冠脉造影正常的老年急性心肌梗死

Normal Coronary Angiography of Elder Patient with Acute Myocardial Infarction

5例老年急性心肌梗死患者,平均年龄68岁,有心绞痛史5例,高血压史4例,糖尿病史3例,高脂血症4例,吸烟史2例。心电图诊断:前壁心梗2例,前间壁心梗2例,下室伴右室面心梗1例,Q波心梗4例,非Q波心梗1例。心脏彩超,梗死2周内室壁运动异常3例,随诊后3例均恢复正常。5例病人行冠脉造影及左心室造影结果,5例冠脉造影正常,3例左室室壁运动异常。结论:老年急性心肌梗死造影正常的原因很可能是冠脉造影局限性出现的假阴性所致。

Objective: To report five old patients with myocardial infarction in the study: mean age 69 years old. 5 patients had history of angina pectoris, 4 patients had hypertension, 3 patients complicated with diabetis mellitus, 4 patients had hyper lipemia and 2 patients had history of smoking. Electrocardio-graphy showed: anterior infarction in 2 patients, anterior septal infarction in 2 patients, inferior and right ventricular infarction in 1 patient, Q-wave infarction in 4 patients and non-Q-wave infarction in 1 patient. Echo-cardiography showed: 3 patients had left ventricular dysfunction during first two weeks and became normal during follow up. Angiography and left ventriculography were performed in 5 patients showed nor-mal coronary angiography while 3 of them with left ventricular dysfunction. Conclusion: The cause of nor-mal coronary angiography in elder patient with acute myocardial infarction might be due to the limitation of coronary angiography that caused pseudo-negative result.