Loewe C
Klinische Abteilung für Kardiovaskuläre und Interventionelle Radiologie, Universitätsklinik für Radiodiagnostik, Medizinische Universität Wien, Währinger Gürtel 18-20, A-1090, Wien, Osterreich.
Radiologe. 2008 May;48(5):448-56. doi: 10.1007/s00117-008-1656-3.
Acute chest pain represents a very common clinical occurrence and at the same time poses a severe diagnostic dilemma. It can be due to an acute life-threatening event such as acute cardiac infarct, or a relatively harmless condition of pain and illness (e.g. vertebrogenic pain) under the main symptom category of acute chest pain. This often unclear symptomatic, behind which there can always be a life-threatening disease leads to an exaggerated grouping of patients into emergency cases and to an increased number of inpatients for observation. The diagnosis of acute coronary syndrome with no initial ECG changes typical for ischemia is especially problematic. The availability of modern multidetector computed tomography is becoming increasingly more important for radiologists in the diagnosis and clarification of acute chest pain. In this article the clinical difficulties and radiology options for the diagnosis of patients with acute chest pain will be presented and possible future algorithms for diagnosis will be discussed.
急性胸痛是一种非常常见的临床症状，同时也带来了严重的诊断难题。它可能是由急性危及生命的事件引起的，如急性心肌梗死，也可能是急性胸痛主要症状类别下相对无害的疼痛和疾病状况（如脊椎源性疼痛）。这种症状往往不明确，其背后可能总是存在危及生命的疾病，导致将患者过度归类为急诊病例，并增加了住院观察的人数。对于最初没有典型缺血性心电图改变的急性冠状动脉综合征的诊断尤其成问题。现代多排螺旋计算机断层扫描对于放射科医生诊断和明确急性胸痛越来越重要。本文将介绍急性胸痛患者诊断的临床难点和放射学检查方法，并讨论未来可能的诊断算法。
