青年人因大量饮酒诱发不典型心肌梗死一例报道并文献复习  

Atypical Myocardial Infarction Associated With Heavy Alcohol Intake Among Young Adults: A Case Report and Review of Literatures

作　　者：任慧玲[1] 黄素芳[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院急诊科,湖北省武汉市430030

出　　处：《中国全科医学》2015年第24期2979-2982,共4页Chinese General Practice

摘　　要：目的总结探讨青年人心肌梗死的临床特点及高危因素,提高对青年人心肌梗死的认知,减少漏诊发生。方法对1例因大量饮酒诱发不典型心肌梗死青年患者的临床资料进行分析,并检索复习国内外相关文献。结果本例患者仅以醉酒后头晕、乏力伴胸闷,无胸痛,血压低为主要临床表现前来就诊,病初给予多巴胺、补液等对症治疗,血压基本恢复正常,症状好转,要求出院。但考虑其异常指标,建议入院观察,后经床旁胸部X线片、肺部非创伤性血管成像(CTA)及冠状动脉造影检查确诊为非ST段抬高性心肌梗死。行经皮冠状动脉介入术(PCI)后3 d康复出院。结论对于没有典型临床表现的青年人,尤其以大量饮酒后前来就诊者,要考虑心肌梗死的可能。与急性乙醇中毒相鉴别,加强对主诉良好但指标异常患者的深层次分析,做到对疾病的早期识别。Objective To summarize and explore the clinical characteristics and high risk factors of myocardial infarction （ MI） among young adults , so as to improve the understanding of MI among young adults and reduce the rate of missed diagnosis.Methods Clinical data of one case with atypical myocardial infarction associated with heavy alcohol intake were followed up and analyzed , and relevant literatures at home and abroad were reviewed .Results The patient visited doctors for dizzy, acratia with chest tightness but with no pain , and low blood pressure.He was treated with fluid replacement therapy , such as dopamine and so on in the early period , then blood pressure returned to normal level and symptoms improved , so he wanted to leave hospital.However, the abnormal indicators existed , the patient was suggested to be admitted for observation .Later, the patient was confirmed as non -ST-elevation myocardial infarction （NSTEMI） according to the results of chest radiograph , lung CTA, and coronary angiograph examination .Three days after the percutaneous coronary intervention （ PCI） surgery, the patient was cured and discharged .Conclusion MI should be considered for young patients with atypical clinical manifestation , especially for those who visit doctors after heavy alcohol drinking .In order to make early diagnosis , it should be differentiated from acute alcoholism by the deep analysis of patients with mild complaints and abnormal indicators .

关 键 词：心肌梗死 青年人 饮酒 临床特点 

分 类 号：R542.22[医药卫生—心血管疾病]