Chest pain

Introduction Chest pain is a common symptom, usually caused by chest disease. The severity is not necessarily related to the cause of chest pain. For example, chest herpes zoster can cause severe chest pain, and the chest pain of acute myocardial infarction is sometimes not very serious. Therefore, patients with chest pain should be carefully examined to find the cause of chest pain as much as possible.

Cause

1, psychological implied. Many patients, after learning that they have a certain disease, always feel that they are not comfortable here, and they are always uncomfortable. They always feel that they have symptoms of these diseases. This can be said to be psychological suggestion or mental illness.

2, chest muscle strain. This is usually caused by excessive labor or heavy loads. This kind of chest pain is not a problem. Just take a break and do not overload the weightlifting.

3, caused by disease. More common in rib neuralgia, costal cartilage, heart disease, lung disease and liver disease, said liver disease, which involves hepatitis B. It is well known that hepatitis B patients often have liver damage, liver damage can cause liver and Peripheral organ lesions will be involved in the liver capsule, and there are nerve lines on the liver capsule, which may be delayed to the chest leading to chest pain, mostly concentrated on the right side of the human body.

an examination

Related inspection

Chest MRI chest CT examination chest B-ultrasound

Physical examination

Chest wall disease can be determined by visual inspection and palpation. The internal organs of the chest must be detailed and detailed, and the unilateral thoracic cavity should be treated to the pleural effusion. Tactile tremors should be seen in pneumonia, and pneumonia or real sound should be considered for pneumonia, pulmonary infarction, lung cancer, and pleural mesothelioma. Percussive drum sounds consider pneumothorax. Patients with angina pectoris and myocardial infarction have normal or enlarged heart, and heart rate increases and auscultation has abnormal findings. Abdominal and crying disorders have corresponding abdominal signs.

Laboratory inspection

Blood routine is routinely examined, and changes in white blood cells can provide a basis. The bacteriological examination of sputum can determine the pathogens of pneumonia and tuberculosis, and exfoliative cytology can help diagnose lung cancer. The laboratory and cytological examination of cerebral and pericardial puncture fluids are beneficial to the diagnosis. The increase of hemoglobin and the increase of serum myocardial enzyme contribute to the diagnosis of acute myocardial infarction.

Device inspection

Electrocardiography is helpful in the diagnosis of angina and acute myocardial infarction. Echocardiography is important for the diagnosis of pericardial effusion and the observation of effusion volume, affirming the diagnosis of valvular disease. Chest X-ray examination plays an important role in the diagnosis of modern chest diseases. Conventional X-ray examination can show images of multiple chest lesions, as a basis for diagnosis of diseases such as pneumonia, tuberculosis, pulmonary infarction, lung cancer, pleural lesions, and pneumothorax. CT examination has high resolution, high diagnostic readiness and sensitivity. CT is a cross-sectional view of the chest section. It shows good effect on the mediastinum, around the diaphragm and subpleural lesions. It often distinguishes blood vessels and fat. Water and various soft tissue density lesions. It is commonly used for the identification of hilar enlargement in the mediastinal lesions, microscopic lesions and pleural lesions in the lungs, and MRI has coronal and sagittal tomography. It also has the advantages of higher resolution of soft tissue in the mediastinum, and can directly display the three-dimensional or even oblique angle of the angle to facilitate the display and localization of the lesion. However, CT and MRI examinations should not be the first choice for chest lesions, and can only be used as a method for further examination. Radionuclide scanning is helpful for the diagnosis of pulmonary infarction, intrapulmonary space-occupying lesions, and myocardial infarction. Cardiac catheterization is of particular value for the diagnosis of congenital and certain acquired cardiovascular diseases, and is also useful for the diagnosis of lung diseases. Fiberoptic bronchoscopy can penetrate deep into the surface and sub-segment bronchus, can be biopsy and brushing under direct vision, do biopsy, bronchoalveolar lavage fluid for microbiology, cytology, immunology, molecular biology examination for lung disease The cause and pathological diagnosis are very helpful. Thoracoscopy is used for the diagnosis of pleural disease, classification of pneumothorax and treatment.

Differential diagnosis

When a clinician diagnoses chest pain, he must master comprehensive clinical data and conduct detailed analysis.

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