{"id":34489,"date":"2023-06-05T22:16:09","date_gmt":"2023-06-05T15:16:09","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=34489"},"modified":"2023-06-05T22:16:09","modified_gmt":"2023-06-05T15:16:09","slug":"tieu-chuan-chan-doan-suy-tim","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/06\/05\/tieu-chuan-chan-doan-suy-tim\/","title":{"rendered":"Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n suy tim theo ESC: C\u00e1c b\u00e1c s\u0129 c\u1ea7n n\u1eafm r\u00f5 \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c"},"content":{"rendered":"<p><strong>Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n suy tim theo ESC &#8211; Hi\u1ec7p h\u1ed9i Tim m\u1ea1ch Ch\u00e2u \u00c2u n\u0103m 2016 \u0111\u1ecbnh ngh\u0129a: \u201cSuy tim l\u00e0 m\u1ed9t h\u1ed9i ch\u1ee9ng l\u00e2m s\u00e0ng \u0111\u1eb7c tr\u01b0ng b\u1edfi c\u00e1c tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng \u0111i\u1ec3n h\u00ecnh (v\u00ed d\u1ee5: kh\u00f3 th\u1edf, ph\u00f9 ch\u00e2n v\u00e0 m\u1ec7t m\u1ecfi) m\u00e0 c\u00f3 th\u1ec3 \u0111i k\u00e8m v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3 (nh\u01b0 nh\u1ecbp tim nhanh,\u00a0 th\u1edf nhanh, t\u0129nh m\u1ea1ch m\u1ea1ch c\u1ed5 n\u1ed5i, ran \u1edf ph\u1ed5i v\u00e0 ph\u00f9 ngo\u1ea1i vi) g\u00e2y ra b\u1edfi b\u1ea5t th\u01b0\u1eddng c\u1ea5u tr\u00fac v\u00e0\/ho\u1eb7c ch\u1ee9c n\u0103ng tim m\u1ea1ch, d\u1eabn \u0111\u1ebfn cung l\u01b0\u1ee3ng tim gi\u1ea3m v\u00e0\/ho\u1eb7c \u00e1p l\u1ef1c trong bu\u1ed3ng tim cao l\u00fac ngh\u1ec9 ho\u1eb7c khi g\u1eafng s\u1ee9c\/tress\u201d. T\u1eeb \u0111\u00f3 c\u00f3 th\u1ec3 th\u1ea5y, c\u00e1c b\u00e1c s\u0129 c\u1ea7n n\u1eafm r\u00f5 c\u00e1c ti\u00eau chu\u1ea9n c\u1ee5 th\u1ec3 \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n suy tim theo ESC tr\u00ean l\u00e2m s\u00e0ng. B\u00e0i vi\u1ebft n\u00e0y s\u1ebd ph\u00e2n t\u00edch h\u01a1n c\u00e1c ti\u00eau chu\u1ea9n c\u1ee5 th\u1ec3 \u0111\u01b0\u1ee3c n\u00eau ra trong ch\u1ea9n \u0111o\u00e1n suy tim theo ESC.<\/strong><\/p>\n<h2>1. Ch\u1ea9n \u0111o\u00e1n theo Hi\u1ec7p h\u1ed9i tim m\u1ea1ch Ch\u00e2u \u00c2u<\/h2>\n<p><span class=\"fontstyle0\">M\u1ed9t v\u1ea5n \u0111\u1ec1 c\u1ee5 th\u1ec3 v\u1edbi suy tim l\u00e0 suy gi\u1ea3m cung l\u01b0\u1ee3ng tim, c\u00f9ng v\u1edbi suy gi\u1ea3m b\u01a1m m\u00e1u cho c\u00e1c c\u01a1<br \/>\nquan, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn m\u1ed9t s\u1ed1 c\u01a1 ch\u1ebf b\u00f9 tr\u1eeb. Trong s\u1ed1 c\u00e1c c\u01a1 ch\u1ebf b\u00f9 tr\u1eeb l\u00e0 