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目的分析临床表现不典型的心肌梗死误诊为扩张型心肌病的原因,提高心肌梗死与扩张型心肌病鉴别诊断水平。方法回顾分析2例误诊为扩张型心肌病的心肌梗死的临床资料。结果 2例均表现为反复胸闷、气短,入院前加重,心电图检查提示频发室性早搏或房性早搏,经超声心动图检查误诊为扩张型心肌病,予相应治疗,病情加重,经核素心肌灌注显像和冠状动脉造影检查确诊为心肌梗死,例1行冠状动脉介入治疗,例2予保守治疗,2例均病情缓解后出院。结论核素心肌灌注显像检查在心肌梗死与扩张型心肌病的鉴别诊断中具有重要意义,可避免临床表现不典型心肌梗死的误诊。
Objective To analyze the causes of misdiagnosis of myocardial infarction with atypical clinical manifestations as dilated cardiomyopathy and to improve the differential diagnosis of myocardial infarction and dilated cardiomyopathy. Methods The clinical data of 2 cases of myocardial infarction misdiagnosed as dilated cardiomyopathy were retrospectively analyzed. Results 2 cases showed repeated chest tightness, shortness of breath, aggravated before admission, ECG showed frequent premature ventricular contractions or atrial premature beats by echocardiography misdiagnosed as dilated cardiomyopathy, to the corresponding treatment, exacerbations, by the radionuclide Myocardial perfusion imaging and coronary angiography were diagnosed as myocardial infarction. In case 1, coronary intervention was performed. In case 2, conservative treatment was performed. All patients were discharged after being relieved. Conclusion Radionuclide myocardial perfusion imaging in the differential diagnosis of myocardial infarction and dilated cardiomyopathy is of great significance, to avoid misdiagnosis of clinical manifestations of atypical myocardial infarction.