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不稳定型心绞痛

  • 概述
  • 理论
  • 诊断
  • 治疗
  • 随访
  • 资源
最后审阅： 14 Feb 2025
最后更新： 05 Sep 2018

Summary

Definition

History and exam

Key diagnostic factors

  • 存在的危险因素
  • 胸痛频率增加
  • 胸痛程度增加
  • 胸骨后胸痛放射到颌、手臂或颈部
  • 呼吸困难
  • 第 4 心音 (S4)
Full details

Other diagnostic factors

  • 不典型胸部不适
  • 发汗
  • 恶心
  • 心动过速
  • 颈动脉杂音
  • 外周脉搏弱
  • 晕厥
  • 第 3 心音 (S3)
  • 杂音
  • 啰音
Full details

Risk factors

  • 女性
  • 冠状动脉病变 (CAD) 个人史
  • 年龄增长
  • CAD 家族史
  • 高血压
  • 吸烟
  • 糖尿病
  • 高脂血症
  • 外周血管疾病
  • 肥胖/缺乏运动
  • 慢性肾病
  • C 反应蛋白 (CRP) 水平升高
  • 纵膈放疗
  • 高海拔
Full details

Diagnostic tests

1st tests to order

  • 心电图（ECG）
  • 心脏生物标志物
  • 全血细胞计数（FBC）
  • 电解质和肾功能
  • 血糖
  • 血脂检查
  • 凝血指标
  • 胸部 X 线检查（CXR）
  • 静息下超声
  • 静态心肌灌注研究
  • 胸部 CT 或 MRI 扫描
  • 冠状动脉造影
Full details

Tests to consider

  • 负荷超声
  • 负荷心肌灌注研究
  • 冠状动脉 CT 造影
Full details

Treatment algorithm

INITIAL

可疑心源性胸痛

ACUTE

非 ST 段抬高型急性冠脉综合征

ONGOING

确诊的 UA（无心脏生物标志物水平升高）

Contributors

Authors

Syed Wamique Yusuf, MBBS, FRCPI
Syed Wamique Yusuf

Professor of Medicine

Department of Cardiology

University of Texas

MD Anderson Cancer Center

Houston

TX

Disclosures

SWY declares that he has no competing interests.

Acknowledgements

Dr Syed Wamique Yusuf would like to gratefully acknowledge Dr Iyad N. Daher, the previous contributor to this topic. IND declares that he has no competing interests.

Peer reviewers

John Charpie, MD, PhD

Associate Professor of Pediatrics

Medical Director

Pediatric Cardiothoracic Intensive Care Unit

University of Michigan Congenital Heart Center

Ann Arbor

MI

Disclosures

JC declares that he has no competing interests.

Zaza Iakobishvili, MD, PhD

Director

Emergency Cardiac Service ICCU

Department of Cardiology

Rabin Medical Center

Petah Tikva

Israel

Disclosures

ZI declares that he has no competing interests.

Helge Mollmann, MD

Kerckhoff Heart and Thorax Center

Bad Nauheim

Germany

Disclosures

HM declares that he has no competing interests.

  • 不稳定型心绞痛 images

  • Differentials

    • 稳定型心绞痛
    • 变异型心绞痛 (Prinzmetalangina)（变异性或血管痉挛性）
    • 非 ST 段抬高型心肌梗死
    More Differentials

  • Guidelines

    • 2018 ESC/EACTS 心肌血流重建指南
    • 心脏康复
    More Guidelines

  • Patient information

    Unstable angina: what is it?

    Unstable angina: what treatments work?

    More Patient information

  • Calculators

    预测急性冠脉综合征患者预后的 GRACE 评分

    More Calculators

  • Videos

    静脉穿刺和抽血的动画演示

    关于如何进行心电图的动画演示

    More videos
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