论文部分内容阅读
急性心肌梗塞发病率有逐年上升趋势,且病死率高,要做到正确识别和及时处理应注意以下几点:①对不典型的胸痛胸闷并有心衰症的病者应想到有心梗的可能。②心电图表现不典型,一般在发病一两天内就诊者其心电图约有60%左右不大典型,特别是高侧壁、后壁、小灶块心内膜下梗塞,传导阻滞等均需密切观察。③对可疑患者要系统追踪观察,不可凭一两次心电图否定急性心肌梗塞而延误诊治。④在症状鉴别诊断上应注意那些不痛型心梗、腹痛型心梗、脑型心梗、放射部不典型心梗,其他表现还有如喘息、休克、心律失常等。作者认为要早期诊断不典型心梗必须依据临床症状、心电图和心肌酶学等检查,综合分析才有利于确诊。
The incidence of acute myocardial infarction has a rising trend year by year, and the high case fatality rate, to achieve the correct identification and timely treatment should note the following: ① atypical chest pain and heart failure patients should think of myocardial infarction may. ② ECG atypical, usually within a day or two of the onset of the doctor’s ECG about 60% is not typical, especially in the high side wall, posterior wall, small block subendocardial infarction, conduction block, etc. must be closely observed . ③ suspicious patients to track the system to observe, not with one or two negative ECG deny the diagnosis and treatment of acute myocardial infarction. ④ in the differential diagnosis should pay attention to those who do not pain myocardial infarction, abdominal pain myocardial infarction, cerebral infarction, radiological atypical MI, other manifestations such as wheezing, shock, arrhythmia and so on. The authors believe that to early diagnosis of atypical myocardial infarction must be based on clinical symptoms, electrocardiogram and myocardial enzymes and other tests, a comprehensive analysis is conducive to the diagnosis.