Study On Etiology And Influencing Factors Of Emergency Chest Pain

Objective: To explore the etiology,clinical characteristics and related influencing factors of patients with emergency chest pain,to provide evidence for emergency doctors to quickly find the cause of chest pain,evaluate the prognosis of the disease and improve the diagnostic accuracy.Methods: Emergency patients with chest pain as first symptoms from January 2018 to December 2018 are chosen,It belongs to the retrospective study method,this study uses unified form record patients' general information,including medical history,emergency vital signs(temperature,breathing,heart rate,blood pressure,oxygen saturation),troponin,muscle enzyme spectrum determination such as preliminary screening test,Some patients were further examined by chest CT,cardiac color B ultrasound,coronary CT and coronary angiography,and electrocardiogram flatbed exercise test and electronic fiber gastroscopy when necessary.Patients were divided into different groups according to etiology,gender,season,age and emergency time of chest pain.and the differences in general conditions,chest pain characteristics and accompanying symptoms of each group were compared.Results: From January 2018 to December 2018,371 patients with emergency chest pain were included,259 of whom were diagnosed with clear etiology involving 19 diseases,of which acute coronary syndrome(40%)was the most common.The patients with chest pain were more male(73.7%)than female(26.3%).Winter and autumn(61.4%)were more than summer and autumn(38.6%).Most patients with emergency chest pain visit the doctor from 8:00 to 17:00(40.2%).There were 201 patients(56.6%)with cardiogenic chest pain,191 males and 68 females,and 209 patients(56.3%)with fatal chest pain.The general situation of cardiogenic chest pain and non-cardiogenic chest pain showed no significant difference between the two groups in gender and age,and cardiogenic chest pain was more common in patients with previous hypertension and smoking habit.Compared with the general situation of non-fatal chest pain,fatal chest pain was more common in patients with previous diabetes and smoking habits,and non-cardiac chest pain was more common in patients with a previous history of coronary heart disease.Cardiac and non-cardiac chest pain have no obvious differences in seasons,time,deadly chest pain with non-lethal chest pain also no significant differences in seasons,time,cardiac chest pain are more vulnerable to radiation than non-cardiac chest pain(p < 0.05),more prone to deadly chest pain than non-lethal chest pain radiating pain(p < 0.05).There was no significant difference in body temperature,respiration,blood pressure and oxygen saturation between cardiogenic chest pain and non-cardiogenic chest pain(p > 0.05).At a low heart rate,cardiogenic chest pain was significantly higher than non-cardiogenic chest pain(p < 0.05).Systolic blood pressure and diastolic blood pressure of patients with fatal chest pain were higher than those with non-fatal chest pain,and oxygen saturation in fatal chest pain was lower than that in non-fatal chest pain,but the difference was not statistically significant(p > 0.05).Conclusion: The etiology of emergency chest pain is complex,involving more than 19 kinds of diseases.The causes of central chest pain and fatal chest pain were common.The acute coronary syndrome is the most common cause of emergency chest pain.Chest pain is more common in men and winter and spring.Patients with chest pain are more common in the daytime.Compared with cardiogenic chest pain,hypertension and smoking are significantly correlated with cardiogenic chest pain,which may be risk factors for cardiogenic chest pain.Compared with non-fatal chest pain,diabetes,smoking,and fatal chest pain were significantly correlated,which might be the risk factors for fatal chest pain.Patients with cardiogenic chest pain had more radiation pain symptoms than those with non-cardiogenic chest pain.Fatal chest pain is more likely to be associated with reflex pain than non-fatal chest pain.Troponin was significantly increased,and the cause of emergency chest pain was more critical,which should be highly vigilant.The changes of vital signs in patients with emergency chest pain also have reference significance for the diagnosis of etiology.