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Myocardial infarction showed clinical symptoms of acute abdomen

2004) 02-0145.0l myocardial infarction showed clinical symptoms of acute abdomen Shuo Wu, Kao-Ping (North UW schools, hospitals, Jilin 132033) Abstract: Objective To analyze the clinical manifestations of myocardial infarction. Methods 11 cases of hospital revenue myocardial infarction cases were analyzed, summarized the clinical manifestations of myocardial infarction. Results After emergency treatment, 10 patients in stable condition after 1 week into the ward. 1 patient died. Conclusions The clinical manifestations of myocardial infarction and some acute abdomen similar to be considered fully in the emergency, and make rapid and accurate diagnosis, prompt emergency treatment, the increase in coronary perfusion, to save the dying heart muscle. Key words: myocardial infarction; clinical performance; abdomen CLC: R542.2 Document code: A myocardial infarction is a myocardial necrosis, clinical manifestations of this disease are pain-based, but for the inferior wall myocardial infarction upper abdominal pain, was sustained like colic, some patients may have nausea, vomiting, accompanied by irritability, easily mistaken for acute abdomen. This disease is a common disease in emergency department, are summarized 11 cases treated in the emergency treatment of patients with myocardial infarction in the situation analysis report is as follows: 1 Data and Methods 11 cases of emergency patients were male, aged 38 to 73 years, mean age 61 years old. According to ECG,[link widoczny dla zalogowanych], serum creatine kinase diagnosis of acute myocardial infarction in 8 cases, 2 patients with acute anterior myocardial infarction, acute posterior wall myocardial infarction in 1 case. Patients with sudden abdominal pain, sweating, irritability, pain face, some patients with frequent vomiting, clammy skin, confusion and other shock performance. 3 patients had abdominal tenderness, no rebound tenderness. 5 cases were leukocytosis (11 × 10 / L ~ 14 × 10 / L), increased neutrophils, serum enzyme levels increased. 11 cases of myocardial infarction in people's homes were the main clinical manifestations: 8 cases of upper abdominal pain, chest back pain in 5 cases, nausea and vomiting in 4 cases, arrhythmia in 6 cases, 4 cases of hypotension, shock in 1 case. Severe pain, give pethidine 50mg intramuscular injection; application of vasodilators, in 100mL 5% glucose addition of 10mg intravenous nitroglycerin; application of bolus thrombolytic agents such as urokinase 250 000 U, and then within a 30min intravenous infusion of urokinase 750,000 U, and then intravenous heparin 12500U 72h; if 10% of shock patients with glucose or intravenous dextran 40U added blood volume, 5% glucose 100mL + 20mg dopamine or norepinephrine 0. ~ 1mg intravenous drip or high blood pressure and other symptomatic treatment. 2 results of 11 patients, 10 cases of emergency treatment in a stable condition after 1 week into the ward. 1 patient, shock, after she died. 3 Discussion myocardial infarction in coronary artery disease on the basis of stenosis, occlusion, coronary blood supply drastically reduced or interrupted, so that the corresponding cardiac sudden interruption of blood supply, resulting in rapid ischemic myocardial necrosis. Basic cause is the cause coronary lumen stenosis and myocardial blood supply interruption, so that serious and sustained myocardial ischemia of acute myocardial infarction occurred more than 30min. After infarction, inferior wall myocardial necrosis caused by reflex stimulation of the diaphragm abdominal pain, combined with arterial perfusion of gastrointestinal congestion and lack of gastrointestinal smooth muscle contraction, spasm, so that digestive disorders, nausea, vomiting. Most patients with myocardial infarction in first clinical manifestations of excessive physical labor after the chest pain, 11 patients, 8 cases of inferior myocardial infarction, to abdominal pain, nausea, vomiting, and other performance. Myocardial infarction and other clinical manifestations were similar to the digestive tract diseases, acute abdomen, acute disease than in the emergency must be considered in full, to avoid misdiagnosis and delayed diagnosis, especially in primary health care units should be more aware that symptoms of abdominal pain Patients should pay attention to the presence of inferior wall myocardial infarction. Once the diagnosis of the disease, should be actively treated, to protect and maintain the principles of cardiac function to save dying myocardium, prevent infarct expansion, reducing the scope of myocardial ischemia and necrosis, the timely processing of serious arrhythmia, pump failure and complications , so that patients not only through the acute phase, but also to maintain a normal life after recovery. Received :2003-05.12 Author: Wu Shuo (1977 a), female, physicians, clinical research is mainly engaged in cardiomyopathy 【Editor: Chen Lihua】