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急诊科急性胸痛的管理:冠状动脉计算机断层扫描血管造影的益处

Management of acute chest pain in the Emergency Department: benefits of coronary computed tomography angiography.

作者信息

Sarto Gianmarco, Simeone Beatrice, Spadafora Luigi, Bernardi Marco, Rocco Erica, Pelle Giuseppe, Liberati Quirino, Forte Maurizio, Schirone Leonardo, Versaci Francesco, Piaz Rita Dal, Palmerio Silvia, Barberi Antonio, Frati Giacomo, Bellini Davide, Rengo Marco, Carbone Iacopo, Sciarretta Sebastiano, Valenti Valentina

机构信息

ICOT Istituto Marco Pasquali, Via Franco Faggiana 1668, Latina, 04100, Italy.

Department of Diagnostic and Interventional Radiology, 'Santa Maria Goretti' Hospital, Latina, Italy.

出版信息

Int J Cardiovasc Imaging. 2024 Dec;40(12):2447-2457. doi: 10.1007/s10554-024-03274-w. Epub 2024 Nov 14.

DOI:10.1007/s10554-024-03274-w
PMID:39541059
Abstract

Acute chest pain (ACP) is a frequent cause of Emergency Department (ED) admissions, with millions of cases reported globally each year. Timely and accurate diagnosis is crucial due to the wide range of underlying causes, such as acute coronary syndrome (ACS), pulmonary embolism (PE), aortic dissection, and others. Misdiagnosis can lead to missed life-saving interventions or, alternatively, unnecessary hospitalizations, escalating healthcare costs. While risk stratification tools like the HEART, GRACE, and TIMI scores are useful, additional imaging is often required to achieve diagnostic precision. Coronary computed tomography angiography (CCTA) has shown significant potential in enhancing diagnostic accuracy and improving patient outcomes. In this review, we explore the challenges physicians encounter when evaluating ACP in the ED, emphasizing the utility of CCTA as a key diagnostic tool. Additionally, we present a clinical case that illustrates how CT scan effectively aids in diagnosing patients with ambiguous symptoms, with CT imaging playing a pivotal role in identifying the underlying pathology.

摘要

急性胸痛(ACP)是急诊科(ED)收治患者的常见原因,全球每年报告数百万病例。由于潜在病因范围广泛,如急性冠状动脉综合征(ACS)、肺栓塞(PE)、主动脉夹层等,及时准确的诊断至关重要。误诊可能导致错过挽救生命的干预措施,或者导致不必要的住院治疗,增加医疗费用。虽然像HEART、GRACE和TIMI评分等风险分层工具很有用,但通常还需要额外的影像学检查来实现诊断的精确性。冠状动脉计算机断层扫描血管造影(CCTA)在提高诊断准确性和改善患者预后方面已显示出巨大潜力。在本综述中,我们探讨了医生在急诊科评估ACP时遇到的挑战,强调了CCTA作为关键诊断工具的实用性。此外,我们还展示了一个临床病例,说明CT扫描如何有效地帮助诊断症状不明确的患者,CT成像在识别潜在病理方面发挥了关键作用。

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本文引用的文献

1
2024 ESC Guidelines for the management of chronic coronary syndromes.2024年欧洲心脏病学会慢性冠状动脉综合征管理指南
Eur Heart J. 2024 Sep 29;45(36):3415-3537. doi: 10.1093/eurheartj/ehae177.
2
Competence of radiologists in cardiac CT and MR imaging in Europe: insights from the ESCR Registry.欧洲心血管 CT 和 MR 成像放射科医生的能力:来自 ESCR 注册研究的见解。
Eur Radiol. 2024 Sep;34(9):5666-5677. doi: 10.1007/s00330-024-10644-4. Epub 2024 Feb 28.
3
2023 ESC Guidelines for the management of acute coronary syndromes.2023年欧洲心脏病学会急性冠状动脉综合征管理指南。
Eur Heart J. 2023 Oct 12;44(38):3720-3826. doi: 10.1093/eurheartj/ehad191.
4
Comparison of an Initial Risk-Based Testing Strategy vs Usual Testing in Stable Symptomatic Patients With Suspected Coronary Artery Disease: The PRECISE Randomized Clinical Trial.比较疑似冠心病稳定症状患者初始基于风险的检测策略与常规检测的效果:PRECISE 随机临床试验。
JAMA Cardiol. 2023 Oct 1;8(10):904-914. doi: 10.1001/jamacardio.2023.2595.
5
Early computed tomography coronary angiography in patients with suspected acute coronary syndrome: randomised controlled trial.疑似急性冠状动脉综合征患者的早期计算机断层冠状动脉造影:随机对照试验。
BMJ. 2021 Sep 29;374:n2106. doi: 10.1136/bmj.n2106.
6
The triple rule out CT in acute chest pain: a challenge for emergency radiologists?急性胸痛三联征 CT 检查:对急诊放射科医生的挑战?
Emerg Radiol. 2021 Aug;28(4):735-742. doi: 10.1007/s10140-021-01911-8. Epub 2021 Feb 18.
7
2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation.2020年欧洲心脏病学会非持续性ST段抬高型急性冠状动脉综合征患者管理指南
Eur Heart J. 2021 Apr 7;42(14):1289-1367. doi: 10.1093/eurheartj/ehaa575.
8
Evaluation of acute chest pain: Evolving paradigm of coronary risk scores and imaging.急性胸痛评估:冠状动脉风险评分和影像学的演变模式。
Rev Cardiovasc Med. 2019 Dec 30;20(4):231-244. doi: 10.31083/j.rcm.2019.04.589.
9
2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes.2019年欧洲心脏病学会慢性冠状动脉综合征诊断和管理指南
Eur Heart J. 2020 Jan 14;41(3):407-477. doi: 10.1093/eurheartj/ehz425.
10
Triple-rule-out CT angiography using two axial scans with 16 cm wide-detector for radiation dose reduction.采用双轴扫描和 16 厘米宽探测器的三重排除 CT 血管造影以减少辐射剂量。
Eur Radiol. 2018 Nov;28(11):4654-4661. doi: 10.1007/s00330-018-5426-y. Epub 2018 May 22.