Schmidt G A, Panzner B, Teichmann W
Z Gesamte Inn Med. 1977 Jun 15;32(12):274-7.
In a retrospective study by means of a half-standardized method of interview in 154 patients with acute myocardial infarction and in a control group of the same age (n = 100) anamnestic data were established, particularly taking into consideration the preinfarction phase. 27% of the patients were surprised by an acute myocardial infarction without prodromal symptoms, in 32% the first occurrence of complaints of angina pectoris was during the last two months before the infarction. 41% had a preexisting angina pectoris which usually showed a crescendo-course with increasing approximation to the infarction. More than half of the patients reported on physical activity or/and emotional stress as causal factors of the preinfarction complaints. The correlation with the localisation of the infarction showed above all an occurrence of the prodromal symptoms in infarctions of the anterior wall and in lesions of the myocardium which in most cases could be ascertained only enzymatically. A greater accumulation of the prodromi was furthermore found in younger patients, in hypertension and preexisting restriction of the heart function. 70% of the patients with warning symptoms consulted a physician because of their heart complaints. In the control group 22% of the persons reported on heart complaints.
在一项回顾性研究中,采用半标准化访谈方法,对154例急性心肌梗死患者及同年龄对照组(n = 100)收集既往史资料,尤其考虑了梗死前期。27%的患者急性心肌梗死发作时无先兆症状,32%患者首次出现心绞痛症状是在梗死前的最后两个月。41%的患者既往有稳定型心绞痛,且通常呈进行性加重,发作频率逐渐增加,直至心肌梗死。超过半数的患者报告身体活动或/和情绪应激是梗死前不适的病因。梗死部位与先兆症状的相关性显示,在前壁梗死和心肌损伤(多数情况下只能通过酶学检测确定)中,先兆症状尤为常见。此外,在年轻患者、高血压患者以及既往存在心脏功能受限的患者中,先兆症状更为多见。70%有警示症状的患者因心脏不适咨询过医生。在对照组中,22%的人报告有心脏不适。