von Bezold M
Hausarztpraxis Alter Zollweg, Alter Zollweg 203, 22147, Hamburg, Deutschland.
Internist (Berl). 2021 Jan;62(1):17-23. doi: 10.1007/s00108-020-00918-6. Epub 2020 Dec 17.
Chest pain is a common symptom for which patients present to their primary care provider. Patients with acute chest pain pose a diagnostic challenge for the general practitioner since a wide range of diagnoses are possible, ranging from life-threatening acute myocardial infarction and pulmonary artery embolism to the far more frequent and harmless muscular tension belonging to the group of chest wall syndromes, as well as gastrointestinal causes such as gastroesophageal reflux disease. The clinical evaluation of patients with acute chest pain is based on a thorough clinical assessment by the physician, including a physical examination and medical history, irrespective of the location of the examination. This is followed by further technical examinations, such as a 12-lead electrocardiogram, and targeted laboratory diagnostics with point-of-care tests, including troponin and D‑dimer tests. Diagnostic pathways and score systems, such as the Marburg Heart Score, have been specially developed to enable patient assessment and provide orientation in the primary care setting.
胸痛是患者向其初级保健提供者就诊时的常见症状。急性胸痛患者给全科医生带来了诊断挑战，因为可能的诊断范围很广，从危及生命的急性心肌梗死和肺动脉栓塞到更为常见且无害的属于胸壁综合征的肌肉紧张，以及诸如胃食管反流病等胃肠道病因。急性胸痛患者的临床评估基于医生的全面临床评估，包括体格检查和病史，无论检查地点如何。随后进行进一步的技术检查，如12导联心电图，以及即时检验的靶向实验室诊断，包括肌钙蛋白和D-二聚体检测。已经专门开发了诊断途径和评分系统，如马尔堡心脏评分，以实现患者评估并在初级保健环境中提供指导。
