{"id":35621,"date":"2023-06-26T12:41:14","date_gmt":"2023-06-26T05:41:14","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=35621"},"modified":"2023-06-26T12:41:14","modified_gmt":"2023-06-26T05:41:14","slug":"hoi-chung-vanh-cap-bo-y-te-khuyen-cao-can-phat-hien-som-va-dieu-tri-kip-thoi","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/06\/26\/hoi-chung-vanh-cap-bo-y-te-khuyen-cao-can-phat-hien-som-va-dieu-tri-kip-thoi\/","title":{"rendered":"H\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p: B\u1ed9 Y t\u1ebf khuy\u1ebfn c\u00e1o c\u1ea7n ph\u00e1t hi\u1ec7n s\u1edbm v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi"},"content":{"rendered":"<p><strong>H\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p l\u00e0 m\u1ed9t c\u1ea5p c\u1ee9u n\u1ed9i khoa, l\u00e0 m\u1ed9t bi\u1ebfn c\u1ed1 do ch\u1ebft t\u1ebf b\u00e0o c\u01a1 tim do thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 c\u1ea5p t\u00ednh ch\u1ee9 kh\u00f4ng ph\u1ea3i ch\u1ebft t\u1ebf b\u00e0o do ch\u1ea5n th\u01b0\u01a1ng hay vi\u00eam c\u01a1 tim. Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng c\u1ee7a b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh l\u00e0 c\u01a1n \u0111au th\u1eaft ng\u1ef1c. Tr\u00ean l\u00e2m s\u00e0ng, h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n qua 3 d\u1ea1ng ch\u1ee7 y\u1ebfu: C\u01a1n \u0111au th\u1eaft ng\u1ef1c kh\u00f4ng \u1ed5n \u0111\u1ecbnh, nh\u1ed3i m\u00e1u c\u01a1 tim kh\u00f4ng ST ch\u00eanh l\u00ean (NSTEMI) v\u00e0 nh\u1ed3i m\u00e1u c\u01a1 tim ST ch\u00eanh l\u00ean (STEMI). Vi\u1ec7c ph\u00e1t hi\u1ec7n s\u1edbm d\u1ef1a v\u00e0o c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi gi\u00fap gi\u1ea3m thi\u1ec3u kh\u1ea3 n\u0103ng ho\u1ea1i t\u1eed t\u1ebf b\u00e0o c\u01a1 tim v\u00e0 t\u0103ng kh\u1ea3 n\u0103ng c\u1ee9u s\u1ed1ng b\u1ec7nh nh\u00e2n.<\/strong><\/p>\n<h2>1. \u00a0\u0110\u1ea1i c\u01b0\u01a1ng h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p<\/h2>\n<ul>\n<li><strong>H\u00f4i ch\u1ee9ng v\u00e0nh c\u00e2p kh\u00f4ng ST ch\u00eanh l\u00ea<\/strong><strong>n<\/strong><strong>:<\/strong><\/li>\n<\/ul>\n<p>H\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p kh\u00f4ng ST ch\u00eanh l\u00ean th\u01b0\u1eddng x\u1ea3y ra l\u00e0 do gi\u1ea3m cung c\u1ea5p oxy cho c\u01a1 tim ho\u1eb7c do t\u0103ng nh\u01b0 c\u1ea7u c\u1ee7a c\u01a1 tim tr\u00ean m\u1ea1ch v\u00e0nh b\u1ecb x\u01a1 v\u1eefa v\u00e0 c\u00f3 h\u1eb9p \u00edt nhi\u1ec1u.<\/p>\n<p>* Huy\u1ebft kh\u1ed1i h\u00ecnh th\u00e0nh t\u1ea1i m\u1ea3ng x\u01a1 v\u1eefa b\u1ecb d\u1ee9t v\u1ee1 v\u00e0 th\u01b0\u1eddng kh\u00f4ng g\u00e2y t\u1eafc m\u1ea1ch ho\u00e0n to\u00e0n ho\u1eb7c huy\u1ebft kh\u1ed1i c\u00f3 th\u1ec3 g\u00e2y t\u1eafc m\u1ea1ch ho\u00e0n to\u00e0n nh\u01b0ng v\u00f9ng c\u01a1 tim n\u00e0y c\u00f3 tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7 kh\u00e1 phong ph\u00fa.