Diagnostic Approach to the Patients with Chest Pain

Yıl 2008, Cilt: 2 Sayı: 1, 280 - 285, 23.03.2008

Murat Akçay

Öz

Chest pain is one of the most frequent symptoms for which patients are evaluated in an emergency department. Chest pain is merely a symptom, not a diagnosis. Many medical problems can cause chest pain, and before the chest pain can be adequately treated, the actual underlying cause needs to be identified. The following is a list of the more common causes of chest pain, roughly in order of the frequency in which they are seen in the emergency room. Angina due to coronary artery disease, benign chest wall pain, anxiety or panic disorder, pneumonia, pleuritis, mitral valve prolapse, pericarditis, chest trauma, peptic ulcer, angina due to coronary artery spasm, angina due to cardiac syndrome X, aortic dissection. Some causes of chest pain require prompt medical attention, such as acute coronary syndromes tearing of the aorta, or pulmonary embolism. Because the cause of chest pain can range, from an ordinary, harmless muscle pull to serious cardiac complication ultimately leading to cardiac arrest. Coronary artery disease is so common and so dangerous that the symptom of chest pain should never be dismissed out of hand as being insignificant. Therefore, an accurate diagnosis is important in providing proper treatment to patients with chest pain. The diagnostic procedure in patients with acute chest pain should serve two major purpose: to quickly identify high risk patients quickly for the fast track and to delineate patients in whom there is little or no suspicion of a life-threatening disease. In this paper, the approach to chest pain was reviewed.

Anahtar Kelimeler

Chest pain;, coronary arteriosclerosis, pain

Göğüs Ağrılı Hastaya Tanısal Yaklaşım

Öz

Göğüs ağrısı acil servislerde hastaların en sık şikayet ettikleri semptomlardan biridir. Göğüs ağrısı bir tanı olmayıp sadece bir semptomdur. Pek çok tıbbi durum göğüs ağnsına yol açabilir ve yeterli bir şekilde tedavi edilmeden önce altta yatan gerçek nedenin aydınlatılması gereklidir. Hastanelerin acil servis bölümlerine başvuran göğüs ağrılı hastaların sıklık sırasına göre kabaca en yaygın göğüs ağrısı nedenleri şu şekilde listelenebilir. Koroner arter hastalığına bağlı göğüs ağrısı, benign göğüs duvarı ağrısı, anksiyete, panik bozukluk, pnömoni veya plörite bağlı göğüs ağrıları, mitral kapak prolapsusu, perikardit, künt göğüs travması, peptik ülsere bağlı göğüs ağnları, koroner arter spazmı, kardiyak sendrom X ve aort diseksiyonuna bağlı göğüs ağrısı. Aort diseksiyonu, pulmoner emboli ve akut koroner sendrom gibi bazı durumlar acil değerlendirme ve tedavi gerektirir. Göğüs ağrısının nedenleri önemsiz bir kas hastalığından ciddi komplikasyonlann olduğu kardiyak arreste kadar geniş bir yelpaze ile karşımıza çıkar. Koroner arter hastalığına bağlı göğüs ağrısı, kesinlikle atlanmaması gereken göğüs ağrısının en tehlikeli ve en yaygın formudur. Bu nedenle göğüs ağrısı olan hastaların doğru teşhis ve uygun tedavi edilmeleri önemlidir. Akut göğüs ağrısına tanısal yaklaşımda iki ana hedef olmalıdır: yüksek riskli hastaların çok hızlı bir şekilde saptanıp tedavisinin planlanması ve hayati tehlikesi çok az olan veya hayati tehlikesi bulunmayan hastaların belirlenmesidir. Bu yazıda göğüs ağrısına yaklaşım incelenmiştir.

Anahtar Kelimeler

Göğüs ağnsı; koroner arter hastalığı, ağrı, göğüs ağrısı

Kaynakça

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