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患者女性,65岁,以心房纤颤,原因待查于1989年5月29日入院。病者近10多年来反复心累、气紧、咳嗽,尤其在劳累后更明显,喜高枕卧;近半年来出现双下肢反复水肿、不能平卧,多次出现夜间阵发性呼吸困难;无潮热、盗汗、咯血等病史。亦无关节红肿史。病后多在医疗站对症治疗可缓解。检查:二尖瓣面容,肺气肿征,双肺底可闻及细湿罗音,心界向左扩大,心律不齐、心音强弱不等,心率154次/分,各瓣膜区未闻及病理性杂音;肝肋下3cm,质中硬,无明显触痛;双下肢踝关节以下凹陷性水肿。心电图示心房纤颤;X线
Female patient, 65 years old with atrial fibrillation, to be investigated on May 29, 1989 admitted to hospital. Over the past 10 years the patient repeatedly tired heart, gas tight, cough, especially after exertion is more obvious, like high pillow; lying in the past six months repeatedly lower extremity edema, can not lie down, multiple occasional paroxysmal dyspnea; Hot flashes, night sweats, hemoptysis and other medical history. No history of joint swelling. After the illness in the medical station symptomatic treatment can be alleviated. Check: mitral valve surface, pulmonary emphysema sign, lung bottom can be heard and fine wet rales, heart left to expand, arrhythmia, heart sound intensity range, heart rate 154 beats / min, the valve area not heard And pathological murmur; liver ribs 3cm, the quality of hard, no obvious tenderness; lower limb ankle depression below the edema. ECG shows atrial fibrillation; X-ray