摘要
Abstract
Objective To investigate clinical characteristics, early misdiagnosed causes and prevention methods for patients with non typical acute myocardial infarction ( NTAMI) . Methods Clinical data of 35 misdiagnosed patients with NT-AMI during January 2015 and January 2016 was retrospectively analyzed. Results All the patients were primarily diagnosed in Mianyang 404 hospital, and the misdiagnosed rate was 27. 78%, among whom 6 patients were early misdiagnosed as having cervical spondylosis oppression hard capsule, 6 patients as having hypotension shock, 5 patients as having acute gastroenteri-tis, 4 patients as having adhesive capsulitis, 4 patients as having acute abdomen, 3 patients as having lacunar infarction, 3 patients as having periodontitis, 2 patients as having bronchitis, 1 patient as having neurosis and 1 patient as having pneumo-nia. The average time of misdiagnosis was 3-19 h, and AMI was confirmed in all patients by examination results of electrocar-diogram ( ECG) and myocardial enzymes. Among the 33 patients, 6 patients were confirmed as having anterior wall AMI, 6 patients as having anterior wall and high lateral wall AMI, 5 patients as having inferior wall AMI, 5 patients as having high lateral wall AMI, 4 patients as having extensive anterior wall AMI, 4 patients as having inferior walls combined with left ven-tricle AMI, 3 patients as having inferior wall and right ventricle AMI, and 2 patients as having inferior and anterior walls AMI, Symptomatic treatments such as anticoagulant, thrombolysis and extension of coronary artery were performed for the 33 patients after confirming diagnosis, and then conditions were obviously improved in 32 patients, 1 patient died of treatment fu-tility, and 2 patients were discharged because of refusal of treatment. Conclusion Patients with non typical acute myocardial infarction in early period is easily misdiagnosed because of complex conditions and various clinical characteristics, clinicians should enhance learning related knowledge, comprehensively think, collect case history, carefully examine and differential di-agnosis in order to avoid misdiagnosis and mistreatment.关键词
心肌梗死/误诊/颈椎病/休克/胃肠炎Key words
Myocardial infarction/Misdiagnosis/Cervical spondylosis/Shock/Gastroenteritis分类
医药卫生
