摘要
Abstract
Objective To investigate clinical characteristics, causes of misdiagnosis and treatment, and prevention methods for Wellens syndrome (WS). Methods Clinical data of 13 (19. 1%) misdiagnosed patients among 68 WS patients undergoing selective coronary arteriography admitted between January 2013 and July 2015 was retrospectively analyzed. Re-sults Among the 13 misdiagnosed patients, 10 patients complained chest pain and dyspnea, in whom 5 patients were misdi-agnosed as having cardiac neurosis, 4 patients as having iritability myocaradial disease and 1 patient as having pericarditis;1 patient, whose symptoms were dyspnea and hypotension, was misdiagnosed as having pulmonary embolism; 1 patient com-plained retrosternal burning pain, was misdiagnosed as having reflux esophagitis;1 patient complained throat tightening, was misdiagnosed as having pharyngitis. Misdiagnosed time was 1-7d. All the 13 patients were confirmed diagnosis by comprehen-sive analysis of clinical manifestation, results of electrocardiogram ( ECG) and coronary arteriongraphy ( CAG) . Stenosis level of the left anterior descending artery ( LAD) equal or more than 70% of 11 patients underwent the percutaneous coronary in-tervention ( PCI) , and then oral medication was followed for 1-3 d, and symptoms of the 11 patients were completely relieved, and no recurrence was found during 12-28 months of follow-up. Stenosis level of the LAD less than 70% of 2 patients accepted long-time medication, and no recurrence of angina pectoris was found during 14-22 months of follow-up. Conclusion Lack of understanding of the clinical and ECG features of WS patients is the main cause of misdiagnosis, and radiating pain caused by myocardial ischemia induces the other cause of misdiagnosis.关键词
Wellens综合征/误诊/神经官能症/心肌病,应激性Key words
Wellens syndrome/Misdiagnosis/Neurosis/Cardiomyopathy/excitability分类
医药卫生
