不稳定型心绞痛

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最后审阅: 23 Jun 2024
最后更新: 26 Sep 2023

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
完整详情

其他诊断因素

  • 明显出汗
  • 上腹痛
  • 呼吸困难
  • 晕厥
  • 背痛
完整详情

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
完整详情

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)
完整详情

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
完整详情

治疗流程

急症处理

疑似或确诊不稳定型心绞痛

持续性治疗

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.

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