患者女,72岁,农民。于1996年11月23日凌晨2时,睡眠中突然头痛伴呕吐。无胸痛、胸闷、憋气和腹痛,1小时后送来我院。既往健康,无高血压、冠心病和头痛病史。查体:血压26.6/13.3kPa,体胖,痛苦表情,查体合作,口唇无紫绀,颈静脉无怒张,双肺呼吸音清,未闻及干湿啰音,心音清,无杂音,心律齐,腹平软无压痛,肝、脾未触及。心电图示:急性下壁心肌梗死。病人步行10米进入病房,约2分钟后突然意识丧失,颈动脉搏动消失。心电图示:心室纤颤。立即行心肺复苏术,经抢救无效死亡。 教训与体会 不典型急性心肌梗死临床常见,若 Female patient, 72 years old, farmer. At 2:00 on November 23, 1996, a sudden headache with vomiting during sleep. No chest pain, chest tightness, suffocation and abdominal pain, 1 hour after delivery to our hospital. Previous health, no history of hypertension, coronary heart disease and headache. Examination: blood pressure 26.6 / 13.3kPa, body fat, painful facial expression, physical examination cooperation, lips cyanosis, no jugular vein engorgement, lung breath sounds clear, no smell and wet and dry rales, clear heart sound, no noise, heart rhythm Qi, abdominal tenderness without tenderness, liver, spleen not touched. ECG shows: acute inferior myocardial infarction. Patient walking 10 meters into the ward, about 2 minutes after a sudden loss of consciousness, carotid artery pulse disappeared. ECG shows: ventricular fibrillation. Cardiopulmonary resuscitation immediately, after the rescue died. Lessons and experiences of atypical acute myocardial infarction clinical common, if