摘要
目的 探讨心尖肥厚型心肌病临床特点及误诊原因.方法 分析28例心尖肥厚型心肌病临床表现、心电图、超声心动图、冠脉造影及左心室造影特征.结果 28例心尖肥厚型心肌病合并有心电图异常,其中25例呈心尖肥厚型心肌病特殊心电图改变,8例ST-T动态改变.心脏超声提示心尖肥厚者22例.冠脉造影25例正常,前降支中段肌桥2例,回旋支狭窄20%1例.左室造影提示黑桃A样改变23例,5例表现心尖部心腔狭小.12例误诊为冠心病,其中4例为非ST段抬高心梗.结论 心尖肥厚型心肌病较易误诊为冠心病.心电图、超声心动图,尤其是左心室及冠脉造影对心尖肥厚型心肌病诊断与鉴别诊断有重要意义.
Objective To determine the clinical characteristics and reasons for diagnostic error of apical hypertrophic cardiomyopathy （ AHCM ）. Methods Clinical manifestation, electrocardiogram, echocardiography, coronary artery angiography and left ventricuography were analysed and compared in 28 patients with AHCM. Results We presented abnormal electrocardiogram manifestation （ n = 28 ） including typical characteristic electrocardiogram manifestation （ n = 25）, dynamic variation of ST segment and T wave （ n = 8 ）. Apical hypertrophy was found in 22 patients through echocardiography. Applying coronary artery angiography, 25 patients were normal, myocardial bridge was observed in the mid segment of the left anterior descending coronary artery in 2 patients, and 1 patient was found with the left circumflex artery 20% stenosis. Spadelike changes in left ventricle were found in 23 patients by left ventriculography, and 5 patients were shown limited apical chamber. 12 patients were misdiagnosed as coronary heart disease including non - ST segment elevated myocardial infarction （ n = 4）. Conclusion AHCM is easily misdiagnosed as coronary heart disease. Electrocardiogram, echocardiography, especially coronary artery angiography and left ventricuography are very important for the diagnosis and differential diagnosis of AHCM.
出处
《医学新知》
CAS
2010年第5期438-439,442,共3页
New Medicine
关键词
心尖肥厚型心肌病
超声心动图
左心室造影
Cardiomyopathy
Hypertrophic
Echocardiography
Left ventricuography
