临床误诊误治Issue(2)：12-15,4.DOI:10.3969/j.issn.1002-3429.2016.02.003
酷似急性心肌梗死的应激性心肌病诊疗回顾分析
Retrospective Analysis of Diagnosis and Treatment of One Case of Stress Cardiomyopathy Misdiagnosed as Acute Myocardial Infarction
赵海峰 1李颖 1付研2
作者信息
- 1. 102600 北京，大兴区人民医院急诊科
- 2. 100176 北京，北京同仁医院急诊科
- 折叠
摘要
Abstract
Objective To study the pathogenesis, diagnosis and differential diagnosis measures, misdiagnosis cause and preventive measures of stress cardiomyopathy ( SCM) . Methods Clinical data of one case of SCM misdiagnosed as acute myocardial infarction ( AMI) was retrospectively analyzed in our hospital. Results The patient was admitted for chest pain, chest tightness and palpitations for ten hours preceded by an emotional stressor. The electrocardiogram ( ECG) showed ST seg-ment elevation of Ⅱ,Ⅲ, aVF and V1 ~V6 . The patient had an increase in creatine kinase MB fraction and cardiac troponin I. AMI was considered at first and the patient underwent immediate treatment for percutaneous coronary intervention ( PCI) . But coronary angiography was normal. The result of left ventricular angiography was the one of apical ballooning or hypokinesia of the apex of the heart. The diagnosis of SCM was eventually confirmed. The patient's clinical symptoms improved after the medication of Aspirin, Metoprolol, Enalapril, Rosuvastatin, Antisterone, and Low Molecular Heparin. The patient was dis-charged after the symptom was improved and the follow-up was lost . Conclusion SCM may mimic AMI. It is necessary to reduce or avoid misdiagnosis and mistherapy and to raise awareness of SCM, widen diagnostic thinking and make differential diagnosis carefully.关键词
心肌疾病/误诊/心肌梗死Key words
Cardiomyopathy/Misdiagnosis/Myocardial infarction分类
医药卫生引用本文复制引用
赵海峰,李颖,付研..酷似急性心肌梗死的应激性心肌病诊疗回顾分析[J].临床误诊误治,2016,(2):12-15,4.
