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患者男性,43岁,工人。因四周前骑自行车途中突然胸闷、心前区紧缩感伴四肢乏力、大汗淋漓、心电图示下壁心肌梗塞,在当地治疗病情稳定后于1985年5月29日转入我院。既往有风湿性心脏病史12年,心房颤动3年。否认有高血压或糖尿病史。体检血压110/80mmHg。颈静脉不怒张。胸廓对称,心尖搏动弥散,心浊音界稍向左下扩大。心率84次/分,心律绝对不规则。心尖区收缩期吹风样杂音Ⅱ～Ⅲ级,向腋下传导,舒张期隆隆样杂音Ⅱ～Ⅲ级。胸骨左缘第3～4肋间收缩期及舒张期杂音各Ⅱ～Ⅲ级。两肺未闻乾湿罗音。腹平软,肝脾未及。下肢无浮肿,足背动脉搏动良好。
Male patient, 43 years old, worker. Due to a sudden chest tightness on the bike four weeks ago, the precordial atrophy with limb weakness, sweating, ECG lower wall myocardial infarction, after local treatment of stable condition on May 29, 1985 into our hospital. Previous history of rheumatic heart disease 12 years, 3 years of atrial fibrillation. Denied having a history of high blood pressure or diabetes. Physical examination blood pressure 110 / 80mmHg. Jugular vein does not rage. Thorax symmetry, apex pulsation dispersion, the heart of the voiced sound community to the lower left slightly expanded. Heart rate 84 beats / min, heart rate is absolutely irregular. Apical systolic hair-like murmur Ⅱ ~ Ⅲ level, conduction to the armpit, diastolic rumbling noise Ⅱ ~ Ⅲ level. Sternal left margin of the 3rd ~ 4 intercostal systolic and diastolic murmur of Ⅱ ~ Ⅲ grade. Two lungs have not heard wet and dry rales. Abdomen soft, liver and spleen not yet. Lower extremity without edema, dorsalis pedis artery pulse well.