Brady William, de Souza Katya
Department of Emergency Medicine, University of Virginia, Charlottesville, 22908, VA, United States.
Turk J Emerg Med. 2018 Jun 14;18(2):47-51. doi: 10.1016/j.tjem.2018.04.004. eCollection 2018 Jun.
Chest pain is one of the most common, potentially serious presenting complaints for adult emergency department (ED) visits. The challenge of acute coronary syndrome (ACS) identification with appropriate disposition is quite significant. Many of these patients are low risk and can be managed non-urgently in the outpatient environment; other patients, however, are intermediate to high risk for ACS and should be managed more aggressively, likely with inpatient admission and cardiology consultation. The HEART score, a recently derived clinical decision rule aimed at the identification of risk in the undifferentiated chest pain patient, is potentially quite useful as an adjunct to physician medical decision-making. The HEART score identifies patients at low, intermediate, and high risk for short-term adverse outcome resulting from ACS. As is true of all such clinical decision rules, the physician should consider the information provided the HEART score yet exercise clinical judgment in the ultimate determination of management strategy in the adult chest pain patient suspected of ACS.
胸痛是成人急诊科就诊时最常见、可能较为严重的主诉之一。通过适当处置来识别急性冠脉综合征（ACS）面临着相当大的挑战。这些患者中有许多风险较低，可以在门诊环境中进行非紧急处理；然而，其他患者ACS风险为中度至高度，应采取更积极的处理措施，可能需要住院并咨询心脏病专家。HEART评分是最近得出的一项临床决策规则，旨在识别未分化胸痛患者的风险，作为医生医疗决策的辅助手段可能非常有用。HEART评分可识别因ACS导致短期不良结局风险低、中、高的患者。与所有此类临床决策规则一样，医生应考虑HEART评分提供的信息，但在最终确定疑似ACS的成年胸痛患者的管理策略时仍需运用临床判断力。
