| Causes and characteristics of the chest pain(in the chest-pain clinic). |
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Yong Sun Choi, Hye Sook Suh, Young Hoon Yoo, Hyung Soo Kim, Mee Young Kim, Jong Lull Yoon |
1Department of Family Medicine, Hangang Sacred Heart Hospital.
2Kangnam Sacred Heart Hospital, College of Medicine, Hallym University.
3Department of Occupational medicine, Chung-ju medical center, College of Medicine, Kunkook University.
4Department of Family Medicine, Hallym University Sacred Heart Hospital. |
| 흉통클리닉을 방문한 환자의 원인 질환과 증상 비교 |
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최용선, 서혜숙, 유영훈, 김형수, 김미영, 윤종률 |
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| Abstract |
Background
: Ischemic heart disease is the most important cause of the chest pain, and its frequency is increasing enormously. The purpose of this study is to find out the way of early detection and/or ruling out the cardiogenic chest pain by history taking.
Methods : From July 1996 to December 1999, 248 patients visited the chest-pain clinic and took the questionnaire about characteristics of the chest pain. And we found out the diagnosis that caused the chest pain. 46 patients of them were excluded because of the unreliable responses or uncertain diagnosis. So, we compared the characteristics of the chest pain with causes for 202 patients.
Results : The sex ratio of patients was 1.43:1(male:female). The average age was 41.8±14.0 for male and 47.3±14.8 for female. The causes of the chest pain were cardiogenic(23.2%), musculoskeletal(19.3%), psychogenic(14.8%), gastrointestinal(12.4%), and pulmonary disease(6.9%), patients with the past history of diabetes, hypertension, alcohol intake, or angina were more likely to have cardiac disease. Choking (O.R=2.19, C.I=1.08-4.44), splitting(O.R=3.38, C.I=1.24-9.21), or exploding pain (O.R=2.65, C.I=1.02-6.88) was more likely to be originated from cardiac disease. And patients with cardiogenic chest pain aggravated their symptoms by climbing the stairs (O.R=3.47, C.I=1.52-7.90). But, pricking pain(O.R=0.18, C.I=0.04-0.82) or chest pain associated with dyspepsia(O.R=0.16, C.I=0.04-069) was less likely to be originated from cardiac disease.
Conclusion : For detection and/or ruling out the cardiogenic chest pain, we have to check out characteristics of the pain, but also factors that associated with the pain or aggravating the pain. |
| 초록 |
연구배경 : 흉통 중 허혈성 심질환에 의한 흉통은 임상적으로 가장 중요하며, 그 빈도가 증가하고 있다. 이에 저자 등은 심장성 질환으로 인한 흉통을 가진 환자들의 병력청취상의 특성을 찾아내어 조기에 질병을 발견 내지는 배제하고자 연구를 실시하였다.
방법 : 1996년 7월부터 1999년 12월까지 일개 대학병원 흉통클리닉을 방문한 248명의 환자 중 설문지 내용이 부실하거나 진단이 확실치 않은 46명을 제외한 202명을 대상으로 원인질환별 흉통의 특성을 비교하였다.
결과 : 남자 119명(58.9%), 여자 83명(41.1%)으로 남녀비가 1.43:1이었다. 평균 연령은 남자 41.8 ± 14.0세, 여자 47.3 ± 14.8세였다. 원인 질환은 심장성 흉통이 47명(23.2%)으로 가장 많았고, 근골격계 39명(19.3%), 심인성 30명(14.8%), 소화기 25명(12.4%), 호흡기 14명(6.9%)이며, 기타가 47명(23.2%)이었다. 과거력상 당뇨(O.R.=5.12, C.I=1.22-21.45), 고혈압(O.R.=5.19, C.I.=1.79-15.07), 음주(O.R.=1.59, C.I.=1.13-2.25), 협심증(O.R.=12.55, C.I.= 2.60-60.72)등이 있었거나, 숨이 막힐 것 같다(O.R.=2.19, C.I.=1.08-4.44), 빠개진다(O.R.=3.38, C.I.=1.24-9.21), 터질 것 같다(O.R.=2.65, C.I.=1.02-6.88)등의 증상이 있거나, 계단 오를 때 악화되는 경우(O.R.=3.47, C.I,=1.52-7.90)에 심장성 흉통이 가능성이 높았다. 바늘로 찌르는 것 같다(O.R.=0.18, C.I.=0.04-0.82)는 증상과 소화장애가 동반되는 경우(O.R.=0.16, C.I=0.04-0.69)에는 심장성 흉통의 가능성이 떨어졌다.
결론 : 심장성 흉통의 감별진단을 위해 통증의 성격뿐 아니라 동반된 증상과 악화요인, 과거병력과 음주력 등에 대한 자세한 문진이 필요하다. |
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