{"id":6232,"date":"2024-07-11T10:40:02","date_gmt":"2024-07-11T03:40:02","guid":{"rendered":"https:\/\/bvndgiadinh.org.vn\/?p=6232"},"modified":"2024-07-11T10:40:02","modified_gmt":"2024-07-11T03:40:02","slug":"vo-thung-tim-khi-dang-tap-gym","status":"publish","type":"post","link":"https:\/\/bvndgiadinh.org.vn\/?p=6232","title":{"rendered":"V\u1ee0 TH\u1ee6NG TIM KHI \u0110ANG T\u1eacP GYM"},"content":{"rendered":"\n

B\u00ea\u0323nh vi\u00ea\u0323n Nh\u00e2n d\u00e2n Gia \u0110i\u0323nh c\u00e2\u0301p c\u01b0\u0301u va\u0300 ph\u00e2\u0303u thu\u00e2\u0323t tha\u0300nh c\u00f4ng cho m\u00f4\u0323t tr\u01b0\u01a1\u0300ng h\u01a1\u0323p ng\u01b0\u01a1\u0300i b\u00ea\u0323nh bi\u0323 ch\u00e8n \u00e9p tim c\u1ea5p tr\u00e0n m\u00e1u m\u00e0ng ngo\u00e0i tim g\u00e2y v\u01a1\u0303, thu\u0309ng tim. Vi\u0323 tri\u0301 v\u00ea\u0301t thu\u0309ng \u1edf th\u00e0nh sau th\u1ea5t tr\u00e1i, lan xu\u1ed1ng ph\u00eda m\u00f5m tim, di\u1ec7n t\u00edch kho\u1ea3ng h\u01a1n 6 cm2, ngay tr\u00ean di\u1ec7n t\u00edm n\u00e0y c\u00f3 m\u1ed9t v\u1ebft th\u1ee7ng d\u00e0i kho\u1ea3ng 7mm, tim g\u1ea7n nh\u01b0 r\u1ed7ng.<\/em><\/strong><\/p>\n\n\n\n

\u0110\u00f3 l\u00e0 tr\u01b0\u1eddng h\u1ee3p ng\u01b0\u1eddi b\u1ec7nh nh\u00e2n \u0110.\u0110.N, nam, 59 tu\u1ed5i, \u1edf B\u00ecnh Th\u1ea1nh TPHCM. Khi anh N \u0111ang t\u1eadp gym (n\u00e2ng t\u1ea1) th\u00ec \u0111\u1ed9t ng\u1ed9t l\u00ean c\u01a1n kh\u00f3 th\u1edf, t\u00edm t\u00e1i, ng\u00e3 g\u1ee5c xu\u1ed1ng, ng\u1ea5t, v\u00e3 m\u1ed3 h\u1ed3i. Ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c \u0111\u01b0a nh\u1eadp vi\u1ec7n c\u1ea5p c\u1ee9u t\u1ea1i BV Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh v\u00e0o l\u00fac 17h15 ng\u00e0y 03\/07\/2024. T\u00ecnh tr\u1ea1ng l\u00fac v\u00e0o vi\u1ec7n ng\u01b0\u1eddi b\u1ec7nh l\u01a1 m\u01a1, ti\u1ebfp x\u00fac r\u1ea5t ch\u1eadm, tay ch\u00e2n l\u1ea1nh, t\u00edm t\u00e1i, v\u00e3 m\u1ed3 h\u00f4i, m\u1ea1ch nhanh 120 l\u1ea7n\/ ph\u00fat, huy\u1ebft \u00e1p kh\u00f4ng \u0111o \u0111\u01b0\u1ee3c, SPO2: 86% v\u1edbi th\u1edf oxy mask 15 l\u00edt\/p. Sau \u0111\u00f3, tri gi\u00e1c ng\u01b0\u1eddi b\u1ec7nh x\u1ea5u d\u1ea7n, huy\u1ebft \u00e1p v\u1eabn kh\u00f4ng \u0111o \u0111\u01b0\u1ee3c, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c h\u1ed3i s\u1ee9c v\u1edbi Noradrenalin li\u1ec1u cao 0,4 ug\/kg\/ph\u00fat \u0111\u1ec3 n\u00e2ng huy\u1ebft \u00e1p.<\/p>\n\n\n

