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一、病历摘要: DR.Kozlowski:女,54岁,无怀孕及分娩史,于1979年12月26日入院。自1974年来一直在治疗高血压及充血性心衰,治疗前血压210/110mmHg。入院前二周突感呼吸困难,端坐呼吸及“发烧感”。过去史中曾于1960年因子宫纤维肌瘤作子宫切除术,1970年作痔切除术。住院前患者用双氢克尿塞50 mg/日及甲基多巴250mg一日四次,使病情获得良好控制,血压150/90。此外,病人海日还接受地高辛0.125mg。患者抽烟,年约40包。过去二月中体重减轻14磅。体检:消瘦,慢性病容。T100°F,BP200/112mmHg。其他明显体征有:1.视神经乳头边缘模糊不清。2.颈静脉怒张。3.两侧肺底啰音。4.左心前区隆起,
First, medical records summary: DR. Kozlowski: female, 54 years old, no history of pregnancy and childbirth, in December 26, 1979 admission. Has been treating hypertension and congestive heart failure since 1974, with pre-treatment blood pressure 210 / 110mmHg. Two weeks before admission, he suddenly had difficulty breathing, sitting on his breathing and feeling “fever.” In the past in the history of uterine fibroids in 1960 for hysterectomy, hemorrhoidectomy in 1970. Patients before hospitalization with hydrochlorothiazide 50 mg / day and methyldopa 250mg four times a day, so that the disease was well controlled, blood pressure 150/90. In addition, patients also received digoxin 0.125mg. Patients smoke about 40 packs a year. Weighed 14 pounds in the past two months. Physical examination: weight loss, chronic disease. T100 ° F, BP200 / 112mmHg. Other obvious signs are: 1. Optic nerve edge blurred. Jugular vein engorgement. 3. Both sides of the lung rales. 4. Left anterior bulge,