论文部分内容阅读
急性心肌梗死多以持续性胸骨后疼痛为首发症状,常伴有胸闷、心慌等。以腹痛、头痛、牙痛为首发者亦有报告。我们遇到1例以左前臂麻木疼痛为唯一首发症状的急性心肌梗死病人,报道如下。患者,女,76岁。既往有高血压病、冠心病史。于早饭后出现左前臂麻木疼痛,因病人惧怕引起心脏问题合化硝酸甘油预防,结果左前臂麻木疼痛消失。至下午4时共发生4次类似情况,每次均含硝酸甘油后消失,但每次症状较前次加重。下午6时左前臂麻木疼痛,且左手不停地抖动,含化硝酸甘油无效。无胸痛、心慌等症状。就诊时间下午6时30分。查体:BP:100/65mmHg,神志清,无烦躁,左手不停抖动。双肺呼吸音清晰。心率62次/min,律齐,心音低,未及杂音。未引出病理反射。左手握力无明显降低。辅助检查:心电图:V_1V_2呈qs型,V_1～V_4ST段斜型上抬0.1～0.6ms,T波正负双向。符合急性前壁心肌
Acute myocardial infarction and more persistent chest pain as the first symptom, often accompanied by chest tightness, palpitation and so on. To abdominal pain, headache, toothache as the first person also reported. We encountered 1 case of acute myocardial infarction with numbness of the left forearm as the sole first symptom, reported below. Patient, female, 76 years old. Past history of hypertension, coronary heart disease. After the onset of the left forearm numbness after breakfast, due to fear of patients with heart problems caused by the combination of nitroglycerin prevention, the results of left forearm numbness pain disappeared. A total of 4 similar episodes occurred at 4 pm, with each disappearing after containing nitroglycerin, but each time the symptoms worsened than before. Left forearm numb pain at 6 o’clock in the afternoon, and his left hand kept shaking, containing nitroglycerin ineffective. No chest pain, palpitation and other symptoms. The doctor’s visit time is 6:30 pm Examination: BP: 100 / 65mmHg, clear consciousness, no irritability, his left hand kept shaking. Breath sounds clear lungs. Heart rate 62 beats / min, law Qi, low heart sound, no noise. Did not lead to pathological reflex. Left hand grip no significant reduction. Auxiliary examination: ECG: V_1V_2 was qs type, V_1 ~ V_4ST oblique type elevation 0.1 ~ 0.6ms, T wave positive and negative two-way. In line with acute anterior myocardial wall