CHẨN đoán PHÂN BIỆT NHỒI máu cơ TIM cầp ở BỆNH NHÂN TRẺ TUỔI

CHT NHI P  BNH NHÂN TR TUI

Nguyễn Cửu Lợi, Lê Phúc Nguyên
Trung tâm Tim mch, BVTW Hu


Giới thiệu:
  

Đối tượng nghiên cứu và kết quả: 

thành tim khu trú và men ti


 
nhanh.
Kết luận: 


SUMMARY
DIFFERENT DIAGNOSIS OF ACUTE MYOCARDIAL INFARTION
IN YOUNG PATIENTS
Background: Coronary artery disease may nowedays happen in young people. It, therefore,
should be paid attention for diagnosis in young patients admitted with chest pain, regional ECG
changes and increased cardiac enzymes.
Materials and results: authors reported 3 young patients admitted to the hospital with chest
pain, regional ECG changes, localized diskinesia of ventricular wall and increased cardiac
enzymes (CK-MB and Troponin T). Thay were all diagnosed to have AMI and managed with
combined anticoagulants (LMWH and antiplatelets), statin and coronary vasodilator. Coronary
angiography, however, did not show any stenotic lesion then the diagnosis of myocarditis was

made. Clinical contexts were improved in all three patients under treatment with antibiotics and
steroids.
Conclusions: acute myocardial infartion was sometimes misdiagnosed even when the
patients had all diagnostic criteria, especially in young patients.


 





NMCT nh
 



 
  -         gày

3.
V1    V3 (Hình 3. venox, Aspégic,
 
 
    


 3.3).








3.2).


Hình 3.1. 
 

Hình 3.2. 
3.1. Di
Ngày
CK (U/L)
CK-MB (ng/mL)
TnT (ng/mL)
17/4/2011
1414
109,5
3,27
18/4/2011
1460
68,65
3,96

801
15,08
1,61


619
10,38
1,09
20/4/2011
258
5,38
0,5

Hình 3.3. 

 

  


V4, V5, DII, DIII, aVF (Hình 3.     3.   

3.



Hình 3.4. 

Hình 3.5. 

3.2. 
Ngày
CK (U/l)
CK-MB (ng/ml)
TnT (ng/ml)

CRP (mg/l)
23/2/2011
441
19,93
1,18
12,3
24/2/2011
147
7,82
0,517

25/2/2011
Không làm
1,89
0,338
6,3


và kháng sinh.
 

    -          -MB= 36,16 U/L;
              
Heparin 

 
5 ngày.

Hình 3.6. 

Hình 3.7. 



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    


NMCT (thay 
 






 








màng ngoài

 
 

       - 









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