易误诊的原发性肥厚型心肌病  

Easily - misdiagnosed primary hypertrophic cardiomopathy

作　　者：佟锡祥[1] 栗建辉[1] 赵真[1] 赵庆春[1] 邸桂新[1] 郝冬梅[1] 陈小英[1] 孙傅[1] 姚红霞 

机构地区：[1]河北省职工医学院附属医院,071000 [2]河北省满城县医院

出　　处：《河北职工医学院学报》2000年第3期12-14,共3页Journal of Hebei Medical College for Continuing Education

摘　　要：目的：为了避免临床误诊而导致错误治疗，本文总结了３例易误诊的原发性肥厚型心肌病的病例。方法：所有病人均进行了心肌酶、心电图、胸部Ｘ光和超声心动图检查。结果：三例病人均显示有心肌酶不同项目的升高，心电图示心肌梗塞，Ｘ线示心脏扩大，超声心动图则显示为肥厚型心肌病的声像图改变。结论：原发性肥厚型心肌病在心电图上常表见为ＳＴ—Ｔ改变，左室肥厚，或左室高电压和异常Ｑ波，并由此而误诊为心肌梗塞或心肌炎。超声心动图可进行正确诊断。核磁共振更能描述本病的形态学特征。Objective To avoid misdiagnosing hypertrophic cardiomyopathy. Methods Three Cases with heart disease were examined by enzymology, electrocardiography, chest X - ray and echocardiog- raphy. Results All patients showed positive findings in enzymology, myocardial infarction in elec- trocardiography and hypertrophic cardiomyopathy in echocardiography. Conclusion Primary hyper- trophic cardiomyopathy frequently showed ST - T changes, left ventricle hypertrophy, or left ven- tricle hypervoltage and abnormal Q waves, thereby a diagnosis of myocadial infarction or myocarditis is often gained. Echocardiography can give a correct diagnosis. Nuclear - magnetic resonance is able to demonstrate a more clear morphologic appearance of hypertrophic cardiomyopathy. A more correct diagnostic rate can be attained when these three modalities are combined to utilize at the same time. Echocardiography is a good approach to detect early hypertrophic cardiomyopathy and to follow up this kind of disease.

关 键 词：心电图 肥厚型心肌病 原发性 误诊 心肌梗塞 病人 心肌酶 结论 图示 目的 

分 类 号：R542.2[医药卫生—心血管疾病] R540.41[医药卫生—内科学]