Clinical Characteristics Of Patients With Acute Chest Pain

Objective: Chest pain is a common reason for patients to visits emergency department.Patient's condition is complicated,multiple organs and systems are often involved,and the severity of the disease varies,its curative effect and prognosis are obviously time dependent.By studying the clinical characteristics of patients with acute chest pain in "chest pain center" of Tianjin Medical University General Hospital,including epidemiological characteristics,etiological factors,and diagnosis and treatment after admission,the characteristics and regularity of the disease at present in this area were revealed.Through this study to improve the cognition of the disease,optimize the diagnosis and treatment of the disease,rapid differential diagnosis of acute fatal chest pain disease,reduce the mortality.Methods:A prospective and continuous collection of clinical data of patients with acute chest pain from June 10,2016 to June 9,2017 at the "Chest pain center" of Tianjin Medical University General Hospital,including patient's gender,age,visiting time,chief complaint,accompanying symptoms,laboratory tests,etc.We can get the ratio of each cause of chest pain,analyze the epidemiological characteristics,summarize diagnosis and treatment of chest pain.All the data were analyzed by SPSS21 software.Results:Finally,4699 patients were collected.1.Epidemiological characteristics of patients:(1)Etiological composition: 2890 cases of cardiovascular chest pain were collected.,accounting for 61.50%,including STEMI 314 cases(6.68%),NSTEMI125 cases(2.66%),angina pectoris1804 cases(38.39%));985 cases of non cardiovascular chest pain were collected,accounting for 20.96%,mainly including disease of respiratory system 311 cases(6.62%),disease of digestive system 199 cases(4.23%),neurological and psychiatric diseases in 215 cases(4.58%),etc;unknown etiology and other diseases in 824 cases(17.54%).(2)Sex: the proportion of males in cardiovascular chest pain group was higher than that in non-cardiovascular chest pain group(P < 0.05).(3)The average onset age of cardiovascular chest pain patients was higher than that of non-cardiovascular chest pain patients(P < 0.001).(4)The rule of patient's visiting doctor throughout the day:“three peaks and one trough”,the overall peak visit time is: 9:00-11:00 in the morning,14:00-16:00 in the afternoon,and20:00-22:00 in the evening.The trough time is: 2:00-6:00 in the morning.2.The patient's diagnosis and treatment status and outcome:(1)The complete rate of electrocardiogram was the highest in 4699 patients(100 %).Followed by blood(92.45%),myocardial enzyme(57.05%).(2)Drug use: The most common are nitrate drugs(26.30%),followed by acid-suppressants(23.69%)and antiplatelet drugs(19.64%).(3)Shunt in patients with cardiovascular chest pain: There were 2890 patients with cardiovascular chest pain.There were 420 cases(14.53 %)in cardiology department,18 cases(0.63%)in surgical department,2171 cases(75.12%)in emergency department,281 cases(9.72%)in automatic leaving hospital.(4)Prognosis of inpatients in cardiology department: the proportion of patients with no adverse events in the interventional therapy group was higher than that of the conservative treatment group,and the proportion of patients with heart failure and hospital death was lower than that of the conservative treatment group(P < 0.001).Conclusions: 1.The cause of acute chest pain disease for patients visit "chest pain center",cardiovascular disease is the main disease,the proportion of coronary heart disease is the highest and the second is respiratory disease;In the spring is the season of high incidence of cardiovascular disease,we should pay attention to keep warm and improve the prevention consciousness of cardiovascular disease.Early morning is a high incidence period of cardiovascular disease,pay attention to diagnosis and differential diagnosis,to prevent misdiagnosis.2.Early interventional therapy can improve the clinical prognosis and reduce the mortality of patients with cardiovascular chest pain.