<\/p>\n<ul>\n<li><strong>H\u00f4i ch\u1ee9ng v\u00e0nh c\u1ea5p c\u00f3 ST ch\u00eanh l\u00ean:<\/strong><\/li>\n<\/ul>\n<p>STEMI th\u01b0\u1eddng x\u1ea3y ra khi c\u00f3 t\u00ecnh tr\u1ea1ng m\u1ea1ch v\u00e0nh \u0111\u00e3 b\u1ecb x\u01a1 v\u1eefa tr\u01b0\u1edbc \u0111\u00f3 b\u1ecb t\u1eafc ngh\u1ebdn ho\u00e0n to\u00e0n v\u00e0 \u0111\u1ed9t ng\u1ed9t c\u1ea5p t\u00ednh do huy\u1ebft kh\u1ed1i h\u00ecnh th\u00e0nh trong l\u00f2ng m\u1ea1ch. Nh\u1eefng m\u1ea1ch v\u00e0nh b\u1ecb h\u1eb9p n\u1eb7ng ti\u1ebfn tri\u1ec3n ch\u1eadm d\u1ea7n theo th\u1eddi gian th\u00ec \u00edt khi g\u00e2y NMCT c\u1ea5p v\u00ec th\u01b0\u1eddng c\u00f3 tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7 h\u00ecnh th\u00e0nh t\u1eeb t\u1eeb tr\u01b0\u1edbc \u0111\u00f3. Thay v\u00e0o \u0111\u00f3 NMCT c\u1ea5p ST ch\u00eanh l\u00ean th\u01b0\u1eddng x\u1ea3y ra do huy\u1ebft kh\u1ed1i h\u00ecnh th\u00e0nh nhanh ch\u00f3ng t\u1ea1i vi tr\u00ed t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u. Nh\u1eefng y\u1ebfu t\u1ed1 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho s\u1ef1 h\u00ecnh th\u00e0nh v\u00e0 ph\u00e1t tri\u1ec3n c\u1ee7a t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u l\u00e0 h\u00fat thu\u1ed1c l\u00e1, t\u0103ng huy\u1ebft \u00e1p v\u00e0 r\u1ed1i lo\u1ea1n lipid m\u00e1u. STEMI th\u01b0\u1eddng x\u1ea3y ra khi m\u1ea3ng x\u01a1 v\u1eefa b\u1ecb \u0111\u1ee9t v\u1ee1 l\u00e0m ph\u01a1i b\u00e0y th\u00e0nh ph\u1ea7n b\u00ean trong m\u1ea3ng x\u01a1 v\u1eefa v\u1edbi d\u00f2ng m\u00e1u v\u00e0 nh\u1eefng \u0111i\u1ec1u ki\u1ec7n t\u1ea1i ch\u1ed7 hay to\u00e0n th\u00e2n t\u1ea1o \u0111i\u1ec1u ki\u1ec7n h\u00ecnh th\u00e0nh huy\u1ebft kh\u1ed1i t\u1ea1i ch\u1ed7. \u0110\u1eb7c \u0111i\u1ec3m m\u1ea3ng x\u01a1 v\u1eefa d\u1ec5 b\u1ecb d\u1ee9t g\u00e3y l\u00e0 nh\u1eefng m\u1ea3ng x\u01a1 v\u1eefa c\u00f3 l\u00f5i gi\u00e0u lipid v\u00e0 v\u1ecf x\u01a1 m\u00f2ng. M\u1ed9t s\u1ed1 \u00edt tr\u01b0\u1eddng h\u1ee3p NMCT ST ch\u00eanh l\u00ean x\u1ea3y ra l\u00e0 do huy\u1ebft kh\u1ed1i di chuy\u1ec3n t\u1eeb ch\u1ed7 kh\u00e1c \u0111\u1ebfn g\u00e2y t\u1eafc do b\u1ea5t th\u01b0\u1eddng m\u1ea1ch v\u00e0nh b\u1ea9m sinh, do co th\u1eaft m\u1ea1ch v\u00e0nh v\u00e0 do nh\u1eefng b\u1ec7nh l\u00ed vi\u00eam to\u00e0n th\u00e2n.<\/p>\n<p>Kh\u1ed1i l\u01b0\u1ee3ng c\u01a1 tim b\u1ecb t\u1ed5n th\u01b0\u01a1ng do t\u1eafc m\u1ea1ch v\u00e0nh ph\u1ee5 thu\u1ed9c v\u00e0o:<\/p>\n<ul>\n<li>V\u00f9ng c\u01a1 tim \u0111\u01b0\u1ee3c nu\u00f4i d\u01b0\u1ee1ng b\u1edfi m\u1ea1ch m\u00e1u b\u1ecb t\u1eafc.