k\u00edch ho\u1ea1t c\u1ee7a h\u1ec7 th\u1ea7n kinh<br \/>\ngiao c\u1ea3m, gi\u1ea3i ph\u00f3ng catecholamine, ho\u1ea1t h\u00f3a h\u1ec7 Renin-Angiotensin-Aldosterone (RAAS), v\u00e0 t\u0103ng s\u1ea3n<br \/>\nxu\u1ea5t ADH. Vi\u1ec7c gi\u1ea3i ph\u00f3ng c\u1ee7a c\u00e1c peptide l\u1ee3i natri, c\u0169ng nh\u01b0 t\u00e1i c\u1ea5u tr\u00fac tim v\u00e0 ph\u00ec \u0111\u1ea1i tim l\u00e0 c\u01a1 ch\u1ebf b\u00f9 tr\u1eeb th\u00eam.<br \/>\nV\u1ea5n \u0111\u1ec1 v\u1edbi c\u00e1c c\u01a1 ch\u1ebf b\u00f9 tr\u1eeb l\u00e0, c\u00f3 \u00edch l\u00fac \u0111\u1ea7u, sau \u0111\u00f3 s\u1ebd d\u1eabn \u0111\u1ebfn s\u1ef1 <\/span><span class=\"fontstyle2\">x\u1ea5u \u0111i \u0111\u00e1ng k\u1ec3 <\/span><span class=\"fontstyle0\">c\u1ee7a suy tim n\u1ebfu b\u1ecb ho\u1ea1t h\u00f3a l\u00e2u d\u00e0i. Tr\u1ecdng l\u01b0\u1ee3ng tim v\u00ed d\u1ee5 500 gram. N\u1ebfu n\u00f3 n\u1eb7ng h\u01a1n, vi\u1ec7c cung c\u1ea5p oxy c\u1ee7a tim tr\u1edf n\u00ean quan tr\u1ecdng. H\u01a1n n\u1eefa, suy tim th\u01b0\u1eddng d\u1eabn \u0111\u1ebfn m\u1ed9t s\u1ef1 m\u1ea5t t\u00ednh co th\u1eaft, m\u1eb7c d\u00f9 t\u0103ng tr\u01b0\u1edfng c\u01a1 tim theo h\u01b0\u1edbng b\u1ec7nh l\u00fd.\u00a0<\/span><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone size-medium wp-image-34490\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/image006-3-241x300.jpg\" alt=\"\" width=\"241\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/image006-3-241x300.jpg 241w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/image006-3-822x1024.jpg 822w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/image006-3-768x957.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/image006-3.jpg 1039w\" sizes=\"(max-width: 241px) 100vw, 241px\" \/><\/p>\n<p><strong>L\u01b0u \u0111\u1ed3 ch\u1ea9n \u0111o\u00e1n suy tim c\u1ee7a H\u1ed9i Tim m\u1ea1ch h\u1ecdc ch\u00e2u \u00c2u <\/strong><strong>(ESC) <\/strong><strong>2016<\/strong><\/p>\n<ul>\n<li><strong><u>Ch\u1ea9n \u0111o\u00e1n suy tim t\u00e2m thu: <\/u><\/strong>3 ti\u00eau chu\u1ea9n:<\/li>\n<li>Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng<\/li>\n<li>Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3<\/li>\n<li>EF gi\u1ea3m.<\/li>\n<li><strong><u>Ch\u1ea9n \u0111o\u00e1n suy tim t\u00e2m tr<\/u><\/strong><strong><u>\u01b0<\/u><\/strong><strong><u>\u01a1ng: <\/u><\/strong>4 ti\u00eau chu\u1ea9n:<\/li>\n<li>Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng<\/li>\n<li>Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3<\/li>\n<li>EF b\u1ea3o t\u1ed3n<\/li>\n<li>B\u1eb1ng ch\u1ee9ng b\u1ec7nh c\u1ea5u tr\u00fac c\u01a1 tim (d\u00e0y th\u1ea5t tr\u00e1i, d\u00e3n nh\u0129 tr\u00e1i) v\u00e0\/ho\u1eb7c r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m tr\u01b0\u01a1ng.<\/li>\n<\/ul>\n<p>B\u1ea3ng 1: Ph\u00e2n \u0111\u1ed9 suy tim d\u1ef1a v\u00e0o ph\u00e2n xu\u1ea5t t\u1ed1ng m\u00e1u (EF) theo ESC<\/p>\n<table width=\"900\">\n<tbody>\n<tr>\n<td width=\"234\">Ph\u00e2n lo\u1ea1i<\/td>\n<td width=\"88\">EF (%)<\/td>\n<td width=\"579\">\u0110\u1eb7c \u0111i\u1ec3m<\/td>\n<\/tr>\n<tr>\n<td width=\"234\">I . Suy tim v\u1edbi ph\u00e2n xu\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m (HFrEF)<\/td>\n<td width=\"88\">\u2264 40<\/td>\n<td width=\"579\">C\u00f2n g\u1ecdi l\u00e0 suy tim t\u00e2m thu<\/td>\n<\/tr>\n<tr>\n<td width=\"234\">II. Suy tim v\u1edbi ph\u00e2n xu\u1ea5t t\u1ed1ng m\u00e1u b\u1ea3o t\u1ed3n (HFpEF)<\/td>\n<td width=\"88\">\u2265 50<\/td>\n<td width=\"579\">C\u00f2n g\u1ecdi l\u00e0 suy tim t\u00e2m tr\u01b0\u01a1ng. \u0110\u00e2y l\u00e0 m\u1ed9t ch\u1ea9n \u0111o\u00e1n kh\u00f3<br \/>\nkh\u0103n c\u00f2n \u0111ang tranh c\u00e3i bao g\u1ed3m c\u00e1c nguy\u00ean nh\u00e2n ngo\u00e0i<br \/>\ntim g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a suy tim<\/td>\n<\/tr>\n<tr>\n<td width=\"234\">a.HFpEF, gi\u1edbi h\u1ea1n<\/td>\n<td width=\"88\">41-49<\/td>\n<td width=\"579\">T\u01b0\u01a1ng t\u1ef1 HFpEF. \u00a0Thu\u1ed9c nh\u00f3m gi\u1edbi h\u1ea1n ho\u1eb7c trung gian<\/td>\n<\/tr>\n<tr>\n<td width=\"234\">b.HFpEF, c\u1ea3i thi\u1ec7n<\/td>\n<td width=\"88\">&gt; 40<\/td>\n<td width=\"579\">B\u00eanh nh\u00e2n tr\u01b0\u1edbc \u0111\u00e2y c\u00f3 EF gi\u1ea3m v\u00e0 \u0111ang c\u1ea3i thi\u1ec7n, kh\u00e1c<br \/>\nv\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 EF gi\u1ea3m<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<h2><strong>2. Hi\u1ec3u r\u00f5 h\u01a1n v\u1ec1 ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n suy tim theo ESC<\/strong><\/h2>\n<p><strong>2.1 Ch\u1ea9n \u0111o\u00e1n suy tim t\u00e2m thu: <\/strong><\/p>\n<p>C\u00e1c nguy\u00ean nh\u00e2n g\u00e2y suy tim t\u00e2m thu th\u01b0\u1eddng g\u1eb7p l\u00e0 b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh (Nh\u1ed3i m\u00e1u c\u01a1 tim, thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 c\u01a1 tim), qu\u00e1 t\u1ea3i \u00e1p l\u1ef1c m\u1ea1n t\u00ednh (T\u0103ng huy\u1ebft \u00e1p, b\u1ec7nh van tim t\u1eafc ngh\u1ebdn), qu\u00e1 t\u1ea3i th\u1ec3 t\u00edch m\u1ea1n ( b\u1ec7nh van tim h\u1edf, b\u1ec7nh tim c\u00f3 shunt Tr\u00e1i \u2013 ph\u1ea3i), b\u1ec7nh c\u01a1 tim, r\u1ed1i lo\u1ea1n nh\u1ecbp tim hay t\u1ea7n s\u1ed1 tim, b\u1ec7nh t\u00e2m ph\u1ebf, r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a&#8230;<\/p>\n<p>&#8211; Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng ch\u1ee7 y\u1ebfu l\u00e0 kh\u00f3 th\u1edf:<\/p>\n<p>+ Kh\u00f3 th\u1edf khi g\u1eafng s\u1ee9c<\/p>\n<p>+ Kh\u00f3 th\u1edf k\u1ecbch ph\u00e1t v\u1ec1 \u0111\u00eam, ho\u1eb7c kh\u00f3 th\u1edf ph\u1ea3i ng\u1ed3i.<\/p>\n<p>&#8211; Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3 \u00a0bao g\u1ed3m:<\/p>\n<p>+ Nh\u1ecbp tim nhanh, Nh\u1ecbp tim &gt;120 l\u1ea7n\/ph\u00fat<\/p>\n<p>+ Nh\u1ecbp th\u1edf nhanh, t\u1ea7n s\u1ed1 &gt;25 l\u1ea7n\/ph\u00fat c\u00f3 s\u1eed d\u1ee5ng c\u01a1 h\u00f4 h\u1ea5p ph\u1ee5,<\/p>\n<p>+ Nghe c\u00f3 ran ph\u1ed5i,<\/p>\n<p>+ Tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i.<\/p>\n<p>+ T\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i.<\/p>\n<p>+ Ph\u00f9 ngo\u1ea1i bi\u00ean, gan to.<br \/>\n&#8211; Si\u00eau \u00e2m tim EF gi\u1ea3m (xem b\u1ea3ng 1)<br \/>\n<strong>2.2 \u00a0Ch\u1ea9n \u0111o\u00e1n suy tim t\u00e2m tr\u01b0\u01a1ng:<\/strong><\/p>\n<p>Suy tim t\u00e2m tr\u01b0\u01a1ng c\u00f3 th\u1ec3 x\u1ea3y ra do nhi\u1ec1u nguy\u00ean nh\u00e2n kh\u00e1c nhau nh\u01b0 b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, b\u1ec7nh van tim, b\u1ec7nh t\u0103ng huy\u1ebft \u00e1p, b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i, c\u01a1 tim h\u1ea1n ch\u1ebf, b\u1ec7nh l\u00fd tuy\u1ebfn gi\u00e1p, ti\u1ec3u \u0111\u01b0\u1eddng, b\u1ec7nh th\u1eadn v\u00e0 s\u1eed d\u1ee5ng thu\u1ed1c g\u00e2y h\u1ea1i cho tim.<strong><br \/>\n<\/strong>&#8211; Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng: c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a suy tim t\u00e2m tr\u01b0\u01a1ng kh\u00e1 \u0111a d\u1ea1ng<\/p>\n<ul>\n<li>M\u1ec7t m\u1ecfi: \u0110\u00e2y l\u00e0 tri\u1ec7u ch\u1ee9ng ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a suy tim t\u00e2m tr\u01b0\u01a1ng. B\u1eb9nh nh\u00e2n c\u00f3 th\u1ec3 c\u1ea3m th\u1ea5y m\u1ec7t m\u1ecfi v\u00e0 kh\u00f3 kh\u0103n trong vi\u1ec7c ho\u1ea1t \u0111\u1ed9ng th\u01b0\u1eddng ng\u00e0y.<\/li>\n<li>Kh\u00f3 th\u1edf: B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u1ea3m th\u1ea5y kh\u00f3 th\u1edf khi th\u1ef1c hi\u1ec7n c\u00e1c ho\u1ea1t \u0111\u1ed9ng nh\u01b0 leo c\u1ea7u thang, t\u1eadp th\u1ec3 d\u1ee5c, ho\u1eb7c th\u1eadm ch\u00ed l\u00e0 trong t\u00ecnh tr\u1ea1ng ngh\u1ec9 ng\u01a1i.