea1o ra c\u00e1c \u0111\u01b0\u1eddng d\u1eabn m\u1edbi cho m\u00e1u ch\u1ea3y qua c\u01a1 tim.<\/div>\n<div><\/div>\n<div><strong>c. \u0110i\u1ec1u tr\u1ecb b\u1eb1ng m\u00e1y:<\/strong> \u0110i\u1ec1u tr\u1ecb b\u1eb1ng m\u00e1y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u00fap c\u01a1 tim ho\u1ea1t \u0111\u1ed9ng \u0111\u00fang c\u00e1ch. C\u00e1c m\u00e1y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng bao g\u1ed3m m\u00e1y nh\u1ed3i m\u00e1u ngo\u1ea1i c\u01a1 th\u1ec3 (ECMO) v\u00e0 m\u00e1y tr\u1ee3 tim (VAD).<\/div>\n<div><\/div>\n<div><strong>d. \u0110i\u1ec1u tr\u1ecb m\u1edbi:<\/strong><\/div>\n<div>\u1ee8c ch\u1ebf prolactin: Bromocriptine v\u00e0 cabergoline l\u00e0 ch\u1ea5t ch\u1ee7 v\u1eadn dopamine D2 v\u00e0 \u1ee9c ch\u1ebf s\u1ea3n xu\u1ea5t prolactin, \u1ee9c ch\u1ebf ti\u1ebft s\u1eefa. Bromocriptine c\u00f3 li\u00ean quan \u0111\u1ebfn c\u00e1c bi\u1ebfn ch\u1ee9ng huy\u1ebft kh\u1ed1i, bao g\u1ed3m nh\u1ed3i m\u00e1u c\u01a1 tim v\u00e0 \u0111\u1ed9t qu\u1ef5 do thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9.<\/div>\n<div>Li\u1ec7u ph\u00e1p antisense kh\u00e1ng microRNA-146a: l\u00e0m gi\u1ea3m s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu<\/div>\n<div>Ch\u1ea5t ch\u1ee7 v\u1eadn VEGF v\u00e0 lo\u1ea1i b\u1ecf c\u00e1c protein ch\u1ed1ng angiogen.<\/div>\n<div>Serelaxin, Perhexiline, Pentoxifylin.<\/div>\n<h2><strong>6. T\u01b0\u01a1ng t\u00e1c thu\u1ed1c:<\/strong><\/h2>\n<div>&#8211; <strong>Thu\u1ed1c beta-blocker<\/strong>: Thu\u1ed1c beta-blocker \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m huy\u1ebft \u00e1p v\u00e0 gi\u1ea3m t\u1ea7n s\u1ed1 tim. Tuy nhi\u00ean, khi s\u1eed d\u1ee5ng c\u00f9ng v\u1edbi thu\u1ed1c kh\u00e1ng histamin (nh\u01b0 diphenhydramine), thu\u1ed1c beta-blocker c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 kh\u00f3 th\u1edf v\u00e0 g\u00e2y ra c\u00e1c ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng.<\/div>\n<div><\/div>\n<div>&#8211; <strong>Thu\u1ed1c digoxin<\/strong>: Thu\u1ed1c digoxin \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 t\u0103ng c\u01b0\u1eddng ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u01a1 tim. Khi s\u1eed d\u1ee5ng c\u00f9ng v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1ng sinh nh\u01b0 erythromycin, clarithromycin ho\u1eb7c azithromycin, c\u00f3 th\u1ec3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 digoxin trong c\u01a1 th\u1ec3 v\u00e0 g\u00e2y ra c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nh\u01b0 bu\u1ed3n n\u00f4n, ch\u00f3ng m\u1eb7t v\u00e0 r\u1ed1i lo\u1ea1n nh\u1ecbp tim.<\/div>\n<div><\/div>\n<div>&#8211; <strong>Thu\u1ed1c kh\u00e1ng \u0111\u00f4ng<\/strong>: Thu\u1ed1c kh\u00e1ng \u0111\u00f4ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ng\u0103n ng\u1eeba h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u v\u00e0 gi\u1ea3m nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 v\u00e0 \u0111au tim. Tuy nhi\u00ean, khi s\u1eed d\u1ee5ng c\u00f9ng v\u1edbi thu\u1ed1c aspirin, c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 ch\u1ea3y m\u00e1u v\u00e0 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 \u0111\u00f4ng m\u00e1u.