不典型急性心肌梗死漏误诊分析

Analysis of the misdiagnosis and missed diagnosis of atypical acute myocardial infarction

目的:探讨急性心肌梗死(AMI)的临床特点。方法:回顾分析8年间217例AMI住院患者的临床资料。结果:36例被漏误诊的AMI患者起病时多无典型心绞痛,首发表现为呼吸困难、胸闷、面色苍白、出汗、乏力、胃肠道反应、意识障碍等症状,多数患者心电图不典型。结论:询问病史、临床症状及动态观察心电图可减少误诊漏诊。

Objective： To discuss the clinical characteristics of acute myocardial infarction（AMI）. Methods： Retrospectively analyzed the clinical data of 217 inpatients with AMI in 8 years. Results： 36 patients with AMI who were misdiagnosed and missed diagnosed had no typical angina pectoris at the onset of disease, and the first manifestations were dyspnea, chest distress, pallor, perspiration, hypodynamia, gastrointestinal reaction, disturbance of consciousness etc, and the electrocardiograms of most patients were untypical. Conclusion： Misdiagnosis and missed diagnosis could be decreased by asking medical history, clinical symptoms as well as observing dynamic electrocardiogram motion.