小结
定义
病史和体格检查
关键诊断因素
- 胸痛
- 心血管疾病危险因素
其他诊断因素
- 明显出汗
- 上腹痛
- 呼吸困难
- 晕厥
- 背痛
危险因素
- 糖尿病
- 高脂血症
- 高血压
- 代谢综合征
- 肾损害
- 外周动脉疾病
- 缺血性心脏病病史和既往治疗史
- 肥胖
- 高龄
- 吸烟
- 使用可卡因
- 缺乏体力活动
- 早发冠状动脉病变家族史
诊断性检查
首要检查
- 心电图(ECG)
- 高敏肌钙蛋白
- 胸部 X 线检查
- 全血细胞计数
- 尿素、电解质和肌酐
- 肝功能检测
- 血糖
- C 反应蛋白 (CRP)
需考虑的检查
- 超声心动图
- 侵入性冠状动脉血管造影
- 功能性(负荷)试验
- 冠状动脉计算机体层成像血管造影
治疗流程
疑似或确诊不稳定型心绞痛
稳定后
撰稿人
专家顾问
Resham Baruah, MBBS, BSc MRCP, PhD
Consultant Cardiologist
Chelsea and Westminster Hospital NHS Foundation Trust
Royal Brompton & Harefield NHS Foundation Trust
London
UK
简介
RB is specialist advisor to the 2018 NICE guideline on chronic heart failure in adults and is a member of the European Heart Failure Association Task Force on palliative care in heart failure.
利益声明
RB has received honoraria/speakers’ fees from Novartis and Boehringer Ingelheim.
Adam D. Hartley, MBBS, BSc, MRCP
Wellcome Trust Clinical Research Fellow
Imperial College London
Specialist Registrar in Cardiology
Imperial College Healthcare NHS Trust
London
UK
利益声明
ADH declares that he has no competing interests.
鸣谢
BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:
Syed Wamique Yusuf, MBBS, FRCPI
Professor of Medicine
Department of Cardiology
University of Texas
MD Anderson Cancer Center
Houston
TX
同行评议者
Gavin Galasko, BM, BCh, MA, DM (Oxon), FRCP
Consultant Interventional Cardiologist
Director of Research, Development and Innovation
Blackpool Teaching Hospitals NHS Foundation Trust
Blackpool
UK
利益声明
GG declares that he has no competing interests.
Gregory Lip, MD, FRCP, DFM, FACC, FESC, FEHRA
Price-Evans Professor of Cardiovascular Medicine
University of Liverpool
Senior Investigator
National Institute for Health Research
Consultant Cardiologist
Liverpool Heart & Chest Hospital NHS Trust
Liverpool
UK
Distinguished Professor
Faculty of Medicine
Aalborg University
Denmark
Adjunct Professor
Yonsei University
Seoul
South Korea
利益声明
GL is a consultant for Bayer/Janssen, BMS/Pfizer, Medtronic, Boehringer Ingelheim, Novartis, Verseon, and Daiichi-Sankyo. He is a speaker for Bayer, BMS/Pfizer, Medtronic, Boehringer Ingelheim, and Daiichi-Sankyo. No fees are directly received personally.
编辑
Annabel Sidwell
Section Editor, BMJ Best Practice
利益声明
AS declares that she has no competing interests.
Susan Mayor
Lead Section Editor, BMJ Best Practice
利益声明
SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including the National Institute for Health and Care Excellence, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, the National Confidential Enquiry into Patient Outcome and Death, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.
Rachel Wheeler
Lead Section Editor, BMJ Best Practice
利益声明
RW declares that she has no competing interests.
Tannaz Aliabadi-Oglesby
Lead Section Editor, BMJ Best Practice
利益声明
TAO declares that she has no competing interests.
Julie Costello
Comorbidities Editor, BMJ Best Practice
利益声明
JC declares that she has no competing interests.
Adam Mitchell
Drug Editor, BMJ Best Practice
利益声明
AM declares that he has no competing interests.
鉴别诊断
- 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
更多 鉴别诊断指南
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- 急性冠脉综合征
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预测急性冠脉综合征患者预后的 GRACE 评分
HAS-BLED 出血风险评分
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关于如何进行心电图的动画演示
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不稳定型心绞痛:是什么?
不稳定型心绞痛:如何有效治疗?
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