栓塞致扩张型心肌病患者AMI急诊干预一例

冠状动脉急性栓塞导致的AMI在临床工作中并不少见，但常因临床症状的非特异性而导致误诊，最常误诊为缺血性心肌病合并AMI。该文报道1例因突发胸痛就诊于急诊的老年女性，急性非ST段抬高型心肌梗死（ NSTEMI ）诊断明确，合并心脏扩大、心房颤动。初诊为缺血性心肌病合并AMI，后经急诊介入干预，修正诊断为扩张型心肌病合并冠状动脉急性血栓栓塞。并根据其临床及介入干预特点，对该类患者如何识别及如何干预进行了分析和阐述。该例提示急诊介入医生，对于栓塞高危患者发生AMI时，应考虑到冠状动脉栓塞的可能性。

An acute coronary intervention to an AMI patient caused by embolism with dilated cardiomyopathy

Acute coronary embolism caused by acute myocardial infarction （ AMI ） is common in clinical work However , it often be misdiagnosed due to its non-specific clinical symptoms.The most frequently misdiagnosis is ischemic heart disease complicated AMI.In this article, we described an old female patient , who has an clinic history of dilated cardiomyopathy and atrial fibrillation , and meet an acute chest pain which is diagnosed non-ST-elevator myocardial infarction （ NSTEMI ）.She was diagnosed as ischemic heart disease combined with AMI at first time.Then, she was diagnosed as Dilated cardiomyopathy with acute coronary artery thrombosis after the coronary intervention.We further analyzed and elaborated how to identify and intervene this class of patients.The case prompted the emergency interventional doctor should take account the possibility of coronary embolism when meet an AMI patient with high risks of embolism.