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Chest pain: An update

机译：胸痛：更新

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Purpose of review: Chest pain is one of the most common symptoms for seeking acute medical care. Evidence of myocardial ischemia, however, can only be established in a minority of patients. The establishment or ruling out of myocardial ischemia is difficult and the cost is high. An effective rationale for ischemia detection, without unneccessary hospital admission, is needed. The development of chest pain units potentially offers a rapid, effective way of identifying patients at high risk for acute coronary syndromes, as well as those with a low probability of ischemia. Other cardiac or noncardiac causes of chest pain should also be considered. Recent findings: Recent developments in chest pain, including the ruling in or out of ischemic pain by triage and different ischemia detection methods, are discussed. Other causes of chest pain such as esophageal, drug related, psychiatric and post-coronary bypass surgery pain are also discussed. Recent findings on syndrome X are reviewed and patients with myocardial infarction presenting without chest pain are discussed. Summary: The possibility of safely and quickly ruling out myocardial ischemia by point-of-care biochemical analyses is reviewed, which might influence our clinical handling of chest pain patients. The importance of biopsychosocial factors, pain perception, esophageal dysfunction, drugs and the coronary artery bypass procedure in itself, is discussed and vital clinical information is provided for the handling of our chest pain patients.
机译：审查目的：胸痛是寻求急性医疗的最常见症状之一。但是，只有少数患者才能确定心肌缺血的证据。建立或排除心肌缺血是困难的，并且成本高。需要一种有效的原理来进行缺血检测，而无需不必要的住院治疗。胸痛病灶的发展潜在地提供了一种快速，有效的方法来识别患有急性冠脉综合征的高危患者以及缺血可能性低的患者。还应考虑引起胸痛的其他心脏或非心脏原因。最新发现：讨论了胸痛的最新发展，包括通过分流和不同的缺血检测方法来控制局部或局部缺血性疼痛。还讨论了胸痛的其他原因，例如食道，药物相关，精神病学和冠状动脉搭桥手术后的疼痛。综述了X综合征的最新发现，并讨论了无胸痛的心肌梗死患者。摘要：回顾了通过即时护理生化分析安全快速排除心肌缺血的可能性，这可能会影响我们对胸痛患者的临床处理。讨论了生物社会心理因素，疼痛知觉，食道功能障碍，药物和冠状动脉搭桥手术本身的重要性，并为治疗胸痛患者提供了重要的临床信息。

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