<\/li>\n<li>M\u1ea1ch m\u00e1u c\u00f3 t\u1eafc ho\u00e0n to\u00e0n hay kh\u00f4ng.<\/li>\n<li>Th\u1eddi gian t\u1eafc m\u1ea1ch.<\/li>\n<li>L\u01b0\u1ee3ng m\u00e1u nu\u00f4i v\u00f9ng c\u01a1 tim nh\u1edd tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7.<\/li>\n<li>Nhu c\u1ea7u oxy c\u1ee7a c\u01a1 tim.<\/li>\n<li>Nh\u1eefng y\u1ebfu t\u1ed1 n\u1ed9i t\u1ea1i gi\u00fap cho s\u1ef1 li gi\u1ea3i c\u1ee5c m\u00e1u \u0111\u00f4ng m\u1ed9t c\u00e1ch t\u1ef1 nhi\u00ean.<\/li>\n<li>M\u1ee9c \u0111\u1ed9 t\u01b0\u1edbi m\u00e1u c\u01a1 tim \u1edf v\u00f9ng nh\u1ed3i m\u00e1u sau khi m\u1ea1ch v\u00e0nh th\u01b0\u1ee3ng m\u1ea1c \u0111\u00e3 \u0111\u01b0\u1ee3c t\u00e1i th\u00f4ng.<\/li>\n<\/ul>\n<p>Khi c\u01a1 tim b\u1ecb thi\u1ebfu m\u00e1u nu\u00f4i k\u00e9o d\u00e0i -&gt; ho\u1ea1i t\u1eed c\u01a1 tim b\u1eaft \u0111\u1ea7u x\u1ea3y ra sau 20 &#8211; 45 ph\u00fat v\u00e0 ho\u1ea1i t\u1eed ho\u00e0n to\u00e0n sau 2 &#8211; 4 gi\u1edd hay l\u00e2u h\u01a1n t\u00f9y tr\u01b0\u1eddng h\u1ee3p.<\/p>\n<ul>\n<li>C\u00e1c bi\u1ebfn ch\u1ee9ng:<\/li>\n<li><strong><em><u>R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t<\/u><\/em><\/strong><em>:<\/em> thay \u0111\u1ed5i <strong><em>s\u1edbm nh\u1ea5t l\u00e0 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m tr\u01b0\u01a1ng<\/em><\/strong><em>.<\/em> \u0110i\u1ec1u n\u00e0y x\u1ea3y ra trong c\u1ea3 thi\u1ebfu m\u00e1u v\u00e0 nh\u1ed3i m\u00e1u c\u01a1 tim, v\u00e0 ch\u1ec9 c\u1ea7n m\u1ed9t v\u00f9ng nh\u1ecf \u0111\u00e3 g\u00e2y ra r\u1ed1i lo\u1ea1n \u0111\u1ed5 \u0111\u1ea7y. Khi c\u01a1 tim b\u1ecb ho\u1ea1i t\u1eed &gt; 20% kh\u1ed1i l\u01b0\u1ee3ng c\u01a1 tim -&gt; ch\u1ee9c n\u0103ng t\u00e2m thu c\u01a1 tim b\u1eaft \u0111\u1ea7u suy y\u1ebfu. S\u1ed1c tim x\u1ea3y ra khi NMCTC x\u1ea3y ra &gt; 40% kh\u1ed1i l\u01b0\u1ee3ng c\u01a1 tim.<\/li>\n<li><strong><em><u>Lo\u1ea1n nh\u1ecbp tim<\/u><\/em><\/strong><em>:<\/em> do v\u00f9ng thi\u1ebfu m\u00e1u s\u1ebd t\u0103ng k\u00edch th\u00edch v\u00e0 s\u1ef1 xu\u1ea5t hi\u1ec7n hi\u1ec7n t\u01b0\u1ee3ng v\u00e0o l\u1ea1i \u1edf v\u00f9ng b\u1ecb thi\u1ebfu m\u00e1u c\u01a1 tim c\u1ee5c b\u1ed9. B\u00ean c\u1ea1nh \u0111\u00f3, c\u00e1c y\u1ebfu t\u1ed1 kh\u00e1c c\u0169ng g\u00f3p ph\u1ea7n v\u00e0o l\u00e0 t\u00ecnh tr\u1ea1ng t\u0103ng catecholamin r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i.<\/li>\n<li><strong><em><u>R\u1ed1i lo\u1ea1n d\u1eabn truy\u1ec1n<\/u><\/em><\/strong><em>:<\/em> do ph\u00f9 n\u1ec1 m\u00f4 d\u1eabn truy\u1ec1n (th\u00e0nh d\u01b0\u1edbi) hay ho\u1ea1i t\u1eed v\u0129nh vi\u1ec5n c\u00e1c \u0111\u01b0\u1eddng d\u1eabn truy\u1ec1n (th\u00e0nh tr\u01b0\u1edbc).