摘要
Abstract
Objective To analyze the causes of aortic dissection misdiagnosed as acute myocardial infarction(AMI)in patients,and to provide the countermeasures.Methods The clinical data of 3 patients with aortic dissection misdiagnosed as AMI from January 2000 to July 2024 were retrospectively analyzed.The literature of aortic dissection misdiagnosed as AMI from 2000 to 2024 was searched in China National Knowledge Infrastructure(CNKI),and the characteristics and causes of misdiagnosis were summarized.Results After searching,5 articles were selected(7 patients were misdiagnosed as myocardial infarction,and the misdiagnosis lasted 2-72 h).Three patients in our hospital(misdiagnosis duration of 24-48 h)and 7 patients retrieved were ad-mitted due to chest pain,with dizziness,pharyngeal discomfort,precordial pain in 1 patient respectively,and back pain in 3 patients.Six patients had a history of hypertension.Electrocardiogram showed features of acute inferior myocardial infarction in 4 patients,ST-segment elevation in 8 patients,T-wave inversion and ST-segment depression in 2 patients.Myocardial enzymes were elevated in 2 patients.All patients were misdiagnosed as AMI.All 10 patients were diagnosed by aortic CT angiography and echocardiography.Renal failure,oliguria and heart block occurred in 1 patient during conservative treatment,1 patient died of sudden hypotension before planned operation,6 patients were given drug treatment,and 2 patients gave up treatment.Finally,5 patients died.One patient was initially treated,transferred to a superior hospital in stable condition and lost to follow-up.Three patients were discharged after con-servative treatment.The symptoms of 1 patient were relieved after treatment and was transferred to a superior hospital for treatment.Conclusion When acute chest pain is the main symptom in patients with aortic dissection accompanied by ST-T changes,it is easy to be confused with AMI.In order to reduce or eliminate the risk of misdiagnosis and improve the prognosis,it is necessary to be high-ly vigilant in clinical practice,through detailed inquiry,careful physical examination and early implementation of imaging examination.关键词
主动脉夹层/误诊/急性心肌梗死/CT血管成像/胸痛/心电图/预后Key words
Aortic dissection/Misdiagnosis/Acute myocardial infarction/CT angiography/Chest pain/Electrocar-diogram/Prognosis分类
医药卫生
