焦虑障碍并发急性下壁心肌梗死1例

Anxiety disorder complicated with acute inferior myocardial infarction: an analysis of 1 case

目的分析焦虑障碍病人并发急性心肌梗死医疗措施。方法对六安市第二人民医院2017年12月收治的1例焦虑障碍病人并发急性心肌梗死病例进行回顾分析。结果病人因"睡眠差、心发急、诸多躯体不适感2个月,加重15 d"入院,诊断:焦虑障碍。给予常规抗焦虑治疗16 d,病人情绪仍不稳定,并突然出现心急、烦躁不安、胸闷、胸痛,经动态监测心电图、急诊冠脉造影示:病人右冠脉中段闭塞;之后行经皮冠状动脉介入治疗(PCI)术,病人胸闷、胸痛症状消失;然焦虑依然明显,转入精神科予以"草酸艾司西酞普兰、阿普唑仑"等治疗,病情好转出院。2周后随访,病人病情平稳。结论焦虑障碍可增加急性心肌梗死不良事件发生率;关注病人的精神状态及病情变化,有助于鉴别诊断,降低病人住院期间的意外发生。

Objective To analyze and to explore the medical measures of the disease.Methods A case report of acute myocardial infarction in a patient with anxiety disorder admitted to Lu an Second People s Hospital in December 2017 was retrospectively analyzed.Results The patient was admitted to hospital for“poor sleep,impatience,and other various physical discomfort for 2 months,aggravated for 15 days”,then diagnosed as anxiety disorder.After routine anti-anxiety treatment for 16 days,the patient s mood was still unstable,and developed sudden impatience,irritability,chest tightness,and chest pain.Dynamic monitoring of electrocardiogram and emergency coronary angiography showed middle occlusion of the right coronary artery.After the treatment of percutaneous coronary intervention(PCI),the patient s symptoms of chest tightness and chest pain disappeared,but the anxiety was still obvious.The patient was then transferred to the psychiatric department and treated with Oxacin oxalic acid and Alprazolam.Later the condition was improved and the patient was discharged.The follow-up two weeks later showed that the patient s condition was stable.Conclusions Anxiety disorders can increase the incidence of adverse events in acute myocardial infarction.Concern on the patient s mental state and changes in the condition can help differential diagnosis and reduce accidents during hospitalization.