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患者,女,80岁。因反复咳嗽、咳痰20余年,下肢浮肿4年,近1月来患者因心悸气喘,时有下肢和颜面浮肿曾间断服用双氧克尿塞,偶服心得安每天1片治疗。入院前1天曾服心得安10mg,次日晨突然出现胸闷气急、烦燥不安、继之出现神志不清,多次发生四肢抽搐。体检:昏迷,紫绀,颜面轻度浮肿,瞳孔等大等圆。颈静脉怒张,双肺散在干湿性罗音及哮鸣音。剑突下可见心脏搏动,心界略向左扩大,心率36次/min,可闻心房音、大泡音,三尖瓣区可闻及Ⅲ级吹风性收缩期杂音。P_2=A_2。肝剑7cm,肋下3cm,质中,肝颈返流征(+),双下肢轻度凹陷性浮肿。实验室检
Patient, female, 80 years old. Due to repeated cough, sputum more than 20 years, lower extremity edema for 4 years, nearly 1 month patients with palpitations asthma, sometimes lower extremity and facial edema had intermittent use of dioxane, uggs sale One day before admission, had convinced 10mg, the next morning suddenly appeared chest tightness, irritability, followed by delirious, repeated limbs convulsions. Physical examination: coma, cyanosis, face mild edema, pupils and other large circle. Jugular vein distention, lungs scattered in wet and dry rales and wheeze. Xiphoid can be seen under the heart beat, heart slightly expanded to the left, heart rate 36 beats / min, can be heard atrial tone, large bubble sound, tricuspid valve area can be heard and Ⅲ grade systolic murmur. P_2 = A_2. Liver sword 7cm, rib 3cm, quality, liver reflux syndrome (+), lower limbs slightly depressed edema. Laboratory test