心絞痛的鑒別心絞痛-在線瀏覽
2025-07-18 04:41本頁面
【正文】 (., fixed delusions) 心絞痛特點 ? SAVES U： – Sudden onset。 – Vague sensation。 – Short duration。 UAP 的主要臨床表現 ? Rest angina: Occurring at rest, usu. 20min, occurring within a week of presentation. ? New onset angina: At least CCSC III severity, 2 months of initial presentation. ? Increasing angina: Distinctly more frequent, longer in duration, lower in Threshold. (ie. Increased by at least one CCSC class in 2 months, to at least CCSC III severity) Noninvasive Testing: ECG/Chest Xray ? ECG: – Normal in ? 50% stable angina. – Abnormal in 50% angina (normal rest ECG). – Equivocal: QIII, QS in V1, V2. – Pseudonormalization of ST depression or T inversion. ? Chest Xray ECHO ? 本例 : 左室肥厚，左室舒張功能減低。 – 室壁運動正常，各瓣膜結構及功能正常，無心包積液。 ? Definition of Significant CAD – ? 70% diameter stenosis of ? 1 major epicardial artery segment. – ? 50 % diameter stenosis of left main. – Although lesions of less stenosis can cause angina, they have much less prognostic significance. Noninvasive Testing: Ultrafast Computed Tomography ? Ultrafast (electron beam) puted tomography (EBCT) for the detection and quantification of coronary calcification: – Sensitivity (detection of calcium): 85100%. – Specificity: 4176%. – Positive predictive value: 5584%. – Negative predictive value: 84100%. Noninvasive Testing: Exercise ECG(1) ? Absolute contraindications: – MI in 2 days。 – Severe AS。 – Acute PE。 – Acute aortic dissection. Noninvasive Testing: Exercise ECG(2) ? Relative contraindication: – Left main coronary stenosis。 – Electrolyte abnormalities。 DBP 110mmHg。 – High degree AVB – HCMP or other forms of OT obstruction。 Noninvasive Testing: Exercise ECG(3) ? Risk: MI and death ? 1/2500 tests. ? A standard percentage (often 85%) of agepredicated maximum hear
試題試卷相關推薦
鄂ICP備17016276號-1