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目的提高对急性心肌梗死的认识,减少误诊。方法分析4例急性心肌梗死患者的临床资料,探讨误诊为急腹症的原因。结果 4例急性心肌梗死患者均无典型胸痛,梗死部位以前壁、下壁,心内膜下心肌梗死为主。所有病例心肌酶谱和肌钙蛋白、肌红蛋白均升高。结论急性心肌梗死临床表现多样化,尤以急腹症为多见,对可疑病例需及时进行心电图及心肌损伤标志物的检查,以明确诊断。
Objective To raise awareness of acute myocardial infarction and reduce misdiagnosis. Methods The clinical data of 4 patients with acute myocardial infarction were analyzed to explore the causes of misdiagnosis as acute abdomen. Results None of the 4 patients with acute myocardial infarction had typical chest pain. The anterior, inferior wall and subendocardial infarction were the main part of infarction. All cases of myocardial enzymes and troponin, myoglobin were increased. Conclusions The clinical manifestations of acute myocardial infarction are diversified, especially acute abdomen is more common. Suspicious cases need timely examination of ECG and myocardial injury markers in order to confirm the diagnosis.