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1、21 cases of elderly patients with acutemyocardial infarctionAuthor:ZhaoYan, Kagehidevelvet,ZhaozhiRu MaJingKeywords myocardial infarctionKeywords: olderpeople; myocardial infarction1 Clinical data10 males, 11 females; aged 70 to75 years old in 13 cases, 8 cases of 76 to 81 years old; sixcases of hyp
2、ertension, diabetes, pulmonary heart diseasecases, old inferior wall infarction in 1 case .15 cases moretypicalsymptomsof chest pain, but theextent andduration of chest pain is not the same in the remaining sixcases painless myocardial infarction: two cases of suddenpale, sweating, lowblood pressure
3、, cardiogenicshock (1case withfrequentventricularpremature beats;patientswith acuteexacerbation of chronicbronchitis symptoms,chesttightness, shortnessofbreath,increasedcough;1caseof80-year-oldpatientswithstrokeadmittedtohospitalwithacuteleftventricularfailure;2casesofunexplainedsevereupperabdominal
4、painwithnausea,vomiting and admission (onepatientwith mild diarrhea.1ECG: 3 cases of extensive anterior infarction; five cases ofanteriorinfarction;anteroseptalinfarctionin3cases(1case with old inferior wall infarction; inferior wall infarctionfivecases;thehighsidewallsinfarctionin2cases;posteriorwa
5、llinfarctionpatients(diagnosisisbasedonthe above leads T R wave in V1, V2 lead higher and wider,R /S> 1; saidleadST-segment depression;thewavetall;doingplusV7-V9 pathologicQ waveandST-Tchanges;subendocardialinfarctionin1case(electrocardiogramshowedleadST segment exceptaVRoutsideeachgenerallyd
6、epressed,T wavetwo-wayorupsidedown,similarmyocardialischemicchanges;1cases only T wave changes from shallow to deep invertedin the hospitalafew weeks, and then faded,combinedwith the clinical symptoms, serum enzyme sensitivity andhighspecificityoftroponinI1,2detectioncanbeconfirmed.24,48,72hand7d,CK
7、-BMpositiverateof95.2%,23.5%,10.5%,0.00%,2 patientswithsymptomsand ECG are not typical patients plus do troponin I testingresultsaftertheonset of 24,48,72 h100% positive,7d,positive,negativetreatmentofsurvivorsis16cases, 5died,includingtwocasesofpainlessAMI .2caseswere2pathological autopsy, were lef
8、t coronary artery is almostcompletelyblocked andthelackofclinicalsymptoms;coronaryinvolvementcount,coronaryarteryocclusionandthe ringnarrowwithplaquehemorrhage,butangina.2caseselectrocardiogramshowedextensiveanterior infarction. reposted in the free papers DownloadCenter 2 DiscussionElderlyAMIincide
9、nceishighcompared to the other age groups of adults 3, the killeris aseriousthreattothehealthandlivesoftheelderly.Elderlycoronaryheartdiseaseisoftenatypicalangina-based 3, the older of drug reaction less sensitive.primarychronicbronchitis,heartfailure,highbloodpressureand cerebralvasculardiseaseofte
10、nmaskthesymptoms of chest pain and to improve the diagnosis, topreventmisdiagnosis4,theelderlyshouldbehighlyvigilanttotimelyelectrocardiogramandserumtheenzymologyofcontinuousobservation.necessarycTn Itest it is an important indicator of the extent of myocardialtissue injury with high sensitivity and
11、 specificity 1. noneof the above conditions, the primary care unit admissionsshouldbehighlyvigilantfollowingtensymptoms:(13suddenappearanceof the leftmandibulartoothache;(2suddenleftshoulder,neckpain;(3 suddenunexplainedupperabdominalpain,andmaybeaccompaniedbynausea, vomiting, or diarrhea; ( no hist
12、ory of ulcers burststomachbleedingassociatedwithcardiacarrhythmias,heart failure; (5 chronic bronchitis sudden asthma or theoriginal respiratory illness symptoms suddenly worsenedpulmonary signs does not comply; (6 hypertensive patients with sudden chest tightness , suffocation, blood pressure decre
13、ased; (7 unexplained sudden heart failure, shock, or serious arrhythmia; (8 sudden dizziness, fainting,or mood disorders; (9 stroke associated with serious arrhythmias or left ventricular failure; (10 extreme fatigue .References:1 WANG Hong-yun, the Sheep the Geng Health, CAO Ping, Meng Yi, Li Zhenk
14、ui, Ji Yuqing, Yang Kan.Cardiopulmonarybypassopen-heartsurgeryinplasmacardiactroponinI changeJ. FourthMilitaryMedicalUniversity, 2000; 21 ( 6:688.2XuYing-hong,ZhangXiuyu,LiuWenli.4Clinical significance of cardiac troponin I in patients withacute myocardial infarction J Cardiovascular Rehabilitation Medicine, 2001; 10 (3:211-2123 Yang province Lee, Guoliang, Huang Jiu-Yi. Comparison of risk factors for coronary heart disease in different age groups J. Fourth Military Medical University,2000; 21 (10:1265-1267.4 Chen Zhenhua, Fuming Yan, Liyuan Min war Xiulan, Zhu Aixia
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