A patient with chest pain in outpatient practice. Guide for practitioners. Prokhorovich E.A., Vertkin A.L.

chest pain can be the earliest and until a certain moment the only manifestation of the heart, respiratory system, gastrointestinal tract, neurotic and affective disorders. When evaluating the pain in the chest, the prognostic significance of the disease is necessarily taken into account, which could cause the appearance of pain.

chronic (intermittent or stable) chest pain, as a rule, does not require emergency assistance; additional laboratory and instrumental studies are carried out in a planned way to clarify its genesis.

and, conversely, an acute intensive chest pain, not bought by taking nitrates for 15 minutes or more, usually requires urgent medical care and emergency hospitalization of the patient. The doctor should first of all exclude life -threatening conditions - ACS, stratification of the chest aorta, pericarditis, fat. This requires the maximum possible detail of complaints with the clarification of the nature of the pain, its localization, the duration of the pain attack, etc., as well as the identification of the “second symptom”.

Obviously, from the first minutes of examination, the doctor usually forms a certain diagnostic concept, and in order to undergo or reject it, a more detailed survey of the patient is often necessary (the corresponding algorithms are presented in chapters dedicated to individual nosological forms).

The book illuminates the main issues of differential diagnosis of chest pain and contains algorithms for detecting frequently found diseases and syndromes.