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患者男性,35岁,主诉心悸气短4年,间断咯血2年,症状加重近4个月而入院。体检:端坐体位,口唇紫绀,颈静脉怒张,心界向两侧扩大,心尖部闻及双期杂音,左4肋间闻及粗糙全收缩期杂音,两肺闻及干湿性罗音,肝大肋下4指,双下肢浮肿。超声心动图:左房、右室扩大,二尖瓣增厚,瓣口1 ×1.7cm,主动脉瓣轻度狭窄,瓣口1.5cm。胸片:两肺纹理增重,肺门血管阴影增重模糊,主动脉结小,肺动脉段凸出,左房增大,左、右室扩大,心胸比0.7。临床诊断:风心病,二尖瓣狭窄伴关闭不全,主动脉瓣狭窄,全心衰竭。
Male patient, 35 years old, complained of heart palpitations shortness of breath 4 years, intermittent hemoptysis for 2 years, symptoms increased nearly 4 months and admitted to hospital. Physical examination: sitting posture, cyanosis of the lips, jugular vein engorgement, expansion of the heart to both sides of the apical snoring and two-phase murmur, left intercostal smelling and rough systolic murmur, both lungs and wet and dry rales , Four fingers of liver ribs, two lower limbs edema. Echocardiography: left atrium, right ventricular enlargement, mitral thickening, flap 1 × 1.7cm, mild aortic stenosis, flap 1.5cm. Chest X-ray: Weight gain of both lungs, hilar vascular thickening fuzzy, small aorta, prominent pulmonary artery segment, left atrial enlargement, left and right ventricular enlargement, cardiothractoric ratio 0.7. Clinical diagnosis: rheumatic heart disease, mitral stenosis with incomplete closure, aortic stenosis, heart failure.