最后审阅: 19 九月 2021
最后更新: 22 四月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 胸痛
  • 呼吸困难
  • 苍白
  • 发汗
  • 心脏危险因素
  • 呼吸音异常
  • 额外心音
  • 心源性休克

其他诊断因素

  • 恶心和/或呕吐
  • 头晕或头重脚轻感
  • 苦恼和焦虑
  • 心悸
  • 意识模糊
  • 低血压
  • 不典型部位或性质的疼痛

危险因素

  • 吸烟
  • 高血压
  • 糖尿病
  • 肥胖
  • 代谢综合征
  • 缺乏体力活动
  • 血脂异常
  • 肾功能不全
  • 已确诊冠状动脉病变
  • 早发冠状动脉病变家族史
  • 吸食可卡因
  • 男性
  • 年龄>50 岁

诊断性检查

首要检查

  • 心电图 (ECG)
  • 冠状动脉造影
  • 心肌肌钙蛋白
  • 葡萄糖
  • 全血细胞计数
  • 电解质、尿素、肌酐和估算的肾小球滤过率(estimated glomerular filtration rate, eGFR)
  • C 反应蛋白 (CRP)
  • 血清脂质

需考虑的检查

  • 动脉血气
  • 胸部 X 线检查
  • 床旁经胸超声心动图

新兴检查

  • 心脏肌球蛋白结合蛋白 C(cardiac myosin-binding protein C, cMyC)

治疗流程

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.

Acknowledgements,

BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work has been retained in parts of the content:

Aung Myat

NIHR Clinical Lecturer in Interventional Cardiology

Brighton and Sussex Medical School

Honorary Interventional Cardiology Fellow

Royal Sussex County Hospital

Brighton

UK

Duha Ilyas

ST4 in Renal Medicine

Leeds Teaching Hospitals

NHS Trust Leeds

UK

Mahi L. Ashwath MD, FACC, FASE

Director, Cardiac MRI

Clinical Associate Professor of Medicine and Radiology

Division of Cardiology

Department of Internal Medicine

University of Iowa Hospitals and Clinics

University of Iowa Health Care

Iowa

IA

Sanjay Gandhi MD, FACC, FAHA, FSCAI

Director, Endovascular Cardiology

Associate Professor of Medicine, Endovascular Cardiology

Case Western Reserve University

Cleveland

OH

利益声明

AM, MLA, and SG declare that they have no competing interests.

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.

Anthony Gershlick,

Honorary Professor of Interventional Cardiology

University of Leicester

Consultant Cardiologist

University Hospitals of Leicester NHS Trust

Leicester

UK

利益声明

At the time of review, AG did not declare any competing interests. Unfortunately, we have since been made aware that AG has passed away.

编辑

Helena Delgado-Cohen,

Section Editor, BMJ Best Practice

利益声明

HDC declares that she has no competing interests.

Jo Haynes,

Head of Editorial, BMJ Knowledge Centre

利益声明

JH 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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