论文部分内容阅读
心尖肥厚型心肌病是原发性肥厚型心肌病的特殊类型,临床上极易误诊。现将我们收治的2例误诊为冠心病的病例报道如下。 例1,女,31岁,以胸骨后压榨性疼痛伴憋气1天,于1990年4月7日入院。查体:T36℃,BP13/8kPa,心肌酶学检查CPK、SGOT、LDH均在正常范围,心电图示左心室高电压,I、aVL、V_2—V_6导联ST段下降>0.05mv,T波深倒,Ⅲ、aVF导联深q波、ST段抬高0.1mv,诊断为冠心病,急性下壁心肌梗塞。入院后给硝酸甘油及营养心肌等药物治疗后症状缓解。遂行心脏B超检查发现室间隔自膜部至心尖部逐渐增厚,靠近心尖部厚达2.6cm,内部回声不均,可见杂乱光斑光点。提示心尖肥厚型心肌病,用β受体阻滞剂治疗2月好转出院。出院后每年复查两次至今,心电图一直无明显改变。最后诊断为心尖肥厚
Apical hypertrophic cardiomyopathy is a special type of primary hypertrophic cardiomyopathy, clinically very easy to misdiagnosis. Now we received 2 cases of misdiagnosed as coronary heart disease reported as follows. Example 1, female, 31 years old, with sternal back pain associated with suffocation 1 day, was admitted on April 7, 1990. Examination: T36 ℃, BP13 / 8kPa, myocardial enzymes CPK, SGOT, LDH were in the normal range, ECG showed left ventricular high voltage, I, aVL, V_2-V_6 lead ST segment decreased> 0.05mv, T wave depth Down, Ⅲ, aVF lead deep q wave, ST segment elevation of 0.1mv, diagnosis of coronary heart disease, acute inferior myocardial infarction. After admission to the nitroglycerin and other nutrients after myocardial infarction relieve symptoms. Carry out the B-ultrasound examination revealed that the septum from the Ministry of membrane to the apex gradually thickening, near the apex thickness of 2.6cm, the internal echo uneven, visible mess spots spots. Tip apical hypertrophic cardiomyopathy with β-blockers improved in February out of hospital. After discharge twice a year so far, the ECG has been no significant change. Finally diagnosed as apical hypertrophy