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患者,女,58岁。于5天前自觉排尿致心悸,气短,持续时间1～10分钟,排尿后数分钟内自行缓解,但发作时症状逐渐加重而来就诊。排尿后立即做心电图,心率37次,室性早搏,呈二联律,V_(?)导联出现多源性室性早搏,V_6S-T段下移0.1mv提示心肌缺血样改变。症状持续约20分钟,自行解。发作后心电图:早搏消失,心律规整,心率60次(心电图略)。给予心律平150mg,每日3次,连续用药15天,排尿时仍有心律失常发生。故改用阿托品0.3mg,每日3次,服药当时排尿时即未发生心律失常,维持4天停药。随访15天未再发病,病人情况良好。排尿时引起心律失常的机制,我们认为,可能是排尿反射过程中迷走神经兴奋性
Patient, female, 58 years old. 5 days ago conscious urination caused by heart palpitations, shortness of breath, the duration of 1 to 10 minutes after urination spontaneous relief within minutes, but the onset of symptoms gradually aggravated. Urine immediately after electrocardiogram, heart rate 37 times, ventricular premature beats, was bipolar law, V_ (?) Lead appears multi-source ventricular premature beats, V_6S-T segment down 0.1mv prompted changes in myocardial ischemia. Symptoms persist for about 20 minutes, self-solve. Post-seizure ECG: premature beat disappeared, regular heartbeat, heart rate 60 (ECG slightly). Give heart rhythm flat 150mg, 3 times a day, continuous medication for 15 days, there is still arrhythmia occurs when urinating. Therefore, the switch to atropine 0.3mg, 3 times a day, when taking medication that no arrhythmia occurs when urination, to maintain the withdrawal for 4 days. Follow-up 15 days without recurrence, the patient is in good condition. The mechanism that causes arrhythmia when micturition, we think, may be vagus nerve excitability during micturition reflex