1例以胸痛为首发症状的冠心病合并急性心肌梗死患者的全科诊疗思考

General Diagnosis and Treatment Thinking in a Patient of Coronary Heart Disease and Acute Myocardial Infarction with Chest Pain as First Symptom

该文回顾性分析1例以胸痛为首发症状的冠心病合并急性心肌梗死患者的治疗过程。社区医院以全科诊疗思维排查胸痛病因,明确诊断后转诊至上级医院进一步治疗,病情稳定后回归社区,全科医生结合专科医师的建议,对患者进行了全面健康风险评估,从行为干预、药物、运动、营养、心理等多方面为患者制定了个体化的心脏康复计划,降低患者心血管事件再发风险,体现出“健全专”一体化管理模式在此类患者管理中的良好应用效果。

This article retrospectively analyzes the treatment process of a patient with coronary heart disease complicated with acute myocardial infarction whose the first symptom was chest pain.The community hospital used the general diagnosis and treatment thinking to investigate the cause of chest pain.After the diagnosis was identified,the patient was transferred to the superior hospital for further treatment,and returned to the community after the condition was stable.In combination with the suggestions of the specialists,the general practitioners conducted a comprehensive health risk assessment on the patient,and formulated an individualized cardiac rehabilitation plan for the patient from the aspects of behavioral intervention,medicine,sports,nutrition,psychology and others.The risk of recurrence of cardiovascular events in the patient was reduced,indicating the good application effect of the integrated management mode of health risk evaluation by general practitioners and specialists.