老年人不典型急性心肌梗塞52例临床分析

目的探讨老年人不典型急性心肌梗塞的临床特点及早期诊断方法。方法采用回顾性分析我院近10年来住院老年不典型急性心肌梗塞52例,归纳其临床特点。结果本组52例病例中,无痛型28例,占54%;其中表现为呼吸道症状者22例,占42%;出现晕厥、类似脑卒中发作者6例,占12%;异位疼痛型24例,占46%。主要表现为牙痛、颈肩痛、肢体痛及腹痛。结论老年人急性心肌梗塞可无典型胸痛症状,而呈无痛、异位疼痛等不典型表现,对可疑患者应及时行心电图、心肌酶、肌钙蛋白检查,并密切观察心电图、心肌酶、肌钙蛋白的动态变化,避免延误诊治。

Objective To investigate clinical characteristics and the methods of early diagnosis for the elderly acute myocardial infarction （AMI） patients.Methods To review the clinical data of 52 cases of elderly untypical AMI patients in hospital, to analysis and sum up clinical characteristics.Results In this group of 52 cases, there are 28 cases （54%） without pain; there are 22 cases （42%） have the symptoms of respiratory tracts; there are 6 cases （12%） occur the syncope, jut like stroke; there are 24 cases （46%） have the heterotopic pain; like toothache, neck and shoulder pain, melalgia and abdominal pain.Conclusion In the elderly AMI patients, almost a half have untypical chstpain, even without any pain, most occur heterotopic pain.If we suspect someone, we must carry out the examinations, just like ECG, cardiac muscle zymograms tests, TnI or TnT, and we must observe the dynamic states above-mentoned, and to avoid the misdiagnosis.