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目的探讨急性心肌梗死首诊误诊原因和预防措施。方法回顾分析42例急性心肌梗死首诊误诊患者的临床资料。结果首诊误诊为:左心衰17例、支气管哮喘5例、心律失常5例、急性胃炎4例、缺血性脑卒中3例、胆石症2例、不明原因休克2例、牙龈炎1例、颈椎病1例、癫痫1例、急性上呼吸道感染1例。误诊时间3~48 h。住院期间共死亡8例。结论熟悉各种不典型急性心肌梗死临床表现,动态检查心电图和心肌酶是防止误诊的关键措施。
Objective To investigate the causes and preventive measures of first misdiagnosis of acute myocardial infarction. Methods The clinical data of 42 patients with first misdiagnosis of acute myocardial infarction were retrospectively analyzed. Results The first diagnosis was misdiagnosed as: 17 cases of left heart failure, 5 cases of bronchial asthma, 5 cases of arrhythmia, 4 cases of acute gastritis, 3 cases of ischemic stroke, 2 cases of cholelithiasis, 2 cases of unexplained shock and 1 case of gingivitis , Cervical spondylosis in 1 case, epilepsy in 1 case, acute upper respiratory tract infection in 1 case. Misdiagnosis time 3 ~ 48 h. A total of 8 patients died during hospitalization. Conclusion Familiar with the clinical manifestations of various atypical acute myocardial infarction, dynamic examination of ECG and myocardial enzymes is the key measure to prevent misdiagnosis.