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患者男性,39岁,因心悸、头昏一月余,反复出现晕厥入院。既往无风湿病史,两个月前曾患感冒。体检:体温37.4℃,脉搏30次/分,血压130/70。心界向左增大,心率30次/分,律不齐,心尖部闻及第三心音及大炮音,主动脉瓣区闻及Ⅳ/Ⅵ收缩期喷射性杂音,向颈部传导,有收缩期震颤,周围血管征阴性,双下肢不肿。心电图示Ⅲ°房室传导阻滞(A-VB),考虑为病毒性心肌炎引起,经用青霉素360万u/日静脉滴注,地塞米松4.5mg/日口服,异丙基肾
Male patient, 39 years old, due to heart palpitations, dizziness for more than a month, repeated syncope admitted. No previous history of rheumatism, had a cold two months ago. Physical examination: body temperature 37.4 ℃, pulse 30 beats / min, blood pressure 130/70. Heart bound to the left increased, the heart rate 30 beats / min, arrhythmia, apical and third heart sounds and cannon sound, aortic valve area smell and Ⅳ / Ⅵ systolic ejection murmur, conduction to the neck, there is contraction Tremor, peripheral blood vessels sign negative, double lower extremity is not swollen. ECG showed Ⅲ ° atrioventricular block (A-VB), considered for viral myocarditis caused by penicillin 3.6 million u / day intravenous infusion of dexamethasone 4.5mg / day orally, isopropyl kidney