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急性心肌梗塞是内科危重病症之一,其特点是,发病急、进展快、死亡率高。有典型临床症状和心电图表现者一般诊断不难。不典型者易误诊漏诊,现将我院31例误漏诊病例如以分析,讨论如下。1 因上腹部疼痛伴恶心呕吐误诊消化道疾病9例 举例:男,57岁,因在进食中突然出现上腹部疼痛伴恶心呕吐半小时来诊。查体:急性面容,血压14/9kPa,心率87次/分,律齐、无杂音。剑突下轻压痛,诊为“急性胃炎”。给予654-210mg肌注,15分钟后症状仍不缓解,患者烦燥不安,胸闷气促,急做心电图示急性前壁心肌梗塞。 讨论:急性心肌梗塞因迷走神经反射而出现消化道症状,以下壁心梗为多见。但其他部位的心梗也应受到重视。此例患者
Acute myocardial infarction is one of the critical medical conditions, which is characterized by acute onset, rapid progression and high mortality. A typical clinical symptoms and ECG performance of the general diagnosis is not difficult. Atypical misdiagnosis misdiagnosis, now in our hospital 31 cases of misdiagnosis, for example, to analyze and discuss as follows. 1 due to upper abdominal pain with nausea and vomiting misdiagnosed digestive diseases 9 cases: male, 57 years old, due to sudden appearing in the upper abdominal pain with nausea and vomiting for half an hour to diagnosis. Physical examination: acute face, blood pressure 14 / 9kPa, heart rate 87 beats / min, law Qi, no noise. Slight soft xiphoid, diagnosed as “acute gastritis.” Give 654-210mg intramuscular injection, 15 minutes after the symptoms are not relieved, the patient was irritable, chest tightness, shortness of breath, urgent ECG showed acute anterior myocardial infarction. Discussion: Acute myocardial infarction due to vagal reflex gastrointestinal symptoms, the following wall myocardial infarction is more common. However, myocardial infarction in other areas should also be taken seriously. This patient