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[酷似急性心肌梗死的临床表现;治疗误区]

[Clinical presentations mimicking acute myocardial infarction; therapeutic pitfalls].

作者信息

Elsman P, Alleman M A, Zijlstra F

机构信息

Afd. Cardiologie, Ziekenhuis De Weezenlanden, Zwolle.

出版信息

Ned Tijdschr Geneeskd. 1998 May 9;142(19):1057-60.

PMID:9623219
Abstract

Acute myocardial infarction remains one of the commonest causes of death. The pathogenesis is usually an occluding thrombus superimposed on a ruptured atherosclerotic plaque. However, several cardiac as well as non-cardiac diseases may give a presentation remarkably similar to acute myocardial infarction. Four patients are described, one woman aged 56 and three men aged 72, 63 and 60 years, who displayed the typical symptoms and ECG signs of acute myocardial infarction. The real conditions, however, were gallstones in two, a phaeochromocytoma in one and myocarditis in one. Two patients died, partly as the consequence of the failure to arrive at the correct diagnosis in time; the other two patients after adequate treatment were discharged in good condition.

摘要

急性心肌梗死仍然是最常见的死亡原因之一。其发病机制通常是在破裂的动脉粥样硬化斑块上形成阻塞性血栓。然而,一些心脏和非心脏疾病可能会表现出与急性心肌梗死非常相似的症状。本文描述了4例患者,1名56岁女性和3名分别为72岁、63岁和60岁的男性,他们表现出急性心肌梗死的典型症状和心电图特征。然而,实际情况是,其中2例为胆结石,1例为嗜铬细胞瘤,1例为心肌炎。2例患者死亡,部分原因是未能及时做出正确诊断;另外2例患者经过适当治疗后康复出院。

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