Analysis of Misdiagnosed 7 Young and Middle-aged Patients with Atypical Acute Myocardial Infarction

ZHANG Shao-li; LI Yan; WANG Xue-hui; CHEN Zhi-gang

doi:10.3969/j.issn.1002-3429.2017.04.017

Abstract：Objective To investigate atypical manifestations and misdiagnosed causes of young and middle-aged patients with atypical acute myocardial infarction (AMI) in order to reduce misdiagnosis rate.Methods Clinical data of 7 young and middle-aged patients with atypical AMI admitted during May 2015 and February 2016 was retrospectively analyzed.Results The range of patients were from 24 to 44 years old.A total of 2 patients were misdiagnosed as having acute gastroenteritis due to gastrointestinal symptoms such as abdominal pain, nausea, vomiting, hiccups, diarrhea;1 patient was misdiagnosed as having bronchitis due to cough, expectoration, shortness of breath and thickening lung markings by chest X-ray;1 patient was misdiagnosed as having intercostal neuritis due to simple chest pain;1 patient was misdiagnosed as having cardiac neuropathy due to palpitations, fatigue and ST segment depression by electrocardiogram (ECG);1 patient was misdiagnosed as having cerebral infarction due to dizziness, both upper extremities powerless and lacunar infarction history;1 patient was misdiagnosed as having postural syncope due to hypotension and syncope.The average time of misdiagnosis was (4.56±1.26)d.The effects of symptomatic treatment for misdiagnosed diseases were poor, and dynamic changes were found after ECG examination, and then AMI was confirmed after finding abnormal result of myocardial enzyme examination.Reperfusion therapy was given after confirming AMI, and patients were discharged after having stable conditions.Conclusion Complex and atypical manifestations can easily lead to misdiagnosis for young and middle-aged patients with AMI, so clinicians should improve the vigilance of young and middle-aged patients with AMI so as to avoid misdiagnosis and mistreatment.