急性心肌梗死的不典型临床症状和心电图表现

目的总结急性心肌梗死(AMI)的不典型临床症状和心电图表现,提高AMI的诊断率。方法回顾性分析我院2009年2月至2011年7月收治的33例不典型AMI患者临床资料。结果本组20例有消化道或呼吸道或其他系统等不典型临床症状,13例无胸闷胸痛及其他部位疼痛。无明显ST段改变,仅出现病理Q波(包括小q波)8例;仅有ST-T缺血改变或损伤型抬高,无出现病理Q波9例;延缓出现梗死图形3例;常规12导联不显示梗死图形2例等不典型心电图表现。治愈出院31例,死亡2例。结论 AMI的诊断要结合临床症状及心肌酶学,仔细观察心电图的动态变化,减少漏诊和误诊。

Atypical clinical symptoms and ECG in 33 cases of acute myocardial infarction

Objective To evaluate the atypical clinical symptoms and ECG in patients with acute myo- cardial infarction （AMI）, increase the rate of diagnosis for AMI. Methods A retrospective analysis of 33 ca- ses admitted in our hospital from February 2009 to July 2011 was not typical of AMI patients clinical data. Re- suits There were atypical clinical symptoms such as gastrointestinal or respiratory or other systems in 20 cases, chest pain and other parts of the pain in 13 cases. No significant ST segment changes, only a pathological Q waves （including small q waves） in 8 cases, only ST-T ischemic changes or injury elevation, pathological Q waves in 9 cases, delay appear infarction graphics in 3 cases, conventional twelve-lead do not show the typical ECG manifestations in 2 cases. Cured 31 cases and 2 deaths. Conclusion We should combine with clinical symptoms and serum creatine kinase when diagnosised for AMI, be careful observation of the dynamic changes in the electrocardiogram, reduce misdiagnosis and misdiagnosis of acute myocardial infarction.