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#医者 #診断 #心臓病 解説: 患者さんが『胸が痛い！』と受診された場合、ざっと下記のような鑑別が思い浮かびます。 狭心症 心筋梗塞 逆流性食道炎 心膜炎 心筋炎 胸膜炎 肋間神経痛 帯状疱疹 プレコーディアルキャッチ症候群 肋骨骨折 消化器疾患などの放散痛 大動脈解離 重症大動脈弁狭窄症 縦隔炎 肺血栓塞栓症 等々 胸が痛いといった場合、必ずしも心臓の病気とは限らないこともよくあります。今回のケースの場合、若年女性で心疾患の既往なく心電図、採血も特記異常がない場合、虚血性心疾患含め心臓の病気を積極的に疑う所見は今のところ乏しいとなります。たとえば逆流性食道炎や肋間神経痛など採血で炎症反応も上がらず、胸の痛みを自覚して受診されるケースもあります。この方は食道裂孔ヘルニアがあり胃カメラで難治性逆流性食道炎が見つかりました。
0:05
#医者 #診断 #心臓病 解説: 患者さんが『胸が痛い！』と受診された場合 …
424.1K viewsJan 7, 2023
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