Nicholas A S, DeBias D A, Ehrenfeuchter W, England K M, England R W, Greene C H, Heilig D, Kirschbaum M
Br Med J (Clin Res Ed). 1985 Jul 6;291(6487):13-7. doi: 10.1136/bmj.291.6487.13.
Sixty two patients were randomised to be seen by osteopathic physicians for palpation of the thoracic paravertebral soft tissue, T1-T8. Twenty five patients had clinically confirmed acute myocardial infarction. Of the remainder, 22 without known cardiovascular disease served as controls and 15 were placed in an excluded group because of diagnosed cardiovascular disease other than myocardial infarction. Observations were described in predetermined standard terminology. The control group was found to have a low incidence of palpable changes throughout the thoracic dorsum, and these changes were uniformly distributed from T1 to T8. Examination of the group with myocardial infarction disclosed a significantly higher incidence of soft tissue changes (increased firmness, warmth, ropiness, oedematous changes, heavy musculature), confined almost entirely to the upper four thoracic levels. The 15 patients who were excluded from the experimental group because they had various cardiovascular diseases other than myocardial infarction also showed significantly different changes on palpation compared with the group with myocardial infarction. These findings suggest that myocardial infarction is accompanied by characteristic paravertebral soft tissue changes which are readily detected by palpation.
62名患者被随机分配由整骨医生触诊胸段脊柱旁软组织，范围为T1 - T8。25名患者临床确诊为急性心肌梗死。其余患者中，22名无已知心血管疾病的患者作为对照组，15名因诊断为除心肌梗死外的心血管疾病而被归为排除组。观察结果用预先确定的标准术语描述。发现对照组整个胸背部可触及变化的发生率较低，且这些变化从T1到T8均匀分布。对心肌梗死组的检查发现软组织变化（硬度增加、发热、条索状、水肿变化、肌肉发达）的发生率显著更高，几乎完全局限于上四个胸段水平。因患有除心肌梗死外的各种心血管疾病而被排除在实验组之外的15名患者，与心肌梗死组相比，触诊时也显示出明显不同的变化。这些发现表明，心肌梗死伴有特征性的脊柱旁软组织变化，通过触诊很容易检测到。
