Ginghina Carmen, Caloianu Geana-Alina, Serban Marinela, Dragomir Dinu
Clinic of Cardiology Emergency Institute for cardiovascular diseases, C.C. Iliescu Bucharest 258 Fundeni Street, Bucharest, Romania.
J Med Life. 2010 Jul-Sep;3(3):242-53.
It is frequently recognized in medical literature as well as in daily clinical practice that right ventricular myocardial infarction and pulmonary embolism are two of the most challenging clinical pictures to differentiate in cardiology and the treatment, often chosen upon a mixture of clinical suspicion criteria subsequently confirmed by other diagnostic methods, can lead to therapeutic success. Differential diagnosis is often difficult due to similar clinical picture, unspecific electrocardiographic changes and unspecific biological markers. It is very important to know the risk factors and the associated comorbidities for these two clinical entities in order to be able to interpret them contextually. In most cases the diagnosis key is the clinical suspicion. Usually in evaluating these cases we are in the position of choosing more complex diagnostic procedures, most likely not available in Emergency Department. In conclusion it is expected from the clinician to use the available methods with a thorough approach to details but in the same time considering the whole clinical picture.
在医学文献以及日常临床实践中，人们经常认识到，右心室心肌梗死和肺栓塞是心脏病学中最难鉴别的两种临床症状，而基于临床怀疑标准并随后通过其他诊断方法得到证实的治疗方法往往能够取得治疗成功。由于临床表现相似、心电图变化不具特异性以及生物标志物不具特异性，鉴别诊断通常很困难。了解这两种临床病症的危险因素和相关合并症对于能够结合背景进行解读非常重要。在大多数情况下，诊断的关键在于临床怀疑。通常在评估这些病例时，我们会选择更复杂的诊断程序，而这些程序在急诊科很可能无法获得。总之，期望临床医生以全面细致的方式使用现有方法，同时考虑整体临床情况。
