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典型急性心肌梗死(简称心梗)临床诊断较容易.非典型急性心肌梗死因无典型胸痛,心电图无病理性Q波,心肌酶升高不明显,极易造成误诊漏诊.笔者就本院1986年以来收治的52例不典型急性心肌梗死病例作一总结,旨在提高对该病的警惕.1 临床资料1.1 一般资料:本组病例中,男34例,女18例,年龄28～84岁,平均年龄62.4岁,其中50岁以上者48例占92%.合并高血压病20例、高脂血症19例、糖尿病8例、脑梗塞7例,慢性支气管炎、肺气肿5例及多发性大动脉炎1例.1.2 病例选择:(1)无典型胸痛;(2)心电图无病理性Q波及ST段弓背向上抬高;(3)血清酶AST、CK等在发后24～48小时内升高超过正常值2倍以上.
Typical acute myocardial infarction (referred to as myocardial infarction) is relatively easy to diagnose the clinical diagnosis of atypical acute myocardial infarction without typical chest pain, ECG without pathological Q wave, elevated myocardial enzymes is not obvious, easily misdiagnosis missed diagnosis. Since the admitted 52 cases of atypical acute myocardial infarction to make a summary aimed at raising the vigilance of the disease.1 Clinical data 1.1 General Information: The group of patients, 34 males and 18 females, aged 28 to 84 years old, With a mean age of 62.4 years, of which 48 cases accounted for 92% of patients over the age of 50. 20 cases of hypertension, 19 cases of hyperlipidemia, 8 cases of diabetes, cerebral infarction in 7 cases, chronic bronchitis, emphysema in 5 cases and multiple (1) no typical chest pain; (2) ECG-free pathological Q wave and ST segment elevation of the bow back; (3) serum enzymes AST, CK, etc. after the onset of 24 to 48 hours Within the rise of more than 2 times the normal above.