Acute coronary syndrome refers to a comprehensive disease manifestation caused by the rupture or invasion of coronary atherosclerotic plaques, followed by complete thrombosis, which includes myocardial infarction, unstable angina pectoris, etc. It is a relatively serious vascular disease and a relatively serious type of coronary heart disease. It often occurs in the elderly and in people with hypertension, hyperglycemia, etc. What does acute coronary syndrome include? 1. Stable angina chest pain is often triggered by physical labor or emotional excitement (such as anger, anxiety, overexcitement, etc.), and can also be triggered by overeating, cold, smoking, tachycardia, shock, etc. The pain usually occurs during exertion or excitement rather than at the end of a hard day. Typical angina often recurs under similar conditions, but sometimes the same exertion causes angina only in the morning and not in the afternoon. After the pain occurs, it often gradually worsens and then disappears within 3 to 5 minutes. Stopping the activity that originally triggered the symptoms or taking sublingual nitroglycerin can relieve them within minutes. 2. The chest pain of aortic dissection reaches its peak at the beginning and often radiates to the back, ribs, abdomen, waist and lower limbs. There may be obvious differences in the blood pressure and pulse of the two upper limbs. There may be manifestations of aortic valve insufficiency, and occasionally there are symptoms of neurological damage such as confusion and hemiplegia. However, there is no elevated serum myocardial necrosis markers for differentiation. Two-dimensional echocardiography, X-ray, or magnetic resonance tomography can aid in the diagnosis. 3. Acute pulmonary embolism may cause chest pain, hemoptysis, dyspnea and shock. However, there are symptoms of a sharp increase in right heart load, such as cyanosis, hyperactive second heart sound in the pulmonary valve area, distension of the jugular vein, hepatomegaly, and lower limb edema. The electrocardiogram shows deepening of the S wave in lead I, significant inversion of the Q wave in lead III, left shift of the transition zone in the chest leads, and inversion of the T wave in the right chest lead, which can be used for identification. 4. Acute abdomen Acute pancreatitis, perforated peptic ulcer, acute cholecystitis, cholelithiasis, etc. all have upper abdominal pain, which may be accompanied by shock. Careful medical history, physical examination, electrocardiogram, and serum myocardial enzyme and troponin measurements can assist in the identification. 5. Acute pericarditis The pain and fever of pericarditis occur simultaneously, aggravated by breathing and coughing. There is pericardial friction sound in the early stage, which and the pain disappear when effusion appears in the pericardial cavity. The systemic symptoms are generally not as severe as AMI. Except for aVR, the other leads of the electrocardiogram have ST segment elevation with a downward arch, inverted T waves, and no abnormal Q waves. |
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