<\/li>\n<\/ul>\n<h2>2. Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng<\/h2>\n<p><strong><em>\u0110au ng\u1ef1c:<\/em><\/strong><\/p>\n<ul>\n<li>L\u00e0 tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t.<\/li>\n<li>\u0110au c\u00f3 t\u00ednh ch\u1ea5t s\u00e2u do t\u1ea1ng. B\u1ec7nh nh\u00e2n th\u01b0\u1eddng m\u00f4 t\u1ea3 c\u1ea3m gi\u00e1c \u0111au nh\u01b0 \u0111\u00e8 n\u1eb7ng, nh\u01b0 nghi\u1ec1n hay nh\u01b0 xo\u1eafn v\u1eb7n. \u0110\u00f4i khi m\u00f4 t\u1ea3 nh\u01b0 dao \u0111\u00e2m hay c\u1ea3m gi\u00e1c \u0111au n\u00f3ng r\u00e1t.<\/li>\n<li>Vi tr\u00ed \u0111au th\u01b0\u1eddng \u1edf gi\u1eefa ng\u1ef1c (sau x\u01b0\u01a1ng \u1ee9c) ho\u1eb7c \u1edf th\u01b0\u1ee3ng v\u1ecb, lan l\u00ean c\u00e1nh tay b\u00ean tr\u00e1i, ho\u1eb7c lan l\u00ean h\u00e0m d\u01b0\u1edbi, c\u1ed5, b\u1ee5ng l\u01b0ng. \u0110au c\u00f3 th\u1ec3 lan cao \u0111\u1ebfn v\u00f9ng ch\u1ea9m nh\u01b0ng kh\u00f4ng bao gi\u1edd lan xu\u1ed1ng d\u01b0\u1edbi r\u1ed1n.<\/li>\n<li>\u0110\u1eb7c \u0111i\u1ec3m \u0111au ng\u1ef1c gi\u1ed1ng nh\u01b0 c\u01a1n \u0111au th\u1eaft ng\u1ef1c kh\u00f4ng \u1ed5n \u0111\u1ecbnh nh\u01b0ng x\u1ea3y ra khi ngh\u1ec9 t\u0129nh v\u1edbi m\u1ee9c \u0111\u1ed9 n\u1eb7ng v\u00e0 th\u1eddi gian k\u00e9o d\u00e0i h\u01a1n th\u01b0\u1eddng &gt; 20 ph\u00fat.<\/li>\n<li>\u0110au ng\u1ef1c c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra khi g\u1eafng s\u1ee9c nh\u01b0ng kh\u00e1c v\u1edbi c\u01a1n \u0111au th\u1eaft ng\u1ef1c \u1ed5n \u0111\u1ecbnh l\u00e0 x\u1ea3y ra kh\u00f4ng gi\u1ea3m khi ngh\u1ec9 ng\u01a1i.<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone wp-image-35622 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/5c1740bc-93e2-445a-be5d-ada64df46209-300x300.jpg\" alt=\"hoi-chung-vanh-cap\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/5c1740bc-93e2-445a-be5d-ada64df46209-300x300.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/5c1740bc-93e2-445a-be5d-ada64df46209-150x150.jpg 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/5c1740bc-93e2-445a-be5d-ada64df46209-768x768.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/5c1740bc-93e2-445a-be5d-ada64df46209.jpg 1024w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p><strong><em>Tri\u1ec7u ch\u1ee9ng \u0111i k\u00e8m:<\/em><\/strong><\/p>\n<p>Y\u1ebfu, v\u00e3 m\u1ed3 h\u00f4i, bu\u1ed3n n\u00f4n, n\u00f4n \u00f3i, lo l\u1eafng, c\u1ea3m gi\u00e1c s\u1ee3 ch\u1ebft.