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H\u00ecnh \u1ea3nh m\u00e1u tr\u00e0o ra ng\u1eadp c\u1ea3 khoang trung th\u1ea5t<\/em><\/p>\n\n\n\n

Ng\u01b0\u1eddi b\u1ec7nh ngay l\u1eadp t\u1ee9c \u0111\u01b0\u1ee3c h\u1ed9i ch\u1ea9n c\u1ea5p c\u1ee9u v\u1edbi b\u00e1c s\u0129 H\u1ed3i S\u1ee9c Tim M\u1ea1ch. K\u1ebft qu\u1ea3 si\u00eau \u00e2m tim t\u1ea1i gi\u01b0\u1eddng cho th\u1ea5y tr\u00e0n d\u1ecbch m\u00e0ng tim l\u01b0\u1ee3ng nhi\u1ec1u, b\u1ec1 d\u00e0y l\u1edbp d\u1ecbch kho\u1ea3ng 25 mm, \u0111\u00e8 s\u1ee5p th\u1ea5t ph\u1ea3i n\u00ean c\u1ea7n ti\u1ebfn h\u00e0nh ch\u1ecdc h\u00fat d\u1ecbch m\u00e0ng ngo\u00e0i tim gi\u1ea3i \u00e1p. Tuy nhi\u00ean, vi\u1ec7c ch\u1ecdc kh\u00f4ng th\u00e0nh c\u00f4ng c\u00f3 th\u1ec3 do m\u00e1u \u0111\u00f3ng b\u00e1nh. H\u1ed9i ch\u1ea9n kh\u1ea9n v\u00e0 chuy\u1ec3n v\u00e0o khoa Ph\u1eabu Thu\u1eadt Tim v\u1edbi ch\u1ea9n \u0111o\u00e1n l\u00e0 ch\u00e8n \u00e9p tim c\u1ea5p tr\u00e0n m\u00e1u m\u00e0ng ngo\u00e0i tim, nghi sau nh\u1ed3i m\u00e1u c\u01a1 tim. T\u00ecnh tr\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh ng\u00e0y c\u00e0ng nguy k\u1ecbch, tr\u1ee5y tim m\u1ea1ch c\u00e0ng n\u1eb7ng h\u01a1n v\u1edbi m\u1ea1ch kh\u00f3 b\u1eaft, huy\u1ebft \u00e1p kh\u00f4ng \u0111o \u0111\u01b0\u1ee3c, t\u00edm to\u00e0n th\u00e2n, ti\u00eau ph\u00e2n kh\u00f4ng t\u1ef1 ch\u1ee7, ti\u1ebfng tim kh\u00f4ng nghe \u0111\u01b0\u1ee3c, men tim 2500 ng\/L.<\/p>\n\n\n

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H\u00ecnh \u1ea3nh ng\u01b0\u1eddi b\u1ec7nh sau khi r\u00fat n\u1ed9i kh\u00ed qu\u1ea3n<\/em><\/p>\n\n\n\n

