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有关青少年发生心肌梗塞报道较少,而冠脉造影正常的心肌梗塞发病率更低。作者报道3例年龄<20岁青少年发生急性心肌梗塞的临床和血管造影学特点。方法:3例急性心肌梗塞患者年龄均<21岁。心电图改变均提示急性心肌缺血。患者除服用硝酸盐和心痛定外,2例在出现急性心肌缺血症状的3小时内接受了静脉溶栓治疗。随后心电图均出现Q波,提示为透壁心肌梗塞。对3例患者在梗塞后1周进行选择性冠脉造影和左室造影。并同时分析其临床和实验结果。结果:患者都存在一种以上的冠心病易患因素。3例冠脉造影结果均正常。心室造影其中1例显示前间壁运动无力、射血分数稍低,余2例基本正常。并对3例患者分别随访3、6、12个月后,心电图仍显示Q波.
There are fewer reports of myocardial infarction in adolescents and a lower incidence of myocardial infarction with normal coronary angiography. The authors report clinical and angiographic features of 3 acute myocardial infarction in adolescents <20 years of age. Methods: All three patients with acute myocardial infarction were 21 years old. ECG changes are prompted acute myocardial ischemia. In addition to taking nitrates and nifedipine, 2 patients received intravenous thrombolysis within 3 hours of onset of acute myocardial ischemia. Q wave were followed by ECG, suggesting that transmural myocardial infarction. Three patients underwent selective coronary angiography and left ventricular angiography 1 week after infarction. And at the same time analyze its clinical and experimental results. Results: All patients had more than one predisposition to coronary heart disease. Three cases of coronary angiography were normal. One case of ventricular angiography showed anterior wall motion weakness, ejection fraction lower, more than 2 cases were normal. And three patients were followed up for 3, 6, 12 months later, the Q wave still shows ECG.