Wielgosz A T
CMAJ. 1996 Sep 1;155(5):552-3.
The author comments on the report by Dr. Akbar Panju and associates (see pages 541 to 547 of this issue) on patient outcomes associated with a discharge diagnosis of "chest pain not yet diagnosed." Acute chest pain without evidence of cardiac involvement presents a diagnostic challenge for the clinician, particularly in the present climate of cost containment. Esophageal disorders and psychiatric conditions appear to be the most prevalent causes of noncardiac chest pain. Although screening by means of electrocardiography and cardiac enzyme testing may rule out acute ischemia, and other tests may clearly point to a gastrointestinal cause, it is possible for cardiac and gastrointestinal problems to present simultaneously. Understanding and managing persistent chest pain even after a diagnosis has been made continues to challenge clinicians and researchers, and further progress in this area will depend on multidisciplinary collaboration.
作者对阿克巴尔·潘朱博士及其同事的报告（见本期第541至547页）发表评论，该报告涉及出院诊断为“胸痛待查”的患者的治疗结果。无心脏受累证据的急性胸痛给临床医生带来了诊断挑战，尤其是在当前成本控制的大环境下。食管疾病和精神疾病似乎是非心源性胸痛最常见的病因。虽然通过心电图和心肌酶检测进行筛查可能排除急性缺血，其他检查可能明确指向胃肠道病因，但心脏和胃肠道问题有可能同时出现。即使在做出诊断后，理解和处理持续性胸痛仍然是临床医生和研究人员面临的挑战，该领域的进一步进展将取决于多学科合作。
