不稳定性心绞痛.pdf

《不稳定性心绞痛.pdf》由会员分享，可在线阅读，更多相关《不稳定性心绞痛.pdf（2页珍藏版）》请在淘文阁 - 分享文档赚钱的网站上搜索。

1、Clinical pathway of Interventional therapy based on UnstableAnginaA.Standard hospitalization process(a)Applicable objectivesThe first diagnosis is unstable Angin（a ICD-10：I20.0/20.1/20.9）Underwent coronary stenting（ICD-9-CM-3：36.06/36.07）(b)Diagnosis basisClinical Practice Guidelines-Department of C

2、ardiology（Edited byChinese Medical Association,Peoples Health Publishing department,2009),Unstable Angina and non-ST-segment elevation myocardialinfarction diagnosis and treatment guidelines(Cardiology Branch ofChinese Medical Association,2007)and the 2007 ACC/AHA and ESCguidelines.1.Characteristics

3、 ofclinicalonset:theclinicalmanifestationisExercise-inducedchest pain or Spontaneous chest pain,it will bequickly relieved when take a rest or sublingual administration ofnitroglycerin.2.The ECG:ST-segmentdepression or elevation 0.1mV on adjacenttwo or more than two-lead ECG or T-wave inversion0.2mV

4、 whenchest pain is onset,the changes in ST-T segment recover itself whenthe chest pain get relieved.3.Markers of myocardial injury are not elevated or not reach the levelof diagnosis of myocardial infarction4.Clinical types1)Initial onset of angina:the new-occurred angina,which has thelargest diseas

5、e course ofa month,can be manifested asSpontaneous and exertional angina onset exist at the same time,andthe pain grading is above level III.2)Worsening exertional angina:patient has a angina history,and theangina get worsened,it attacks frequently,and the onset time isbecominglonger and longer,the

6、pain threshold is getting lowerand lower(Canada exertional angina grade CCS-IIV increased byat least one class or reached at least Class III)3)Resting angina:angina attacks when patients are at rest or at aquiet state,and seizure duration is usually more than 20 minutes.4)Postinfarction angina:it refers to the angina occurred between 245)Variant angina:the angina attacks when the patients are at rest or