最近审阅: 26 十月 2020
最近更新: 17 一月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 脉率 <50 bpm
  • 眩晕/头晕
  • 晕厥
  • 乏力
  • 运动不耐受
  • 呼吸短促
  • 颈静脉搏动大炮 a 波
  • 颈静脉怒张

其他诊断因素

  • 颅内压升高
  • 异常心音
  • 腹部或下肢水肿
  • 低血压
  • 精神状态改变
  • 苍白
  • 四肢厥冷
  • 体温过低
  • 胸痛
  • 皮疹
  • 甲状腺肿大

危险因素

  • 使用已知致病药物
  • 年龄>70 岁
  • 近期心肌梗死
  • 手术
  • 甲状腺功能减退
  • 电解质紊乱
  • 酸中毒
  • 感染
  • 暴露于毒素
  • 体温过低
  • 浸润型疾病
  • 睡眠呼吸暂停

诊断性检查

首要检查

  • 12 导联心电图
  • 动态心电图监测
  • 事件监测器
  • 运动试验
  • 颈动脉窦按摩
  • 超声心动图
  • 甲状腺功能检测
  • 基础代谢检查
  • 动脉血气
  • 心脏生物标志物
  • 血清地高辛水平
  • 血清肌酐
更多 首要检查

需考虑的检查

  • 埋藏式心电循环记录器
  • 直立倾斜试验
  • 伯氏疏螺旋体抗体滴度
  • 电生理检查
  • 夜间脉搏血氧测定法或整夜多导睡眠图监测
更多 需考虑的检查

治疗流程

撰稿人

Brian Olshansky

Professor Emeritus

University of Iowa

Iowa City

Adjunct Professor

Des Moines University

Electrophysiologist

Mercy Hospital North Iowa

Mason City

Covenant Hospital

Waterloo

IA

利益声明

BO is a national research study coordinator for Boehringer Ingelheim. He is a consultant and speaker for Lundbeck.

Cardiologist and Cardiac Electrophysiologist

Oregon Heart Center

Consultant, Cardiology and Cardiac Electrophysiology

Salem Health Hospitals and Clinics

Salem

OR

利益声明

SS declares that he has no competing interests.

Rakesh Gopinathannair

Director, Cardiac Electrophysiology Laboratories

Kansas City Heart Rhythm Institute and Research Foundation

EP Medical Director

Research Medical Center, HCA Midwest Health

Overland Park

KS

Clinical Professor of Medicine

University of Missouri-Columbia

Columbia

MO

Associate Professor of Medicine (adjunct)

University of Louisville

Louisville

KY

利益声明

RG is a consultant for St. Jude Medical and Boston Scientific. He is on the speakers' bureau for Pfizer Inc., Bristol Myers Squibb, and Zoll Medical. He serves as a physician advisor for HealthTrust PG and Abiomed. None of these activities are relevant to the content of this topic.

Professor Brian Olshansky, Dr. Sandeep Saha, and Professor Rakesh Gopinathannair would like to gratefully acknowledge Dr Giselle Statz for her contributions to this version of the topic. They would also like to acknowledge Dr Renee M. Sullivan, Dr Weiwei Li, Dr Alexander Mazur, and Dr Chirag M. Sandesara, previous contributors to this topic.

利益声明

GS, RMS, WL, AM, and CMS declare that they have no competing interests.

同行评议者展开全部内容

Professor of Clinical Medicine

University of California

Chief

Clinical Cardiology

San Francisco General Hospital

Director

Coronary Care Unit

ECG Laboratory and Pacemaker Clinic

San Francisco

CA

利益声明

NG declares that she has no competing interests.

Associate Professor of Medicine

Stanford University

Stanford

CA

利益声明

PH declares that he has no competing interests.

Cardiology Center and Medical Polyclinics

University Hospital Geneva

Geneva

Switzerland

利益声明

JMS declares that he has no competing interests.

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