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患者男,65岁。因胸闷、心悸、气促、腹胀、乏力和食欲减退进行性加重6个月,伴双下肢水肿2个月入院。上述症状于活动时加重,静息时减轻。患者无发热、咳嗽、咯痰和腹泻。入院查体:双侧颈静脉怒张,心浊音界向两侧扩大,心率105次/分,心音遥远,未闻及杂音;双下肢凹陷性水肿。心电图示:ST段压低。肝功能:谷丙转氨酶95U/L、谷草转氨酶78U/L、总胆红素32μmol/L、直接胆红素9.7μmol/L、谷氨
Male patient, 65 years old. Due to chest tightness, palpitations, shortness of breath, bloating, fatigue and loss of appetite increased exacerbations for 6 months, with double lower extremity edema 2 months admitted. The above symptoms aggravate during activity and relieve at rest. The patient had no fever, cough, expectoration and diarrhea. Admission examination: bilateral jugular vein engorgement, heart voiced sound sector to expand on both sides, heart rate 105 beats / min, distant heart sounds, no smell and noise; lower limb pitting edema. ECG shows: ST depression. Liver function: alanine aminotransferase 95U / L, aspartate aminotransferase 78U / L, total bilirubin 32μmol / L, direct bilirubin 9.7μmol / L,