The Importance of Clinical Examination of Patients with Dyspnea and Chest Pain in Choosing the Right Treatment Strategy
Osuman, Ayisha Kuwayih |
Recenzentas / Reviewer |
Įvadas: Dusulys ir krūtinės skausmas suaugusiems yra simptomai, susiję su daugybe širdies ir plaučių ligų, todėl klinikinėje praktikoje dėl jų sutampančių etiologijų yra diagnostinis iššūkis. Šios literatūros apžvalgos tikslas – visapusiškai išnagrinėti su suaugusiųjų dusuliu ir krūtinės skausmu susijusius etio-loginius veiksnius ir diagnostikos metodikas. Kritiškai analizuojant esamus tyrimus, šiuo tyrimu siekiama nustatyti bendras ir skirtingas šių simptomų priežastis, įvertinti dabartinių diagnostikos metodų efek-tyvumą.
Išvada: Šioje disertacijoje pabrėžiamas esminis poreikis visapusiškai suprasti pagrindines dusulio ir krūtinės skausmo priežastis ir veiksmingus diagnostikos metodus, pabrėžiant kardiogeninės ir plaučių kilmės diferencijavimo iššūkius. Jame pabrėžiama, kad svarbu integruoti klinikinius vertinimus su pažan-giomis diagnostikos priemonėmis, siekiant padidinti tikslumą ir pagerinti pacientų valdymo strategijas, propaguojant daugiadisciplininį metodą, skirtą gydyti ir diagnozuoti sudėtingas problemas.
Introduction: Dyspnea and chest pain in adults are symptoms associated with a wide range of cardiopulmonary diseases, presenting a diagnostic challenge in clinical practice due to their overlapping etiologies. The aim of this literature review is to comprehensively examine the etiological factors and diagnostic methodologies associated with dyspnea and chest pain in adults. By critically analyzing existing research, this study seeks to identify common and differential causes of these symptoms, and evaluate the effectiveness of current diagnostic approaches. Methodology: The thesis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology for conducting the study. PubMed NCBI served as the primary database. Out of 4570 articles identified on PubMed using specific keyword combinations, five pertinent literature pieces were extracted. These articles were chosen based on their comparative analysis of individuals presenting symptoms of dyspnea or chest pain who underwent testing involving troponin and/or D-dimer levels. Result: The reviewed studies underscore the significance of D-dimer levels in distinguishing between cardiogenic and pulmonary causes such as aortic dissection, pulmonary embolism, and myocardial infarction, providing a valuable diagnostic tool in emergency settings. The Multidimensional Dyspnea Profile enhances the assessment of dyspnea by capturing its multidimensional nature, improving diagnostic accuracy and patient management in clinical and research settings. Combining D-dimer with cardiac troponins enhances diagnostic precision for venous thromboembolism and helps differentiate between pulmonary embolism and myocardial infarction, guiding appropriate treatment strategies. High-sensitive cardiac troponin T serves as a significant prognostic marker in acute aortic dissection type A, influencing treatment decisions and highlighting the importance of surgical intervention for improved survival outcomes. Conclusion: This thesis highlights the critical need for a comprehensive understanding of the primary causes and effective diagnostic methods for dyspnea and chest pain, underscoring the challenges of differentiating between cardiogenic and pulmonary origins. It emphasizes the importance of integrating clinical assessments with advanced diagnostic tools to enhance accuracy and improve patient management strategies, advocating for a multidisciplinary approach to address the complexities involved in treatment and diagnosis.