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急性心肌梗塞多以典型症状而起病,也有少数患者起病时症状不典型,特别是老年患者症状非典型者多见。症状非典型心肌梗塞起病症状多样化,病性变化快,病死率较高,临床上往往延误诊断及治疗。我院近十年间收治187例,症状非典型者16例,病初均被误诊,现浅析其误诊原因,探讨防止误诊对策。以期降低误诊率。 1 临床资料 1.1 一般资料:本组16例,男9例,女7例,年龄42～68岁,平均58岁。误诊为急性胃炎6例,急性胆囊炎4例,急性胰腺炎2例,发热待查2例,肺部感染2例,误诊时间10～48小时,最长达3天。 1.2 临床表现:病史:高血压病2例,冠心病心绞痛4例,胆囊炎3例,溃疡病2例,5例无任何病史。症状:16例
Acute myocardial infarction and more typical symptoms and onset, but also a small number of patients with atypical symptoms, especially in elderly patients with atypical symptoms more common. Symptoms of atypical myocardial infarction onset symptoms diversification, rapid changes in disease, high mortality, clinical diagnosis and treatment are often delayed. 187 cases of our hospital admitted to the past decade, 16 cases of atypical symptoms, the disease were initially misdiagnosed, are the reasons for misdiagnosis, to explore strategies to prevent misdiagnosis. In order to reduce the misdiagnosis rate. 1 Clinical data 1.1 General Information: The group of 16 patients, 9 males and 7 females, aged 42 to 68 years, mean 58 years. Misdiagnosed as acute gastritis in 6 cases, 4 cases of acute cholecystitis, 2 cases of acute pancreatitis, fever in 2 cases, 2 cases of lung infection, misdiagnosis time 10 ~ 48 hours, up to 3 days. 1.2 Clinical manifestations: medical history: hypertension in 2 cases, 4 cases of coronary heart disease angina, cholecystitis in 3 cases, 2 cases of ulcer disease, 5 cases without any history. Symptoms: 16 cases