Nhung dieu nen biet ve benh hen tim

Thứ sáu, 15 Tháng tư 2011, 00:35 GMT+7

Hen tim la tinh trang kho khe, kho tho xuat hien dot ngot trong the suy tim sung huyet chu khong phai la benh hen theo dung nghia cua no.

Hen tim la do u tre tuan hoan phoi va co hay khong hoi chung phu phoi cap. Su co that phe quan trong benh hen tim nguyen nhan la do ap luc don tro lai tu tim trai toi phoi (tim trai khong du kha nang bom het luong mau dua ve tu phoi gay “u mau giat lui” ve phoi) lam cho duong thong khi cua phoi bi hep lai. Con trong hen phe quan thi co that phe quan la do cac co tron phe quan co that lai gay hep duong tho.

Dau hieu chinh trong hen tim

Hen tim cung kha giong voi hen phe quan. Trong do benh nhan mac benh suy tim hoac cac benh van tim cung xuat hien cac trieu chung kho tho, tho doc (tho nong), co tieng kho khe va ho.

Cac dau hieu lam sang la co so chu yeu chan doan hen tim. Cac dau hieu nay thuong xuat hien khi gang suc, lam viec nang nhoc (nhu leo cau thang, di bo quang duong dai…) hoac co the xuat hien ve nua dem gan sang. Mot so dau hieu chinh bao gom: tho doc (khong nhat thiet phai kem theo co tieng kho khe); nhip tho tang len va tho nong; tang ca nhip tim va huyet ap; tinh than hoang loan. Ngoai nhung dau hieu tren thi trong hen tim con co cac trieu chung cua suy tim de ta phan biet voi hen phe quan. Benh nhan thuong co tien su benh tim mach truoc day. Trieu chung phu o mat ca chan, di tieu it, gan to la nhung trieu chung de dang phat hien nhat. Va khi co cac dau hieu nay thi tien luong benh nhan rat nang. Ngoai ra khi tham kham ta co the thay cac dau hieu tai tim gay nen suy tim nhu tieng thoi do hep ho van hai la, thong lien that…Nghe phoi co tieng ran rit, ran ngay va trong con phu phoi cap co the thay tieng ran dang trao tu day phoi len dinh phoi - goi la dau hieu “thuy trieu dang”.

Nhung dieu nen biet ve benh hen tim

Chia khoa de kiem soat co hieu qua benh hen tim la phai chan doan chinh xac. Phai phan biet duoc giua nhung nguoi benh hen tim do suy tim cap tinh voi nhung nguoi kho tho do cac roi loan khac, chang han nhu benh hen suyen, benh phoi tac nghen man tinh (COPD), viem phoi, embolism phoi hoac hoi chung suy ho hap cap (Ards). Nguyen tac co ban dieu tri hen tim la can phai cai thien kha nang bom mau cua tim de giai phong luong mau u tre o phoi (hay noi cach khac chinh la dieu tri suy tim) ket hop voi thuoc gian phe quan. Neu hen tim nguyen nhan do van tim hoac mot so benh tim bam sinh co thong giua cac buong tim thi phau thuat hoac can thiep qua da can duoc can nhac.

Muc tieu dieu tri can kiem soat duoc cac con ho vao ban dem, kiem soat tinh trang phu thung, kiem soat duoc luong dich vao co the va so luong mau con du trong tam that trai. Dieu tri suy tim cap voi thuoc loi tieu nham giai phong luong dich u tre tai tuan hoan phoi va thuoc giup tang tac dung co bop cua co tim. Khi tinh trang suy tim duoc cai thien thi kho tho se het. Mot so benh nhan xuat hien dong thoi ca hen phe quan va suy tim thi chung ta can chua tri dong thoi ca hai benh cung mot luc.

Thuoc corticosteroid cho benh nhan hen tim cap chi dinh phu thuoc vao tinh trang lam sang va dap ung cua benh nhan voi nhung dieu tri ban dau. Khi ma dieu tri hen tim thuan tuy co tac dung thi kho khe, kho tho se tu dong tan bien. Neu phai dung corticosteroids thi can vai gio moi co tac dung tot nhat.

Nhung ai de bi hen tim?

Hen tim thuong xuat hien o nhung benh nhan nhieu tuoi mac benh suy tim. Doi voi nguoi gia mac benh suy tim thi kha nang co bop tong mau cua co tim lai cang yeu hon va mau rat de bi u tre tai tuan hoan phoi gay nen hen tim. Do do moi nguoi can chu y, dac biet la nhung nguoi nhieu tuoi mac benh suy tim khi xuat hien ho, kho khe, kho tho tang len can den co so y te noi gan nhat de duoc dieu tri kip thoi. 

BS. Tran Tat Dat
Viet Bao (Theo_SK&DS)
 

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