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男,28岁。8天前受凉后发热、头痛、咽痛,3天后觉上腹部和心前区隐痛,1小时前胸骨后持续性压榨痛,大汗淋漓,面色苍白,极度疲乏。既往无心血管病史。体查:体温37℃,脉搏48次,呼吸30次,血压0。急性危重病容,唇微绀,肺无异常,心音低钝,无杂音,肝脾未扪及,下肢无水肿.白细胞8.45×10~9/L,中性64％,淋巴32％,嗜酸性3％,单核1％。血清电解质正常。谷草转氨酶58~u,乳酸脱氢酶570u,胆固醇正常。入院后心电图示窦性心动过缓,Q_(Ⅱ.Ⅲ,avF)时间0.04秒,振幅为同导联R波的1/4～1/2,ST_(Ⅱ,Ⅲ,avF.v～v)弓背向上抬高3～6mm,STv_1,下移2mm。诊断为病毒性心肌炎,心源性休克。
Male, 28 years old. 8 days ago after the cold, fever, headache, sore throat, 3 days after feeling upper abdominal and precordial pain, 1 hour ago persistent pain after sternal compression, sweating, pale, extremely tired. Past history of cardiovascular disease. Physical examination: body temperature 37 ℃, pulse 48 times, breathing 30 times, blood pressure 0. Acute critically ill patients, lip micro cyanosis, lung no abnormalities, low heart sound blunt, no noise, no palpable liver and spleen, lower extremity no edema. White blood cells 8.45 × 10 ~ 9 / L, neutral 64%, lymphatic 32%, eosinophilic 3 %, Mononuclear 1%. Serum electrolytes normal. Aspartate aminotransferase 58 ~ u, lactate dehydrogenase 570u, cholesterol normal. After admission, the electrocardiogram showed sinus bradycardia, and the amplitude of Q_ (Ⅱ.Ⅲ, avF) was 0.04 second with the amplitude of 1/4 ~ 1/2 and ST_ (Ⅱ, Ⅲ, avF.v ~ v) Raise the bow back up 3 ~ 6mm, STv_1, down 2mm. Diagnosis of viral myocarditis, cardiogenic shock.