<\/li>\n<li>S\u1ef1 \u0111au \u0111\u1edbn: B\u1ec7nh nh\u00e2n suy tim t\u00e2m tr\u01b0\u01a1ng c\u00f3 th\u1ec3 c\u1ea3m th\u1ea5y \u0111au ng\u1ef1c ho\u1eb7c kh\u00f3 ch\u1ecbu \u1edf v\u00f9ng ng\u1ef1c.<\/li>\n<li>\u0110au \u0111\u1ea7u: B\u1ec7nh nh\u00e2n suy tim t\u00e2m tr\u01b0\u01a1ng c\u0169ng c\u00f3 th\u1ec3 c\u1ea3m th\u1ea5y \u0111au \u0111\u1ea7u do thi\u1ebfu m\u00e1u v\u00e0 thi\u1ebfu oxy trong n\u00e3o.<\/li>\n<li>Bu\u1ed3n n\u00f4n v\u00e0 kh\u00f3 ti\u00eau: Suy tim t\u00e2m tr\u01b0\u01a1ng c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng v\u1ec1 ti\u00eau h\u00f3a nh\u01b0 bu\u1ed3n n\u00f4n v\u00e0 kh\u00f3 ti\u00eau.<\/li>\n<li>Ch\u00f3ng m\u1eb7t v\u00e0 hoa m\u1eaft: B\u1ec7nh nh\u00e2n suy tim t\u00e2m tr\u01b0\u01a1ng c\u00f3 th\u1ec3 c\u1ea3m th\u1ea5y ch\u00f3ng m\u1eb7t v\u00e0 hoa m\u1eaft do thi\u1ebfu m\u00e1u v\u00e0 oxy \u0111\u1ebfn n\u00e3o.<\/li>\n<\/ul>\n<p>&#8211; Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3<\/p>\n<p>&nbsp;<\/p>\n<p>C\u00e1c tri\u1ec7u ch\u1ee9ng chung c\u1ee7a suy tim nh\u01b0: \u00a0T\u0129nh m\u1ea1ch c\u1ea3nh n\u1ed5i (ho\u1eb7c \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch trung t\u00e2m &gt; 16 mmHg), Ran \u1edf ph\u1ed5i ho\u1eb7c ph\u00f9 ph\u1ed5i c\u1ea5p, Tim to, Ph\u1ea3n x\u1ea1 gan t\u0129nh m\u1ea1ch c\u1ea3nh (+), Th\u1eddi gian tu\u1ea7n ho\u00e0n &gt; 25 gi\u00e2y. \u0110\u00e1p \u1ee9ng v\u1edbi l\u1ee3i ti\u1ec3u (gi\u1ea3m &gt; 4,5 kg trong 5 ng\u00e0y), Tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i , Dung t\u00edch s\u1ed1ng &lt; 2\/3 b\u00ecnh th\u01b0\u1eddng , Gan to\u2026. Ch\u1ea9n \u0111o\u00e1n suy tim EF b\u1ea3o t\u1ed3n v\u1eabn l\u00e0 th\u1eed th\u00e1ch v\u1edbi nh\u00e2n vi\u00ean y t\u1ebf v\u00ec ph\u1ea7n l\u1edbn l\u00e0 ch\u1ea9n \u0111o\u00e1n lo\u1ea1i tr\u1eeb c\u00e1c nguy\u00ean nh\u00e2n kh\u00f4ng do tim kh\u00e1c v\u1edbi nh\u1eefng tri\u1ec7u ch\u1ee9ng g\u1ee3i \u00fd suy tim tr\u00ean l\u00e2m s\u00e0ng. Cho \u0111\u1ebfn nay.<\/p>\n<p>Si\u00eau \u00e2m tim EF b\u1ea3o t\u1ed3n (Xem b\u1ea3ng 1)<br \/>\n&#8211; Ch\u1ee9ng c\u1ee9 b\u1ec7nh tim c\u1ea7u tr\u00fac (d\u00e0y th\u1ea5t tr\u00e1i,d\u00e3n nh\u1ec9 tr\u00e1i v\u00e0 \/ ho\u1eb7c r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m tr\u01b0\u01a1ng)<br \/>\nC\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb suy tim t\u00e2m tr\u01b0\u01a1ng bao g\u1ed3m:<\/p>\n<p>&#8211; Ki\u1ec3m so\u00e1t t\u1ed1t huy\u1ebft \u00e1p t\u00e2m thu v\u00e0 huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng.