急诊科急性胸痛的处理:冠状动脉计算机断层扫描血管造影术的益处。

Gianmarco Sarto, Beatrice Simeone, Luigi Spadafora, Marco Bernardi, Erica Rocco, Giuseppe Pelle, Quirino Liberati, Maurizio Forte, Leonardo Schirone, Francesco Versaci, Rita Dal Piaz, Silvia Palmerio, Antonio Barberi, Giacomo Frati, Davide Bellini, Marco Rengo, Iacopo Carbone, Sebastiano Sciarretta, Valentina Valenti
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引用次数: 0

摘要

急性胸痛(ACP)是急诊科(ED)入院的常见病因,全球每年报告的病例数以百万计。由于急性冠状动脉综合征 (ACS)、肺栓塞 (PE)、主动脉夹层等潜在病因多种多样,因此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,从而增加医疗成本。虽然 HEART、GRACE 和 TIMI 评分等风险分层工具很有用,但要实现精确诊断,通常还需要额外的成像检查。冠状动脉计算机断层扫描血管造影术(CCTA)在提高诊断准确性和改善患者预后方面显示出巨大的潜力。在这篇综述中,我们探讨了医生在急诊室评估 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,我们还介绍了一个临床病例,说明 CT 扫描如何有效地帮助诊断症状模糊的患者,其中 CT 成像在确定潜在病理方面发挥了关键作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Management of acute chest pain in the Emergency Department: benefits of coronary computed tomography angiography.

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.

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