异位疼痛为首发表现的急性冠脉综合征临床特点分析  

Analysis of clinical characteristics of acute coronary syndrome with ectopic pain as the first symptom

作　　者：姜继超 姜胜文 刘宗泽 何向东 JIANG Jichao;JIANG Shengwen;LIU Zongze;HE Xiangdong(Department of Cardiology,Liping County People's Hospital,Liping County,Guizhou Province,557300,China;Department of Emergency,Liping County People's Hospital,Liping County,Guizhou Province,557300,China)

机构地区：[1]贵州省黎平县人民医院心内科,贵州黎平557300 [2]贵州省黎平县人民医院急诊科,贵州黎平557300

出　　处：《蛇志》2023年第3期364-366,共3页Journal of Snake

摘　　要：目的探讨异位疼痛为首发表现的急性冠脉综合征(ACS)的临床特点,为医院胸痛中心建设及可持续发展提供理论依据。方法选择2021年1月至2023年5月在我院治疗的以异位疼痛为首发表现的急性冠脉综合征患者60例的临床资料,分析以异位疼痛为首发表现的急性冠脉综合征临床特点和误诊、漏诊主要原因及诊疗结果。结果60例以异位疼痛为首发表现的急性冠脉综合征患者中,男47例(78.33%),女13例(21.67%);首发症状主要表现为头痛、头晕,牙痛,咽痛,颈肩背痛,上腹痛,下肢疼痛等。经完善相关检查后确诊为ST段抬高型心肌梗死(STEMI)41例,不稳定性心绞痛(UA)10例,非ST段抬高型心肌梗死(NSTEMI)9例;除4例放弃治疗外,56例均治疗好转出院。结论临床表现不典型及认识不足是急性冠脉综合征误诊、漏诊的主要原因,加强对异位疼痛所致的ACS认识,及时完善相关检查并动态追踪观察可避免或减少误诊、漏诊发生。Objective To investigate the clinical characteristics of acute coronary syndrome(ACS)with ectopic pain as the first manifestation,and to provide theoretical basis for the construction and sustainable development of chest pain center in hospital.Methods Clinical data of 60 patients with acute coronary syndrome with ectopic pain as the first manifestation were selected from our hospital from January 2021 to May 2023,and the clinical characteristics,main causes of misdiagnosis,missed diagnosis and treatment results of acute coronary syndrome with ectopic pain as the first manifestation were analyzed.Results Among 60 patients with acute coronary syndrome with ectopic pain,47 were males(78.33%)and 13 were females(21.67%).The first symptoms are headache,dizziness,toothache,throat pain,neck,shoulder and back pain,upper abdomen pain,lower limb pain and so on.After improved examination,41 cases were diagnosed as ST elevation myocardial infarction(STEMI),10 as unstable angina pectoris(UA),and 9 as non-ST elevation myocardial infarction(NSTEMI).Except for 4 patients who gave up treatment,56 patients were discharged from hospital after treatment.Conclusion Atypical clinical manifestations and insufficient understanding are the main causes of misdiagnosis and missed diagnosis of acute coronary syndromes.Strengthening the understanding of ACS caused by ectopic pain,timely improvement of relevant examinations and dynamic follow-up observation can avoid or reduce the occurrence of misdiagnosis and missed diagnosis.

关 键 词：异位疼痛 首发表现 急性冠脉综合征 误诊误治 

分 类 号：R543.3[医药卫生—心血管疾病]