<\/p>\n<p><strong><em>Tri\u1ec7u ch\u1ee9ng kh\u00e1c:<\/em><\/strong><\/p>\n<p>M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 \u0111au ng\u1ef1c nh\u01b0ng t\u00ecnh tr\u1ea1ng n\u00e0y ch\u1ec9 x\u1ea3y ra \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i, ph\u1ee5 n\u1eef hay b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/p>\n<p>\u1ede ng\u01b0\u1eddi l\u1edbn tu\u1ed5i, NMCTC c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n v\u1edbi t\u00ecnh tr\u1ea1ng kh\u00f3 th\u1edf \u0111\u1ed9t ng\u1ed9t di\u1ec5n ti\u1ebfn t\u1edbi ph\u00f9 ph\u1ed5i c\u1ea5p. Ngo\u00e0i ra c\u00f3 th\u1ec3 g\u1eb7p c\u00e1c tri\u1ec7u ch\u1ee9ng t\u01b0\u01a1ng \u0111\u01b0\u01a1ng nh\u01b0 l\u00e0 r\u1ed1i lo\u1ea1n tri gi\u00e1c, r\u1ed1i lo\u1ea1n nh\u1ecbp, c\u1ea3m gi\u00e1c y\u1ebfu m\u1ec7t, thuy\u00ean t\u1eafc ngo\u1ea1i bi\u00ean v\u00e0 t\u1ee5t huy\u1ebft \u00e1p kh\u00f4ng gi\u1ea3i th\u00edch \u0111\u01b0\u1ee3c.<\/p>\n<p><strong><u>Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3:<\/u><\/strong><\/p>\n<p><strong><em>To\u00e0n th\u00e2n:<\/em><\/strong><\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n t\u1ecf v\u1ebb lo l\u1eafng, xanh xao, v\u00e3 m\u1ed3 h\u00f4i l\u1ea1nh chi.<\/li>\n<li>M\u1ea1ch v\u00e0 huy\u1ebft \u00e1p: c\u00f3 th\u1ec3 ho\u00e0n to\u00e0n b\u00ecnh th\u01b0\u1eddng. C\u00f3 th\u1ec3 t\u0103ng ho\u1ea1t giao c\u1ea3m bi\u1ec3u hi\u1ec7n v\u1edbi t\u0103ng huy\u1ebft \u00e1p ho\u1eb7c nh\u1ecbp nhanh (nh\u1ed3i m\u00e1u c\u01a1 tim th\u00e0nh tr\u01b0\u1edbc). C\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n v\u1edbi c\u01b0\u1eddng ph\u00f3 giao c\u1ea3m (nh\u1ecbp ch\u1eadm v\u00e0 t\u1ee5t huy\u1ebft \u00e1p) th\u01b0\u1eddng x\u1ea3y ra \u1edf b\u1ec7nh nh\u00e2n NMCT th\u00e0nh d\u01b0\u1edbi.<\/li>\n<li>Th\u00e2n nhi\u1ec7t th\u01b0\u1eddng t\u0103ng trong v\u00f2ng 24 &#8211; 48 gi\u1edd sau khi nh\u1ed3i m\u00e1u. Nhi\u1ec7t \u0111\u1ed9 \u0111o \u0111\u01b0\u1ee3c \u1edf tr\u1ef1c tr\u00e0ng c\u00f3 th\u1ec3 l\u00ean t\u1edbi 38.9<sup>0<\/sup> Nh\u01b0ng s\u1ed1t th\u01b0\u1eddng gi\u1ea3m sau 4 &#8211; 5 ng\u00e0y.<\/li>\n<\/ul>\n<p><strong><em>T\u1ea1i tim:<\/em><\/strong><\/p>\n<ul>\n<li>M\u1ecfm tim kh\u00f3 s\u1edd.<\/li>\n<li>T1 m\u1edd do PR k\u00e9o d\u00e0i.<\/li>\n<li>T2 t\u00e1ch \u0111\u00f4i ngh\u1ecbch \u0111\u1ea3o khi c\u00f3 LBBB hay ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i b\u1ecb suy n\u1eb7ng.<\/li>\n<li>T4 th\u01b0\u1eddng hi\u1ec7n di\u1ec7n nh\u01b0ng \u00edt c\u00f3 gi\u00e1 tr\u1ecb ch\u1ea9n \u0111o\u00e1n.<\/li>\n<li>T3 nghe \u0111\u01b0\u1ee3c khi c\u00f3 suy ch\u1ee9c n\u0103ng th\u1ea5t hay do h\u1edf van hai l\u00e1 hay th\u00f4ng li\u00ean th\u1ea5t (bi\u1ebfn ch\u1ee9ng c\u01a1 h\u1ecdc c\u1ee7a NMCT c\u1ea5p).<\/li>\n<li>\u00c2m th\u1ed5i t\u00e2m thu gi\u1eefa t\u00e2m thu hay cu\u1ed1i th\u00ec t\u00e2m thu \u1edf v\u00f9ng m\u1ecfm tim do r\u1ed1i l\u1ecda ch\u1ee9c n\u0103ng b\u1ed9 m\u00e1y van hai l\u00e1.