d**u
发帖数: 278 | 1 讨教一个问题：
CCS 急性胸痛的体检前的 emergent management 如何处理？
我觉得因为不做体检 和 必要的X ray，EKG，很难给出相关的 急诊处理。
比如：
1. 心梗，心绞痛：aspirin, nitroglycerin, beta blocker。体检前就该给。
2. 主动脉dissection： aspirin应该不能给吧？应该先做PE和 X ray，EKG，再给予治
疗吧？不能直接给 nitroglycerin，beta blocker吧？
3. 急性肺水肿：给了beta blocker可能会加重肺水肿和心衰吧？也应该 PE 和 X ray,
EKG 后再治疗吧？
对于这3中情况该如何给出各自的急诊management？（因为一上来都是胸痛，很难直接
给药）
多谢了！ | l****b
发帖数: 400 | 2 I would just give oxygen, oximeter first and then do a focused PE before
other treatment. One can get lots of clues from Hx, such as age, sex,
description of the pain, sudden/slow onset, so the DDx would be narrowed
down to just 1-2. However, I do think one needs to listen to the heart and
lung before giving BB, nitro, or chest tube.
My two cents |
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