TS.BS B\u00f9i Minh Th\u00e0nh \u2013 Tr\u01b0\u1edfng khoa Ph\u1eabu thu\u1eadt tim cho bi\u1ebft: \u201cTr\u01b0\u1edbc t\u00ecnh th\u1ebf nguy nan n\u00e0y, c\u00e1c b\u00e1c s\u0129 \u0111\u00e3 v\u1eeba h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c ngay trong ph\u00f2ng m\u1ed5 v\u00e0 ti\u1ebfn h\u00e0nh m\u1edf ng\u1ef1c c\u1ea5p c\u1ee9u. Ngay sau khi c\u01b0a nhanh x\u01b0\u01a1ng \u1ee9c b\u1ed9c l\u1ed9 tim, m\u00e0ng ngo\u00e0i tim r\u1ea5t c\u0103ng, kh\u00f4ng \u0111\u1eadp, ch\u1ee9a \u0111\u1ea7y m\u00e1u. M\u1edf m\u00e0ng ngay m\u00e0ng ngo\u00e0i tim, m\u00e1u tr\u00e0o ra ng\u1eadp c\u1ea3 khoang trung th\u1ea5t, h\u00fat \u0111\u01b0\u1ee3c h\u01a1n 800 ml, tim \u0111\u01b0\u1ee3c gi\u1ea3i \u00e1p v\u00e0 \u0111\u1eadp nhanh nh\u01b0ng \u0111\u01b0\u1ee3c bao b\u1ecdc b\u1edfi m\u1ed9t l\u1edbp m\u00e1u \u0111\u00f4ng kh\u00e1 d\u00e0y (ch\u00ednh l\u1edbp m\u00e1u \u0111\u00f4ng n\u00e0y \u0111\u00e3 c\u1ee9u s\u1ed1ng b\u1ec7nh nh\u00e2n). L\u1ea5y to\u00e0n b\u1ed9 l\u1edbp m\u00e1u \u0111\u00f4ng n\u00e0y, c\u00e1c b\u00e1c s\u0129 ph\u00e1t hi\u1ec7n m\u1ed9t v\u00f9ng t\u00edm, m\u1ec1m m\u0169n, \u1edf th\u00e0nh sau th\u1ea5t tr\u00e1i, lan xu\u1ed1ng ph\u00eda m\u00f5m tim, di\u1ec7n t\u00edch kho\u1ea3ng h\u01a1n 6 cm2, ngay tr\u00ean di\u1ec7n t\u00edm n\u00e0y c\u00f3 m\u1ed9t v\u1ebft th\u1ee7ng d\u00e0i kho\u1ea3ng 7mm, tim g\u1ea7n nh\u01b0 r\u1ed7ng. \u00ca k\u00edp ph\u1eabu thu\u1eadt t\u00edch c\u1ef1c b\u01a1m m\u00e1u, b\u00f9 d\u1ecbch, t\u1ee7a l\u1ea1nh\u2026 \u0111\u1ed3ng th\u1eddi ti\u1ebfn h\u00e0nh kh\u00e2u \u0111\u00f3ng v\u1ebft th\u1ee7ng tim tr\u00ean n\u1ec1n nh\u1ed3i m\u00e1u c\u01a1 tim v\u1edbi k\u1ef9 thu\u1eadt chuy\u00ean bi\u1ec7t. Ca ph\u1eabu thu\u1eadt k\u00e9o d\u00e0i kho\u1ea3ng 3,5 ti\u1ebfng \u0111\u1ed3ng h\u1ed3\u201d.<\/em><\/p>\n\n\n\n

