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題名 | 以餐後胸痛來表現之不穩定性心絞痛:病例報告=Postprandial Chest Pain as the Manifestation of Unstable Angina Pectoris--A Case Report |
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作者 | 林錦龍; 鍾嫈嫈; 陳明豐; Lin, Chin-jung; Tjung, Jin-jin; Chen, Ming-fong; |
期刊 | 中華民國家庭醫學雜誌 |
出版日期 | 19971200 |
卷期 | 7:4 1997.12[民86.12] |
頁次 | 頁206-212 |
分類號 | 415.3161 |
語文 | chi |
關鍵詞 | 餐後胸痛; 不穩定性心絞痛; 忽然死亡; Angina pectoris; Sudden cardiac death; |
中文摘要 | 隨著社會進步,臺灣地區冠狀動脈心臟病的病患逐年增多,不少冠狀動脈心臟病 的病患會在基層醫療執業場所接受治療,冠狀動脈心臟病的病患其嚴重度不一,較嚴重者則 需轉診進一步檢查及治療。本篇報告一位六十九歲男性,經過二年的高血壓及冠狀動脈心臟 病穩定治療後發現有餐後胸痛的症狀,由於懷疑病患病情惡化之可能,在門診進行簡單的階 梯式運動心電圖檢查發現有嚴重的心肌缺氧。從病患的臨床情況診斷為預後較差之不穩定性 心紋痛( unstable angina pectoris )之下馬上被送至急診並住院接受進一步檢查及治療 。 經冠狀動脈攝影發現是三條冠狀動脈血管疾病( triple vessel disease )。不幸地, 病人還來不及進行冠狀動脈繞道手術就忽然死亡( sudden cardiac death )。本篇報告目 的是要提醒吾等同業在執行繁忙的基層醫業時,如發現有餐後胸痛( postprandial angina pectoris )之病患, 應提高警覺可能是預後不好,可能很快就會變成急性心肌梗塞或致命 的心律不整而突然死亡之嚴重的冠狀動脈心臟病,應細心評估,儘快轉診,以期得到最好的 治療,改善病患康復後的生活品質,減少死亡率及減少醫療糾紛。 |
英文摘要 | The number of patients with coronary heart disease in our country has increased markedly year by year during this century. A lot of such patients are treated of private clinics. Some patients' disease is more serious than others'. The patients with serious disease should be transferred to hospital for careful reexamination and treatment as necessary. Herein we report a 69-year-old male patient who had suffered from hypertension and coronary heart disease for two years. He noticed postprandial chest discomfort after a long period of steady treatment. His condition appeared to be worsening day after day. A severe myocardial ischemia was discovered by Master's exercise test. Under a diagnosis of unstable angina pectoris, he was sent to the emergency room immediately and was admitted to the hospital for further examination and management. He was found to have triple vessel disease by coronary angiography. Unfortunately, the patient sustained sudden cardiac death before coronary artery bypass graft surgery could be applied. The purpose of this report is to remind the physicians that if a postprandial chest discomfort is present, it may indicate an attack of postprandial angina pectoris which may be a harbinger of an unfavorable outcome and a symptom of severe coronary heart disease, such as acute myocardial infarction or life-threatening arrhythmia. It is very important that such syndrome may be resulted in sudden cardiac death. Such patients should be examined carefully and transferred to a medical center as soon as possible in order to receive the best therapy as possible. It is not only to decrease the mortality rate in such patients, but also prevent malpractice. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。