心内膜下心肌梗死的常见误诊病例浅析

目的:探讨心内膜下心肌梗死的常见误诊原因及对策。方法:回顾性分析9例心内膜下心肌梗死患者的病历资料,包括病史、系统体格检查,ECG、心肌酶谱、胸片、超声心动图检查等。结果:9例心内膜下心肌梗死患者均有临床症状、ECG及心肌酶学指标的动态变化,诊断明确,以冠状动脉病变为其主要病因,在此基础上由其他因素诱导发病。结论:临床医师对心内膜下心肌梗死认识不足、对ECG和心肌酶谱的特异性动态改变未充分认识,是导致误诊的主要原因,建议详细询问病史、系统体格检查及辅助检查,综合判断明确诊断。

Misdiagnosis Analysis on Common Cases of Subendocardial Myocardial Infarction

Objective: To explore the common cause and countermeasure on subendocardial myocardial infarction''s misdiagnosis. Methods: Retrospective analysis of nine subendocardial myocardial infarction''s cases, including medical history, system physical examination, ECG, myocardial enzymes, chest radiograph, echocardiography and so on. Results: 9 cases of subendocardial myocardial infarction all had dynamic changes of clinical symptoms, ECG and myocardial enzyme. The diagnosis was definite, and coronary artery disease was their main cause, induced by other factors on above basis. Conclusion: Clinicians didn''t pay enough attention to subendocardial myocardial infarction, or were not familiar with dynamic changes of ECG and myocardial enzymes, and they were the main reason on subendocardial myocardial infarction''s misdiagnosis. The author suggested inquiring detailed medical history, systemically applying physical and laboratory examinations, and sensibly judging to diagnosis.