V\u1ee1 tim l\u00e0 t\u00ecnh tr\u1ea1ng khi ng\u01b0\u1eddi b\u1ec7nh b\u1ecb nh\u1ed3i m\u00e1u c\u01a1 tim, g\u00e2y ho\u1ea1i t\u1eed th\u00e0nh c\u01a1 tim v\u00e0 v\u1ee1 th\u00e0nh c\u01a1 tim t\u1ea1i nh\u1eefng \u0111i\u1ec3m c\u01a1 tim b\u1ecb suy y\u1ebfu do ho\u1ea1i t\u1eed. V\u1ee1 tim g\u00e2y ch\u1ea3y m\u00e1u, s\u1ed1c tim, suy tim n\u1eb7ng. \u0110\u00e2y l\u00e0 t\u00ecnh tr\u1ea1ng \u0111\u1eb7c bi\u1ec7t nguy hi\u1ec3m, t\u1ef7 l\u1ec7 t\u1eed vong r\u1ea5t cao. Th\u1eadm ch\u00ed, sau m\u1ed5 t\u1ef7 l\u1ec7 t\u1eed vong c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh v\u1eabn c\u00f3 th\u1ec3 x\u1ea3y ra do nh\u1eefng bi\u1ebfn ch\u1ee9ng c\u1ee7a v\u1ee1 tim g\u00e2y ra. Nh\u1eefng ng\u00e0y h\u1ed3i s\u1ee9c tim, m\u1eb7c d\u00f9 ng\u01b0\u1eddi b\u1ec7nh c\u00f3 m\u1ea1ch huy\u1ebft \u00e1p c\u1ea3i thi\u1ec7n d\u1ea7n, t\u1eeb v\u00f4 ni\u1ec7u, thi\u1ec3u ni\u1ec7u r\u1ed3i n\u01b0\u1edbc ti\u1ec3u nhi\u1ec1u v\u00e0 v\u00e0ng trong h\u01a1n, ch\u1ee9c n\u0103ng th\u1eadn v\u00e0 gan h\u1ed3i ph\u1ee5c. Men tim t\u0103ng l\u00ean 7700 ng\/L. Tuy nhi\u00ean, b\u1ec7nh nh\u00e2n r\u01a1i v\u00e0o t\u00ecnh tr\u1ea1ng c\u00f3 nh\u1eefng c\u01a1n lo\u1ea1n th\u1ea7n v\u00e0 n\u00f3i nh\u1ea3m do thi\u1ebfu m\u00e1u n\u00e3o, c\u1ea7n ph\u1ea3i d\u00f9ng an th\u1ea7n li\u1ec1u cao. Sau 7 ng\u00e0y \u0111\u01b0\u1ee3c h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c, s\u1ee9c kh\u1ecfe ng\u01b0\u1eddi b\u1ec7nh d\u1ea7n \u1ed5n \u0111\u1ecbnh, r\u00fat n\u1ed9i kh\u00ed qu\u1ea3n, c\u00e1c d\u1ea5u hi\u1ec7u sinh t\u1ed3n b\u00ecnh th\u01b0\u1eddng, tri gi\u00e1c h\u1ed3i ph\u1ee5c, t\u1ec9nh t\u00e1o ho\u00e0n to\u00e0n, kh\u00f4ng \u0111au ng\u1ef1c. Ng\u01b0\u1eddi b\u1ec7nh nh\u00e2n s\u1ebd \u0111\u01b0\u1ee3c ch\u1ee5p m\u1ea1ch v\u00e0nh \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c v\u1ecb tr\u00ed \u0111\u1ed9ng m\u1ea1ch v\u00e0nh b\u1ecb t\u1eafc ngh\u1ebdn t\u1eeb \u0111\u00f3 b\u00e1c s\u1ef9 \u0111\u01b0a ra ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p.<\/p>\n\n\n

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B\u00e1c s\u0129 th\u0103m kh\u00e1m cho ng\u01b0\u1eddi b\u1ec7nh<\/em><\/p>\n\n\n\n

