Hill B, Geraci S A
Oxford Lung Physicians, P.C., Baptist Memorial Hospital, Miss., USA.
Nurse Pract. 1998 Apr;23(4):20-4, 29-30, 33-4 passim; quiz 46-7. doi: 10.1097/00006205-199804000-00001.
Pain is a major reason patients seek health care. Chest pain, in particular, is a serious concern for patients and clinicians because of its potentially life-threatening implications--misdiagnosis can be fatal. Diagnosis of chest pain is complicated by shared neurologic pathways for thoracic and abdominal visceral organs. The importance of a medical history in the differential diagnosis is discussed. A helpful mnemonic is offered both as an organizational guide for novice practitioners and as a reminder for the seasoned clinician. Included are detailed discussions regarding the neuroanatomy of chest pain, followed by common historical presentations and physical findings related to selected cardiovascular and noncardiovascular etiologies of the condition. A brief discussion of confirmatory laboratory evaluations is included. Several etiologies not discussed in detail are presented in table format.
疼痛是患者寻求医疗护理的主要原因。尤其是胸痛，因其可能危及生命——误诊可能是致命的，所以是患者和临床医生严重关切的问题。胸部和腹部内脏器官共享神经通路，这使得胸痛的诊断变得复杂。文中讨论了病史在鉴别诊断中的重要性。提供了一个有用的记忆法，既作为新手从业者的组织指南，也作为经验丰富的临床医生的提醒。内容包括关于胸痛神经解剖学的详细讨论，随后是与该病症选定的心血管和非心血管病因相关的常见病史表现和体格检查结果。还包括对确诊实验室评估的简要讨论。未详细讨论的几种病因以表格形式列出。