<\/p>\n<p>&#8211; Ki\u1ec3m so\u00e1t t\u1ed1t t\u1ea7n s\u1ed1 th\u1ea5t \u1edf b\u1ec7nh rung nh\u0129 c\u00f3 suy tim t\u00e2m tr\u01b0\u01a1ng.<\/p>\n<p>&#8211; L\u1ee3i ti\u1ec3u r\u1ea5t hi\u1ec7u qu\u1ea3 \u0111\u1ec3 ch\u1ed1ng ph\u00f9 v\u00e0 gi\u1ea3m sung huy\u1ebft ph\u1ed5i.<\/p>\n<p>&#8211; T\u00e1i t\u01b0\u1edbi m\u00e1u m\u1ea1ch v\u00e0nh c\u1ea7n thi\u1ebft \u1edf b\u1ec7nh nh\u00e2n suy tim t\u00e2m tr\u01b0\u01a1ng ti\u1ec1n s\u1eed b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh.<\/p>\n<p>&#8211; \u00a0C\u00e1c \u00a0thu\u1ed1c \u00a0\u1ee9c ch\u1ebf beta, \u00a0\u1ee9c ch\u1ebf men chuy\u1ec3n, \u00a0ch\u1eb9n th\u1ee5 th\u1ec3 agiotensin ho\u1eb7c \u00a0ch\u1eb9n k\u00eanh Canxi \u00a0c\u00f3 \u00a0th\u1ec3 \u00a0gi\u1ea3m \u00a0tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng \u1edf b\u1ec7nh nh\u00e2n suy tim t\u00e2m tr\u01b0\u01a1ng.<\/p>\n<p><strong>So s\u00e1nh suy tim <\/strong><strong>EF b\u1ea3o t\u1ed3n <\/strong><strong>\u00a0v\u00e0 suy tim <\/strong><strong>EF gi\u1ea3m<\/strong><\/p>\n<table width=\"750\">\n<tbody>\n<tr>\n<td width=\"360\"><\/td>\n<td width=\"197\"><strong>Suy tim PSTMG<\/strong><\/td>\n<td width=\"193\"><strong>Suy tim PSTMBT<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"360\"><strong>B\u1ec7nh s\u1eed<\/strong><\/p>\n<p>B\u1ec7nh m\u1ea1ch v\u00e0nh<\/p>\n<p>T\u0103ng huy\u1ebft \u00e1p<\/p>\n<p>\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng<\/p>\n<p>B\u1ec7nh van tim<\/p>\n<p>Kh\u00f3 th\u1edf k\u1ecbch ph\u00e1t<\/td>\n<td width=\"197\">&nbsp;<\/p>\n<p>+++<\/p>\n<p>++<\/p>\n<p>++<\/p>\n<p>++++<\/p>\n<p>++<\/td>\n<td width=\"193\">&nbsp;<\/p>\n<p>++<\/p>\n<p>++++<\/p>\n<p>++<\/p>\n<p>+<\/p>\n<p>+++<\/td>\n<\/tr>\n<tr>\n<td width=\"360\"><strong>Kh\u00e1m l\u00e2m s\u00e0ng<\/strong><\/p>\n<p>Tim to<\/p>\n<p>Ti\u1ebfng tim m\u1edd<\/p>\n<p>Ti\u1ebfng ng\u1ef1a phi T3<\/p>\n<p>Ti\u1ebfng ng\u1ef1a phi T4<\/p>\n<p>T\u0103ng huy\u1ebft \u00e1p<\/p>\n<p>H\u1edf van 2 l\u00e1<\/p>\n<p>Ran ph\u1ed5i<\/p>\n<p>Ph\u00f9<\/p>\n<p>T\u0129nh m\u1ea1ch c\u1ed5 n\u1ed5i<\/td>\n<td width=\"197\">&nbsp;<\/p>\n<p>+++<\/p>\n<p>++++<\/p>\n<p>+++<\/p>\n<p>+<\/p>\n<p>++<\/p>\n<p>+++<\/p>\n<p>++<\/p>\n<p>+++<\/p>\n<p>+++<\/td>\n<td width=\"193\">&nbsp;<\/p>\n<p>+<\/p>\n<p>+<\/p>\n<p>+<\/p>\n<p>+++<\/p>\n<p>++++<\/p>\n<p>+<\/p>\n<p>+<\/p>\n<p>+<\/p>\n<p>+<\/td>\n<\/tr>\n<tr>\n<td width=\"360\"><strong>X-quang ng\u1ef1c th\u1eb3ng<\/strong><\/p>\n<p>Tim to<\/p>\n<p>Sung huy\u1ebft ph\u1ed5i<\/td>\n<td