新的指导方针帮助医生诊断胸痛——但前提是你必须采取行动

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胸痛不仅仅是胸部疼痛. 但是当它突然出现的时候, experts behind new guidelines on evaluating and diagnosing it don't want you pondering nuances. 他们想让你行动起来. 现在.

"The most important thing people need to know about chest pain is that if they experience it, 他们应该打911,”医生说。. 菲利普·利维, a professor of emergency medicine and assistant vice president for research at Wayne State University in Detroit. “人们不应该浪费线上电子游戏飞禽走兽试图自我诊断. 他们应该立即去最近的医院. And if they're going to go to the nearest hospital to get evaluated for chest pain, 在理想的情况下, 应该是救护车送来的."

列维帮助领导了一个委员会 new guidelines from the 美国心脏协会 and American College of Cardiology. The recommendations aim to help patients and health care professionals act faster, 做出更明智的选择，更好地沟通胸痛.

Part of that is spreading the word that some people may not report chest "pain" but rather chest "discomfort,这可能包括胸部和其他部位的压力或紧张, 包括肩膀, 武器, 脖子, 回来, 上腹部或下颚.

The sudden onset of any of those symptoms could be a sign of reduced blood flow to the heart, 博士说. 玛莎Gulati, president-elect of the American Society for Preventive Cardiology and chair of the writing committee for the guidelines published Thursday in the AHA journal Circulation.

胸痛并不总是意味着心脏病发作, 当心脏供血停止时会发生什么, 使它缺氧.

“大多数胸痛都不会危及生命，”古拉蒂说. “事实上，大多数胸痛不是心源性的.“这可能是由于呼吸系统, 肌肉骨骼, 胃肠, 心理或其他原因.

古拉蒂说:“但如果是心脏疾病，就可能是致命的。.

这就是为什么就医是当务之急. “我们有这么好的治疗方法，但线上电子游戏飞禽走兽就是心脏肌肉，”她说. “我们越早看到你，就能越早治疗你."

胸痛占6.在美国每年有500万急诊就诊, 加上近400万人次的门诊就诊. 的指导方针, 第一个来自美国心脏协会和ACC专门用于胸痛, outline standards to help doctors identify who is most at risk and reduce unnecessary testing in those who aren't.

包括共同决策. "It is a rethinking of conversations where doctors and patients are both participants in the decisions of what happens next,利维说. 这个概念听起来可能很简单, but "there is a generation of patients who are just used to the doctor saying something, 这就是发生的事情."

But if a patient doesn't feel comfortable with the decisions being made by the doctor, 这会导致不确定性, 他说. 研究表明，“如果他们参与决策, 病人对所提供的治疗更满意."

The guidance suggests other ways for health care professionals to alter how they talk to patients. For example, doctors should stop using the term "atypical" to describe chest pain. 除了让人困惑之外, 这是一个对女性意义重大的技术细节, 古拉蒂说.

While both women and men experiencing heart problems most commonly report "typical" chest pain similarly, 女性更常报告其他“非典型”症状，如恶心, 疲劳和呼吸短促. This has resulted in women being less likely to receive timely and appropriate care.

"In the past, we have often said that women presented 'atypically,'" 古拉蒂说. “不过, 这似乎是用来说明疼痛不是心源性的, 而不是说一个女人的表现与预期不同,她说. Instead, doctors should use the term "noncardiac" if heart disease is not suspected.

的指导方针 also say health care professionals should be trained to ensure they can help people of diverse racial and ethnic 回来grounds. 这包括承认和解决这个问题, 像女人一样, 患有胸痛的黑人不太可能得到紧急治疗, 古拉蒂说. It also means taking the time to use translators when a patient does not speak English.

"If we're not connecting with our patients in a way that they feel respected and that they feel listened to, 我们将无法弥补心血管护理方面的差距, 特别是解决他们的胸痛,她说.

整体, Levy说, the guidelines should help doctors and other health care professionals make better choices faster. "These are things not to create ambiguity in the clinical world, but to create more certainty." The clear-cut advice should give doctors "a lot of comfort to their decision-making."

但除非有人呼救，否则这一切都不可能发生.

即使大多数突发胸痛的病例最终与心脏无关, 这是不容忽视的. 当人们推迟去急诊室的时候, Levy说, they're more likely to suffer complications if they are indeed having a heart attack. 这些并发症可能严重到死亡."

古拉蒂说，没有人应该害怕他们无缘无故地打电话. "I always tell my patients it's better for us to laugh together once we find some other cause for it versus us not being able to laugh together again."

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