3例误诊为急性冠脉综合征实施介入诊治死亡病例的启示

Three Death Cases of Patients with Erroneous Diagnosis of Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

探讨3例被误诊为急性冠脉综合征(ACS)而急诊实施介入诊治死亡病例的临床特点及误诊原因,提高对ACS的诊断意识。收集我院比较典型的3例误诊死亡病例进行回顾性分析。3例死亡病例中1例为肺栓塞、1例为主动脉夹层动脉瘤(AD)、1例为流行性出血热,3例均实施了冠状动脉造影,1例于前降支植入了1枚支架。ACS患者临床表现复杂,误诊原因多为首诊医师思路狭窄,应充分利用现代影像技术,仔细分析临床症状和体征,可减少误诊死亡的发生。

To elucidate clinical characteristics and reasons of erroneous diagnosis in 3 death cases of patients with acute coronary syndrome （ACS} undergoing percutaneous coronary intervention, and to improve diagnosis ability in patients with ACS. Three death cases of patients with erroneous diagnosis of acute coronary syndrome undergoing percutaneous coronary intervention were collected retrospectively. Erroneous diagnosis in those three cases includes pulmonary embolism, aortic dissection and hemorrhagic fever respectively. All three patients＇ underwent coronary angiography and one patient underwent single stent implantation. Patients with ACS have complex clinical presentation, and one of reasons of erroneous diagnosis is that doctors have a narrow differentiation ideas. To reduce such a mistake, modern imaging techniques should be used and doctors should analyze clinical presentation and signs carefully.