Khai th\u00e1c ti\u1ec1n s\u1eed cho th\u1ea5y ng\u01b0\u1eddi b\u1ec7nh c\u00f3 \u0111au ng\u1ef1c tr\u01b0\u1edbc nh\u1eadp vi\u1ec7n 5 ng\u00e0y, c\u01a1n \u0111au k\u00e9o d\u00e0i h\u01a1n 10 ph\u00fat. Theo suy \u0111o\u00e1n c\u1ee7a b\u00e1c s\u1ef9, th\u1eddi \u0111i\u1ec3m \u0111\u00f3 c\u00f3 th\u1ec3 ng\u01b0\u1eddi b\u1ec7nh b\u1ecb nh\u1ed3i m\u00e1u c\u01a1 tim. Kho\u1ea3ng th\u1eddi gian n\u00e0y \u0111\u1ee7 \u0111\u1ec3 l\u00e0m c\u01a1 tim b\u1ecb thi\u1ebfu m\u00e1u, r\u1ed3i ho\u1ea1i t\u1eed. Khi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 ho\u1ea1t \u0111\u1ed9ng g\u1eafng s\u1ee9c m\u1ea1nh,trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y l\u00e0 n\u00e2ng t\u1ea1 khi t\u1eadp gym th\u00ec g\u00e2y n\u00ean v\u1ee1 hay th\u1ee7ng tim. M\u1eb7t kh\u00e1c, th\u00e0nh sau th\u1ea5t tr\u00e1i l\u00e0 v\u1ecb tr\u00ed m\u1ecfng nh\u1ea5t c\u1ee7a th\u1ea5t tr\u00e1i (th\u1ea5t tr\u00e1i co b\u00f3p s\u1ebd b\u01a1m m\u00e1u \u0111i nu\u00f4i c\u01a1 th\u1ec3), v\u1ecb tr\u00ed nh\u1ed3i m\u00e1u l\u1ea1i ngay ch\u1ed7 m\u1ecfng nh\u1ea5t c\u1ee7a th\u1ea5t tr\u00e1i, cho n\u00ean d\u1ec5 c\u00f3 nguy c\u01a1 v\u1ee1 th\u1ea5t tr\u00e1i, nh\u1ea5t l\u00e0 trong nh\u1ed3i m\u00e1u c\u01a1 tim xuy\u00ean th\u00e0nh, g\u00e2y t\u1eed vong nhanh n\u1ebfu kh\u00f4ng can thi\u1ec7p k\u1ecbp th\u1eddi.<\/p>\n\n\n\n

Ho\u1ea1t \u0111\u1ed9ng th\u1ec3 d\u1ee5c l\u00e0 c\u1ea7n thi\u1ebft, nh\u01b0ng t\u00f9y theo t\u1eebng \u0111\u1ed9 tu\u1ed5i v\u00e0 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe, \u00e1p d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p t\u1eadp luy\u1ec7n ph\u00f9 h\u1ee3p, kh\u00f4ng n\u00ean g\u1eafng s\u1ee9c khi \u0111\u00e3 c\u00f3 tu\u1ed5i. Khi th\u1ea5y c\u00f3 d\u1ea5u hi\u1ec7u \u0111au ng\u1ef1c, k\u00e9o d\u00e0i h\u01a1n 10-15 ph\u00fat, \u0111au g\u00e2y ng\u01b0ng th\u1edf\u2026 th\u00ec n\u00ean \u0111i kh\u00e1m b\u1ec7nh, \u0111\u1ec3 ph\u00e1t hi\u1ec7n, \u0111i\u1ec1u tr\u1ecb v\u00e0 theo d\u00f5i c\u01a1n \u0111au th\u1eaft ng\u1ef1c hay nh\u1ed3i m\u00e1u c\u01a1 tim \u201cth\u1ea7m l\u1eb7ng\u201d.<\/p>\n","protected":false},"excerpt":{"rendered":"

B\u00ea\u0323nh vi\u00ea\u0323n Nh\u00e2n d\u00e2n Gia \u0110i\u0323nh c\u00e2\u0301p c\u01b0\u0301u va\u0300 ph\u00e2\u0303u thu\u00e2\u0323t tha\u0300nh c\u00f4ng cho m\u00f4\u0323t tr\u01b0\u01a1\u0300ng h\u01a1\u0323p ng\u01b0\u01a1\u0300i b\u00ea\u0323nh bi\u0323 ch\u00e8n \u00e9p tim c\u1ea5p tr\u00e0n m\u00e1u m\u00e0ng ngo\u00e0i tim g\u00e2y v\u01a1\u0303, thu\u0309ng tim. Vi\u0323 tri\u0301 v\u00ea\u0301t thu\u0309ng \u1edf th\u00e0nh sau th\u1ea5t tr\u00e1i, lan xu\u1ed1ng ph\u00eda m\u00f5m tim, di\u1ec7n t\u00edch kho\u1ea3ng h\u01a1n 6 cm2, ngay tr\u00ean 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