С целью определения точности рутинных методов прижизненной диагностики инфаркта миокарда проанализирована 41 история болезни пациентов с Q-позитивным и Q-негативным инфарктом миокарда отделения неотложной кардиологии ГБУРО ОКБ. ЭКГи ЭхоКГболее информативны при поражении боковой, передней и нижней стеноклевого желудочка. Полное совпадение результатов интерпретации ЭКГи ЭхоКГ с результатами аутопсии наблюдалось в 4 % случаев. Креатинфосфокиназа и креатинфосфокиназа-МВбыли повышены в 97% случаев, тропонины -в 70%. Выявлена прижизненная как гипо-, так и гипердиагностика инфаркта миокарда.
To estimate an accuracy of methods of myocardial infarction diagnostics (ECC, echocardiography, biomarkers) 41 case history reports of patients with Q(+) and Q(-) myocardial infarction and lethal outcome were analyzed. ECG and echocardiography were proved to be most accurate in case of anterior (67 % and 67 %), lateral (71 % and 67 %) and inferior (46 % and 79%) localizations of myocardial infarction. Interventricular septum and posterior localizations were not detected on ECG (0%). Complete coincidence of ECG and echocardiography with autopsy results was detected only in 4 %. CPC and CPC-МВ levels were elevated in 97%, troponins were positive in 70 %. Risk factors of lethal outcome in case of myocardial infarction include sex (male), comorbid pathology (arterial hypertension, cerebrovascular disease, diabetes mellitus type 2), complications (rhythm disorders, cardiogenic shock, congestive heart failure), absence of thrombolytic therapy and its inefficacy. Myocardial infarction hypo- and hyperdiagnosis were detected.
The authors declare that there are no conflicts of interest present.