最后审阅: 18 五月 2021
最后更新: 20 一月 2021

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
  • 大量出汗
  • 心源性休克
  • 急性心力衰竭

其他诊断因素

  • 恶心和呕吐
  • 心律失常
  • 心脏杂音
  • 上腹痛
  • 呼吸困难
  • 晕厥
  • 背痛

危险因素

  • 动脉粥样硬化(心绞痛、心肌梗死、卒中、短暂性脑缺血发作和外周血管疾病史
  • 糖尿病
  • 吸烟
  • 血脂异常
  • 早发冠状动脉病变 (CAD) 的家族史
  • 年龄>65 岁
  • 高血压
  • 肥胖及代谢综合征的表型
  • 缺乏体力活动
  • 使用可卡因
  • 抑郁症
  • 支架内血栓形成或再狭窄
  • 慢性肾病
  • 手术治疗(包括手术期间及手术后期
  • 睡眠呼吸暂停

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

需考虑的检查

  • 超声心动图
  • 有创性冠状动脉血管造影术(invasive coronary angiography, ICA

治疗流程

撰稿人

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.

Wellcome Trust Clinical Research Fellow

Imperial College London

Specialist Registrar in Cardiology

Imperial College Healthcare NHS Trust

London

UK

利益声明

AH declares that he has no competing interests.

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

Cody S Deen, MD

Assistant Professor of Medicine

Director of Cardiology

Hillsborough Hospital

University of North Carolina

Hillsborough

NC

利益声明

CSD was previously the Director of Cardiac Rehab for Chatham Hospital, which was financially set up as a consultancy relationship, until 2017. CSD has spoken (unpaid) at the Update in Cardiology and Update in Internal Medicine Conferences at UNC for the last 5 years. CSD has served as the PI for the Dal-GeneE (site now closed) and the ACCELERATE Trials at the University of North Carolina (trial now completed). Each trial required paid travel to an investigator meeting.

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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.

Section Editor, BMJ Best Practice

利益声明

AS declares that she has no competing interests.

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.

Lead Section Editor, BMJ Best Practice

利益声明

RW declares that she has no competing interests.

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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