[酷似急性前壁心肌梗死的肺栓塞：诊断陷阱]

[Pulmonary embolism mimicking acute anterior myocardial infarction: diagnostic trap].

作者信息

Yaméogo N V, Mbaye A, Kagambèga L J, Diack B, Pessinaba S, Hakim R, Ndiaye M B, Bodian M, Diao M, Sow D Diagne, Kane M, Kane A

机构信息

Service de cardiologie, hôpital général de Grand Yoff, Dakar, Sénégal.

出版信息

Ann Cardiol Angeiol (Paris). 2011 Jun;60(3):169-72. doi: 10.1016/j.ancard.2010.12.011. Epub 2011 Jan 11.

DOI:10.1016/j.ancard.2010.12.011

PMID:21272851

Abstract

Pulmonary embolism remains the major malingerer of acute chest disease. The clinical and electrocardiographic manifestations may deviate to a diagnosis of myocardial infarction. We report a case of bilateral pulmonary embolism in a patient of 50 years. The electrocardiogram showed ST elevation in anteroseptal and lateral leads. The diagnosis of acute myocardial infarction was selected and a fibrinolysis achieved. Getting out under beta-blocker therapy, antiplatelet, statin and angiotensin-converting enzyme inhibitors after 10 days hospitalization, the patient was readmitted one month later for a massive pulmonary embolism. Coronary angiography performed after the second hospitalization was normal.

摘要

肺栓塞仍然是急性胸部疾病的主要伪装者。其临床和心电图表现可能会使人误诊为心肌梗死。我们报告一例50岁患者的双侧肺栓塞病例。心电图显示前间隔和侧壁导联ST段抬高。诊断为急性心肌梗死并进行了纤溶治疗。住院10天后在β受体阻滞剂、抗血小板药物、他汀类药物和血管紧张素转换酶抑制剂治疗下出院，患者在1个月后因大面积肺栓塞再次入院。第二次住院后进行的冠状动脉造影正常。