Not a typical misdiagnosis of acute myocardial infarction.doc

 PAGE \* MERGEFORMAT 8 Not a typical misdiagnosis of acute myocardial infarction [Keywords: myocardial infarction diagnosis In our hospital in 2005 -2009 were treated with acute myocardial infarction (AMI) patients with 524 cases, including early disease misdiagnosed in 38 cases, the misdiagnosis rate of 7.25%. Clinical manifestations are not typical, accounting for the same period patient is not typical AMI 15.45% (246 cases). are as follows. 1 Clinical data 1.1 General Information of this group 20 males and 18 females, aged 45-85 years. The basis of heart disease: coronary heart disease in 16 cases, 6 cases of hypertensive heart disease, chronic obstructive pulmonary heart disease in 4 cases, no heart disease 12 cases. 16 cases of type 2 diabetes mellitus, pulmonary infection, chronic bronchitis, hypertension, chronic renal insufficiency in 26 cases. 1.2 Methods The dynamic observation of ECG and cardiac injury markers, all cases were diagnosed as AMI. Admission 8h, the main consideration of other diseases or missed diagnosis, did not use thrombolysis, anticoagulation, and (or) anti-platelet aggregation and other treatment for the misdiagnosed cases. 1.3 misdiagnosis misdiagnosed as gastrointestinal diseases in this group 16 cases, mainly abdominal pain, followed by abdominal distension, diarrhea, nausea, vomiting, misdiagnosed as peptic ulcer, acute cholecystitis, acute pancreatitis, acute enteritis, misdiagnosed as nervous system diseases 10 cases, the performance of repeated syncope, disturbance of consciousness, paralysis, repeated vertigo, body extreme fatigue, diagnosed as transient ischemic attack, cerebral infarction, vertebrobasilar insufficiency, respiratory disease, 6 cases misdiagnosed as asthma attacks, pulmonary embolism , septic shock, the other were misdiagnosed as gingivitis, frozen shoulder, cervical spondylosis. which is not typical of 24 cases with ECG, non-specific ST segment and T wave changes in 16 cases