全科临床诊疗思维系列——胸痛

Clinical diagnosis and treatment thinking series——chest pain

全科医师接诊胸痛患者时需从症状和体征入手,首先需排除致命性胸痛,然后根据胸痛的特征展开相关辅助检查,注意识别引起胸痛的心理因素,进而明确胸痛的病因、健康问题,评估患者的危险分层,进行鉴别诊断,才能根据病情制定诊疗和干预计划,必要时初步处理后及时恰当转诊。

According to the symptoms and signs,general practitioners(GPs) should rule out life-threatening chest firstly. Secondly, relevant auxiliary examinations should be carried out according to the characteristics of chest pain, attention should be paid to identify the psychological factors causing chest pain. Then, GPs can clarify the causes of chest pain and health problems, evaluate the risk stratification, make differential diagnose. Only in this way can diagnosis and treatment plan be formulated according to the condition of the patient and intervention plan. GPs should referral the patient appropriately after primary treatment when necessary.