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患者男,57岁．因突发晕厥2次,胸闷、胸痛1d于2006年2月10日入院。患者于入院1周前站起时突然摔倒在地,伴恶心,持续数秒钟自行缓解。入院当日晨5时,患者在睡眠中突然憋醒、胸闷、胸痛。排尿后晕厥,胸痛不能缓解来我院。既往有高血压病史16年。有高血压家族史,吸烟少量。查体：血压125/80mmHg。双肺未闻及干湿性啰音。心界不大,心率80次/min,律齐,心音有力。各瓣膜听诊区未闻及杂音。入院后心电图显示胸前导联V_(2-6)ST-T改变,肌酸激酶(CK)482 U/L、肌酸激酶MB同功酶(CK-MB)37U/L；肌钙蛋白T0．80ng/ml。诊断：急性前壁心肌梗死、血管迷走性晕厥。冠状动脉造影示左前降支(LADl中段可见2处肌桥(图1)。造影过程中出现晕厥,心率60次/min,血压40/20mmHg．经用多巴胺后3min血压恢复至100/60mmHg。
Male patient, 57 years old. Due to sudden syncope 2 times, chest tightness, chest pain 1d on February 10, 2006 admission. Patients suddenly fell to the ground when standing up one week before admission, with nausea, sustained for a few seconds to ease themselves. At 5:00 on the day of admission, the patient suddenly awaked in sleep, chest tightness, chest pain. After urination syncope, chest pain can not be relieved to our hospital. Previous history of hypertension 16 years. Have a family history of high blood pressure, a small amount of smoking. Physical examination: blood pressure 125 / 80mmHg. Unhealthy lungs and wet rales. Heart, heart rate 80 beats / min, law Qi, heart sound powerful. The valve auscultation area did not smell and noise. ECG at admission showed V_ (2-6) ST-T changes in the lead of the chest, creatine kinase (CK) 482 U / L and creatine kinase MB isozyme (CKUMB) 37U / .80ng / ml. Diagnosis: acute anterior myocardial infarction, vasovagal syncope. Coronary angiography showed left anterior descending (LADl middle of the two can be seen in the muscle bridge (Figure 1) Syncope occurred during angiography, heart rate 60 beats / min, blood pressure 40 / 20mmHg after 3min with dopamine blood pressure returned to 100 / 60mmHg.