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目的提高临床医生对不典型心肌梗死的认识。方法分析52例不典型心肌梗死患者的临床资料,探讨误诊、漏诊原因。结果 52例心梗患者均无典型胸痛,首发症状心悸、头晕、胸闷、腹痛、恶心、出汗、臂痛等为主,梗死部位以前壁、下壁,心内膜下心梗为主。所有病例最后均有心肌酶、肌钙蛋白及心电图特征性改变证实。结论不典型心肌梗死临床表现多样化,临床医生要提高警惕,对可疑病例及时行相关检查,明确诊断。
Objective To improve clinicians’ understanding of atypical myocardial infarction. Methods The clinical data of 52 patients with atypical myocardial infarction were analyzed to explore the causes of misdiagnosis and missed diagnosis. Results There were no typical chest pains in the 52 patients with myocardial infarction. The first symptom was heart palpitations, dizziness, chest tightness, abdominal pain, nausea, sweating and arm pain. The infarct sites were mainly anterior wall, inferior wall and subendocardial myocardial infarction. All cases were finally confirmed by cardiac enzymes, troponin and ECG changes. Conclusions The clinical manifestations of atypical myocardial infarction are diversified. Clinicians should be vigilant. The suspicious cases should be promptly checked and diagnosed in time.