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Ho van tim bao nhieu dang lo?
TT - “Ho van hai la 2/4”, “ho van ba la 1/4”... Nhieu nguoi khi kham suc khoe dinh ky rat lo lang khi thay ket qua sieu am tim ghi nhu vay. Xung quanh benh ho van tim, PGS.TS Do Kim Que - pho giam doc Benh vien Thong Nhat, TP.HCM - cho biet:

Mot ca phau thuat tim ho tai Benh vien Thong Nhat, TP.HCM - Anh: L.TH.H.

- Van tim cua con nguoi giong nhu van mot chieu trong he thong may bom, giup mau luu thong theo mot chieu, mau tu tinh mach ve tim va tu tim di ra dong mach ma khong the chay theo chieu nguoc lai. Neu khong co van tim, mau se luu thong hai chieu va tim khong the day mau di nuoi co the. Van tim bi ho se lam qua trinh luu thong mau kho khan hon.

Tim nguoi co bon van: van hai la, van ba la, van dong mach chu va van dong mach phoi. Van de bi ton thuong nhat la van hai la, ke den la van dong mach chu, con van ba la va van dong mach phoi it bi ton thuong hon.

* Thua PGS, ho van tim bao nhieu moi dang lo va can dieu tri the nao?

- Quy uoc tren sieu am tinh do ho cua van tim co bon muc: ho 1/4, 2/4, 3/4 va 4/4. Neu chi bi ho tu 2/4 tro xuong thi khong phai lo lang nhieu vi do la chuyen binh thuong, chua phai dieu tri ma chi can dinh ky tai kham, theo doi; ngoai tru viec ho van tim la hau qua cua nhung benh khac nhu thieu mau co tim, nhoi mau co tim, thap tim...

Van tim bi ho tu 2/4 tro len moi can phai chu y, kiem tra de xac dinh nguyen nhan va dieu tri. Khi van tim bi ho 3/4 tro len moi phai dieu tri tich cuc. Neu bi ho tu 3,5/4 tro len se mo de sua chua van tim hoac thay van tim nhan tao.

Ve dieu tri, tuy nguyen nhan gay ho van tim ma viec dieu tri se khac nhau. Neu ho van tim do tim bi gian, khi dieu tri tim nho lai se het ho. Neu ho do day chang bi dai hoac bi dut thi khong the het, nhat la khi bi dut thi phai mo de sua lai, nhung van phai dieu tri de benh khong nang them va khong dan toi suy tim. Khi bi ho van tim tu 2/4 tro len, benh nhan nen den bac si tim mach kham tim nhung yeu to nguy co co the thuc day benh nang them de dieu tri...

* Nguyen nhan nao khien van tim bi ho, thua PGS?

- Cac ton thuong khien van tim bi ho co the chia lam hai nhom. Nhom thu nhat do nguyen nhan bam sinh, tuc moi sinh ra da co di tat bam sinh o tim. Nhom thu hai do nguyen nhan nguoi benh co nhung benh ly mac phai.

Trong benh ly ho van tim do mac phai lai chia ra lam hai dang benh thuong gap: Benh ly van tim mac phai do hau thap, tuc la sau khi bi thap khop, thap tim moi dan den bi ho van tim; ho van tim do nguyen nhan nay hien nay chiem ti le cao nhat o VN va nhung nuoc dang phat trien. Benh ly van tim mac phai do thoai hoa, ho van tim do thoai hoa co the do thoai hoa cua tuoi gia, hoac do benh ly nao do lam tim thoai hoa nhanh hon so voi nguoi binh thuong.

Ben canh ho van tim do thoai hoa con co nhung benh ly co the gay ra ton thuong o van tim, cu the nhu thieu mau (thieu mau co tim, nhoi mau co tim). Khi van tim bi hu nhu vay se lam dut nhung day chang, dut phan co giu van tim o trong khien van tim bi ho. Ngoai ra con nhung benh ly khac hiem gap nhung cung co the lam van tim bi ho, nhu benh co tim gian no hoac benh nhan bi phinh dong mach chu, viem noi tam mac...

* Nhung trieu chung cua ho van tim the nao?

- Thong thuong ho van tim nhe se khong co trieu chung. Chi khi ho van tim da lam tim bi suy, tham chi bi phu, gan da lon thi luc do moi xuat hien trieu chung kho tho, met, dau nguc, khong nam dau thap duoc. Doi voi nhung truong hop ho van tim ma chua co trieu chung phai sieu am moi thay.

* Co khi nao sieu am tim bi sai khong?

- Ket qua sieu am phu thuoc vao nguoi thuc hien. Neu nguoi lam co kinh nghiem thi ket qua se chinh xac hon nguoi khong co kinh nghiem. Trang thiet bi cung anh huong rat nhieu den ket qua sieu am tim. Voi may moc tot, do nhay cao, do phan giai cao se nhin ro hon, chinh xac hon so voi may cu, may co do phan giai thap...

Ngoai ra, can luu y van tim khong phai luc nao cung co dinh. Co luc no ho mot chut, co luc lai het ho vi van tim la nhung cai la rat mong, khi that lai voi nhau thi kin, nhung co khi vi mot ly do nao do bi hoi ho mot chut nhung sau do lai tro ve binh thuong. Vi the moi co chuyen benh nhan thac mac cho nay sieu am bao ho, cho khac lai bao khong ho. Thuc te co khi van tim het ho that chu khong phai do bac si sieu am sai.

* Xin cam on PGS.

LE THANH HA thuc hien