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患者,女,50岁。发作性心前区疼痛3年,因情绪不佳症状加重1天,于1991年9月13日入院。血压13.3/8 kPa(100/60 mmHg),心率70次/分,音纯律正,第一心音低钝,余正常。心电图示Ⅱ、Ⅲ、aVF、Ⅴ_(4～6)导联的ST段水平压低0.05 mV,心肌酶谱正常。诊断冠心病、心绞痛。经扩冠治疗,症状缓解。于入院第6天,心绞痛再发,且向肛门周围放散,坠胀疼痛,伴颜面苍白、冷汗。经询问病史及直肠指诊后,排除外科疾患,给予舌下含服硝酸异山梨酯(消心痛)10 mg,2～3分钟后,随着心绞痛的缓解肛周坠胀疼痛亦消失。入院第9天下午,上述症状再发,治疗同前,疗效也同
Patient, female, 50 years old. Episodic pain in the anterior region 3 years, due to poor mood symptoms aggravated one day, in September 13, 1991 admission. Blood pressure 13.3 / 8 kPa (100/60 mmHg), heart rate 70 beats / min, pure sound law positive, the first heart sound low blunt, more than normal. ECG showed Ⅱ, Ⅲ, aVF, V_ (4 ~ 6) ST segment depression level of 0.05 mV, myocardial enzymes normal. Diagnosis of coronary heart disease, angina pectoris. The crown after treatment, relieve symptoms. In the first 6 days of admission, recurrence of angina pectoris, and to the anal discharge, swelling pain, accompanied by pale face, cold sweat. After consultation with medical history and digital rectal examination, surgical problems were excluded and sublingual 10 mg isosorbide dinitrate was given. After 2-3 minutes, perianal swelling pain disappeared with the relief of angina pectoris. The afternoon of the 9th day of admission, the recurrence of the above symptoms, treatment with the former, the same effect