<\/li>\n<li>Ti\u1ebfng c\u1ecd m\u00e0ng tim: NMCT xuy\u00ean th\u00e0nh.<\/li>\n<\/ul>\n<p><strong><u>NSTEMI<\/u><\/strong><\/p>\n<ul>\n<li>Tri\u1ec7u ch\u1ee9ng ch\u1ee7 y\u1ebfu l\u00e0 \u0111au ng\u1ef1c v\u1edbi t\u00ednh ch\u1ea5t c\u1ee7a b\u1ec7nh m\u1ea1ch v\u00e0nh. Trong khi \u0111\u00f3, c\u00e1c tri\u1ec7u ch\u1ee9ng t\u01b0\u01a1ng \u0111\u01b0\u01a1ng \u0111au ng\u1ef1c th\u00ec \u00edt g\u1eb7p h\u01a1n, v\u00e0 n\u1ebfu c\u00f3 g\u1eb7p th\u00ec th\u01b0\u1eddng hay g\u1eb7p \u1edf ph\u1ee5 n\u1eef.<\/li>\n<li>Kh\u00e1m th\u1ef1c th\u1ec3 th\u00ec c\u0169ng gi\u1ed1ng nh\u01b0 trong \u0111au th\u1eaft ng\u1ef1c \u1ed5n \u0111\u1ecbnh ngh\u0129a l\u00e0 c\u00f3 th\u1ec3 ho\u00e0n to\u00e0n kh\u00e1m kh\u00f4ng th\u1ea5y b\u1ea5t th\u01b0\u1eddng g\u00ec c\u1ea3! Nh\u01b0ng n\u1ebfu b\u1ec7nh nh\u00e2n b\u1ecb thi\u1ebfu m\u00e1u c\u01a1 tim m\u1ed9t v\u00f9ng r\u1ed9ng (th\u00f4ng th\u01b0\u1eddng l\u00e0 STEMI h\u01a1n l\u00e0 NSTEMI) v\u00e0 xu\u1ea5t hi\u1ec7n bi\u1ebfn ch\u1ee9ng th\u00ec b\u1ec7nh nh\u00e2n s\u1ebd c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3 c\u1ee7a bi\u1ebfn ch\u1ee9ng.<\/li>\n<\/ul>\n<h2>3. \u0110i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p<\/h2>\n<p>B\u1ec7nh nh\u00e2n c\u00f3 h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p th\u01b0\u1eddng s\u1ebd nh\u1eadp vi\u1ec7n \u1edf 1 trong 2 b\u1ec7nh c\u1ea3nh: h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p c\u00f3 bi\u1ebfn ch\u1ee9ng hay h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p ch\u01b0a c\u00f3 bi\u1ebfn ch\u1ee9ng.<\/p>\n<p>&#8211; Nh\u01b0 v\u1eady tr\u00ean l\u00e0m s\u00e0ng khi ti\u1ebfp c\u1eadn ban \u0111\u1ea7u vi\u1ec7c \u0111\u1ea7u ti\u00ean m\u00e0 ta c\u1ea7n ph\u1ea3i x\u00e1c \u0111\u1ecbnh l\u00e0 ph\u1ea3i bi\u1ebft \u0111\u01b0\u1ee3c r\u1eb1ng b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ebfn ch\u1ee9ng hay kh\u00f4ng. Ngh\u0129a l\u00e0 ph\u1ea3i x\u00e1c \u0111\u1ecbnh b\u1ec7nh nh\u00e2n h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p c\u00f3 bi\u1ebfn ch\u1ee9ng hay kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng. Th\u00f4ng th\u01b0\u1eddng khi h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p c\u00f3 bi\u1ebfn ch\u1ee9ng l\u00e0 h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p c\u00f3 ST ch\u00eanh l\u00ean.<\/p>\n<ul>\n<li>H\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p c\u00f3 bi\u1ebfn ch\u1ee9ng c\u0169ng ph\u1ea3i \u0111\u01b0\u1ee3c chia th\u00e0nh h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p c\u00f3 ST ch\u00eanh l\u00ean hay h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p kh\u00f4ng c\u00f3 ST ch\u00eanh l\u00ean.