ĐẶC điểm lâm SÀNG của NHỒI máu cơ TIM cấp ở BỆNH NHÂN lớn TUỔI tại BỆNH VIỆN đa KHOA TRUNG ƯƠNG cần THƠ

M LÂM SÀNG CA NHP  BNH NHÂN LN TUI
TI BNH VI

Nguyễn Thị Diễm
i hc C



t                  

Kết quả

         



Kết luận: 
 


SUMMARY
CLINICAL ASPECT OF ACUTE MYOCARDIAL INFARCTION IN OLD PATIENTS
This study was conducted on 90 patients with acute myocardial infarction.
Result        
chest pain, there are 35,3% without typical chest pain. Dyspnea occupies 53,3%. There are
77,8% old patients hospitalized later 6 hours and 35,5% at Killip II, III.
Conclusion: Old patients with acute myocardial infarction, often have dyspnea or atypical
chest pain instead of typical chest pain. Most of them are hospitalized late and had complication.





[2].
Trên thực tế lâm sàng, ghi nhận ban đầu của người thầy thuốc đối với BN bị NMCT khi mới
vào viện là cơn đau thắt ngực, nhưng không phải bất kỳ BN nào cũng thế [9]. Do đó, người thầy
thuốc sẽ ít chú ý, dễ bỏ sót hay chẩn đoán chậm trễ [5]. Vì thế, nhằm giúp cho bác sĩ tim mạch
nói riêng và các bác sĩ nội khoa nói chung có thêm những thông tin trong chẩn đoán NMCT cấp
ở BN lớn tuổi [4], chúng tôi đặt vấn đề nghiên cứu này. Mục tiêu:
1. Khảo sát các triệu chứng cơ năng của NMCT cấp ở BN lớn tuổi.
2. Khảo sát các triệu chứng thực thể, biến chứng và mức độ nặng của NMCT theo phân độ Killip.



                
.

10/2007 [3][9][10][11]:
- 
- Triệu chứng lâm sàng thiếu máu cơ tim.
- Thay đổi trên điện tâm đồ chỉ ra thiếu máu cơ tim mới (thay đổi ST-T mới hoặc block
nhánh trái mới xuất hiện), tiến triển sóng Q bệnh lý trên điện tâm đồ.
- 


- 
- 












4 (8,9 %)
11 (24,4 %)
15 (16,7 %)

41 (91,1 %)
34 (75,6 %)
75 (83,3 %)

45 (100 %)
45 (100 %)
90 (100 %)
p= 0,048






  



g





14 (31,1%)
24 (53,3%)
p= 0,033


34 (75,6%)
29 (64,4%)
p= 0,250

 (p= 0,033).









 


()


12 (26,7%)

16 (35,6%)
p= 0,362
(         


                 
(p=0,362).



     
                   
(p=0,048)


[31].





[31]



31,1%, p=0,033).

[31].
V.C. Woon và K. H. Lim 


[36].

BN
-6

                   





1. Trong 



   









      





1. , 3(2),
trang 5-6.
2. 
-202.
3. 
4. , Nhà
-85.
5. 

6.              


7. 

-84.
8. 
- Harrison-229.
9. The European Society Of Cardiology Guidelines (2008), Management Of Acute
Myocardial Infarction In Patients Presenting With Persistent ST-Segment Elevation,
European Heart Journal, 29, pp 29092945.
10. The Joint European Society of Cardiology / American College of Cardiology Committee
(2000), Myocardial infarction redefined: a consensus document of The Joint European
Society of Cardiology/American College of Cardiology Committee for Myocardial
Infarction Redefinition, European Heart Journal, 21, pp 15021513.