老年急性右心室心肌梗死误漏诊18例临床分析

目的分析老年急性右心室心肌梗死的误诊、漏诊原因,降低临床误诊率。方法回顾性分析选择总参保健处在2011年1月~2014年2月收治的18例老年急性右室心肌梗死的误诊、漏诊病例资料进行回顾性分析。结果 18例误诊、漏诊患者中误诊为急性前壁心肌梗死2例,心功能不全2例,急性上腹痛2例,脑血管病2例,肺源性心脏病2例,感染性休克1例,急性咽痛1例,急性肠炎1例;仅诊断其他部位心肌梗死而漏诊急性右室心肌梗死者5例。结论老年急性右心室心肌梗死临床表现不典型,易发生误诊、漏诊,临床工作中应提高警惕,仔细辨认尽力减少误漏诊事件的发生。

Misdiagnosed acute right ventricular myocardial infarction in 18 elderly cases

Objective To analyze the causes of misdiagnosing acute right ventricular myocardial infarction （ARMI） in elderly cases for reducing clinical misdiagnostic rate. Methods The misdiagnostic data was retrospectively analyzed in 18 elderly patients with ARMI chosen from Jan. 2011 to Feb. 2014. Results Among 18 misdiagnostic cases, 2 were misdiagnosed as acute anterior myocardial infarction, 2 as cardiac insufficiency, 2 as acute epigastric pain, 2 as cerebral vascular disease, 2 as pulmonary heart disease, 1 as inflammatory shock, 1 as acute sore throat, 1 as acute enteritis, and 5 as myocardial infarction of other positions. Conclusion The symptoms of senile ARMI are not specific, so it is easily to be misdiagnosed. More attention should be paid to careful distinguishment for preventing misdiagnosis.