10例心尖肥厚型心肌病诊断及误诊分析

目的:探讨心尖肥厚型心肌病(AHCM)临床特点,提高诊断水平。方法:对10例AHCM患者进行病史回顾,并对体格检查、心电图、超声心动图、左室造影及核磁共振结果进行分析。结果:AHCM患者病史不典型,但是心电图有特征性改变,超声心动图提示心尖区增厚7例,左室造影提示舒张期呈"黑桃"型改变3例,初诊误诊为冠心病3例。结论:AHCM易被误诊为冠心病,超声心动图是诊断该病的重要手段,必要时可做核磁共振检查。

Diagnostic and misdiagnostic analysis of 10 patients with apical hypertrophic cardiomyopathy

Objective To explore the clinical manifestation of apical hypertrophic cardiomyopathy（AHCM）and improve the diagnosis level of AHCM.Method The history review,physical examination,electrocardiogram,echocardiogram,left ventriculography and nuclear magnetic resonance results of 10 cases with AHCM were analyzed.Results The history of AHCM was not typical,but its ECG had characteristic changes.Nine cases had apical wall thickening in echocardiogram,3 cases had a ＂spade-like＂ configuration on left ventriculogram,3 cases were misdiagnosed as coronary heart disease initially.Conclusion AHCM is easy to be misdiagnosed as coronary heart disease,echocardiogram plays an important role in the diagnosis of AHCM,in patients with suspicion of AHCM and inadequate echo image,the use of MRI should be considered.