急性前壁心肌梗死患者手腕疼痛的罕见表现：病例报告及文献复习。
Unusual and very rare presentation of wrist pain in a man with acute anterior myocardial infarction, a case report and literature of review.
机构信息
Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran.
Department of Cardiology, Cardiovascular Diseases Research Centre, Birjand University of Medical Sciences, Birjand, Iran.
出版信息
J Cardiothorac Surg. 2024 Aug 14;19(1):482. doi: 10.1186/s13019-024-02976-5.
BACKGROUND
As acute myocardial infarction (AMI) prevalence is increasing because of lifestyle changes, the incidence of atypical symptoms in acute coronary syndrome (ACS) is rising and making misdiagnosing of this fatal event more probable. To better approach the patients with atypical symptoms, we tend to present a rare case of AMI with wrist pain.
CASE REPORT
A 41-year-old man presented to the emergency room (ER) with severe both-hand wrist pain and mild epigastric pain. His electrocardiogram (ECG) showed anterior ST-elevation myocardial infarction (MI) with an ejection fraction of 35-40%. His angiography showed severe left anterior descending artery (LAD), and first obtuse marginal artery (OM1) artery stenosis. He underwent Primary percutaneous coronary intervention (PCI). The patient recovered without serious complications and was discharged the day after PCI.
DISCUSSION
In this rare case of AMI with wrist pain, it is important to know that atypical symptoms can be present at various levels of symptoms, which prevents future misdiagnosis.
背景
由于生活方式的改变，急性心肌梗死（AMI）的患病率正在增加，急性冠状动脉综合征（ACS）的非典型症状的发病率也在上升，使得这种致命事件的误诊可能性更大。为了更好地处理具有非典型症状的患者，我们倾向于呈现一例罕见的以腕痛为表现的 AMI 病例。
病例报告
一名 41 岁男性因严重双手腕痛和轻度上腹痛到急诊室（ER）就诊。他的心电图（ECG）显示前壁 ST 段抬高型心肌梗死（MI），射血分数为 35-40%。他的血管造影显示严重的左前降支（LAD）和第一钝缘支（OM1）动脉狭窄。他接受了经皮冠状动脉介入治疗（PCI）。患者未出现严重并发症并在 PCI 后第二天出院。
讨论
在这个罕见的以腕痛为表现的 AMI 病例中，重要的是要知道非典型症状可能出现在不同程度的症状中，这可以防止未来的误诊。
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