Zusammenfassung
Die im notfallmedizinischen Setting häufig angegebenen thorakal lokalisierten Schmerzen stellen eine diagnostische wie therapeutische Herausforderung dar. Zu berücksichtigen und zu überprüfen sind zahlreiche Differenzialdiagnosen, etliche von ihnen sind mit hoher Mortalität assoziiert. Erschwert wird das Management dadurch, dass schnell und überraschend eintretende sowie rasch fortschreitende Verschlechterungen bei anfangs nicht gravierend krank erscheinenden Patienten nicht selten sind, dass die körperliche Untersuchung bei manchen zugrundeliegenden Pathologien ein unauffälliges, d. h. „falsch-negatives“ Ergebnis haben kann und dass atypische Präsentationen Anlass für Fehlinterpretationen sein können. Ausführlich referiert werden klinische wie apparative diagnostische Methoden, ihre Durchführung und Interpretation einschließlich möglicher Fehlerquellen und Limitationen.
Abstract
Thoracic pain is a common symptom in the emergency medicine setting and represents a diagnostic and therapeutic challenge. A multitude of differential diagnoses must be considered many of which are associated with a high mortality. Management of this situation is complicated by the fact that rapid and unexpectedly occurring and rapidly progressing deterioration are not uncommon in patients who initially did not appear to be seriously ill. Also for some underlying pathologies the physical examination can have an inconspicuous or“false negative” result and atypical presentations can give rise to false interpretations. The clinical and technical diagnostic methods, the implementation and interpretation including possible sources of error and limitations will be described in detail.
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Hobbach, HP., Lemm, H. & Buerke, M. Brustschmerzen in der Notaufnahme. Med Klin Intensivmed Notfmed 108, 7–18 (2013). https://doi.org/10.1007/s00063-012-0169-z
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DOI: https://doi.org/10.1007/s00063-012-0169-z