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患者男性,54岁。因心前区疼痛并向左肩放射伴心慌,于1990年10月23日入院。查体:T36.5℃,R22次/分,BP16/11kPa,神清,颈静脉无怒张,甲状腺不肿大,双肺无明显异常,心界向左下扩大,P97次/分,律整。心尖部可闻及ⅢSM。X 线心象提示心脏向左下扩大,心胸比例0.64,主动脉结突出。二维超声心动图(2DE)提示左房38mm,左室59mm,室间隔11mm。ECG 示Ⅱ、Ⅲ、aVF、V_4～V_(?)的 ST 段抬高0.2～0.35mv,伴 T 波倒置,提示心肌下壁、前壁、侧壁及正后壁心肌缺血,变异型心绞痛。给与 Ca2~+通道拮抗剂及β受体阻滞剂对症治疗。入院第3日病人出现烦躁,上午9时病
Male patient, 54 years old. Because of precordial pain and radiation to the left shoulder with palpitation, admitted to hospital on October 23, 1990. Physical examination: T36.5 ℃, R22 beats / min, BP16 / 11kPa, Shen Qing, jugular vein without tension, thyroid enlargement, no obvious lung abnormalities, heart bound to the lower left, P97 beats / min, . Apex can be heard and ⅢSM. X-ray heart prompted the heart to expand to the left, heart ratio 0.64, prominent aortic knot. Two-dimensional echocardiography (2DE) prompted left atrium 38mm, left ventricular 59mm, ventricular septal 11mm. ECG showed Ⅱ, Ⅲ, aVF, V_4 ~ V_ (ST-segment elevation of 0.2 ~ 0.35mv, with T wave inversion, suggesting that the myocardial wall, the anterior wall, the posterior wall and the posterior wall myocardial ischemia, variant angina . Give Ca2 ~ + channel antagonist and β-blocker symptomatic treatment. On the 3rd day of hospitalization, the patient became irritable and got sick at 9 o’clock in the morning