<\/li>\n<\/ul>\n<p>C\u00e1c nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb:<\/p>\n<p>Th\u1edf oxy: cho nh\u1eefng b\u00eanh nh\u00e2n c\u00f3 \u0111\u00f4 b\u00e3o ho\u00e0 oxy m\u00e1u &lt;90%<\/p>\n<p>Gi\u1ea3m \u0111au-gi\u1ea3m lo \u00e2u:<\/p>\n<ul>\n<li>Morphine:<\/li>\n<li>An th\u1ea7n: n\u1ebfu b\u1ec7nh nh\u00e2n qu\u00e1 k\u00edch \u0111\u1ed9ng, c\u00f3 th\u1ec3 d\u00f9ng th\u00eam an th\u1ea7n.<\/li>\n<li>C\u00e1c thu\u1ed1c kh\u00e1c: Nitrate, \u1ee9c ch\u1ebf b\u00eata v\u00e0 cung c\u1ea5p oxy c\u0169ng gi\u00fap gi\u1ea3m \u0111au.<\/li>\n<li>Kh\u00e1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u: 3 nh\u00f3m<\/li>\n<li>Kh\u00e1ng \u0111\u00f4ng<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb t\u00e1i t\u01b0\u1edbi m\u00e1u<\/li>\n<\/ul>\n<p>Xem th\u00eam:<\/p>\n<p><a href=\"https:\/\/vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/benh-mach-vanh-bieu-hien-nguyen-nhan-va-cach-dieu-tri-o-vinmec\/\">B\u1ec7nh m\u1ea1ch v\u00e0nh: Bi\u1ec3u hi\u1ec7n, nguy\u00ean nh\u00e2n v\u00e0 c\u00e1ch \u0111i\u1ec1u tr\u1ecb \u1edf Vinmec<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>H\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p l\u00e0 m\u1ed9t c\u1ea5p c\u1ee9u n\u1ed9i khoa, l\u00e0 m\u1ed9t bi\u1ebfn c\u1ed1 do ch\u1ebft t\u1ebf b\u00e0o c\u01a1 tim do thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 c\u1ea5p t\u00ednh ch\u1ee9 kh\u00f4ng ph\u1ea3i ch\u1ebft t\u1ebf b\u00e0o do ch\u1ea5n th\u01b0\u01a1ng hay vi\u00eam c\u01a1 tim. Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng c\u1ee7a b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh l\u00e0 c\u01a1n \u0111au th\u1eaft ng\u1ef1c. Tr\u00ean [&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>H\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p: B\u1ed9 Y t\u1ebf khuy\u1ebfn c\u00e1o c\u1ea7n ph\u00e1t hi\u1ec7n s\u1edbm v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi - Vinmec<\/title>\n<meta name=\"description\" content=\"H\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p l\u00e0, l\u00e0 m\u1ed9t bi\u1ebfn c\u1ed1 do ch\u1ebft t\u1ebf b\u00e0o c\u01a1 tim do thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 c\u1ea5p t\u00ednh ch\u1ee9 kh\u00f4ng ph\u1ea3i ch\u1ebft t\u1ebf b\u00e0o do ch\u1ea5n th\u01b0\u01a1ng hay vi\u00eam\" \/>\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=\"H\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p: B\u1ed9 Y t\u1ebf khuy\u1ebfn c\u00e1o c\u1ea7n ph\u00e1t hi\u1ec7n s\u1edbm v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi - 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