Chest pain can be life-threatening, and the causes of chest pain are complex and diverse, including acute coronary syndrome, aortic dissection, pulmonary embolism, pneumothorax, pericardial tamponade and so on.
According to domestic and foreign research, the mortality rate of aortic dissection aneurysm is as high as 90%. How to diagnose and distinguish the causes of acute coronary syndrome and other fatal chest pain quickly and accurately has become the difficulty and focus of emergency treatment.
Sometimes, when an internal organ and a certain part of the body surface are innervated by afferent nerves from the posterior root of spinal nerve, the sensory impulse from the internal organ can not only cause local pain, but also cause pain on the corresponding body surface, which is called radiation pain. Such as angina pectoris, in addition to the pain in the posterior sternum or precordial area, it also radiates to the left shoulder and the inner side of the left arm.
The purpose of treatment of chest pain is to clarify the cause and relieve symptoms, mainly through long-term drug treatment, and some serious patients may need surgery.
First, differential diagnosis
The characteristics of this symptom are very clear, and it is the patient's chief complaint, which generally does not need to be distinguished from other symptoms.
Second, treatment.
The treatment of chest pain should first clarify the cause and treat the primary disease. If the patient suffers from chest pain caused by coronary heart disease, the patient may need long-term drug treatment, and in severe cases, coronary stent implantation or heart bypass surgery may be needed. In addition, certain analgesic drugs can be given according to the specific situation of patients to relieve symptoms.
Family handling
After the occurrence of chest pain, patients should stop moving and stay in bed. Patients with a history of heart disease can take some standing first-aid drugs. If the symptoms of chest pain persist or worsen, you should call the emergency number in time and wait for the ambulance to receive treatment. Patients can't drive to see a doctor by themselves.
Go to the hospital for treatment
Treat primary disease
Those caused by visceral diseases should be treated according to their causes, such as pneumonia and pleurisy, and anti-infection treatment should be actively strengthened. Choose sensitive antibiotics according to drug sensitivity. Patients with angina pectoris should rest and use nitroglycerin to relieve pain. Patients with myocardial infarction need to be given strong analgesics and special treatment such as revascularization in time to relieve chest pain. For chest wall injury, the chest wall should be properly fixed to reduce its mobility. Those caused by esophageal diseases should be treated appropriately according to different reasons. Surgery or radiotherapy should be used for those caused by tumors.
Symptomatic treatment
For chest wall muscle pain and pleurisy pain, antipyretic, analgesic and anti-inflammatory drugs, such as diazepam, can be appropriately selected. For chest pain caused by other reasons, local intercostal nerve block can be performed when necessary.
Third, diet.
Patients with chest pain should pay attention to light diet, soft rice balls or liquid food when considering esophageal lesions, so as not to aggravate the symptoms of chest pain. It is recommended to fast when chest pain occurs, and selectively eat digestible food after symptoms are relieved.
Diet regulation
Liquid diet, such as rice porridge, soup, noodles and so on. It can be given after the chest pain stops, but it should not be overheated.
Eat less or no spicy food, and avoid alcohol, tobacco, coffee or strong tea.
Fourth, nursing.
Patients with chest pain often have anxiety and fear, so they should be comforted reasonably, strengthen health knowledge education, explain the causes of chest pain to patients, and promote a calm treatment of the disease.
Daily nursing
Adjust posture
Take a comfortable posture to relieve chest pain, such as chest pain caused by lung or pleural lesions, take the affected side and reduce the activities of chest wall and lungs, so as to achieve the purpose of relieving pain.
Relieve pain
According to the condition, wet hot compress, cold wet compress or intercostal nerve block can be used to relieve pain.
Disease surveillance
Patients with angina pectoris and myocardial infarction should closely observe the changes of patients' condition, such as electrocardiogram, blood pressure, oxygen saturation and body temperature. If there is anything unusual, they should inform the doctor in time.
Psychological nursing
Patients with chest pain may have excessive mental stress. Family members should be careful and patient to comfort, eliminate tension, accompany them at all times, and give patients enough sense of security.
Verb (short for verb) prevention
preventive measure
In the past, patients with obesity, coronary atherosclerosis, hyperlipidemia and hypertension should be admitted to the hospital for physical examination at least once a year, and the lesions should be found and treated in time to prevent the aggravation of cardiovascular diseases.
In daily life, we should also pay attention to the rules of work and rest, keep enough sleep, keep a happy mood and exercise properly.