最近审阅: 25 十月 2020
最近更新: 04 七月 2019

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 年龄>50~60 岁
  • 晕厥
  • 心率<40 次/分
  • 先兆晕厥

其他诊断因素

  • 男性
  • 疲劳
  • 呼吸困难
  • 胸痛、心悸和恶心或呕吐
  • 血压升高(血压降低相对少见)
  • 颈静脉巨大 A 波(大炮波)
  • 缺氧
  • 房室传导阻滞家族史
  • Lyme 病的特征

危险因素

  • 在传导系统中与年龄有关的退化性改变
  • 迷走神经张力升高
  • 房室结传导阻滞剂
  • 慢性稳定型冠状动脉疾病
  • 急性冠脉综合征
  • 充血性心力衰竭
  • 高血压
  • 心肌病
  • 左心室肥大
  • 近期心脏手术
  • 酸碱失衡或电解质紊乱
  • 神经肌肉类疾病
  • 结节病
  • 心肌炎
  • 感染性心内膜炎
  • 低氧血症
  • 心脏钝性损伤
  • 某些本土药物

诊断性检查

首要检查

  • 12 导联心电图
  • 血清肌钙蛋白
  • 血清钾
  • 血清钙
  • 血清 pH
  • 血清洋地黄水平
更多 首要检查

需考虑的检查

  • 24 小时动态心电图或者事件记录器监测
  • 胸部 X 线检查
  • 经胸超声心动图
  • Lyme 病的血清学检测
  • 植入式循环记录器
  • 直立倾斜试验
  • 电生理学检查
  • 心脏负荷试验
  • 冠状动脉造影
  • 血清 CK-MB
更多 需考虑的检查

治疗流程

撰稿人

Consultant Cardiologist/Electrophysiologist

Royal Wolverhampton NHS Trust

Heart and Lung Centre

New Cross Hospital

Wolverhampton

UK

利益声明

SP has received speaker's honoraria from Bayer, Bristol-Myers Squibb, MSD, and Pfizer. SP has received hospitality and/or accommodation from Bayer, Medtronic, St Jude, and Boston Scientific for attending conferences or meetings.

EP and Devices Fellow

New Cross Hospital

Wolverhampton

UK

利益声明

JP declares that he has no competing interests.

Specialty Registrar Cardiology 

New Cross Hospital

Wolverhampton

UK

利益声明

AA declares that he has no competing interests.

Dr Petkar, Dr Pathiraja, and Dr Aziz would like to gratefully acknowledge Dr Susan S. Kim, Dr John F. Beshai, and Dr Stephen L. Archer, previous contributors to this topic. Dr Petkar would also like to gratefully acknowledge the assistance of Dr Arka Das. AD, SSK, JFB, and SLA declare that they have no competing interests.

同行评议者展开全部内容

Professor of Medicine

Section of Cardiology

Director

Cardiac Electrophysiology

University of Chicago Medical Center

Chicago

IL

利益声明

BPK declares that he has no competing interests.

Associate Professor of Medicine

Section of Cardiology

Cardiac Electrophysiology

University of Chicago Medical Center

Chicago

IL

利益声明

MCB declares that he has no competing interests.

Consultant Cardiologist

King’s College Hospital

London

UK

利益声明

NG declares that he has no competing interests.

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