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患者男性,57岁,,半年前因胸闷、气短,间有胸痛、头晕,经当地医院诊断为冠心病、高度房室传导阻滞。给予扩冠及静滴654-2,疗效不著,不能从事轻体力劳动。此次因夜间阵发性呼吸困难10天,于1986年7月20日住入院。体检:T36.2℃,P38次/分,BP140/80。头高位,肥胖体型,颈静脉不怒张。胸廓对称,双肺闻及细小湿罗音,心尖搏动位于左第5肋间锁骨中线外0.5cm处,心界向左扩大,心音低钝,心律齐,心尖部闻Ⅰ级收缩期杂音。肝大剑突下2cm。肝颈返流征(一),双下肢无水肿。实验室:
Male, 57 years old, six months ago due to chest tightness, shortness of breath, chest pain, dizziness, the diagnosis of coronary heart disease by a local hospital, a high degree of atrioventricular block. Give crown and intravenous infusion of 654-2, curative effect is not, can not engage in light manual labor. This time due to paroxysmal nocturnal dyspnea 10 days, admitted to hospital on July 20, 1986. Physical examination: T36.2 ℃, P38 beats / min, BP140 / 80. Head high, obese body, jugular vein does not anger. Thorax symmetry, lungs smell small wet rales, apical beats in the left intercostal clavicle 0.5cm midline, the heart to the left to expand, low heart sound blunted, rhythm Qi, apex symphony Ⅰ systolic murmur. Big chin xiphoid 2cm. Liver reflux syndrome (a), no lower extremity edema. laboratory: