AMI诊断的主要依据:①病史;②心电图;③放射性核素;④生化诊断;主要是酶学。 典型病史有很大的价值,但病史不典型者约占20％,尤其是老年人。心电图检查简便迅速,有较高的特异性和敏感性。但近有报道,心电图对下壁AMI的阳性率约为40％。如梗塞面积小于1c㎡或心内膜下梗塞、左束支阻滞合并心肌梗塞等,可造成心电图诊断上的困难。另外,肥厚性心肌病、心肌淀粉样变、心脏肿瘤、肺心病等可出现深的Q波,易与心肌梗塞 The main basis for the diagnosis of AMI: ① history; ② ECG; ③ radionuclide; ④ biochemical diagnosis; mainly enzymology. Typical medical history is of great value, but atypical history accounts for about 20%, especially in the elderly. ECG quick and easy, with high specificity and sensitivity. However, it has been reported recently that the positive rate of ECG on inferior wall AMI is about 40%. Such as infarction area is less than 1c㎡ or subendocardial infarction, left bundle branch block with myocardial infarction, ECG diagnosis can cause difficulties. In addition, hypertrophic cardiomyopathy, myocardial amyloidosis, cardiac tumors, pulmonary heart disease can occur deep Q wave, easy and myocardial infarction