<\/div>\n<div><\/div>\n<div>&#8211; <strong>Thu\u1ed1c ACE inhibitor<\/strong>: Thu\u1ed1c ACE inhibitor \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m huy\u1ebft \u00e1p v\u00e0 gi\u1ea3m t\u1ea7n s\u1ed1 tim. Khi s\u1eed d\u1ee5ng c\u00f9ng v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1ng histamin nh\u01b0 cimetidine ho\u1eb7c ranitidine, c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 kh\u00f3 th\u1edf v\u00e0 g\u00e2y ra c\u00e1c ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng.<\/div>\n<div><\/div>\n<div>&#8211; <strong>Thu\u1ed1c ch\u1ed1ng co gi\u1eadt<\/strong>: Thu\u1ed1c ch\u1ed1ng co gi\u1eadt nh\u01b0 carbamazepine v\u00e0 phenytoin c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m hi\u1ec7u qu\u1ea3 c\u1ee7a thu\u1ed1c beta-blocker v\u00e0 l\u00e0m t\u0103ng t\u1ea7n s\u1ed1 tim.<\/div>\n<div><\/div>\n<div>Trong tr\u01b0\u1eddng h\u1ee3p s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c nhau, b\u1ec7nh nh\u00e2n c\u1ea7n th\u1ea3o lu\u1eadn v\u1edbi b\u00e1c s\u0129 ho\u1eb7c nh\u00e0 d\u01b0\u1ee3c v\u1ec1 t\u01b0\u01a1ng t\u00e1c thu\u1ed1c \u0111\u1ec3 tr\u00e1nh g\u00e2y ra c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 v\u00e0 \u0111\u1ea3m b\u1ea3o hi\u1ec7u qu\u1ea3 c\u1ee7a \u0111i\u1ec1u tr\u1ecb. B\u1ec7nh nh\u00e2n c\u0169ng n\u00ean th\u1ef1c hi\u1ec7n theo ch\u1ec9 \u0111\u1ecbnh c\u1ee7a b\u00e1c s\u0129 v\u00e0 kh\u00f4ng thay \u0111\u1ed5i li\u1ec1u.<\/div>\n<div><\/div>\n<div><strong>Ngu\u1ed3n tham kh\u1ea3o:<\/strong><\/div>\n<ul>\n<li>B\u00e0i gi\u1ea3ng l\u00e2m s\u00e0ng \u2013 Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc K\u1ef9 thu\u1eadt Y D\u01b0\u1ee3c \u0110\u00e0 N\u1eb5ng<\/li>\n<\/ul>\n<div id=\"USE_CHAT_GPT_AI_ROOT\" style=\"display: none; z-index: -1; position: absolute; top: -10000px; left: -10000px; width: 1px; height: 1px; overflow: hidden; opacity: 0; pointer-events: none;\">usechatgpt init success<\/div>\n<div id=\"USE_CHAT_GPT_AI_ROOT\" style=\"display: none; z-index: -1; position: absolute; top: -10000px; left: -10000px; width: 1px; height: 1px; overflow: hidden; opacity: 0; pointer-events: none;\">usechatgpt init success<\/div>\n<div id=\"USE_CHAT_GPT_AI_ROOT\" style=\"display: none; z-index: -1; position: absolute; top: -10000px; left: -10000px; width: 1px; height: 1px; overflow: hidden; opacity: 0; pointer-events: none;\">usechatgpt init success<\/div>\n","protected":false},"excerpt":{"rendered":"<p>B\u1ec7nh c\u01a1 tim chu sinh (PPCM) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 th\u1ed1ng tim m\u1ea1ch, g\u00e2y ra s\u1ef1 suy y\u1ebfu ho\u1eb7c m\u1ea5t ch\u1ee9c n\u0103ng c\u1ee7a c\u01a1 tim chu. Trong b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang ta s\u1ebd t\u00ecm hi\u1ec3u v\u1ec1 b\u1ec7nh c\u01a1 tim chu sinh, c\u00e1c nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng v\u00e0 c\u00e1ch \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>B\u1ec7nh c\u01a1 tim chu sinh Peripartum cardiomyopathy (PPCM) - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh c\u01a1 tim chu sinh l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 th\u1ed1ng tim m\u1ea1ch, g\u00e2y ra s\u1ef1 suy y\u1ebfu ho\u1eb7c m\u1ea5t ch\u1ee9c n\u0103ng c\u1ee7a c\u01a1 tim chu.\" \/>\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 sinh Peripartum cardiomyopathy (PPCM) - 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