胸痛的診斷和鑒別診斷-資料下載頁(yè)
2025-08-05 16:04本頁(yè)面
【正文】 ? 抽煙史 20年，每天 10支，飲酒史 30年，每天 2兩，已戒 5年 ? 2月前我院門診運(yùn)動(dòng)試驗(yàn)陽(yáng)性 ? 查體未見(jiàn)陽(yáng)性體征 ? 靜息心電圖未見(jiàn)異常 胸痛的診斷和鑒別診斷 冠脈造影結(jié)果 注入硝酸甘油前 注入硝酸甘油后 胸痛的診斷和鑒別診斷 胸痛的診斷和鑒別診斷 心肌橋是一種冠狀動(dòng)脈解剖的異常，心外膜中冠狀動(dòng)脈局部血管被長(zhǎng)短不一的心肌纖維覆蓋而形成，在心肌內(nèi)的冠狀動(dòng)脈又被稱為心肌橋段動(dòng)脈。 M246。hlenkamp S, Hort W, Ge J, et 2022。106:26162622 胸痛的診斷和鑒別診斷 主動(dòng)脈夾層 ? Sudden onset severe pain ? Tearing, sharp, stabbing ? Substernal with radiation to back ? Most severe when dissection happen, in contrast to MI which has a crescendo pattern ? Pulse asymmetry, neurologic deficit 胸痛的診斷和鑒別診斷 胸痛的診斷和鑒別診斷 胸痛的診斷和鑒別診斷 胸痛的診斷和鑒別診斷 肺動(dòng)脈栓塞 ? Substernal , pleuritic, may be aggravated by breath ? High level of suspicion needed ? Ddimer, EKG, Chest CT, UCG, Lung scan, pulmonary angiogram 胸痛的診斷和鑒別診斷 Most mon symptoms and signs among the 2454 patients in the International Cooperative Pulmonary Embolism Registry (ICOPER) Goldhaber SZ, et al. Lancet, 1999, 353:1386 胸痛的診斷和鑒別診斷 胸痛的診斷和鑒別診斷 SIQIIITIII 胸痛的診斷和鑒別診斷 胸痛的診斷和鑒別診斷 UCG signs of pulmonary Embolism 1. Direct visualization of thrombosis (rare) 2. Right ventricular dilation 3. Right ventricular hypokinesis (with sparing of the apex) 4. Abnormal interventricular septal motion 5. Tricuspid valve regurgitation 6. Pulmonary artery dilatitation 7. Lack fo decreased inspiratory collapse of inferior vena cava 胸痛的診斷和鑒別診斷 胸痛的診斷和鑒別診斷 胸痛的診斷和鑒別診斷 ：氣胸等 急性胸痛 急性胸痛的診斷不要忘了 胸痛的診斷和鑒別診斷 謝 謝
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