13例心尖肥厚型心肌病诊断及误诊分析

Diagnostic analysis and misdiagnostic analysis of thirteen patients with apical hypertrophic cardiomyopathy

目的:总结心尖肥厚型心肌病(AHCM)的临床特点,提高对该病的诊断水平。方法:对13例AHCM的心电图、超声心动图、左室造影及磁共振结果进行分析。结果:13例AHCM中心电图有特征性改变12例,超声心动图提示心尖区增厚12例,左室造影提示舒张期呈"黑桃"形改变3例,初诊误诊为冠心病7例。结论:AHCM易被误诊为冠心病,超声心动图是诊断该病的重要手段,必要时可做心脏超声造影术或磁共振检查。

Objective： To discuss the chnical manifestation of apical hypertrophic cardiomyopathy and improve the correct diagnosis of AHCM. Methods： To analyze electrocardiogram, echocardiogram,left ventriculography, nuclear magnetic resonance results of 13 cases with AHCM. Results： 12 cases had apical wall thickening in echocardiogram, 3 cases had a ＂spade- hke＂ configuration on left ventriculogram, 7cases were misdiagnosed as coronary heart disease initially. Conclusion： AHCM is easy to be misdiagnosed as coronary heart disease, echocardiogram plays important role in the diagnosis of AHCM, in patients with suspicion of AHCM and inadequate echo images, the use of contrast echocardiography or MRI should be considered.