主动脉夹层误诊心肌梗死超急性期2例  

Aortic dissection misdiagnosed as myocardial infarction:two cases report

作　　者：陈英[1,2] 曹佳宁[1] 杨承健[1] 李勋[2] 

机构地区：[1]南京医科大学附属无锡第二院心内科,江苏无锡214000 [2]苏州大学附属第一医院心内科

出　　处：《临床心血管病杂志》2018年第1期102-104,共3页Journal of Clinical Cardiology

摘　　要：1病例资料病例1,男,32岁。有高血压、胃出血、吸烟史,因＂胸闷气促10min＂当地医院就诊伴恶心、冷汗,体检：血压130/80mmHg（1mmHg=0.133kPa）,神志清,呼吸平,大汗淋漓,两肺呼吸音清,心率66次/min,腹软,无压痛及反跳痛,肝脾肋下未及,双下肢不肿。在当地医院留察过程中胸闷不缓解、胸背部牵涉痛、中上腹痛,并出现双手、双足发麻。血常规：白细胞11.6×10^9/L、中性粒细胞56%,Two cases presenting with chest pain of abrupt onset were initially misdiagnosed as acute myocardial infarction.Both of their electrocardiogram（ECG）seemed to have a dynamic evolution in V1-6 lead,but myocardial injury markers were normal.The false dynamic change in ECG was because of the ECG gain.Patients who presented with chest pain,ST segment elevation in ECG,and seemed to have a dynamic evolution needed to pay more attention to the gain of ECG lead.It is important to analysis the change of myocardial injury markers,aorta CTA,MRI and echocardiography systematically in order to avoid misjudgment.

关 键 词：动脉瘤 夹层 心肌梗死 误诊 

分 类 号：R543.1[医药卫生—心血管疾病]