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男性,61岁。因患支气管扩张并咯血入院。患过“甲亢”、已痊愈。慢性咳嗽10余年。3年前间歇劳累性心悸、气促、胸骨后及心前区疼痛,外院疑诊冠心病。否认高血压史。体查:体温36.8℃,血压16/8kPa,呼吸平稳,无紫绀,神清合作,眼球突出,甲状腺不肿大,无血管性杂音。双肺无罗音。心界不大,心率50次,律齐,各瓣膜区无杂音。心电图:窦缓,顺时针转位。胸片及心脏B超检查正常。血生化,T_3,T_4,血三脂均正常。住院期间心电监护示窦性心动过缓(44～52次/分),余无特殊。 住院后,咳嗽、咯血等症状很快被控制,但心率缓慢无改善。在心电监护下做阿托品试验,阿托品1.5mg+10％葡萄糖20ml静注,当注入1.2mg时,患者突感胸闷不适,心电图示结性及室性紊乱心律,并有长间歇及心搏暂停现象,继之心室颤动。立即加大吸氧流量,静注利多卡因0.1g无效,心跳停止。行
Male, 61 years old. Due to bronchiectasis and hemoptysis admitted. Suffering from “hyperthyroidism”, has been cured. Chronic cough for more than 10 years. 3 years ago, intermittent exertion palpitations, shortness of breath, chest and anterior chamber pain, suspected coronary heart disease outside the hospital. Denied the history of hypertension. Physical examination: body temperature 36.8 ℃, blood pressure 16 / 8kPa, stable breathing, no cyanosis, Shen Qing cooperation, prominent eyes, thyroid enlargement, vascular murmur. Lungs without rales. Heart, heart rate 50 times, law Qi, the valve area without noise. Electrocardiogram: slow sinus, clockwise translocation. Chest X-ray and heart B-test normal. Blood biochemistry, T_3, T_4, blood triglyceride are normal. ECG during hospitalization showed sinus bradycardia (44 ~ 52 beats / min), I no special. After hospitalization, cough, hemoptysis and other symptoms were quickly controlled, but no improvement in heart rate slowly. Atropine test under ECG monitoring, atropine 1.5mg + 10% glucose 20ml intravenous injection when injected 1.2mg, the patient suddenly felt chest discomfort, ECG showed ventricular tachycardia and ventricular arrhythmia, and intermittent and asystole pause phenomenon , Followed by ventricular fibrillation. Immediately increase oxygen flow, intravenous injection of lidocaine 0.1g invalid, heartbeat stopped. Row