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最近收治1例急性心肌梗塞后反复发生扭转性室速伴阿斯综合症的患者,经反复抢救复苏5次成功,最终因心肌损害范围过大,顽固复发而死亡。患者男性,65岁,因持续胸闷出冷汗5小时于1986年6月4日入院。既往有糖尿病史8年。查体:血压100/70mmHg,神清,面色苍白,皮肤湿冷,颈静脉无怒张,两肺底可闻中等量湿罗音。心界略向左侧扩大,心音低钝,心率98次/分,可闻早搏5～6次/分。双下肢无浮肿,余检查正常。心电图示:急性广泛前壁侧壁心肌梗塞。高峰酶值CPK1550.6~u,CK-Mb265~u,GOT241~u。胸片示“心影扩大,两肺重度淤血及模糊片影”,考虑肺水肿。入院后第三天患者发生急性左心衰竭,经用硝普钠。吗啡缓解。以后常在进食后出现阵发性呼吸困难,持续静滴硝酸甘油及用地高辛0.125 mg/日,速尿
Recently admitted to a case of recurrent torsade ventricular tachycardia with Asperger’s syndrome after acute myocardial infarction patients, after repeated rescue and recovery five successful, and ultimately because of the scope of myocardial damage is too large, die of recurrent death. Male patient, aged 65, was admitted to hospital on June 4, 1986, after 5 hours of perspiration and chest cold. Past history of diabetes 8 years. Physical examination: blood pressure 100 / 70mmHg, Shen Qing, pale, skin wet and cold, jugular vein without rage, two lungs can be heard in moderate amount of wet rales. Heart widened slightly to the left, heart sound low blunt, heart rate 98 beats / min, can be heard premature beats 5 to 6 beats / min. No lower extremity edema, I checked normal. ECG shows: Acute extensive anterior wall myocardial infarction. Peak enzyme CPK1550.6 ~ u, CK-Mb265 ~ u, GOT241 ~ u. Chest radiography showed “heart shadow expansion, severe lung congestion and blur film”, consider pulmonary edema. On the third day after admission, patients developed acute left heart failure and were treated with sodium nitroprusside. Morphine ease. Paroxysmal dyspnea often occurs after eating, with continuous infusion of nitroglycerin and digoxin 0.125 mg / day, furosemide