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目前,尽管临床上采用一些新技术来诊断冠心病,但病史和心电图改变依然是本病的主要诊断依据,体征有时也可提供诊断的线索。有人将冠脉造影结果与临床症状作了对比分析,发现在具有典型心绞痛症状的患者中,有90%其冠脉有一支以上呈现明显的阻塞性病变。这说明根据典型症状诊断冠心病心绞痛的可靠性可达90%。然而,由于心绞痛的表现形式不一,加上某些患者对症状发作的特点注意不够而不能正确、全面地叙述病史,混淆了典型心绞痛与非心肌缺血性胸痛,从而降低了病史所应有的诊断价值。因此,医生必须耐心、细致地询问病史,并对病史进行全面的分析。典型心绞痛具有以下几个特点: 1.疼痛部位:位于胸骨后中部或上部,范围常较广泛,患者往往用手掌而不是用手指指示疼痛部位,可放射至左肩、左臂内侧直至小指、无名
At present, although some new techniques are used clinically to diagnose coronary heart disease, the history and electrocardiogram changes are still the main diagnosis basis of the disease. Signs can sometimes provide clues to diagnosis. Coronary angiography results and clinical symptoms were compared and analyzed, found that in patients with typical angina symptoms, 90% of its coronary artery showed more than one obvious obstructive lesions. This shows that according to the typical symptoms of coronary heart disease diagnosis of angina up to 90% reliability. However, due to the different manifestations of angina pectoris and some patients’ inadequate attention paid to the characteristics of the onset of symptoms, the history can not be correctly and comprehensively described, the typical angina pectoris and non-ischemic chest pain are confused, thus reducing the history The diagnostic value. Therefore, the doctor must patiently and carefully ask the history, and a comprehensive analysis of the history. Typical angina pectoris has the following characteristics: 1. Pain site: located in the middle or upper part of the sternum, the scope is more extensive, patients often use the palm instead of using your fingers to indicate the site of pain, can radiate to the left shoulder, left arm until the little finger, medial