Clinical Analysis Of Coronary Angiograply In Patients With Newly Diagnosed Coronary Heart Disease

Objective:This study is aim to clearly the situation of coronary artery lesions and diagnosis in patients with initially diagnosed as coronary heart disease. The causes of misdiagnosis was investigated. As well as we administer platelet glycoprotein Ⅱ b/Ⅲ a receptor antagonist to patients with coronary thrombosis by catheter and evaluate efficacy.Methods: The total of108cases were selected from March2010to March2012in our hospital initially diagnosed as coronary heart disease, including49males and59females, aged28to78years (the average age of54.53±9.74years old). Enrolled patients mainlyrecurrent episodes of precordial pain, chest tightness, shortness of breath, such as coronary heart disease symptoms. Clearly diagnosed coronary heart disease was excluded by coronary angiography、coronary angiography,、ECG dynamic evolution of cardiac examination and cardiac enzymes determination as well as valvular heart disease、cardiomyopathy、pulmonary embolism and other chest diseases by CT, ultrasonography and other relevant inspectionaortic dissections. After admission, patients were routinely given oral Aspirin, nitrates, beta blockers, angiotensin-converting enzyme inhibitor drugs (ACEI) or angiotensin Ⅱ receptor blockers (ARB) class of drugs, statins and improve circulation drugs. According to the wishes, patients were underwent coronary angiography admitted to hospital within a week and given platelet glycoprotein Ⅱ b/Ⅲ a receptor antagonist (tirofiban)8ug/10min injected through the catheter who were found intracoronary thrombus formation and review coronary angiography at10minutes after administration. We observed all selected patients with coronary artery disease, a clear diagnosis of coronary heart disease, analysis of the causes of misdiagnosis; the efficacy given tirofibanthose Results:①According to the results of coronary angiography, classifying to CHD and non-CHD group. CHD group,92(92/108) of cases, accounting for85.18%, including coronary artery stenosis>50%of42cases (42/92), accounting for45.65%; coronary artery stenosis, but with the contrast agent staining50cases of thrombosis (50/92), accounting for54.34%. Non-CHD group,16cases (16/108), coronary artery ignorance narrow (stenosis <50%), misdiagnosis rate of14.81%; the③CHD group and non-CHD group in age, BMI, smoking, blood lipids risk factors such as blood sugar, no significant statistical difference.④ECG ST-T changes in the CHD group,75(75/92), accounting for81.52%, non-CAD group (12/16) cases, accounting for75%, coronary thrombosis, stenosis <50%there are significant differences (P <0.05), narrow)50%were not statistically significant (P>0.05).⑤coronary thrombosis, tirof iban given within the coronary artery by catheter treatment, symptoms improved in44(44/50) cases, accounting for88%, no response (6/50) cases, accounting for12%. Administered10min after the review of coronary angiography thrombosis was significantly reduced or disappeared in42(42/50) cases, accounting for84%, no significant changes in8(8/50) cases, accounting for16%, postoperative ECG improved markedly compared with the preoperative (no change)24(24/38), except for surgery, accounting for63.15%; no significant improvement (except for preoperative no change)14(14/38) cases, accounting for36.84%; not statistically significant, P>0.05.Conclusion:1. There is a certain rate of misdiagnosis to coronary heart disease patients with chest pain, chest symptoms. Based on ECG changes and risk factors can not be identified. Coronary angiography is the gold standard for the diagnosis of coronary heart disease.2Coronary artery without serious disease was confirmed by coronary angiography but associated with thrombosis as high as54.34%, given tirofiban has significantly contribution...