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女性,54岁。因心前区剧痛3小时来诊。近3天,因月经量过多,到当地卫生院就诊。上午8时许,予肌注麦角新硷0.5mg,一天2次。当晚8时许,突然心前区压榨样疼痛,并向背部及左上肢端放射,随着肢麻,恶心呕吐,面色苍白,于1988年1月18日急诊入院。过去有高血压史十余年,诊断为冠心病3年。体检:神清、呻吟、面色苍白,呼吸促,呈急性重病容。T 36.5℃,P 100,R30,血压150/100mmHg。心律整,心界无扩大,各瓣膜未闻及杂音。肝脾不大,白细胞16200/mm~3。心电图检查:心率115次/分,胸前导联V_1-V_4呈QR形,但RV_1-V_4顺次递减。RV_1:1.8毫伏(mv),V_5呈QS波形,
Female, 54 years old. Because of precordial pain 3 hours to diagnosis. Nearly 3 days, due to excessive menstrual flow, to the local hospital for treatment. 8 am, intramuscular ergometrine 0.5mg, 2 times a day. 8 o’clock that night, a sudden heart area press-like pain, and to the back and left upper extremity radiation, with limb numbness, nausea and vomiting, pale, January 18, 1988 emergency admission. In the past more than ten years history of hypertension, diagnosis of coronary heart disease for three years. Physical examination: God clear, moaning, pale, breathing, was acute serious illness. T 36.5 ° C, P 100, R 30, blood pressure 150/100 mmHg. Whole heart rhythm, heart without expansion, the valve did not smell and noise. Little liver and spleen, white blood cells 16200 / mm ~ 3. ECG: heart rate 115 beats / min, chest lead V_1-V_4 was QR-shaped, but RV_1-V_4 in descending order. RV_1: 1.8 mV, V_5 is QS waveform,