最后审阅: 21 八月 2021
最后更新: 08 三月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 胸痛
  • 劳力性呼吸困难
  • 低血压
  • 啰音
  • S3 奔马律
  • 血压 >140/90mmHg
  • 恶心
  • 发汗
  • 心动过速
  • 消化不良

其他诊断因素

  • 单侧肢体无力、麻木和/或刺痛
  • 头痛
  • 间歇性跛行
  • 杂音
  • 失语症
  • 偏身感觉缺失
  • 颅神经麻痹
  • 惊厥
  • 眩晕
  • 静息肢体痛
  • 下肢脉搏减弱/消失
  • 溃疡或坏疽
  • 外周水肿
  • 皮肤光滑发光,毛发脱落
  • 苍白

危险因素

  • 吸烟
  • 高血压
  • 血脂异常
  • 血糖控制不佳
  • 缺乏体力活动
  • 白蛋白尿
  • C-反应蛋白水平升高
  • 心血管疾病 (CVD) 家族史
  • 超重和肥胖
  • 男性

诊断性检查

需考虑的检查

  • 运动试验
  • 平板运动试验或药物负荷超声心动图
  • 平板运动试验或药理学心肌灌注扫描
  • 踝肱指数 (ankle-brachial index, ABI)
  • CT 血管造影术
  • 冠状动脉造影
  • 非增强头颅CT
  • 颅脑 MRI 扫描
  • 颈动脉多普勒超声检查
  • C 反应蛋白

治疗流程

撰稿人

作者

Alexander Meyer, MD

Cardiovascular Medicine Fellow

Wexner Medical Center

The Ohio State University

Columbus

OH

利益声明

AM declares that he has no competing interests.

Laura Davidson, MD, MS

Assistant Professor of Medicine

Division of Cardiology

Bluhm Cardiovascular Institute

Northwestern University

Feinberg School of Medicine

Chicago

IL

利益声明

LD declares that she has no competing interests.

Charles Davidson, MD

Vice Chairman, Clinical Affairs

Department of Medicine

Clinical Chief

Division of Cardiology

Medical Director

Bluhm Cardiovascular Institute

Northwestern Memorial Hospital

Professor of Medicine

Northwestern University

Feinberg School of Medicine

Chicago

IL

利益声明

CD declares that he has no competing interests.

鸣谢

Dr Laura Davidson and Dr Charles Davidson would like to gratefully acknowledge Dr Leonard E. Egede, the previous contributor to this topic, and would like to gratefully acknowledge the review by Dr Shreenidhi Venuraju, MB BS, MRCP, Wellington Hospital South, UK.

利益声明

LEE is an author of a number of references cited in this topic. SV not disclosed.

同行评议者

Irfan Moinuddin, MD

Assistant Professor

Chicago Medical School

Rosalind Franklin University

Lombard

IL

利益声明

IM declares that he has no competing interests.

David Leehey, MD

Medical Director

Hines VA Hospital

Hines

IL

利益声明

DL declares that he has no competing interests.

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