Clinical Analysis of Atypical Coronary Heart Disease Misdiagnosed as Multiple Diseases
YIN HANG
CUI Wenwen
GAO Jie
TIAN Peng
ZHANG Xianpei
SUN Yucui
LIU Jia
Abstract：Objective To investigate the clinical characteristics,causes of misdiagnosis and preventive measures in patients with atypical coronary heart disease(CHD).Methods From February 2022 to February 2024,12 patients with atypical CHD misdiagnosed were selected,their clinical data were analyzed,and the causes of misdiagnosis were summarized.Results Of 12 patients,5 were misdiagnosed with gastroenteritis because of abdominal pain,nausea,vomiting and other symptoms,4 were misdiagnosed with upper respiratory tract infection because of cough,shortness of breath and other re-spiratory symptoms,and 3 were misdiagnosed as cervical spondylosis because of neck and back pain.After receiving initial treatment,the symptoms did not improve significantly,and then the patients were diagnosed with CHD by further examination of electrocardiogram,myocardial enzyme spectrum and coronary angiography.The misdiagnosis lasted 10 d～3 years After diagnosis,all patients were given antiplatelet therapy,coronary artery dilatation,improvement of heart function and other symptomatic treatment,of which 4 patients with severe condition were treated with coronary artery stent implantation(n=2)or coronary artery bypass grafting(n=2).The patients'conditions were improved to varying degrees.After 6 months of follow-up,10 patients had stable cardiac function,no obvious recurrence of cardiovascular events,and the quality of life was significantly improved.Two patients had recurrent symptoms,which was relieved after drug adjustment in one patient,and the other patient did not develop any serious complications.Conclusion Because the symptoms of CHD are often atypical and there is no typical chest pain,especially in elderly patients or with other chronic diseases,it is more likely to lead to misdiagnosis.In order to avoid misdiagnosis,medical history inquiry,comprehensive physical examination,enhanced understanding of the disease,careful differential diagnosis,and early specific examinations such as electrocardiogram,myocardial enzyme spectrum and coronary angiography should are necessary.
Keywords：Coronary diseaseMisdiagnosisGastroenteritisUpper respiratory tract infectionCervical spondylosisDiagnosisdifferentialMyocardial enzyme examinationCoronary angiography
Publication Date：2025-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 7-11 )