Dissertation
Dissertation > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease

Differential Diagnosis Significance in Patients with Chest Tightness Chest Pain and Analysis for the Risk Factors of Airflow Limitation

Author GuoDongCi
Tutor ZhangPengQiang
School Dalian Medical University
Course Internal Medicine
Keywords chest tightness chest pain differential diagnosis bronchial dilation test airflow limitation disease risk factors
CLC R54
Type Master's thesis
Year 2011
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Chest tightness, chest pain is a common non-specific symptom of cardiopulmonary diseases. Coronary heart disease, hypertension, bronchial asthma, COPD all have the similar symptoms of chest tightness or chest pain. Many of patients have the chief symptoms of chest tightness or chest pain may be exist cardiovascular disease, may be exist lung disease, but they see a doctor to Cardiology. If patients suffer from hypertension, coronary heart disease, chest tightness and chest pain were likely to be interpreted by cardiovascular diseases, but lung disease is often neglected, if not examined bronchial dilation test. Therefore, differential diagnosis requires clinicians to pay more attention. We judge the patients whether had asthma and COPD by bronchial dilation test forced vital capacity (FVC), 1 second forced expiratory volume (FEV1) changes and analyze risk factors of airflow limitation lung diseases.Bronchial dilation test is confirmed an important differential diagnosis for patients with chest tightness and chest pain. If patients existing risk factors of airflow limitation disease should pay attention to bronchial dilation test, clear chest tightness and chest pain etiology.Objective:1. By bronchial dilation test to identity the proportion of patients with chest tightness or chest pain as the main symptoms treatment in cardiology ward or clinic.2. The risk factors of existence airflow limitation disease are analyzed for differential diagnosis provide the basis. Clear high-risk patients. These patients have risk factors should be bronchial dilation test, provide the basis for the differential diagnosis.3. Bronchial dilation test is confirmed it is an important differential diagnosis for have the symptoms of chest tightness, chest pain treatment in cardiology ward or clinic, to guide further treatment.Methods: Selected 104 patients from January, 2008 to March, 2011 to the Department of Cardiology of our hospital outpatient or ward, they had the chief symptoms of chest tightness and chest pain. 46 patients were male, 58 patients were female, average age (61.8±10.5) old. Through the patient’s past medical history, symptoms, predisposing factors, occupation, with or without smoking, pulmonary disease of family and the examination of blood pressure, electrocardiogram or treadmill test or coronary angiography, bronchial dilation test etc, According to the test results and patient history, clinical manifestations in patients, cleared the reasons for chest pain in patients with chest tightness or chest pain. According to bronchial dilation test results, The selected group of patients with airflow limitation and flow into the normal group, from gender, age, occupational exposure history, allergy history, smoking history, presence of cardiovascular disease, lung disease, family history aspects analyzed differences between the two groups and risk factors for there is airflow limitation in patients.Results:1.104 patients with the chief symptoms of chest tightness or chest pain was selected, In 104 patients, 10patients have typical respiratory symptoms of respiratory disease, account for 9.6%, the remaining 90.4% of patients had no typical symptoms of respiratory disease.75 patients had cardiovascular disease (hypertension and coronary heart disease), the remaining 29 patients excluded structural heart disease by various examination. In the104 patients, 64 patients had disease of airflow limitation (bronchial asthma and COPD), accounted for 62%. In 75 patients with cardiovascular disease, 51 patients were found airflow limitation disease existed, accounted for 68.0%, the group of 29 patients without cardiovascular disease, there was 13 patients existing airflow limitation, accounted for 44.8%.2. Air flow limitation group and no airflow limitation disease group compared. In the airflow limitation patients, the group of airflow limitation patients older (63.5±9.78vs59.23±10.3) P <0.05, a high proportion of patients with a history of occupational exposure (53.1% vs15%) P< 0.01, a high proportion of patients with allergy (75% vs27.5%) P<0.05, a high proportion of smoking history (48.4% vs25%) P<0.05, a high proportion of cardiovascular disease (79.7%vs60%) P<0.05. By logistic regression analysis, occupational exposure history and allergy were risk factors of airflow limitation disease.Conclusions:1. The patients with chief complaint of chest tightness and / or chest pain received treatment in the Department of Cardiology, there is a higher proportion of airflow limitation disease, The patients of older, have smoking history, with allergies, occupational exposure history and cardiovascular disease, airflow limitation disease is a high proportion incidence rate(bronchial asthma and COPD). Bronchial dilation test should be used.2. Occupational exposure history and allergies are the risk factors of airflow limitation disease. The patients with risk factors of chest tightness and chest pain should examine bronchial dilation test identified.3. Bronchial dilation test is an important differential diagnosis values, help to further guide treatment for the patients with the symptoms of chest tightness and chest pain.

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