23例不典型心肌梗死误诊分析

23 Misdiagnosis Cases of Atypical Myocardial Infarction

目的分析不典型心肌梗死的误诊原因,以减少不典型心肌梗死的误诊率。方法本组23例误诊病例中,误诊为心绞痛4例,呼吸系统疾病2例,急性胃肠炎3例,特殊部位疼痛5例,脑梗2例,心律失常5例,尿潴留1例,更年期综合征1例。本组23例病例分别经心电图、心肌酶谱、动态心电图及冠脉造影检查后,确诊为不典型心肌梗死。结果 23例误诊病例中,22例经确诊后,给予对症治疗痊愈;1例因室颤,抢救无效死亡。结论对各种不明原因的胸闷、心悸状况,应首先给予心电图、心肌酶谱检查,以提高对不典型心肌梗死诊断的准确性,减少其误诊率。

Objective To analyze the causes of misdiagnosis of atypical myocardial infarction, in order to reduce the rate of misdiagnosis of atypical myocardial infarction. Methods 23 cases of misdiagnosed cases were analyzed, those including： misdiagnosed as angina pectoris in 4 cases, 2 cases of respiratory system disease, 3 cases of acute gastroenteritis, special site pain in 5 cases, cerebral infarction in 2 cases, 5 cases of arrhythmia, 1 case of urinary retention, 1 case of climacteric syndrome. All cases were diagnosed as atypical myocardial infarction, respectively, by electrocardiogram and myocardial enzyme spectrum, dynamic electrocardiogram and coronary arteriograpby. Results 22 cases were cured after diagnosed by symptomatic treatment ; 1 case death of ventricular fibrillation and rescue invalid. Conclusion Patients with various unexplained symptoms of chest tightness, palpitation should be given ECG and myocardial enzyme spectrum examination first, in order to improve the accuracy of diagnosis of atypical acute myocardial infarction, reduce the rate of misdiagnosis.