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让病人做个检查,医生就摊上大事了?

2017-09-15 佚名 华医网

看个小病医生也让你做心电图,这就摊上大事了?

临床工作中,你是不是也会经常遇到这种情况——

“医生,我就是个牙疼/我就是个感冒/我就是个嗓子疼/我就是个肚子疼/我就是个呕吐/我就是个头晕、头痛/我就是个......”

“医生,我以前做过心电图,没有事,不用给我做心电图了。”

“我前几天刚做过心电图,为什么还要给我做?”

“我现在不难受,做心电图也没用,什么也看不出来。”

也许甚至还有患者质疑医生过度检查,为什么让我做心电图?真是个无良医生,只为赚钱!!

其实,心电图作为一项无创伤性的检查,在心脏疾患诊断中有着非常重要作用。

临床上,心绞痛、急性心肌梗死,都是极其危险的疾病,典型的心绞痛、急性心肌梗死,疼痛的部位在胸骨后上段或中段,疼痛性质,类似压榨样痛,时常会伴有大汗淋漓、呼吸困难等。心绞痛时间一般不超过15分钟,当疼痛大于30分钟,并伴有濒死感,就要考虑急性心肌梗死了,需要立即就医。

但是有些患者,患有心脏病,起病并无心前区疼痛,而是以其他症状为首发症状。例如:有的患者以左侧牙痛、咽痛,为首发症状,就诊牙科、咽喉科;有的患者腹痛,以剑突下疼痛显着,常以为是胃病而延误诊治;还有患者首发症状为呕吐,以为吃坏了肚子,延误诊治;还有以剧烈头痛、头晕、乏力、晕厥,甚至猝死为首发表现,而这些症状都是心绞痛或者急性心肌梗死疼痛放射或伴发症状的表现。

不是每一种疾病都像教科书讲得那样典型,疾病形形色色,而医生诊病,就像福尔摩斯分析案情一样,需要鉴别,一个十几元钱的常规心电图,就能够在极短的时间,快速判断心脏是否有严重问题,及时救治致命性的心肌梗死、心肌炎。

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    2017-09-15 清风拂面

    谢谢分享.学习了

    0

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    2017-09-15 1de3b290m83(暂无匿称)

    该做还得做

    0

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    2017-09-15 戒馋,懒,贪

    谢谢分享

    0

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    2017-09-15 jet747

    学习了.是要注意了.很重要

    0

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    2017-09-15 忠诚向上

    好好学习.多看看

    0

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虽然患者一开始误认为自己是胃肠道问题,并出现干呕不适。但问诊时明确有左上肢牵涉痛,伴有大汗淋漓,因怀疑患者为急性冠脉综合征。需要就诊后立即检查心电图。该患者心电图明确提示ST段抬高型心肌梗死。结合患者胸痛表现,可不等心肌损伤标志物检查结果即可考虑冠脉造影。但需要注意患者血常规、凝血指标和肾功能情况。

心电图也是会骗人的,你知道吗?

心电图是通过仪器从体表记录心电活动的变化图,从而推测心脏疾病。既然是推测,就有可能出错,比如急性心肌梗死。临床偶尔会遇见心电图表现虽然酷似心梗,但并不是心梗,需鉴别。小编查阅相关资料,总结可能发生“假心梗”的疾病,并将其按发生机制分别整理于下。

心电图诊断致心律失常性右室心肌病 表现和注意事项有哪些?

本例患者反复胸闷、心悸十余年,经心电图诊断为致心律失常性右室心肌病。其心电图表现有哪些?Fontaine导联描记方法有什么优势?ε波的临床意义是什么?这些问题将在下文详细解答。

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