width=\"197\">&nbsp;<\/p>\n<p>+++<\/p>\n<p>+++<\/td>\n<td width=\"193\">&nbsp;<\/p>\n<p>+<\/p>\n<p>+++<\/td>\n<\/tr>\n<tr>\n<td width=\"360\"><strong>\u0110i\u1ec7n t\u00e2m \u0111\u1ed3<\/strong><\/p>\n<p>Ph\u00ec \u0111\u1ea1i th\u1ea5t tr\u00e1i<\/p>\n<p>S\u00f3ng Q<\/p>\n<p>\u0110i\u1ec7n th\u1ebf th\u1ea5p<\/td>\n<td width=\"197\">&nbsp;<\/p>\n<p>++<\/p>\n<p>++<\/p>\n<p>+++<\/td>\n<td width=\"193\">&nbsp;<\/p>\n<p>++++<\/p>\n<p>+<\/p>\n<p>\u2013<\/td>\n<\/tr>\n<tr>\n<td width=\"360\"><strong>Si\u00eau \u00e2m tim<\/strong><\/p>\n<p>Ph\u00ec \u0111\u1ea1i th\u1ea5t tr\u00e1i<\/p>\n<p>D\u00e3n th\u1ea5t tr\u00e1i<\/p>\n<p>L\u1edbn nh\u0129 tr\u00e1i<\/p>\n<p>Ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m<\/td>\n<td width=\"197\">&nbsp;<\/p>\n<p>++<\/p>\n<p>++<\/p>\n<p>++<\/p>\n<p>++++<\/td>\n<td width=\"193\">&nbsp;<\/p>\n<p>++++<\/p>\n<p>\u2013<\/p>\n<p>++<\/p>\n<p>\u2013<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Ngu\u1ed3n tham kh\u1ea3o: https:\/\/timmachhoc.vn\/suy-tim-phan-suat-tong-mau-bao-ton-tu-co-che-benh-sinh-den-chan-doan-va-dieu-tri\/<\/p>\n<p>Xem th\u00eam:<a href=\"https:\/\/vinmec.com\/vi\/tim-mach\/thong-tin-suc-khoe\/suy-tim-tam-truong-nhung-dieu-can-biet\/\"> Suy tim t\u00e2m tr\u01b0\u01a1ng: Nh\u1eefng \u0111i\u1ec1u c\u1ea7n bi\u1ebft<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n suy tim theo ESC &#8211; Hi\u1ec7p h\u1ed9i Tim m\u1ea1ch Ch\u00e2u \u00c2u n\u0103m 2016 \u0111\u1ecbnh ngh\u0129a: \u201cSuy tim l\u00e0 m\u1ed9t h\u1ed9i ch\u1ee9ng l\u00e2m s\u00e0ng \u0111\u1eb7c tr\u01b0ng b\u1edfi c\u00e1c tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng \u0111i\u1ec3n h\u00ecnh (v\u00ed d\u1ee5: kh\u00f3 th\u1edf, ph\u00f9 ch\u00e2n v\u00e0 m\u1ec7t m\u1ecfi) m\u00e0 c\u00f3 th\u1ec3 \u0111i k\u00e8m v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng [&hellip;]<\/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":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n suy tim theo ESC: C\u00e1c b\u00e1c s\u0129 c\u1ea7n n\u1eafm r\u00f5 \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c - Vinmec<\/title>\n<meta name=\"description\" content=\"Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n suy tim theo ESC ph\u00e2n chia suy tim ra th\u00e0nh suy tim t\u00e2m thu v\u00e0 t\u00e2m tr\u01b0\u01a1ng d\u1ef1a tr\u00ean tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng v\u00e0 th\u1ef1c th\u1ec3\" \/>\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 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